OBJECTIVE: To observe the clinical efficacy of acupoint thread-embedding therapy of regulating governor vessel, dispersing lung, and suppressing reflux for gastroesophageal reflux cough (GERC). METHODS: A total of 120 GERC patients were randomly assigned to an observation group (60 cases, 1 case dropped out) and a control group (60 cases, 1 case was eliminated). The observation group received acupoint thread-embedding treatment at positive response points of governor vessel. If no such points were detected, the following acupoints were used: Dazhui (GV14), Fenghu (Extra), Shendao (GV11), Lingtai (GV10), and Zhiyang (GV9). Treatment was administered once every two weeks. The control group received oral rabeprazole enteric capsules at 20 mg twice daily. All the treatment was given for 6 weeks. Clinical outcomes were assessed using cough symptom score, reflux disease questionnaire (RDQ) score, and Leicester cough questionnaire (LCQ) score before and after treatment in the two groups. Clinical efficacy was also compared between the two groups. RESULTS: After treatment, both groups showed decreased cough symptom scores and the each item scores and total scores of RDQ (P<0.001), and increased LCQ scores (P<0.001) compare with those before treatment. The observation group exhibited lower cough symptom score and chest pain, reflux and total score of RDQ, and higher LCQ score compared to those in the control group (P<0.05). The total effective rate in the observation group was 94.9% (56/59), which was higher than 84.7% (50/59) in the control group (P<0.05). CONCLUSION Acupoint thread-embedding therapy of regulating governor vessel, dispersing lung, and suppressing reflux could effectively alleviate cough and reflux symptoms in patients with GERC and improve their quality of life.
Humans ; Acupuncture Points ; Gastroesophageal Reflux/physiopathology* ; Male ; Female ; Cough/physiopathology* ; Middle Aged ; Aged ; Acupuncture Therapy ; Adult ; Treatment Outcome ; Lung/physiopathology* ; Meridians

A 66-year-old female patient was admitted to the Emergency Surgery Department of Shaanxi Provincial People’s Hospital in November 2019 due to sudden high fever accompanied by skin redness and pain in the whole abdomen and perineum. After systemic anti-infection and local drainage of perineum area, the patient was discharged with improved symptoms. However, the symptoms recurred 12 days later and the patient was admitted to emergency surgery again. After the treatment, the effect was poor, and the drainage volume was maintained at 100-150 ml/d. Multidisciplinary consultation was organized and after detailed medical history questioning by plastic surgeons, it was confirmed that the patient had received polyacrylamide gel (PAAG) injection for breast augmentation 30 years ago and was therefore transferred to plastic surgery for systematic treatment. According to the patient’s clinical manifestations, bilateral breast and abdominal wall imaging result and medical history, PAAG was diagnosed as chronic non-specific inflammation of the whole abdominal wall and perineum after breast augmentation. PAAG was removed by infra mammary fold incision, combined with liposuction tube vacuum suction and whole abdominal fascial space debridement and lavage drainage. Pathological examination of capsule tissue after the operation showed foreign body granulomatous inflammation, consistent with chronic non-specific inflammatory changes after PAAG injection. The patient recovered well after surgery and was discharged 7 days later. During the 6-year follow-up, the patient no longer experienced related symptoms and accepted the current breast shape. The patient is currently under continuous follow-up observation. The treatment process of this patient indicates that a detailed medical history, comprehensive physical examination, and clear diagnosis are key prerequisites for ensuring correct treatment. Ultrasound and MRI are important methods for assessing the residual and distribution of fillers. For injection augmentation surgeries, regular follow-ups after surgery are necessary.

A 66-year-old female patient was admitted to the Emergency Surgery Department of Shaanxi Provincial People’s Hospital in November 2019 due to sudden high fever accompanied by skin redness and pain in the whole abdomen and perineum. After systemic anti-infection and local drainage of perineum area, the patient was discharged with improved symptoms. However, the symptoms recurred 12 days later and the patient was admitted to emergency surgery again. After the treatment, the effect was poor, and the drainage volume was maintained at 100-150 ml/d. Multidisciplinary consultation was organized and after detailed medical history questioning by plastic surgeons, it was confirmed that the patient had received polyacrylamide gel (PAAG) injection for breast augmentation 30 years ago and was therefore transferred to plastic surgery for systematic treatment. According to the patient’s clinical manifestations, bilateral breast and abdominal wall imaging result and medical history, PAAG was diagnosed as chronic non-specific inflammation of the whole abdominal wall and perineum after breast augmentation. PAAG was removed by infra mammary fold incision, combined with liposuction tube vacuum suction and whole abdominal fascial space debridement and lavage drainage. Pathological examination of capsule tissue after the operation showed foreign body granulomatous inflammation, consistent with chronic non-specific inflammatory changes after PAAG injection. The patient recovered well after surgery and was discharged 7 days later. During the 6-year follow-up, the patient no longer experienced related symptoms and accepted the current breast shape. The patient is currently under continuous follow-up observation. The treatment process of this patient indicates that a detailed medical history, comprehensive physical examination, and clear diagnosis are key prerequisites for ensuring correct treatment. Ultrasound and MRI are important methods for assessing the residual and distribution of fillers. For injection augmentation surgeries, regular follow-ups after surgery are necessary.

Objective To explore the utility of different endoscopic retrograde cholangiopancreatography(ERCP)complexity scales in the training of endoscopists.Methods Clinical data of 237 patients treated by ERCP completed by trainee physicians at two hospitals in Eastern China from February 2022 to February 2023 were prospectively collected.All ERCP cases were classified using previously proposed complexity grading scales,including the American Society of Gastrointestinal Endoscopy(ASGE),Morriston and HOUSE grading scales,compared with the hepatopancreatic ampulla features classification.Successful intubation,successful surgical treatment and complication rates within 48 h were recorded.Results Within each grading,subgroups were divided according to severity,and the comparison of intubation success rates between subgroups in the 3 different grades showed statistically significant differences(P = 0.000).The treatment success rate and intubation success rate had similar findings(P = 0.000).There was no correlation between the complication rate and ASGE grading(P = 0.361),Morriston grading(P = 0.332),and HOUSE grading(P = 0.586).When only cases with primitive papillae were considered,the intubation success rate depended on the complexity grading after the newly added classification of hepatopancreatic ampulla features.In the ASGE group,the success rate of intubation was compared between different subgroups,and the difference was statistically significant(P = 0.004);in the Morriston group,the success rate of intubation was compared between different subgroups,and the success rate of intubation was statistically significant(P = 0.002);in the HOUSE group,the success rate of intubation was compared between different subgroups,and the difference was statistically significant(P = 0.000);In the hepatopancreatic ampulla characteristics group,the difference in intubation success rate was statistically significant when compared between different subgroups(P = 0.000).Similar findings were also found for treatment success rate and intubation success rate(P = 0.000).There was no correlation between the complication rate and ASGE group(P = 0.586),Morriston group(P = 0.443),HOUSE group(P = 0.306),and hepatopancreatic ampulla characteristics group(P = 0.350).Conclusion The use of hepatopancreatic ampulla features as a classification of biliary cannulation complexity is feasible and could be an alternative or additional means of predicting successful biliary cannulation and surgical treatment success and could be used in the future to assess endoscopist training and learning progress and technical standards.

【Objective】 To explore the risk factors for the production of anti-HLA antibodies in patients with hematological diseases before hematopoietic stemcell transplantation. 【Methods】 The results and clinical data of 1 008 patients with hematological diseases in our hospital who underwent anti-HLA antibody testing were collected by using Luminex technology platform before transplantation from 2016 to 2018 for statistical analysis. 【Results】 The total positive rate of anti-HLA antibodies in 1 008 patients was 24.08%. Multivariate analysis showed that independent risk factors associated with the production of anti-HLA antibodies included age≥30 years old(P=0.046, OR1.467, 95%CI1.007-2.136), time from disease diagnosis to antibody testing≥41 days(P=0.000, OR1.830, 95%CI1.306-2.565), initial platelet count<20×10⁹/L(P=0.020, OR1.543, 95%CI1.072-2.220), prior pregnancy(P=0.000, OR5.187, 95%CI3.689-7.293), transfusions before admission(P=0.001, OR1.762, 95%CI1.257-2.470)and total platelet transfusion volumes after admission≥30 U(P=0.000, OR2.352, 95%CI1.638-3.376). Age ≥30 years old(P=0.023, OR=1.839, 95%CI1.088-3.108)and prior pregnancy(P=0.042, OR=5.258, 95%CI1.062-26.038)are associated with the production of anti-HLA class Ⅰ and class Ⅱ antibodies, respectively. The time from disease diagnosis to antibody testing≥41 days(P=0.000, OR=2.873, 95%CI1.612-5.119), initial platelet count<20×10⁹/L(P=0.008, OR=2.164, 95%CI1.225-3.822), prior pregnancy(P=0.002, OR=6.734, 95%CI1.993-22.751), transfusions before admission(P=0.001, OR=2.746, 95%CI1.531-4.925)and total platelet transfusion volumes after admission>30 U(P=0.006, OR=3.459, 95%CI1.416-8.451)are associated with the production of anti-HLA class Ⅰ and Ⅱ antibodies. 【Conclusion】 Older age, longer course of disease, lower PLT count, history of pregnancy and blood transfusion, and higher total amount of PLT transfusion are risk factors which affect the production of anti-HLA antibodies.Therefore, it is advisable to test for anti-HLA antibodies according to the situation before transplantation, which is of great value in guiding donor selection, monitoring antibody changes and improving transplant prognosis.

AIM:To investigate the effects of ginkgetin on neurological deficit and angiogenesis induced by cerebral ischemia/reperfusion(I/R)and its underlying mechanism.METHODS:Sixty SD rats were randomly allocated into three groups:sham group,I/R model group,and ginkgetin(40 mg/kg)treatment(I/R+ginkgetin)group,with twenty rats in each group.The middle cerebral artery occlusion/reperfusion(MCAO/R)rat model was employed to simulate cere-bral I/R,and ginkgetin was administered continuously for 7 days following reperfusion.The cerebral infarction volume was quantified using TTC staining.Neuronal density in the ischemic penumbra was assessed through Nissl staining and immu-nohistochemistry for neuron-specific nuclear protein(NeuN).Microvessel density and angiogenesis in the ischemic pen-umbra of each group were analyzed using CD31 labeling and BrdU/von willebrand factor(vWF)double labeling immuno-fluorescence staining.Western blot analysis was performed to determine the levels of heat shock protein 70(HSP70),vas-cular endothelial growth factor(VEGF),and hypoxia inducible factor-1α(HIF-1α)in the ischemic penumbra.RE-SULTS:Compared with the I/R model group,the cerebral infarction volume was significantly reduced in ginkgetin treat-ment group(P<0.01),the number of neurons,the microvessel density,angiogenesis and the expression levels of HIF-1α,VEGF,and HSP70 in the ischemic penumbra were significantly increased(P<0.01).CONCLUSION:Ginkgetin exhibits the potential to augment angiogenesis and facilitate neurological function recovery in MCAO rats,while concur-rently upregulating the expression of HSP70,VEGF,and HIF-1α within the ischemic penumbra.

Objective The objective of this study was to analyze the 2021 global burden of disease database assessment of deaths and disability-adjusted life year(DALY)attributed to alcohol exposure induced malignant tumors in China,providing a scientif-ic basis for the prevention and control of alcohol exposure-related malignancies in China.Methods The 2021 global burden of dis-ease database were retrieved,analyzed the number of deaths and mortality,DALYs,and DALY rates for malignant tumors in China,and analyzed the mortality and DALY situations attributed to alcohol exposure for different gender and types of tumors.Results In 2021,the number of cancer-related deaths in China was 2.8178 million,accounting for 28.50%of the global total cancer deaths(2.8178 million vs.9.8884 million).The DALYs of malignant tumors in China were 2.8209 million person-year,accounting for 30.20%of the global DALY of malignant tumors(2.8209 million person-year vs.9.3407 million person-year).The mortality of malignant tumors attributed to alcohol exposure in males(12.80/100,000 vs.1.37/100,000)and DALY rate(354.08/100,000 vs.34.96/100,000)were higher than those in females.From the perspective of age distribution,the mortality of malignant tumors caused by alco-hol exposure increased with age,and the DALY rate reached its peak in the 70-year-old age group and then decreased again.The top three tumors with the highest disease burden caused by alcohol exposure were esophageal cancer,liver cancer,and colorectal cancer.Conclusion Alcohol exposure in China leads to a heavier burden of malignant tumor mortality and DALY,with higher in male malig-nant tumor mortality than that in females.Alcohol exposure mainly causes gastrointestinal tumors.The prevention and treatment of male gastrointestinal tumors should focus on alcohol exposure.

Objective The objective of this study was to analyze the 2021 global burden of disease database assessment of deaths and disability-adjusted life year(DALY)attributed to alcohol exposure induced malignant tumors in China,providing a scientif-ic basis for the prevention and control of alcohol exposure-related malignancies in China.Methods The 2021 global burden of dis-ease database were retrieved,analyzed the number of deaths and mortality,DALYs,and DALY rates for malignant tumors in China,and analyzed the mortality and DALY situations attributed to alcohol exposure for different gender and types of tumors.Results In 2021,the number of cancer-related deaths in China was 2.8178 million,accounting for 28.50%of the global total cancer deaths(2.8178 million vs.9.8884 million).The DALYs of malignant tumors in China were 2.8209 million person-year,accounting for 30.20%of the global DALY of malignant tumors(2.8209 million person-year vs.9.3407 million person-year).The mortality of malignant tumors attributed to alcohol exposure in males(12.80/100,000 vs.1.37/100,000)and DALY rate(354.08/100,000 vs.34.96/100,000)were higher than those in females.From the perspective of age distribution,the mortality of malignant tumors caused by alco-hol exposure increased with age,and the DALY rate reached its peak in the 70-year-old age group and then decreased again.The top three tumors with the highest disease burden caused by alcohol exposure were esophageal cancer,liver cancer,and colorectal cancer.Conclusion Alcohol exposure in China leads to a heavier burden of malignant tumor mortality and DALY,with higher in male malig-nant tumor mortality than that in females.Alcohol exposure mainly causes gastrointestinal tumors.The prevention and treatment of male gastrointestinal tumors should focus on alcohol exposure.

Objective:To determine the relationship between health self-empowerment level and health self-management skill in older adults.Methods:A household survey was conducted from June 2020 to April 2021, among older adults in two communities each in Zhuzhou and Changsha selected by stratified cluster sampling. Data were collected through a general questionnaire, simplified. Elders Health Empowerment Scale, and Rating Scale of Health Self-Management Skill for Adults. A total of 444 questionnaires were distributed, of which 425 were valid. Pearson correlation and hierarchical regression analyses were used to analyze the relationship between health self-empowerment level and health self-management skill.Results:Final sample included 425 elderly people. Health self-empowerment was at medium to high level (30.9±5.6), whereas health self-management was at medium level (146.2±21.7); and the two factors were significantly correlated (Pearson coefficient was 0.724). After controlling for confounding factors (demographic characteristics), health self-empowerment independently accounted for 34.3% of the variation in health self-management ability.Conclusion:Health self-empowerment positively affects health self-management ability among older adults, which suggests the importance of stimulating health self-empowerment awareness in the process of health self-management.

Objective:To investigate the molecular mechanism of sorafenib against hepatocellular carcinoma.Methods:Sorafenib efficacy was screened and verified by the hepatocellular carcinoma patient-derived tumor xenograft (PDX) model. Veterinary B-mode ultrasonography and in vivo confocal laser scanning microscopy were used to observe PDX angiogenesis. Immunohistochemistry was used to observe the expression of proliferation and angiogenesis-related proteins in PDX tissue. Real-time quantitative PCR technology was used to observe the RUNX3 gene in PDX tissues. SPSS 17.0 statistical software was used for statistical analysis.Results:Four cases of PDX were used to screen the efficacy of sorafenib. PDX1 had a significant response to sorafenib, with an inhibition rate of 68.07%. Compared with the control group, sorafenib had significantly inhibited PDX1 relative tumor volume (5.76±2.14 vs. 11.71±2.87, P<0.05). Cell division index (39.50±7.72 vs. 67.10±9.14, P<0.05) and Ki67 expression (288.6±43.40 vs. 531.70±55.60, P<0.05) were significantly decreased. Veterinary B-mode ultrasonography showed evident blood flow signals in PDX1 tumors. In vivo confocal laser scanning microscopy results showed that sorafenib had significantly reduced the total vessel length (1573.00±236.21 vs. 2675.03±162.00, P<0.05) and area (11 145.33±1931.97 vs. 20 105.37±885.93, P<0.05)) of PDX1 tumors. Immunohistochemical results showed that sorafenib had significantly down-regulated the protein expressions of CD34 (27.55±3.76 vs. 45.47±5.57, P<0.05), VEGF (16.33±2.86 vs. 22.77±3.20, P<0.05) and MVD (38.75±6.01 vs. 55.50±8.61, P<0.05). Real-time PCR results showed that sorafenib had significantly up-regulated RUNX3 gene expression (2.14±0.71 vs. 1.00±0.36, P<0.05). However, there was a negative correlation between the expression of RUNX3 gene and the ratio of VEGF-positive cells in sorafenib group ( R2=0.509 7). Conclusion:Sorafenib may inhibit the PDX angiogenesis and the growth of hepatocellular carcinoma by regulating the RUNX3-VEGF pathway.