OBJECTIVE: To compare the clinical efficacy of electroacupuncture (EA) at neuro-arterial stimulation points with topical western medication in treating post-stroke shoulder-hand syndrome (SHS). METHODS: A total of 72 patients with post-stroke SHS were randomly assigned to an observation group (n=36, 2 cases dropped out) and a control group (n=36, 3 cases dropped out). Both groups received standard neurological treatment, comprehensive rehabilitation, and physical therapy. The observation group received EA at neuro-arterial stimulation points, including the ipsilateral stellate ganglion point, vagus nerve trunk and auricular branch (left side), and stimulation points of the radial and ulnar arteries, radial nerve, ulnar nerve, and median nerve, once daily for 4 weeks. The control group was treated with topical diclofenac diethylamine emulgel, and mucopolysaccharide polysulfate cream was added for patients with pronounced early-stage edema, twice a day for 4 weeks. The VAS pain score and hand edema volume were recorded before treatment, at 2 and 4 weeks during treatment, and 2 weeks after treatment completion (follow-up). Musculoskeletal ultrasound was used to measure the thickness of the dorsal hand and middle finger skin on the affected side before and after 4 weeks of treatment. RESULTS: Compared before treatment, the VAS pain scores and edema volume of the affected hand in both groups were decreased at week 2, week 4, and follow-up (P<0.05). At week 4, both groups showed lower VAS pain scores and edema volume than those at week 2 (P<0.05); during follow-up, both VAS pain scores and edema volume were further reduced compared to those at week 4 (P<0.05). At week 2, week 4, and follow-up, the VAS scores and edema volume of the affected hand in the observation group were lower than those in the control group (P<0.05). Compared before treatment, the dorsal hand skin thickness and middle finger skin thickness on the affected side were decreased in both groups after 4 weeks of treatment (P<0.05). Compared with the control group, the observation group showed thinner dorsal hand and middle finger skin thickness after 4 weeks of treatment (P<0.05). CONCLUSION EA at neuro-arterial stimulation points effectively alleviates pain and edema in patients with post-stroke SHS, and demonstrates superior efficacy compared to topical western medication.
Humans ; Male ; Female ; Middle Aged ; Electroacupuncture ; Aged ; Stroke/complications* ; Acupuncture Points ; Adult ; Reflex Sympathetic Dystrophy/physiopathology* ; Treatment Outcome ; Hand

The patients with skeletal class Ⅱ malocclusion are often accompanied by structural and functional abnormalities of the upper airway,and obstructive sleep apnea hypopnea syndrome(OSAHS)may occur in severe cases.The morphologic and fluid dynamic changes of the upper airway in one patient with skeletal class Ⅱ malocclusion accompanied by OSAHS after maxillomandibular advancement(MMA)surgery were observed.The patient was a 27-year-old male with skeletal class Ⅱ malocclusion and moderate OSAHS.Combined orthodontic and orthognathic treatment was conducted,involving the anterior movement of the maxilla and mandible.After surgery,the patient's facial and intraoral features showed a satisfactory occlusion relationship with normal overbite,overjet and canine-molar relationships.There was also a significant improvement in the upper airway flow field.Two years after surgery,the cross-sectional area of the nasopharyngeal airway increased by 10.76％with a 55.36％reduction in pressure.The oropharyngeal airway showed a 108.25％increase in cross-sectional area with a 98.14％pressure reduction.The hypopharyngeal airway exhibited a 97.51％increase in cross-sectional area with a 351.03％pressure reduction.The laryngopharyngeal airway demonstrated a 27.54％increase in cross-sectional area with a 95.62％pressure reduction.The apnea-hypopnea index(AHI)decreased by 55.45％,achieving the treatment goal.Morphological measurements combined with fluid dynamic analysis can comprehensively evaluate the condition of the upper airway.The approximate value of the critical closing pressure(Pcrit)obtained from computational fluid dynamics(CFD)analysis may serve as a simple quantitative indicator for assessing the upper airway condition.

Objective:To evaluate the diagnostic performance of radiomics model based on contrast-enhanced ultrasound(CEUS) in predicting pathological complete response(pCR) after neoadjuvant chemoradiotherapy(nCRT) in patients with locally advanced rectal cancer(LARC).Methods:One hundred and six patients with LARC who underwent total mesorectal excision after nCRT between April 2018 and April 2023 in the First Affiliated Hospital of Guangxi Medical University were retrospectively included, the patients were randomly divided into a training set of 63(14 pCR patients) and a validation set of 43(12 pCR patients) in a 6∶4 ratios. Radiomics features were extracted from the tumors′ region of interest of CEUS images based on PyRadiomics. Intra-class correlation coefficient(ICC), Mann-Whitney U test, and least absolute shrinkage and selection operator(LASSO) algorithms were used to reduce features dimension. Finally, 7 radiomics features relevanted to pCR were selected to construct an ultrasomics model using elastic network regression, based on the R language. A combined model was constructed by jointing clinical feature. The performance of the models was assessed with the area under the ROC curve(AUC). Results:The AUC of the ultrasomics model and the combined model was 0.695(95% CI=0.532-0.859) and 0.726(95% CI=0.584-0.868) respectively in the training set. The AUC of the ultrasomics model and the combined model was 0.763(95% CI=0.625-0.902) and 0.790(95% CI=0.653-0.928) respectively in the validation set. Both univariate and multivariate Logistic regression analyses showed that CA199( P<0.05) and ultrasomics score( P<0.001) could be an independent predictor of pCR after nCRT in patients with LARC. Conclusions:The CEUS-based radiomics scores has certain predictive value for whether LARC patients achieve pCR after nCRT, and may provide a non-invasive imaging biomarker for predicting LARC patients achieve pCR after nCRT.

BackgroundRehabilitation for schizophrenia typically relies on pharmacological interventions， yet their efficacy in improving social function and quality of life remains limited. In recent years， non-pharmacological approaches have shown promise in enhancing rehabilitation outcomes. However， research on the effectiveness of psychomotor therapy specifically for young and middle-aged schizophrenic inpatients is limited. ObjectiveTo explore the effects of psychomotor therapy on the rehabilitation of young and middle-aged schizophrenic inpatients， and to provide a reference for treatment strategies. MethodsA total of 104 young and middle-aged schizophrenic inpatients who met the International Classification of Diseases，tenth edition （ICD-10） diagnostic criteria and hospitalized in the Fourth People's Hospital of Wuhu from June 2021 to June 2022 were selected. Patients were randomly divided into two groups of 52 each using random number table method. Both groups received treatment with risperidone tablets （2~4 mg/d） ， along with routine nursing care. Additionally， the research group received an extra 45~55 minutes of psychomotor therapy 2~3 times per week for 12 weeks. The control group received the same psychomotor therapy after the study. Positive and Negative Symptom Scale （PANSS）， Scales of Social-skills for Psychiatric Inpatient （SSPI） and Insight and Treatment Attitude Questionnaire （ITAQ） were used to assess the patients before the intervention and at 4^th， 8^th and 12^th week after the intervention. ResultsThe main effects of intervention at different time points for PANSS positive symptoms， negative symptoms and general psychopathology subscale scores， PANSS total score， SSPI score and ITAQ score were all statistically significant （F=33.989， 204.245， 82.817， 279.596， 26.144， 7.463， P<0.01）. Furthermore， statistically significant between-group differences were observed in PANSS negative symptoms and general psychopathology subscale scores， PANSS total score， SSPI score and ITAQ score （F=30.053， 5.306， 33.417， 33.013， 18.608， P<0.05 or 0.01）. Moreover， the interaction effect of time and group were statistically significant for PANSS positive symptoms， negative symptoms and general psychopathology subscale score， PANSS total score and SSPI score （F=3.472， 9.798， 3.843， 14.390， 20.661， P<0.05 or 0.01）. After 12 weeks of intervention， the research group exhibited statistically significantly lower PANSS total score and subscale scores compared with baseline （P<0.01）， while their SSPI total score was significantly higher than that of control group（P<0.01）. Additionally， compared with the control group， the research group had statistically significantly lower PANSS total score and subscale scores ， while their SSPI score was statistically significantly higher than those of control group（P<0.01）. ConclusionPsychomotor therapy may contribute to the improvement of the psychiatric symptoms and social function in young and middle-aged inpatients with schizophrenia， enhancing their rehabilitation outcomes. ［Funded by Health Commission Scientific Research Project of Wuhu （number， WHWJ2021y073）］

Skin modeling of transdermal drug delivery system refers to experimental models that mimic the structure and function of human skin to explore and evaluate absorption,penetration,and efficacy of medicines in transdermal drug delivery.It provides an alternative to traditional human skin experiments and reduces the use of human skin in medical research,which is convenient,controllable,and cost effective.For skin models of transdermal drug delivery systems,this article introduces commonly used animal skin models,artificial skin models,and recombinant human skin models from the perspective of the transdermal absorption pathway of medicines,and analyzes their advantages,disadvantages,and applications so provide references the research and development of transdermal formulations and topical therapies.

Background Lung cancer is a malignancy of high incidence rate and mortality in China.The fear of relapse can affect the patient's treatment compliance and reduce their quality of life.There have been previous studies on the relationship between fear of lung cancer relapse and disease perception,as well as disease perception and psychological flexibility.However,current research on the status quo of fear of lung cancer relapse and its correlation with illness perception and psychological flexibility is limited.Objective To explore the fear of cancer relapse and its relations with illness perception and psychological flexibility in patients with lung cancer,and to provide references for subsequent related clinical interventions.Methods A total of 96 patients were selected as the research subjects,who were pathologically diagnosed with lung cancer and admitted to Fuyang People's Hospital from January 2021 to July 2022.Fear of Progression Questionnaire-Short Form(FoP-Q-SF),Brief Illness Perception Questionnaire(BIPQ)and Acceptance and Action Questionnaire-Ⅱ(AAQ-Ⅱ)were used for evaluation.Pearson correlation analysis was used to examine the correlation between scores of various scales,and multiple linear regression analysis was used to explore the influencing factors of relapse fear in lung cancer patients.Results The total FoP-Q-SF score of lung cancer patients was(35.35±7.66)and a total of 65 cases(67.71%)had a FoP-Q-SF score≥34.As relevant analyses showed,the BIPQ total score of lung cancer patients was positively correlated with the total score,social family dimension score and physiological health dimension score of Fop-Q-SF(r=0.586,0.445,0.475,P<0.05),the AAQ-Ⅱ score was positively correlated with the total score,social family dimension score and physiological health dimension score of FoP-Q-SF(r=0.485,0.652,0.513,P<0.05).According to the results of single factor analysis and multiple linear regression analysis,age(β=-0.142,P<0.01),education level(β=-0.254,P<0.01),monthly household income(β=-0.527,P<0.01),illness perception(β=0.847,P<0.01)and psychological flexibility(β=0.781,P<0.01)are all factors influencing the fear of relapse in lung cancer patients.Conclusion Most lung cancer patients have a fear of recurrence.It is not only related to illness perception and psychological flexibility,but also influenced by factors including age,education level and monthly family income.

Aldosterone synthetase deficiency (ASD) is a rare autosomal recessive genetic disorder caused by the CYP11B2 gene mutation.The clinical manifestations are mainly repeated vomiting, diarrhea, slow physical growth, hyponatremia, hyperkalemia, and hypovolemia in infants and young children.It is clinically difficult to distinguish it from other infantile salt loss diseases.At present, the diagnosis of ASD mainly depends on the measurement of steroid hormone levels and the analysis of genetic variants.9α-Fluhydrocortisone is the main drug for the treatment of ASD, but the treatment regimens are not yet unified.This article reviews the research progress in the etiology, pathogenesis, clinical phenotype, diagnosis and treatment of ASD in order to improve clinicians′ competence in diagnosing and treating this disease.

Objective To investigate the current status of knowledge-attitude-practice of cardiac rehabilitation in patients undergoing coronary artery bypass grafting(CABG) and analyze its influencing factors. Methods From July to November 2022, 288 patients with CABG in the coronary heart disease surgery center of Beijing Anzhen Hospital Affiliated to Capital Medical University were conveniently included, and general information questionnaire and cardiac rehabilitation knowledge and practice questionnaire were used to investigate the general situation and the level of knowledge-attitude-practice of cardiac rehabilitation in patients with coronary heart disease. Results A total of 290 questionnaires were sent out in this study, and 288 were effectively collected, with an effective recovery rate of 99.31%. The total score of the questionnaire was (106.81±13.35), and the total score rate was 62.83%, including the knowledge questionnaire scoring (39.34±9.13), belief questionnaire scoring (32.86±3.39) and behavior questionnaire scoring (34.61±3.54). The scoring rates of knowledge, attitude and practice questionnaire were 46.28%, 82.15% and 76.91%, respectively. Multiple linearregression analysis showed that patients who lived in rural areas, had education background of primary school or below, were farmers, had public health insurance, and had no previous coronary intervention, had lower levels of knowledge-attitude-practice of cardiac rehabilitation (P < 0.05). Conclusion The knowledge-attitude-practice of cardiac rehabilitation, especially the level of knowledge, in patients with CABG is needed to be improved. The factors that affect the level of knowledge-attitude-practice of cardiac rehabilitation in this population are diversified, suggesting that individual cardiac rehabilitation guidance should be implemented according to different people and local conditions, and diversified cardiac rehabilitation models should be established to improve the long-term and compliance of cardiac rehabilitation.

OBJECTIVE To prepare spider fibroin membrane loaded with Periplaneta americana extract， and investigate its characterization， in vitro drug release property and cytotoxicity. METHODS Using natural spider silk collected from Chilobrachys guangxiensis as raw material， P. americana extract as model drug， the drug-loaded spider fibroin membrane （hereinafter referred to as drug-loaded membrane） was prepared by solvent casting method. The material matrix spider fibroin membrane without P. americana extract （hereinafter referred to as blank membrane） was prepared with same method. The membrane structure was characterized by static water contact angle， Fourier infrared chromatography， X-ray diffraction and scanning electron microscopy from different angles； drug release characteristics in artificial saliva were simulated in vitro to evaluate the drug sustained-release performance. MTT assay was adopted to validate the cytotoxicity of drug-loaded membrane. RESULTS The drug-loaded membrane was prepared， and the static water contact angle was less than 90°， which was less than that of blank membrane. The drug-loaded membrane showed the characteristic absorption peak to polypeptide of P. americana extract at 1 500-1 700 cm－1. X-ray diffraction and scanning electron microscopy also proved that the drug was successfully loaded into the pellicle. The release time of the pellicle in artificial saliva was more than 200 min. The MTT test results showed that the cell proliferation rates of blank membrane and drug-loaded membrane were 84.6% and 79.4% （both greater than 70%）， respectively， without significant potential cytotoxicity. CONCLUSIONS Drug-loaded membrane prepared with natural spider silk has a certain sustained-release effect in artificial saliva， which can be further developed as a drug sustained-release carrier with excellent biological characteristics and biocompatibility.

Objective:To study the clinical features, genetic characteristics and prognosis of neonatal diabetes mellitus (NDM).Methods:From January 2015 to January 2022, neonates with NDM admitted to the Department of Neonatology of our hospital were retrospectively reviewed.Their clinical manifestations, biochemical data, genetic tests, treatments and outcomes were analyzed.Results:A total of 6 cases with NDM were included, with 3 males and 3 females. All 6 cases were full-term infants, 5 were low birth weight infants and 1 had family history of diabetes. High blood glucose were found on 1~11 d (average 4 d) after birth. 3 cases were diagnosed during blood glucose screening for low birth weight and 3 cases were diagnosed due to infection and/or diabetic ketoacidosis. Blood C-peptide levels were below normal range in all 6 cases. Blood insulin levels were decreased in 5 cases and remained at the lower limit of normal range in 1 case. All infants received genetic tests and 4 showed abnormal results, including 2 cases of ABCC8 gene mutation [c.2060C>T (p.T687M), not reported; c.674T>C (p.L225P), reported], 1 case of KCNJ11 gene mutation [c.602G>A (p.Arg201His), not reported] and 1 case of paternal uniparental disomy (UPD)6q24 (reported). All 6 cases were treated with insulin. Glibenclamide was experimented to replace insulin in 3 cases and 1 case was successful. During follow-up (at the age 4 months~5 years old), 4 cases were diagnosed with transient NDM, 1 case with permanent NDM and 1 case died at the age of 4 months without classification. 1 case showed psychomotor and language delay and the others had otherwise normal development.Conclusions:Most NDM infants are low birth weight infants with reduced blood insulin and C-peptide.Transient NDM are common. Proactive genetic testing may help treatment.