Objective:To compare the efficacy of body posture combined with pharmacotherapy and pharmacotherapy alone in the treatment of chronic subdural hematoma(CSDH).Methods:Firstly, retrospective case series study was conducted. Thirty cases of CSDH that had received body posture combined with pharmacotherapy at Department of Neurosurgery, Huashan Hospital Affiliated to Fudan University from December 2016 to October 2020 were studied retrospectively. Twenty-seven patients were male, and 3 patients were female. The age of patients ( M(IQR)) was 66(16) years (range:28 to 84). Nineteen patients had unilateral hematoma, and 11 patients had bilateral hematoma. All patients received pharmacotherapy and body posture therapy that was to raise their lower limbs 20 to 30 cm with leg lift pad and get abdominal compressed with customized abdominal belt in supine position. Patients were required to maintain the body posture as much as possible, with the maximum to 16 to 18 hours per day. Patients with unilateral hematoma should tilt the head to the affected side and avoid tilting it to the opposite side. For patients with bilateral hematoma, there was no need for head lateralization. Patient were treated with oral dexamethasone and atorvastatin simultaneously. The preliminary efficacy of body posture combined with pharmacotherapy was determined by hematoma improvement rate which was analyzed by Clopper-Pearson method. Then, the multi-center, prospective, randomized controlled trial had carried out in 9 medical centers from August 2020 to November 2021. The stratified block randomization method was adopted. Patients were randomized in a ratio of 1∶1 to either receive pharmacotherapy alone(the control group) or body posture combined with pharmacotherapy(the experiment group) for 3 months and followed up for 6 months. Effective treatment was defined as complete absorption of hematoma, or the hematoma volume decreased by more than 10 ml and Markwalder grading scale score had improved by more than 1 point compared to the baseline. The efficacy rate and surgery conversion rate at 3 months and recurrence at 6 months were observed. Comparison between groups was performed with paired sample t test, Mann-Whitney U test, χ2 test, corrected χ2 test, or Fisher exact probability method. Logistic regression was used to compare the effective rate and operation rate between the two groups. Results:In the respective study, 30 patients completed follow-up 13 to 353 days after treatment. At the last follow-up, the incidence of almost complete absorption or significantly absorption of hematoma (hematoma volume was significantly reduced accompanied by symptom improvement) was 93.3%. The 95% CI for the incidence that analyzed by the Clopper-Pearson method was 77.9% to 99.2%. One hundred and six patients were enrolled in the multicenter study. Fifty-five patients underwent body posture combined with pharmacotherapy. The age was 74(17) years (range:26 to 92). Thirty-nine patients were males and 16 were females. Fifty-one patients underwent pharmacotherapy alone. The age was 69(12) years (range:48 to 84). Thirty-seven patients were males and 14 were females. The length of body posture recorded in diary card was (15.7±2.3) hours(range:7.6 to 19.3 hours). The efficacy rate in the body posture combined with pharmacotherapy group and pharmacotherapy alone group were 83.6% (46/55) and 56.9% (29/51), respectively at 3 months. The result of the logistic regression analysis showed that the efficacy of body posture combined with pharmacotherapy group was better than that of pharmacotherapy alone group ( OR=3.88,95% CI:1.57 to 9.58, P=0.003). Surgery rate in the body posture combined with pharmacotherapy group and pharmacotherapy alone group were 5.5% (3/55) and 21.6% (11/51) respectively. The result of Logistic regression showed that the pharmacotherapy alone group was more likely to be converted to surgery ( OR=0.21,95% CI:0.05 to 0.80, P=0.023). At the 6 months, no recurrence of cases was found in the body posture combined with pharmacotherapy group. However, the recurrence rate of pharmacotherapy alone group was 6.3% (3/48), there was no significant difference between the two groups ( P>0.05). Conclusion:The effect of body posture combined with pharmacotherapy for chronic subdural hematoma is better than that of pharmacotherapy alone.

Chronic pain causes physical suffering and can have major psychological impacts in patients.Chronic pain can induce depressive disorder,and clinical studies have consistently shown that chronic pain and depression frequently co-occur,suggesting the possibility of shared pathogenic mechanisms underlying these conditions.Acupuncture,as an alternative therapy,has been widely used for analgesia and to treat depression,with demonstrated clinical efficacy.The therapeutic mechanism of acupuncture is related to neural and endocrine regulation.This review considers the mechanism of chronic pain accompanied by depression,in relation to the brain regions and neural circuits affected by acupuncture treatment.This review provides a new approach for the treatment of depression caused by chronic pain.

Chronic pain causes physical suffering and can have major psychological impacts in patients.Chronic pain can induce depressive disorder,and clinical studies have consistently shown that chronic pain and depression frequently co-occur,suggesting the possibility of shared pathogenic mechanisms underlying these conditions.Acupuncture,as an alternative therapy,has been widely used for analgesia and to treat depression,with demonstrated clinical efficacy.The therapeutic mechanism of acupuncture is related to neural and endocrine regulation.This review considers the mechanism of chronic pain accompanied by depression,in relation to the brain regions and neural circuits affected by acupuncture treatment.This review provides a new approach for the treatment of depression caused by chronic pain.

Objective:To compare the efficacy of body posture combined with pharmacotherapy and pharmacotherapy alone in the treatment of chronic subdural hematoma(CSDH).Methods:Firstly, retrospective case series study was conducted. Thirty cases of CSDH that had received body posture combined with pharmacotherapy at Department of Neurosurgery, Huashan Hospital Affiliated to Fudan University from December 2016 to October 2020 were studied retrospectively. Twenty-seven patients were male, and 3 patients were female. The age of patients ( M(IQR)) was 66(16) years (range:28 to 84). Nineteen patients had unilateral hematoma, and 11 patients had bilateral hematoma. All patients received pharmacotherapy and body posture therapy that was to raise their lower limbs 20 to 30 cm with leg lift pad and get abdominal compressed with customized abdominal belt in supine position. Patients were required to maintain the body posture as much as possible, with the maximum to 16 to 18 hours per day. Patients with unilateral hematoma should tilt the head to the affected side and avoid tilting it to the opposite side. For patients with bilateral hematoma, there was no need for head lateralization. Patient were treated with oral dexamethasone and atorvastatin simultaneously. The preliminary efficacy of body posture combined with pharmacotherapy was determined by hematoma improvement rate which was analyzed by Clopper-Pearson method. Then, the multi-center, prospective, randomized controlled trial had carried out in 9 medical centers from August 2020 to November 2021. The stratified block randomization method was adopted. Patients were randomized in a ratio of 1∶1 to either receive pharmacotherapy alone(the control group) or body posture combined with pharmacotherapy(the experiment group) for 3 months and followed up for 6 months. Effective treatment was defined as complete absorption of hematoma, or the hematoma volume decreased by more than 10 ml and Markwalder grading scale score had improved by more than 1 point compared to the baseline. The efficacy rate and surgery conversion rate at 3 months and recurrence at 6 months were observed. Comparison between groups was performed with paired sample t test, Mann-Whitney U test, χ2 test, corrected χ2 test, or Fisher exact probability method. Logistic regression was used to compare the effective rate and operation rate between the two groups. Results:In the respective study, 30 patients completed follow-up 13 to 353 days after treatment. At the last follow-up, the incidence of almost complete absorption or significantly absorption of hematoma (hematoma volume was significantly reduced accompanied by symptom improvement) was 93.3%. The 95% CI for the incidence that analyzed by the Clopper-Pearson method was 77.9% to 99.2%. One hundred and six patients were enrolled in the multicenter study. Fifty-five patients underwent body posture combined with pharmacotherapy. The age was 74(17) years (range:26 to 92). Thirty-nine patients were males and 16 were females. Fifty-one patients underwent pharmacotherapy alone. The age was 69(12) years (range:48 to 84). Thirty-seven patients were males and 14 were females. The length of body posture recorded in diary card was (15.7±2.3) hours(range:7.6 to 19.3 hours). The efficacy rate in the body posture combined with pharmacotherapy group and pharmacotherapy alone group were 83.6% (46/55) and 56.9% (29/51), respectively at 3 months. The result of the logistic regression analysis showed that the efficacy of body posture combined with pharmacotherapy group was better than that of pharmacotherapy alone group ( OR=3.88,95% CI:1.57 to 9.58, P=0.003). Surgery rate in the body posture combined with pharmacotherapy group and pharmacotherapy alone group were 5.5% (3/55) and 21.6% (11/51) respectively. The result of Logistic regression showed that the pharmacotherapy alone group was more likely to be converted to surgery ( OR=0.21,95% CI:0.05 to 0.80, P=0.023). At the 6 months, no recurrence of cases was found in the body posture combined with pharmacotherapy group. However, the recurrence rate of pharmacotherapy alone group was 6.3% (3/48), there was no significant difference between the two groups ( P>0.05). Conclusion:The effect of body posture combined with pharmacotherapy for chronic subdural hematoma is better than that of pharmacotherapy alone.

Objective:To investigate the effect of mobile phone dependence on suppression control under the conditions of emotional loss and cognitive loss in college students.Methods:A total of 553 college students were recruited,and 108 in the mobile phone dependence group and 194 in the non-dependent group were screened with the Mobile Phone Addiction Tendency Scale(MPATS).Ninety-nine of them were selected to participate in experi-ment 1,and the effect of emotional loss on the inhibitory control,and 101 students were selected to participate in ex-periment 2 to investigate the effect of cognitive loss on the inhibitory control.The GO/NOGO paradigm was used to compare the correct rate and response of different mobile phones dependent on college students under different emo-tional and cognitive depletion conditions.Results:In experiment 1,the main effect of emotional loss was statistically significant[F(1,55)=6.16,178.91;Ps＜0.05],the inhibition control accuracy rates were lower and reaction tim-es were shorter in the high emotional loss group than in the low emotional loss group.In experiment 2,the main effect of the group was statistically significant[F(1,57)=17.90,19.06;Ps＜0.001],the accuracy rates of inhibi-tion control were lower and the inhibition control reaction times were longer in the mobile phone-dependent group than in the non-dependent group.The interaction between groups and cognitive loss types was statistically significant[F(1,57)=7.95,P＜0.01],and the inhibition control accuracy rates of the mobile phone-dependent group were lower under high cognitive loss.Conclusion:Emotional loss and cognitive loss could reduce the inhibition and con-trol ability of individuals,and the mobile phone dependence group is more likely to be affected in the case of cogni-tive loss.

Objective:To investigate correlation between neutrophil extracellular traps(NETs) formation and T cell subsets in mice with experimental autoimmune thyroiditis(EAT) and the impact of active vitamin D intervention.Methods:Six-week-old female BALB/c mice were randomly divided into Control group, EAT group and 1, 25 dihydroxy vitamin D 3[1, 25(OH) 2D 3] treatment group(VitD group; n=6/group). HE staining was used to observe thyroid pathology. Plasma thyroglobulin antibody(TGAb), thyroid peroxidase antibody(TPOAb), and 1, 25(OH) 2D 3 were measured by ELISA. Peripheral NETs formation, Th1, Th2, and Th17 cell ratio from spleen were measured by flow cytometry. Correlation between NETs formation rate and Th1, Th2, and Th17 cell ratio was analyzed. Results:Compared with Control group, mice in EAT group had significantly increased thyroid inflammation scores, thyroiditis morbidity, TPOAb, TGAb levels, NETs formation rate, Th2(CD4 + IL-4 + or CD4 + IL-13 + )and Th17 cell proportions( P were <0.001, 0.002, 0.007, <0.001, <0.001, 0.003, 0.001, and 0.002, respectively), and significant decreased 1, 25(OH) 2D 3, Th1 cell proportions, Th1/Th2(CD4 + IL-4 + ), Th1/Th2(CD4 + IL-13 + ), and Th1/Th17 ratios( P were 0.010, 0.018, 0.010, 0.005, and 0.007, respectively). Compared with the EAT group, the VitD group had lower thyroid inflammation scores, TPOAb, TGAb levels, NETs formation rate, Th2(CD4 + IL-4 + or CD4 + IL-13 + ) and Th17 cell proportions( P were 0.044, 0.007, <0.001, 0.001, 0.014, 0.008, and 0.001, respectively), and significant higher Th1 cell ratio, Th1/Th2(CD4 + IL-13 + ) and Th1/Th17 ratio( P were 0.011, 0.009, and 0.003, respectively). The Th1/Th2(CD4 + IL-4 + ) was not significantly increased in VitD group compared with EAT group( P=0.174). NETs formation rate was positively correlated with Th2(CD4 + IL-4 + or CD4 + IL-13 + ) and Th17 cell proportion( r were 0.65, 0.59, and 0.61; and P were 0.004, 0.010, and 0.007, respectively), but not with Th1 cell proportion( r=-0.47, P=0.051). Conclusion:EAT mice were more prone to NETs formation. Active vitamin D may relieve immune imbalance with increased Th2 and Th17 cell ratio and decreased Th1 cell ratio by reducing the formation of NETs in EAT mice. Vitamin D played the protective role in thyroid by reducing thyroid pathological damage and thyroid autoantibody levels, and relived overall lymphocyte imbalance.

We conducted a randomized, open-label, parallel-controlled, multicenter trial on the use of Shuanghuanglian (SHL), a traditional Chinese patent medicine, in treating cases of COVID-19. A total of 176 patients received SHL by three doses (56 in low dose, 61 in middle dose, and 59 in high dose) in addition to standard care. The control group was composed of 59 patients who received standard therapy alone. Treatment with SHL was not associated with a difference from standard care in the time to disease recovery. Patients with 14-day SHL treatment had significantly higher rate in negative conversion of SARS-CoV-2 in nucleic acid swab tests than the patients from the control group (93.4% vs. 73.9%, P = 0.006). Analysis of chest computed tomography images showed that treatment with high-dose SHL significantly promoted absorption of inflammatory focus of pneumonia, which was evaluated by density reduction of inflammatory focus from baseline, at day 7 (mean difference (95% CI), -46.39 (-86.83 to -5.94) HU; P = 0.025) and day 14 (mean difference (95% CI), -74.21 (-133.35 to -15.08) HU; P = 0.014). No serious adverse events occurred in the SHL groups. This study illustrated that SHL in combination with standard care was safe and partially effective for the treatment of COVID-19.
COVID-19 ; Humans ; Medicine, Chinese Traditional ; Research ; SARS-CoV-2 ; Treatment Outcome

Objective To explore the histological basis of diffusion tensor tractography (DTT)fiber tracer images of benign prostatic hyperplasia (BPH)and prostate cancer (PCa).Methods Sixty-eight patients with PCa and sixty patients with BPH confirmed by pathology were recruited for this study.Conventional MRI and DTI examinations were performed.The original DTI data were processed at the AW4.5 workstation.After pos-t processed,FA and ADC values were recorded,DTT was plotted.Fiber bundle travel was observed and scored by two senior radiologists.The BPH and PCa specimens were stained with Masson fibers,and the diameter and angle of the fiber bundles were recorded.Results The FA values of BPH and PCa were 0.22±0.05 and 0.47±0.01 ,respectively.ADC values of BPH and PCa were (1.31 ±0.27)×10－3 mm2/s and (0.6 1 ±0.09)× 10－3 mm2/s,respectively.The differences in ADC and FA values among BPH and PCa were statistically significant (P＜0.05).DTT showeded that the fibers of BPH were dense and long,while the fibers of PCa were messy and short.The diameter and angle of collagen fibers and smooth muscle fibers for BPH were both larger than those for PCa,but only the difference between the diameter of smooth muscle fibers was statistically significant (P＜0.05).Conclusion There are significant differences between BPH and PCa in DTT images,which is consistent with the characteristics of fiber structure.DTI fiber bundle can reflect the differences of fiber structure between BPH and PCa.

Objective To explore the diagnostic value of ESWAN in uterine fibroids by analyzing the ESWAN signal of uterine fibroid. Methods Conventional MRI and ESWAN were carried out in thirty-seven patients with uterine fibroids.The differences of ESWAN indexes between uterine fibroids and myometrium were analyzed by paired t-test.The value of ESWAN on diagnosing uterine fibroids was analyzed by receiver operating characteristic curve(ROC curve).Results The magnitude value,phase value,R2* value and T2*value of uterine fibroids were 1 661.69 ± 45.24,(0.006 7 ± 0.007 7)Hz,(26.69 ± 1.04)Hz and(34.68 ± 1.73)ms,respectively.The magnitude value,phase value,R2* value and T2* value of myometrium were 1 790.95 ± 49.04,(0.013 1 ± 0.011 8)Hz,(22.35 ± 0.84)Hz and(42.53 ± 2.16)ms.The magnitude value,phase value and T2* value of uterine fibroids were lower than those of myometrium (P=0.008,P=0.659 and P=0.002).While the R2* value of of uterine fibroids was higher than that of myometrium(P=0.001). The area under curve(AUC)of magnitude value,phase value,R2* value and T2* value were 0.604,0.553,0.666 and 0.662.Conclusion ESWAN can show the differences between uterine fibroids and myometrium ，while the ability to independently diagnose uterine fibroids was modest.

Objective To explore the value of enhanced T2 star weighted angiography(ESWAN)in the treatment of uterine fibroids with high intensity focus ultrasound(HIFU) by analyzing the changes of ESWAN. Methods Uterine fibroids were detected through pelvic conventional MRI and ESWAN 1 day before and after HIFU operation. Different indexes of ESWAN were measured ,and differences were compared with the paired t-test. Results The preoperative and postoperative values of magnitude were 1624.59 ± 53.07 and 1750.13 ± 39.81, phase values were 0.0012 ± 0.0081 Hz and 0.0025 ± 0.1063 Hz,R2*value were 27.69 ± 1.27 Hz and 24.19 ± 1.20 Hz,and T2*values were 34.66 ± 2.07 ms and 36.46 ± 2.14 ms. After HIFU operation,magnitude value,phase value and T2*value were higher(P=0.04,P=0.91 and P=0.45),and R2*value was lower(P=0.019). Conclusions ESWAN can provide more information about histopathologic changes of uterine fibroids after HIFU.