OBJECTIVE: To observe the efficacy and safety of Tiaowei Jiannao acupuncture (acupuncture for regulating defensive qi and nourishing brain) for post-ischemic stroke insomnia (PISI). METHODS: A total of 96 patients with PISI were randomized into an acupuncture group (32 cases, 1 case was excluded), a medication group (32 cases, 1 case dropped out, 1 case was excluded) and a sham-acupuncture group (32 cases, 1 case dropped out, 1 case was excluded). In the acupuncture group, Tiaowei Jiannao acupuncture was applied at bilateral Shenmai (BL62), Zhaohai (KI6), Hegu (LI4), Taichong (LR3), and Baihui (GV20), Sishencong (EX-HN1), Yintang (GV24⁺), Shenting (GV24), once a day, 1-day interval was taken after 6-day treatment, for 3 weeks totally. In the medication group, eszopiclone tablet was given orally, 1-3 mg a time, once a day for 3 weeks. In the sham-acupuncture group, non-invasive sham acupuncture was applied, the acupoint selection, frequency and course of treatment were the same as the acupuncture group. Before treatment, after 2,3 weeks of treatment, the scores of Pittsburgh sleep quality index (PSQI), self-rating sleep scale (SRSS), National Institutes of Health Stroke scale (NIHSS), Hamilton depression scale-17 (HAMD-17) were observed; before and after treatment, the sleep parameters were recorded using polysomnography (PSG); and the efficacy and safety were evaluated after treatment in the 3 groups. RESULTS: After 2,3 weeks of treatment, the scores of PSQI, HAMD-17 and SRSS in the acupuncture group and the medication group, as well as the SRSS scores in the sham-acupuncture group were decreased compared with those before treatment (P<0.05); after 2 weeks of treatment, the NIHSS score in the acupuncture group was decreased compared with that before treatment (P<0.05); after 3 weeks of treatment, the NIHSS scores in the acupuncture group, the medication group and the sham-acupuncture group were decreased compared with those before treatment (P<0.05). After 3 weeks of treatment, the scores of PSQI, SRSS, HAMD-17 and NIHSS in the acupuncture group and the medication group, as well as the NIHSS score in the sham-acupuncture group were decreased compared with those after 2 weeks of treatment (P<0.05). After 2,3 weeks of treatment, the scores of PSQI, SRSS and HAMD-17 in the acupuncture group and the medication group were lower than those in the sham-acupuncture group (P<0.05), the NIHSS scores in the acupuncture group were lower than those in the medication group and the sham-acupuncture group (P<0.05); after 3 weeks of treatment, HAMD-17 score in the acupuncture group was lower than that in the medication group (P<0.05), the NIHSS score in the medication group was lower than that in the sham-acupuncture group (P<0.05). Compared before treatment, after treatment, the total sleep time was prolonged (P<0.05), the wake after sleep onset, sleep latency, and non-rapid eye movement (NREM) sleep latency were shortened (P<0.05), the sleep efficiency was improved (P<0.05), the number of awakenings was reduced (P<0.05), the percentage of rapid eye movement (REM%) and the percentage of NREM stage 1 (N1%) were decreased (P<0.05), the percentage of NREM stage 2 (N2%) and the percentage of NREM stage 3 (N3%) were increased (P<0.05) in the acupuncture group and the medication group; the sleep latency was shortened in the sham-acupuncture group (P<0.05). After treatment, the PSG indexes in the acupuncture group and the medication group were superior to those in the sham-acupuncture group (P<0.05); in the acupuncture group, the number of awakenings was less than that in the medication group (P<0.05), the REM% and N1% were lower than those in the medication group (P<0.05), the N2% and N3% were higher than those in the medication group (P<0.05). The total effective rate were 93.5% (29/31) and 90.0% (27/30) in the acupuncture group and the medication group respectively, which were higher than 10.0% (3/30) in the sham-acupuncture group (P<0.05). There was no serious adverse events in any of the 3 groups. CONCLUSION Tiaowei Jiannao acupuncture improves the insomnia symptoms in patients with ischemic stroke, improves the quality of sleep, increases the deep sleep, promotes the recovery of neurological function, and relieves the depression. It is effective and safe for the treatment of PISI.
Humans ; Acupuncture Therapy ; Male ; Sleep Initiation and Maintenance Disorders/physiopathology* ; Female ; Middle Aged ; Aged ; Acupuncture Points ; Treatment Outcome ; Adult ; Ischemic Stroke/complications* ; Stroke/complications* ; Sleep

BACKGROUND:Inherited heart disease has a high prevalence and mortality rate,but its pathogenesis has not yet been clarified.Although relevant animal models have been established to provide a foundation for the pathogenesis research of inherited heart disease,the value of these research results has been significantly reduced due to differences among species.Therefore,a new model is needed to explore its occurrence and development. OBJECTIVE:To review the current role of induced pluripotent stem cells in disease modeling and potential application prospects in various inherited heart diseases. METHODS:The first author searched the relevant articles published nearly 13 years in PubMed from January to March 2023.The search terms were"induced pluripotent stem cell,inherited heart disease,congenital heart disease".Finally,76 articles were included for analysis. RESULTS AND CONCLUSION:Since 2007,when induced pluripotent stem cells were induced from human somatic cells,many studies have been reported on disease-specific induced pluripotent stem cells.Due to the ability of disease-specific induced pluripotent stem cells to reproduce disease phenotypes,they are expected to become a new research tool for in vitro disease modeling,used to analyze pathogenesis and develop auxiliary drugs.In the research of cardiovascular genetic diseases,cardiomyocytes derived from patient-specific induced pluripotent stem cells contain gene mutations that are involved in cardiac dysplasia.Therefore,it can be used as a new tool to study the potential mechanisms of inherited heart disease.Up to now,induced pluripotent stem cells-derived cardiomyocytes have been widely used to study the molecular mechanisms of various genetic heart diseases,such as cardiac electrophysiological diseases,cardiomyopathy,and some syndromic inherited heart diseases.

Objective To discuss the clinical application of coronary CT angiography(CCTA)-derived fractional flow reserve(CT-FFR)in evaluating the risk stratification of the coronary artery stenosis and atherosclerotic plaque quantitative parameters.Methods A total of 122 patients,who received CCTA examination at the Xuzhou Municipal Central Hospital of China,were enrolled in this study.The patients were divided into non-ischemia group(CT-FFR＞0.8,n=66)and ischemia group(CT-FFR0.8,n=56).The characteristics of atherosclerotic plaque were compared between the two groups.Logistic regression analysis was used to analyze the correlation between plaque characteristics and ischemic lesions.Results There were 218 vessels having a CT-FFR＞0.8 and 174 vessels having a CT-FFR ≤0.8.Statistically significant differences in the total plaque volume,calcified plaque volume,plaque length,and stenosis ratio＞50％existed between the two groups(all P＜0.05).Logistic regression analysis indicated that the total plaque volume,calcified plaque volume,plaque length,and stenosis ratio＞50％were the risk factors for myocardial ischemia.Conclusion CT-FFR can be used for the risk stratification of coronary stenosis and atherosclerotic plaque characteristics,which can evaluate the local myocardial blood supply condition from the anatomical stenosis and functional level so as to optimize the diagnosis and treatment measures.

BACKGROUND: Induced pluripotent stem cells are a type of reprogrammed cells with similar characteristics to embryonic stem cells, which are capable of differentiating into phenotypes associated with patient specific diseases. Moreover, their clinical application avoids ethical issues. OBJECTIVE: To review the research progress of induced pluripotent stem cells in myocardial regeneration and repair, cardiovascular disease models, drug development and screening, and drug toxicity testing. METHODS: PubMed (2006-2018) and CNKI (2013-2018) databases were retrieved for relevant articles using the keywords of "induction of pluripotent stem cells; myocardial infarction; arrhythmia; cardiovascular disease; heart failure; heart transplantation; disease model; drug toxicity" in English and Chinese, respectively. The data were reviewed one by one, and the citations involved in the literatures were also reviewed. RESULTS AND CONCLUSION: Induced pluripotent stem cells have great potential value in myocardial regeneration and repair, establishment of cardiovascular disease models, new drug development and screening, and drug toxicity detection. The application prospect of the cells is broad, but most of the research is still in the experimental stage. In addition, safety problems, such as low induction efficiency and tumorigenicity, will limit the clinical application of induced pluripotent stem cells.

Objective To analyze the four types of laparoscopic operation in the treatment of upper ureteral calculi with diameter more than 1 cm.Methods From July 2012 to September 2015,150 cases of patients with upper ureteral calculi diameter more than 1cm were analyzed.According to the different surgical methods,patients were divided into four groups.There are 39 cases in URL group,32 cases in RLU group,36 cases in PCNL group and 43 cases in FURL group.The diameter of calculi in RLU group and PCNL group was much larger than those in URL group and FURL group(P ＜ 0.05).There was no difference in terms of sex,age,stone location,stone composition,and the ESWL treatment failure rate among the four groups(P ＞ 0.05).The operation time,postoperative hospitalization days,postoperative bowel recovery,postoperative ESWL rate,complications and postoperative calculi clearance rate were compared among the four groups.Results In RLU,PCNL,URL and FURL group,the operation time were (38.5 ± 13.0) min,(83.4 ± 6.1) min,(69.6 ± 13.0) min and (50.1 ± 6.3) min,respectively,and there were significant differences among the four groups (RLU group ＞ PCNL group ＞ FURL group ＞ URL group,P ＜ 0.05).Postoperative hospitalization days of RLU group,PCNL group,URL group and FURL group were (6.5 ± 0.6) d,(9.5 ± 0.7) d,(8.4 ± 0.7) d and (7.7 ± 0.7) d respectively,and there were significant differences in terms of hospitalization days (RLU group ＞ PCNL group ＞ FURL group ＞ URL group,P ＜ 0.05).The calculi clearance rates of RLU group,PCNL group,URL group and FURL group were 79.5％,100.0％,94.4％ and 88.4％ at 3 days after operation,and 82.1％,100.0％,97.2％ and 95.3％ at 1 month after operation.The postoperative calculi clearance rates at 3 days and 1 month in RLU group were higher than those in URL group(P ＜ 0.05),but there was no difference between PCNL group and RLU group (P ＞ 0.05).Postoperative ESWL rates of RLU group,PCNL group,URL group and FURL group were 12.8％,0,2.8％ and 4.7％,and there was no difference among the four groups.The decreased value of RBC in PCNL group and FURL group was higher than that of URL group and RLU group(P ＜ 0.05).One patient in PCNL group suffered from massive hemorrhage,and required blood transfusion.The complication rates in the four groups were 23.1％ (9/39),9.4％ (3/32),13.9％ (5/36) and 9.3％ (4/43) respectively,and there was no difference of complication among them(P ＞ 0.05).Conclusions Four types of endoscopes have the advantages of safety,small wound and quick recovery for ureter calculi larger than 1 cm.The URL operation is simple,with less injury,quick recovery,but low stone clearance rate.FURL requires high level of skill for the operator,and is an effective treatment for ureteric,renal pelvic,and kidney stones which are smaller than 2 cm.FURL avoids the extra ESWL treatment,but costs much.PCNL has more injury and requires high-level surgical skills with a high stone clearance rate.RLU has a high stone clearance rate but is much difficult,which can be used as a remedy for the failure of FURL or PCNL.

Objective:To analyze the curative effects of laparoscopic radical prostatectomy for the prostate cancer and the its effect on the level serum hormones levels.Methods:86 patients with prostate cancer were selected and divided into the control group and the observation group with 43 cases in each group according to the draw method.The control group was treated by open radical prostatectomy,while the observation group was treated by laparoscopic radical prostatectomy.The operation indicators,serum follicle stimulating hormone (FSH),luteinizing hormone (LH),dihydrotestosterone (DHT),free testosterone (FT),total testosterone (T),prostate specific antigen (T-PSA,F-PSA) levels,CD3+,CD4+,CD8+,CD4+/CD8+ before and after the surgery as well as the occurrence of postoperative complications were compared between two groups.Results:The operation time of observation group was significantly longer than that of the control group,and the blood loss,bowel function recovery time,hospital stay,pain scores of observation group was significantly lower or shorter than those of the control group (P＜0.05).No significant difference was found in the serum FSH,LH,DHT,FT,T,T-PSA,F-PSA levels before and after the surgery between two group(P＞0.05).The CD3+,CD4+,CD4+/CD8+ of observation group was significantly higher than those of the control group (P＜0.05),the CD8+ of observation group was lower than that of the control group(P＜ 0.05).The incidence rate of postoperative complication in the observation group was significantly lower than that of the control group (P＜0.05).Conclusion:Laparoscopic radical prostatectomy could play a similar effect with the open surgery on the tumor control,it could improve the level of serum testosterone,immune function with high safety.

Objective To explore the biological behavior of renal cell carcinoma cases after treatment with siRNA silencing epidermal growth factor receptor (EGFR) gene.Methods Renal cell carcinoma cell line ACHN were divided into three groups,the control group without any intervention,negative control transfection group by adding the nonspecific transfection reagent and siRNA interference,and the observation group adding transfection reagent and siRNA interference.Cells with EGFR expression and proliferation activity,growth curve,migration and invasion activity were detected in three groups.Results After 72 h of siRNA treatment,the observation group had significantly lower EGFR expression levels,and cell growth activity ability,and cell number of RNAi group after 48 h than negative control transfection group and control group (P ＜ 0.05).Compared with the blank control group and negative control transfection group,the observation group was significantly inhibited (P ＜0.05),and cell scratch distance after 12 h and 24 h was significantly higher than that of the control group and negative control transfection group (P ＜ 0.05).The control group and negative control transfection group showed no significant difference in the cell membrane at 12 h (P ＞0.05).The observation group had significantly lower transmembrane cell number than the control group and negative control transfection group (P ＜ 0.05).Conclusion The proliferation,growth,migration and invasion of renal carcinoma cells can be effectively improved by using siRNA EGFR protein.

Objective To explore the biological behavior of renal cell carcinoma cases after treatment with siRNA silencing epidermal growth factor receptor (EGFR) gene.Methods Renal cell carcinoma cell line ACHN were divided into three groups,the control group without any intervention,negative control transfection group by adding the nonspecific transfection reagent and siRNA interference,and the observation group adding transfection reagent and siRNA interference.Cells with EGFR expression and proliferation activity,growth curve,migration and invasion activity were detected in three groups.Results After 72 h of siRNA treatment,the observation group had significantly lower EGFR expression levels,and cell growth activity ability,and cell number of RNAi group after 48 h than negative control transfection group and control group (P ＜ 0.05).Compared with the blank control group and negative control transfection group,the observation group was significantly inhibited (P ＜0.05),and cell scratch distance after 12 h and 24 h was significantly higher than that of the control group and negative control transfection group (P ＜ 0.05).The control group and negative control transfection group showed no significant difference in the cell membrane at 12 h (P ＞0.05).The observation group had significantly lower transmembrane cell number than the control group and negative control transfection group (P ＜ 0.05).Conclusion The proliferation,growth,migration and invasion of renal carcinoma cells can be effectively improved by using siRNA EGFR protein.

BACKGROUND:Mesenchymal stem cells are capable of self-renew,a high degree of proliferation,with multi-differentiation potential,low immunogenicity and immunomodulatory properties.Both in vivo and in vitro it is able to regulate allogeneic immune response,to induce immune tolerance.In the solid organ transplantation it is playing an increasingly important role.OBJECTIVE:To summarize the research progress on the immunomodulatory mechanism and application of mesenchymal stem cells in solid organ transplantation.METHODS:An online search of Pubmed was undertaken by using the key words of "Mesenchymal Stem Cells,Mesenchymal Stem Cell Transplantation,Organ Transplantation,Transplantation Immunology,Immunologic Graft Enhancement,Graft vs.Host Disease" in Mesh to identify the relevant articles published in English from January 1994 to October 2009.At the same time,Wanfang database was screened to identify the relevant articles published between January 1994 and October 2009 with the key words of "Mesenchymal Stem Cells,Organ Transplantation,Transplantation Immunology" in Chinese.Inclusive criterion:The articles related to the immunomodulatory properties,transplantation immunology and application of mesenchymal stem calls in the solid organ transplantation were included.Exclusive criterion:The articles with repetitive research or Meta analysis were excluded.RESULTS AND CONCLUSION:Totally 200 relevant articles were selected and 86 of them met the inclusive criterion.Mesenchymal stem cells exhibit low immunogenicity and immunomodulatory properties,have an indispensable advantage about inducing graft tolerance and repairing tissue in solid organ transplantation.The mechanism of inducting immune tolerance may be related to soluble factors,regulatory T cells,tolerant dendritic cells,bone marrow chimerism,anti-inflammatory and tissue repair,dose and time of injecting MSCs.

Objective To introduce operative skill of liver resection by blocking hilum of liver under normal temperature.Method Retrospective analysis of experience treating 86 cases of liver cancer with the operation.Result Among 86 cases of hepatic malignant tumor,there were not serious complications such as death,massive haemorrhage etc.during operation;postoperative liver failure occurred in 7 cases,among them,cure 5 cases and 2 cases of death.The incision infection occurred in 5 patients;The thorax dropsy occurred in 19 cases, which was absorbed by oneself after treating in 14 cases,cured by puncture occurred in 5 cases.Conclusion Operative skill of blocking hilum of liver under normal temperature is more ideal means in treating the liver cancer.