OBJECTIVE: To observe the therapeutic effect of electroacupuncture (EA) in improving early enteral nutrition tolerance in patients with acute pancreatitis (AP) under the concept of accelerated rehabilitation, and to explore the related mechanism based on the changes in autonomic nerve characteristics. METHODS: A total of 42 patients with AP were randomized into an observation group (21 cases, 1 case dropped out) and a control group (21 cases, 1 case dropped out). The control group received standard basic treatment for AP. On the basis of the treatment in the control group, EA was applied in the observation group, bilateral Zusanli (ST36), Yixian point (Extra), Tianshu (ST25), Neiguan (PC6) and Zhongwan (CV12) were selected as the main points, and the supplementary points were selected according to syndrome differentiation. Ipsilateral Zusanli (ST36) and Yixian point (Extra) were connected to EA, using discontinuous wave, in frequency of 2 Hz, 30 min a time, once a day for 6 continuous days. The enteral nutrition tolerance score was observed before treatment and after 3 and 5 days of treatment; the visual analogue scale (VAS) score for abdominal pain was observed before treatment and after 3 days of treatment; the time of reaching the feeding goal and hospital stay was recorded; the levels of C-reactive protein (CRP) and amylase were measured before treatment and after 5 days of treatment; the heart rate variability (HRV) indexes (standard deviation of NN intervals [SDNN], average standard deviation of NN intervals [SDANN], root mean square of successive NN interval differences [rMSSD], low frequency [LF] and high frequency [HF], ratio of low frequency to high frequency [LF/HF]) were monitored in the two groups. RESULTS: After 3 and 5 days of treatment, the enteral nutrition tolerance scores were decreased compared with those before treatment in both groups (P<0.01), the reductions in the observation group were larger than those in the control group (P<0.01). After 3 days of treatment, the VAS scores for abdominal pain were decreased compared with those before treatment in both groups (P<0.01), the reduction in the observation group was larger than that in the control group (P<0.01). The time of reaching the feeding goal and hospital stay in the observation group was shorter than that in the control group (P<0.05). After 5 days of treatment, the CRP and amylase levels were decreased compared with those before treatment in both groups (P<0.01), the reduction of CRP level in the observation group was larger than that in the control group (P<0.01). In the observation group, SDNN, SDANN and LF/HF were lower than those in the control group (P<0.05, P<0.01), while rMSSD was higher than that in the control group (P<0.01). SDNN, SDANN and LF/HF were positively correlated with the enteral nutrition tolerance scores after 3 and 5 days of treatment (P<0.05), while rMSSD was negatively correlated with the enteral nutrition tolerance scores after 3 and 5 days of treatment (P<0.01). CONCLUSION Electroacupuncture can improve enteral nutrition tolerance in patients with AP by regulating autonomic nervous function, alleviating the inflammation, promoting accelerated recovery, and reducing the length of hospital stay.
Humans ; Electroacupuncture ; Male ; Female ; Enteral Nutrition ; Middle Aged ; Adult ; Pancreatitis/physiopathology* ; Aged ; Acupuncture Points ; Young Adult ; Acute Disease/therapy* ; Autonomic Pathways/physiopathology*

Chronic obstructive pulmonary disease (COPD) and pulmonary hypertension (PH) are both chronic progressive respiratory diseases that cannot be completely cured. COPD is characterized by irreversible airflow limitation, chronic airway inflammation, and gradual decline in lung function, whereas PH is characterized by pulmonary vasoconstriction, remodeling, and infiltration of inflammatory cells. These diseases have similar pathological features, such as vascular hyperplasia, arteriolar contraction, and inflammatory infiltration. Despite these well-documented observations, the exact mechanisms underlying the occurrence and development of COPD and PH remain unclear. Evidence that mitochondrial dynamics imbalance is one major factor in the development of COPD and PH. Mitochondrial dynamics is precisely regulated by mitochondrial fusion proteins and fission proteins. When mitochondrial dynamics equilibrium is disrupted, it causes mitochondrial and even cell morphological dysfunction. Mitochondrial dynamics participates in various pathological processes for heart and lung disease. Mitochondrial dynamics may be different in the early and late stages of COPD and PH. In the early stages of the disease, mitochondrial fusion increases, inhibiting fission, and thereby compensatorily increasing adenosine triphosphate (ATP) production. With the development of the disease, mitochondria decompensation causes excessive fission. Mitochondrial dynamics is involved in the development of COPD and PH in a spatiotemporal manner. Based on this understanding, treatment strategies for mitochondrial dynamics abnormalities may be different at different stages of COPD and PH disease. This article will provide new ideas for the potential treatment of related diseases.
Humans ; Mitochondrial Dynamics/physiology* ; Pulmonary Disease, Chronic Obstructive/metabolism* ; Hypertension, Pulmonary/metabolism* ; Mitochondria/metabolism* ; Animals

Objective To analyze the correlation between serum oxidative stress indicators and cog-nitive dysfunction in patients with sleep disorders accompanied by anxiety and depression.Methods A total of 196 patients with sleep disorders accompanied by anxiety and depression in the hospital from A-pril 2021 to April 2023 were selected as research objects,and serum malondialdehyde(MDA),total superoxide dismutase(T-SOD),interleukin-6(IL-6)and γ-glutamyltransferase(γ-GGT)levels were measured in all the patients.Montreal Cognitive Assessment Scale(MoCA)was used to evaluate pa-tients'cognitive function,and based on MoCA score,they were divided into cognitive dysfunction group(n=80)and non-cognitive dysfunction group(n=116).Pearson correlation analysis was used to explore the correlations of serum MDA,T-SOD,IL-6 and γ-GGT levels with Pittsburgh Sleep Quali-ty Index(PSQI)score.Spearman rank correlation analysis was used to explore the correlations of ser-um MDA,T-SOD,IL-6 and γ-GGT levels with cognitive dysfunction in patients with sleep disorders accompanied by anxiety and depression.Receiver operating characteristic(ROC)curve was used to evaluate the values of serum MDA,T-SOD,IL-6 and γ-GGT in assessing cognitive dysfunction in patients with sleep disorders accompanied by anxiety and depression.Results Serum MDA,IL-6 and γ-GGT levels as well as PSQI score were significantly higher in the cognitive dysfunction group than those in the non-cognitive dysfunction group,while the T-SOD level was significantly lower in the cognitive dysfunction group(P＜0.05).Pearson correlation analysis results showed that serum MDA,IL-6 and γ-GGT levels were positively correlated with PSQI score(r=0.128,r=0.317,r=0.261,P=0.037,P＜0.001,P＜0.001,respectively),while serum T-SOD level was nega-tively correlated with PSQI score(r=-0.145,P=0.021).Spearman rank correlation analysis re-sults showed that serum MDA,IL-6 and γ-GGT levels were positively correlated with the occurrence of cognitive dysfunction(r=0.322,0.554,0.441,P＜0.001),while serum T-SOD level was negatively correlated with the occurrence of cognitive dysfunction(r=-0.330,P＜0.001).ROC curve analysis results showed that the areas under the curve(AUCs)for the individual and com-bined assessment of serum MDA,T-SOD,IL-6 and γ-GGT in patients with sleep disorders accompa-nied by anxiety and depression for cognitive dysfunction were 0.689,0.694,0.825,0.759 and 0.955 respectively,with cut-off values of 9.6 mmol/L,71.6 U/L,5.2 μg/L and 48.8 U/L,sen-sitivities of 50.00％,77.50％,71.25％,73.75％and 91.25％respectively,and specificities of 84.48％,62.93％,81.90％,70.69％and 88.79％respectively.Conclusion Cognitive dys-function in patients with sleep disorders accompanied by anxiety and depression is closely related to serum MDA,T-SOD,IL-6 and γ-GGT,and early measurement of these indicators can provide a ref-erence for the clinical assessment of cognitive dysfunction.

Primary central nervous system lymphoma (PCNSL) is a highly aggressive malignant lymphoma. As most chemotherapy drugs have difficulty in crossing the blood-brain barrier, PCNSL shows a difficulty in clinical treatment, a high recurrence rate and a poor prognosis. Early identification of relapsed patients and prompt initiation of salvage therapy play a critical role in the improvement of patients' prognosis. Brain biopsy is the gold standard to identify recurrence, while the risk of operation failure and complications is still high. Non-invasive imaging techniques are beneficial for early identification of recurrence in PCNSL and can provide an important basis for guiding relapsed patients to adjust treatment plans in time. However, there is no unified evaluation standard for imaging methods of monitoring the relapsed lesions of PCNSL. With the further research of the pathophysiological mechanism of PCNSL, biomarker detection has become a new method to identify recurrence and more clinical evidence is still needed in the future.

Objective To investigate the general well-being of breast cancer peer educators and to analyze its influencing factors.Methods Convenience sampling method was used to select 210 breast cancer peer educators from 8 tertiary hospitals in China from January to February 2023.General information questionnaires,General Well-Being Scale,Cornor-Davidson Resilience Scale,and Social Support Rating Scale were used for investigation.Multiple linear regression analysis was used to explore the influencing factors of the general well-being in peer educators of breast cancer.Results A total of 206 breast cancer peer educators were investigated.The general well-being score was(86.70±14.08).The results of multiple linear regression analysis showed that psychological resilience,the utilization of social support and the current self-funded treatment of less than 1,000 yuan per month were the influencing factors of general well-being(P＜0.001).Conclusion The general well-being of breast cancer peer educators is at a high level.Improving the social support system for breast cancer patients,selecting peer educators with strong psychological resilience,high utilization of social support and low self-funded treatment,and paying attention to the psychologic status of peer educators,providing timely and positive psychological interventions will help to raise the general well-being of breast cancer peer educators and ensure the quality and continuity of peer education.

Objective:To analyze the ultrasound characteristics of small bowel volvulus among adults and to investigate the value of ultrasound in the diagnosis of small bowel volvulus.Methods:Totally 34 adults with small bowel volvulus confirmed by clinical diagnosis or surgery and who underwent ultrasound examination at Peking Union Medical College Hospital from August 2017 to October 2022 were enrolled, including 19 males and 15 females, aged (55.0±21.8) years (range: 19 to 94 years). The clinical characteristics, CT images and ultrasound images of the patients were retrospectively reviewed, and the ultra, sound features of small bowel volvulus and its diagnostic efficacy were analyzed.Results:Abdominal pain was the typical clinical symptom of all patients. Other symptoms included 21 cases of abdominal distension, 19 cases of nausea and vomiting, and 13 cases of cessation of passage of stool or flatus. Eight patients had signs of peritonitis and 22 patients had abnormal bowel sounds. Twenty patients had a history of abdominal surgery. Twenty-seven patients underwent surgery for intestinal obstruction, and the remaining 7 patients improved after conservative treatment. All cases were evaluated by ultrasound, 11 cases showed a “whirl sign” and were diagnosed as small bowel volvulus, the diagnostic accuracy rate was 32.4% (11/34), ultrasound simultaneously diagnosed intestinal obstruction in 21 cases, 17 cases of abdominal effusion, 4 cases of intestinal wall thickening, 2 cases of abdominal mass, 1 case of intussusception, 1 case of right sided inguinal hernia. CT and ultrasound had a consistent positive discovery in 88.2% (30/34) of all the patients.Conclusion:Ultrasound is valuable in the diagnosis of small bowel volvulus and the evaluation of complications.

Objective:To analyze the ultrasound characteristics of small bowel volvulus among adults and to investigate the value of ultrasound in the diagnosis of small bowel volvulus.Methods:Totally 34 adults with small bowel volvulus confirmed by clinical diagnosis or surgery and who underwent ultrasound examination at Peking Union Medical College Hospital from August 2017 to October 2022 were enrolled, including 19 males and 15 females, aged (55.0±21.8) years (range: 19 to 94 years). The clinical characteristics, CT images and ultrasound images of the patients were retrospectively reviewed, and the ultra, sound features of small bowel volvulus and its diagnostic efficacy were analyzed.Results:Abdominal pain was the typical clinical symptom of all patients. Other symptoms included 21 cases of abdominal distension, 19 cases of nausea and vomiting, and 13 cases of cessation of passage of stool or flatus. Eight patients had signs of peritonitis and 22 patients had abnormal bowel sounds. Twenty patients had a history of abdominal surgery. Twenty-seven patients underwent surgery for intestinal obstruction, and the remaining 7 patients improved after conservative treatment. All cases were evaluated by ultrasound, 11 cases showed a “whirl sign” and were diagnosed as small bowel volvulus, the diagnostic accuracy rate was 32.4% (11/34), ultrasound simultaneously diagnosed intestinal obstruction in 21 cases, 17 cases of abdominal effusion, 4 cases of intestinal wall thickening, 2 cases of abdominal mass, 1 case of intussusception, 1 case of right sided inguinal hernia. CT and ultrasound had a consistent positive discovery in 88.2% (30/34) of all the patients.Conclusion:Ultrasound is valuable in the diagnosis of small bowel volvulus and the evaluation of complications.

Objective : To understand the spatial distribution of multidrug resistant/rifampicin resistant pulmonary tuberculosis（MDR/RR PTB）in Wenzhou from 2014 to 2017,and to provide the scientific basis for MDR/RR TB control and prevention. Methods : The data of MDR/RR PTB cases in Wenzhou from 2014 to 2017 were collected from the Tuberculosis Management Information System of the Chinese Disease Prevention and Control Information System,and was associated with the geographic information database of Wenzhou Survey and Mapping Research Institute. The global spatial autocorrelation analysis was carried out by ArcGIS 10.1 to determine if there was spatial clustering of MDR/RR PTB cases in Wenzhou. The specific clustering areas of the MDR/RR PTB in Wenzhou was analyzed by SaTScan 9.3 and presented by ArcGIS. Results : There were 452 MDR/RR PTB cases reported in Wenzhou from 2014 to 2017,with a total registration rate of 4.74/100 000. The incidence rate of MDR/RR PTB in Wenzhou was unevenly distributed;the areas with registration rates of more than 7.45/100 000 were the north-central parts of Yongjia,the south-central parts of Yueqing and the east-central parts of Wencheng. The results of global spatial autocorrelation analysis showed that there were obvious clustering for MDR/RR PTB in Wenzhou（Moran's I=0.321,Z=7.352,P<0.001）. The spatial scanning found two clusters：20 towns/streets in the southeastern part of Yongjia and the south of Yueqing were the primary clustering areas（RR=2.213,LLR=22.353,P<0.001）;Yangyi Street and Shuangyu Street in Lucheng were the secondary clustering areas（RR=2.488,LLR=9.889,P=0.004）. Conclusion The MDR/RR PTB cases reported from 2014 to 2017 in Wenzhou had spatial clustering. The high-incidence areas were in the southeast of Yongjia,south of Yueqing,Yangyi Street and Shuangyu Street of Lucheng.

To explore the clinical characteristics and imaging features of miliary tuberculomas in central nervous system (CNS).A total of 5 cases diagnosed with tuberculosis in CNS first diagnosed by neurologists in Navy General Hospital of PLA were enrolled in the study.All clinical and imaging data were collected and analyzed retrospectively.The main initial symptoms were fever and headache (4/5).Multiple diffused miliary lesions were shown by brain MRI,with maximum diameter ranged from 1-4 mm and ringshape or nodular enhancement after gadolinium injection.As mycobacterium tuberculosis could seldomly be found in serum and cerebrospinal fluid,contrast MRI remains the effective method for detecting miliary tuberculomas in CNS.

Objective To investigate the incidence,features and inducing factors of military training injuries in a certain naval special force,and also to find out prevention measures against special training injuries by referring to the current status and trend in the prevention and protection of training injuries in foreign military forces and other special forces.Methods An investigation of military training injuries in 240 personnel of a certain naval special force was performed by questionnaire.Analyses and comparisons were made in the following aspects:the percentages of training injuries,the time of first training injury,the prognosis of training injuries,the impact of training injuries on combat and military training,the relationship between training injuries and training subjects,and the analysis of inducing facfors in training injury.Results The rate of training injuries in the naval special force was 75.83％ and first injury that occurred within 1 year after joining the service was 50.29％;The rate of good prognosis was 90.11％,and the rate of poor prognosis was 9.89％;The rate of no affection on training was 36.25％,and the rate of training interruption due to training injuries was 29.17％;Average training interruption time was 9.23 days/person,and the rate of training interruption in a month was 30.77 times in one hundred people.The top 3 high risk training subjects were:basic physical performance training,5-kilometer cross-country race and other subjects.Conclusions The rate of training injury in the naval special force is relatively high,and corresponding countermeasures should be taken to reduce the rate of occurrence.