BACKGROUND:Studies have found that massage can reduce blood sugar,promote myogenic factor expression,and increase skeletal muscle content.The extracellular matrix is an important component of skeletal muscle,and association between massage and extracellular matrix and their mechanism of action are still unclear.OBJECTIVE:To explore the effect of massage on extracellular matrix collagen deposition in type 2 diabetic sarcopenia rats.METHODS:Totally 24 Wistar male rats were randomly divided into blank group,model group,and massage group.High-fat diet combined with the streptozotocin method was used to establish a type 2 diabetes mellitus and sarcopenia model.After successful model establishment,the massage group used abdominal massage combined with hind limbs.After 8 weeks of treatment,the fasting blood glucose and serum insulin levels of the rats were measured.The skeletal muscle mass was detected by dual-energy X-ray.The exhaustion time was measured by small animal treadmill.The sliding angle was measured by inclined board test.The pathological changes of skeletal muscle tissue were observed by hematoxylin-eosin staining.The skeletal muscle collagen deposition was observed by Masson staining.The mRNA and protein expressions of type Ⅰ and type Ⅲ collagen in skeletal muscle were detected by qPCR and western blot assay.RESULTS AND CONCLUSION:(1)Compared with the model group,the blood glucose(P＜0.05)and serum insulin(P＜0.01)decreased in the massage group.(2)Compared with the model group,the skeletal muscle mass,running exhaustion time,and the angle of inclined plate experiment were increased in massage group(P＜0.05).(3)Compared with the model group,the skeletal muscles of the massage group were arranged neatly,muscle atrophy was improved,and collagen fiber deposition was reduced.(4)Compared with the model group,the expression levels of type Ⅰ and type Ⅲ collagen mRNA and protein in skeletal muscle were decreased in the massage group(P＜0.05).(5)The results suggest that massage can enhance insulin sensitivity,lower blood sugar,improve skeletal muscle mass,strength and function,and diminish collagen deposition in rats with type 2 diabetes,and may be a potential target for massage to exert its therapeutic effects.

BACKGROUND:Studies have found that massage can reduce blood sugar,promote myogenic factor expression,and increase skeletal muscle content.The extracellular matrix is an important component of skeletal muscle,and association between massage and extracellular matrix and their mechanism of action are still unclear.OBJECTIVE:To explore the effect of massage on extracellular matrix collagen deposition in type 2 diabetic sarcopenia rats.METHODS:Totally 24 Wistar male rats were randomly divided into blank group,model group,and massage group.High-fat diet combined with the streptozotocin method was used to establish a type 2 diabetes mellitus and sarcopenia model.After successful model establishment,the massage group used abdominal massage combined with hind limbs.After 8 weeks of treatment,the fasting blood glucose and serum insulin levels of the rats were measured.The skeletal muscle mass was detected by dual-energy X-ray.The exhaustion time was measured by small animal treadmill.The sliding angle was measured by inclined board test.The pathological changes of skeletal muscle tissue were observed by hematoxylin-eosin staining.The skeletal muscle collagen deposition was observed by Masson staining.The mRNA and protein expressions of type Ⅰ and type Ⅲ collagen in skeletal muscle were detected by qPCR and western blot assay.RESULTS AND CONCLUSION:(1)Compared with the model group,the blood glucose(P＜0.05)and serum insulin(P＜0.01)decreased in the massage group.(2)Compared with the model group,the skeletal muscle mass,running exhaustion time,and the angle of inclined plate experiment were increased in massage group(P＜0.05).(3)Compared with the model group,the skeletal muscles of the massage group were arranged neatly,muscle atrophy was improved,and collagen fiber deposition was reduced.(4)Compared with the model group,the expression levels of type Ⅰ and type Ⅲ collagen mRNA and protein in skeletal muscle were decreased in the massage group(P＜0.05).(5)The results suggest that massage can enhance insulin sensitivity,lower blood sugar,improve skeletal muscle mass,strength and function,and diminish collagen deposition in rats with type 2 diabetes,and may be a potential target for massage to exert its therapeutic effects.

Objective To observe the clinical efficacy of Sushen Jiubao decoction in the treatment of acute exacerbation of bronchial asthma and its effect on Th1/Th2 factors.Methods Ninety-eight patients with acute exacerbation of bronchial asthma treated in Sishengbianji Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University from February 2022 to May 2023 were selected and divided into treatment group and control group according to random number table method,with 49 cases in each group.The control group was given conventional treatment such as oxygen inhalation and atomization,and the treatment group was additionally treated with Sushen Jiubao decoctionon based on the treatment of control group.The clinical efficacy,TCM syndrome score,pulmonary function indicators[forced expiratory volume in first second(FEV1),peak expiratory flow(PEF)],and laboratory indicators[interleukin(IL)-4,IL-13,interferon-γ(IFN-γ),immunoglobulin E(IgE)].Results The total effective rate of treatment group was significantly higher than that of control group(χ2=9.287,P=0.010).After treatment,the TCM syndrome scores,serum IL-4,IL-13 and IgE levels of two groups were significantly lower than before treatment,and FEV1,PEF and IFN-γ were significantly higher than before treatment(P<0.05).The TCM syndrome score,serum IL-4,IL-13 and IgE levels in treatment group were significantly lower than those in control group,and FEV1,PEF and IFN-γ were significantly higher than those in control group(P<0.05).Conclusion Sushen Jiubao decoction can significantly improve clinical efficacy,reduce the level of inflammatory factors,and improve pulmonary function in the treatment of acute exacerbation of bronchial asthma.

"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions.
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Objective: To evaluate the accuracy of endoscopic titanium clip localization combined with CT three-dimensional reconstruction for the control of incision margin in early gastric cancer under laparoscopy. Methods: A prospective analysis was made for gastric cancer whose lesions were located in the middle of the stomach and T stage was 1 to 2 from October 2017 to January 2019 at Department of Gastrointestinal and Pancreatic Surgery, Zhejiang Provincial People′s Hospital. Totally 25 patients were eventually enrolled in the study. There were 17 males and 8 females aging of (63.6±7.2) years (range: 48 to 77 years). All cases were treated with titanium clip localization under endoscope combined with CT three-dimensional(3D) reconstruction to construct a virtual panorama of gastric cavity and lesions, and to design surgical margins. Laparoscopic surgical resection was performed according to the surgical margins designed before operation. The distance from the gastric angle to the origin of the minor curvature of the incisional margin, the distance from the gastric angle to the the center of lesion and the distance of the upper incision margin were measured under three-dimensional CT reconstruction and under actual specimen. Paired t test was used to compare the three distances measured by two methods. Results: The measured distances from the gastric angle to the center of the lesion and the proximal incisional margin under 3D reconstruction CT were according to the measured values of actual specimens ((2.67±1.38) cm vs. (2.83±1.56) cm, t=1.51, P=0.14; (5.23±0.60) cm vs. 5 cm, t=1.93, P=0.07); the measured distances from the gastric angle to the origin of the minor curvature of the incisional margin under CT 3D reconstruction were different with the measured values of solid specimens ((5.94±0.94) cm vs. (6.37±0.90) cm, t=3.52, P=0.00). Conclusion The method of titanium clip localization combined with CT 3D reconstruction can provide a feasible laparoscopic localization method and incision edge solution for T1 to T2 gastric central cancer.

Objective To evaluate the accuracy of endoscopic titanium clip localization combined with CT three?dimensional reconstruction for the control of incision margin in early gastric cancer under laparoscopy. Methods A prospective analysis was made for gastric cancer whose lesions were located in the middle of the stomach and T stage was 1 to 2 from October 2017 to January 2019 at Department of Gastrointestinal and Pancreatic Surgery, Zhejiang Provincial People′s Hospital. Totally 25 patients were eventually enrolled in the study. There were 17 males and 8 females aging of (63.6± 7.2) years (range: 48 to 77 years). All cases were treated with titanium clip localization under endoscope combined with CT three?dimensional(3D) reconstruction to construct a virtual panorama of gastric cavity and lesions, and to design surgical margins. Laparoscopic surgical resection was performed according to the surgical margins designed before operation. The distance from the gastric angle to the origin of the minor curvature of the incisional margin, the distance from the gastric angle to the the center of lesion and the distance of the upper incision margin were measured under three?dimensional CT reconstruction and under actual specimen. Paired t test was used to compare the three distances measured by two methods. Results The measured distances from the gastric angle to the center of the lesion and the proximal incisional margin under 3D reconstruction CT were according to the measured values of actual specimens ((2.67±1.38) cm vs. (2.83±1.56) cm, t=1.51, P=0.14; (5.23±0.60) cm vs. 5 cm, t=1.93, P=0.07); the measured distances from the gastric angle to the origin of the minor curvature of the incisional margin under CT 3D reconstruction were different with the measured values of solid specimens ((5.94±0.94) cm vs. (6.37±0.90) cm, t=3.52, P=0.00). Conclusion The method of titanium clip localization combined with CT 3D reconstruction can provide a feasible laparoscopic localization method and incision edge solution for T1 to T2 gastric central cancer.

Objective To evaluate the accuracy of endoscopic titanium clip localization combined with CT three?dimensional reconstruction for the control of incision margin in early gastric cancer under laparoscopy. Methods A prospective analysis was made for gastric cancer whose lesions were located in the middle of the stomach and T stage was 1 to 2 from October 2017 to January 2019 at Department of Gastrointestinal and Pancreatic Surgery, Zhejiang Provincial People′s Hospital. Totally 25 patients were eventually enrolled in the study. There were 17 males and 8 females aging of (63.6± 7.2) years (range: 48 to 77 years). All cases were treated with titanium clip localization under endoscope combined with CT three?dimensional(3D) reconstruction to construct a virtual panorama of gastric cavity and lesions, and to design surgical margins. Laparoscopic surgical resection was performed according to the surgical margins designed before operation. The distance from the gastric angle to the origin of the minor curvature of the incisional margin, the distance from the gastric angle to the the center of lesion and the distance of the upper incision margin were measured under three?dimensional CT reconstruction and under actual specimen. Paired t test was used to compare the three distances measured by two methods. Results The measured distances from the gastric angle to the center of the lesion and the proximal incisional margin under 3D reconstruction CT were according to the measured values of actual specimens ((2.67±1.38) cm vs. (2.83±1.56) cm, t=1.51, P=0.14; (5.23±0.60) cm vs. 5 cm, t=1.93, P=0.07); the measured distances from the gastric angle to the origin of the minor curvature of the incisional margin under CT 3D reconstruction were different with the measured values of solid specimens ((5.94±0.94) cm vs. (6.37±0.90) cm, t=3.52, P=0.00). Conclusion The method of titanium clip localization combined with CT 3D reconstruction can provide a feasible laparoscopic localization method and incision edge solution for T1 to T2 gastric central cancer.

OBJECTIVEThis study aims to evaluate the efficacy and safety of crizotinib for advanced ALK-positive non-small cell lung cancer (NSCLC) patients.

METHODSTwenty-eight patients with advanced ALK-positive NSCLC were given orally crizotinib 250 mg b. i.d., and were followed up to evaluate the therapeutic efficacy and safety.

RESULTSAmong the 28 patients, the objective response rate (ORR) was 71.4% (20/28) and disease control rate (DCR) was 92.9% (26/28). Three patients achieved complete response. Seventeen patients had partial response. The most common drug-related adverse events were mild flickering vision and gastrointestinal reaction. Eleven patients experienced flickering vision. Nine patients had nausea and vomiting. Eight patients had diarrhea. They were all reversible and of grade I or II. Only one patient had grade III myelosuppression. Among the 28 patients, 16 cases were disease-free and 12 cases had progressive disease, with a progression-free survival of 8.2 months.

CONCLUSIONSCrizotinib is effective and tolerable in the treatment of advanced ALK-positive NSLCC. However, its long-term treatment efficacy requires to be further studied.

Antineoplastic Agents ; adverse effects ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; enzymology ; pathology ; Diarrhea ; chemically induced ; Disease-Free Survival ; Humans ; Lung Neoplasms ; drug therapy ; enzymology ; pathology ; Nausea ; chemically induced ; Protein Kinase Inhibitors ; adverse effects ; therapeutic use ; Pyrazoles ; adverse effects ; therapeutic use ; Pyridines ; adverse effects ; therapeutic use ; Receptor Protein-Tyrosine Kinases ; Vomiting ; chemically induced

Objective To assess the influence of atrial fibrillation on post-thrombolytic hemorrhagic transformation and functional prognosis in acute ischemic stroke patients within different time window.Methods We retrospectively reviewed the clinical and imaging data of patients of acute ischemic stroke with intravenous thrombolysis admitted from June 2009 to October 2013.According to onset-to-needle time,we divided patients into 3 groups and then assessed the effect of the comorbidity with atrial fibrillation on the occurrence of hemorrhagic transformation and favorable outcome (defined as modified Rankin Scale score≤2 at 90 days) after thrombolysis within different time window.Results A total of 345 patients were included in this study,among whom 101 (29.3％) were treated by intravenous thrombolysis within 3.0 h (≤3.0 h),157(45.5％) ＞3.0 h and≤4.5 h,87(25.2％) over 4.5 h(＞4.5 h).Atrial fibrillation was observed in 50.5％ (51/101) patients in ≤3.0 h group,37.6％ (59/157) in ＞3.0 h and≤4.5 h group and 40.2％ (35/87) in ＞ 4.5 h group (x2 =4.362,P =0.113).There were no statistically significant differences among these three groups about the rate of hemorrhagic transformation (hemorrhagic infarction:16.8％ (17/101),22.3％ (35/157),20.7％ (18/87),and parenchymal hematoma:5.0％ (5/101),10.2％ (16/157),10.3％ (9/87),x2 =4.278,P =0.370) and favorable outcome (51.5％ (52/101),53.5％ (84/ 157),47.1％ (41/87),x2 =0.913,P =0.633).Multivariate analysis demonstrated that atrial fibrillation was associated with hemorrhagic infarction for patients in ＞ 4.5 h group (OR =3.637,95％ CI 1.101-12.013,P =0.034),and the presence of atrial fibrillation independently predicted parenchymal hematoma for patients in ＞ 3.0 h and ≤4.5 h group (OR =3.757,95％ CI 1.133-12.457,P =0.030).There was no significant association between atrial fibrillation and favorable outcome at 90 days.Conclusions The presence of atrial fibrillation is not associated with the prognosis in thrombolytic patients.However,it enhanced the risk of parenchymal hematoma if patients were treated within the time window ＞ 3.0 h and ≤4.5h.

Objective To evaluate the value of neutrophil CD64 positive cells percentage(CD64%)detec-tion to stop using antibiotic in patients with severe pneumonia.Methods 60 accepted antibiotic therapy patients with severe pneumonia,in accordance with the random number table,were separated into observation group(n =30)and control group(n =30).Antibiotics were stopped according to CD64% in observation group,while it according to the clinical symptoms,the plasma level of white blood cell and C -reactive protein in control group.The main observation indexes included the days of antibiotics use,the length of Intensive Care Unit(ICU)stay,clinical efficacy and the case fatality rate.Results The days of antibiotics use in the observation group was (10.3 ±5.2)d,while it was (16.8 ± 5.8)d for patients in the control group,and it had significant difference(t =-4.570,P <0.01).The length of ICU stay in the observation group was shorter than that in the control group[(6.5 ±3.5)d vs (10.5 ±4.5)d],and it had significant difference(t =3.843,P <0.01).The clinical efficacy were 83.67% and 82.12%,and the case fatality rate were 9.68% and 10.24% in the observation group and control group,respectively,and both had no significant difference(P >0.05).Conclusion Stop using antibiotics according to the neutrophil CD64 % is safe,reliable,and can effectively reduce the excessive use of antibiotics and shorten the length of ICU stay in patients with severe pneumonia.