Objective To explore the clinical efficacy of acupuncture on post-stroke insomnia.Methods 148 outpatients and inpatients with post-stroke insomnia were recruited in the Shanghai municipal Hospital of Traditional Chinese Medicine from June 2016 to January 2018.They were randomly divided into two groups,acupuncture group(n=74)and control group(n=74).The acupuncture group was treated with GV20,GV24,GV29,HN22,HT7 and SP6 20 minutes each time,3 times per week for 4 weeks.The follow-up was after 4 weeks.The control group was treated with sham acupuncture on the same acupoints.The needles did not pierce the skin.The Insomnia Severity Index Scale(ISI),the Hospital Anxiety and Depression Scale(HADS)and the Stroke Special Quality of Life Scale(SS-QoL)were used to evaluate the patients before treatment,after 2 weeks of treatment,after 4 weeks of treatment and follow-up.The occurrence of adverse events of acupuncture was also recorded.Results ① ISI:after 2 weeks of treatment,4 weeks of treatment and follow-up,the score of treatment group was decreased compared with the control group,and the difference was statistically significant(P＜0.01).Compared with baseline,the ISI score of the treatment group was decreased after 4 weeks of treatment(P＜0.05).② HADS score:The difference between 4-week treatment and baseline score of the HADS-A,the difference between the treatment group and the control group was statistically significant(P＜0.01);the difference between 4-week treatment and baseline,and between follow-up and baseline score of the HADS-D,the difference between the treatment group and the control group was statistically significant(P＜0.01).③SS-QoL score:The difference between 2-week treatment and baseline,between 4-week treatment and baseline,and between follow-up and baseline score of the SS-QoL,the difference between the treatment group and the control group was statistically significant(P＜0.01).Conclusion Acupuncture is an effective and safe therapy in improving the severity of insomnia of patients with post-stroke insomnia.Compared with sham acupuncture,acupuncture can improve the anxiety and depression status and quality of life of patients.

Objective To observe the clinical efficacy of Tongdu Tiaoyang rolling needle pricking-cupping(RNP-C)therapy for cervical spondylosis of qi stagnation and blood stasis type.Methods A total of 90 patients with cervical spondylosis of qi stagnation and blood stasis type were randomly divided into the rolling needle pricking-cupping(RNP-C)group and the electroacupuncture(EA)group,with 45 cases in either group.Both groups were treated with electroacupuncture at Tianzhu(BL 10),Jingjiaji(EX-B2),Houxi(SI 3),Shenmai(BL 62),Xuanzhong(GB 39),Geshu(BL 17),Hegu(LI 4)and Ashi points with continuous wave and 2 Hz of frequency for once a day,7 times as a treatment course.On the basis of electroacupuncture treatment,the rolling needle pricking-cupping(RNP-C)group was treated with bloodletting by rolling needle on the neck Du Mai and three yang channels,from Fengfu(DU 16)to Taodao(DU 13),Yuzhen(BL 9)to Dazhu(BL 11),Fengchi(GB 20)to Jianjing(GB 21),and Yifeng(SJ 17)to Tianyou(SJ 16),followed by fire cupping,for once every other day,and 3 times in all.The visual analogue scale(VAS)scores and Japanese Orthopaedic Association Scores(JOA)were observed before and after treatment,and the efficacy was evaluated.Results Compared before treatment,the scores of VAS in either group were all significantly reduced after treatment(P＜0.01).The scores of VAS in the RNP-C group were significantly inferior to those in the EA group after treatment(P＜0.01).Compared before treatment,the scores of JOA in either group were all significantly promoted after treatment(P＜0.01).The differences of JOA scores between the RNP-C group and EA group after treatment were not significant(P＞0.05).The therapeutic effecacy of the RNP-C group is superior to that of the traditional EA group(P＜0.05).Conclusion Tongdu Tiaoyang rolling needle pricking-cupping(RNP-C)therapy combining with traditional electroacupuncture could improve the cervical pain symptoms of patients with cervical spondylosis of qi stagnation and blood stasis type in a short period of time,and the clinical efficacy is better than traditional electroacupuncture.

Objective To explore the clinical efficacy of acupuncture on post-stroke insomnia.Methods 148 outpatients and inpatients with post-stroke insomnia were recruited in the Shanghai municipal Hospital of Traditional Chinese Medicine from June 2016 to January 2018.They were randomly divided into two groups,acupuncture group(n=74)and control group(n=74).The acupuncture group was treated with GV20,GV24,GV29,HN22,HT7 and SP6 20 minutes each time,3 times per week for 4 weeks.The follow-up was after 4 weeks.The control group was treated with sham acupuncture on the same acupoints.The needles did not pierce the skin.The Insomnia Severity Index Scale(ISI),the Hospital Anxiety and Depression Scale(HADS)and the Stroke Special Quality of Life Scale(SS-QoL)were used to evaluate the patients before treatment,after 2 weeks of treatment,after 4 weeks of treatment and follow-up.The occurrence of adverse events of acupuncture was also recorded.Results ① ISI:after 2 weeks of treatment,4 weeks of treatment and follow-up,the score of treatment group was decreased compared with the control group,and the difference was statistically significant(P＜0.01).Compared with baseline,the ISI score of the treatment group was decreased after 4 weeks of treatment(P＜0.05).② HADS score:The difference between 4-week treatment and baseline score of the HADS-A,the difference between the treatment group and the control group was statistically significant(P＜0.01);the difference between 4-week treatment and baseline,and between follow-up and baseline score of the HADS-D,the difference between the treatment group and the control group was statistically significant(P＜0.01).③SS-QoL score:The difference between 2-week treatment and baseline,between 4-week treatment and baseline,and between follow-up and baseline score of the SS-QoL,the difference between the treatment group and the control group was statistically significant(P＜0.01).Conclusion Acupuncture is an effective and safe therapy in improving the severity of insomnia of patients with post-stroke insomnia.Compared with sham acupuncture,acupuncture can improve the anxiety and depression status and quality of life of patients.

Objective To observe the clinical efficacy of Tongdu Tiaoyang rolling needle pricking-cupping(RNP-C)therapy for cervical spondylosis of qi stagnation and blood stasis type.Methods A total of 90 patients with cervical spondylosis of qi stagnation and blood stasis type were randomly divided into the rolling needle pricking-cupping(RNP-C)group and the electroacupuncture(EA)group,with 45 cases in either group.Both groups were treated with electroacupuncture at Tianzhu(BL 10),Jingjiaji(EX-B2),Houxi(SI 3),Shenmai(BL 62),Xuanzhong(GB 39),Geshu(BL 17),Hegu(LI 4)and Ashi points with continuous wave and 2 Hz of frequency for once a day,7 times as a treatment course.On the basis of electroacupuncture treatment,the rolling needle pricking-cupping(RNP-C)group was treated with bloodletting by rolling needle on the neck Du Mai and three yang channels,from Fengfu(DU 16)to Taodao(DU 13),Yuzhen(BL 9)to Dazhu(BL 11),Fengchi(GB 20)to Jianjing(GB 21),and Yifeng(SJ 17)to Tianyou(SJ 16),followed by fire cupping,for once every other day,and 3 times in all.The visual analogue scale(VAS)scores and Japanese Orthopaedic Association Scores(JOA)were observed before and after treatment,and the efficacy was evaluated.Results Compared before treatment,the scores of VAS in either group were all significantly reduced after treatment(P＜0.01).The scores of VAS in the RNP-C group were significantly inferior to those in the EA group after treatment(P＜0.01).Compared before treatment,the scores of JOA in either group were all significantly promoted after treatment(P＜0.01).The differences of JOA scores between the RNP-C group and EA group after treatment were not significant(P＞0.05).The therapeutic effecacy of the RNP-C group is superior to that of the traditional EA group(P＜0.05).Conclusion Tongdu Tiaoyang rolling needle pricking-cupping(RNP-C)therapy combining with traditional electroacupuncture could improve the cervical pain symptoms of patients with cervical spondylosis of qi stagnation and blood stasis type in a short period of time,and the clinical efficacy is better than traditional electroacupuncture.

Objective:To evaluate the clinical efficacy of omalizumab in the treatment of patients with chronic spontaneous urticaria accompanied by other allergic diseases.Methods:Clinical data were retrospectively collected from 74 patients, who were clinically diagnosed with chronic spontaneous urticaria and other allergic diseases, and received subcutaneous injections of omalizumab in the Department of Allergy, Tianjin Medical University General Hospital from June 2020 to September 2022. Types of allergic diseases, serum total IgE (tIgE) and allergen-specific IgE (sIgE) levels before treatment, treatment outcomes and adverse drug reactions were analyzed. Differences before and after treatment were assessed using paired t-test and Wilcoxon signed-rank sum test. Results:A total of 74 patients with chronic spontaneous urticaria were involved, including 29 with complicated allergic asthma (39.2%) , 61 with complicated allergic rhinitis (82.4%) , 6 with complicated atopic dermatitis (8.1%) , and 4 with food allergy (5.4%) . Before treatment, elevated serum tIgE or sIgE levels were observed in 44 (59.5%) patients. After the first omalizumab treatment, the urticaria control test (UCT) score significantly increased compared with that before treatment (16.00 [13.0.0, 16.00] vs. 6.00 [5.75, 9.00], Z = 7.39, P < 0.001) ; after 4 sessions of the omalizumab treatment, 82.5% (33/40) of the patients achieved complete control of urticaria symptoms or showed complete response. After omalizumab treatment, asthmatic attacks were decreased in 29 patients with allergic asthma, and asthma control test (ACT) scores significantly increased compared with those before treatment (21.07 ± 2.88 points [after the first treatment] vs. 18.48 ± 3.20 points [before treatment], t = 8.87, P < 0.001) ; among 61 patients with allergic rhinitis, global rhinitis symptom-based visual analog scale (VAS) scores (before treatment: 5.89 ± 1.29 points; after the first treatment: 3.28 ±1.46 points) and rhinoconjunctivitis quality of life questionnaire (RQLQ) scores (before treatment: 60.10 ± 20.53 points; after the first treatment: 37.26 ± 18.83 points) both significantly decreased after the first treatment ( t = 15.04, 10.01, respectively, both P < 0.001) , and rhinitis symptoms were relieved at the same time; skin itching was relieved in 4 patients with atopic dermatitis, and allergic symptoms after contact with food allergens were also relieved in the 2 patients with food allergy after omalizumab treatment. During the treatment, only 1 patient experienced erythematous swelling, induration, and pain at the injection site. Conclusions:In the treatment of chronic spontaneous urticaria accompanied by allergic diseases, the use of omalizumab not only effectively improved urticaria symptoms, but also well controlled allergic diseases, with a good safety profile. Multiple benefits may be achieved by the use of omalizumabin in patients with chronic spontaneous urticaria accompanied by other allergic diseases.

Objective:In this study, the role of IL-17 in the pathogenesis of idiopathic myositis (IIM) was preliminarily investigated by detecting the expression of IL-17 in the muscle tissues of patients with idiopathic inflammatory myositis (IIM) and normal controls.Methods:Twenty-eight patients (20 in DM group with dermatomyositis and 8 in ASS group with anti-synthase syndrome) who were diagnosed with IIM after muscle biopsy and autoantibody detection in our hospital for the first time from October 2019 to August 2021 were included. Twelve cases with normal muscle tissue matched for age and sex were included as the control group. Western blot and immunohistochemical techniques were used to detect the expression level of IL-17 in muscle tissue, and enzyme-linked immunosorbent assay (ELISA) was used to detect serum IL-6. Mann-Whitney U rank sum test was used to compare the difference of IL-17 expression in muscle tissue between the two groups, and non-parametric test was used for comparison between multiple groups. Chi-square test and Spearman rank correlation analysis were used, and P<0.05 was considered statistically significant. Results:① The expression level of IL-17 in IIM muscle tissue[1.63(1.30, 2.05)pg/ml was higher than that in control group[1.00(0.96, 1.00)pg/ml, and the difference was statistically significant ( Z=-3.52, P<0.001). The difference be-tween DM[1.94(1.58, 2.14)pg/ml] and ASS[1.22(1.04,1.55)pg/ml was statistically significant ( Z=-3.20, P=0.001). ② Compared with healthy control group [4.08(3.01, 5.67)pg/ml, the expression of IL-6 in ⅡM serum[8.88(4.93, 13.64) was high ( Z=-3.01, P=0.003), which was positively correlated with the expression of IL-17 ( r=0.42, P=0.027). ③ The ex-pression of IL-17 in muscle tissue was higher in IIM associated with muscle weakness[1.91(1.56, 2.14) pg/ml vs 1.50(1.04, 2.00)pg/ml] ( Z=-1.38, P=0.020), dysphagia [2.06(1.99, 2.14)pg/ml vs 1.62(1.52, 2.04)pg/ml] ( Z=-2.74, P=0.010) and skin involvement[1.98(1.57, 2.14)pg/ml vs 1.04(0.86, 1.61)pg/ml] ( Z=-3.20, P<0.010), and the differences were statistically significant ( P<0.05). ④IL-17 was positively correlated with Myoact-total activity ( r=0.51, P=0.006), Myoact-muscle symptom ( r=0.45, P=0.016), erythrocyte sedimen tation ( r=0.48, P=0.020), and myoenzyme increase ( r=0.56, P=0.002). Conclusion:IL-17 and IL-6 are synergistically involved in the pathogenesis of IIM, suggesting that IL-17 is the therapeutic target of IIM.

Objective To investigate the expression of programmed death ligand 1(PD-L1) in primary tumor cells(TCs) and tumor-infiltrating immune cells(TICs) in patients with liver metastases from colorectal cancer(CRC) and determine its predictive value for recurrence after microwave ablation(MWA) of liver metastases. Methods The paraffin-embedded specimens of 28 patients with CRC liver metastasis were collected retrospectively. The expression of PD-L1 in the primary lesions was detected by immunohistochemistry, and the relationship between PD-L1 and clinical features was analyzed. Recurrence-free survival(RFS) was analyzed by Kaplan-Meier method and Log rank test. Cox proportional hazards regression model was used to analyze the factors influencing recurrence. Results The positive rates of PD-L1 in TCs and TICs in primary CRC were 14.3%(4/28) and 46.4%(13/28), respectively. PD-L1 expression in primary TICs of CRC patients with liver metastases was significantly correlated with the largest hepatic tumor diameter (P < 0.05). PD-L1 expression in primary TICs of CRC patients with liver metastasis was correlated with poor RFS after MWA (P < 0.05). PD-L1 expression in primary TICs and the largest hepatic tumor diameter > 3 cm in CRC patients with liver metastases were the risk factors for recurrence after MWA (P < 0.05). Conclusion PD-L1 expression in primary TICs of CRC patients with liver metastasis may increase the risk of recurrence after MWA for liver metastasis.

Background: Abnormal glucose metabolism is one of the malignant characteristics of tumors. LncRNA plays an important role in the process of aerobic glycolysis of tumors. Aims: To investigate the expression of LncRNA MEG3 in gastric cancer and its correlation with glycolysis. Methods: RT-qPCR was used to detect the mRNA expression of MEG3 in gastric cancer and paracancerous tissue. Immunohistochemical EnVision method was used to detect the protein expressions of PKM2, LDHA, mTOR, HIF-1α in gastric cancer and paracancerous tissue. Relationship between expressions of above-mentioned indices and clinicopathological features of gastric cancer were analyzed. The correlation between MEG3 and glycolysis level of gastric cancer was analyzed by Spearman correlation analysis, and its possible mechanism was explored. Results: The expression of MEG3 in gastric cancer tissue was significantly lower than that in paracancerous tissue (P< 0.05), and was correlated with lymph node metastasis (P<0.05). The positivity rates of expression of PKM2, LDHA, mTOR and HIF-1α in gastric cancer tissue were significantly higher than those in paracancerous tissue, and were correlated with the depth of tumor invasion, lymph node metastasis and pTNM stage (P<0.05). Spearman correlation analysis showed that the expression of MEG3 was negatively correlated with the expressions of PKM2, LDHA, mTOR and HIF-1α (r=-0.346，r= -0.306，r=-0.389, r=-0.338; P<0.05). The expression of MEG3 in HIF-1α

Antibodies, Neutralizing ; Antibodies, Viral/isolation & purification* ; B-Lymphocytes/virology* ; COVID-19/virology* ; Humans ; Immunity/genetics* ; RNA, Viral/immunology* ; SARS-CoV-2/pathogenicity* ; Single-Cell Analysis

Objective:To investigate the distribution and antimicrobial resistance profile of clinical bacteria isolated from blood culture in China.Methods:The clinical bacterial strains isolated from blood culture from member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS) were collected during January 2018 to December 2019. Antibiotic susceptibility tests were conducted with agar dilution or broth dilution methods recommended by US Clinical and Laboratory Standards Institute (CLSI). WHONET 5.6 was used to analyze data.Results:During the study period, 14 778 bacterial strains were collected from 50 hospitals, of which 4 117 (27.9%) were Gram-positive bacteria and 10 661(72.1%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (37.2%), Klebsiella pneumoniae (17.0%), Staphylococcus aureus (9.7%), coagulase-negative Staphylococci (8.7%), Pseudomonas aeruginosa (3.7%), Enterococcus faecium (3.4%), Acinetobacter baumannii(3.4%), Enterobacter cloacae (2.9%), Streptococci(2.8%) and Enterococcus faecalis (2.3%). The the prevalence of methicillin-resistant S. aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus were 27.4% (394/1 438) and 70.4% (905/1 285), respectively. No glycopeptide-resistant Staphylococcus was detected. More than 95% of S. aureus were sensitive to amikacin, rifampicin and SMZco. The resistance rate of E. faecium to vancomycin was 0.4% (2/504), and no vancomycin-resistant E. faecalis was detected. The ESBLs-producing rates in no carbapenem-resistance E. coli, carbapenem sensitive K. pneumoniae and Proteus were 50.4% (2 731/5 415), 24.6% (493/2001) and 35.2% (31/88), respectively. The prevalence of carbapenem-resistance in E. coli and K. pneumoniae were 1.5% (85/5 500), 20.6% (518/2 519), respectively. 8.3% (27/325) of carbapenem-resistance K. pneumoniae was resistant to ceftazidime/avibactam combination. The resistance rates of A. baumannii to polymyxin and tigecycline were 2.8% (14/501) and 3.4% (17/501) respectively, and that of P. aeruginosa to carbapenem were 18.9% (103/546). Conclusions:The surveillance results from 2018 to 2019 showed that the main pathogens of bloodstream infection in China were gram-negative bacteria, while E. coli was the most common pathogen, and ESBLs-producing strains were in majority; the MRSA incidence is getting lower in China; carbapenem-resistant E. coli keeps at a low level, while carbapenem-resistant K. pneumoniae is on the rise obviously.