OBJECTIVE: To observe the clinical efficacy of auricular electroacupuncture for post-stroke dysphagia in the pharyngeal phase. METHODS: Eighty-two patients with post-stroke dysphagia in the pharyngeal phase were randomized into an auricular electroacupuncture group (41 cases) and a swallowing electrical stimulation group (41 cases, 1 case dropped out). In the auricular electroacupuncture group, electroacupuncture was applied at auricular points, i.e. Xin (CO₁₅) and Yanhou (TG₃), using disperse-dense wave, in frequency of 2 Hz/10 Hz, 30 min a time. In the swallowing electrical stimulation group, swallowing electrical stimulation was delivered for 30 min a time. Both groups were treated once daily for 4 weeks. The functional oral intake scale (FOIS) grade, as well as the hyolaryngeal complex displacement, the pharyngeal constriction rate (PCR) and the pharyngeal delay time (PDT) under video fluoroscopic study of swallowing (VFSS) were observed before and after treatment, and the clinical efficacy was evaluated in the two groups. RESULTS: Compared before treatment, the FOIS grade was improved (P<0.01), the forward and upward displacement amplitude of hyoid bone and thyroid cartilage was increased (P<0.05), and the PCR and PDT were decreased (P<0.05) after treatment in the two groups. After treatment, compared with the swallowing electrical stimulation group, the FOIS grade was superior (P<0.01), the upward displacement amplitude of hyoid bone and thyroid cartilage was larger (P<0.05) and the PCR and PDT were lower (P<0.05) in the auricular electroacupuncture group. The total effective rate was 85.4% (35/41) in the auricular electroacupuncture group, which was higher than 62.5% (25/40) in the swallowing electrical stimulation group (P<0.05). CONCLUSION Auricular electroacupuncture can effectively trigger pharyngeal initiation and improve post-stroke dysphagia in the pharyngeal phase.
Humans ; Electroacupuncture ; Male ; Deglutition Disorders/etiology* ; Female ; Middle Aged ; Aged ; Stroke/physiopathology* ; Pharynx/physiopathology* ; Acupuncture, Ear ; Acupuncture Points ; Deglutition ; Treatment Outcome ; Adult

Objective To explore the application effect of foot massage based on the brain-gut axis theory in patients with spleen-kidney yang deficiency syndrome undergoing maintenance hemodialysis and suffering from insomnia,and to provide references for improving patients' sleep quality and gastrointestinal symptoms.Methods A total of 88 patients with spleen-kidney yang deficiency syndrome undergoing maintenance hemodialysis and suffering from insomnia,who were treated at a Blood Purification Center of a tertiary-A general hospital in Hangzhou,Zhejiang Province from April to September 2024,were selected as a study subjects.They were randomly divided into an experimental group and a control group using the random number table method,with 44 cases in each group.The experimental group received foot massage based on the guidance of the brain-gut axis theory in addition to conventional treatment and nursing care,while the control group received conventional treatment and nursing care only.The intervention lasted for 3 months.The differences in the Pittsburgh Sleep Quality Index(PSQI)scores,Gastrointestinal Symptom Rating Scale(GSRS)scores,traditional Chinese medicine(TCM)syndrome scores,and serum 5-hydroxytryptamine and melatonin levels between the 2 groups before and after the intervention were compared.Results During the study period,no cases were lost in the experimental group,while 5 cases were lost in the control group.Ultimately,44 cases were included in the experimental group and 39 cases in the control group.After the intervention,the PSQI scores,GSRS scores,and TCM syndrome scores in both groups were lower than those before the intervention,and those in the experimental group were lower than those in the control group.The serum 5-hydroxytryptamine and melatonin levels were higher than those before the intervention,and the levels in the experimental group were higher than those in the control group,with statistically significant differences(all P＜0.001).Conclusion Foot massage based on the brain-gut axis theory can improve gastrointestinal symptoms and TCM syndromes in patients with spleen-kidney yang deficiency syndrome undergoing maintenance hemodialysis and suffering from insomnia,and enhance their sleep quality.

Alzheimer's disease(AD)is an age-related neurodegenerative disease with an increasing incidence worldwide.A large number of studies have shown that the incidence rates of hearing loss is high in patients with mild cognitive impairment and Alzheimer's disease,and may be a risk factor for the occurrence and development of cognitive impairment.There is an interaction between the two,but the causal mechanism is still unclear.Early screening and management of hearing impairment may play an important role in the early diagnosis,symptom im-provement and disease progression of Alzheimer's disease.This paper reviews relevant clinical and basic research to discuss the correlation between hearing loss and Alzheimer's disease,and the possible causal mechanism between them.

Objective:To explore the effectiveness of diversified teaching methods in the clinical teaching of nurses training in extracorporeal membrane pulmonary oxygenation (ECMO) .Methods:From March 2019 to August 2023, 167 out-of-hospital nurses who furthered their knowledge of ECMO at China-Japan Friendship Hospital were selected using convenience sampling method. ECMO training and teaching team was set up, adopting a three-tier teaching management model of "nurse leader-teaching instructor-clinical instructor", and implementing a diversified teaching method that integrated nursing rounds teaching, scenario simulation teaching, and Workshop teaching. Theoretical scores before and after training, operational scores after training, application effects after returning to the hospital and satisfaction with diversified teaching were recorded for training nurses.Results:After training, the theoretical scores of the training nurses were (76.59±6.88), which were higher than the pre-training scores of (52.74±6.86), and the difference was statistically significant ( P<0.01). The post-training nurses' operational score was (94.10±3.26) and the satisfaction of the training nurses with the teaching was 95.81% (160/167). When applying ECMO back to the hospital after the training, more than 95% of the nurses believed that the degree of medical and nursing cooperation increased, the time of tube placement and the preparation time for supplies shortened, the completeness of supplies preparation improved, and they were able to respond successfully to emergency events in ECMO patients. Conclusions:Diversified teaching methods can improve the comprehensive specialty competence of ECMO training nurses and help to improve the quality of teaching in the department, which can be promoted and applied in the teaching of ECMO training.

Objective To explore the value of diffusion kurtosis imaging(DKI)in the diagnosis of Parkinson's disease with mild cognitive impairment(PD-MCI)patients.Methods A total of 18 patients with Parkinson's disease cognitive normal(PDN),22 patients with PD-MCI,and 24 healthy controls(HC)were prospectively included.All participants underwent DKI,and regions of interest(ROI)were selected in the substantia nigra,red nucleus,striatum,and posterior cingulate gyrus for post-processing.The diagnostic efficacy of DKI parameters on PD patients' cognitive status was analyzed by the receiver operating characteristic(ROC)curve.Results Compared with the PDN group,the PD-MCI group had a longer disease duration and a higher H-Y stage.Compared with the HC group,the PD-MCI group showed significantly lower mean kurtosis(MK),radial kurtosis(RK),axial kurtosis(AK),and fractional anisotropy(FA)values in the substantia nigra and posterior cingulate gyrus.In the PDN group,FA and MK values in the substantia nigra were significantly decreased,while FA values in the striatum and posterior cingulate gyrus were significantly increased(P＜0.05).Compared with the PDN group,the PD-MCI group showed significantly decreased DKI parameter values in the substantia nigra and posterior cingulate gyrus,and significantly decreased RK,AK,and FA values in the striatum(P＜0.05).The FA values of striatum,posterior cingulate gyrus and joint predictors were the most effective in the diagnosis of PD-MCI and the area under the curve(AUC)were 0.826,0.853 and 0.960,respectively.Conclusion DKI can detect microstructural changes in PD patients.Microstructural alterations in the striatum and posterior cingulate gyrus have an impact on early cognitive function changes in PD patients.FA demonstrate high sensitivity and specificity in the diagnosis of PD-MCI,and the combined diagnostic efficacy across multiple regions is even higher.

Objective:To explore the distribution of cardiovascular disease(CVD)and cardiovascular risk fac-tors(CVRF)in patients with epithelial ovarian cancer before treatment and their correlation with the histological type,stage and grade of ovarian cancer.Methods:A total of 401 newly diagnosed epithelial ovarian cancer pa-tients admitted to The First Affiliated Hospital of Dalian Medical University from January 1,2015 to December 31,2022 were enrolled.Analyze the distribution of CVD(including hypertension,coronary heart disease,stroke,etc.)and CVRF(including diabetes,dyslipidemia,high level of uric acid)in epithelial ovarian cancer patients.Univari-ate analysis and multivariate Logistic regression were performed on the association between CVD,CVRF and the histological type,grade and stage of epithelial ovarian cancer.Results:①Among 401 epithelial ovarian cancer pa-tients,43.6％had at least one CVD before therapy.The most common CVD was hypertension(41.1％),and the most common CVRF was dyslipidemia(57.9％).②Multivariate Logistic regression analysis showed that age ≥60 years was an independent risk factor for serous,high-grade,and advanced epithelial ovarian cancer(OR＞1,P＜0.05).Dyslipidemia was an independent risk factor for high-grade and advanced epithelial ovarian cancer(OR＞1,P＜0.05).High level of uric acid was an independent risk factor for advanced epithelial ovarian cancer(OR＞1,P＜0.05).③The proportion of high-density lipoprotein cholesterol(HDL-C)and lipoprotein A[Lp(A)]abnor-malities in patients with advanced epithelial ovarian cancer was significantly higher than in those with early stage epithelial ovarian cancer(P＜0.05),and the proportion of number of abnormal lipid components was higher in pa-tients with high grade and advanced epithelial ovarian cancer than in patients with low grade and early stage epi-thelial ovarian cancer,respectively(P＜0.05).Conclusions:Patients with epithelial ovarian cancer bear a signifi-cant burden of CVD and CVRF.Hypertension is the most common CVD,and dyslipidemia is the most common CVRF.Dyslipidemia was associated with epithelial ovarian cancer grade and stage.High level of uric acid was as-sociated with epithelial ovarian cancer stage.Active control of blood pressure and blood lipid levels is very impor-tant for epithelial ovarian cancer patients.

Acute symptomatic osteoporotic thoracolumbar compression fracture (ASOTLF) can lead to chronic low back pain, kyphosis deformity, pulmonary dysfunction, loss of mobility, and even life-threatening complications. Vertebral augmentation is currently the mainstream treatment method for this condition. In 2019, the Editorial Board of Chinese Journal of Trauma and the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association collaboratively led the development of Clinical guideline for vertebral augmentation for acute symptomatic osteoporotic thoracolumbar compression fractures. Six years later, with advances in clinical diagnosis and treatment techniques as well as accumulating evidence in related fields, the 2019 guideline requires updating. To this end, the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association, the Spinal Health Professional Committee of China Human Health Science and Technology Promotion Association, and the Minimally Invasive Orthopedics Professional Committee of Shaanxi Medical Doctor Association have organized experts in the field to develop the Clinical guideline for vertebral augmentation of acute symptomatic osteoporotic thoracolumbar compression fractures ( version 2025) , based on the latest evidence-based medical researches. This guideline incorporates 3 recommendations retained from the 2019 version with updated strength of evidence, along with 12 new recommendations. It provides recommendations from six aspects of diagnosis, pain management, treatment option selection, prevention of postoperative complications, anti-osteoporosis therapy, and postoperative rehabilitation, aiming to provide a reference for standard treatment of vertebral augmentation for ASOTLF in hospitals at all levels.

Acute symptomatic osteoporotic thoracolumbar compression fracture (ASOTLF) can lead to chronic low back pain, kyphosis deformity, pulmonary dysfunction, loss of mobility, and even life-threatening complications. Vertebral augmentation is currently the mainstream treatment method for this condition. In 2019, the Editorial Board of Chinese Journal of Trauma and the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association collaboratively led the development of Clinical guideline for vertebral augmentation for acute symptomatic osteoporotic thoracolumbar compression fractures. Six years later, with advances in clinical diagnosis and treatment techniques as well as accumulating evidence in related fields, the 2019 guideline requires updating. To this end, the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association, the Spinal Health Professional Committee of China Human Health Science and Technology Promotion Association, and the Minimally Invasive Orthopedics Professional Committee of Shaanxi Medical Doctor Association have organized experts in the field to develop the Clinical guideline for vertebral augmentation of acute symptomatic osteoporotic thoracolumbar compression fractures ( version 2025) , based on the latest evidence-based medical researches. This guideline incorporates 3 recommendations retained from the 2019 version with updated strength of evidence, along with 12 new recommendations. It provides recommendations from six aspects of diagnosis, pain management, treatment option selection, prevention of postoperative complications, anti-osteoporosis therapy, and postoperative rehabilitation, aiming to provide a reference for standard treatment of vertebral augmentation for ASOTLF in hospitals at all levels.

This study investigated the regulatory potential of salidroside (SAL), a primary active compound in Rhodiola rosea L., on osteoclast differentiation by modulating the hypoxia-inducible factor 1-alpha (HIF-1a) pathway in osteoblasts. Luciferase reporter assay and chromatin immunoprecipitation (ChIP) assay were employed to validate whether the receptor activator of nuclear factor-?B ligand (RANKL) is the downstream target gene of HIF-1a in osteoblasts. The study also utilized lipopolysaccharide (LPS)-induced mouse osteolysis to examine the impact of SAL on osteolysis in vivo. Furthermore, conditioned medium (CM) from SAL-pretreated osteoblasts was used to investigate the paracrine effects on osteoclastogenesis through the HIF-1a pathway. Hypoxic condition-induced overexpression of HIF-1a upregulated RANKL levels by binding to the RANKL promoter and enhancing transcription in osteoblastic cells. In vivo, SAL significantly alleviated bone tissue hypoxia and decreased the expression of HIF-1a by downregulating the expression of RANKL, vascular endothelial growth factor (VEGF), interleukin 6 (IL-6), and angiopoietin-like 4 (ANGPTL4). In the paracrine experiment, conditioned media from SAL-pretreated osteoblasts inhibited differentiation through the HIF-1a/RANKL, VEGF, IL-6, and ANGPTL4 pathways. RANKL emerges as the downstream target gene regulated by HIF-1a in osteoblasts. SAL significantly alleviates bone tissue hypoxia and bone loss in LPS-induced osteolysis through the HIF-1a/RANKL, VEGF, IL-6, and ANGPTL4 pathways. SAL inhibits osteoclast differentiation by regulating osteoblast paracrine secretion.
Animals ; Osteoblasts/cytology* ; Hypoxia-Inducible Factor 1, alpha Subunit/genetics* ; Glucosides/administration & dosage* ; Cell Differentiation/drug effects* ; Phenols/administration & dosage* ; Mice ; Osteoclasts/metabolism* ; RANK Ligand/genetics* ; Rhodiola/chemistry* ; Osteogenesis/drug effects* ; Signal Transduction/drug effects* ; Interleukin-6/genetics* ; Male ; RAW 264.7 Cells ; Osteolysis/genetics* ; Humans ; Mice, Inbred C57BL

Objective To explore the application effect of foot massage based on the brain-gut axis theory in patients with spleen-kidney yang deficiency syndrome undergoing maintenance hemodialysis and suffering from insomnia,and to provide references for improving patients' sleep quality and gastrointestinal symptoms.Methods A total of 88 patients with spleen-kidney yang deficiency syndrome undergoing maintenance hemodialysis and suffering from insomnia,who were treated at a Blood Purification Center of a tertiary-A general hospital in Hangzhou,Zhejiang Province from April to September 2024,were selected as a study subjects.They were randomly divided into an experimental group and a control group using the random number table method,with 44 cases in each group.The experimental group received foot massage based on the guidance of the brain-gut axis theory in addition to conventional treatment and nursing care,while the control group received conventional treatment and nursing care only.The intervention lasted for 3 months.The differences in the Pittsburgh Sleep Quality Index(PSQI)scores,Gastrointestinal Symptom Rating Scale(GSRS)scores,traditional Chinese medicine(TCM)syndrome scores,and serum 5-hydroxytryptamine and melatonin levels between the 2 groups before and after the intervention were compared.Results During the study period,no cases were lost in the experimental group,while 5 cases were lost in the control group.Ultimately,44 cases were included in the experimental group and 39 cases in the control group.After the intervention,the PSQI scores,GSRS scores,and TCM syndrome scores in both groups were lower than those before the intervention,and those in the experimental group were lower than those in the control group.The serum 5-hydroxytryptamine and melatonin levels were higher than those before the intervention,and the levels in the experimental group were higher than those in the control group,with statistically significant differences(all P＜0.001).Conclusion Foot massage based on the brain-gut axis theory can improve gastrointestinal symptoms and TCM syndromes in patients with spleen-kidney yang deficiency syndrome undergoing maintenance hemodialysis and suffering from insomnia,and enhance their sleep quality.