OBJECTIVE: To observe the clinical efficacy of Fu's subcutaneous needling based on "multi-joint muscle spiral balance chain" theory for cervical vertigo (CV) and its effect on blood flow velocity of vertebral artery. METHODS: A total of 60 patients with CV were randomized into a Fu's subcutaneous needling group and a medication group, 30 cases in each one. In the Fu's subcutaneous needling group, Fu's subcutaneous needling was delivered at Dazhui (GV14), the flexible tube was retained for 5 min after sweeping manipulation, and the treatment was given once every other day, 3 times a week for 3 weeks. In the medication group, betahistine mesylate tablet and diclofenac sodium dual-release enteric capsule were taken orally for continuous 3 weeks. Before treatment, after treatment, and in follow-up of one month after treatment completion, the scores of dizziness handicap inventory (DHI) and visual analogue scale (VAS) were observed; before and after treatment, the blood flow velocity of vertebral artery was measured by transcranial Doppler, and the clinical efficacy was evaluated after treatment in the two groups. RESULTS: After treatment and in follow-up, each item scores and total scores of DHI were decreased compared with those before treatment in the two groups (P<0.05); the VAS scores after treatment in the two groups, as well as the VAS score in follow-up of the Fu's subcutaneous needling group, were decreased compared with those before treatment (P<0.05). In the Fu's subcutaneous needling group, after treatment and in follow-up, the physical scores and the total scores of DHI, and the VAS scores were lower than those in the medication group (P<0.05); in follow-up, the emotional and functional scores of DHI were lower than those in the medication group (P<0.05). After treatment, the mean blood flow velocity (Vm) of the left vertebral artery (LVA) and the right vertebral artery (RVA) was increased compared with that before treatment in the two groups (P<0.05), and the Vm of LVA and RVA in the Fu's subcutaneous needling group was higher than that in the medication group (P<0.05). The total effective rate was 100.0% (30/30) in the Fu's subcutaneous needling group, which was superior to 73.3% (22/30) in the medication group (P<0.05). CONCLUSION Fu's subcutaneous needling based on the "multi-joint muscle spiral balance chain" theory can effectively alleviate the vertigo and neck pain, and improve the blood flow velocity of vertebral artery in CV patients, and has a long-term therapeutic effect.
Humans ; Female ; Male ; Middle Aged ; Acupuncture Therapy/instrumentation* ; Vertebral Artery/physiopathology* ; Adult ; Vertigo/physiopathology* ; Aged ; Blood Flow Velocity ; Treatment Outcome ; Acupuncture Points ; Young Adult

Objective:To compare the therapeutic efficacy, safety and drug cost between generic enteric-coated mycophenolate sodium (EC-MPS) and branded EC-MPS in immunosuppressive treatment for adult recipients of renal transplantation (RT) .Methods:From January, 2022 to October, 2023, 60 adult RT patients were continuously enrolled and randomized into two groups. Patients receiving generic EC-MPS were selected as cohort 1 (n=30) while those taking branded EC-MPS designated as cohort 2 (n=30). Hepatic/renal function, blood routine parameters, drug concentrations, adverse events (AEs) and drug costs were recorded and compared between two cohorts at baseline (<3 days before/after day of RT, W0), week 1 (W1), week 4 (W4), week 8 (W8), week 12 (W12) and week 24 (W24) post-RT.Results:Only urine protein was elevated at W24[0.4 (0-0.6) vs 0 (0-0.2) g/24 h, P=0.049]in cohort 1 as compared with cohort 2. Aspartate aminotransferase at W12 (15.6±3.3 vs 20.3±9.7 U/L, P=0.010), leucocyte count at W1 (8.4±2.3 vs 10.1±3.8 ×10 9/L, P=0.045) and platelet count at W1 (158.5±51.5 vs 185.8±46.8 ×10 9/L, P=0.036) all declined in cohort 1 as compared with cohort 2. However, these parameters at other timepoints did not vary between two cohorts (all P>0.050). In addition, blood concentration of MPS after dosing, area under the concentration-time curve and trough concentration of tacrolimus at different timepoints were not different between two cohorts (all P>0.050). Similarly, helper T cells (Th), suppressor T cells (Ts), Th/Ts and B cells at W4/12 did not vary between two cohorts (all P>0.050). Concerning drug cost, no difference existed in the number of tablets or length of stay between two cohorts (both P>0.050). However, cost of EC-MPS (￥1 333.5±419.6 vs ￥2 368.6±596.0, P<0.001) and total cost during hospitalization (￥96 403.3±29 159.8 vs ￥117 062.8±28 782.1, P=0.001) were lower in cohort 1 than cohort 2. The most common AEs in cohort 1 included acid regurgitation (n=19, 63.3%), hypoalbuminemia (n=16, 53.3%), anemia (n=12, 40.0%) and hypokalemia (n=11, 36.7%). And the most common AEs in cohort 2 included acid regurgitation (n=20, 66.7%), anemia (n=14, 46.7%) and hypoalbuminemia (n=9, 30.0%). Notably, the incidence of all AEs was not different between two cohorts (all P>0.050) . Conclusion:Generic EC-MPS has comparable therapeutic efficacy and safety profile with lower drug cost in adult RT patients. It provides more options for maintenance treatment in RT patients.

Objective:To compare the therapeutic efficacy, safety and drug cost between generic enteric-coated mycophenolate sodium (EC-MPS) and branded EC-MPS in immunosuppressive treatment for adult recipients of renal transplantation (RT) .Methods:From January, 2022 to October, 2023, 60 adult RT patients were continuously enrolled and randomized into two groups. Patients receiving generic EC-MPS were selected as cohort 1 (n=30) while those taking branded EC-MPS designated as cohort 2 (n=30). Hepatic/renal function, blood routine parameters, drug concentrations, adverse events (AEs) and drug costs were recorded and compared between two cohorts at baseline (<3 days before/after day of RT, W0), week 1 (W1), week 4 (W4), week 8 (W8), week 12 (W12) and week 24 (W24) post-RT.Results:Only urine protein was elevated at W24[0.4 (0-0.6) vs 0 (0-0.2) g/24 h, P=0.049]in cohort 1 as compared with cohort 2. Aspartate aminotransferase at W12 (15.6±3.3 vs 20.3±9.7 U/L, P=0.010), leucocyte count at W1 (8.4±2.3 vs 10.1±3.8 ×10 9/L, P=0.045) and platelet count at W1 (158.5±51.5 vs 185.8±46.8 ×10 9/L, P=0.036) all declined in cohort 1 as compared with cohort 2. However, these parameters at other timepoints did not vary between two cohorts (all P>0.050). In addition, blood concentration of MPS after dosing, area under the concentration-time curve and trough concentration of tacrolimus at different timepoints were not different between two cohorts (all P>0.050). Similarly, helper T cells (Th), suppressor T cells (Ts), Th/Ts and B cells at W4/12 did not vary between two cohorts (all P>0.050). Concerning drug cost, no difference existed in the number of tablets or length of stay between two cohorts (both P>0.050). However, cost of EC-MPS (￥1 333.5±419.6 vs ￥2 368.6±596.0, P<0.001) and total cost during hospitalization (￥96 403.3±29 159.8 vs ￥117 062.8±28 782.1, P=0.001) were lower in cohort 1 than cohort 2. The most common AEs in cohort 1 included acid regurgitation (n=19, 63.3%), hypoalbuminemia (n=16, 53.3%), anemia (n=12, 40.0%) and hypokalemia (n=11, 36.7%). And the most common AEs in cohort 2 included acid regurgitation (n=20, 66.7%), anemia (n=14, 46.7%) and hypoalbuminemia (n=9, 30.0%). Notably, the incidence of all AEs was not different between two cohorts (all P>0.050) . Conclusion:Generic EC-MPS has comparable therapeutic efficacy and safety profile with lower drug cost in adult RT patients. It provides more options for maintenance treatment in RT patients.

OBJECTIVE: To study the chemical constituents of the roots of Angelica dahurica, a well-known Chinese herbal medicine named Baizhi in Chinese. METHODS: Compounds were separated by various chromatographies, and the structures of new compounds were elucidated based on the analysis of their spectroscopic and spectrometric data (1D, 2D NMR, HRESI MS, IR, and UV). The absolute configurations of new compounds were determined by the calculated electronic circular dichroism and chemical derivatization. The inhibitory activities of all isolates against nitric oxide (NO) production were evaluated using lipopolysaccharide-activated RAW 264.7 macrophage cells. RESULTS: Seven new 3,4-dihydro-furanocoumarin derivatives ( 1a/ 1b, 2a/ 2b, 3a/ 3b, 4) together with a known furanocoumarin ( 5) were isolated from the roots of A. dahurica. The new compounds included three pairs of enantiomers, (4S, 2''R)-angelicadin A ( 1a)/(4R, 2''S)-angelicadin A ( 1b), (4S, 2''S)-angelicadin A ( 2a)/(4R, 2''R)-angelicadin A ( 2b), and (4S, 2''S)-secoangelicadin A ( 3a)/(4R, 2''R)-secoangelicadin A ( 3b), together with (4R, 2''R)-secoangelicadin A methyl ester ( 4). The known xanthotoxol ( 5) inhibited the NO production with the half-maximal inhibitory concentration (IC₅₀) value of (32.8 ± 0.8) µmol/L, but all the new compounds showed no inhibitory activities at the concentration of 100 µmol/L. CONCLUSION This is the first report of the discovery of 3,4-dihydro-furanocoumarins from A. dahurica. The results are not only meaningful for the understanding of the chemical constituents of A. dahurica, but also enrich the reservoir of natural products.

A 37-year-old male patient was treated with tacrolimus, sirolimus, and methylprednisolone after renal transplantation to prevent rejection reaction. The function of the transplanted kidney recovered, serum creatinine was about 130 μmol/L, and serum uric acid was about 350 μmol/L. After 2 years and 6 months of renal transplantation, sirolimus was switched to mizolibin due to edema of his lower extremities. After taking mizolibin for 21 days, the patient developed nausea, poor appetite, and decreased urine volume (1 500 ml/24 h), and the symptoms gradually worsened. Laboratory tests showed serum creatinine 635 μmol/L and serum uric acid 1 750 μmol/L. The color Doppler ultrasonography of the transplanted kidney showed multiple stones and decreased color of blood flow signal. Acute renal failure, hyperuricemia, and calculus in transplanted kidney were diagnosed. Considering that it was related to mizolibin, the drug was discontinued and replaced by sirolimus, and hemodialysis, uric acid lowering, alkalizing urine, and other treatments were given. After 6 days of mizolibin discontinuation, the patient had no nausea or poor appetite. His urine volume was 3 000 ml/24 h, serum creatinine was 247 μmol/L and serum uric acid was 207 μmol/L. The color Doppler ultrasonography of the transplanted kidney showed no stone with abundant colorful blood flow signals. After 13 days of mizolibin discontinuation, the serum creatinine was 156 μmol/L and the serum uric acid was 123 μmol/L.

A 37-year-old male patient was treated with tacrolimus, sirolimus, and methylprednisolone after renal transplantation to prevent rejection reaction. The function of the transplanted kidney recovered, serum creatinine was about 130 μmol/L, and serum uric acid was about 350 μmol/L. After 2 years and 6 months of renal transplantation, sirolimus was switched to mizolibin due to edema of his lower extremities. After taking mizolibin for 21 days, the patient developed nausea, poor appetite, and decreased urine volume (1 500 ml/24 h), and the symptoms gradually worsened. Laboratory tests showed serum creatinine 635 μmol/L and serum uric acid 1 750 μmol/L. The color Doppler ultrasonography of the transplanted kidney showed multiple stones and decreased color of blood flow signal. Acute renal failure, hyperuricemia, and calculus in transplanted kidney were diagnosed. Considering that it was related to mizolibin, the drug was discontinued and replaced by sirolimus, and hemodialysis, uric acid lowering, alkalizing urine, and other treatments were given. After 6 days of mizolibin discontinuation, the patient had no nausea or poor appetite. His urine volume was 3 000 ml/24 h, serum creatinine was 247 μmol/L and serum uric acid was 207 μmol/L. The color Doppler ultrasonography of the transplanted kidney showed no stone with abundant colorful blood flow signals. After 13 days of mizolibin discontinuation, the serum creatinine was 156 μmol/L and the serum uric acid was 123 μmol/L.

BACKGROUND: The anti-tumor effect of pigment epithelium-derived factor (PEDF) has been widely confirmed. However, the anti-tumor effect of its peptides is rarely reported. This study aims to investigate the effects of PEDF and its peptides on the apoptosis and migration of non-small cell lung cancer (NSCLC). METHODS: In this study, A549 cells and H1299 cells were selected as the research object, and the cells were divided into normal group, PEDF treatment group, 34 peptide treatment group, 44 peptide treatment group and 34+44 peptide treatment group by administering different drugs at the same concentration to the cells. The proliferation activity of cells in each group was detected by CCK-8 method; the migration ability of cells was detected by scratch test; the expression levels of apoptosis related proteins such as protein kinase 3 (RIP3) and cleaved-caspase-3 were detected by Western blot; the expression levels of epithelial mesenchymal transition (EMT) markers in each group, such as cadherin (E-cadherin) and α-smooth muscle actin (α-SMA) were detected by Western blot; the apoptosis rate of each group was detected by flow cytometry. RESULTS: The results of CCK-8 showed that PEDF and its peptides could inhibit cell proliferation, and the inhibitory effect of 34+44 peptide was the strongest (P<0.05); Observation under the microscope found that PEDF and its peptides can inhibit the proliferation and mesenchymal transformation of A549 cells and H1299 cells, and the inhibitory effect of the 34+44 peptide group is the most obvious; Western blot indicated that compared with other groups, the expressions of cleaved-caspase-3 and RIP3 in 34+44 peptide group were significantly higher (P<0.05), and the expressions of EMT protein E-cadherin were higher, the expression of α-SMA decreased (P<0.05); The results of flow cytometry showed that the apoptosis rate of 34+44 peptide group was significantly higher than those of other groups (P<0.05); The scratch test showed that compared with all the other groups, the healing rate of 34+44 peptide group was the lowest (P<0.05). CONCLUSIONS 34+44 combination peptide can better promote the apoptosis of NSCLC, inhibit the migration of NSCLC, and thereby inhibit the growth of NSCLC.
Apoptosis ; Cadherins/genetics* ; Carcinoma, Non-Small-Cell Lung/genetics* ; Caspase 3 ; Cell Line, Tumor ; Cell Movement ; Cell Proliferation ; Epithelial-Mesenchymal Transition ; Eye Proteins ; Humans ; Lung Neoplasms/genetics* ; Nerve Growth Factors ; Peptides/pharmacology* ; Serpins ; Sincalide

With the aging of population, cerebral small vessel disease has attracted more and more attention. A growing body of literature has confirmed that retinal vascular changes can be used as a potential marker for the prediction of cerebral small vessel disease. The retina is recognized as a window into cerebrovascular and systemic vascular conditions. Combining traditional fundus photograph and fundus fluorescein angiography with optical coherence tomography angiography, the retinal vascular system of patients with cerebral small vessel disease can be comprehensively analyzed. This paper summarizes and analyzes the application of retinal angiography technology in different image types of cerebral small vessel disease and makes a review, in order to provide reference for the early diagnosis and prevention of cerebral small vessel disease.

Objective:To explore the surgical indications, techniques and methods of closed reduction and minimally invasive fixation for the treatment of pelvic fractures of Tile C2 and C3, and evaluate the clinical efficacy.Methods:A retrospective analysis of the data of 20 cases with Tile C2 and C3 pelvic fractures treated with closed reduction and minimally invasive fixation from January 2016 to July 2019. There were 7 males and 13 female, with an average age of 35.6±14.6 years (range 12-60 years). The time from injury to operation was 5-30 d, with an average of 19.3±7.1 d. Tile classification of pelvic fracture: 13 cases of C2 type and 7 cases of C3 Type. 2 cases were complicated with ipsilateral or bilateral lumbosacral nerve injury. Classification of nerve injury: 2 cases were partial injury, British Medical Research Council (BMRC) Grade M3. The operation is treated with closed reduction and minimally invasive fixation. First, the side with obvious displacement is fixed on the operating table with a pelvic reduction frame, and the side with less displacement is traction. After reduction, insert S 1 and S 2 sacroiliac screw guide-pin on this side to the contralateral sacral fracture. And then change the traction, fix the reset side on the operating table, change the side with obvious traction displacement, after the reset is ideal, pass the inserted guide-pin through the contralateral sacroiliac joint to the outer iliactable. Then insert the sacroiliac screw. The patients complicated with acetabular fracture were reduced and fixed by the corresponding approach, and the anterior ring was fixed by INFIX. The operation time, intraoperative bleeding volume and postoperative complications were recorded. The quality of fracture reduction was evaluated by Matta's criteria, and the clinical effect was evaluated by Majeed score. Results:All the 20 patients successfully completed the operation. The operation time was 105-210 min, with an average of 167.00±31.21 min. The intraoperative bleeding volume was 30-100 ml, with an average of 82.00±5.36 ml. Postoperative X-ray and CT showed that the fracture was reduced and fixed. According to the Matta's criteria, the reduction quality was rated as excellent in 14 cases, good in 4 case, fair in 2 case, with an excellent and good rate of 90%. Two patients showed symptoms of lateral femoral cutaneous nerve injury without other complications related to surgery. Follow-up for 1 to 4 years, the fractures healed, and the healing time was 6 to 12 weeks. According to the Majeed score, the result was rated as excellent in 18 cases, good in 2 case, with an excellent and good rate of 100%.Conclusion:Closed reduction and minimally invasive fixation for the treatment of pelvic fractures of type C2 and C3, with the characteristics of less damage and good results, will become a trend in the treatment of pelvic fractures.

Objective To analyze the effects of laparoscope-assisted Ivor-Lewis surgery on perioperative stress,immune responses and intestinal barrier function in elderly patients with esophageal cancer.Methods A prospective study including 55 elderly esophageal cancer patients undergoing laparoscope-assisted Ivor Lewis surgery (the treatment group,n =25) and Ivor-Lewis surgery(the control group,n=25) was conducted.The white blood cell count,neutrophil-to-lymphocyte ratio,percentages of CD4 and CD8 cells,CD4/CD8 ratio,C reactive protein (CRP) and D-lactic acid levels were compared between the two groups before and at 1,4 and 7 d after operation.Results The white blood cell count(t =2.689,P =0.010) and neutrophil-to-lymphocyte ratio (t =3.300,P =0.002)were lower in the treatment group than in the control group at 1 d after operation.The percentage of CD4 cells was higher in the treatment group than in the control group at 1 d(t =2.242,P =0.029)and 4 d(t =2.031,P =0.047) after operation.The percentage of CD8 cells was higher in the treatment group than in the control group at 1 d after operation(t =2.041,P=0.046).The CD4/CD8 ratio was higher in the treatment group than in the control group at 1 d(t =2.833,P =0.007)and 4 d(t=2.111,P=0.036)after operation.The CRP level was lower in the treatment group than in the control group at 1 d(t=2.267,P=0.028)and 4 d(t =2.111,P =0.036)after operation.The D-lactic acid level was lower in the treatment group than in the control group at 1 d(t =2.267,P=0.028),4 d (t =7.967,P ＜ 0.01) and 7 d (t =2.541,P =0.014) after operation.Conclusions Laparoscopeassisted Ivor-Lewis surgery has good protective effects on perioperative stress,immune responses and intestinal barrier function in elderly patients with esophageal cancer.