Objective To evaluate the effectiveness and safety of acupuncture in patients with Major Depressive Disorders.Methods Search the database for relevant literature published before April 15,2023.Select randomized controlled trial that meeting the enrollment criteria,evaluate the quality of the literature and classify before meta-analysis systematic evaluation.Results 15 RCTs are included in this study,with a total of 1077 patients.The results showed that acupuncture treatment,compared with antidepressants alone,The score of Hamilton Depression Scale(HAMD)in patients with liver-qi depression disorder[MD=-0.73,95%CI(-1.22,-0.24),P<0.05],the score of TCM Syndrome Scale[MD=-1.89,95%CI(-2.35,-1.44),P<0.001],effective rate[RR=1.09,95%CI(1.03,1.153),P=0.001]and TESS score[MD=-2.76,95%CI(-3.68,-1.85),P<0.001]were statistically significant.Compared with fluoxetine hydrochloride,the effective rate of HAMD scale score was statistically significant[RR=1.07,95%CI(1.01,1.14),P<0.05].Conclusion Compared with antidepressants alone,acupuncture therapy has the advantages for the improvement of HAMD score in patients,the improvement of Traditional Chinese medicine symptoms,and significantly less adverse effects than those in the control group.Through this study,it is considered that acupuncture can be a safe and effective treatment modality.However,due to the quantity and quality of the included literature,the above conclusions still need to be verified by more high-quality clinical trials.

Objective To explore the prognostic value of serum neutrophils/lymphocytes(NLR)for first-line treatment of patients with advanced gastric cancer using programmed cell death receptor 1(PD-1)inhibitors.Methods A total of 168 patients with advanced gastric cancer who were treated with immunotherapy combined with chemotherapy in the Fourth Hospital of Qinhuangdao from January 2018 to January 2021 were selected as study subjects,and the follow-up period was terminated at January 2023.The patients'data were collected,hematological and tumor markers before the combined treatment were analyzed,and the optimal cut-off value of NLR was calculated using X-tile software.The effect of NLR expression on the survival rate of patients with advanced gastric cancer was analysed by the Kaplan-Meier survival curve.Receiver operating curve(ROC)was used to analyze the predictive value of NLR in patients with advanced gastric cancer.The related factors affecting the disease progression of patients with advanced gastric cancer were screened combined with Cox proportional risk model.Results Among 168 patients,the optimal cut-off value of serum NLR before treatment was 2.41.Patients were divided into high NLR group(NLR＞2.41,n=93)and low NLR group(NLR＜2.41,n=75).NLR was related to tumor differentiation,distant metastasis,composite positive scores of PD-L1,carcinoembryonic antigen and cancer antigen 125(P＜0.05);the effective rate in the low NLR group was significantly higher than that in the high NLR group(P＜0.05);the median progression free survival(PFS)and the overall survival(OS)of patients in the low NLR group were both longer than those in the high NLR group(PFS:P=0.006;OS:P=0.023);ROC analysis showed that the area under the curve of NLR for the prognosis of advanced gastric cancer patients was 0.740,sensitivity was 81.50％,and specificity was 69.70％;in multivariate analysis,except initial NLR value,tumor differentiation degree and distant metastasis were also independent predictors of poor prognosis in patients with advanced gastric cancer(P＜0.05).Conclusion Among patients with advanced gastric cancer who received first-line immunotherapy combined with chemotherapy,pretreatment NLR is correlated with efficacy and PFS/OS,and has high value in predicting the prognosis of immunotherapy for advanced gastric cancer.

Objective To construct and evaluate the rat model of thyroid nodule liver-qi depression syndrome with the combination of disease and syndrome,so as to lay a foundation for the exploration of the mechanism and clinical research of traditional Chinese medicine in the treatment of thyroid nodule.Methods 36 rats were randomly divided into three groups.The model was induced by chronic unpredictable mild stress(CUMS)stimulation combined with propylthiouracil(PTU).The rats in the blank group were fed with saline at the dose of 1 mL·100 g-1·d-1,and the rats in the PTU group were fed with 0.1%PTU solution at the dose of 1 mL·100 g-1·d-1.The rats in the CUMS+PTU group were fed with CUMS stimulation in a single cage and intragastric administration of 0.1%PTU solution according to the dose of 1 mL·100 g-1·d-1,and the modeling time lasted for 6 weeks.After the establishment of the model,the model of combination of disease and syndrome was evaluated comprehensively by means of animal behavior detection,ultrasonic image,apparent morphology observation,pathological staining and serum hormone index detection.Results Compared with control group and PTU group,the total distance in the open field was significantly shortened,the sucrose preference rate was significantly decreased,and the swimming suspension time was significantly prolonged in the CUMS+PTU group,showing obvious symptoms of liver qi stagnation.In addition,compared with the other two groups,the thyroid gland of CUMS+PTU group showed obvious enlargement and nodule formation,thyroid index significantly increased,and thyroid follicular epithelial cells showed a high phase of proliferation.In terms of hormone levels,compared with control group,the serum levels of free triiodothyronine(FT3)and free thyroxine(FT4)in CUMS+PTU group were significantly lower,while the level of thyroid stimulating hormone(TSH)was significantly higher,which was in line with the current evaluation criteria of thyroid nodule model.Conclusion The method of CUMS stimulation combined with PTU drug induction can successfully prepare the rat model of thyroid nodule liver-qi depression syndrome,and the comprehensive evaluation method is stable and reliable,which is helpful to improve the scientific nature of the disease-syndrome combination model.

Medical imaging is an important auxiliary means of disease diagnosis. In the process of diagnosis, diseases are usually presented in a static way, which is one of the characteristics of imaging diagnosis. However, this static representation of diseases imposes certain limitations, which can, to some extent, lead to the loss of medical humanities. Therefore, it is very important for imaging diagnostic doctors to correctly use philosophical thinking to understand, analyze, and solve problems. The reinforcement of philosophical thinking in imaging diagnosis entails commitment to the "patient-centered" perspective in medicine as well as the integration of comprehensiveness, regularity, and proactivity. This not only effectively trains the diagnostic thinking of imaging diagnostic doctors but also improves their humanistic quality, thereby addressing the problems associated with these limitations. This allows the diagnosis to be both technically accurate and emotionally attuned.

Disclosure ; Genetic Counseling ; Genetic Testing ; United States

Objective To compare the effects of different right ventricular pacing sites on left ventricle systolic function in elderly patients with sick sinus syndrome (SSS).Methods A total of 78 elderly patients with SSS were selected in our hospital from 2014 to 2016,and were divided into the right ventricular apical group (RVA group,40 cases) and right ventricular outflow tract group (RVOT group,38 cases) according to sites of right ventrieular pacing.The QRS duration,accumulative total right ventricular pacing percentage and left ventricle function indicators were compared between the two groups before operation and 3,9 months after operation.Results There was no statistically significant difference in QRS duration and left ventricle function indicators before operation between the two groups (P＞0.05).The QRS durations in the RVA group at 3,9 months after operation were longer than those in the RVOT group,there were statistically significant differences (P＜0.05).No statistically significant difference was found in accumulative total right ventricular pacing percentage at 9 months after operation between the two groups (P＞ 0.05).At 9 months after operation,the left ventricular ejection fraction in the RVOT group was higher than that in the RVA group,and the left ventricular end diastolic diameter was lower than that in the RVA group,there were statistically significant differences (P＜0.05).Conclusion The effects of RVOT pacing on left ventricle systolic function in elderly patients with SSS is superior to the RVA pacing.

Objective To compare the curative effect and safety of non-X-ray fluoroscopic radiofrequency catheter ablation and conventional X-ray fluoroscopic radiofrequency catheter ablation in treating paroxysmal supraventricular tachycardia by Ensite Velocity three-dimensional electroanatomical mapping system.Methods One hundred cases diagnosed as paroxysmal supraventricular tachycardia in this hospital during 2014-2016 were selected and randomly divided into the control group (conventional X-ray exposure) and the experimental group(non-X-ray exposure by three-dimensional electroanatomical mapping system),50 cases in each group.The operation time,X-ray exposure time,complication rate,immediate and follow-up success rate were compared between two groups.Results There was no statistically significant difference in the operation time between the two groups (P＞0.05),but the X-ray exposure time in the experimental group [(0.46±0.14) min] was significantly lower than that of the control group [(13.87 ±4.03) min] and the complication rate (0 ％) was also significantly lower than that of the control group (8.00％);the immediate success rate (98.00 ％) was significantly was significantly decreased compared with the control group[(0.46± 0.14)min vs.(13.87 ±4.03)min],the complication rate was significantly lower than that in the control group(0 ％ vs.8 ％),the immediate success rate was significantly higher than that in the control group(98.00 ％ vs.84.00 ％),the follow up success rate was also significantly higher than that in the control group (94.00 ％ vs.74.00 ％),the differences were statistically significant (P＜0.05).Conclusion Using Ensite Velocity three-dimensional electroanatomical mapping system to conduct radiofrequency catheter ablation has an ideal clinical effect in the treatment of paroxysmal supraventricular tachycardia,which is safe and reliable.

Objective To study the expression of metastasic suppressor gene( KAI1 / CD82)and cell adhesion molecules(CD44v6)in human laryngeal squamous cell carcinoma(LSCC),precancerous lesion,polyps,and normal mucosa. Methods Immunohistochemical technique( Envision)was used to detect the expression of KAI1 / CD82 protein and CD44v6 protein in 64 cases of LSCC,21 cases of laryngeal precancerous lesion(LPL),15 cases of polyp of larynx(LP)and 15 cases of normal laryngeal mucosa(NLM). Results The result turned out to be as follows:①KAI1 / CD82 protein was highly expressed in NLM and LP,and lowly expressed in LPL and LSCC,the positive rates of KAI1 / CD82 protein expression were 86. 67%(13 / 15),80. 00%(12 / 15),38. 10%(8 / 21)and 37. 50%(24 /64),respectively. There was statistically significant difference in NLM and LSCC. ② CD44v6 protein was lowly ex-pressed in NLM and LP and highly expressed in LPL and LSCC,the positive rates of CD44v6 protein expression were 26. 67%(4 / 15),33. 33%(5 / 15),80. 95%(17 / 21)and 75. 00%(48 / 64),respectively. There was statisti-cally significant difference in NLM and LSCC. Conclusion ① The down-regulation or deletion of KAI1 / CD82 and the up-regulation of CD44v6 are related to carcinogenesis,development of LSCC. ② The combined detection of KAI1 / CD82 and CD44v6 may provide clinical basis for the early diagnosis of LSCC.

This paper was aimed to analyze the theoretical connotation with liver bodyyin with function yang, and to explain the physiological and pathological mechanism of body yin and function yang, respectively. The mechanism of its corresponding syndrome and symptoms were described and the composing principle of classical prescription for liver regulation was analyzed. The clinical significance of liver body yin with function yangwas confirmed by clinical cases. This paper argued that the liver ascending characteristics, which is a necessary guarantee for ascendingqi in the human body to adapt to the ascending gas of the world, is the key point to maintain balance of qi ascending and descending in the body. The liver ascending disorder mainly manifested for the excessive ascending and ascending deficiency, which analyzed the pathogenesis characteristic and clinical manifestation of the liver qi ascending disorder. This paper put forward a new view that the liver storing blood referred to the convergence and the conservation properties of the liver, which demonstrated the relationship between liver storing blood and controlling dispersion. It suggested that liver blood convergences liverqi so as not to make liverqi too excessive. The liver storing blood can raise spirit. Liver blood is the source of menstruation, and etc. This paper finally put forward the clinical prescription viewpoint of soothing liver and dropping inverse should raiseyin and gentle liver necessarily, releasing liver should raise liver and nourish blood and clearing away the liver-fire should cool blood and nourishyin. This research had certain clinical value.

Purpose To study the expression of metastasis suppressor gene (KAI1/CD82) and cell adhesion molecules(CD44v6) in human laryngeal squamous cell carcinoma ( LSCC) and its clinical significance, and to investigate their relationship. Methods EnVi-sion immunohistochemistry was used to detect the expression of KAI1/CD82 and CD44v6 protein in 64 cases of LSCC tissues and 15 ca-ses of normal laryngeal mucosa ( NLM) tissues. Results The positive rate of KAI1/CD82 in LSCC tissues ( 37. 50%) was signifi-cantly lower than that of the NLM tissues(86. 67%) (P=0. 031), and the positive rate of CD44v6 in LSCC tissues(75. 00%) was significantly higher than that of the NLM tissues(26. 67%) (P=0. 011). The expression of KAI1/CD82 was associated with clinical stages, grade of tumor differentiation, neck lymph node metastasis ( P<0. 05 ) while not related with age, sex and prognosis ( P>0. 05). And CD44v6 with grade of tumor differentiation, neck lymph node metastasis and prognosis (P<0. 05), but not with age, sex and clinical stages (P>0. 05). In addition, KAI1/CD82 expression was negatively correlated with CD44v6 expression (rs = -0. 504, P=0. 036). Conclusion KAI1/CD82 and CD44v6 are mutually inhibited in the tumorigenesis, progress, invasion and metastasis, and detection of the expression of KAI1/CD82 and CD44v6 may be helpful for judging the biological behaviors of LSCC.