Objective: To investigate whether acupoint penetration acupuncture (APA) could regulate chondrocyte autophagy and apoptosis via the PI3K/Akt-mTOR signaling pathway to reduce cartilage degeneration in knee osteoarthritis (KOA) rats. Methods: KOA was induced in rats via intra-articular injection of sodium iodoacetate resolution. Forty male Sprague-Dawley rats were randomly assigned to blank control, model, APA, electro-acupuncture (EA), and sham model groups (n = 8) and those in the APA and EA groups received their respective therapies. Following completion of the treatment course, histological examinations of cartilage and muscle were conducted. Levels of apoptosis- and autophagy-related factors, including Bax, Bcl-2, mTOR, ULK-1, and Beclin-1 protein, and mRNAs were assessed. Additionally, β-endorphin (β-EP) concentrations in the brain and serum were measured. Results: Histological analysis revealed that APA alleviated cartilage and muscle damage compared with the model group. APA inhibited cartilage degeneration by modulating the expression of apoptosis- and autophagy-related proteins and mRNA, thus preventing chondrocyte apoptosis. In the APA group, Bax and mTOR protein levels were significantly lower than those in the model group (both P = .024). Conversely, the Bcl-2 expression level was significantly higher than that in the EA group (P = .035). Additionally, ULK-1 expression was significantly lower than that in the EA group (P = .045). The mRNA level of Bax was significantly higher than that in the blank control group (P < .001). However, Beclin-1 levels were significantly higher than those in both the model and EA groups (both P < .001). ELISA results showed a significant decrease in the concentration of β-EP in the brains of the rats in the APA group compared with those in the model group (P = .032). Conclusions APA reduced osteoarthritis-related pain and alleviated cartilage damage by upregulating chondrocyte autophagy and down-regulating apoptosis via signaling pathways involving PI3K/Akt-mTOR in KOA rats.

Objective To explore the effect and possible pharmacological mechanism of Bufei Tongbi Decoction in the treatment of systemic lupus erythematosus interstitial lung disease (SLE-ILD).Methods The effective components and related targets of Bufei Tongbi Decoction were obtained using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and Uniprot database. Key genes for SLE-ILD were screened based on DrugBank,DisGeNET,GeneCards,PharmGKB,OMIM,and GEO databases. Using Cytoscape software,a drug active ingredient-target-disease relationship network diagram was constructed to obtain the effective active ingredients and possible mechanisms of action of Bufei Tongbi Decoction in the treatment of SLE-ILD. Gene ontology (GO) function enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were used to reveal related target genes and pathway functions. Taking C57BL/6 mice as normal group,MRL/lpr mice were injected with bleomycin 5mg/kg in the nasal cavity. According to the random number table method,the mice were divided into model group,Bufei Tongbi Decoction low-dose group (10.4 g/(kg·d)),Bufei Tongbi Decoction medium-dose group (20.8 g/(kg·d)),Bufei Tongbi Decoction high-dose group (41.6 g/(kg·d)) and prednisone group (3 mg/(kg·d)). The intervention lasted for 28 days. Hematein eosin and Masson staining were used to observe the pathological changes of mouse lung tissue,the expressions of transforming growth factor-β1 (TGF-β1) and collagen type Ⅲ (Col-Ⅲ) in lung tissue were detected by immunohistochemistry,and the expressions of interleukin-1β(IL-1β),interleukin-10 (IL-10) and interleukin-17 (IL-17) in serum were detected by ELISA. The mRNA expressions of matrix metallopeptidase 1(MMP-1),hypoxia inducible factor-1α(HIF-1α),retinoid-related orphan receptor γt (RORγt ) and forkhead box P3 (FOXP3) in lung tissue were analyzed by RT-PCR,the protein expressions of HIF-1α and MMP-1 in lung tissue were detected by Western blotting,and the expressions of T helper 17 cells (Th17) and regulatory T cells (Treg cells) in blood were detected by cytometry.Results A total of 163 effective ingredients,259 targets,1729 SLE-ILD disease targets,958 SLE-ILD differential genes and 40 drug-disease interaction targets were obtained by screening. GO functional enrichment and KEGG pathway enrichment showed that IL-17 signaling pathway activated by IL-1β and MMP-1,and Th17 cell differentiation activated by IL-1β and HIF-1α were the main pathways. Animal experiments showed that Bufei Tongbi Decoction could effectively improve the degree of lung interstitial lesion and reduce the expressions of TGF-β1 and Col-Ⅲ in SLE-ILD mice (P<0.01). The expressions of IL-1β,HIF-1α and IL-17 were decreased (P<0.01). Medium and high doses of Bufei Tongbi Decoction decreased the expressions of MMP-1 and RORγt mRNA (P<0.01),and increased the expressions of IL-10 and FOXP3 mRNA (P<0.01). Bufei Tongbi Decoction could reduce the proportion of Th17 cells,increase the proportion of Treg cells,downregulate the balance of Th17/Treg (P<0.05),and improve the immune disorder. Conclusion Bufei Tongbi Decoction has the characteristics of multi-target and multi-pathway in treating SLE-ILD,and its mechanism may be related to the regulation of Th17/Treg cell balance.

Myocardial infarction (MI) has the characteristics of high mortality rate, strong suddenness and invisibility. There are problems such as the delayed diagnosis, misdiagnosis and missed diagnosis in clinical practice. Electrocardiogram (ECG) examination is the simplest and fastest way to diagnose MI. The research on MI intelligent auxiliary diagnosis based on ECG is of great significance. On the basis of the pathophysiological mechanism of MI and characteristic changes in ECG, feature point extraction and morphology recognition of ECG, along with intelligent auxiliary diagnosis method of MI based on machine learning and deep learning are all summarized. The models, datasets, the number of ECG, the number of leads, input modes, evaluation methods and effects of different methods are compared. Finally, future research directions and development trends are pointed out, including data enhancement of MI, feature points and dynamic features extraction of ECG, the generalization and clinical interpretability of models, which are expected to provide references for researchers in related fields of MI intelligent auxiliary diagnosis.
Humans ; Electrocardiography ; Myocardial Infarction/diagnosis* ; Recognition, Psychology

Objective:To investigate the effect of chimney stent for reconstruction of left subclavical artery (LSA) in thoracic endovascular aotic repair (TEVAR) for acute Stanford type B aortic dissection with insufficient anchorage zone and non-thrombotic false lumen.Methods:TEVAR with chimney stent for LSA in 39 cases of acute Stanford type B aortic dissection with insufficient anchorage zone and non-thrombotic false lumen was done from Feb 2013 to Jan 2021.Results:Covered chimney stents was used in 11 cases and bare chimney stents in 28 cases. There was no postoperative stroke, left upper limb ischemia, paraplegia, hemiplegia and death. No stent migration, reverse tear and dissection rupture were observed. One bare stent was obstructed after 18 months, and all the remaining stents were patent during follow-up. The rate of immediate type Ⅰa endoleak in covered chimney stent group and bare chimney stent group were 0(0/11) and 32.1%(9/28) respectively ( P=0.04). The distance from proximal tear to LSA in covered chimney stent group, endoleak subgroup and non-endoleak subgroup in bare chimney stent were (5.1±2.3)mm, (14.4±5.2)mm and (7.8±7.0)mm respectively ( P<0.05). False lumen thrombosis was formed in endoleak subgroup 2-8 weeks after operation, and endoleak disappeared. Conclusions:There is a correlation between immediate type Ⅰa endoleak in bare chimney stent for LSA and the distance from proximal tear to LSA, covered chimney stent can reduce the incidence of immediate type Ⅰa endoleak in TEVAR for acute Stanford type B aortic dissection with insufficient anchorage zone and non-thrombotic false lumen.

Objective Through the statistics of drug consumption in the task of Harmonious Mission -2018, sort out the process of medication supply of overseas medical services, analyze and evaluate the medication supply services. Methods Count the types and quantities of medicines consumed by marine hospitals in the Harmonious Mission-2018, analyze whether the preparation of medicines is sufficient, effective, and economically reasonable, and find way to improve the process of medicine supply in overseas medical services. Results Statistics on the consumption of drugs in the Harmonious Mission-2018 show that the number of drugs consumed accounted for 68.21% of the total kinds of medicine carried, that the total amount of drugs consumed accounted for 40.61% of the total costs of medicine carried, and that the total number of boxes of drugs consumed (the number of the smallest packages) accounted for 21.72% of the total number of boxes of medicine carried. Conclusion The medicine support services in the Harmonious Mission-2018 was sufficient and effective. But, the workflow and the processes of the services still need to be further improved.

Objective: To explore the effect of post-abortion care service based on Wechat follow-up on contraceptive compliance of multiple induced abortion patients, and to evaluate the satisfaction with PAC service. Methods: A quasi-experimental method was adopted. A total of 300 cases of induced abortion were selected in Beijing Obstetrics and Gynecology Hospital affiliated to Capital Medical University from March 2018 to March 2019, with 150 cases from eastern branch in the experimental group and 150 cases from western branch in the control group. The control group received routine nursing care and post-abortion care service based on telephone follow-up, while the experimental group received routine nursing care and post-abortion care service based on Wechat follow-up. The missing rate of follow-up, the contraceptive method and the occurrence of unexpected pregnancy within one year after operation were collected in the two groups. Patients′ follow-up compliance and nursing satisfaction were evaluated. Results: The awareness of the risk of induced abortion in the experimental group was 90.4% (120/135) higher than that in the control group 77.5% (88/111), and the difference was statistically significant (χ² value was 9.128, P=0.010). The contraceptive consciousness of the two groups was 99.3% (134/135) and 94.6% (105/135), respectively, and the difference was not statistically significant (χ² value was 3.256, P=0.071). There was a statistically significant difference in the missing rate of follow-up between the two groups in January, March, June, and December (χ² value was 13.664, P=0.003). Compared with 19.8% (22/111) in the control group, 73.3% (99/135) patients in the study group chose high-efficiency contraception, the difference was statistically significant (χ² value was 69.795, P<0.01).There were no recurring pregnancies in the experimental group within one year, compared with 6.3% (7/111) in the control group, the difference was statistically significant (χ² value was 6.630, P=0.003). In the experimental group, the participation rate of the follow-up were (95.37±12.29)%, which were higher than that in the control group (90.77±16.49)%. The difference was statistically significant (t value was 2.438, P<0.05). The overall satisfaction score of the experimental group was 26.55 ± 2.80, which was higher than that of the control group (23.66 ± 3.32). The difference was statistically significant (t value was 7.285, P <0.01). Conclusion Post-abortion care service based on Wechat follow-up could enhance patients′ compliance and satisfaction, guide patients to choose the right contraceptive methods, reduce the rate of repeated abortion and promote female reproductive health.

Eight cembrane-type diterpenoids, namely, (+)-(6)-6-hydroxyisosarcophytoxide (), (+)-(6)-6-acetoxyisosarcophytoxide (), (+)-17-hydroxyisosarcophytoxide (), sarcomililatins A-D (-), and sarcomililatol (), were isolated from the soft coral collected from Weizhou Island, Guangxi Autonomous Region, together with 2 known related analogues, (+)-isosarcophytoxide () and (+)-isosarcophine (). The structures of these compounds were elucidated by a combination of detailed spectroscopic analyses, chemical methods, and comparison with reported data. The absolute configuration of compound was established by the modified Mosher׳s method, while the absolute configurations of compounds and were assigned by electronic circular dichroism (ECD) spectroscopy and that of compound was established by time-dependent density functional theory electronic circular dichroism (TD-DFT ECD) calculation. In bioassays, compound displayed significant cytotoxicity against the human cancer cell lines human promyelocytic leukemia cells (HL-60) and human lung adenocarcinoma cells (A-549) with IC values of 0.78±0.21 and 1.26±0.80 μmol/L, respectively. Compounds and also showed moderate inhibitory effects on the TNF-induced Nuclear factor kappa B (NF-B, a therapeutical target in cancer) activation, showing IC values of 35.23±12.42 and 22.52±4.44 μmol/L, respectively.

Objective: To investigate the effect of knee-chest position on exhaust and defecation of gynecologic diseases patients after laparoscopic surgery. Methods: This quasi-experiment trail was conducted between July 2016 to May 2017, in a birth control ward at an obstetrics and gynecology hospital in Beijing, China. The study included a total of 258 patients who had gynecological benign diseases and received gynecological laparoscopic surgery. Participants were recruited in the trail by using a convenient sampling method with 130 patients who received gynecological laparoscopic surgery from July 2016 to December 2016 in the experimental group (on the basis of routine care, patients preformed a knee-chest position intervention after 6 hours of the surgery) and 128 patients who received gynecologic laparoscopic surgery between January 2017 and May 2017 in the control group (patients received a routine care). The primary end point was the postoperative anal exhaust. Results: The ambulation rate before post-operative ventilation of the experimental group was 21.5% (28/130) less than that of the control group (91.4%, 117/128). The difference was statistically significant (χ²=127.903, P<0.01). The incidence of abdominal distension after operation was 0, lower than that of the control group 7.0% (9/128), the difference was statistically significant (χ²=9.471, P<0.01). The postoperative exhaust time and defecation time of the experimental group was (8.17 ± 2.88) h,(27.86 ± 4.29) h, earlier than that of the control group, (21.24 ± 5.90) h,(38.69 ± 7.73) h, and the differences were statistically significant (t=22.580, 13.885, P<0.01). Conclusions Postoperative knee-chest position significantly improved the exhaust and defecation of patients with gynecological benign disease after laparoscopic surgery.

Nowadays,transjugular intrahepatic portosystemic shunt (TIPS) has already become the main means for the treatment of portal hypertension and its complications due to cirrhosis.The Viatorr stent that is specifically designed for TIPS has been available in China since the end of 2015,but it has not been widely used in clinical practice in China so far.At present,superimposed release dual-stent technology by using one bare stent and one covered stent,as simulation of Viatorr stent,to perform TIPS is still employed in many clinical centers in China.Dual stent technology carries unique advantages,although the long-term efficacy of dual-stent implantation technology is not as good as that of single-stent implantation technology.This paper aims to make a comprehensive review about the dual-stent technology used for TIPS,focusing on the dual-stent technique classification and advantages,the causes and the managements of postoperative shunt dysfunction,etc.so as to let this technique can be mnore effectively used in treating portal hypertension caused by cirrhosis.

AIM: To investigate the immunomodulatory effect of pachyman polysaccharides (PPS) on T helper 17 cell (Th17)/regulatory T cell (Treg) balance in the peripheral blood of systemic lupus erythematosus (SLE) patients.METHODS: The CD4+ T cells were isolated from the peripheral blood samples obtained from 45 SLE patients and 35 healthy controls enrolled in our study using magnetic bead separation method.The proportions of Th17 and Treg cells were measured by flow cytometry.The CD4+ T cells from SLE patients and healthy controls were treated with PPS.The cytoto-xicity of PPS was evaluated by detecting cell viability with MTT assay.The contents of interleukin-17 (IL-17), IL-6, IL-10 and transforming growth factor-β (TGF-β) were measured by ELISA.The expression of retinoid-related orphan receptor γt (RORγt) and forkhead box protein P3 (Foxp3) at mRNA and protein levels was determined by RT-qPCR and Western blot, respectively.RESULTS: The Th17 cells were significantly elevated, while Treg cells were obviously decreased in the SLE patients compared with the healthy control group (P<0.05).Compare with control group, the contents of IL-17 and IL-6 were decreased, while the contents of IL-10 and TGF-β were increased (P<0.05).The expression of RORγt at mRNA and protein levels was down-regulated and the expression of Foxp3 was up-regulated (P<0.05).The ratio of Th17/Treg was decreased in 100 μg/L nontoxic PPS-treated CD4+ T cells isolated from the SLE patients (P<0.05).CONCLUSION: PPS treatment inhibits Th17 cells and elevates Treg cells in the CD4+ T cells isolated from SLE patients, which may have a therapeutic effect on SLE patients.