Objective This study aimed to develop an experimental animal platform for evaluating the feasibility and safety of intelligent acupuncture robots and to lay the foundation for further research.Methods Six 2-month-old Guangxi Bama miniature pigs were used as experimental subjects for acupuncture verification after anesthesia.First,manual acupuncture verification was carried out.Six acupoints were selected for each experimental animal and the needles were left for 20 min after the lifting,inserting,and twisting manipulation.Before and after controls were included.The experiment was carried out for 28 days,and each experiment was conducted once every 2 days for a total of 10 times.After verification of manual acupuncture,a point 10 mm from each of the six selected acupoints was selected,with a total of 12 points,and acupuncture operations were carried out on the experimental animals using the intelligent acupuncture module of the acupuncture robot at different frequencies and angles,to further verify the stability and feasibility of the animal platform.Results Routine safety-related blood indicators and blood biochemistry indicators after the procedure were normal and stable compared with those before the procedure.The average heart rate of the animals was 124 beats/min,the average blood pressure was 87/36 mmHg,and the average body temperature of was 36℃at a room temperature of 25℃,with no significant change in body temperature during and after the experiment.On the basis of this experimental platform,acupuncture manipulation using the intelligent acupuncture module of the acupuncture robot was completed successfully,with no abnormalities related to acupuncture such as bending,breaking,or stagnation of needles during the experimental process,and the experimental animals showed no obvious abnormalities.Conclusions This study established a stable experimental animal platform for evaluating the feasibility and safety of acupuncture carried out by intelligent acupuncture robots,based on the existing experimental method of miniature pigs.These result lay a foundation for further research related to the use of intelligent acupuncture robots.

Objective:To analyze the intervention effect of rehabilitation platform-based online psycho-education on patients with bipolar disorder (BD) in remission stage.Methods:In this randomized controlled study, 91 patients with BD in remission stage who attended the community health center in Xicheng District, Beijing from July to August 2021 were randomly divided into a test group (46 cases) and a control group (45 cases) according to a 1∶1 ratio using the random number table. Baseline data were collected from both groups, and the control group received conventional medication and community telephone follow-up, while the test group was given online mental health education in the form of a WeChat subscription number on this basis, including BD mental health education course push (twice a week) and disease self-management (daily recording of mood, sleep, medication, exercise and gratitude diary), and the intervention period was 6 months in both groups. During the intervention, one patient in the test group was admitted to hospital due to exacerbation of mental illness and the trial was terminated. A total of 90 cases were included in the study. The scores of Medication Adherence Rating Scale (MARS), Hamilton Depression Scale (HAMD), Young Mania Rating Scale (YMRS) and Perceived Devaluation-Discrimination Scale (PDD) were assessed at baseline, after 3 months and 6 months of intervention in both groups, respectively. And the differences in baseline data between the two groups were compared using two independent samples t test and χ2 test, and the repeated-measures ANOVA was used to compare the differences in MARS, HAMD, YMRS, and PDD scores between the two groups before and after the intervention, and to analyze the intervention effects of network mental health education based on the rehabilitation platform on patients in remission stage of BD. Results:After 6 months of intervention, MARS scores in the test group was significantly higher than that in the control group [(8.47±1.75) vs (7.47±1.85)], and was significantly higher than that at baseline (7.36±2.13) and after 3 months of intervention (8.04±1.68) (all P<0.05). YMRS and PDD scores in the test group were significantly lower than those at baseline after 3 and 6 months of intervention [YMRS, 2.0(1.0,4.0),2.0(0,3.0) vs 3.0(1.0,5.5); PDD, (31.18±4.65), (30.13±4.76) vs (32.51±4.51)] (all P<0.05); the differences in YMRS and PDD scores in the control group were not statistically significant (all P>0.05). There was no statistically significant difference in HAMD scores between the two groups before and after the intervention (all P>0.05). Conclusion:Combining mental health education based on rehabilitation platform with conventional medication and community management can significantly improve the medication compliance of patients with BD in remission stage, and improve their manic symptoms and reduce the stigma of the disease.

The research on risk factors for stroke is of great significance for the early identification of high-risk groups and the improvement of prognosis. Studies have confirmed that insulin resistance （IR） is an independent risk factor for cerebrovascular diseases. Triglyceride-glucose （TyG） index has a great potential value as a simple and reliable alternative index for IR. A relatively high TyG index is associated with increases in atherosclerosis， carotid intima-media thickness， carotid plaque instability， and the incidence rate of cardiovascular diseases. A large number of evidence has proved that TyG index can predict the risk of ischemic stroke. TyG index is independently associated with the adverse clinical outcomes of ischemic stroke， which can aggravate the deterioration of the nervous system during hospitalization and cause the recurrence of ischemic stroke. Individuals with a high TyG index are more likely to develop cerebrovascular diseases， and a potential linear dose-response relationship is observed. This article systematically summarizes the evidence for the association between TyG index and stroke and discusses the value of TyG in optimizing the risk stratification of ischemic stroke.

Objective:To compare the effectiveness and recurrence rate of different types of mesh or without mesh in laparoscopic hiatal hernia repair.Methods:From Jan 2016 to Mar 2022 at the three hospital 90 patients with hiatal hernia, including 26 cases without mesh, 29 cases using synthetic mesh, and 35 cases using biological mesh underwent laparoscopic hiatal hernia repair.Results:The surgical procedures was successful in all the 90 cases without conversion to open surgeny. There were no statistically significant differences in operative time, intraoperative blood loss and postoperative hospital stay among the three groups ( P>0.05), and there were statistically significant differences in hospital cost between the group without mesh and synthetic mesh and biological mesh ( P<0.05). Long-term follow-up was achieved in 87 patients, with a follow-up rate of 96.7% (87/90), and a median follow-up time of 44 months. There were no significant differences in the incidence of postoperative complications (diarrhea, dysphagia, abdominal distension, chest pain), recurrence rate of symptoms (acid reflux, heartburn) and patient satisfaction among the three groups ( P>0.05). Conclusion:In laparoscopic hiatal hernia repair, the mesh should be carefully selected according to the specific intraoperative situation for a satisfactory clinical efficacy.

Objective:To evaluate the visibility of intracranial deep medullary vein (DMV) by sensitivity weighted imaging (SWI), and explore its correlation with recent small subcortical infarct (RSSI).Methods:From March 2021 to May 2022, 277 patients with cerebral small vascular disease (CSVD) confirmed by cranial MRI in Department of Neurology, Third Hospital of Hebei Medical University, were consecutively enrolled. These patients were divided into RSSI group ( n=128) and non-RSSI group ( n=149) according to RSSI presence or not within one week of onset. According to the DMV scores, these patients were divided into mild-moderate DMV group (0-12 scores, n=199) and severe DMV group (13-18 scores, n=78). The clinical and imaging data of these groups were analyzed retrospectively and compared. Multivariate Logistic regression analysis was used to determine the correlation between DMV and RSSI, as well as the independent influencing factors for DMV grading. Results:The cerebral microbleed (CMB), periventricular white matter hyperintensity (WMH) scores, deep WMH scores, total WMH scores, total CSVD burden scores, and DMV scores in patients of the RSSI group were significantly higher than those in the non-RSSI group ( P<0.05); and patients in the RSSI group had significantly younger age and significantly lower high density lipoprotein cholesterol (HDL-C) level than those in the non-RSSI group ( P<0.05). Multivariate Logistic regression analysis showed that DMV score ( OR=1.142, 95%CI: 1.026-1.271, P=0.016) was an independent influencing factor for RSSI after adjusting for HDL-C and deep WMH scores. The severe DMV group had significantly older age, statistically higher percentages of patients having history of hypertension, CMB, lacuna and moderate to severe EPVS in basal ganglia, and significantly higher periventricular WMH scores, deep WMH scores, total WMH scores, and total CSVD burden scores as compared with the mild-moderate DMV group ( P<0.05). Multivariate Logistic regression analysis showed that age ( OR=1.101, 95%CI: 1.060-1.143, P<0.001) and total CSVD burden scores ( OR=3.589, 95%CI: 2.506-5.141, P<0.001) were independent influencing factors for DMV scores. Conclusion:DMV is involved in the mechanism of RSSI, and DMV visibility can be used as an indicator to diagnose RSSI and evaluate RSSI progression.

Objective:To investigate the damaging traits of cognitive function in late-onset depression.Methods:In this cross-sectional study,30 elderly out-and in-patients whose first onset of major depression occurred at 60 years of age and older were included as the case group,and 30 age-and gender-matched normal elderly people were included as the controls.The diagnoses of moderate to severe depressive episode or recurrent depression were made according to the International Statistical Classification of Diseases and Related Health Problems,Tenth Revision (ICD-10) diagnostic criteria.The Wisconsin Card Sorting Test (WCST),Stroop Test and Verbal Fluency Test (VFT) were used to assess attentional set shifting,attentional inhibition and working memory.The severity of depression was evaluated with the Hamilton Depression Scale-17(HAMD-17).Results:The performance scores of errors,perseverative responses,perseverative errors,percent of perseverative errors in the WCST were significantly higher in the patient group then in the control group[(61 ± 23) vs.(41 ± 25),(44 ± 27) vs.(27± 19),(36 ± 20) vs.(23 ± 16),(28 ± 15) vs.(19 ± 11),P ＜ 0.01].The scores of conceptual level responses [(36±24) vs.(54 ±26)],the correct scores of consistent group in Stroop test[(19 ±3) vs.(20 ±2)] and the scores of VFT in WCST[(10 ±2) vs.(11 ±2)] were lower in the patient group than in the control group (Ps ＜0.01).The scores of perseverative responses in the WCST were positively correlated with retardation factor scores(r =0.38,P ＜ 0.05).The correct scores of consistent group in the Stroop test were negatively correlated with retardation factor scores(r =-0.41,P ＜ 0.05).The scores of VFT were negatively correlated with retardation factor scores(r =-0.52,P ＜ 0.01).Conclusion:There may be impairment of cognitive function in late-onset depression,especially severe executive dysfunction.

Objective To explore the effect of citalopram on tau phosphorylation and memory defi-cits induced by social isolation (SI) in adult rats.Methods Sixty Sprague-Dawley adult rats (8 months) were grouped or isolation reared for six-weeks.Following the initial two-week period of rearing, citalopram ( 10 mg/kg,i.p.) was administered for 4 weeks.Novel object recognition test,Western blot and ELISA were used to detect recognitive function,the levels of tau and GSK-3βprotein,and melatonin level respectively. Results In the novel object recognition test,compared with the citalopram group(0.71±0.05) and housed group(0.73±0.13),discrimination ratio(0.48±0.15) in SI group was significant decreased (P<0.05).Tau hyperphosphorylation at Tau-1 ((0.88±0.11)),Ser396 (3.94±0.74) episodes were found and almost re-versed by citalopram at Tau-1 (1.56±0.17),Ser396 (2.31±0.24) episodes in SI group.Compared with GH group,the total level of GSK-3β(1.12±0.09) was significantly increased,while the level of Ser9-phosphoryl-ated GSK-3β(inactive form) (0.47±0.11) was significantly decreased in the SI group,both of which were reversed by citalopram (GSK-3β(0.87±0.08) and Ser9-phosphorylated GSK-3β(0.80±0.07)).The me-latonin level was decreased in SI group ((359.54±18.80)pg/ml),and citalopram could partly restore the level of melatonin (418.15±18.72)pg/ml, P<0.05).Conclusion The results demonstrate that citalopram increases the level of melatonin which negatively regulates GSK-3βand attenuates tau hyperphosphorylation and memory deficits induced by SI in adult rats.

Objective:To evaluate the validity and reliability of the Problem Area in Diabetes Scale (PAID) for assessing diabetes-related distress in patients with type 2 diabetes. Methods:Totally 203 outpatients with type 2 diabetes from a tertiary hospital in Beijing were selected. They were assessed with PAID,Hamilton Depression Scale (HAMD-17),Patient Health Questionaire-9(PHQ-9),World Health Organization Five item Well-Being Index (WHO-5 ),Mini-International Neuropsychiatric Interview (MINI)and HbA1 C. Item analysis and exploratory factoranalysis were conducted to test constructive validity. Concurrent validity was evaluated by the correlation coeffi-cients with the other instruments mentioned above. Totally 3 1 subjects were retested 4 weeks later to obtain the test-retest reliability. Results:Exploratory factor analysis produced 4 factors,including emotional,therapeutic,diet and perceived society support problems specific to diabetics. The total variance contribution ratio was 64. 33%. Except i-tem 7 and 20,no item was across two factors. The correlation coefficients of each item with relevant subscale score ranged from 0. 67 to 0. 86. The PAID scores were positively correlated with the scores of HAMD-17,PHQ-9 and HbA1C (r=0. 48,0. 43,0. 21,P<0. 001 or 0. 01),and negatively correlated with WHO-5 scores (r=-0. 46,P<0. 001). The Cronbach's αcoefficients were 0. 94 for the total scale and 0. 81 -0. 88 for the 4 subscales. The test-retest reliability coefficient was 0. 65 for the total scale and 0. 53-0. 73 for the 4 subscales. Conclusion:The validi-ty and reliability of the Problem Area in Diabetes Scale are acceptable in Chinese mainland,and can be available to assess the stress related to diabetics.

OBJECTIVETo investigate the role of the PI3K/Akt signaling pathway in hydrogen sulfide-induced alterations in expression of collagen I and collagen III in hepatic stellate cells.

METHODSIn vitro cultured rat hepatic stellate cells (HSC-T6) were treated with hydrogen sulfide, or left untreated for use as controls, and divided into groups for treatment with different inhibitors for the various factors involved in the PI3K/Akt signaling pathway. Reverse transcription-PCR was used to measure Collagen I and collagen III mRNA expression. Western blotting was used to detect the protein expression of PI3K and p-Akt, which are upstream proteins of the PI3K/Akt pathway.

RESULTSCompared with the untreated control cells, the hydrogen sulfide treated cells showed elevated expression of collagen I mRNA (F =14.635, P less than 0.05), collagen III mRNA (F =14.620, P less than 0.05), PI3K protein (F =26.672, P less than 0.05), and p-Akt (F =23.522, P less than 0.05). Compared to the cells treated with hydrogen sulfide alone, the cells treated with the various inhibitors showed lower expression of collagen I mRNA (F =14.635, P less than 0.05), collagen III mRNA (F=14.620, P less than 0.05), PI3K protein (F =26.672, P less than 0.05), and p-Akt protein (F =23.522, P less than 0.05).

CONCLUSIONHydrogen sulfide can activate the PI3K/Akt pathway and elevate the expression of collagen I and collagen III in rat hepatic stellate cells.

Animals ; Cells, Cultured ; Collagen Type I ; metabolism ; Collagen Type III ; metabolism ; Hepatic Stellate Cells ; drug effects ; metabolism ; Hydrogen Sulfide ; pharmacology ; Phosphatidylinositol 3-Kinases ; metabolism ; Proto-Oncogene Proteins c-akt ; metabolism ; RNA, Messenger ; genetics ; Rats ; Signal Transduction

Objective To explore the influence of icotinib in the apoptosis of the human salivary adenoid cystic carcinoma cells ACC-M, and to clarify the mechanism of icotinib for the treatment of salivary adenoid cystic carcinoma.Methods The ACC-M cells were randomly divided into control group,2,4,8μmo1·L-1 icotinib groups,p38-MAPK inhibitor SB203580 (20μmol· L-1 )group,SB203580 (20 μmol· L-1 )+4μmo1 · L-1 icotinib group;the cells were collected 4 h after treatment.The viability of ACC-M cells was measured by MTT assay.The apoptosis of ACC-M cells was assessed by caspase-3 activity kit. The expression of p-p38-MAPK protein was determined by Western blotting analysis.Results Compared with control group,the inhibitory rates of growth of the ACC-M cells in icotinib groups were significantly decreased (P<0.05 ), and the activities of caspase-3 were increased (P<0.05),and the expression levels of p-p38-MAPK were significantly increased (P<0.05).Compared with 4μmo1·L-1 icotinib group,the expression level of p-p38-MAPK in SB203580+icotinib group were decreased (P < 0.05 ), and the activity of caspase-3 was decreased dramatically (P < 0.05 ). Conclusion Icotinib may induce the apoptosis of ACC-M cells through the activation of p38-MAPK signaling pathway.