Objective:To observe the effects of liver-soothing spirit-regulating acupuncture on the behaviors and expression levels of 5-hydroxytryptamine receptor 1A(5-HT1AR)and 5-hydroxytryptamine receptor 2A(5-HT2AR)in the hippocampus of insomnia rats due to liver Qi stagnation. Methods:Ten of the 70 Wistar rats were randomly selected as the blank group,and the remaining rats were subjected to preparing the insomnia model due to liver Qi stagnation by the chronic tail clamping stimulation combined with intraperitoneal injection of para-chlorophenyl alanine.Fifty successful model rats were randomly divided into a model group,a grasp group,a Western medicine group,an acupuncture group,and a sham acupuncture group,with 10 rats in each group.Rats in the grasp group were grabbed in the same way as those in the acupuncture group.Rats in the Western medicine group were given estazolam solution by intragastric administration.Rats in the acupuncture group received liver-soothing spirit-regulating acupuncture at Baihui(GV20),Neiguan(PC6),Shenmen(HT7),and Taichong(LR3);rats in the sham acupuncture group received acupuncture at 4 non-meridian non-point spots.All groups were treated once a day for 7 d.Pentobarbital sleep test was used to evaluate the sleep latency(SL)and sleep time(ST)of rats in each group after 7 d of intervention;the proportion of the number of entry into the open arms(OE％)and the proportion of the residence time in the open arms(OT％)were monitored by elevated plus maze test(EPMT);the open field test(OFT)was used to monitor the numbers of standing upright,horizontal cross-grid,and fecal grains in rats.The expression levels of 5-HT1AR and 5-HT2AR in rat hippocampus were detected by Western blotting. Results:The body mass gain,ST,OE％,OT％,upright standing times,horizontal cross-grid times,and the 5-HT1AR expression level in the hippocampus were significantly decreased(P<0.01),while the SL and 5-HT2AR expression level in the hippocampus were significantly increased(P<0.01)in the model group compared with the blank group.After intervention,the body mass,ST,OT％,OE％,upright standing times,horizontal cross-grid times,and hippocampal 5-HT1AR expression level were significantly increased(P<0.01 or P<0.05),while the SL and hippocampal 5-HT2AR expression level were significantly decreased(P<0.01 or P<0.05)in the acupuncture group and the Western medicine group compared with the grasp group.Compared with the Western medicine group,OT％,SL,and hippocampal 5-HT1AR expression level were significantly increased in the acupuncture group(P<0.05).The body mass,OT％,OE％,ST,upright standing times,horizontal cross-grid times,and the 5-HT1AR expression level in the hippocampus were significantly increased(P<0.01),while the SL and 5-HT2AR expression level in the hippocampus were significantly decreased(P<0.01)in the acupuncture group compared with the sham acupuncture group. Conclusion:Liver-soothing spirit-regulating acupuncture can not only improve sleep but also improve the abnormal behaviors and mood of insomnia rats due to liver Qi stagnation,and the improvement effect on abnormal mood is better than that of Western medicine.The mechanism may be related to the regulation of 5-HT1AR and 5-HT2AR

Depressive disorder seriously affects people's physical and mental health.Acupuncture is a safe and effective treatment for depression,yet,its mechanism is unclear.Therefore,acupuncture's action mechanism in intervening depression was summarized from several perspectives,including morphology and ultrastructure of neurons in depression-related brain areas,function and structure of glial cells,brain functional and structural connectivity,and neuroelectrophysiology.It's discovered that acupuncture can repair the morphological and ultrastructural damage of neurons in the hippocampus and prefrontal lobe,mitigate the functional and structural injuries of glial cells in the hippocampus and prefrontal lobe,strengthen functional connectivity and heal structural connection,and promote neuroelectrophysiological activities,which possibly are the principal mechanisms of how acupuncture works in intervening depressive disorder.

Objective:To explore the selection of surgical methods for different sites of symptomatic Rathke's cleft cyst (RCC) and the clinical efficacies of these patients.Methods:Forty-seven patients with symptomatic RCC, admitted to our hospital from January 2016 to December 2019, were chosen in our study; 21 patients with intrasellar symptomatic RCC accepted surgery via unilateral nasal approach at the right side, 19 patients with intra-suprasellar symptomatic RCC accepted surgery via bilateral nasal approach, 3 patients with suprasellar symptomatic RCC accepted endonasal transsphenoidal surgery under endoscope, and 4 patients with suprasellar symptomatic RCC accepted craniotomy via pterion approach. The clinical efficacies and complications of patients accepted different surgical methods were compared. All patients were followed up for 3-36 months to observe the recurrence.Results:The postoperative symptoms of the patients were effectively improved, including headache relief ratio of 27/31, vision loss improvement ratio of 5/5, high prolactin relief ratio of 11/13, pituitary function improvement ratio of 9/18. Complications occurred in 6 patients, presenting as diabetes insipidus. Four patients recurred during follow-up.Conclusion:Intrasellar and intra-suprasellar symptomatic RCC accepted surgery via endoscopic transnasal transsphenoidal approach are safe and effective; selection of surgical methods for suprasellar symptomatic RCC should be determined according to the sizes and growth directions of cysts.

Objective To analyze and summarize the risk factors and treatment options of post-renal transplantation. Methods We reviewed 445 renal transplant cases from May 1991 to October 2016 from our hospital. And we had 24 patient received renal transplantation elsewhere who developed malignant tumor afterwards. Among them, 14 patients were male, and 10 patients were female. The age ranged from 42 to 61 years old, with an average age of 54.5 years. 22 patients underwent hemodialysis, with an average of 14.6 months; 2 patients underwent peritoneal dialysis, and the duration is 15 months. 19 patients underwent the transplant for the first time, and 5 patients underwent second transplant. 13 of them developed tumors, and the incidence is 2.9%. In the 24 tumor patients: 19 were urothelial cancer, accounting for 79% (9 renal pelvis and ureter cancer, 8 primary ureter urothelial cancer and 2 primary bladder urothelial cancer), transplant kidney cancer 1 case, thyroid cancer 1 case, colon cancer 1 case and lymphoma 1 case. We analyzed the incidence rate of tumor, type of tumor, time to malignant tumor after surgery, time to diagnosis of tumor after surgery, usage of immune-suppressive medications and prognosis to stratify risk factors of malignant tumor development.Results Only 1 patient with lymphoma underwent chemotherapy, other 23 patients underwent radical operations. All the patients underwent eradicative surgery of malignant tumor, except one patient with lymphoma underwent chemotherapy. Among the 21 patients with urinary system cancers: 2 patients underwent open surgeries (1 patient underwent semi-urinary system resection, 1 patient underwent transplant kidney partial resection), 2 patient underwent TURBT, 17 patients underwent laparoscopic renal pelvis and ureter kidney resection. 3 patients underwent secondary TURBT in one year, 2 patients underwent 3 operations due to recurrent. 18 of them remain healthy; 5 patients had tumor recurrence after the surgery and are deceased 3 years later.Conclusions Post-transplantation patients are susceptible to malignant tumor development, which is closely related to the use of immune suppressant after transplantation. The key to optimal treatment is to detect tumor at an early stage.

Objective:To observe the clinical effects of aligned needling therapy for lumbar intervertebral disc herniation (LIDH).
Methods:A total of 80 cases with LIDH in conformity with the inclusion criteria were randomly divided into a treatment group or a control group by their visit order, 40 cases in each group. The points from the Governor Vessel, L1-L5 Jiaji (EX-B 2) points, from the first lateral line of the Bladder Meridian, Huantiao (GB 30), Weizhong (BL 40) and Yanglingquan (GB 34) were selected for acupuncture in the treatment group. Shenshu (BL 23), Dachangshu (BL 25), Ashi (Extra) points and Weizhong (BL 40) were used for routine acupuncture in the control group. The clinical effects of the two groups after 2-course treatments and recurrence rates three months later were observed. The pain severity before and after treatments was assessed by visual analog scale (VAS). The improvement of the patient’s pathological situation was evaluated by the performance assessment of lumbar disease treatment from Japanese Orthopedic Association (JOA).
Results:After the treatment for two courses, there was no dropped-out case in the two groups. The curative rates and total effective rates were respectively 32.5% and 92.5% in the treatment group versus respectively 12.5% and 82.5% in the control group. The differences in the curative rates and total effective rates between the two groups were statistically significant (bothP<0.01). After the treatment, VAS and JOA scores remarkably declined in the patients of the two groups, with statistical differences in comparison with those of the same group before treatment (bothP<0.05). In follow-up check of three months, the recurrence rate was 10.7% in the cured and remarkably effective cases in the treatment group and was 29.4% in the control group. The recurrence rates of the two groups were statistically different (P<0.05).
Conclusion:The aligned needling technique is remarkable in the clinical effects, obvious in the analgesic effects and low in the recurrence rate in the treatment of LIDH.

Objective To determine the content of ferulic acid, water and extract of Angelica formula particles, provide a reliable method for evaluation and quality control, and compare the quality of Angelica formula particles and Angelica pieces. Methods HPLC method was used with Kromasil C18 column (4.6 mm×250 mm, 5μm), flow rate of 1.0 mL/min, detection wavelength of 316 nm, column temperature at 28 ℃. The mobile phase was acetonitrile-0.05%phosphoric acid in water gradient elution system. Results Ferulic acid showed good linear relationship in the range of 0.033-0.165 μg (r=0.999 8). The average recovery was 98.78% and RSD=0.99%. Angelica formula particles met the quality requirement in the content indicators, the content of ferulic acid was higher than Angelica pieces. Conclusion The HPLC method for determination of ferulic acid in Angelica formula particles is simple and reliable, with good reproducibility, and can be used as the quality control method of Angelica formula particles.

Objective To explore effects of fresh slices on quality of angelica;To provide a reliable method for scientific evaluation and the effective control of quality of angelica;To compare the quality of fresh slices and pieces of angelica.Methods Extraction method and the chromatographic conditions were optimized on the basis of 2010 edition of Chinese Pharmacopoeia. Ferulic acid content was determined by HPLC, with a Kromasil C18 column (4.6 mm×250 mm, 5μm) and mobile phase of acetonitrile-0.05% phosphoric acid-water gradient elution at flow rate of 1.0 mL/min, detection wavelength of 316 nm, and the column temperature was 28℃.Results The content of ferulic acid in the fresh slices of angelica was higher than that in angelica pieces. When other external conditions were the same, the content of ferulic acid in the fresh sliced angelica was the highest with 70% methanol extracted for 30 min.Conclusion The method for determination of ferulic acid in angelica is simple, reliable, reproducible, and can be used as an effective way to control quality of angelica.

Objective To investigate the effect of nursing intervention guided with self-management on self-management behavior and quality of life of kidney-transplant patients .Methods 192 eligible subjects were randomly divided into the experimental group ( n =99 ) and the control group ( n =93 ) .The control group received conventional nursing and follow-up visits while the experimental group adopted nursing intervention guided with self-management in addition , including collective education , group discussion , individual guidance and information.Self-management scale and quality of life scale were used to assess patients ’ self-management behavior and quality of life before and 3 months after intervention .Results There was no statistically significant difference of self-management behavior and quality of life between two groups before intervention (P>0.05). But after intervention , there was statistically significant difference of self-management behavior and quality of life between two groups (t=9.25,-6.65, respectively;P<0.05).In the experimental group, the score of self-management scale before and after intervention was respectively (93.22 ±3.28) and(100.44 ±4.44), the score of quality of life was (12.16 ±1.46)and(10.92 ±0.92), and the differences were statistically significant (t=-9.11,5.01, respectively; P<0.05).Conclusions Nursing intervention guided with self-management can improve the self-management level and quality of life of kidney transplant patients and has clinical significance for preventing rejection and increasing survival rate .

Objective To investigate self-management behaviors of kidney transplantation recipients after discharge.Methods A total of 97 kidney transplantation recipients were recruited from a teaching hospital of Peking University From September 2009 to June 2012,and all eligible subjects were then assigned to 3 groups:post-transplantation less than 6 months group (group A),post-transplantation 6-12 months group (group B),and post-transplantation more than 12 months group (group C).The subjects were required to complete self-management scale for renal transplant recipients.ANOVA was used for data analysis.Results There were 32 patients in group A,31 in group B,and 34 in group C.Self-management behavior score of the participants of the three groups was 100.1 ± 7.0,99.0 ± 7.3 and 91.3 ± 5.8,respectively (F =3.53,P =0.03).In terms of diet,group B got the highest score (F =16.41,P =0.00).However,group A showed excellence in physical activities (F =11.50,P =0.00).For three groups,score of drug effect and side effect was 2.00 ±0.00,2.03 ±0.18,and 2.41 ±0.50; score of routine laboratory values was 2.00 ±0.00,2.05 ± 0.16 and 2.82 ±0.39; and score of skin protection was 3.09 ±0.30,3.03 ± 0.91,and 2.85 ±0.36,respectively.Conclusions Post-transplantive self-management behavior of patients who completed the surgery for more than 12 months may not be better than others.Healthcare professionals need to improve patients' self-management through health education.

Objective The chemical components of lyophilized powder of Sinisan were analyzed by the method of RP-HPLC.Methods HPLC Method was applied for quality assessment on lyophilized powder of Sinisan.Column: Kromasil C18 column(250 mm ? 4.6 mm,5 ?m);wavelength: 210 and 240 nm;flow-rate: 1.0 mL/min;column temperature: 28 ℃.Mobile phase: acetonitrile(A) and H2O(acidified to pH=3 with phosphoric acid)(B).Concentration of lyophilized powder of Sinisan was resolved into different parts and analyzed by the same method,the variation of the chemical components was analyzed.Results At 240 nm,21 peaks were detected and two of them were confirmed to be from Bupleurum chinense,three from Paeonla lactiflora,ten from Citrus aurantium,and five from Glycyrrhiza uralensis.At 210 nm,24 peaks were detected and one of them was confirmed to be from B.chinense,four from P.lactiflora,fourteen from C.aurantium,and five form G.uralensis.Conclusion This method can be used to establish the fingerprint chromatograph of lyophilized powder of Sinisan and elucidate the variation of chemical components completely.