Objective To objectively evaluate the clinical efficacy and safety of acupuncture in regulating the mood of patients with post-stroke depression(PSD)and explore the possible target of acupuncture intervention.Methods 76 patients with PSD were randomly divided into treatment group and control group.The control group was treated with routine treatment measures for stroke,and the treatment group was treated with acupuncture on this basis.The main acupoints were Shangxing,Baihui,Shenting,Fengchi and Dugu,supplemented by acupuncture on Taichong,Hegu,Quchi,Neiguan,Yanglingquan,Zusanli and Taixi,5 times a week,continuously treated for 4 weeks,followed up on the 90th day after treatment.The levels of serum 5-hydroxytryptamine,norepinephrine and intestinal microflora before and after treatment were compared with the 17 Hamilton Depression Scale scores(HAMD),modified Barthel Index(MBI),and the levels of serum 5-hydroxytryptamine and norepinephrine before and after treatment.Results The HAMD score and MBI index of the two groups after treatment and follow-up were lower than those before treatment.The levels of 5-hydroxytryptamine and norepinephrine in the treatment group after treatment were higher than those before treatment(P<0.01),and significantly higher than those in the control group(P<0.01).After acupuncture,the dominant bacterial groups of Bacteroides,Thick-wall bacteria and Broughter bacteria in patients showed an upward trend(P>0.05).The difference of bacteria before and after treatment was mainly concentrated in signal pathways such as ECM-receptor interaction,and the difference was statistically significant(P<0.01).Conclusion Acupuncture can help patients improve their ability of daily living,and also improve the relative abundance of intestinal flora in PSD patients to a certain extent,so as to regulate the levels of 5-HT and NE to relieve the depression of patients,which is worthy of promotion in clinical practice.

Humans ; Enteral Nutrition ; Intubation, Gastrointestinal ; Gastrointestinal Hemorrhage ; Platelet-Rich Plasma

Background: Although the erector spinae plane block has been used in various truncal surgical procedures, its clinical benefits in patients undergoing spinal surgery remain controversial. The aim of this meta-analysis was to evaluate the clinical benefits of erector spinae plane block in patients undergoing spinal surgery. Methods: We searched the Cochrane Library, PubMed, EMBASE, and China National Knowledge Infrastructure for randomized controlled trials comparing the erector spinae plane block with a nonblocked control for spinal surgery. Results: Twelve studies encompassing 696 subjects were included in our systematic review and meta-analysis. We found that the erector spinae plane block decreased postoperative pain scores and opioid consumption in the postoperative and intraoperative periods. Moreover, it prolonged the time to the first rescue analgesic, reduced the number of patients who required rescue analgesia, and lowered the incidence of postoperative nausea and vomiting. However, it did not exhibit efficacy in decreasing the incidence of urinary retention and itching or shortening the length of hospital stays, or the time to first ambulation. Conclusions Erector spinae plane block improves analgesic efficacy among patients undergoing spinal surgery compared with nonblocked controls; however, there is insufficient evidence regarding the benefits of erector spinae plane block for rapid recovery.

Background: Although the erector spinae plane block has been used in various truncal surgical procedures, its clinical benefits in patients undergoing spinal surgery remain controversial. The aim of this meta-analysis was to evaluate the clinical benefits of erector spinae plane block in patients undergoing spinal surgery. Methods: We searched the Cochrane Library, PubMed, EMBASE, and China National Knowledge Infrastructure for randomized controlled trials comparing the erector spinae plane block with a nonblocked control for spinal surgery. Results: Twelve studies encompassing 696 subjects were included in our systematic review and meta-analysis. We found that the erector spinae plane block decreased postoperative pain scores and opioid consumption in the postoperative and intraoperative periods. Moreover, it prolonged the time to the first rescue analgesic, reduced the number of patients who required rescue analgesia, and lowered the incidence of postoperative nausea and vomiting. However, it did not exhibit efficacy in decreasing the incidence of urinary retention and itching or shortening the length of hospital stays, or the time to first ambulation. Conclusions Erector spinae plane block improves analgesic efficacy among patients undergoing spinal surgery compared with nonblocked controls; however, there is insufficient evidence regarding the benefits of erector spinae plane block for rapid recovery.

Objective:To evaluate the status and influencing factors of psychiatric comorbidities of patients with epilepsy (PWEs) in Hubei province during the outbreak of COVID-19.Methods:From February 23, 2020 to March 5, 2020, a network questionnaire survey (including demographic characteristics, seizures, Generalized Anxiety Disorder Scale-7 score, Patient Health Questionnaire-9 score, Insomnia Severity Index score) was conducted among 570 PWEs who visited the Epilepsy Center of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology during April 1, 2019 and January 20, 2020. SPSS 22.0 software was used for correlation analysis of sociodemographic characteristics, epilepsy related factors, perceived threat to the COVID-19 and psychiatric comorbidity (depression, anxiety and insomnia) of PWEs during the COVID-19 epidemic.Results:A total of 362 valid questionnaires were included for analysis (the response rate was 63.51%,362/570). Thirty-four (9.4%), forty-seven (13.0%) and seventy-one (19.6%) patients suffered from anxiety, depression and insomnia, respectively. Patients with seizure frequency ≥2 times/month before the epidemic ( OR=3.395,95% CI 1.561-7.384, P=0.002), poor subjective quality of life during the epidemic ( OR=10.753,95% CI 1.938-59.654, P=0.024), and moderate to severe worry about bad impact of the epidemic on epilepsy ( OR=3.077, 95% CI 1.382-6.853, P=0.006) were more likely to be anxious. Patients with poor subjective quality of life during the epidemic ( OR=6.188, 95% CI 1.317-29.079, P=0.021) were more likely to be depressed. Patients with COVID-19 related symptoms ( OR=3.609, 95% CI 1.674-7.778, P=0.001), children ( OR=3.090, 95% CI 1.759-5.431, P<0.001), seizure frequency ≥2 times/month before the epidemic ( OR=1.907, 95% CI 1.017-3.575, P=0.044), and moderate to severe worry about unanticipated seizures ( OR=2.555, 95% CI 1.370-4.764, P=0.003) were more likely to suffer from insomnia. Conclusions:During the COVID-19 epidemic, parts of PWEs suffered from anxiety, depression and insomnia. PWEs with poor subjective quality of life, high frequency of epileptic seizures before the epidemic, excessive worry about bad impact of the epidemic on epilepsy and excessive worry about unanticipated seizures were prone to anxiety, depression and insomnia.

Object the current radiological health situation of different ranks medical institutions of interventional radiology in a city of Pearl Delta. Methods all the medical institutions in the city, which had carried out interventional radiology before December 31, 2019 as the research objects by survey. By using the method of field epidemiological investigation, the basic situation of general messages, the status of protective facilities, environmental radiation does, personal protective equipment, occupational health monitoring were investigated. Results There were 12 interventional radiology equipment and 180 employees in 7 medical institutions in the city, before December 31, 2019. There was no statistical significance in the composition of employees of different ranks medical institutions (P > 0.05). There was no statistical significance in the composition of protective facilities for interventional treatment in different ranks hospitals (P > 0.05). The environmental radiation dose in interventional radiology devices room of grade A class 3 hospital was higher than that of grade A class 2 hospital (P < 0.05). There was no statistical significance in the composition of individual protective equipment for interventional therapy in different ranks medical institutions (P > 0.05). The proportion of occupational health examination before work and during work in grade A class 2 hospital was higher than A class 3 hospital (P < 0.01). Conclusion The current situation of radiological health of different ranks medical institutions of interventional radiology in a city of Pearl Delta was good momentum. It may be helpful to improve the radiological health protection level of interventional therapy in this city by strengthening the radiological protection management of applying for interventional therapy, actively carrying out the evaluation of radiological protection against occupational disease hazards in construction projects, and urging the employee to carry out the occupational health monitoring inspection as required.

Objective: To explore the feasibility, safety and long-term efficacy of laparoscopic total gastrectomy combined with distal pancreaticosplenectomy for the treatment of T4b gastric cancer. Methods: A retrospective cohort study was performed. Clinical data of consecutive patients with T4b gastric cancer invading pancreatic tail undergoing laparoscopic or open total gastrectomy combined with distal pancreaticosplenectomy from January 2010 to December 2014 were analyzed retrospectively. Enrollment criteria: (1) primary gastric cancer confirmed by pathology as T4b adenocarcinoma; (2) chest+abdominal+pelvic enhanced CT indicated cancer invading pancreatic tail without distant metastasis, and R0 resection was evaluated as feasible before operation; (3) physical status was ECOG score 0 to 2, and was tolerant to operation. Patients with peritoneal implant metastasis and tumor invasion of other organs during operation, or changes in surgical methods for other reasons were excluded. All the operations were performed by the same surgical team, which had the experiences of more than 100 cases of laparoscopic and 100 cases of open radical gastrectomy with D2 lymph node dissection. The choice of surgical procedure was discussed by the surgeon and the patient, and decided according to the patient′s intension. Patients were divided into the laparoscopic group and open group according to the surgical method. Intraoperative and perioperative findings were compared between the two groups. The 3-year disease-free survival rate were analyzed with Kaplan-Meier survival curve and compared by using log-rank test. Results: A total of 37 consecutive patients were enrolled, including 21 in the laparoscopic group and 16 in the open group, and no one receiving laparoscopic procedure was converted to open surgery. The baseline data of two groups were comparable (all P>0.05). Compared with the open group, the laparoscopic group had significantly longer operation time [(264.0±35.1) minutes vs. (226.6±49.9) minutes, t=2.685, P=0.011], significantly less intraoperative blood loss [(65.7±37.4) ml vs. (182.2±94.6) ml, t=-4.658, P<0.001], significantly shorter time to postoperative flatus [(2.8±0.7) days vs. (4.1±0.7) days, t=-5.776, P<0.001] and significantly shorter postoperative hospital stay [(13.3±2.8) days vs. (16.6±4.3) days, t=-2.822, P=0.008]. Morbidity of postoperative complications, including anastomotic leakage, pancreatic fistula, abdominal abscess, intraperitoneal hemorrhage and duodenal stump leakage, in two groups was similar [19.0% (4/21) vs. 4/16, P=0.705]. There were no cases of anastomotic bleeding or stenosis. The 30-day postoperative mortality was 0 in the laparoscopic group and 1/16 in the open group, respectively (P=0.432). The 3-year disease-free survival rates were 38.1% and 37.5% in the laparoscopic and open group, respectively (P=0.751). Conclusion Laparoscopic total gastrectomy combined with distal pancreaticosplenectomy performed by experienced surgeons for T4b gastric cancer is safe and effective.

Objective: To study the correlation of occupation musculoskeletal disease (OMD) and safety behavior in assembly line workers. Methods: Selected assembly line workers of 3 manufacturing factory in Pacity as the objects of this study by judgement sampling. Questionnaires were used for messages collection including the general sociodemographic characteristic, OMD condition, occupational safety behaviors. Results: This study shows that, 826 OMD workers were found that the annual prevalence was 38.03%. The scores of work posture, handling habits, health habit in OMD group was lower than non-OMD group (P<0.01) but personal protection behavior was higher than non-OMD group (P<0.01) . Test of binary logistic regression revealed that age, workage, work posture, handling habits were the factors of OMD (P<0.01) . Conclusion Safety behaviors were the potent factors of OMD that work posture and handling habits should be broadcast.

Objective To study the surgical treatment and clinical effect of growth hormone type pituitary tumor complica-ting cardiomyopathy .Methods Sixty-five cases of growth hormone type pituitary adenoma complicating cardiomyopathy in the hos-pital from June 2012 to June 2016 were selected and performed transsphenoidal approach pituitary adenoma resection .Then serum growth hormone level ,ECG results ,ultrasound cardiogram results and clinical symptoms were observed at 2 weeks after operation . Results The signs were significantly improved after surgery ,acromegaly and nasolabial hypertrophy were significantly improved , dizziness ,fatigue ,hypertension and hyperglycemia were significantly improved ;the average postoperative growth hormone level was (4 .37 ± 2 .03)μg/L ,which was significantly lower than (40 .27 ± 4 .18)μg/L before operation ,and the difference was statistically significant (P< 0 .01 );postoperative IVST ,LVIDd and LVPWT were significantly lower than those before operation ,and the difference was statistically significant (P<0 .01);postoperative average E/A and LVEF were significantly lower than those before operation ,and the difference was statistically significant (P<0 .01) .Conclusion Transsphenoidal pituitary tumor resection can re-duce the level of grow th hormone and improves the cardiac function .

Objective This study aimed to explore the clinical value of human papilloma virus ( HPV) E6/E7 mRNA tests in identifying precancerous lesions of the uterine cervix-cervical intraepithelial neoplasia 2 or more CIN2+( CINⅡand CINⅢ).Methods This study is a cross-sectional survey design , between December 2011 to December 2013.The specimens were collected from the First People′s Hospital of Huizhou and the Third People′s Hospital of Huizhou in Department of Obstetrics and Gynecology outpatient and inpatient of cervical disease suspected patients , with thin-prep cytologic test ( TCT ) and histopathological results as reference , detected 345 patients of exfoliated cervical epithelial cells by using the branched DNA (b-DNA) technology to evaluate the application value of high risk HPV E 6 /E7mRNA in the clinical diagnosis of CIN.Using spss 19.0 software for data analysis.Results (1)Compared with TCT, the positive rate of E6/E7 mRNA in 325 samples were grading by cytology as follows: no intraepithelial lesion cells (NILM) 21.1%(40/190), atypical squamous cells (ASC) 38.5%(15/39 ), low-grade squamous intraepithelial lesions ( LSIL ) 76.9% ( 30/39 ) , atypical squamous cells can not exclude high-grade intraepithelial lesions (ASC-H) (8/10), high-grade squamous intraepithelial lesions (HSIL) 72.3%(34/47), TCT grades and HPV E6/E7 mRNA positive rate showed linear association (χ2 =67.654,P<0.01;r=0.497, P<0.01 ); and with HPV E6/E7 mRNA copy number was also relevant ( r =0.511, P <0.01).(2) Compared with pathological results , the positive rate of E6/E7 mRNA in 164 women samples were grading by pathology as follows:with NILM was 27.8%(10/36), with CIN Ⅰwas 65.9%(29/44), with CINⅡwas 80.6%(54/67), and with CINⅢwas 82.4%(14/17), pathological grades and HPV E6/E7 mRNA positive rate showed a linear correlation (χ2 =26.426, P<0.01; r=0.438, P<0.01); and the number of copies correlated with the increase of pathological grades too (r=0.543, P<0.01).(3) Screening effectiveness analysis results showed , the sensitivity of HPV E6 /E7mRNA was 84.6% while TCT was 47.7%.The sensitivity and specificity were 40.0% and 91.1% respectively when HPV E6/E7 mRNA and TCT processed as sequential detection test.The CIN2 +( CINⅡand CIN Ⅲ) best diagnostic critical point of 890.26 copies/ml,was established using receiver operating characteristic ( ROC) curve.The sensitivity and specificity were 58.5% and 93.7%, respectively.Conclusions The sensitivity of HPV E6/E7 mRNA test is better than TCT, the specificity is high in HPV E6/E7 mRNA and TCT processed as sequential detection test.Using the optimal cut-off value of ROC curve to detect CIN 2+has high sensitivity and specificity, so the detection of HPV E6/E7 mRNA may have some clinical value in screening and risk assessment of precancerous lesions of the uterine cervix.