Objective To observe the body surface calorific value characteristics of Governor Vessel and Conception Vessel,triple energizer,and zang-fu organs chronic insomnia patients with heart-spleen deficiency syndrome through infrared thermal imaging technology.Methods Totally 150 patients with chronic insomnia with heart-spleen deficiency syndrome who were treated in the outpatient department of Shenzhen Hospital of Beijing University of Chinese Medicine(Longgang)from December 2021 to December 2022 were selected as the observation group.Another 50 healthy subjects were recruited as the normal control group.Infrared thermal imaging technology was used to collect and measure the temperature of surface areas of Governor Vessel and Conception Vessel,triple energizer,and zang-fu organs,and the calorific values were analyzed and compared.Results Compared with healthy subjects,chronic insomnia patients with heart-spleen deficiency syndrome had a statistically significant decrease in the temperature of the Governor Vessel(P<0.05);there were statistically significant decreased in the temperature of upper energizer and middle energizer(P<0.05);there were statistically significant decreased in the temperature of chest,apex,right chest,epigastric region,big abdomen,and the temperature of left and right flank increased(P<0.05).Conclusion There were significant differences in infrared thermography distribution characteristics of Governor Vessel and Conception Vessel,triple energizer,and zang-fu organs between patients with chronic insomnia with heart-spleen deficiency syndrome and healthy subjects,which can provide some reference for the clinical diagnosis and syndrome differentiation of chronic insomnia with heart-spleen deficiency syndrome.

This paper aimed to explain the clinical thinking of using the method of unblocking the bowels and harmonizing viscera. Based on theory of "viscera-bowels extraordinary connection" of The Gateway to Medicine （《医学入门》）， combined with the theoretical research， clinical practice and individual experience of ancient physicians， modern scholars， it is believed that viscera qi disorder caused by bowels qi blocking is the basic mechanism of insomnia. In clinic， it is common that gallbladder phlegm-heat harassing the heart spirit， stagnant blood and qi in stomach blocking the pericardium， turbid heat in large intestine causing fire and affecting liver， dampness insmall intestine trapping the spleen， water retention in the bladder drying up lungs， and the inhibited original qi of sanjiao damaging the kidney， which could be treated with Wendan Decoction （温胆汤）， Taohe Chengqi Decoction （桃核承气汤）， Chengqi-series Decoction （承气汤类方）， Linggui Zhugan Decoction （苓桂术甘汤）， Wuling Powder （五苓散）， Xiaochaihu Decoction （小柴胡汤）， respectively.

Objective:To investigate the expression of acetyl-CoA carboxylase 1 (ACC1) in ovarian cancer tissues and cells, and the related mechanisms of the effect of ACC1 on cell migration and lipogenesis in ovarian cancer.Methods:Samples including 1 case of normal ovarian tissue, 1 case of ovarian cancer primary lesion tissue and 1 case of ovarian cancer omentum metastatic tissue diagnosed by pathology examination of patients undergoing surgery resection who admitted to Linyi Cancer Hospital between January 2019 and December 2021 were collected. Immunohistochemistry was used to detect the protein levels of ACC1 and Yin Yang protein 1 (YY1) of all tissues. The PROMO database was used to predict the possible binding sites of YY1 and ACC1 promoter region. Through the assembled viral vector, the HEY cells of human ovarian cancer with ACC1 or YY1 expression [the untreated cells were treated as the negative control (NC)], or knocked down ACC1 or YY1 (the interference sequence sh1, sh2, sh3 was transferred to the target gene, and the negative control sequence shNC was transferred to the interference sequence). Double luciferase reporter gene assay was used to verify the binding sites of YY1 and ACC1 promoter and the activity of transcriptional regulation. Real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) and Western blot were used to detect the mRNA and protein expression levels of ACC1 and YY1 in the treated HEY cells, respectively. Transwell assay was used to detect the migration ability of HEY cells. Oil red O staining and Nile red staining were used to detect the lipid droplets in HEY cells.Results:The immunohistochemical scores of ACC1 and YY1 were 0, 2, 8 scores and 0, 4, 6 scores, respectively in normal ovarian tissue, primary lesion of ovarian cancer, and omentum metastatic tissue. Transwell assay showed that the number of invasive HEY cells in ACC1 overexpression group was more than that in NC group [(87.7±7.4) vs. (52.2±4.2), t = 5.19, P = 0.003]. The number of invasive HEY cells in ACC1-sh1 group, and ACC1-sh2 group with the knockdown of ACC1 was less than that in shNC group [(21.2±1.5), (29.7±2.3) vs. (56.2±5.3); t value was 6.41, 3.77; P < 0.001, P < 0.005]. The number of lipid droplets in HEY cells in the ACC1 overexpression group was more than that in the control NC group [Oil red O staining: (301±25) vs. (215±21); Nile red staining: (287±15) vs. (207±10); all P < 0.05]; the number of lipid droplets in HEY cells in ACC1-sh1 and ACC1-sh2 group with the knockdown of ACC1 was less than that in ACC1-shNC group [Oil red O staining: (113±8), (119±12) vs. (195±18); Nile red staining: (82±8), (117±11) vs. (165±17); all P < 0.05]. The result of dual luciferase reporter assay showed that overexpression of YY1 promoted the luciferase activity of the wild type ACC1 promoter region report gene ( P = 0.003), while the luciferase activity of the report gene was inhibited compared with the wild type after the mutation of binding sites of YY1 in ACCI promoter region ( P = 0.008). Western blot results showed that the expression levels of YY1 and ACC1 protein in HEY cells with YY1 overexpression group were higher than those in NC group, which indicated a synergistic increasing trend of both YY1 and ACC1; the expression levels of YY1 and ACC1 protein in YY1-sh1 group, YY1-sh2 group and YY1-sh3 group with the knockdown of YY1 were lower than those in the control YY1-shNC group, which indicated a synergistic decreasing trend of both YY1 and ACC1. Conclusions:ACC1 and YY1 are highly expressed in ovarian cancer metastatic tissues and both show a positive correlation trend. The expression level of ACC1 in vitro has an impact on cell migration and lipogenesis in ovarian cancer via YY1 transcriptionally regulating ACC1.

Objective:To explore the application and effect of multidisciplinary collaboration in patients with tophi during perioperative period.Methods:Forty-five patients undergoing tophaceous gout surgery in our hospital from May to October 2020 were selected as the control group and treated with routine treatment.From November 2020 to April 2021, 41 patients undergoing tophaceous gout surgery in our hospital who were treated with multidisciplinary collaboration management mode were included as the intervention group. Postoperative pain, blood uric acid level, hospitalization expenses, hospitalization days and patient satisfaction were compared between the two groups.Results:After implementing the multidisciplinary integration man-agement mode, the pain score of the patients at 4 hours, 1 day and 3 days after operation was lower than that of the control group [(3.6±1.0) vs (4.1±1.0), t=2.33, P=0.022; (2.5±0.8) vs (3.0±0.6), t=3.85, P<0.001; (1.8±0.5) vs (2.2±0.7), t=3.52, P<0.001], the serum uric acid level was significantly lower than that of the control group at 1 month and 3 months after operation [(355±58) vs (3928±39), t=3.50, P=0.001; (316±48) vs (366±47), t=4.84, P<0.001], the hospitalization days and hospitalization expenses were significantly decreased [(8.90±2.48) d vs (10.62±3.96) d, t=2.44, P=0.017; (1.00±0.13) ten thousand yuan vs (1.11±0.17) ten thousand yuan, t=3.34, P=0.001], and the patient satisfaction was markedly improved (97.6% vs 82.2%, χ2=3.87, P=0.049). Conclusion:The multi-disciplinary collaboration mode in patients with tophi during perioperative period can effectively reduce the postoperative pain, improve the quality of care, promote reha-bilitation, improve the outcome, and reduce the economic burden of patients, which is worthy of popularization and being applied in clinic.

Objective:To explore the effects of experiential teaching based Carolina care model on humanistic care ability, emotional intelligence and communication skills among undergraduate practice nursing students.Methods:In August 2018, this study selected 80 undergraduate practice nursing students with clinical practice in the Affiliated Hospital of Qingdao University as subjects by conveniences sampling. The experiential teaching based Carolina care model for nursing students was implemented during clinical practice for 6 months. The intervention effects were assessed with the Caring Ability Inventory (CAI) , Emotional Intelligence Scale (EIS) and the Supportive Communicative Scale (SCS) . SPSS 22.0 was used to data analysis. The paired t test was used to compare the scores of CAI, EIS and SCS in undergraduate nursing students before and after intervention. Results:After intervention, the scores of CAI, EIS and SCS of undergraduate practice nursing students were (224.31±15.98) , (135.43±11.50) and (78.80±7.90) respectively higher than those [ (194.23±19.73) , (133.75±12.17) and (74.58±8.23) ]before intervention with statistical differences ( t=24.11, 2.20, 3.00; P<0.05) . Conclusions:Carolina care model based experiential teaching can improve humanistic care ability, emotional intelligence and communication skills of undergraduate practice nursing students.

Objective To determine the occurrence and clinical characteristics of ectopic pituitary adenoma (EPA) in China.Methods The study are done by searching systematically and comprehensively on major Chinese and English medical literature databases and conference papers before 2015,which are only limited to collected,summarized,sorted and analyzed EPA cases that reported by Chinese authors in English or Chinese occurred in China.Results ① Among the 86 Chinese articles and 27 English articles related to ectopic pituitary adenoma (EPA) gathered by the author,except for cases that have been confirmed as repeated reports,a total of 73 EPA cases were found.Of 70 cases with complete data,31 were male cases,accounting for 44.29％;39 were female cases,accounting for 55.71％;the ratio is 1:1.3.The frequency of EPA occurrence according to the location of the lesion,from high to low in turn,was sphenoid sinus (31 cases,42.47％),nasopharynx (7 cases,9.59％),suprasellar region (7 cases,9.59％),clivus (5 cases,6.85％),followed by the third ventricle,sphenoid sinus/clivus,nasal cavity,and the temporal lobe of the brain,with the same incidence of 4.11％.According to the functional properties of EPA,the frequency of different secreting hormones adenoma was PRL-ma(21 cases,28.77％),NF-ma (21 cases,28.77％),ACTH-ma (15 cases,20.55％),GH-ma (10 cases,13.70％),TSH-ma (2 cases,2.74％) and FSH-ma (1 cases.1.37％).Three cases of EPA were uncertain in their property due to lack of information.The incidence of PRL and nonfunctional tumors was the highest,which was different from what was reported in other countries.Among them,one case of EPA was in pineal region and one in parapharyngeal space,which was even more rare and were never reported abroad.(② Except for 3 cases with incomplete medical records,15 out of 70 cases of EPA were accompanied by empty sella,accounting for 21.43％,among which 11 (73.33％) cases involved the sphenoid sinus,and 3 (20％) cases involved clivus.The sphenoid sinus and clivus cases together accounted for 93.33％.(③ 29 out of the 69 cases of EPA with complete record were invasive pituitary adenomas,accounting for 42.03％ and including 1 case of pituitary adenocarcinoma,which accounted for 1.45％.(④ All cases were treated with surgery as the first choice,and some of them were treated with radiotherapy or drug therapy.Conc lusion Ectopic pituitary adenoma is extremely rare.By the end of 2015,the total number of cases reported in China is only 73,which are mostly located in the sphenoid sinus,suprasellar region and nasopharynx.In the functional classification,the most common types are still PRL adenoma and nonfunctional adenoma as in situ pituitary adenoma.42.03％ of EPA adenomas are invasive.Surgical resection of EPA is the first choice and some cases can be treated with radiotherapy and drug therapy.

PURPOSE: Self-management is critical to improve health outcomes of elderly patients with coronary heart disease (CHD). Sense of coherence (SOC) is found to be linked with self-management behaviors. However, their deeper relationship is not clear. The purposes of this study were to investigate the association between SOC and self-management behaviors among elderly CHD patients in China, and whether confrontation mediates this association. METHODS: A cross-sectional design was used. A total of 275 elderly patients with CHD recruited from the cardiology department in a general hospital in North China were surveyed from October 2015 to April 2016. SOC, confrontation, and self-management behaviors were measured using the Chinese version of the SOC scale, subscale of Medical Coping Modes Questionnair—Confrontation, and the CHD self-management scale, respectively. Correlation analysis and path analysis were conducted to analyze the data. RESULTS: The mean (±standard deviation) scores of SOC, confrontation, and self-management behaviors were 62.20 (±9.61), 19.55 (±3.15), and 76.17 (±10.63), respectively. Correlation analysis showed that SOC, confrontation, and self-management behaviors were significantly correlated with each other. Path analysis indicated that SOC exerted a direct effect on self-management behaviors, whereas could affect self-management indirectly via confrontation. Bootstrap test result showed that confrontation played a mediating role (β = .20, p < .001) in the relationship between SOC and self-management behaviors. CONCLUSION: SOC was related to self-management behaviors, whereas confrontation mediated the effect of SOC on self-management behaviors. In practice, the role of confrontation coping should be valued when developing strategies to strengthen SOC and to improve self-management practice among elderly CHD patients.
Aged* ; Asian Continental Ancestry Group ; Cardiology ; China* ; Coronary Disease* ; Hospitals, General ; Humans ; Negotiating ; Self Care* ; Sense of Coherence*

Objective To compare if the Montreal cognitive assessment (MoCA) performed in the morning or afternoon would affect abnormal rate of cognitive function in the elderly with stroke.Methods A total of 378 senile patients (≥ 65 years) with acute ischemic stroke and low NIHSS score (≤ 3) were enrolled in the prospective study,which was held in the Department of Neurology at Cangzhou Hospital of Integrated Traditional Chinese Medicine.MoCA was assessed after one month of hospitalization.Based on the time of MoCA assessment,all patients were randomly divided into the group A (assessed in the morning,9 am-12 am) and the group B (assessed in the afternoon,12 am to 5 pm).Clinical data were collected,and RANKIN scale (mRS) examination was performed.Moreover,patients were further divided into severe cognitive impairment (SCI) subgroup (score ＜ 20),mild cognitive impairment (MCI) subgroup (score 20-25) and no cognitive impairment (NCI) subgroup (score ＞ 26) according to the MoCA score.Results There were 189 patients in the group A (50％),and 189 cases in the group B (50％).There was no significant difference in age,gender,education level,disability (mRS score ＜ 1),history of hypertension,diabetes,hyperlipidemia,smoking and atrial fibrillation between the two groups.Based on the MoCA score,211 cases had NCI,142 had MCI,and 25 had SCI.Compared with patients in group B,patients in group A was associated with significantly higher positive rate of SCI[12.2％ (23/189)vs.1.1％ (2/189),P=0.000],MCI[40.2％ (76/189)vs.34.9％ (66/189),P=0.013]and slightly higher positive rate of NCI[56.6％ (107/189)vs.55.0％ (104/189),P=0.214].Conclusions The test time of MoCA may have an effect on the cognitive function detection rate in elderly patients with stroke,and the time of MoCA examination should be considered in clinical examination.

Objective To observe the efficacy of electroacupuncture(EA) on the acupoint combination of He-(sea) points, front-mu points, and shu-points(abbrev. He-Mu-Shu) for the treatment of functional diarrhea, and to explore the effect of He-Mu-Shu point combination EA on the anxiety of patients. Methods A randomized controlled clinical trial was performed in 62 functional diarrhea patients. All of the patients were randomly divided into He-Mu-Shu group(32 cases) and medicine group(30 cases). He-Mu-Shu group was treated with EA on unilateral Quchi, Shangjuxu, Tianshu, Dachangshu point alternatively, and medicine group was treated with oral use of Loperamide hydrochloride capsules. Both groups were treated for 4 continuous weeks. Defecation frequency, stool property and anxiety scores were observed before treatment and 2, 4 weeks after treatment. Results After treatment, weekly defecation frequency, stool property and anxiety scores were improved in both groups, and the differences were statistically significant compared with those before treatment(P < 0.05). He-Mu-Shu point combination EA had better effect on improving weekly defecation frequency, stool property and anxiety scores of functional diarrhea patients than Loperamide hydrochloride capsules, and the differences were statistically significant (P < 0.05). Conclusion The clinical efficacy and anxiety-relief action of He-Mu-Shu point combination EA on functional diarrhea are superior to oral use of Loperamide hydrochloride capsules.

Objective To investigate the safety and efficacy of mechanical thrombectomy (MT) compared with In?tra-arterial Thrombolysis (IAT) treatment in patients with severe acute ischemic stroke (AIS) caused by large cerebral ar?tery occlusion. Method The patients with AIS caused by large cerebral artery occlusion and underwent MT or IAT from 2005 May to 2014 May was included. A retrospective analysis was conducted on the onset to emergency(OTE)time, emergency to acupuncture(ETA)time, acupuncture to recanalization (ATR) time, stroke severity as measured by the Na?tional Institutes of Health Stroke Scale (NIHSS) score, and site of arterial occlusion on magnetic resonance angiography (MRA). A comparison was made between MT and IAT patients in rates of recanalization, symptomatic intracranial bleed?ing (SIB), mortality, and functional outcome. Three-month favourable outcome was defined as a modified Rankin Scale (mRS) score≤2. Result One hundred and two AIS patients were treated with MT and 50 with IAT. There was no differ?ence between MT and IAT groups with regard to demographics, onset NIHSS score (13.37±6.95 vs. 12.70±6.11;P=0.572) and discharge NIHSS score (8.40 ± 6.69 vs. 7.53 ± 7.28, P= 0.522) and the change of NIHSS score (3.87 ± 7.14 vs. 4.26 ± 5.42, P=0.766). There were significantly differences between MT and IAT groups in the OTE time (Median 300 min vs. 120 min,Z=-5.704,P=0.000) , ATR time (Median 30 min vs. 65 min,Z=-5.011,P=0.001) ,recanalization (91.2%vs. 60.0%,P =0.01),the rate of AIB(21.7% vs. 36.0%,P =0.046),3-month mortality (16.6% vs. 26.0%,P =0.043). The above parameters were better in MT group than in the IAT group. There were no significant differences between MT and IAT groups in the rate of SIB (12% vs. 16%,P =0.055), the NIHSS change(Median 3 vs. 4,Z =-0.236,P =0.823) and mRS score on 90d ( 48.2%vs. 46.0%, P=0.823). MT patients had significantly higher percentages of stent use (22.5%vs. 8%,P=0.018) . The Recanalization for ICA(81.8%vs. 55.6%,P=0.048),BA(93.1%vs. 55.6%,P=0.032)and MCA( 97.5% vs. 60.0%,P =0.026)was higher in MT group than in IAT group .The SIB rate for ICA(13.8% vs. 33.3%,P =0.000),BA(13.8%vs. 33.3%,P=0.000)was lower in MT group than in IAT group . The mortality rate of was significant?ly lower in MT than in IAT group for MCA (2.5%vs. 20.0%,P=0.000) . the good outcome rate for BA was higher in MT group than in IAT group(41.3%vs. 22.2%,P﹤0.01). Conclusions Compared to IAT,MT can provide broader time win?dow,higher recanalization rate and better outcome in patients with severe acute ischemic stroke (AIS) caused by large ce?rebral artery occlusion.