ObjectiveTo explore the clinical characteristics of idiopathic hypereosinophilic syndrome (IHES), and improve the early diagnosis and treatment of such diseases.MethodsThe clinical diagnosis and treatment data were retrospectively analyzed from the patients with confirmed IHES hospitalized in China-Japan Friendship Hospital between September 2010 to May 2018.ResultsFifteen patients were included. There were 3 women and 12 men in the study, with an average age of 53.7±21.3 years. Eleven patients had respiratory problems, with an average course of 7 months. Most lesions occurred in both lungs. Patchy distribution, ground glass opacity, pleural effusion and mediastinal lymph node enlargement were common in the chest computed tomography. Serum total IgE was significantly increased. Four patients had other systems involved rather than respiratory system. One of them had digestive problems and another 3 had skin diseases. There was a significant increase in eosinophils in peripheral blood, bone marrow and histopathology, the same as eosinophils in sputum, pleural effusion, and bronchoalveolar lavage fluid. Hypoxemia was common in patients with respiratory problems. The blood eosinophil and total IgE were reduced after glucocorticoid treatment, and the hypoxemia was significantly improved.ConclusionsThe clinical symptoms, signs and image of chest computed tomography are not specific in IHES, so the rate of misdiagnosis and wrong diagnosis is high. This disease involves many organs or systems, so the pathological examination should be completed as soon as possible to make a clear diagnosis to prevent further damage. Glucocorticoid treatment is effective in this disease.
ObjectiveTo investigate the prognostic value of platelet volume indices ［mean platelet volume (MPV) and platelet distribution width (PDW)］ in early period for patients with sepsis .MethodsThis retrospective study was conducted in a general ICU at a University Hospital from January 2015 to January 2017. Patients with sepsis were divided into a survival group and a death group according to 28-day prognosis. The demographic and clinical data were recorded and analyzed, including platelet indices, Charlson comorbidity index, Glasgow Coma Scale (GCS) score and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHEⅡ) score. Multivariable COX proportional hazard ratio model was used to evaluate the 28-day mortality risk, and receiver operating characteristic (ROC) curve were used to evaluate the value of platelet volume indices.ResultsA total of 209 patients were enrolled in this study. Mean arterial pressure, pH, platelet count, serum creatinine, bilirubin, troponin I, prothrombin time, GCS score and platelet volume indices showed significant differences between the survival group (n=137) and the death group (n=72) (all P<0.05). Multivariable COX regression analysis revealed that the PDW was independently associated with 28-day mortality in sepsis (HR=1.068, 95%CI 1.002-1.139, P=0.043). The area under the ROC curve of PDW was 0.762 (95%CI 0.694 - 0.831), with a sensitivity of 86% and a specificity of 63% at a cut-off value of 18.65%.ConclusionPDW can be used as a powerful prognostic indicator in patients with sepsis following 28-day.
Objective To systematically review the efficacy and safety of acupuncture for the treatment of tumor-related cognitive dysfunction. Methods The PubMed, The Cochrane Library, EMbase, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect studies on acupuncture for the treatment of tumor-related cognitive dysfunction from the establishment of the database to February 13th, 2022. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.4.1 software. Results A total of 16 studies involving 1 361 patients were included. The results of meta-analysis showed that the mini-mental state examination (MD=1.82, 95%CI 1.49 to 2.15, P<0.000 01) and Montreal cognitive assessment (MD=1.56, 95%CI 0.83 to 2.29, P<0.0001) scores of the acupuncture treatment group were superior to those in the control group. Furthermore, the acupuncture treatment group showed a reduced incidence of postoperative cognitive dysfunction (RR=0.50, 95%CI 0.39 to 0.63, P<0.000 01) and decreased levels of interleukin-6 (MD=−10.43, 95%CI −14.91 to −5.95, P<0.000 01), interleukin-1β (MD=−47.14, 95%CI −63.92 to −30.36, P<0.000 01), and tumor necrosis factor-α (MD=−9.13, 95%CI −12.38 to −5.89, P<0.000 01). In contrast, the visual analog scale score of the acupuncture treatment group (MD=−1.26, 95%CI −2.06 to −0.47, P=0.002) was better than that of the control group. No significant difference was found in the level of central nervous system-specific protein (S100β) (MD=−0.06, 95%CI −0.13 to 0.01, P=0.12) between the two groups. Conclusion Acupuncture therapy can improve tumor-related cognitive function in patients. Its curative effect is better than that of non-acupuncture therapy; however, its ability to reduce S100β levels is not significantly different from that of non-acupuncture therapy. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
To investigate the mechanism of cAMP/Ca2+ signaling pathway inducing bone marrow mesenchymal stem cells to differentiate into neuronal cells, we cultured the bone marrow mesenchymal stem cells D1 cells in the present study. D1 cells were divided into two groups: control group and salidroside inducing groups. Control group was cultured with complete culture solution D/F12, while salidroside inducing groups were induced with 100 mg·L–1 salidroside for different time periods (24, 48 and 72 hours). PCR-array assay was used to detect expression of 84 calcium related mRNA, and significantly different genes were chosen to analyse. As a result, there were 4 significantly upregulated mRNAs inclu-ding DNA damage-inducible transcript 3 (Ddit3), heat shock protein 5 (Hspa5), protein phosphatase 1 regulatory subunit (Ppp1r15a) and prostaglandin-endoperoxide synthase 2 (Ptgs-2), and 4 significantly downregulated mRNAs including glucagon (Gcg), interleukin 2 (Il2), tumor necrosis factor (Tnf) and somatostatin (Sst) in the cAMP/Ca2+ signaling pathway. They probably had an effect on the process of salidroside induced D1 cells differentiating into neuronal cells.
ObjectiveTo provide a scoping review of the clinical studies of acupuncture on Alzheimer' s disease (AD). MethodsThe CNKI, WanFang Data, VIP, CBM, Web of Science, PubMed, EMbase, Cochrane Library databases, and ClinicalTrials.gov, ChiCTR clinical trial registration systems were searched to collect clinical studies on acupuncture treatment of AD from inception to May 14, 2022. Scope review method was used to summarize and analyze the publication year trend, type, degree of disease, traditional Chinese medicine (TCM) syndrome differentiation, sample size, treatment plan, intervention time, and outcome. ResultsA total of 226 clinical original research were included. This field emerged in 1995 and has been increasing. The main type of clinical research was randomized controlled trials. 56 studies paid attention to the severity of AD. Only 54 studies classified AD according to different criteria of TCM syndrome differentiation. There were only 4 studies with large sample size (>200 cases). Conventional acupuncture was the main intervention method in clinical research, with a total of 129 articles. Electroacupuncture was the main special acupuncture method, a total of 31 articles. More than 70 % of the studies had a course of intervention between 84 and 168 days. Among the 12 types of outcome indicators, cognitive function, clinical efficiency, activity function evaluation, cerebrospinal fluid and blood biomarkers, and adverse reactions were the most concerned outcomes. However, less attention was paid to neuropsychiatric symptoms and quality of life in AD patients. Acupuncture could improve the cognitive function of AD patients, but the current clinical related mechanism research was shallow, and the acupuncture point selection was also more diverse. ConclusionThe clinical research of acupuncture in AD has formed a scale, but the current research type is single. The clinical research design schemes are various but not yet unified, and there is a lack of relevant authoritative TCM standards.
Objective To discuss the curative effect of expanding ulnar nerve groove and interfascicular neurolysis under microscope in treating severe cubital tunnel syndrome (Cub Ts), and to compare with that of the forward moving of ulnar nerve and interfascicular neurolysis under microscope to find out the best way to treat severe Cub Ts. Methods From December 2002 to January 2007, 22 severe Cub Ts cases were treated with expansion of ulnar nerve groove and interfascicular neurolysis under microscope (treatment group), and other 22 cases were treated with forward moving of ulnar nerve and interfascicular neurolysis under microscope (control group). In treatment group, there were 17 males and 5 females, aged 21-66 years (mean 43.8 years). Pathogenic causes were elbow arthritis in 17 cases, ulnar nerve dislocation in 3 cases and elbow ectroption in 2 cases. The locations were left elbow in 8 cases and right elbow in 14 cases. Thecourse of disease was 6-69 months. In control group, there were 18 males and 4 females, aged 20-64 years (mean 42.1 years). Pathogenic causes were elbow in arthritis 16 cases, ulnar nerve dislocation in 3 cases, elbow ectroption in 1 case and narrowing and shallowing of ulnar nerve groove caused by abnormal heal ing of medial condyle fracture in 1 case. The locations were left elbow in 7 cases and right elbow in 15 cases. The course of disease was 5-67 months. Results For all patients of both groups, the wound healed by first intention, and all were followed up for 12-45 months. In treatment group, the numbness in l ittle finger was obviously rel ieved, or disappeared in 22 cases 1 day after operation. In control group, the numbness in l ittle finger was obviously rel ieved or disappeared in 22 cases 3-5 days after operation. EMG showed that conduction speed of ulnar nerve was normal. Evaluated by upper l imbs function standard of China Medical Association, Surgery Association and Lascar grades, the results were excellent in 21 cases and good in 1 case in treatment group; whilet excellent in 19 cases, good in 2 cases and fair in 1 case in control group. There was significant difference between treatment group and control group (P lt; 0.01). Conclusion Either expansion of ulnar nerve groove and interfascicular neurolysis or forward moving of ulnar nerve and interfascicular neurolysis is an effective method to treat severe Cub Ts, but the former is better than the latter.
ObjectivesTo analyze the development of acupuncture registered trials based on WHO international clinical trial registration platform (ICTRP) in the past 5 years.MethodsWHO ICTRP database was electronically searched to collect acupuncture-related clinical trials registered from January 1st, 2014 to December 31st, 2018. Two reviewers independently screened items, extracted data, and descriptive analysis was performed for the included trials.ResultsThe results showed that there were 1 556 registered clinical trials on acupuncture, and the most registered year was 2017. China was in the main country in applying for acupuncture-related clinical trials, however, the most registered unit was Kyung Hee University in Korea. The trials were mainly interventional research, mostly used randomized, blinded methods, and design modes were mainly based on parallel trials. In clinical trial phase, the majority were in the clinical trial period of treatment of new technologies. The field of clinical research was expected to be on pain in the future.ConclusionsAlthough acupuncture research is currently in a good stage of development, it should still value on the quality and innovative training of relevant trials, strengthen Chinese ties with other countries, focus on regional, domestic and international cooperation, expand research types, and enhance acupuncture applicability.