Immediate effects of scalp acupuncture with twirling reinforcing manipulation on hemiplegia following acute ischemic stroke: a hidden association study

Data mining has the potential to provide information for improving clinical acupuncture strategies by uncovering hidden rules between acupuncture manipulation and therapeutic effects in a data set. In this study, we performed acupuncture on 30 patients with hemiplegia due to acute ischemic stroke. All participants were pre-screened to ensure that they exhibited immediate responses to acupuncture. We used a twirling reinforcing acupuncture manipulation at the specific lines between the bilateral Baihui（GV20） and Taiyang（EX-HN5）. We collected neurologic deficit score, simplified Fugl-Meyer assessment score, muscle strength of the proximal and distal hemiplegic limbs, ratio of the maximal H-reflex to the maximal M-wave（Hmax/Mmax）, muscle tension at baseline and immediately after treatment, and the syndromes of traditional Chinese medicine at baseline. We then conducted data mining using an association algorithm and an artificial neural network backpropagation algorithm. We found that the twirling reinforcing manipulation had no obvious therapeutic difference in traditional Chinese medicine syndromes of ＂Deficiency and Excess＂. The change in the muscle strength of the upper distal and lower proximal limbs was one of the main factors affecting the immediate change in Fugl-Meyer scores. Additionally, we found a positive correlation between the muscle tension change of the upper limb and Hmax/Mmax immediate change, and both positive and negative correlations existed between the muscle tension change of the lower limb and immediate Hmax/Mmax change. Additionally, when the difference value of muscle tension for the upper and lower limbs was 〉 0 or 〈 0, the difference value of Hmax/Mmax was correspondingly positive or negative, indicating the scalp acupuncture has a bidirectional effect on muscle tension in hemiplegic limbs. Therefore, acupuncture with twirling reinforcing manipulation has distinct effects on acute ischemic stroke patients with different symptoms or stages of disease. Improved muscle tension in the upper and lower limbs, reflected by the variation in the Hmax/Mmax ratio, is crucial for recovery of motor function from hemiplegia.

标准通道辅助微通道经皮肾镜取石术联合EMS治疗鹿角形肾结石合并脓肾的经验总结

目的探讨标准通道辅助微通道经皮肾镜取石术(MPCNL)联合EMS碎石清石系统治疗鹿角形肾结石合并脓肾的疗效及安全性。方法回顾性分析该院2015年10月-2017年5月在泌尿专用超声穿刺探头引导下,采用穹窿穿刺法标准通道辅助MPCNL联合EMS,治疗鹿角形肾结石合并脓肾53例(55侧,2例双侧)患者的临床资料。总结其手术时间、结石清除率、术后住院天数、术后输血率和并发症。结果 53例患者共55侧肾脏均Ⅰ期建立F24通道,并成功碎石取石。手术时间(82.3±22.5)min;72.7%的肾脏Ⅰ期F24辅助F16/18双通道;18.2%为Ⅰ期F24辅助Ⅱ期F16/18的双通道或多通道;9.1%为Ⅲ期经原通道PCNL联合逆行输尿管软镜碎石术;4例行体外冲击波碎石术辅助治疗。Ⅰ期结石清除率70.9%(39/55),总结石清除率89.1%(49/55)。2例患者术后输血,1例行超选择性肾动脉栓塞术止血,3例患者出现术后发热,1例出现感染性休克;2例少量液胸保守治疗;1例因尿外渗引起明显腰痛,给予止痛药物处理,未发生其他严重并发症。结论泌尿专用超声穿刺探头引导下,采用经穹窿穿刺法标准通道辅助微通道PCNL联合EMS碎石清石系统治疗鹿角形肾结石合并脓肾,具有结石清除效率高、肾盂内压低、安全性高和并发症发生率低等优点,值得临床应用。

Anti-apoptotic effect of Shudipingchan granule in the substantia nigra of rat models of Parkinson＇s disease

Levodopa is the gold-standard treatment for Parkinson＇s disease. However, although it alleviates the clinical symptoms, it cannot delay the progressive apoptosis of dopaminergic neurons or prevent motor complications in the long term. In the present study, we investigated the effect of Shudipingchan granule on neuronal apoptosis in a rat model of Parkinson＇s disease, established by injecting 6-hydroxydopamine into the substantia nigra pars compacta and ventral tegmental area. We then administered levodopa （20 mg/kg intraperitoneally, twice daily） with or without Shudipingchan granule （7.5 mL/kg intragastrically, twice daily）, for 4 weeks. The long-term use of levodopa accel- erated apoptosis of nigral cells and worsened behavioral symptoms by activating the extracellular signal-regulated kinase pathway and downstream apoptotic factors. However, administration of Shudipingchan granule with levodopa reduced expression of phosphorylated extracellular signal-regulated kinase 1/2 and Bax, increased tyrosine hydroxylase and Bcl-2, reduced apoptosis in the substantia nigra, and markedly improved dyskinesia. These findings suggest that Shudipingchan granule suppresses neuronal apoptosis by inhibiting the hyper- phosphorylation of extracellular signal-regulated kinase and downregulating expression of anti-apoptotic genes. Shudipingchan granule, used in combination with levodopa, can effectively reduce the symptoms of Parkinson＇s disease.

Zishenpingchan granules for the treatment of Parkinson＇s disease：a randomized,double-blind,placebo-controlled clinical trial

Levodopa preparations remain the preferred drug for Parkinson＇s disease.However,long-term use of levodopa may lead to a series of motor complications.Previous studies have shown that the combination of levodopa and Zishenpingchan granules（consisting of Radix Rehmanniae preparata,Lycium barbarum,Herba Taxilli,Rhizoma Gastrodiae,Stiff Silkorm,Curcuma phaeocaulis,Radix Paeoniae Alba,Rhizoma Arisaematis,Scorpio and Centipede） can markedly improve dyskinesia and delay the progression of Parkinson＇s disease,with especially dramatic improvements of non-motor symptoms.However,the efficacy of this combination has not been confirmed by randomized controlled trials.The current study was approved by the Hospital Ethics Committee and was registered in the Chinese Clinical Trial Register（registration number：Chi CTR-INR-1701194）.From December 2014 to December 2016,128 patients（72 males and 56 females,mean age of 65.78 ± 6.34 years） with Parkinson＇s disease were recruited from the Department of Neurology of Longhua Hospital and Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine in China.Patients were equally allocated into treatment and control groups.In addition to treatment with dopamine,patients in treatment and control groups were given Zishenpingchan granules or placebo,respectively,for 24 weeks.Therapeutic efficacy was assessed using the Unified Parkinson＇s Disease Rating Scale,on-off phenomenon,Hoehn-Yahr grade,Scales for Outcomes in Parkinson＇s disease–Autonomic,Parkinson＇s disease sleep scale,Hamilton Anxiety Scale,Hamilton Depression Scale,Mini-Mental State Examination,and the Parkinson＇s Disease Quality of Life Questionnaire.Artificial neural networks were used to determine weights at which to scale these parameters.Our results demonstrated that Zishenpingchan granules significantly reduced the occurrence of motor complications,and were useful for mitigating dyskinesia and non-motor symptoms of Parkinson＇s disease.This combination of Chinese and Western medicine has the potential to reduce levodopa dosages,and no obvious side effects were found.These findings indicate that Zishenpingchan granules can mitigate symptoms of Parkinson＇s disease,reduce toxic side effects of dopaminergic agents,and exert synergistic and detoxifying effects.

Optimization Model Research on Major Underlying Factors in the Subhealth Condition Evaluation in 1 City and 7 Provinces in China

Background:The study aimed to analyze major underlying factors of the subhealth condition evaluation and find the optimization model.Methods:Selected 524 cases of health state and 453 cases of subhealth state from the research objects.A genetic algorithm was applied to discover the optimization model.The decision tree algorithm was used to find the main performance in the areas of physical,psychological,and social adaptation in the two populations which were the health state and the subhealth state.Conclusions:To establish the optimization model,the author would set up a curve-fitting equation between reduction of health self-assessment score(S-G1)and white blood cell(WBC)value in routine blood,so as to establish the relationship between S-G1 and WBC and found the approximate minimum solution of each equation.Besides,the author would analyze the differences between two populations in WBC examination to seize the difference.Revealed the differences of two populations in the areas of physical,psychological,and social adaptation by data mining and got the result that WBC of"the health state population"was higher than that of"the sub-health state population"in the index changes of WBC.The problem in social adaptation area of the subhealth state population was more serious in degree than the health state population;the reason was complex.If WBC of the health state population was near or below 5.5079,the object may be in the state of subhealth.However,if WBC was near or below 4.35,it is possible to enter the"morbid state."