Are acupoints specific for diseases? A systematic review of the randomized controlled trials with sham acupuncture controls

Background  

The results of many clinical trials and experimental studies regarding acupoint specificity are contradictory. This review aims to investigate whether a difference in efficacy exists between ordinary acupuncture on specific acupoints and sham acupuncture controls on non-acupoints or on irrelevant acupoints.     

Identification and immunological characterization of thioredoxin transmembrane-related protein from Clonorchis sinensis

Thioredoxin transmembrane related protein (TMX), a member of thioredoxin superfamily, is localized to the endoplasmic reticulum and possesses a thioredoxin-like domain that plays an important role as an oxidoreductase. The functions of TMX in Clonorchis sinensis remain to be elucidated. In this study, we cloned and characterized a novel TMX of C. sinensis (CsTMX). The CsTMX cDNA sequence contained a 414-nucleotide open-reading frame encoding a protein of 137 amino acids. A thioredoxin domain was found in the position of aa_21–117 and contained the putative active-site motif Cys–Pro–Ala–Cys. BLASTx analysis showed that CsTMX shared 39–57 % amino acid identities with TMX of other organisms. Quantitative RT-PCR analysis demonstrated that CsTMX was differentially transcribed, with the highest level of expression in the adult worm stage and the lowest expression in egg stage. In addition, immunofluorescence assay showed CsTMX was localized in the tegument, vitelline gland, intestine, and intrauterine eggs of adult worm. Besides, immunoblot assay revealed that the recombinant CsTMX (rCsTMX) could be recognized by the sera from rats infected with C. sinensis and the sera from rats immunized by excretory–secretory products. Furthermore, analysis of the antibody isotype profile revealed that rats subcutaneously immunized with rCsTMX developed rCsTMX-specific antibody, which is dominance of IgG2a in sera. Meanwhile, production of IFN-γ was elevated strongly in the supernatants of spleen cell. The results collectively indicated that CsTMX might play an important role in the host–parasite interaction, as well as CsTMX probably involved in immunoregulation of host by inducing Th1-type dominated immune response in rats.     

医学生宿舍人际关系重要性分析

目前关于大学生人际关系的研究相对较少,相关文献占文章总数的0.319%(核心期刊比例为0.312%)[1],而关于大学生宿舍人际关系重要性的研究文章则更少,且大多数研究者仅从定性的角度来分析宿舍人际关系的特点及影响因素,本文从定量的角度对医学生宿舍人际关系重要性做出分析,希望初步反应医学生宿舍人际关系重视程度情况,为高校学生宿舍管理工作提供一定的借鉴.     

双相情感障碍Ⅰ型、Ⅱ型缓解期患者的认知功能对照研究

目的 分析双相情感障碍Ⅰ型和Ⅱ型缓解期患者的认知功能损害的差异。方法 选取 2020 年 1— 12 月在北京回龙观医院门诊就诊及住院的患者为研究对象,根据 DSM-5 诊断标准,分为双 相情感障碍Ⅰ型和Ⅱ型组,每组 30 例,同时纳入性别、年龄、受教育程度相匹配的健康对照者 35 名（对 照组）。采用一般情况调查表、杨氏躁狂量表、汉密尔顿抑郁量表、中文版精神分裂症认知功能成套测 验（MCCB）对 3 组研究对象进行测评。采用 Spearman 相关分析双相情感障碍患者认知功能与临床资 料的相关性。结果 双相情感障碍Ⅰ型组、双相情感障碍Ⅱ型组及对照组比较,言语学习和记忆得 分［（51.07±9.75）分比（57.07±9.67）分比（57.66±6.96）分］、视觉学习和记忆得分［（46.17±12.03）分比 （53.80±6.39）分比（55.57±7.47）分］、推理与问题解决能力得分［（49.80±10.24）分比（55.03±5.44）分比 （55.80±7.33）分］、MCCB 总分［（48.33±8.55）分比（53.10±6.97）分比（55.86±5.11）分］,差异有统计学意 义（F=5.333、9.885、5.336、9.636; P＜0.05）。双相情感障碍组患者与对照组的处理速度得分［（52.00±8.94）分 比（60.74±7.50）分］、言语学习和记忆得分［（54.07±10.09）分比（57.66±6.96）分］、视觉学习和记忆得分 ［（49.98±10.30）分比（55.57±7.48）分］、推理与问题解决能力得分［（52.42±8.55）分比（55.80±7.33）分］、 MCCB 总分［（50.72±8.10）分比（55.86±5.11）分］比较,差异有统计学意义（t=4.871、1.861、2.806、2.040、 3.379; P＜ 0.05）。Spearman 相关性分析显示,轻躁狂发作次数和视觉学习和记忆呈正相关,躁狂发作 次数和推理与问题解决能力呈负相关,发作次数与注意 / 警觉呈负相关（P＜ 0.05）。结论 双相情感障 碍Ⅰ型比Ⅱ型缓解期患者的认知功能受损重,双相情感障碍缓解期患者的认知功能受损。     

Regenerative and protective effects of calcium silicate on senescent fibroblasts induced by high glucose

Diabetic wounds are a common complication of diabetes and therefore a pressing issue for clinicians. High‐glucose (HG)‐induced fibroblast senescence is mainly responsible for delayed wound healing. Calcium silicate (CS), a kind of bioceramic, is thought to have regenerative properties. The aim of this study was to determine the regenerative and protective effects of CS on senescent fibroblasts induced by HG. Fibroblasts were passaged five times and treated with HG and CS. Compared with the normal glucose (NG) group, the proliferation, migration, and differentiation capacity of HG‐induced fibroblasts significantly decreased (P < .05). After treatment with CS, the functions of HG‐induced senescent fibroblasts were partly restored (P < .05). The mechanism of the regenerative and protective effects of CS may be related to the decreased reactive oxygen species generation, improved senescent state (SA‐β‐gal expression decreased), up‐regulated expression of Smad2 and phosphorylated Smad2, and down‐regulated expression of p16, p21, and p53. An in vivo experiment also demonstrated that CS had a therapeutic effect on diabetic wounds via differentiation of fibroblasts into myofibroblasts and enhanced collagen deposition. These results indicate that CS may be a promising candidate for diabetic wound therapy.     

关节镜下半月板部分切除术的临床效果评价

目的探究关节镜下半月板部分切除术治疗膝关节半月板损伤的临床效果。 方法选取2017年11月至2018年11月南通大学第四附属医院骨科收治的膝关节半月板损伤患者98例,其中采用关节镜下半月板部分切除者纳入研究组(n＝49),应用小切口半月板部分切除者纳入对照组(n＝49)。采用t检验对比分析两组患者的手术时间、手术费用、术前术后的疼痛视觉模拟评分(VAS评分),术前术后膝关节Lysholm功能评分,采用卡方检验对比两组的临床治疗效果。 结果研究组的治疗效果明显优于对照组(χ²＝5.124,P<0.05)、两组患者术前Lysholm评分差异无统计学意义(t＝1.562,P>0.05),研究组术后3 d(t＝14.154,P<0.05)及术后1年(t＝15.685,P<0.05)的Lysholm评分都显著高于对照组。两组患者术前疼痛评分无差异(P>0.05),术后3 d研究组患者的静息痛评分(t＝13.974,P<0.05)和行走痛评分(t＝13.976,P<0.05)均低于对照组,术后1年研究组患者的静息痛评分(t＝14.258,P<0.05)和行走痛评分(t＝14.859,P<0.05)亦显著低于对照组。对照组的手术时间短于研究组(t＝8.568,P<0.05),且手术费用更低(t＝3.405,P<0.05)。 结论关节镜下半月板部分切除治疗膝关节半月板损伤的临床效果较好,且有创伤小,疼痛轻等优点,小切口半月板部分切除术的技术难度较低,亦可在临床中选择性采用。     

全腔镜手术联合加速康复外科理念指导的呼吸功能锻炼在食管癌围手术期的应用

目的探讨全腔镜手术联合加速康复外科（ERAS）理念的呼吸功能锻炼对食管癌患者术后肺部并发症、术后疼痛、下床时间、胸腔引流量、拔管时间以及住院时间的影响。 方法选择2018年6月至2020年6月在扬州大学附属医院行食管癌手术的160例患者,随机分为4组,每组40例。A组患者采用全腔镜食管癌手术,术前行ERAS理念宣教和呼吸功能锻炼;B组采用传统开放手术,术前行ERAS理念宣教和呼吸功能锻炼;C组采用全腔镜食管癌手术,术前行常规入院宣教和护理指导,常规呼吸功能锻炼,无术前ERAS理念宣教;D组采用传统开放手术,行常规入院宣教和护理指导,常规呼吸功能锻炼,无术前ERAS理念宣教。记录4组患者术后肺部并发症的发生数量、术后疼痛、下床时间、拔管时间及住院时间。 结果与B、C两组比较,A组肺部并发症发生率明显降低,下床时间、拔管时间和住院时间明显缩短;A组较B组术后疼痛明显减轻,差异均有统计学意义（P<0.05）。与D组比较,B组肺部并发症发生率、下床时间、拔管时间和住院时间明显减少,差异均有统计学意义（P<0.05）。与D组比较,C组术后疼痛、肺部并发症发生率均降低,下床时间、拔管时间和住院时间均缩短,差异有统计学意义（P<0.05）。 结论对于食管癌手术患者,ERAS理念指导下的呼吸功能锻炼联合全腔镜手术可有效降低肺部并发症的发生率和术后疼痛,缩短下床时间、拔管时间以及住院时间。