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To explore the interventional mechanism of electroacupuncture (EA) of "Zusanli"(ST36)based on the involvement of mast cells/ transient receptor potential vanilloid type1 (TRPV1) signaling pathway in relieving visceral hypersensitivity in functional dyspepsia (FD) rats.Sixty SD rats (half male and half female, 10 days in age) were randomly divided into normal control, model, medication (ketotifen) and EA groups, with 15 rats in each group. The FD model was established by gavage of iodoacetamide combined with tail clamping (stress stimulation). Rats of the medication group received intraperitoneal injection of ketotifen (1 mg·kgWhen the intragastric pressure was at 50, 60 and 70 mm Hg, the gastric compliance was significantly decreased (EA of ST36 can suppress visceral hypersensitivity and increase the gastric compliance in FD rats, which may be related with its effects in inhibiting the activation of gastric mast cells, and down-regulating the expression of gastric PAR2 and TRPV1 proteins and SP and CGRP contents.

To observe the effect of transcutaneous auricular vagus nerve stimulation (taVNS) on the depressive behavior in depression rats, so as to explore its mechanism underlying improvement of depression.A total of 24 male Sprague Dawley rats were randomly divided into normal, depression model, taVNS, tnVNS (transcutaneous auricular none-vagus nerve stimulaton) groups (Following modeling, the increase amount of body weight was decreased, the forced swimming immobility time and expression TLR4, MyD88 and IL-18 protein in the prefrontal cortex were increased in the model group than those in the normal group (TaVNS is able to improve depression in depression rats, which is probably related to its effect in inhibiting inflammatory response of TLR4/MyD88 signaling pathway in prefrontal cortex.

The hypothalamus-pituitary-adrenal axis is the most important endocrine system to control irritability response. Functional dyspepsia (FD) is closely related to irritability. This study aimed to preliminarily explore the corticotropin-releasing factor (CRF) mechanism of auricular vagus nerve stimulation (aVNS) for FD model rats.Sprague-Dawley adult male rats were randomly divided into normal group, model group, aVNS group, and sham-aVNS group. Except for the normal rats, all other rats were induced into the FD model through tail-clamping stimulation for 3 weeks. Once the rat model was developed successfully, rats in the aVNS group and sham-aVNS group were intervened with aVNS or sham-aVNS for 2 weeks. No intervention was given to rats in the normal and model groups. The effect of aVNS was assessed. The expressions of hippocampal corticotropin-releasing hormone receptor 1 (CRHR1), hypothalamus CRF, adrenocorticotropic hormone (ACTH), and corticosterone in serum were assessed.1. Compared with normal rats, model-developing rats showed FD-like behavior. 2. Compared with model rats, rats in the aVNS group showed an improved general condition score and gastric motility, and increased horizontal and vertical motion scores. 3. The release of corticosterone, ACTH in serum, and CRF in the hypothalamus all increased in model rats but decreased with aVNS instead of sham-aVNS. 4. The expression of hippocampus CRHR1 was lower in model rats but higher in the aVNS group.aVNS ameliorates gastric motility and improves the mental state in the FD-like rat, probably via inhibiting the CRF pathway.

To explore the effect of transcutaneous auricular vagus nerve stimulation (taVNS) on blood glucose regulation and the expression of insulin receptors (INR) of hypothalamus, liver and skeletal muscle tissues in impaired glucose tolerance (IGT) rats, so as to reveal its mechanisms underlying improvement of IGT.Thirty-six male Wistar rats were randomly divided into control, model, transcutaneous auricular none-vagus nerve stimulation (tnVNS), and taVNS groups (After modeling, the rats' body weight, the contents of FPG, 2 h PG, GC and GHbA1c were significantly up-regulated (taVNS can improve the blood glucose and insulin sensitivity in IGT rats, which may contribute to its effectiveness in up-regulating the expression of INR in hypothalamus, liver and skeletal muscle tissues.

Purpose To evaluate the efficacy of induction chemotherapy in the treatment of stage II nasopharyngeal carcinoma (NPC) in era of intensity modulated radiotherapy (IMRT). Methods and materials A total of 173 patients with American Joint Committee on Cancer (AJCC) 7th stage II NPC from two institutions were included. All patients were divided into two groups: induction chemotherapy + concurrent chemoradiotherapy group (ICRT) group and concurrent chemoradiotherapy group (CCRT). Induction chemotherapy was consisted of one to three cycles of cisplatin plus fluorouracil (PF) or paclitaxel plus cisplatin (TP). Concurrent chemotherapy included one to three cycles of cisplatin. We retrospectively assessed overall survival (OS), progression-free survival (PFS), locoregional failure free survival (LRFFS) and distant metastasis free survival (DMFS) in patients of both groups. T-test, Chi-square test, Kaplan–Meier methodology and Cox proportional hazards model were used to analyze. Results With a median follow up of 64.7 months, no significant difference was found in grade 3–4 hematologic toxicity, liver dysfunction and renal impairment between ICRT and CCRT group. Univariable analyses shown adding induction chemotherapy to CCRT significantly decreased 5-year OS (87.9% vs 95.5%, P = 0.033), 5-year PFS (74.0% vs 86.1%, P = 0.035), 5-year LRFFS (80.0% vs 91.2%, P = 0.016), but there was no statistically significant difference in 5-year DMFS (87.1% vs 94.7%, P = 0.095). In multivariable analyses, we found the consistent results that induction chemotherapy was a negative factor associated with OS (HR of death = 3.768, 95% CI = 1.117–12.709; P = 0.032), PFS (HR of progression = 2.156, 95% CI = 1.060–4.386; P = 0.034), LRFFS (HR of locoregional relapse = 2.435, 95% CI = 1.009–5.874; P = 0.048) and also DMFS (HR of metastasis = 2.873, 95% CI = 1.005–8.211; P = 0.049), in stage II NPC patients. Conclusion In present study, we found that induction chemotherapy caused deleterious effect on stage II NPC patients. However, this is a retrospective study and the adverse effects of induction chemotherapy has not been previously reported. It warrants further investigation.

ObjectiveTo evaluate the diagnostic accuracy of transthoracic echocardiography (TTE) in patients with pulmonary hypertension (PH).DesignSystematic review and meta-analysis.Data sources and eligibility criteriaEmbase, Cochrane Library for clinical trials, PubMed and Web of Science were used to search studies from inception to 19 June, 2019. Studies using both TTE and right heart catheterisation (RHC) to diagnose PH were included.Main resultsA total of 27 studies involving 4386 subjects were considered as eligible for analysis. TTE had a pooled sensitivity of 85%, a pooled specificity of 74%, a pooled positive likelihood ratio of 3.2, a pooled negative likelihood ratio of 0.20, a pooled diagnostic OR of 16 and finally an area under the summary receiver operating characteristic curve of 0.88. The subgroup with the shortest time interval between TTE and RHC had the best diagnostic effect, with sensitivity, specificity and area under the curve (AUC) of 88%, 90% and 0.94, respectively. TTE had lower sensitivity (81%), specificity (61%) and AUC (0.73) in the subgroup of patients with definite lung diseases. Subgroup analysis also showed that different thresholds of TTE resulted in a different diagnostic performance in the diagnosis of PH.ConclusionTTE has a clinical value in diagnosing PH, although it cannot yet replace RHC considered as the gold standard. The accuracy of TTE may be improved by shortening the time interval between TTE and RHC and by developing an appropriate threshold. TTE may not be suitable to assess pulmonary arterial pressure in patients with pulmonary diseases.PROSPERO registration numberPROSPERO CRD42019123289.

Background: Although much attention has been paid to the pharmacokinetics (PKs) of different factor VIII (FVIII) concentrates in persons with hemophilia A (HA), limited information is available in young boys with severe HA. In this study, we aimed to assess the PK parameters of FVIII products in boys with severe HA in China. Methods: A total of 36 boys (plasma-derived [pd]-FVIII, n = 15; recombinant [r] FVIII, n = 21) were enrolled between January 2015 and May 2016 in Beijing Children’s Hospital. PK characteristics of FVIII products were studied according to a reduced 4-sampling time point design (1 h, 9 h, 24 h, and 48 h postinfusion). Results: The mean FVIII half-life (t1/2) was 10.99 ± 3 .45 h (range 5.52- 20.02 h), the mean in vivo recovery (IVR) was 2.01 ± 0.42 IU/dl per IU/kg (range 1.24–3.02 IU/dl per IU/kg) and mean clearance (CL) of FVIII is 4.34 ± 1.58 ml·kg−1·h−1 (range 2.29–7.90 ml·kg−1·h−1). We also analyzed the influence of several parameters that potentially modulate FVIII PK. The age was closely associated with FVIII half-life (R2 = 0.32, P< 0.01). The t1/2 of FVIII increased by 0.59 h per year. Besides age, von Willebrand factor antigen (VWF:Ag) also was associated with FVIII half-life (R2 = 0.52, P< 0.01). Patients with blood Group O had a shorter FVIII half-life than patients with non-O blood group (9.40 ± 0.68 h vs. 12.3 ± 0.79 h, t = 2.70, P= 0.01). The FVIII IVR correlated with age (R2 = 0.21, P< 0.01) and VWF:Ag level (R2 = 0.28, P< 0.01). CL rates were faster in young patients and in those with low-VWF:Ag levels. CL rates of FVIII are higher in blood Group O versus non-blood Group O persons (5.02 ± 0.38 vs. 4.00 ± 0.32 ml·kg−1·h−1, t= 2.53, P= 0.02). Conclusions: Chinese boys with severe HA have similar PK values to other ethnic groups and large differences in FVIII PK between individual patients. Age, blood group, and VWF:Ag levels are important determining factors for FVIII CL. Key words: Boys; Factor VIII; Hemophilia A; Pharmacokinetics

Quality of life (QoL) post-stroke is an important health outcome. Physical deconditioning and physical inactivity are highly prevalent in stroke survivors. This study aimed to assess the long-term trends in QoL and to explore the effect of exercise on the QoL of ischaemic stroke patients.Data for this prospective study were collected at baseline using face-to-face interviews, and telephone follow-ups were completed every three months from 2010 through 2014. QoL was evaluated with the 12-item Short-Form Health Survey (SF-12). The relationship between changes in exercise and QoL changes was analysed with a multi-level model.Exercise and QoL generally increased during the study period. After adjusting for covariates, the SF-12 Physical Component Summary (PCS) scores increased by 0.60 on average for each unit increase in exercise frequency and by 0.52 for each hour increase in weekly exercise time. For weekly exercise times ≤ 22.73 h, the PCS scores continued to increase with increasing exercise time. The Mental Component Summary scores increased by 0.51 on average for each unit increase in exercise frequency and by 0.35 for each hour increase in weekly exercise time. Furthermore, the standard deviations of exercise frequency and exercise time were inversely associated with changes in the PCS score.Exercise is an important modifiable behaviour. Long-term regular mild exercise should be recommended to improve QoL among stroke survivors.

To observe the effect of electroacupuncture (EA) on incisional pain and expression of tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10) and interleukin-4 (IL-4) of cervical dorsal part of spinal cord in rats with incisional neck pain, so as to explore its analgesic mechanisms.Eighty-four male SD rats were randomly divided into normal control, model, EA-Futu(LI18) and EA-Zusanli(ST36)-Yanglingquan(GB34, EA-ST36-GB34) groups (Compared with the normal group, the TPT of the incisional area was significantly decreased at 4, 24 and 48 h after neck-incision (EA of LI18 has an analgesic effect in incisional neck pain rats, which may be related to its effect in down-regulating the expression of TNF-α, IL-10 and promoting IL-4 /IL-4R signaling in dorsal portions of the cervical spinal cord. The analgesic effect of EA LI18 is better than that of EA ST36-GB34.

Some important pro-inflammatory cytokines such as interleukin-6, tumor necrosis factor-α and nitric oxide are thought to play key roles in the destruction of cartilage and bone tissue in joints affected by rheumatoid arthritis. In the present study, a series of new myricetin-pentadienone hybrids were designed and synthesized. Majority of them effectively inhibited the expressions liposaccharide-induced secretion of IL-6, TNF-α and NO in RAW264.7. The most prominent compound 5o could significantly decrease production of above inflammatory factors with IC50 values of 5.22 µM, 8.22 µM and 9.31 µM, respectively. Preliminary mechanism studies indicated that it could inhibit the expression of thioredoxin reductase, resulting in inhibiting of cell signaling pathway nuclear factor (N-κB) and mitogen-activated protein kinases. Significantly, compound 5o was found to effectively inhibit Freund’s complete adjuvant induced rat adjuvant arthritis in vivo.

To observe the effect of auricular electroacupuncture (EA) on intracellular Raf/ extracellular signal-regulated kinase (ERK)/ ribosomal S6 kinase (RSK)/ cAMP response element-binding protein (CREB) signal pathway in the hippocampus of depression model rats, so as to explore its anti-depressive mechanism.A total of 60 male SD rats were randomly divided into control, model, auricular EA, PD98059(ERK inhibitor), DMSO (Dimethylsulfoxide), PD98059+EA groups (Following modeling, the sucrose consumption volume, and the expression levels of hippocampal Raf, p-Raf, ERK, p-ERK, RSK, CREB, p-CREB proteins were significantly lower in the model group than those in the control group (EA of auricular "Xin" and "Shenmen" is able to improve depression in depression rats, which is probably related to its effect in promoting activities of hippocampal Raf/ERK/RSK/CREB signaling.

Aim Acupuncture has benefits in the rehabilitation of neuropsychiatric sequelae of stroke. This study was aimed to evaluate the effectiveness of dense cranial electroacupuncture stimulation plus body acupuncture (DCEAS+BA) in treating poststroke depression (PSD), functional disability, and cognitive deterioration. Methods In this assessor- and participant-blinded, randomized controlled trial, 91 stroke patients who initially had PSD were randomly assigned to either DCEAS+BA (n = 45) or minimum acupuncture stimulation as controls (n = 46) for three sessions per week over 8 consecutive weeks. The primary outcome was baseline-to-end-point change in score of the 17-item Hamilton Depression Rating Scale. Secondary outcomes included the Montgomery-Asberg Depression Rating Scale for depressive symptoms, the Barthel Index for functional disability, and the Montreal Cognitive Assessment for cognitive function. Results DCEAS+BA-treated patients showed strikingly greater end-point reduction than MAS-treated patients in scores of the three symptom domains. The clinical response rate, defined as an at least 50% baseline-to-end-point reduction in 17-item Hamilton Depression Rating Scale score, was markedly higher in the DCEAS+BA-treated group than that of controls (40.0% vs 17.4%, P = 0.031). Incidence of adverse events was not different in the two groups. Subgroup analysis revealed that DCEAS+BA with electrical stimulation on forehead acupoints was more apparent in reducing Barthel-Index-measured disability than that without electrical stimulation. Conclusion DCEAS+BA, particularly with electrical stimulation on forehead acupoints, reduces PSD, functional disability, and cognitive deterioration of stroke patients. It can serve as an effective rehabilitation therapy for neuropsychiatric sequelae of stroke.

Introduction: White matter hyperintensities (WMHs) were commonly seen in brain magnetic resonance imaging (MRI) of the elderly. Many studies found that WMHs were associated with cognitive decline and dementia. However, the association between WMHs in different brain regions and cognitive decline remains debated. Methods: We explored the association of the severity of WMHs and cognitive decline in 115 non-demented elderly (≥50 years old) sampled from the Wuliqiao Community located in urban area of Shanghai. MRI scans were done during 2009–2011 at the beginning of the study. Severity of WMHs in different brain regions was scored by Improved Scheltens Scale and Cholinergic Pathways Hyperintensities Scale (CHIPS). Cognitive function was evaluated by Mini-Mental State Examination (MMSE) every 2 to 4 years during 2009–2018. Results: After adjusting for confounding factors including age, gender, education level, smoking status, alcohol consumption, depression, hypertension, diabetes, hyperlipidemia, brain infarcts, brain atrophy, apoE4 status, and baseline MMSE score, periventricular and subcortical WMH lesions as well as WMHs in cholinergic pathways were significantly associated with annual MMSE decline ( p < 0.05), in which the severity of periventricular WMHs predicted a faster MMSE decline (–0.187 points/year, 95% confidence interval: –0.349, –0.026, p = 0.024). Conclusions: The severity of WMHs at baseline was associated with cognitive decline in the non-demented elderly over time. Interventions on WMH lesions may offer some benefits for cognitive deterioration.

Background Computerized multi-model training has been widely studied for its effect on delaying cognitive decline. In this study, we designed the first Chinese-version computer-based multi-model cognitive training for mild cognitive impairment (MCI) patients. Neuropsychological effects and neural activity changes assessed by functional MRI were both evaluated. Method MCI patients in the training group were asked to take training 3–4 times per week for 6 months. Neuropsychological and resting-state fMRI assessment were performed at baseline and at 6 months. Patients in both groups were continuously followed up for another 12 months and assessed by neuropsychological tests again. Results 78 patients in the training group and 63 patients in the control group accomplished 6-month follow-up. Training group improved 0.23 standard deviation (SD) of mini-mental state examination, while control group had 0.5 SD decline. Addenbrooke's cognitive examination-revised scores in attention (p = 0.002) and memory (p = 0.006), as well as stroop color-word test interference index (p = 0.038) and complex figure test-copy score (p = 0.035) were also in favor of the training effect. Difference between the changes of two groups after training was not statistically significant. The fMRI showed increased regional activity at bilateral temporal poles, insular cortices and hippocampus. However, difference between the changes of two groups after another 12 months was not statistically significant. Conclusions Multi-model cognitive training help MCI patients to gained cognition benefit, especially in memory, attention and executive function. Functional neuroimaging provided consistent neural activation evidence. Nevertheless, after one-year follow up after last training, training effects were not significant. The study provided new evidence of beneficial effect of multi-model cognitive training., Highlights • The cognitive training for mild cognitive impairment had positive effect on memory, attention and executive function. • The beneficial effect was observed immediately after six-month training and confined to trained cognitive domains. • In the 12 months after training, training and control group had no difference in cognitive decline. • Functional neuroimaging showed increased regional activity at bilateral temporal poles, insular cortices and hippocampus.

Background Whether the ABO blood group is associated with the survival of patients with laryngeal cancer remains unknown. The purpose of this study was to investigate the association between the ABO blood group and clinicopathologic characteristics of patients with laryngeal cancer and assess whether the ABO blood group was associated with prognosis. Methods We analyzed the records of 1260 patients with laryngeal cancer who underwent curative treatment at Sun Yat-sen University Cancer Center between January 1993 and December 2009. The Chi-square test was used to assess the relationship between the ABO blood group and clinicopathologic characteristics. The Kaplan–Meier method was used to estimate 3-, 5-, and 10-year overall survival (OS) rates. The Cox proportional hazards model was used in univariate and multivariate analyses of OS. Results No significant association was found between the ABO blood group and clinicopathologic characteristics except for primary tumor site. The median OS for patients with blood groups A, B, AB, and O were 87.0, 80.0, 90.0, and 72.5 months, respectively. The 3-, 5-, and 10-year OS rates were 82.4%, 76.0%, and 67.5% for patients with blood group A; 77.4%, 69.8%, and 58.4% for patients with blood group B; 82.2%, 73.1%, and 65.6% for patients with blood group AB; and 71.7%, 66.4%, and 55.5% for patients with blood group O, respectively. Univariate and multivariate analyses showed that the ABO blood group had significant effects on prognosis in patients with laryngeal cancer. Conclusions The ABO blood group is associated with survival in patients with laryngeal cancer. Patients with blood group O had significantly shorter OS than patients with other ABO blood groups.

This study is aim to investigate the effect of electro-acupuncture at PC6 (Neiguan-point) on the gene and protein expressions of classical inward-rectifier potassium channels (Kir) in myocardial ischemia (MI) rats induced by isoproterenol (ISO). With ten for each one, 50 rats were divided into 5 groups which were control group, MI group, PC6 group, LU7 (Lieque-point) group and non-acupoint group. The control group was injected normal saline solution (85mg/kg), the other groups were injected ISO (85mg/kg). All the rats were injected once daily for two days and recorded electrocardiograms (ECGs) after every injection. Electro-acupuncture (EA) was operated at PC6, LU7 and non-acupoint respectively in the rats of PC6 group, LU7 group and non-acupoint group after twice injections. EA was performed to these three groups with disperse-dense wave (4-20Hz), pulse amplitude of 14V, 20mins a day remaining 7 days. The gene and protein expressions of Kir2.1, Kir2.2 and Kir2.3 were analyzed by Western Immunoblotting Technology (Western Blot) and Real-time Fluorescence Quantitative Polymerase Chain Reaction (RT-PCR). But it is regrettable that we did not detect meaningful gene and protein expressions Kir2.3, and the expressions of Kir2.1 and Kir2.2 in MI induced groups were lower [The gene and protein decreased 39.4 ± 27.3% and 38.7 ± 17.1% respectively.] than control group (PPP < 0.05). The results show that PC6 has a better positive effect than LU7 on MI rats, and the mechanism is probably that EA at PC6 can significantly increase the gene and protein expressions of Kir2.1 and Kir2.2.

Rapidly progressive glomerulonephritis presents crescentic glomerulonephritis (CrGN) pathologically. Immune complex (IC)-mediated CrGN is characterized by glomerular IC deposits, whereas pauci-immune CrGN is characterized by presence of antineutrophil cytoplasmic antibody (ANCA) and absence of glomerular IC deposits. CrGN cases presenting both IC deposits and ANCA were common. We retrospectively investigated 91patients with rapidly progressive glomerulonephritis, including 36 patients with idiopathic IC-mediated CrGN and 55 patients with pauci-immune CrGN. On the basis of ANCA and IC deposits, there were 42 patients with ANCA alone (ANCA+IC-), 6 patients with IC deposits alone (ANCA-IC+), 30 patients with both ANCA and IC deposits (ANCA+IC+), and 13 patients with neither ANCA nor IC deposits. The patients with IC-mediated CrGN had more proteinuria, lower estimated glomerular filtration rate (eGFR), higher percentage of cellular crescent formation, and a worse renal outcome compared with those with pauci-immune CrGN. The ANCA+IC+ CrGN patients had lower eGFR level, higher percentage of crescent formation and a tendency of more proteinuria, and worse renal outcome compared with ANCA+IC- CrGN patients, but had no significant differences on the above characteristics compared with ANCA-IC+ CrGN patients. Within a median 7.1 months, 22 patients developed end-stage renal disease. Cox regression revealed the factors including lower eGFR level, more proteinuria, lower platelet level, higher glomerular global sclerosis rate, and glomerular IgG deposits were the independent factors for worse renal outcome. In conclusion, the clinicopathologic spectrum of ANCA+IC+ CrGN was similar with IC-mediated CrGN and glomerular IgG deposition was one of the independent factors for worse renal outcome.

Objective: The treatment of Henoch-Schönlein purpura (HSP) with moderate proteinuria remains controversial. We retrospectively analyzed the efficacy of immune suppressants, with a particular emphasis on mycophenolate mofetil (MMF). Methods: Ninety-five HSP patients with moderate proteinuria (1.0–3.5 g/24 h) after at least three months of therapy with angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) were divided into three groups: an MMF group (n=33) that received MMF 1.0–1.5 g/d combined with prednisone (0.4–0.5 mg/(kg·d)), a corticosteroid (CS) group (n=31) that received full-dose prednisone (0.8–1.0 mg/(kg·d)), and a control group (n=31). Patients in the MMF and CS groups continued to take ACEI or ARB at the original dose. The patients in the control group continued to take ACEI or ARB but the dose was increased by (1.73±0.58)-fold. The patients were followed up for 6–78 months (median 28 months). Results: The baseline proteinuria was higher in the MMF group ((2.1±0.9) g/24 h) than in the control group ((1.6±0.8) g/24 h) (P=0.039). The proteinuria decreased significantly in all groups during follow-up, but only in the MMF group did it decrease significantly after the first month. At the end of follow-up, the proteinuria was (0.4±0.7) g/24 h in the MMF group and (0.4±0.4) g/24 h in the CS group, significantly lower than that in the control group ((0.9±1.1) g/24 h). The remission rates in the MMF group, CS group, and control group were respectively 72.7%, 71.0%, and 48.4% at six months and 72.7%, 64.5%, and 45.2% at the end of follow-up. The overall number of reported adverse events was 17 in the MMF group, 30 in the CS group, and 6 in the control group (P

To observe the influence of electroacupuncture stimulation (EA) of "Neiguan" (PC 6)/"Lieque" (LU 7) on ST segment of electrocardiogram (ECG) and the expression of myocardiac chloride channel (CLC)-2 and calcium (CaThirty ASIC 3Outcomes of HE staining showed that the ischemic injury (sarcoplasm swelling and necrosis, etc.) of the left ventrical myocardial tissue after mo-deling was relatively milder in the EA-PC 6 group, not in the EA-non-acupoint group. The SOD activity was significantly lower in the model group than in the control group (EA of "Neiguan" (PC 6) can effectively suppress the increase of expression of CLC-2 and CLCA proteins in the left ventricle myocardium, which may contribute to its effect in relieving myocardial injury in mice.

To observe the effect of electroacupuncture (EA) stimulation of "Futu"(LI 18), etc. on activities of satellite glial cells (SGCs) in the dorsal root ganglia (DRG) in rats with neck-incision pain so as to explore its mechanism underlying reduction of post-surgical pain of thyroidectomy.Male SD rats were randomly divided into control, model, EA-Futu (LI 18), EA-Hegu (LI 4)-Neiguan (PC 6), and EA-Zusanli (ST 36)-Yanglingquan (GB 34) groups, with 20 rats in each group. The neck-incision pain model was established by making a longitudinal incision and repeated mechanical stimulation. In the EA-LI 18, EA-LI 4-PC 6 and EA-ST 36-GB 34 groups, EA stimulation was administrated for 30 min, once a day,continuously for 3 days. The thermal pain threshold (PT) of the neck-incision region was detected. The immunoactivity of glial fibrillary acidic protein (GFAP,a specific marker for SGCs) and connexin 43 (Cx 43) of DRGs (C 2-C 6) was determined by fluorescent immunohistochemistry. The expression levels of GFAP, IL-1 β, IL-6, and TNF-α mRNAs were determined by quantitative Real-time PCR, and the contents of IL-1 β,IL-6,TNF-α assayed by enzyme linked immunosorbent assay (ELISA) and the expression of Cx 43 protein was detected by Western blot.After EA intervention at LI 18 and LI 4-PC 6 (but not ST 36-GB 34), neck incision-induced reduction of the thermal PT was obviously prolonged in comparison with the model group (EA stimulation of LI 18 and LI 4-PC 6 can significantly suppress pain reaction of neck incision in the rat, which is closely associated with its effects in down-regulating the activity of SGCs, decreasing the release of pro-inflammatory cytokines and in weakening the expression of Cx 43 in the cervical DRGs.

INTRODUCTION As the pharmacokinetics (PK) of factor VIII (FVIII) is individualized in children with haemophilia A (HA), PK parameters may be indicators of patients' bleeding phenotype and instruction for their personalized replacement program. AIM The aim of this study was to investigate the possible relationship between PK/FVIII level and bleeding frequency in Chinese paediatric patients with severe (HA). METHODS A total of 24 patients were enrolled in Beijing Children's Hospital from February to October 2015, all of whom were given 50 IU/kg of FVIII concentrates after a 72-hours washout period. Samples' activities (FVIII:C) were tested at 5 time points, using WinNonlin software for PK testing, and then the individual half-life(t1/2 ) and the time (h) of FVIII concentrations

To determine factors associated with smoking relapse in men who survived from their first stroke.Data were collected through face to face interviews with stroke patients in the hospital, and then repeated every three months via telephone over the period from 2010 to 2014. Kaplan-Meier method and competing risk model were adopted to estimate and predict smoking relapse rates.The Kaplan-Meier method estimated a higher relapse rate than the competing risk model. The four-year relapse rate was 43.1% after adjustment of competing risk. Exposure to environmental tobacco smoking outside of home and workplace (such as bars and restaurants) (When competing risks exist, competing risks model should be used in data analyses. Smoking interventions should give priorities to those without a spouse and those with a heavy smoking history. Smoking ban in public settings can reduce smoking relapse in stroke patients.

Continued smoking following stroke is associated with adverse outcomes including increased risk of mortality and secondary stroke. The aim of this study was to examine the long-term trends in smoking behaviors and factors associated with smoking relapse among men who survived their first-ever stroke. Data collection for this longitudinal study was conducted at baseline through face-to-face interviews and follow-up was completed every 3 months via telephone, beginning in 2010 and continuing through 2014. Cox proportional hazard regression models were used to identify predictors of smoking relapse behavior. At baseline, 372 male patients were recruited into the study. Totally, 155 (41.7%) of these patients stopped smoking for stroke, and 61 (39.3%) began smoking again within 57 months after discharge with an increasing trend in the number of cigarettes smoked per day. Exposure to environmental tobacco smoke at places outside of home and work (such as bars, restaurants) (HR, 2.34; 95% CI, 1.04-5.29, P=0.04), not having a spouse (HR, 0.12; 95% CI, 0.04-0.36; P=0.0002) and smoking at least 20 cigarettes per day before stroke (HR, 2.42; 95% CI, 1.14-5.14, P=0.02) were predictors of smoking relapse. It was concluded that environmental tobacco smoke is an important determinant of smoking relapse among men who survive their first stroke. Environmental tobacco smoke should be addressed by smoke-free policies in public places.

To determine the association between smoking and ischemic stroke recurrence.We conducted a prospective follow-up study of patients with first incidence of stroke. A competing risks model was used to establish the association between smoking and stroke recurrence.A total of 594 stroke patients were recruited. Among the 361 male patients, 59 recurrent events and 13 competing events occurred. Among the 233 female patients (all were non-smokers), 49 recurrent events and 11 competing events occurred. Adjusted for confounding factors, male nonsmokers exposed to passive smoking had a SHR of 3. 040 in comparison with those without exposure to smoking and the P value was borderline significant. Those who smoked 100-200 cigarettes a year had a SHR of 0. 947. The other groups with exposure to smoking had a greater than 1 SHR, but without statistical significance. Moreover, no significant associations between recurrence of ischemic stroke and smoking index/cumulative smoking were found. The female nonsmokers who had exposure to passive smoking only at follow-ups had a SHR of 1. 4 (and all other groups had less than 1 SHR). But no statistical significances were found in the comparisons.Further research with a larger sample size is needed to establish the association between smoking and recurrence of ischemic stroke.

Supplemental Digital Content is available in the text, To evaluate the clinical significance of pretreatment levels of plasma Epstein–Barr virus DNA (pEBV DNA) on prognoses in pediatric nasopharyngeal carcinoma (NPC) patients. Eighty-nine patients aged 21 years old or younger with nonmetastatic NPC were evaluated to determine the effect of pEBV DNA levels on progression-free survival (PFS), distant metastasis-free survival (DMFS), and overall survival (OS). Survival probabilities in patient groups that were segregated by clinical stage or pEBV DNA load (low or high) were compared. The median pretreatment concentrations of pEBV DNA were 3440 copies/mL in 35 patients with stage III disease and 14,900 copies/mL in 50 patients with stage IV disease (P = 0.059). The median concentration of pEBV DNA was 34,500 copies/mL in 17 patients with relapse, which was higher than the concentration in 72 patients without relapse, who had a median level of 4985 copies/mL (P = 0.057). Further study showed that pretreatment pEBV DNA load was an independent prognostic indicator in pediatric NPC patients. High pEBV DNA was associated with adverse clinical outcomes, including PFS [3-year PFS rate = 80.5% versus 95.8%, hazard ratio (HR) = 5.00, 95% confidence interval (CI) = 1.00–25.00; P = 0.050], DMFS (3-year DMFS rate = 80.5% versus 95.8%, HR = 5.20, 95% CI = 1.04–26.00; P = 0.045), and OS (3-year OS rate = 82.9% versus 95.8%, HR = 5.41, 95% CI = 1.08–27.22; P = 0.040). Pretreatment pEBV DNA load was an independent prognostic indicator for PFS, DMFS, and OS in pediatric patients with NPC. Prospective studies, however, are needed to validate these results.

In order to determine the prevalence of GIGYF2 (Grb10-Interacting GYF Protein 2) variants in the Chinese population and to better understand the association between GIGYF2 and Parkinson's disease (PD), we conducted the genetic screening of GIGYF2 in the Chinese population. Twelve exonic variants were identified in 52 familial PD probands and 56 healthy controls. Non-synonymous point variants (Thr25Ala, Asn457Th and Pro460Th) were analyzed in 510 PD patients and 481 healthy controls of Chinese Han ethnicity. The insertion and deletion variants in Exon 25 (Ins Q 1212, Ins QQ 1217, Del Q 1210, Del Q 1216 and Del PPQ1217_1219) are not related to the onset of familial PD. Our data indicate the GIGYF2 variants are not associated with PD in the mainland Chinese Population.

We conducted a case-control study to determine the prevalence of the CALHM1 P86L polymorphism (rs2986017) in patients with Alzheimer's disease (AD) in the Chinese population of mainland China, and also to clarify whether this polymorphism is a risk factor for AD. Fourteen heterozygous P86L carriers were identified among 198 AD patients. One control subject was also found to be a P86L heterozygous carrier. The allelic frequencies of the AD patients and control subjects were found to be significantly different. Our study indicates that the CALHM1-P86L polymorphism is associated with AD in the ethnic Chinese Han.

Summary 1 Blood pressure variability (BPV) includes physiological and random variations in blood pressure (BP). Commonly used approaches, such as standard deviation (SD) and weighted standard deviation (wSD) methods, do not efficiently assess random variation in BP. In the present study, we propose a novel method to assess individual BP variations, extracting random variation in BP by eliminating physiological variation mathematically. This novel assessment method furthers our understanding of the relationship between BP variation and lacunar infarction (LACI). 2 In the present study, we analysed ambulatory blood pressure monitoring recordings taken from 1526 men aged 60–98 years of age. Individual curves were created using a mathematical method and the related BP variation calculated, namely the SD for individual BP variations. In addition, correlations between LACI and BP variations as determined by the classical SD method, wSD and our novel assessment method (SD′) were evaluated. 3 The results demonstrated that 24 h variations in systolic BP (SBP) were closely associated with LACI when the SD and wSD methods were used (P

Grb10-Interacting GYF Protein-2 gene (GIGYF2) has been suggested as a candidate gene for PARK11 locus since seven different GIGYF2 missense mutations were identified in familial Parkinson's disease (PD) patients of European descent. To evaluate the frequency and distribution of GIGYF2 Asn56Ser mutation in Chinese PD patients, we analyzed 469 patients with PD from mainland China, including 36 cases with familial PD and 433 cases with sporadic PD. A total of 451 subjects without neurological disorders from the same region in China were set as a control group. The result showed that the GIGYF2 Asn56Ser mutation was not present in all subjects. Our finding suggests that the GIGYF2 Asn56Ser mutation is rare in Chinese PD patients.

Purpose To estimate the influence of prolonged radiation treatment time (RTT) on survival outcomes in nasopharyngeal carcinoma after continuous intensity-modulated radiation therapy. Methods and Materials Retrospectively review 321 patients with NPC treated between October 2009 and December 2010 and all of them underwent simultaneous accelerated intensity-modulated radiation therapy. The fractionated dose was 2–2.47 Gy/F (median 2.27 Gy), and the total dose for nasopharyngeal region was 64–74 Gy/ 28–33 fractions. The association of prolonged RTT and treatment interruption with PFS, LRFS and DFFS were assessed by univariate analysis and multivariate analysis. Survival analyses were carried out using Kaplan–Meier methodology and the log-rank test was used to assess the difference. The Cox regression proportional hazard model was used for multivariate analyses and evaluating the prognostic parameters for PFS, LRFS and DFFS. Results Univariate analysis revealed no significant associations between prolonged RTT and PFS, LRFS, DFFS when dichotomized using various cut-off values (all P>0.05). In multivariate analysis, RTT (range, 36–63 days) as a continuous variable, had no influence on any survival outcome as well (P>0.05). T and N classification were independent prognostic factors for PFS, LRFS and DFFS (all P

This study explored the mechanism of electro-acupuncture (EA) at PC6 to improve the heart function by regulating the cardiac transient outward potassium current (=Ito) channel in myocardial ischemia (MI). Kv1.4 is the main component of the slow Ito (Ito. s) channel. Kv4.2 and Kv4.3 are the main components of the fast Ito (Ito. f) channel. KChIP2 is a compound protein of Ito channel. In this experiment, MI was induced by injecting isoproterenol in rats, and the gene and protein expressions of Kv1.4, Kv4.2, Kv4.3 and KChIP2 were lower [The gene and protein decreased (42.8±4.3)% and (37.2±4.7)% respectively.] than the control rats significantly (p < 0.05). After MI induction, the MI rats were divided into three groups, including PC6, LU7 (Lieque-point) and Non-acupoint group which were acupunctured at once a day for 7 days respectively. After EA at PC6 and LU7, the gene and protein expressions showed obvious increased [EA at PC6: the gene and protein increased (50.2±5.4)% and (39.1±5.3)% respectively. EA at LU7: the gene and protein increased (24.6±2.8)% and (22.0±5.5)% respectively] and they are all higher than MI rats significantly (p < 0.05). EA at PC6 and LU7 showed the same variation, and the effects of EA at PC6 and LU7 were better than Non-acupuncture-point (p < 0.05). The effects of EA at PC6 were significantly better [The gene and protein increased (19.7±2.7)% and (14.1±4.4)% respectively] than LU7 (p < 0.05). PC6 is an acupoint of the pericardium meridian, and the pericardium meridian which corresponds to adrenal gland according to Omura Y's research, can affect the heart function directly. LU7 belong to the lung meridian, and the lung plays an important factor in blood circulation according to TCM. So PC6 is more effective than LU7 on heart function regulation. The results suggested that PC6 showed the target effect of meridian specificity on regulating the Kv channel in MI.

To observe changes of electrical activities of wide dynamic neurons (WDR) in the lumbar spinal cord after electroacupuncture (EA) stimulation of "Zusanli" (ST 36) during colorectal distension in rats, so as to analyze alternations of acupoint's functions under pathological conditions.Experiments were performed in male Sprague-Dawley rats. Visceral nociceptive information input was generated by colorectal distension (CRD). Extracellular discharges of WDR neu- rons in the dorsal horns of L(1-3) spinal cord were recorded using glass micropipettes and a microelectrode amplifier. EA stimulation (15 Hz, 1, 4, 7, 10 mA) was applied to ipsilateral "Zusanli" (ST 36) area.A total of 40 neurons were recorded in the present study. Under no CRD conditions, the firing rates of WDR neurons were significantly increased by (18.12 +/- 13.56)% (1 mA), (152.38 +/- 36.19)% (4 mA), (231.21 +/- 49.74)% (7 mA) and (331.54 +/- 61.89)% (10 mA) respectively after EA sti- mulation of ST 36. Under CRD conditions, the firing rates of these WDR neurons were increased by (226.78 +/- 39.59)% (1 mA), (282.80 +/- 47.54)% (4 mA), (343.06 +/- 58.35)% (7 mA), and (338.62 +/- 80.04)% (10 mA) respectively after EA stimulation. It showed a considerablely increased sensitivity of electrical activities of WDR neurons to EA stimulation during CRD nociceptive stimulation.colorectal distension (visceral nociceptive stimulation) can strengthen the sensitivity of acupoint-EA stimulation-induced increase of firing rates of WDR neurons in the dorsal horns of the lumbar spinal cord in rats, suggesting a potentiation of the acupoint action under visceral nociceptive signal inputs.

Recent studies have revealed that noxious visceral inputs travel in the dorsal column pathway, and interactions between colorectal noxious and tactile inputs occur in the ventrobasal thalamus. This investigation was to test whether the somatovisceral interactions also take place at a lower level in the dorsal column nuclei. Extracellular single neuron recordings were carried out in nucleus gracilus of anesthetized rats. Forty-three neurons responsive to colorectal distension (CRD) all had excitatory responses to tactile stimuli, and their tactile responses were predominantly (31/43 units) enhanced by preceding CRD. In contrast, the neuronal responses to CRD were reduced in 22/43 units when preceded by tactile stimulation but in two units there was an enhancement. The similarity and differences in the gracile response features in comparison with the thalamic recordings suggest that somatovisceral interactions take place at multiple levels in the dorsal column-medial lemniscus system.

To observe the cardioprotective effect of electroacupuncture (EA) stimulation at "Neiguan" (PC 6) in mice with myocardial ischemia (MI) and to explore the involvement of cardiac beta-adrenergic receptors (beta-AR) in the cardioprotective effect of EA intervention.Adult male C 57 BL/6 mice of wild type and beta1/beta2-AR double-knockout (beta1/beta2-AR(-/-)) mice were randomly and respectively divided into control group and EA group, with 8 mice in each group. These mice were subject to procedures of basic control, fatigue swimming and fatigue swimming + EA. The model was established by fatigue swimming for inducing acute MI. EA (2 Hz, 0.5 mA) was applied to bilateral "Neiguan" (PC 6) for 30 min, once daily for 7 days in both EA groups. The ST-segment of electrocardiogram (ECG) of standard limb lead II, heart rate were recorded by using a biophysical amplifier and the arrhythmia score was assessed according to Curtis and Walker's methods (1988).Self-comparison showed that, compared with the baseline, the amplitude of ECG-ST II segment was obviously increased in swimming fatigue C 57 BL/6 mice (P0.01) and further obviously increased in beta1/beta2-AR(-/-) mice (P0.01), suggesting an acute MI in C 57 BL/6 mice and a worsened MI in beta1/beta2-AR(-/-) mice. Simultaneously, the heart rate was markedly decreased (P0.05), and the score of arrhythmia obviously increased in both C 57 BL/6 and beta1/beta2-AR(-/-) mice (P0.05). Compared with the modeling procedures, ECG-ST II amplitude and arrhythmia score were significantly decreased in C 57 BL/6 mice of the EA group (P0.01, P0.05), rather than in the beta1/beta2-AR(-/-) mice of the EA group (P0.05). In addition, heart rate levels of both C 57 BL/6 mice and beta1/beta2-AR(-/-) mice had no significant differences between control and EA groups (P0.05).EA at "Neiguan" (PC 6) can protect the heart from swimming fatigue-induced MI in C 57 BL/6 mice not in beta1/beta2-AR(-/-) mice, suggesting an involvement of beta1/beta2-AR in the protective effect of EA.

According to the theory of traditional Chinese medicine about "close association between the lung and the large intestine", the present study was designed to investigate the functional relationship between the Lung and Large Intestine Meridians and the colorectum by using electrophysiological methods.A total of 40 SD rats were used in the present study. Under anesthesia, the cardiopulmonary branch of the left sympathetic nerve (CPSN) was separated for recording the electrical activities with a pair of platinum wire electrodes. Intra-colorectal pressure was recorded using a water-balloon inserted into the anus and connected to a pressure-transducer for observing rectocolonic pressure changes (mobility). Electroacupuncture (EA) stimulation was applied to bilateral "Taiyuan" (LU 9)- "Jingqu" (LU 8) of the Lung Meridian, "Yangxi" (LI 5)-"Pianli" (LI 6) of the Large Intestine Meridian, and "Shangjuxu" (ST 37)-"Zusanli" (ST 36) of the Stomach Meridian, respectively. Colorectal distension (CRD, visceral pain stimulation, 60 mmHg and 80 mmHg) was performed using an air-balloon for observing its influence on EA stimulation of LU 9- LU 8 induced changes of electrical activities of CPSN.Under anesthesia conditions, no spontaneous electrical activities of the CPSN were found in rats. After EA stimulation (3 times of the threshold intensity) of the bilateral "Taiyuan" (LU 9)- "Jingqu" (LU 8) of the Lung Meridian, and "Yangxi" (LI 5)-"Pianli" (LI 6) of the Large Intestine Meridian, the evoked discharge numbers of the cardiopulmonary sympathetic nerve were (11.26 +/- 2.34) and (10.73 +/- 2.62) spikes, respectively, without significant differences between the two groups (P0.05). Compared with pre-stimulation, the colorectal motility (amplitudes of the intra-colorectal pressure waves) was obviously increased following EA stimulation of LU 9-LU 8 of the Lung Meridian, LI 5-LI 6 of the Large Intestine Meridian and "Shangjuxu" (ST 37)-"Zusanli" (ST 36) , Lower-Ho (Sea) acupoints of the Large Intestine Meridian (P0.05). After CRD stimulation at 60 mmHg and 80 mmHg, the LU 9- LU 8-stimulation evoked discharge rates of CPSN were reduced by 43.46% and 67.42%, respectively.EA stimulation of LU 9- LU 8 of the Lung Meridian and LI 5-LI 6 of the Large Intestine Meridian can activate discharges of CPSN, and increase the colorectal motility in the rat. CRD stimulation inhibits the activated effect of EA on electrical activities of CPSN. These results show a functional communication or cross-talk between the lung and the colorectum.

To study the prevalence of smoking and its influential factors among pupils in Shandong.A multi-stage stratified-cluster random sampling method was used in the survey. 6050 students from 3 different cities of Shandong province were selected as the study population. A self-administered anonymous questionnaire was designed and the survey was conducted by trained investigators.The rate of attempting smoking among pupils under study in Shandong province was 6.0% while the current smoking rate was 1.2%. The average age of children who initiated smoking cigarette was 7.8±2.1 with 80.5% of them due to curiosity. 34.7% of them got the cigarettes from their families. In terms of the motivation of buying cigarettes, 74.3% of them claimed that the access to purchase was easy. Data from multivariate unconditional logistic regression analysis showed that the smoking behavior of pupils was influenced by their familial or surrounding environments.Tobacco control programs on pupils should be strengthened with more powerful control measures including health education.

An economical, convenient portable drug delivery system combining osmotic pump with subcutaneous infusion was developed, which was composed of three primary components: water chamber, osmotic pump chamber and support base. Ceftriaxone sodium (CRO) was selected as the model drug and osmotic pump tablets were prepared. The influence of osmotic agents on drug release profiles was evaluated. As the adjustment made by the osmotic agents was limited, the compositions of semipermeable membrane were investigated to determine significant associations of factors based on orthogonal design. The in vitro release profiles of the optimum formulation achieved to the predetermined value (15 ± 3 min for the initial release time T(i) and 5.75 ± 0.25 h for the extent release time T(e)). The pharmacokinetic profiles of this drug delivery system were evaluated in Beagle dogs. In vivo results demonstrated that the osmotic pump subcutaneous infusion administration was equivalent to intravenous injection administration in terms of bioavailability. Moreover, constant drug plasma levels with minimized fluctuations could be achieved with this osmotic pump subcutaneous infusion system, compared with intravenous injection.

To observe the effect of electroacupuncture (EA) of auricular concha region (ACR), "Zusanli" (ST 36) and "Sanyinjiao"(SP 6) on abnormal skin barrier and color in streptozotocin (STZ)-induced type 2 diabetes mellitus (T 2 DM) rats so as to find a better therapeutic method.Fifty male Sprague Dawley (SD) rats were randomized into control (n = 10), model (n = 13), EA-ST 36-SP 6 (n = 14) and EA-ACR (n = 13) groups. T 2 DM model was established by intraperitoneal injection of 1% STZ (50 mg/kg) and by feeding the animals with high-fat diet for 30 days. EA (15 Hz, 1 mA) was applied to bilateral "Zusanli" (ST 36), "Sanyinjiao" (SP 6) and ACR respectively for 30 min, once daily for 14 days. Multi Probe Adapter 9 skin measurement system (MPA 9) was used to measure the stratum corneum hydration (SCH), transepidermal water loss (TEWL), erythema index (El), melanin index (MI) and chromatic aberration values (L. a. b.) of the abdomenal and back (L1 - L6) skin, respectively.In comparison with the control group and pre-modeling, blood glucose contents of the model, EA-ST 36-SP 6 and EA-ACR groups were increased significantly (P0.01) after modeling. Compared with the model group, blood glucose levels of both EA-ST 36-SP 6 and EA-ACR groups were down-regulated apparently (P0.01) after treatment. Thirty days after modeling, the SCH, TEWL, EI, MI, L. and a. levels of the back skin, and the SCH and L. levels of the abdominal skin were decreased significantly (P0.05), while the level of b. in the back skin, and those of TEWL, EL, a. and b. of the abdominal skin increased considerably in the model group (P0.05). After EA, the levels of SCH, TEWL MI, L. a. and b. in the EA-ST 36-SP 6 group, SCH, TEWL, L. and b. in the EA-ACR group of the back skin, and SCH, L. and b. of both EAST 36-SP 6 and EA-ACR groups, as well as EI and a. of the EA-ST 36-SP 6 group of the abdominal skin were reversed remarkably (P0.05). No significant differences were found between the EA-ST 36-SP 6 and model groups in the levels of El of the back skin, TEWL and MI of the abdominal skin, and between the EA-ACR and model groups in the levels of SCH, EI, MI and a. of the back skin, and TEWL, EI, MI and a. of the abdominal skin (P0.05). In spite of a mildly better therapeutic effect of EA-ST 36-SP 6 in regulating some of the abovementioned indexes, no significant differences were found between the two EA groups in all the indexes (P0.05).EA of both ST 36-SP 6 and ACR can effectively down-regulate blood glucose level, suppress DM-induced decrease of SCH, TEWL, L. and a. of the back skin, and SCH of the abdominal skin, and down-regulate b. levels of the back and abdominal skin in T 2 DM rats, showing an improvement of the impaired skin barrier and color changes following EA intervention.

To assess the value of acupuncture for promoting the recovery of patients with ischemic stroke and to determine whether the outcomes of combined physiotherapy and acupuncture are superior to those with physiotherapy alone.Prospective randomized controlled trial.Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, P. R. China.120 inpatients and outpatients (84 men and 36 women).Acupuncture, physiotherapy, and physiotherapy combined with acupuncture.Motor function in the limbs was measured with the Fugl-Meyer assessment (FMA). The modified Barthel index (MBI) was used to rate activities of daily living. All evaluations were performed by assessors blinded to treatment group.On the first day of therapy (day 0, baseline), FMA and MBI scores did not significantly differ among the treatment groups. Compared with baseline, on the 28th day of therapy the mean FMA scores of the physiotherapy, acupuncture, and combined treatment groups had increased by 65.6%, 57.7%, and 67.2%, respectively; on the 56th day, FMA scores had increased by 88.1%, 64.5%, and 88.6%, respectively (p0.05). The respective MBI scores in the three groups increased by 85.2%, 60.4%, and 63.4% at day 28 and by 108.0%, 71.2%, and 86.2% at day 56, respectively (p0.05). However, FMA scores did not significantly differ among the three treatment groups on the 28th day. By the 56th day, the FMA and MBI scores of the physiotherapy group were 46.1% and 33.2% greater, respectively, than those in the acupuncture group p0.05). No significant differences were seen between the combined treatment group and the other groups. In addition, the FMA subscores for the upper extremities did not reflect any significant improvement in any group on the 56th day. Although the FMA subscores for the upper and lower extremities and the MBI score in the combined treatment group were higher than those in the acupuncture group, the differences were not statistically significant.Acupuncture is less effective for the outcome measures studied than is physiotherapy. Moreover, the therapeutic effect of combining acupuncture with physiotherapy was not superior to that of physiotherapy alone. A larger-scale clinical trial is necessary to confirm these findings.

AIM: To compare outcome of stapled hemorrhoidopexy (SH) vs LigaSure hemorrhoidectomy (LH) by a meta-analysis of available randomized controlled trials (RCTs). METHODS: Databases, including PubMed, EMBASE, the Cochrane Library, and the Science Citation Index updated to December 2012, were searched. The main outcomes measured were operating time, early postoperative pain, postoperative urinary retention and bleeding, wound problems, gas or fecal incontinence, anal stenosis, length of hospital stay, residual skin tags, prolapse, and recurrence. The meta-analysis was performed using the free software Review Manager. Differences observed between the two groups were expressed as the odds ratio (OR) with 95%CI. A fixed-effects model was used to pool data when statistical heterogeneity was not present. If statistical heterogeneity was present (P < 0.05), a random-effects model was used. RESULTS: The initial search identified 10 publications. After screening, five RCTs published as full articles were included in this meta-analysis. Among the five studies, all described a comparison of the patient baseline characteristics and showed that there was no statistically significant difference between the two groups. Although most of the analyzed outcomes were similar between the two operative techniques, the operating time for SH was significantly longer than for LH (P < 0.00001; OR= -6.39, 95%CI: -7.68 - -5.10). The incidence of residual skin tags and prolapse was significantly lower in the LH group than in the SH group [2/111 (1.8%) vs 16/105 (15.2%); P = 0.0004; OR= 0.17, 95%CI: 0.06-0.45). The incidence of recurrence after the procedures was significantly lower in the LH group than in the SH group [2/173 (1.2%) vs 13/174 (7.5%); P = 0.003; OR= 0.21, 95%CI: 0.07-0.59]. CONCLUSION: Both SH and LH are probably equally valuable techniques in modern hemorrhoid surgery. However, LigaSure might have slightly favorable immediate postoperative results and technical advantages.

In the present paper, the authors make a bibliometrics study on clinical indications of acupuncture therapy based on the published foreign articles about acupuncture clinical trials collected from PubMed database and Excerpta Medica database (EMbase). In 1996, 64 acupuncture indications were declared by WHO in Milan conference. But in recent 15 years, clinical trials have been conducted extensively in the foreign countries. Till now, 77 new indications for acupuncture therapy have been found in the foreign journals. The authors recommended that 29 indications (knee osteoarthritis, critique age problems, muscular fasciae ache, anxiety, etc.) should be added to the first class, 4 indications (irritable bowel syndrome, malposition, backache, simple obesity) should be upgraded from the second class to the first class, and the other 3 indications (childbirth pain, male and female barren) should be upgraded from the third class to the first class due to their application frequency in clinical trials. Increase of clinical indications reflects extensive application of acupuncture therapy and may help providing a better service for people's health.

To observe the effect of electroacupuncture (EA) of auricular point "Xin" (Heart), "Neiguan" (PC 6) and "Zusanli" (ST 36) on electrical activities of the presser reflex-related neurons in the nucleus of the solitary tract (NTS) in rats.A total of 47 SD rats were used in the present study. Extracellular electrical activities of neurons in the NTS (AP: 1.0 mm, Left and right:0 - 1.0 mm, depth: 0.3-0.8 mm)were recorded by using glass microelectrodes (10 - 15 M(omega)). Carotid arterial pressure changes were monitored and recorded by using a pressure transducer. EA(2 mA, 10 Hz, duration: 500 ms) was randomly applied to the left auricular point "Xin", "Neiguan" (PC 6) and "Zusanli" (ST 36) for 30 s, respectively. Elevation of arterial pressure was induced by intravenous injection of Phenylephrine (PE, 6- 12 microg/kg, 2 microg/mL).Of the 67 NTS neurons, 15 were activated by intravenous injection of PE (which were called as presser reflex-related neurons). Following EA of the auricular point "Xin" and ST 36, the mean arterial pressure (MAP) levels in normal rats and PE-induced MAP increase rats were lowered significantly (P0.001, P0.05). Concomitantly, the firing rates of presser reflex-related NTS neurons were increased considerably by EA stimulation of auricular point "Xin" and ST 36, but not by EA of PC 6. EA of PC 6 had no apparent influence on MAP in normal rats and in PE-induced MAP increase rats (P0.05).Electroacupuncture stimulation of auricular point "Xin" and "Zusanli" (ST 36) can lower MAP in normal rats and PE-induced MAP elevation rats, and enhance presser reflex induced increase of firing rates of NTS neurons, suggesting an interaction between signals from electroacupuncture stimulation of "Xin" and "Zusanli" (ST 36) and from cardiovascular activities in the NTS neurons.

OBJECTIVE To observe the effect of electroacupuncture (EA) stimulation of auricular concha region (ACR) on behavior changes of depression rats.A total of 80 male Wistar rats were randomized into depression model (model, n = 6), EA-ACR (n = 12), preventive EA-ACR (Pre-EA-ACR, n = 11) and EA-ear-tip (n = 12) groups. Depression model was established by chronic unpredictable mild stress for 21 days and isolated breeding. Open-field test and sucrose solution intake preference test were conducted to assess changes of the rats' behavior activities before modeling and on day 22, 36 and 50 after starting model. For rats of the pre-EA-ACR group, EA (2 Hz, 1 mA) was applied to the bilateral auricular concha area for 20 min, once daily for 14 days, beginning from the 8th day on after starting model preparation till the end of the modeling, and for rats of the EA-ACR and EA-ear-tip groups, EA was given to the bilateral ACR and ear-tips respectively, beginning after modeling, once daily for 14 days.In comparison with pre-modeling, the percentages of sucrose solution consumption in rats of the model group decreased gradually from day 22 to 50 (P0.05). Compared with the model group,the percentage of sucrose solution consumption in the EA-ACR group was increased significantly on day 50 (P0.05), suggesting an inhibitory effect of EA on the reduction of sucrose intake preference at this time-point. No significant differences were found between the pre-EA-ACR and the model groups and between the EA-ear-tip and model groups as well as between the EA-ACR and model groups at most time-points (P0.05). Open-field test showed that in comparison with pre-modeling in the same one group, the total scores, crossing and rearing scores on day 22 were decreased considerably in the model and EA-ear-tip groups (P0.05, P0.01), rather than in the pre-EA-ACR and EA-ARC groups (P0.05), suggesting a suppressing effect of pre-EA-ACR and EA-ACR on depression behavior. Compared to day 22 in the same one group, the total scores, crossing and rearing scores on day 36 and 50 in the pre-EA-ACR and EA-ear-tip groups were decreased significantly (P0.05, P0.01).EA of auricular concha region can restrain the development of depression behavioral status in depression rats, which is superior to that of EA of ear-tip.

Background: Asthma is a common chronic inflammatory respiratory disease. Previous studies have suggested that the pathogenesis of asthma may be affected by epigenetic regulation. The purpose of this study is to characterize the effect of the methylation of each CpG site in the ADAM33 (a disintegrin and metalloproteinase 33) gene in adult asthma. Methods: A human CpG island microarray was used to examine 4 asthmatic cases and 4 healthy controls, and the results suggested that there might be differences in methylation within exon 9 of the ADAM33 gene. Therefore, we designed a case-control study with 50 asthmatic patients and 50 age- and sex-matched healthy controls to examine the relationship between the CpG methylation of the ADAM33 gene and asthma using bisulfite deoxyribonucleic acid modification and sequencing. Results: Bisulfite sequencing experiments showed that the 14 CpG sites in exon 9 of the ADAM33 gene were highly methylated (100%) in all individuals. The proportions of methylation of the 14 CpG sites in ADAM33 in the case group were not different from those of the control group. The methylation of exon 9 of this locus was not associated with age, sex, IgE levels, or lung function. This study found no association between the methylation of CpG sites in exon 9 of the ADAM33 gene and adult asthma. Conclusions: The 14 CpG sites were highly methylated in the case and control groups. Further investigation of exon 9 in ADAM33 in a larger population is needed to evaluate its role in asthma.

To observe the anti-seizure effect of electroacupuncture (EA) at different sites regions of the auricle in awake rats.Sixty male SD rats were randomly divided into model, ear-apex, ear-outer-margin, earlobe, cymba-concha, cavitas-conchae groups (n = 10 in each group). A metal microelectrode (diameter: 50 microm) was implanted into the somatosensary cortex for recording the field potentials (FPs). Epileptic seizure model was established by intraperitoneal injection of pentylenetetrazol (PTZ, 60 mg/kg). EA (20 Hz, 1 mA) was applied to ear-apex, ear-outer-margin, earlobe, cymaba-concha and cavitas-conchae for 30 min, respectively. The epileptic behavior changes (scores) were determined in the light of Racine's method, and the epileptic seizure was assessed according to the epileptic FPs (5-folds above the basic amplitude) of the cerebral cortex.In comparison with the model group, the latency of the first seizure of epilepsy in the ear-outer-margin, earlobe, cymba-concha, cavitas-conchae groups were increased significantly (P0.01), while the scores of epileptic behavior and the duration of seizure shown by FPs decreased considerably in the ear-apex, ear-outer-margin, earlobe, cymba-concha, cavitas-conchae groups (P0.01). Comparison among the five EA treatment groups showed that the effects of both cymba-concha and cavitas-conchae groups were significantly superior to those of ear-apex, earlobe and ear-outer-margin groups in increasing the latency of the first seizure of epilepsy, and reducing the scores of the epileptic behavior and seizure duration (P0.01). No significant differences were found between the cymba-concha and cavitas-conchae groups in the above-mentioned 3 indexes (P0.05).EA of cymba-concha and cavitas-conchae has a good effect in suppressing epileptic seizures, which may be mediated via the auricular branch of the vagus nerve.

Objective: We conducted a case–control study to investigate whether clusterin polymorphism (rs11136000) was associated with late-onset Alzheimer’s disease in Chinese Han population. Methods: Polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP) assay was performed on genotype rs11136000 and APOEε4 in 127 patients with late-onset Alzheimer’s disease and 143 control individuals. Previous published data from other Chinese samples was also included for further meta-analysis. Results: APOEε4 was demonstrated to increase the risk of Alzheimer’s disease in Chinese population (odds ratio = 2.35, 95% confidence interval: 1.40-3.96). There is no significant association between clusterin rs11136000 with late-onset sporadic AD in our small cohort. However, meta-analysis revealed significant allele and genotype differences between Alzheimer’s disease and controls following a recessive model. Conclusion: Clusterin (rs11136000) was associated with Alzheimer’s disease in Chinese Han population.

To observe the effect of regional thermal (moxibustion-like) stimulation on discharges of neurons in the medullary subnucleus reticularis dorsalis (SRD) and to study the best thermal stimulation parameters in the rat.Experiments were performed on 15 male Sprague-Dawley rats under anesthesia (10% urethane, 1.0-1.5 g/kg). Unit discharges of single neurons in the medullary SRD were recorded extracellularly with glass micropipettes. Thermal stimulation (warm water filled in a glass bottle) with different temperature (40 degrees C, 42 degrees C, 44 degrees C, 46 degrees C, 48 degrees C, 50 degrees C, 52 degrees C) and covering different area (diameter: 1.0 cm x 1.5 cm, 2.0 cm, 2.5 cm, 3.0 cm, 3.5 cm, 4.0 cm) was applied to "Zhongwan"(CV 12) region for 30 s. Firing rates of SRD neurons were analyzed by using Power-Lab Chart 5.0.When thermal stimulation with temperature of 40 degrees C and 42 degrees C and the stimulated area of 1.0-4.0 cm in diameter was applied to CV 12 region, discharges of the medullary SRD neurons had no obvious changes. When the temperature was increased to 44 degrees C and 46 degrees C, the electrical activities of SRD neurons were increased linearly along with the increase of the stimulated area of 1.0-4.0 cm in diameter. When the temperature was increased further from 48 degrees C to 52 degrees C, the increased electrical activities of SRD neurons peaked at the stimulated area of 3.5 cm in diameter. In addition, thermal stimulation at a temperature of 50 degrees C and an area of 4.0 cm in diameter induced a larger increase of discharges of SRD neurons in comparison with that of 46 degrees C plus an area of 3.5 cm/4.0 cm in diameter (P0.05). No significant differences were found between 50 degrees C and 52 degrees C at any stimulated areas mentioned above (P0.05).Noxious thermal (44-52 degrees C) stimulation of CV 12 region can activate SRD neuron, which reaches a plateau when the stimulated area is increased to a certain range.

To evaluate the effect of electroacupuncture (EA) of the auricular concha (EA-AC) on serum cytokines contents and pulmonary transcription factor nuclear factor-kappaB (NF-kappaB) expression in lipopolysaccharide (LPS) induced endotoxaemia rats so as to study its mechanism underlying cholinergic anti-inflammatory efficacy.Male SD rats were randomized into normal control, model (LPS), simple EA-AC, EA-AC + LPS, vagal nerve stimulation (VNS) + LPS, and EA-Zusanli (ST 36) + LPS groups (n = 12/group). Endotoxaemia model was duplicated by intravenous (tail vein) injection of LPS (0.5 mL/kg). Two intradermal needles were inserted into the central sites of the cavity of concha and cymba of auricular concha respectively on each side and stimulated electrically by using an electrical stimulator (i.e, EA-AC). VNS was applied to the left cervical vagal nerve, and EA (1 mA, 10 Hz, pulse-width 1 ms) was also applied to bilateral "Zusanli" (ST 36). Serum cytokines (TNF-alpha IL-6) contents 2 h after modeling were determined by using enzyme linked immunosorbent assay (ELISA), and pulmonary NF-kappaB p 65 expression 2 h after modeling was detected by using western blotting.Compared with the normal control group, serum TNF-alpha and IL-6 contents, and pulmonary NF-kappaB p65 expression level in the model group were increased significantly (P0.01). In comparison with the model group, serum TNF-alpha contents in the simple EA-AC, EA-AC + LPS, VNS+ LPS and ST 36 + LPS groups, and serum IL-6 contents and pulmonary NF-kappaB p 65 expression levels in the simple EA-AC, EA-AC + LPS and VNS + LPS groups were down-regulated considerably (P0.05, P0.01). Compared with the VNS + LPS group, serum TNF-alpha -28) and IL-6 contents, and pulmonary NF-kappaB p 65 expression level in the ST 36 + LPS group were increased significantly (P0.05, P0.01). In comparison with the EA-AC + LPS group, pulmonary NF-kappaB p 65 expression level in the ST 36 + creased remarkably (P0.05).Both EA of auricular concha and vagus nerve stimulation can serum TNF-alpha and IL-6 contents, and down-regulate pulmonary NF-kappaB p 65 expression level in endotoxaemia similar cholinergic anti-inflammatory mechanism between them.