[WANG Haidong's experience in treatment of wrist rheumatoid arthritis with acupotomy mobilization at the muscle regions of three yang meridians of hand].

The paper introduces professor WANG Haidong's clinical experience in treatment of wrist rheumatoid arthritis with acupotomy mobilization at the muscle regions (sinews/fascia) of three yang meridians of hand. Professor WANG Haidong believes that wrist rheumatoid arthritis belongs to the disorder of meridian muscle regions and is especially associated with the damage of the muscle regions of three yang meridians of hand running through the wrist. Under the guidance of meridian muscle region theory, on the basis of modern anatomy, and the treatment principle, "needling the affected areas may treat disorders of sinews/fascia and dysfunction of meridians simultaneously", acupotomy mobilization is adopted to balance sinews/fascia and bones, operated directly at the involved meridian muscle regions. Besides the foci (palpable knotted sites) on the distribution of muscle regions, acupoints along the affected meridians are stimulated in combination. With this therapy, after determining the location of illness, both the disorder of sinews/fascia and that of meridians can be treated.

Research hotspots and trends of artificial intelligence in rheumatoid arthritis: A bibliometric and visualized study.

Artificial intelligence (AI) applications on rheumatoid arthritis (RA) are becoming increasingly popular. In this bibliometric study, we aimed to analyze the characteristics of publications relevant to the research of AI in RA, thereby developing a thorough overview of this research topic. Web of Science was used to retrieve publications on the application of AI in RA from 2003 to 2022. Bibliometric analysis and visualization were performed using Microsoft Excel (2019), R software (4.2.2) and VOSviewer (1.6.18). The overall distribution of yearly outputs, leading countries, top institutions and authors, active journals, co-cited references and keywords were analyzed. A total of 859 relevant articles were identified in the Web of Science with an increasing trend. USA and China were the leading countries in this field, accounting for 71.59% of publications in total. Harvard University was the most influential institution. Arthritis Research & Therapy was the most active journal. Primary topics in this field focused on estimating the risk of developing RA, diagnosing RA using sensor, clinical, imaging and omics data, identifying the phenotype of RA patients using electronic health records, predicting treatment response, tracking the progression of the disease and predicting prognosis and developing new drugs. Machine learning and deep learning algorithms were the recent research hotspots and trends in this field. AI has potential applications in various fields of RA, including the risk assessment, screening, early diagnosis, monitoring, prognosis determination, achieving optimal therapeutic outcomes and new drug development for RA patients. Incorporating machine learning and deep learning algorithms into real-world clinical practice will be a future research hotspot and trend for AI in RA. Extensive collaboration to improve model maturity and robustness will be a critical step in the advancement of AI in healthcare.

LncRNA-mediated cell autophagy: An emerging field in bone destruction in rheumatoid arthritis.

In recent years, research on the mechanism of bone destruction in rheumatoid arthritis (RA) has remained in the initial stages, and the mechanism has not been fully elucidated to date. Recent studies have shown that long noncoding RNAs (lncRNAs) participate in RA bone destruction via autophagy, but the specific regulatory mechanism of lncRNA-mediated autophagy is unclear. Therefore, in this article, we review the mechanisms of lncRNA-mediated autophagy in fibroblast-like synoviocytes and chondrocytes in RA bone destruction. We explain that lncRNAs mediate autophagy and participate in many specific pathological processes of RA bone destruction by regulating signalling pathways and the expression of target genes. Specific lncRNAs can be used as markers for molecular diagnosis, mechanistic regulation, treatment and prognosis of RA.

[Heat-tonifying acupuncture relieves pain and synovial inflammatory injury by regulating Keap1-Nrf2/ARE/ HO-1 signaling pathway in rabbits with cold syndrome type rheumatoid arthritis].

OBJECTIVE: To observe the effect of heat-tonifying needling on Keap1-Nrf2/ARE/HO-1 signal transduction pathway in knee synovium in rabbits with cold syndrome type rheumatoid arthritis (RA), so as to explore its mechanisms underl-ying improvement of RA. METHODS: New Zealand rabbits were randomly divided into normal control, RA model, uniform reinforcing-reducing acupuncture, twisting reinforcing acupuncture and heat-tonifying acupuncture groups, with 6 rabbits in each group. The cold syndrome type RA model was established by subcutaneous injection of mixture fluid of ovalbumin and Freund's complete adjuvant at the shoulder-back as well as injection of mixture of ovalbumin and normal saline into knee-joint cavity combined with ice-compress freezing. Acupuncture stimulation (uniform reinforcing-reducing, or twisting reinforcing or heat-tonifying) was applied to bilateral "Zusanli"(ST36) for 1 min with the needle retained for 30 min, once a day for 7 consecutive days. The general conditions of rabbits in each group were recorded, the thermal pain threshold (TPT) and perimeter of knee joints was measured. Conditions of the synovium in the knee cavity, hydrops, blood flow signal, articular surface, and related muscles were observed by using a color Doppler ultrasonic diagnostic apparatus, and the blood flow signals inside the synovium (image scores) were divided into 0 (no signals), I (1 or 2 dot-like signal), II (less than half) ad III (more than half). After H.E. staining, the pathological changes (0-3 points) were assessed according to the state of inflammatory cell infiltration, and hyperplasia of synovial matrix and coating cells. The expression levels of Keap1, Nrf2, HO-1 and GSH-PX1 mRNAs in the knee synovium were detected by quantitative real-time PCR, and the expression of knee synovial HO-1 protein was measured by Western blot. RESULTS: In comparison with the normal control group, the model group had a significant increase in the perimeter, pathological score, expression of Nrf2, HO-1 mRNAs and HO-1 protein (P<0.05), and an obvious decrease in the TPT, expression levels of Keap1 and GSH-PX1 mRNAs (P<0.05). Relevant to the model group, all the three acupuncture maneuvers reversed modeling-induced increase of perimeter and pathological score (P<0.05), decrease of TPT and expression of GSH-PX1 mRNA(P<0.05), further down-regulated expression of Keap1 mRNA (P<0.05), further up-regulated the expression of Nrf2, HO-1 mRNAs and HO-1 protein (P<0.05). The heat-reinforcing manipulation was significantly superior to uniform reinforcing-reducing and twirling reinforcing manipulations in up-regulating TPT, and expression of Nrf2 mRNA, GSH-PX1 mRNA, HO-1 mRNA and protein (P<0.05), and in down-regulating pathological score and Keap1 mRNA expression (P<0.05). CONCLUSION: Heat-tonifying, uniform reinforcing-reducing and twirling reinforcing needling manipulations may relieve pain and improve pathological state in RA rabbits, which may be associated with their functions in raising the ability of anti-oxidative stress by regulating Keap1-Nrf2/ARE/ HO-1 signaling pathway, the therapeutic effect of heat-tonifying needling is superior to that of uniform reinforcing-reducing and twirling reinforcing needling.