Treatment of stellate ganglion block in diseases: Its role and application prospect.

The stellate ganglion (SG), as a type of sympathetic ganglion, consists of the sixth and seventh cervical vertebrae and the first thoracic sympathetic ganglia. SG block (SGB) is a minimally invasive injection that aims to inject low-concentration local anesthetics to induce a broad sympathetic blocking effect near the SG. There have been no changes and progress in the clinical application of SGB since the 1830s due to several potential risks, including hematoma from blood vessel injury, hoarseness from recurrent laryngeal nerve injury, and cardiopulmonary arrest. The feasibility and safety of SGB have greatly improved since the appearance of ultrasound-guided SGB. In recent years, SGB has been widely applied in the field of non-anesthesiology sedation, with significant therapeutic effects on pain, immunological diseases, somnipathy, psychological disorders, arrhythmias, and endocrine diseases. The present study reviews the present application of SGB in clinical practice.

A deep learning model based on contrast-enhanced computed tomography for differential diagnosis of gallbladder carcinoma.

BACKGROUND: Gallbladder carcinoma (GBC) is highly malignant, and its early diagnosis remains difficult. This study aimed to develop a deep learning model based on contrast-enhanced computed tomography (CT) images to assist radiologists in identifying GBC. METHODS: We retrospectively enrolled 278 patients with gallbladder lesions (> 10 mm) who underwent contrast-enhanced CT and cholecystectomy and divided them into the training (n = 194) and validation (n = 84) datasets. The deep learning model was developed based on ResNet50 network. Radiomics and clinical models were built based on support vector machine (SVM) method. We comprehensively compared the performance of deep learning, radiomics, clinical models, and three radiologists. RESULTS: Three radiomics features including LoG_3.0 gray-level size zone matrix zone variance, HHL first-order kurtosis, and LHL gray-level co-occurrence matrix dependence variance were significantly different between benign gallbladder lesions and GBC, and were selected for developing radiomics model. Multivariate regression analysis revealed that age ≥ 65 years [odds ratios (OR) = 4.4, 95% confidence interval (CI): 2.1-9.1, P < 0.001], lesion size (OR = 2.6, 95% CI: 1.6-4.1, P < 0.001), and CA-19-9 > 37 U/mL (OR = 4.0, 95% CI: 1.6-10.0, P = 0.003) were significant clinical risk factors of GBC. The deep learning model achieved the area under the receiver operating characteristic curve (AUC) values of 0.864 (95% CI: 0.814-0.915) and 0.857 (95% CI: 0.773-0.942) in the training and validation datasets, which were comparable with radiomics, clinical models and three radiologists. The sensitivity of deep learning model was the highest both in the training [90% (95% CI: 82%-96%)] and validation [85% (95% CI: 68%-95%)] datasets. CONCLUSIONS: The deep learning model may be a useful tool for radiologists to distinguish between GBC and benign gallbladder lesions.

[Assay of 18 amino acids in Chuanmingshen violaceum roots by pre-column derivative HPLC].

The roots of Chuanmingshen violaceum is a commonly used Chinese herb and food, which contains rich amino acids. However, the kinds and amounts of amino acids are variety in this herb among the geographical location and ecological environment. Therefore, this study firstly developed a new pre-column derived HPLC method to quantify the levels of 18 amino acids in Ch. violaceum roots. Then 24 Ch. violaceum samples were harvested from its main cultivating areas in Sichuan, China. These samples were divided into 4 producing areas based on their geographical sites. The 18 kinds of amino acids were quantified in these sample by the developed method. The differences of these amino acids were further analyzed among these herbal samples and the 4 producing areas by t-test and principal component analysis(PCA). The result indicated the peaks of the 18 kinds of amino acids were separated well in 70 min.The correlation coefficients between peak areas and concentration of these amino acids were more than 0.999 1(n=6). All of their recoveries were in the range of 97.38%-101.3%(n=6).Their detection limit was in the range of 0.003-0.379 µg·mL~(-1).It demonstrates that the developed HPLC method can accurately quantify the amounts of multi-amino acids in this herb. The results of t-test analysis showed the contents of histidine, cystine, leucine, valine, tryptophan, phenylalanine and threonine were significantly different(P<0.05) among the 4 producing areas. But the differences of other amino acids were not significant.The first five factors were extracted by PCA to calculate the comprehensive score. The order of comprehensive score for the 4 producing areas was B(0.603, n=10), C(0.206, n=3), A(-0.283, n=7) and D(-1.167, n=4). The total content of amino acids in Ch. violaceum collected in B producing area was largest(12.5 mg·g~(-1)). It is concluded the Ch. violaceum contains multi-kinds of amino acids. On the basis of amino acid amount, Langzhong city and Cangxi county in Sichuan province(producing area B) is the suitable areas for cultivating Ch. violaceum.

Acupuncture protects the interstitial cells of Cajal by regulating miR-222 in a rat model of post-operative ileus.

BACKGROUND: Recovery of the interstitial cells of Cajal (ICCs) during post-operative ileus (POI) is important for the restoration of gastrointestinal (GI) motility. Acupuncture can protect ICCs, but the underlying mechanisms remain unclear. In this study, we investigated whether miR-222, c-kit and endothelial nitric oxide synthase (eNOS) are involved in the putative effects of acupuncture on ICC recovery. METHODS: A POI model was established in Sprague-Dawley rats by colo-colic anastomosis, and then acupuncture was performed at bilateral ST36, SP6 and LR3 once daily for 3 consecutive days. C-kit protein expression in the colonic tissue adjacent to the incision site was determined by immunohistochemistry and Western blotting. mRNA levels of c-kit, eNOS and miR-222 were measured by real-time polymerase chain reaction (RT-PCR). RESULTS: The levels of c-kit mRNA/protein and eNOS mRNA decreased, while miR-222 increased in the colonic tissues of POI model rats. Acupuncture treatment improved GI motility, inhibited the up-regulation of miR-222 and blocked the down-regulation of c-kit mRNA/protein and eNOS mRNA. The levels of miR-222 and c-kit were negatively correlated. CONCLUSION: Acupuncture at ST36, SP6 and LR3 facilitates ICC recovery and improves post-operative GI motility in part through regulation of miR-222, c-kit and eNOS.

[Effect of Acupuncture on Expression of Receptor Tyrosine Kinase c-kit in Interstitial Cells of Cajal, Carbon Monoxide and Heme Oxygenase in Colon Tissue After Colonic Anastomosis in Rats].

OBJECTIVE: To observe the effect of acupuncture on expression of receptor tyrosine kinase (RTK) c-kit in interstitial cells of Cajal (ICCs), carbon monoxide (CO) and heme oxygenase (HO) in colon tissue after colonic anastomosis, so as to explore the mechanism of acupuncture in improving gastrointestinal motility. METHODS: SD rats were randomly devided into control group, model group and acupuncture group. The model was established using colonic anastomosis. Each group was further devided into 3, 5, and 10 d (time-point) subgroups (n=10 in each). Acupuncture was applied to acupuncture group at bilateral "Zusanli" (ST 36), "Sanyinjiao" (SP 6) and "Taichong" (LR 3) for 15 min, once daily after modeling. The first defecation time was recorded, and the intestinal propulsive rate was measured. The expression of c-kit in colon tissue was detected by immunohistochemistry. The content of CO, the activities of HO-1 and HO-2 in colon tissue were detected by biochemical method and ELISA, respectively. RESULTS: Compared to the control group, the intestinal propulsive rate and the expression level of c-kit in ICCs were decreased in the model group(P<0.05), the content of CO and the activity of HO-1 were increased in model 3 d and 5 d subgroups(P<0.05), the activity of HO-2 was increased in model 3 d subgroup(P<0.05), while the opposite results appeared in model 5 d and 10 d subgroups(P<0.05). Compared to the model group, the first defecation time was shortened (P<0.05), the intestinal propulsive rate and the expression level of c-kit in ICCs were increased in the acupuncture group (P<0.05), the content of CO and the activity of HO-1 were decreased in acupuncture 3 d and 5 d subgroups(P<0.05), the activity of HO-2 was decreased in acupuncture 3 d subgroup(P<0.05), while the opposite result appeared in acupuncture 10 d subgroup(P<0.05). Compared to the 3 d subgroup, the intestinal propulsive rate and the expression level of c-kit in ICCs were increased, the content of CO, the activities of HO-1 and HO-2 were decreased in both model and acupuncture 5 d subgroups (P<0.05). In model 10 d subgroup, the intestinal propulsive rate and the expression level of c-kit in ICCs were increased, the content of CO and the activity of HO-1 were decreased in comparison with the model 5 d subgroup(P<0.05). CONCLUSIONS: Acupuncture can improve postoperative gastrointestinal motility by declining CO content and HO-1 and HO-2 activity in colon tissue, and promoting ICCs restoration.

Two new isoflavone 7-O-α-4″-anhydro-4″,5″-didehydroglucuronides from Streptomyces sp. LZ35ΔgdmAI.

Two isoflavone 7-O-α-4″-anhydro-4″,5″-didehydroglucuronides, namely daidzein 7-O-α-4″-anhydro-4″,5″-didehydroglucuronide (1) and genistein 7-O-α-4″-anhydro-4″,5″-didehydroglucuronide (2), were isolated and identified from the mutant strain of Streptomyces sp. LZ35ΔgdmAI. Their structures were elucidated by the analysis of their high resolution mass spectrometry (HR-MS) and 1D, 2D Nuclear magnetic Resonance (NMR) spectroscopic data. They are new natural products and maybe the transformed products of the soybean meal by Streptomyces sp. LZ35ΔgdmAI.

Identification of AstG1, A LAL family regulator that positively controls ansatrienins production in Streptomyces sp. XZQH13.

Ansamycins is a group of type I polyketides characterized by the unique starter unit 3-amino-5-hydroxybenzoic acid. This family of secondary metabolites shows diverse biological activities, well-known members of which include rifamycin, geldanamycin, and maytansine. Previously, we isolated an AHBA synthase gene-positive strain Streptomyces sp. XZQH13 containing a "silent" ansamycin biosynthetic gene cluster ast. The constitutive expression of the Large-ATP-binding regulators of the LuxR family regulator gene astG1 located within the cluster triggered the expression of the biosynthetic genes. Reverse transcription-PCR experiments showed that the expression of the key biosynthetic genes, astB4, astD1, and astF1, was induced in the astG1 overexpression mutant compared to the wild type. This led to the isolation of two known ansatrienins, hydroxymycotrienin A (1) and thiazinotrienomycin G (2), which were identified by analysis of the mass spectral and NMR spectral data, from the mutant. These observations suggest that astG1 is probably a pathway-specific positive regulator for the biosynthesis of ansatrienin.

[Effect of acupuncture intervention on gastrointestinal motility and liver pathological changes in cirrhotic rats].

OBJECTIVE: To observe the effect of acupuncture intervention on gastrointestinal motility and liver pathologic changes in cirrhotic rats so as to reveal its underlying mechanisms in improving cirrhosis. METHODS: Cirrhotic model was established by subcutaneous injection of CCL 4-olive oil (3-5 mL/kg), and intake of high fat diet mixed with 15% ethanol aqueous. Forty SD rats were randomly divided into control, model, acupuncture and medication groups (n = 10 in each group). For rats of the acupuncture group, EA was applied to bilateral "Zusanli" (ST 36), "Sanyinjiao" (SP 6) and "Taichong" (LR 3) for 15 min, once daily for 14 days. Rats of the medication group were treated by gavage of Domperidone liquid (100 mg/100 mL, 0.6 mL/100 g) once daily for 14 days. The food-intake state, propulsive rate of small intestine, liver index, portal vein diameter were recorded or measured, and the liver pathological changes were observed under microscope after H. E. and reticular fibers staining. RESULTS: In the model group, the food-intake amount and propulsive rate of small intestine were significantly reduced (P < 0.05), the liver index and portal vein diameter were considerably increased (P < 0.05) when compared with those of the control group. While in comparison with the model group, the food-intake amount and propulsive rate of the small intestine were apparently increased in both acupuncture and medication groups (P < 0.05), while the liver index and portal vein diameter were obviously down-regulated in the acupuncture group (P < 0.05), not in the medication group (P > 0.05). H.E. and reticular fibers stain showed that CCL 4-induced changes of the liver tissue such as cirrhosis, fibroplasias, pseudo-lobulation, fibroplasias, diffusive inflammatory cell infiltration, etc. were relatively milder in the acupuncture group, rather than in the medication group. CONCLUSION: Electroacupuncture therapy has a positive effect in improving gastrointestinal motility and may be favorable to relieve hepatic pathological changes in liver cirrhosis rats.

Identification and catalytic characterization of a nonribosomal peptide synthetase-like (NRPS-like) enzyme involved in the biosynthesis of echosides from Streptomyces sp. LZ35.

Echosides, isolated from Streptomyces sp. LZ35, represent a class of para-terphenyl natural products that display DNA topoisomerase I and IIα inhibitory activities. By analyzing the genome draft of strain LZ35, the ech gene cluster was identified to be responsible for the biosynthesis of echosides, which was further confirmed by gene disruption and HPLC analysis. Meanwhile, the biosynthetic pathway for echosides was proposed. Furthermore, the echA-gene, encoding a tri-domain nonribosomal peptide synthetase (NRPS)-like enzyme, was identified as a polyporic acid synthetase and biochemically characterized in vitro. This is the first study to our knowledge on the biochemical characterization of an Actinobacteria quinone synthetase, which accepts phenylpyruvic acid as a native substrate. Therefore, our results may help investigate the function of other NRPS-like enzymes in Actinobacteria.

Cuevaenes C-E: Three new triene carboxylic derivatives from Streptomyces sp. LZ35ΔgdmAI.

Two pairs of geometrical isomers - cuevaenes A (1) and C (3) as well as cuevaenes D (4) and E (5) - and cuevaene B (2) were isolated from gdmAI-disrupted Streptomyces sp. LZ35. The constitution of cuevaene C (3) was found to be identical to cuevaene A (1) by means of NMR spectroscopy and high resolution mass spectrometry. However, the relative configurations of the triene side chain moieties were determined to be different. It was established on the basis of spectroscopic data that cuevaenes D (4) and E (5) are amides and geometrical isomers. Cuevaenes A-C (1-3) displayed moderate activity against Gram-positive bacteria (e.g., Bacillus subtilis strain ATCC 11060) and modest activity against fungi (e.g., Fusarium verticillioides strain S68 and Rhizoctonia solani strain GXE4). However, cuevaenes D (4) and E (5) showed no inhibitory activity against any of the tested microbes.

[Efficacy controlled observation on acupuncture and western medicine for gastrointestinal dysmotility in liver cirrhosis].

OBJECTIVE: To observe the therapeutic effect of acupuncture on gastrointestinal dysmotility in liver cirrhosis. METHODS: Forty cases of gastrointestinal dysmotility in liver cirrhosis were randomized into an acupuncture group and a motilium group, 20 cases in each one. In the acupuncture group, on the basis of the conventional treatment, electroacupuncture was applied at Zusanli (ST 36), Sanyinjiao (SP 6) and Taichong (LR 3) for 30 min, once a day. In the motilium group, on the basis of the conventional treatment, motilium was taken orally 30 min before meals, 10 mg each time, three times a day. The treatment was required for 2 weeks in both groups. The changes in the digestive tract symptom score and liver function Child-Pugh score were observed and the efficacy was assessed. RESULTS: The total effective rate of digestive tract symptoms was 85.0% (17/20) in the acupuncture group and 70.0% (14/20) in the motilium group. The score improvements in abdominal distention, belching and vomiting in the acupuncture group were superior to those in the motilium group (all P < 0.05). In the acupuncture group, the liver function Child-Pugh total score was 8.40 +/- 0.22 before treatment and reduced to 5.36 +/- 0.17 after treatment, in which the scores for ascites, serum bilirubin and albumin were all reduced (all P < 0.05) and the reducing range was increased in tendency with the improvements in digestive tract symptoms. In the motilium group, Child-Pugh score was not changed obviously as compared with that before treatment. CONCLUSION Acupuncture effectively alleviates digestive tract symptoms and improves liver function for the patients of liver cirrhosis, its efficacy on gastrointestinal dysmotility in liver cirrhosis is superior to motilium.

Effect of arctiin on glomerular filtration barrier damage in STZ-induced diabetic nephropathy rats.

Diabetic nephropathy (DN) is the major life-threatening complication of diabetes. Abnormal permeability of glomerular basement membrane plays an important role in DN pathogenesis. This study was performed to assess the effect of arctiin, the lignan constituent from Arctium lappa L., on metabolic profile and aggravation of renal lesions in a rat model of streptozotocin (STZ)-induced DN. STZ-induced diabetic rats were treated with arctiin at the dosage of 60 or 40 mg/kg/day via intraperitoneal injection for 8 weeks. Blood glucose and 24-h urinary albumin content were measured, and kidney histopathological changes were monitored. RT-PCR and immunohistochemistry were used to detect the mRNA and protein levels of nephrin, podocin and heparanase (HPSE) in the kidney cortex of rats, respectively. Treatment with arctiin significantly decreased the levels of 24-h urinary albumin, prevented the sclerosis of glomeruli and effectively restored the glomerular filtration barrier damage by up-regulating the expression of nephrin and podocin and down-regulating HPSE level. Our studies suggest that arctiin might be beneficial for DN. The effects of arctiin on attenuating albuminuria and glomerulosclerosis are possibly mediated by regulating the expression of nephrin and podocin and HPSE in STZ-induced diabetic rats.

[Effect of acupuncture on gastrointestinal stem cell factor/kit system after colocolic anastomosis in rats].

OBJECTIVE: To observe the effect of acupuncture on colonic stem cell factor (SCF)-receptor tyrosine kinase (Kit, a transmembrane protein c-kit) system in colocolic anastomosis rats so as to explore its underlying mechanism in regulating intestinal motility after enteroenterostomy. METHODS: Thirty SD rats were randomized into control, model (colocolic anastomosis) and acupuncture groups (n = 10/group). Acupuncture was applied to bilateral "Zusanli" (ST 36), "Sanyinjiao" (SP 6) and "Taichong" (LR 3), once a day for 3 days. The fecal-excretion time and the propulsive rate of the small intestine were measured. The immunoactivity of c-kit immunoreaction positive products in the colon tissue 2 cm below the caecum was detected using immunohistochemistry and the expression of SCF mRNA detected using real time-polymerase chain reaction (RT-PCR) method. RESULTS: Following colocolic anastomosis, the intestinal propulsive rate in the model group was decreased considerably in comparison with the control group (P < 0.01). Compared with the model group, the first fecal-excretion time and the intestinal propulsive rate were improved significantly in the acupuncture group (P < 0.05). In comparison with the control group, the immunoactivity of c-kit and the expression of SCF mRNA in colon tissue were down-regulated obviously in the model group (P < 0.05, P < 0.01), while in comparison with the model group, the expression levels of c-kit and SCF mRNA were increased in the acupuncture group significantly (P < 0.05). CONCLUSION: Acupuncture can suppress enteroenterostomy-induced down-regulation of the expression of c-kit protein and SCF mRNA in colocolic anastomosis rats, which may contribute to its effect in regulating the intestinal motility after enteroenterostomy.

[Observation on the therapeutic effect of acupuncture treatment of autism children].

OBJECTIVE: To observe the therapeutic effect of acupuncture ("Jin's Sanzhen") treatment for autism patients with different severity. METHODS: A total of 202 autism children were divided into treatment group (n=118) and control group (n=84) according to their parents' will. Autism children in the treatment group were treated with "Jin's Sanzhen" therapy [for example, Niesanzhen: the point 2 cun superior to the ear tip, and those at the same level 1 cun apart on the left and right sides; Naosanzhen: Naohu (GV 17), bilateral Naokong (GB 19), etc.], while those of control group accepted special training: behavior education (cognition, speech, communication ability, life self-care ability, etc.) and sensory integration training. The treatment was given to the patients in both groups once per day, six times a week for 4 months. RESULTS: Of the 78 and 58 severe patients in the treatment and control groups, 63 (80.8%) and4 (6.9%) experienced marked improvement, 9 (11.5%) and 33 (56.9%) experienced improvement, 6 (7.7%) and 21 (36.2%) failed, with the effective rates being 92.3% and 63.8% respectively. Of the 118 and 84 patients in the treatment and control groups, after the treatment, the no symptoms, mild, moderate and severe cases were 12 (10.2%) and 3 (3.6%), 56 (47.5%) and 25 (29.8%), 45 (38.1%) and 23 (27.4%), 5 (4.2%) and 33 (39.3%), respectively. The total score of Childhood Autism Rating Scale of treatment group was significantly lower than that of control group after the treatment in severe cases (P < 0.01), showing a better therapeutic effect of the treatment group. CONCLUSION: "Jin's Sanzhen" therapy has a better therapeutic effect for improving the autism patients symptoms at different severity.