Characteristics of Acupoint Selection and Therapeutic Effect Analysis of Acupuncture Treatment for Patients with Chronic Kidney Disease.

OBJECTIVES: The therapeutic effect of acupuncture treatment on chronic kidney disease (CKD) was assessed, and the characteristics of acupoint selection in different CKD types were summarised. METHODS: A total of 100 patients with CKD were enrolled in this retrospective cohort study, of whom 50 received acupuncture treatment for 12 weeks (acupuncture group) and 50 received routine treatment for 12 weeks (control group). Routine treatment included appropriate rest, low-salt and low-protein diet and correction of the disturbance in water, electrolyte and acid-base balance. Hypertensive patients received antihypertensive treatment, and patients with hyperuricaemia received uric acid lowering treatment. Acupuncture acupoints were selected in accordance with traditional Chinese medicine (TCM) theory. Baseline characteristics, therapeutic effects and adverse events were assessed, and kidney function indexes, urine albumin creatine ratios (UACRs) and estimated glomerular filtration rates (eGFRs) were compared at different time points (before acupuncture treatment, T1; Immediately after acupuncture treatment, T2; After 3 months of follow-up, T3). RESULTS: The baseline data were slightly different between the groups (p > 0.05), specifically gender, age, duration time, TCM syndrome, CKD stage, systolic blood pressure (SBP), diastolic blood pressure (DBP), and cholesterol, triglyceride, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). The acupuncture group presented better therapeutic effects than the control group (82.00% vs. 60.00%, p = 0.015). At T2 or T3, the value of UACR in both groups obviously decreased (p < 0.05), whereas the eGFRs markedly increased (p < 0.05). In addition, at T2 or T3, the UACRs were significantly lower in the acupuncture group than in the control group (p < 0.01), whereas an opposite result was obtained for eGFR (p < 0.05). The adverse event rate barely differed between the groups (8.00% vs. 6.00%, p = 0.695). CONCLUSIONS: Acupuncture treatment can effectively treat CKD and can improve kidney function. This study provides a theoretical basis for clinical application.

New insights into pathogenesis of IgA nephropathy.

IgA nephropathy (IgAN) is the usual form of glomerulonephritis worldwide; however, the pathogenesis remains complex and uncertain. The interactions of gene, immune and environment lead to the variability of IgAN clinical presentations. Except for gene, it is still a question that what kind of the external factors that may cause IgAN. We summarized exposome, microbiome and infectome may be involved in the pathogenesis of IgAN through literature. Based on the above discoveries, we proposed a hypothesis of the course of IgAN that gene determines the internal cause, while skin and mucosa inflammations are the conditions of inducing immune disorders, the low point of immune disorders and change of immune status caused by internal and external environment lead to the disease onset. Therefore, a more detailed clinical phemomics of IgAN was required to be collected for further study.

Smoothing Complete Feature Pyramid Networks for Roll Mark Detection of Steel Strips.

Steel strip acts as a fundamental material for the steel industry. Surface defects threaten the steel quality and cause substantial economic and reputation losses. Roll marks, always occurring periodically in a large area, are put on the top of the list of the most serious defects by steel mills. Essentially, the online roll mark detection is a tiny target inspection task in high-resolution images captured under harsh environment. In this paper, a novel method-namely, Smoothing Complete Feature Pyramid Networks (SCFPN)-is proposed for the above focused task. In particular, the concept of complete intersection over union (CIoU) is applied in feature pyramid networks to obtain faster fitting speed and higher prediction accuracy by suppressing the vanishing gradient in training process. Furthermore, label smoothing is employed to promote the generalization ability of model. In view of lack of public surface image database of steel strips, a raw defect database of hot-rolled steel strip surface, CSU_STEEL, is opened for the first time. Experiments on two public databases (DeepPCB and NEU) and one fresh texture database (CSU_STEEL) indicate that our SCFPN yields more competitive results than several prestigious networks-including Faster R-CNN, SSD, YOLOv3, YOLOv4, FPN, DIN, DDN, and CFPN.

HIF-1α/JMJD1A signaling regulates inflammation and oxidative stress following hyperglycemia and hypoxia-induced vascular cell injury.

BACKGROUND: Endothelial cell (EC) injury accelerates the progression of diabetic macrovascular complications. Hypoxia is an important cause of EC injury. Hypoxia-inducible factor-1 alpha (HIF-1α) is an important hypoxia regulatory protein. Our previous studies showed that high-glucose and hypoxic conditions could upregulate HIF-1α expression and enhance EC inflammatory injury, independently of the nuclear factor kappa-B (NF-κB) pathway. However, it is not clear whether HIF-1α plays a role in vascular disease through epigenetic-related mechanisms. METHODS: We conducted gene expression analysis and molecular mechanistic studies in human umbilical vein endothelial cells (HUVECs) induced by hyperglycemia and hypoxia using RNA sequencing (RNA-seq) and small interfering HIF-1α (si-HIF-1α). We determined HIF-1α and Jumonji domain-containing protein 1 A (JMJD1A) expression by quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and Western blot, analyzed inflammatory protein secretion in the cell supernatant by enzymelinked immunosorbent assay (ELISA), and assessed protein interaction between HIF-1α and JMJD1A by chromatin immunoprecipitation (Ch-IP). We used the Cell Counting Kit8 (CCK-8) assay to analyze cell viability, and assessed oxidative stress indicators by using a detection kit and flow cytometry. RESULTS: High glucose and hypoxia up-regulated HIF-1α expression, and down-regulated HIF-1α decreased the level of inflammation and oxidative stress in HUVECs. To determine the downstream pathways, we observed histone demethylases genes and related pathway by RNA-sEq. Among these, JMJD1A was the most upregulated gene in histone demethylases. Moreover, we observed that HIF-1α bound to the promoter of JMJD1A, and the ameliorative effects of si-HIF-1α on oxidative stress and inflammatory cytokines in high-glucose and hypoxia-induced HUVECs were reversed by JMJD1A overexpression. Furthermore, knockdown of JMJD1A decreased inflammatory and oxidative stress injury. To determine the JMJD1A-related factors, we conducted gene expression analysis on JMJD1A-knockdown HUVECs. We observed that downregulation of inflammation and the oxidative stress pathway were enriched and FOS and FOSB might be important protective transcription factors. CONCLUSIONS: These findings provide novel evidence that the HIF-1α/JMJD1A signaling pathway is involved in inflammation and oxidative stress in HUVECs induced by high glucose and hypoxia. Also, this pathway might act as a novel regulator of oxidative stress and inflammatory-related events in response to diabetic vascular injury and thus contribute to the pathological progression of diabetes and vascular disease.

[Heat-sensitive moxibustion combined with western medication for low back pain of osteoporosis with kidney-yang deficiency: a randomized controlled trial].

OBJECTIVE: To compare the clinical therapeutic effect between heat-sensitive moxibustion combined with western medication and simple western medication for low back pain of osteoporosis with kidney-yang deficiency. METHODS: A total of 60 patients with osteoporosis were randomized into an observation group (32 cases, 2 cases dropped off) and a control group (32 cases, 3 cases dropped off). In the control group, alendronate sodium tablet and calcium carbonate and vitamin D3 tablet were taken orally. On the basis of the control group, heat-sensitive moxibustion was applied at Mingmen (GV 4), Yaoyangguan (GV 3), Guanyuan (CV 4), Shenshu (BL 23), Zusanli (ST 36) in the observation group, once a day, 5 times a week for 8 weeks. Before and after treatment，the visual analogue scale (VAS) score, Oswestry disability index (ODI) score, bone mineral density (BMD) and TCM clinical symptom score were compared in the two groups. RESULTS: The VAS scores, ODI scores and TCM clinical symptom scores after treatment were reduced in the two groups (P<0.05, P<0.01), and those in the observation group were lower than the control group (P<0.05, P<0.01). The BMD after treatment was increased in the two groups (P<0.01), and that in the observation group was higher than the control group (P<0.05). CONCLUSION: Heat-sensitive moxibustion combined with western medication could relieve low back pain, improve BMD in patients of osteoporosis with kidney-yang deficiency, and its clinical effect is superior to simple western medication.

JMJD1A/NR4A1 Signaling Regulates the Procession of Renal Tubular Epithelial Interstitial Fibrosis Induced by AGEs in HK-2.

Diabetic kidney disease (DKD) is one of the most serious complications of diabetic patients. Advanced glycation end products (AGEs) induce epithelial-mesenchymal transformation (EMT) of renal tubular epithelial cells (HK-2), resulting in renal tubulointerstitial fibrosis. However, the underlying epigenetic mechanisms remain to be further investigated. In this work, we investigated the functional role of JMJD1A involved in DKD progression. The molecular mechanism study was performed in AGEs-induced HK-2 cells by gene expression analysis, RNA sequencing (RNA-seq), and JMJD1A lentiviral knockdown and overexpression particle transfection. The results showed that AGEs could upregulate JMJD1A, and the expressions of related fibrotic factor were also increased. At the same time, in the DKD animal model induced by unilateral nephrectomy plus streptozotocin (STZ), IHC immunohistochemical staining showed that compared with the control group, the expressions of JMJD1A, FN, and COL1 in the model group were all increased, masson staining results also show that the model group has typical fibrotic changes. This is consistent with the results of our in vitro experiments. In order to determine the downstream pathway, we screened out JMJD1A downstream transcription factors by RNA-seq. Further analysis showed that JMJD1A overexpression could accelerate the progression of AGEs-induced renal fibrosis by reducing the expression of NR4A1 in HK-2 cells. Meanwhile, NR4A1 inhibitor can promote the expression of fibrosis-related factors such as VIM, a-SMA in HK-2 cells, and aggravate the process of fibrosis. Taken together, JMJD1A/NR4A1 signaling can regulate the procession of renal tubular epithelial interstitial fibrosis induced by AGEs in HK-2.

Up-regulation of miR-146a increases the sensitivity of non-small cell lung cancer to DDP by downregulating cyclin J.

BACKGROUND: Cisplatin (DDP)-based chemotherapy is the common first-line therapy for lung cancer. However, their efficacy is often limited by primary drug resistance and/or acquired drug resistance. The aim of this study was to investigate the function of miRNA-146a (miR-146a) in DDP-resistant non-small cell lung cancer (NSCLC), as well as the underlying mechanisms. METHODS: The effect of overexpression of miR-146a and/or knockdown of cyclin J (CCNJ) in A549/DDP and SPC-A1/DDP cells were investigated as follows. The cellular sensitivity to DDP, cell apoptosis, cell cycle and cell mobility were detected by CCK-8, flow cytometry, hoechst staining and cell invasion/migration assay, respectively. The effects of miR-146a overexpression in NSCLC resistant cells were further analyzed in a nude mouse xenograft model. RESULTS: Overexpression of miR-146a and/or knockdown of CCNJ significantly increased the sensitivity to DDP in A549/DDP and SPC-A1/DDP cells compared to NC group via arresting cell cycle, enhancing cell apoptosis, inhibiting cell viability and motility in vitro and in vivo. Furthermore, miR-146a could specially degrade the mRNA of CCNJ, as examined by dual luciferase report assay. CONCLUSION: The study indicates a crucial role of miR-146a in the development of acquired drug resistance to DDP in NSCLC cells. Further understanding of miR-146a mediated crosstalk networks may promote the clinical use of miR-146a analogue in NSCLC therapy.

Primary Sjögren syndrome that initially presented with repeated hypergammaglobulinemic purpura after prolonged sitting: A case report.

RATIONALE: Purpura is a common dermatologic manifestation in Sjögren syndrome (SS). When a patient presents with sicca symptoms, the diagnosis of SS is not difficult. PATIENT CONCERNS: Here, we reported a case of a 52-year-old Chinese woman who initially presented with nonpalpable purpura on both lower extremities, and these lesions had developed soon after prolonged sitting. In the past 2 years, she had repeated cutaneous nonpalpable purpura 4 times. She had no sicca symptoms, dry eyes, or dry mouth. DIAGNOSES: Combining the laboratory findings, Schirmer test, and labial gland biopsy, primary SS was confirmed. INTERVENTIONS: The patient was placed on a trial of hydroxychloroquine (200 mg once daily). OUTCOMES: The purpura on both lower extremities had faded at the sixth day after onset and at the third day after hydroxychloroquine treatment. LESSONS: These case was not easy to diagnosis primary SS because she had no sicca symptoms. A patient with primary SS who initially presented with recurrent purpura associated with prolonged sitting. Prolonged sitting had been a possible aggravating factor for the cutaneous purpura of this patient with primary SS.