Effect of recombinant human epidermal growth factor on neuropathic pain associated with radiotherapy for head and neck malignancies and nursing strategy.

OBJECTIVE: To evaluate the effect of recombinant human epidermal growth factor (rhEGF) on radiotherapy-related neuropathic pain in patients with head and neck malignancies, and to explore comprehensive nursing strategies. METHODS: In this retrospective study, a total of 80 patients diagnosed with head and neck malignancy and receiving radiotherapy were divided into 2 groups according to treatment. Patients in the control group received conventional radiation therapy and postoperative care, and those in the trial group received rhEGF in addition to conventional radiation therapy and care. Visual analogue scale (VAS) was used to evaluate the pain degree of patients before and after treatment, EORTC QLQ-C30 scale was used to evaluate the quality of life of patients before and after treatment, and the skin and mucosal reactions of patients after radiotherapy were observed. RESULTS: Baseline characteristics were similar between the two groups. VAS scores in the trial group were significantly lower than those in the control group during and after radiotherapy (p < 0.001), and skin and mucosal reactions were less severe (p < 0.05). In addition, compared with the control group, the quality of life and symptom scores of the trial group were significantly improved after treatment (p < 0.05). CONCLUSION: rhEGF can effectively alleviate neuropathic pain during and after radiotherapy in patients with head and neck malignancies, improve skin and mucosal response, and improve quality of life.

Applications of deep learning for detecting ophthalmic diseases with ultrawide-field fundus images.

AIM: To summarize the application of deep learning in detecting ophthalmic disease with ultrawide-field fundus images and analyze the advantages, limitations, and possible solutions common to all tasks. METHODS: We searched three academic databases, including PubMed, Web of Science, and Ovid, with the date of August 2022. We matched and screened according to the target keywords and publication year and retrieved a total of 4358 research papers according to the keywords, of which 23 studies were retrieved on applying deep learning in diagnosing ophthalmic disease with ultrawide-field images. RESULTS: Deep learning in ultrawide-field images can detect various ophthalmic diseases and achieve great performance, including diabetic retinopathy, glaucoma, age-related macular degeneration, retinal vein occlusions, retinal detachment, and other peripheral retinal diseases. Compared to fundus images, the ultrawide-field fundus scanning laser ophthalmoscopy enables the capture of the ocular fundus up to 200° in a single exposure, which can observe more areas of the retina. CONCLUSION: The combination of ultrawide-field fundus images and artificial intelligence will achieve great performance in diagnosing multiple ophthalmic diseases in the future.

Fine-grained attention & knowledge-based collaborative network for diabetic retinopathy grading.

Accurate diabetic retinopathy (DR) grading is crucial for making the proper treatment plan to reduce the damage caused by vision loss. This task is challenging due to the fact that the DR related lesions are often small and subtle in visual differences and intra-class variations. Moreover, relationships between the lesions and the DR levels are complicated. Although many deep learning (DL) DR grading systems have been developed with some success, there are still rooms for grading accuracy improvement. A common issue is that not much medical knowledge was used in these DL DR grading systems. As a result, the grading results are not properly interpreted by ophthalmologists, thus hinder the potential for practical applications. This paper proposes a novel fine-grained attention & knowledge-based collaborative network (FA+KC-Net) to address this concern. The fine-grained attention network dynamically divides the extracted feature maps into smaller patches and effectively captures small image features that are meaningful in the sense of its training from large amount of retinopathy fundus images. The knowledge-based collaborative network extracts a-priori medical knowledge features, i.e., lesions such as the microaneurysms (MAs), soft exudates (SEs), hard exudates (EXs), and hemorrhages (HEs). Finally, decision rules are developed to fuse the DR grading results from the fine-grained network and the knowledge-based collaborative network to make the final grading. Extensive experiments are carried out on four widely-used datasets, the DDR, Messidor, APTOS, and EyePACS to evaluate the efficacy of our method and compare with other state-of-the-art (SOTA) DL models. Simulation results show that proposed FA+KC-Net is accurate and stable, achieves the best performances on the DDR, Messidor, and APTOS datasets.

Assessment of anti-inflammatory efficacy of acupuncture in patients with inflammatory bowel disease: A systematic review and meta-analysis.

BACKGROUND: Inflammation has a significant role in the onset and progression of inflammatory bowel disease (IBD). Increasing attention has been paid to the use of acupuncture in IBD patients; however, its regulatory effects on inflammatory factors in IBD still require validation. Here, we systematically evaluated the effects of acupuncture on inflammatory factors in IBD patients. METHODS: Eight electronic databases were searched for studies that met the inclusion criteria. After evaluating the quality of the studies selected by two reviewers, the meta-analysis was performed to assess the efficacy of acupuncture in IBD patients and the impact on inflammatory factors (TNF-α, IL-1, IL-8 and IL-10). RESULTS: Four randomized controlled trials with a total of 228 patients satisfied the inclusion criteria. Acupuncture has a positive therapeutic impact on IBD (MD = 1.22, 95% CI [1.07, 1.39], P = 0.003). Moreover, it regulates the levels of TNF-α (MD =-60.58, 95% CI [-100.30, -20.89], P = 0.003), IL-8 (MD =-56.40, 95% CI [-60.02, -52.14], P < 0.00001) and IL-10 (MD =35.96, 95% CI [11.02, 60.91], P = 0.005) in IBD patients. However, the P value of meta-analysis in IL-1 great than 0.05.(MD =-27.90, 95% CI [-97.82, 42.02], P = 0.11). CONCLUSION: Acupuncture has a positive therapeutic impact on IBD and can effectively regulate inflammatory factors in IBD patients. TNF-α, IL-8 and IL-10 are more appropriate inflammatory indicators for clinically evaluating the anti-inflammatory response in the blood of IBD patients by acupuncture.

Genome-wide detection of genotype environment interactions for flowering time in Brassica napus.

Flowering time is strongly related to the environment, while the genotype-by-environment interaction study for flowering time is lacking in Brassica napus. Here, a total of 11,700,689 single nucleotide polymorphisms in 490 B. napus accessions were used to associate with the flowering time and related climatic index in eight environments using a compressed variance-component mixed model, 3VmrMLM. As a result, 19 stable main-effect quantitative trait nucleotides (QTNs) and 32 QTN-by-environment interactions (QEIs) for flowering time were detected. Four windows of daily average temperature and precipitation were found to be climatic factors highly correlated with flowering time. Ten main-effect QTNs were found to be associated with these flowering-time-related climatic indexes. Using differentially expressed gene (DEG) analysis in semi-winter and spring oilseed rapes, 5,850 and 5,511 DEGs were found to be significantly expressed before and after vernalization. Twelve and 14 DEGs, including 7 and 9 known homologs in Arabidopsis, were found to be candidate genes for stable QTNs and QEIs for flowering time, respectively. Five DEGs were found to be candidate genes for main-effect QTNs for flowering-time-related climatic index. These candidate genes, such as BnaFLCs, BnaFTs, BnaA02.VIN3, and BnaC09.PRR7, were further validated by the haplotype, selective sweep, and co-expression networks analysis. The candidate genes identified in this study will be helpful to breed B. napus varieties adapted to particular environments with optimized flowering time.

Predictive value of a serum tumor biomarkers scoring system for clinical stage II/III rectal cancer with neoadjuvant chemoradiotherapy.

BACKGROUND: Multiple classes of molecular biomarkers have been studied as potential predictors for rectal cancer (RC) response. Carcinoembryonic antigen (CEA) is the most widely used blood-based marker of RC and has proven to be an effective predictive marker. Cancer antigen 19-9 (CA19-9) is another tumor biomarker used for RC diagnosis and postoperative monitoring, as well as monitoring of the therapeutic effect. Using a panel of tumor markers for RC outcome prediction is a practical approach. AIM: To assess the predictive effect of pre-neoadjuvant chemoradiotherapy (NCRT) CEA and CA19-9 levels on the prognosis of stage II/III RC patients. METHODS: CEA and CA19-9 levels were evaluated 1 wk before NCRT. According to the receiver operating characteristic curve analysis, the optimal cut-off point of CEA and CA19-9 levels for the prognosis were 3.55 and 19.01, respectively. The novel serum tumor biomarker (NSTB) scores were as follows: score 0: Pre-NCRT CEA < 3.55 and CA19-9 < 19.01; score 2: Pre-NCRT CEA > 3.55 and CA19-9 > 19.01; score 1: Other situations. Pathological information was recorded according to histopathological reports after the operation. RESULTS: In the univariate analysis, pre-NCRT CEA < 3.55 [P = 0.025 for overall survival (OS), P = 0.019 for disease-free survival (DFS)], pre-NCRT CA19-9 < 19.01 (P = 0.014 for OS, P = 0.009 for DFS), a lower NSTB score (0-1 vs 2, P = 0.009 for OS, P = 0.005 for DFS) could predict a better prognosis. However, in the multivariate analysis, only a lower NSTB score (0-1 vs 2; for OS, HR = 0.485, 95%CI: 0.251-0.940, P = 0.032; for DFS, HR = 0.453, 95%CI: 0.234-0.877, P = 0.019) and higher pathological grade, node and metastasis stage (0-I vs II-III; for OS, HR = 0.363, 95%CI: 0.158-0.837, P = 0.017; for DFS, HR = 0.342, 95%CI: 0.149-0.786, P = 0.012) were independent predictive factors. CONCLUSION: The combination of post-NCRT CEA and CA19-9 was a predictive factor for clinical stage II/III RC patients receiving NCRT, and the combined index had a stronger predictive effect.

Pyruvate transporter BnaBASS2 impacts seed oil accumulation in Brassica napus.

Bile acid: sodium symporter family protein 2 (BASS2) is a sodium-dependent pyruvate transporter, which transports pyruvate from cytosol into plastid in plants. In this study, we investigated the function of chloroplast envelope membrane-localized BnaBASS2 in seed metabolism and seed oil accumulation of Brassica napus (B. napus). Four BASS2 genes were identified in the genome of B. napus. BnaA05.BASS2 was overexpressed while BnaA05.BASS2 and BnaC04.BASS2-1 were mutated by CRISPR in B. napus. Metabolite analysis revealed that the manipulation of BnaBASS2 caused significant changes in glycolysis-, fatty acid synthesis-, and energy-related metabolites in the chloroplasts of 31 day-after-flowering (DAF) seeds. The analysis of fatty acids and lipids in developing seeds showed that BnaBASS2 could affect lipid metabolism and oil accumulation in developing seeds. Moreover, the overexpression (OE) of BnaA05.BASS2 could promote the expression level of multiple genes involved in the synthesis of oil and the formation of oil body during seed development. Disruption of BnaA05.BASS2 and BnaC04.BASS2-1 resulted in decreasing the seed oil content (SOC) by 2.8%-5.0%, while OE of BnaA05.BASS2 significantly promoted the SOC by 1.4%-3.4%. Together, our results suggest that BnaBASS2 is a potential target gene for breeding B. napus with high SOC.

BnaPPT1 is essential for chloroplast development and seed oil accumulation in Brassica napus.

INTRODUCTION: Phosphoenolpyruvate/phosphate translocator (PPT) transports phosphoenolpyruvate from the cytosol into the plastid for fatty acid (FA) and other metabolites biosynthesis. OBJECTIVES: This study investigated PPTs' functions in plant growth and seed oil biosynthesis in oilseed crop Brassica napus. METHODS: We created over-expression and mutant material of BnaPPT1. The plant development, oil content, lipids, metabolites and ultrastructure of seeds were compared to evaluate the gene function. RESULTS: The plastid membrane localized BnaPPT1 was found to be required for normal growth of B. napus. The plants grew slower with yellowish leaves in BnaA08.PPT1 and BnaC08.PPT1 double mutant plants. The results of chloroplast ultrastructural observation and lipid analysis show that BnaPPT1 plays an essential role in membrane lipid synthesis and chloroplast development in leaves, thereby affecting photosynthesis. Moreover, the analysis of primary metabolites and lipids in developing seeds showed that BnaPPT1 could impact seed glycolytic metabolism and lipid level. Knockout of BnaA08.PPT1 and BnaC08.PPT1 resulted in decreasing of the seed oil content by 2.2 to 9.1%, while overexpression of BnaC08.PPT1 significantly promoted the seed oil content by 2.1 to 3.3%. CONCLUSION: Our results suggest that BnaPPT1 is necessary for plant chloroplast development, and it plays an important role in maintaining plant growth and promoting seed oil accumulation in B. napus.

Novel Development of Nanoparticles-A Promising Direction for Precise Tumor Management.

Although the clinical application of nanoparticles is still limited by biological barriers and distribution, with the deepening of our understanding of nanoparticles over the past decades, people are gradually breaking through the previous limitations in the diagnosis and treatment of tumors, providing novel strategies for clinical decision makers. The transition of nanoparticles from passive targeting to active tumor-targeting by abundant surface-modified nanoparticles is also a development process of precision cancer treatment. Different particles can be used as targeted delivery tools of antitumor drugs. The mechanism of gold nanoparticles inducing apoptosis and cycle arrest of tumor cells has been discovered. Moreover, the unique photothermal effect of gold nanoparticles may be widely used in tumor therapy in the future, with less side effects on surrounding tissues. Lipid-based nanoparticles are expected to overcome the blood-brain barrier due to their special characteristics, while polymer-based nanoparticles show better biocompatibility and lower toxicity. In this paper, we discuss the development of nanoparticles in tumor therapy and the challenges that need to be addressed.

Acupuncture for inflammatory bowel disease: A protocol for systematic review and meta-analysis.

BACKGROUND: Inflammatory bowel disease is a prevalent condition that has a major impact on the patient's life. The conventional drugs for IBD have limits, such as unpleasant events and a difficult recovery. External treatment such as acupuncture, is a traditional Chinese medicine-based therapy in which needles are used to restore the body's internal balance, and is gaining more and more popularity as a therapeutic option for IBD. However, there is a lack of evidence to support its efficacy and safety in IBD patients. The goal of this systematic review is to assess the evidence of acupuncture's efficacy and safety for IBD. METHODS: MEDLINE, the Cochrane library, EMBASE, Web of Science, China National Knowledge Infrastructure, the Chongqing VIP Chinese Science, Technology Periodical Database, the Wanfang database, Japanese medical database, Korean Robotics Institute Summer Scholars, and Thailand Thai-Journal Citation Index Centre will be searched from their inception to 9 November, 2022. Randomized controlled trials evaluating the efficacy of manual acupuncture for patients with IBD, whether or not the blind technique is utilized, will be considered. Language and publication time are both unrestricted. Review Manager (V.5.3.5) will be used by 2 separate researchers to perform article retrieval, duplicate removal, screening, quality evaluation, and data analysis. Efficacy and safety of acupuncture for IBD will be assessed using outcomes including as total effective rate or cure rate, clinical symptom integral (abdominal pain, diarrhea, purulent stool), recurrence rate, inflammatory cytokines, and the Baron and Mayo scores. RESULTS: The protocol of this study systematically will assess the effectiveness and safety of acupuncture for IBD. CONCLUSION: This study investigates the efficacy and safety of acupuncture for IBD, providing clinicians and patients with additional options for the treatment of this disease.

Comparative evaluation of the morphological accuracy of dental crowns fabricated by different technologies.

STATEMENT OF PROBLEM: Information on the morphological accuracy of crowns produced by different technologies is limited. PURPOSE: The purpose of this in vitro study was to compare the morphology and contacts of crowns fabricated with intraoral systems, extraoral systems, and conventional method. MATERIAL AND METHODS: A typodont mandibular first molar (Nissin Dental Product) received a complete ceramic crown preparation and a reference crown. Microcomputed tomography (µCT) was used to obtain the virtual data (REF) of the reference crown. Three groups of replicated crowns were made: intraoral scanning system (TRIOS), extraoral scanning system (D700), and the conventional method (CONV) (n=8). The groups TRIOS and D700 were designed by the correlation method. All crowns were scanned with µCT to obtain 3D data. The data were superimposed on each other or the REF in an inspection software to evaluate precision and trueness. The contact penetration area of the occlusal surfaces of the crowns was calculated. An independent sample t test and 1-way ANOVA with the post hoc least significant difference (LSD) test were used to compare the data (α=.05). RESULTS: The crowns fabricated with the extraoral scanners showed significantly lower root mean square (RMS) values for trueness (F=1456.90, df=2, P<.001) and precision (F=188.88, df=2, P<.001) than the others. The penetration contact area ratio and the differences in the CONV group were both significantly higher than those of the other groups. CONCLUSIONS: The average discrepancies of the crown morphology fabricated from the extraoral scanning were significantly lower than those from others. The conventional method restored the occlusal contact with significantly less accuracy than the other groups.

Preparation of poly-dopamine-silk fibroin sponge and its dye molecular adsorption.

This paper proposes a process for fabricating a poly-dopamine-silk fibroin sponge (PDA-SF) by using dopamine self-assembly and coating the skeleton of a silk fibroin sponge. The PDA-SF sponge was characterized by SEM, TEM, XPS, XRD and FT-IR. It was found that the sponge exhibits sheet structures with a pore size of 60 ± 20 µm and poly-dopamine adhered to the surface of pure silk fibroin through noncovalent bond forces. With a hierarchical porous structure, the derived sponge provides fast flow channels and abundant active sites, which will benefit the diffusion and removal of cationic dyes. Batch adsorption and dynamic adsorption of crystal violet (CV) were studied. The batch adsorption capacity of the PDA-SF sponge for CV increased with its PDA content. Under a dynamic adsorption mode, the adsorption efficiency of the PDA-SF sponge for CV (5 mg/L, 200 mL) can reach up to 98.2% after 12 min, whereas it is only 90.2% under stationary mode after 72 h. Furthermore, the sponge shows an outstanding smart adsorption performance. More importantly, the composite sponge still keeps high separation and adsorption efficiencies after 20 cycles, and the appearance remains good.

Efficacy of raman spectroscopy in the diagnosis of kidney cancer: A systematic review and meta-analysis.

OBJECTIVE: To comprehensively analyze the relative effectiveness of Raman spectroscopy (RS) in the diagnosis of suspected kidney cancer. PATIENTS AND METHODS: We performed a complete systematic review based on studies from PubMed/Medline, EMBASE, Web of Science, Ovid, Web of Knowledge, Cochrane Library and China National Knowledge Infrastructure. We identified 2413 spectra with strict criteria in 6 individual studies published between January 2008 and November 2018 in accordance to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We summarized the test performance using random effects models. RESULTS: General pooled diagnostic sensitivity and specificity of RS to kidney cancer were 0.96 (95% confidence interval [CI] 0.95-0.97) and 0.91 (95% CI 0.89-0.92). The pooled positive likelihood ratio (LR) was 9.57 (95% CI 5.73-15.46) while the negative LR was 0.04 (95% CI 0.02-0.11). The pooled diagnostic odds ratio was 238.06 (95% CI 77.79-728.54). The area under curve of summary receiver operator characteristics was 0.9466. CONCLUSION: Through this meta-analysis, we found a promisingly high sensitivity and specificity of RS in the diagnosis of suspected kidney masses and tumors. Other parameters like positive LR, negative LR, diagnostic odds ratio and area under curve of the summary receiver operator characteristics curve all helped to illustrate the high efficacy of RS in the diagnosis of kidney cancer.

Early activation of high volume fly ash by ternary activator and its activation mechanism.

To solve the problems of low early strength and severe plastic cracking caused by high volume fly ash used in cement-based materials. Triethanolamine (TEA), calcium hydroxide (Ca(OH)2), and sodium silicate (Na2SiO3) or sodium sulfate (Na2SO4) were selected to conduct a ternary doping test. The compressive strength of samples was measured to determine the best ratio, content, and time effect of the activator, and its action mechanism was studied by various micro test. The quantitative calculation model of main hydration products was established in the fly ash-cement system. Based on the simulation of molecular dynamics, the structure of NASH gel was studied under alkali activation. The results show that the optimal mixing mass ratio of TEA:Ca(OH)2:Na2SiO3 is 2:75:25 and the optimal dosage is 1.02% of the cementitious material. There are a large number of needle-like ettringite, petaloid hydrated calcium aluminate and clusters of hydrated calcium silicate gel in the system, whereas the amount of plate-like CH decreased significantly at hydration for 14 days. The Si/Al is three and aluminium coordination is predominantly tetrahedral, and the order of bonds stability and atoms mobility are Si-O > Al-O > Na-O and Na > O > Al> in the NASH gel, respectively. Under the Na+ and alkali environment, the Si(OH)4 and Al(OH)4- formed polycondensation reaction to reform polymers Si-O-Si and Al-O-Si, forming a large amount of NASH gel.

Comparison and evaluation of the morphology of crowns generated by biogeneric design technique with CEREC chairside system.

OBJECTIVES: To better guide clinicians to choose the appropriate chairside system, we compared and evaluated the morphology of crowns generated by three different biogeneric design modes (biogeneric copy (BC), biogeneric individual (BI), and biogeneric reference (BR)) of the CEREC software. METHODS: Maxillary and mandibular casts were obtained from twelve volunteers and digital impressions were acquired. All ceramic crown preparations of all right maxillary central incisors were prepared and digital impressions were taken. Then, crowns were automatically designed under BC, BI and BR modes separately and their morphologies were evaluated by six doctors. The "optimal fitting alignment" and "3D analysis" functions of the Geomagic Qualify software were carried out between original teeth and auto-generated full crowns. The auto-generated crowns were modified by a technician according to clinical criteria and the adjustment time was recorded. The discrepancies between technician modified crowns and the auto-generated full crowns were evaluated with the same functions in the Geomagic Qualify software. RESULTS: The subjective evaluation results of BC group were significantly better than those of BI and BR group (p < 0.05). Compared with the original teeth and modified crowns, auto-generated crowns in BC group all had the smallest differences, followed by BR and BI group (p < 0.05). BC group needed the shortest adjustment time than BI and BR group (p < 0.05). CONCLUSIONS: Using crowns generated by BC mode is more aesthetic and suitable in clinics use than those generated by BI and BR modes and can reduce clinic adjustment time.

Acanthiline A, a pyrido[1,2-a]indole alkaloid from Chinese mangrove Acanthus ilicifolius.

Chemical investigation of the leaves and stems of the Chinese mangrove Acanthus ilicifolius Linn. led to the isolation and structure elucidation of one new pyrido[1,2-a]indole alkaloid named acanthiline A (1), together with one known compound aurantiamide acetate (2). Compound 1 has a previously unreported natural product skeleton. The structure elucidation of 1 was based on the analysis of its 1D and 2D NMR and mass spectroscopic data.

Effects of three pro-nuclei (3PN) proportion incidence on clinical outcomes of patients with lower retrieved oocytes in the fresh cleavage-stage embryo transfer (ET) cycles.

PURPOSE: To analyze the three pro-nuclei (3PN) incidence on clinical outcomes of patients with lower retrieved oocytes in the fresh cleavage-stage embryo transfer (ET) cycles. METHODS: This study included 1200 fresh cleavage-stage ET cycles from January 2013 to June 2015. The patients were divided into 3PN = 0% (773 cycles) and 3PN > 0% (427 cycles) group. Main outcomes compared were fertilization, cleavage, normal fertilization, good quality embryo, implantation, clinical pregnancy, and early abortion rate. RESULTS: We observed that there was no significant difference in female's age, the number of retrieved oocytes, the number of transferred embryos, the number of good quality embryos, endometrial thickness, infertile time, basal serum follicle-stimulating hormone, and E2 value between two groups (p > 0.05). The fertilization (89.43 versus 83.90%, p < 0.001) and cleavage (98.34 versus 97.19%, p = 0.048) rates were significantly higher in 3PN > 0% than 3PN = 0% group. However, the normal fertilization (70.05 versus 50.67%, p < 0.001), good quality embryos (37.11 versus 26.47%, p < 0.001), and clinical pregnancy (49.81 versus 43.79%, p = 0.046) rates were significantly higher in 3PN = 0% than 3PN > 0% group. The implantation (35.88 versus 33.78%, p = 0.333) and early abortion (8.83 versus 10.70%, p = 0.474) rates were not significantly different between two groups. CONCLUSION: 3PN incidence might make a negative effect on clinical outcomes for patients with lower retrieved oocytes in the fresh cleavage-stage ET cycles.

[Effects of "menstrual cycle-based acupuncture therapy" on IVF-ET in patients with decline in ovarian reserve].

OBJECTIVE: To observe the effects of "menstrual cycle-based acupuncture therapy" on ovarian function and pregnancy results of in vitro fertilization-embryo transfer (IVF-ET) in patients with decline in ovarian reserve (DOR). METHODS: A total of 63 patients of DOR who received treatment of IVF/intracytoplasmic sperm injection (ICSI) were randomly divided into an observation group (30 cases) and a control group (33 cases). The patients in the observation group were treated with "menstrual cycle-based acupuncture therapy". The syndrome differentiation and treatment were given based on different phases of menstruation. Shiqizhui (EX-B 8) and Mingmen (GV 4) were selected during menstrual phase, Shenshu (BL 23), Geshu (BL 17), Sanyinjiao (SP 6) and Taixi (KI 3) were selected after menstruation, Qihai (CV 6), Guanyuan (CV 4), Zigong (EX-CA 1), Zusanli (ST 36) were selected during ovulatory period, Qihai (CV 6), Guanyuan (CV 4), Yanglingquan (GB 34), Taichong (LR 3) were selected before menstruation. The acupuncture was given twice a week until second menstrual cycle of oocyte retrieval. The total times of acupuncture was (15 ± 2). After acupuncture, patients were treated with IVF-ET. The patients in the control group were treated with IVF-ET but no acupuncture. The indices of ovarian reserve function, including basic follicle-stimulating hormone (FSH), estradiol (E2), antral follicle count (AFC), number of retrieved oocytes, number of fertilization and number of high quality embryo, were compared and analyzed before and after acupuncture in the observation group. The differences of outcomes of IVF-ET, including the cycle cancellation rate, implantation rate, the clinical pregnancy rate, were compared between the two groups. RESULTS: Compared before acupuncture, the E2, AFC, number of retrieved oocytes, number of high quality embrgo and number of fertilization were all increased after acupuncture in the observation group (all P< 0. 05). Compared with the control group, levels of the E2, the number of retrieved oocytes, number of fertilization and number of high quality embryo were all increased in the observation group (all P < 0.05). Also, the implantation rate, the clinical pregnancy rate were improved (both P < 0.01) and cycle cancellation rate was reduced (P< 0.01). CONCLUSION: The "menstrual cycle-based acupuncture therapy" can effectively improve the ovarian reserve function in DOR patients, leading to an improved clinical pregnancy rate of IVF-ET.

Effects and mechanisms of auricular vagus nerve stimulation on high-fat-diet--induced obese rats.

OBJECTIVE: Obesity is a major public health problem. Regulating food intake and promoting metabolism of fat are two important options for treating obesity. Auricular vagus nerve stimulation (AVNS) is considered as an alternative approach to vagal nerve stimulation. The aim of this study was to investigate the effects of AVNS and its mechanisms on obesity in obese rats. METHODS: Male Sprague-Dawley rats were fed either a high-fat diet (HFD) or a normal diet for 8 wk. Qualified HFD rats were randomly divided into three groups: the HFD group, the AVNS group, and the sham group for 6 wk treatment. Body weight and daily energy intake were recorded weekly. The rats were sacrificed for measurement of weight of bilateral perirenal, epididymal white adipose tissue (WAT), dorsal brown adipose tissue (BAT), and gastric emptying. Serum cholecystokinin (CCK), peptide YY3 to 36 (PYY3-36) and norepinephrine (NE) were assayed by enzyme-linked immunosorbent assay. Real-time quantitative polymerase chain reaction was used to assess the mRNA expressions of CCK subtype receptor a (CCKa) in the antrum, PYY3-36 receptor in the distal ileum, ß3-adrenoceptor, and uncoupling protein gene 1 (UCP1) in the BAT. RESULTS: Compared with HFD group, AVNS significantly reduced body weight and epididymal WAT and increased BAT weight, serum NE, mRNA expressions of ß3-adrenoceptors, and UCP1 of the BAT, but had no effect on daily energy intake, perirenal WAT weight, gastric emptying, serum levels of CCK and PYY, or mRNA expressions of CCKa receptor and PYY3-36 receptor in the relevant tissues. The sham group, as a comparison group for AVNS, saw less effect in any of the indexes compared with the HFD group. AVNS had more effect on weight loss, reduction of perirenal WAT, and increase of NE, ß3-adrenoceptor, and UCP1 than sham. CONCLUSIONS: AVNS was more effective in reducing body weight and causing visceral fat loss. Biochemical tests found more NE released in the serum and more ß3-adrenoceptor and UCP1 expression in the BAT. All of these features suggested that energy expenditure might play an important role in obesity management by AVNS.