Effects of vitamin family members on insulin resistance and diabetes complications.

The following letter to the editor highlights the article "Effects of vitamin D supplementation on glucose and lipid metabolism in patients with type 2 diabetes mellitus and risk factors for insulin resistance" in World J Diabetes 2023 Oct 15; 14 (10): 1514-1523. It is necessary to explore the role of vitamin family members in insulin resistance and diabetes complications.

Mechanisms of Actinidia chinensis Planch in treating colon cancer based on the integration of network pharmacology, molecular docking, and experimental verification.

BACKGROUND: As an anticancer Chinese herbal medicine, the effective components and mechanism of Actinidia chinensis Planch (ACP, Tengligen) in the treatment of colon cancer are still unclear. In the present study, the integration of network pharmacology, molecular docking, and cell experiments was employed to study the effective mechanism of ACP against colon cancer. METHODS: The Venn diagram and STRING database were used to construct the protein-protein interaction network (PPI) of ACP-colon cancer, and further topological analysis was used to obtain the key target genes of ACP in colon cancer. The Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were used to visualize the related functions and pathways. Molecular docking between key targets and compounds was determined using software such as AutoDockTools. Finally, the effect of ACP on CT26 cells was observed in vitro. RESULTS: The study identified 40 ACP-colon key targets, including CASP3, CDK2, GSK3B, and PIK3R1. GO and KEGG enrichment analyses found that these genes were involved in 211 biological processes and 92 pathways, among which pathways in cancer, PI3K-Akt, p53, and cell cycle might be the main pathways of ACP against colon cancer. Molecular docking verified that the key components of ACP could stably bind to the corresponding targets. The experimental results showed that ACP could inhibit proliferation, induce apoptosis, and downregulate the phosphorylation of PIK3R1, Akt, and GSK3B in CT26 cells. CONCLUSION: ACP is an anti-colon cancer herb with multiple components, and involvement of multiple target genes and signaling pathways. ACP can significantly inhibit proliferation and induce apoptosis of colon cancer cells, which may be closely related to the regulation of PI3K/AKT/GSK3B signal transduction.

Exploring the components and mechanism of Solanum nigrum L. for colon cancer treatment based on network pharmacology and molecular docking.

Background: Solanum nigrum L. (SNL) (Longkui) is a Chinese herb that can be used to treat colon cancer. The present study explored the components and mechanisms of SNL in treating colon cancer by using network pharmacology and molecular docking. Methods: The components of SNL were collected from the TCMSP, ETCM, HERB, and NPASS databases. Meanwhile, the target proteins of these ingredients were collected/predicted by the TCMSP, SEA, SwissTargetPrediction, and the STITCH databases colon cancer-related target genes were identified from TCGA and GTEx databases. The interaction networks were established via Cytoscape 3.7.2. Gene Ontology and KEGG pathways were enriched by using the David 6.8 online tool. Finally, the binding of key components and targets was verified by molecular docking, and the cellular thermal shift assay (CETSA) was used to detect the efficiency of apigenin and kaempferol binding to the AURKB protein in CT26 cells. Results: A total of 37 SNL components, 796 SNL targets, 5,356 colon cancer genes, and 241 shared targets of SNL and colon cancer were identified. A total of 43 key targets were obtained through topology analysis. These key targets are involved in multiple biological processes, such as signal transduction and response to drug and protein phosphorylation. At the same time, 104 signaling pathways, such as pathways in cancer, human cytomegalovirus infection, and PI3K-Akt signaling pathway, are also involved. The binding of the four key components (i.e., quercetin, apigenin, kaempferol, and luteolin) and the key targets was verified by molecular docking. The CETSA results showed that apigenin and kaempferol were able to bind to the AURKB protein to exert anti-CRC effects. Conclusions: Quercetin, apigenin, kaempferol, and luteolin are the main components of SNL in treating colon cancer. SNL regulates multiple bioprocesses via signaling pathways, such as pathways in cancer, PI3K-Akt, and cell cycle signaling pathways.

[Terpenoids from fruits of Amomum villosum and their hypoglycemic activity].

Eight terpenoids were isolated from the fruits of Amomum villosum by silica gel, Sephadex LH-20, Rp-C_(18), MCI GEL CHP20 P column chromatography, preparative TLC, and HPLC. Their structures were identified by HR-ESI-MS, ~1H and ~(13)C-NMR, IR, UV, [α]_D, and ECD spectroscopic data as kravanhin A 3-O-ß-D-glucopyranoside(1), kravanhin B(2), 6-eudesmene-1ß,4ß-diol(3), oplodiol(4), vicodiol(5),(1R,2S,4R,7S)-vicodiol 9-O-ß-D-glucopyranoside(6),(1R,2S,4S,5R)-angelicoidenol 2-O-ß-D-glucopyranoside(7), and(1S,2S,4R,6S)-bornane-2,6-diol 2-O-ß-D-glucopyranoside(8). Compound 1 was a new compound, and compounds 2-5 were isolated from A. villosum for the first time. Their hypoglycemic activity was tested based on STC-1 cell model and two enzymatic models(GPa and PTP1 B). The results showed that compounds 1, 7, and 8 could stimulate GLP-1 with the secretion rates of 692.8%, 398.6%, and 483.3% at 25.0 µmol·L~(-1), and compound 6 showed inhibitory activity against GPa with an IC_(50) value of 78.6 µmol·L~(-1).

Signal pathways in the treatment of Alzheimer's disease with traditional Chinese medicine.

AIM OF THE REVIEW: This study aimed to reveal the classical signal pathways and important potential targets of traditional Chinese medicine (TCM) for treating Alzheimer's disease (AD), and provide support for further investigation on TCM and its active ingredients. MATERIALS AND METHODS: Literature survey was conducted using PubMed, Web of Science, Google Scholar, CNKI, and other databases, with "Alzheimer's disease," "traditional Chinese medicine," "medicinal herb," "Chinese herb," and "natural plant" as the primary keywords. RESULTS: TCM could modulate signal pathways related to AD pathological progression, including NF-κB, Nrf2, JAK/STAT, ubiquitin-proteasome pathway, autophagy-lysosome pathway-related AMPK/mTOR, GSK-3/mTOR, and PI3K/Akt/mTOR, as well as SIRT1 and PPARα pathway. It could regulate crosstalk between pathways through a multitarget, thus maintaining chronic inflammatory interaction balance, inhibiting oxidative stress damage, regulating ubiquitin-proteasome system function, modulating autophagy, and eventually improving cognitive impairment in patients with AD. CONCLUSION: TCM could be multilevel, multitargeted, and multifaceted to prevent and treat AD. In-depth research on the prevention and treatment of AD with TCM could provide new ideas for exploring the pathogenesis of AD and developing new anti-AD drugs.

Acupuncture-Moxibustion Combined with Rehabilitation Training Is Conducive to Improving the Curative Effect, Cognitive Function, and Daily Activities of Patients with Cerebral Infarction.

Objective: To elucidate the effect of acupuncture-moxibustion combined with rehabilitation training (RHT) on the curative effect, cognitive function (CF), and activities of daily living (ADL) of patients with cerebral infarction (CI). Methods: This study enrolled 150 patients with CI admitted to the Wuhan Sixth Hospital, Affiliated Hospital of Jianghan University from June 2020 to July 2021. Among them, 80 patients who were treated with acupuncture-moxibustion combined with RHT were included in the research group, and 70 patients who received acupuncture-moxibustion alone were included in the control group. The efficacy, CF, and ADL were observed in both groups, and the influences of the two therapies on serum uric acid (UA), high-sensitivity C-reactive protein (hs-CRP), and cystatin C (Cys-C) were compared. Among the various indexes, the CF of patients was assessed by the Montreal Cognitive Assessment (MoCA), and the ADL was evaluated by the Barthel index. Results: After treatment, the research group presented significantly better efficacy, CF, and ADL than the control group, with lower levels of serum UA, hs-CRP, and Cys-C than the control group and before treatment. Conclusion: Acupuncture-moxibustion combined with RHT can inhibit serum UA, hs-CRP, and Cys-C levels of patients with CI while improving the curative effect, CF, and ADL, which is worthy of clinical promotion.

Norlignans as potent GLP-1 secretagogues from the fruits of Amomum villosum.

The dried fruit of Amomum villosum (Amomi Fructus) is an important spices and traditional Chinese medicine. In this study, the EtOH extract of Amomi Fructus was revealed with hypoglycemic effects on db/db mice by increasing plasma insulin levels. After extracted with EtOAc, the EtOAc fraction showed increased activity in stimulating glucagon-like peptide-1 (GLP-1) secretion compared with the EtOH extract. In order to clarify the antidiabetic constituents, four undescribed norlignans, amovillosumins A‒D, were isolated from the EtOAc fraction, and the subsequent chiral resolution yielded three pairs of enantiomers. Their structures were determined by extensive spectroscopic data (1D and 2D NMR, HRESIMS, IR, UV and [α]D) and ECD calculations. Amovillosumins A and B significantly stimulated GLP-1 secretion by 375.1% and 222.7% at 25.0 µM, and 166.9% and 62.7% at 12.5 µM, representing a new type of GLP-1 secretagogues.

[Rules of acupoint selection in treatment of erectile dysfunction with acupuncture and moxibustion based on data mining technology].

Data mining technology was adopted to analyze the rules of acupoint selection in treatment of erectile dysfunction with acupuncture and moxibustion. All of the articles for acupuncture and moxibustion in treatment of erectile dysfunction were searched from the databases, i.e. Chinese national knowledge infrastructure (CNKI), Wanfang database, VIP, Chinese biomedical literature database (SinoMed) and PubMed, and the clinical trials on erectile dysfunction treated with acupuncture and moxibustion were screened. The database was set up by using Excel 2019 and input into R 4.0.3, and then, the therapeutic method, use frequency of acupoint, meridian tropism, collection visualization analysis, cluster analysis and association rule analysis were summarized. A total of 240 articles were included, with 516 prescriptions and 145 acupoints involved. The methods for treatment of erectile dysfunction included acupuncture and moxibustion therapy, acupuncture, acupoint injection, electroacupuncture, etc. The acupoints with high use frequency were Guanyuan (CV 4), Shenshu (BL 23), Sanyinjiao (SP 6), Mingmen (GV 4), Zusanli (ST 36), Zhongji (CV 3), Ciliao (BL 32), Qihai (CV 6), Taixi (KI 3) and Taichong (LR 3). The meridians involved with high frequency were the bladder meridian of foot-taiyang, the conception vessel, the spleen meridian of foot-taiyin, etc. The common acupoint combination was Shangliao (BL 31), Zhongliao (BL 33), Ciliao (BL 32), Xialiao (BL 34) and Sanyinjiao (SP 6), Shenshu (BL 23), Guanyuan (CV 4). In association rule analysis (confidence ≥ 90%, support ≥ 20%), there were 27 association rules in total. The acupoint combination with the highest support referred to "Shenshu (BL 23), Sanyinjiao (SP 6)→Guanyuan (CV 4)" (support 46.7%) and the acupoint combination with the highest confidence was "Sanyinjiao (SP 6), Qihai (CV 6)→Guanyuan (CV 4)" (confidence 98.0%). The acupoints could be divided into 5 effective clusters. Acupuncture and moxibustion therapy has a certain of rules of acupoint selection in treatment of erectile dysfunction, which provides the evidences for modern clinical trial and treatment.

[Bidirectional regulation of acupuncture: a subgroup analysis of multicenter randomized controlled trial of acupuncture with Tiaoshen Jianpi for irritable bowel syndrome].

OBJECTIVE: To explore the bidirectional regulation of acupuncture based on a subgroup analysis of multicenter randomized controlled trial of acupuncture with Tiaoshen Jianpi for irritable bowel syndrome (IBS). METHODS: A total of 519 patients were included in the analysis, including 137 patients with constipation type irritable bowel syndrome (IBS-C) (92 cases in the acupuncture group and 45 cases in the polyethylene glycol [PEG] group), and 382 patients with diarrhea type irritable bowel syndrome (IBS-D) (252 cases in the acupuncture group and 130 cases in the pinaverium group). The patients in the acupuncture group were given acupuncture at Baihui (GV 20), Yintang (GV 29), Tianshu (ST 25), Shangjuxu (ST 37), Zusanli (ST 36), Sanyinjiao (SP 6) and Taichong (LR 3) once every other day, 3 times a week. The patients in the PEG group received polyethylene glycol 4000 powder orally, and the pinaverium group received pinaverium bromide tablets orally. All were treated for 6 weeks. The IBS symptom severity score (IBS-SSS) was assessed at baseline, treatment period (2, 4, 6 weeks of treatment) and 12 weeks of follow-up, and the IBS quality of life (IBS-QOL) score was evaluated at the baseline period, 6 weeks of treatment and 12 weeks of follow-up. RESULTS: The total IBS-SSS scores of the two groups of IBS-C patients at 2, 4, 6 weeks of treatment and follow-up of 12 weeks were lower than those in the baseline period (P<0.01). The total IBS-SSS score in the IBS-C acupuncture group was lower than that in the PEG group at 12 weeks of follow-up (P<0.05). The total IBS-SSS scores of the two groups of IBS-D patients at 2, 4, 6 weeks of treatment and 12 weeks of follow-up were lower than those in the baseline period (P<0.01). The total IBS-SSS scores in the IBS-D acupuncture group were lower than those in the pinaverium group at 2, 4, 6 weeks of treatment and 12 weeks of follow-up (P<0.05). The total IBS-QOL scores at 6 weeks of treatment and 12 weeks of follow-up were higher than those in the baseline period in both groups of patients with IBS-C (P<0.01). The total IBS-QOL scores at 6 weeks of treatment and 12 weeks of follow-up were higher than those in the baseline period in both groups in patients with IBS-D (P<0.01). The total IBS-QOL score in the IBS-D acupuncture group was higher than that in the pinaverium group at 18 weeks of follow-up (P<0.05). CONCLUSION: Acupuncture with Tiaoshen Jianpi can improve the clinical symptoms and quality of life of patients with IBS-C and IBS-D, which can regulate different functional states (constipation and diarrhea) of the same disease (irritable bowel syndrome), reflecting the bidirectional regulation of acupuncture.

Governor vessel acupuncture for acute ischemic stroke: a systematic review and meta-analysis.

BACKGROUND: Acute ischemic stroke (AIS) is the major type of stroke, which highly risks human health and life quality. Governor vessel acupuncture (GV Ac) is one specific acupoint selection treatment. This study aimed to systematically evaluate the clinical value of GV Ac in AIS patients. METHODS: Seven electronic databases were searched for all related randomized controlled trials before December 2020. The included studies should meet the following criteria: all target patients were diagnosed as AIS; the experimental group used GV Ac as the only intervention or combined with routine neurology therapy as conventional treatment; the control group received ordinary acupuncture, or the same conventional treatment as the experimental group, or both. Evaluated the quality of all included trials and performed a meta-analysis of the extracted data. RESULTS: A total of 18 trials were included, involving 1,543 AIS patients. The results showed compared to the conventional treatment, GV Ac combining with conventional therapy resulted in Barthel Index (BI) (MD =14.16, 95% CI: 7.34, 20.79) improvement, mRS (MD =-0.63, 95% CI: -0.95, -0.32, P<0.0001) decrease, better National Institute of Health Stroke Scale (NIHSS) scores (MD =-1.18, 95% CI: -1.52, -0.83), and lower China Stroke Score (CSS)/Modified Edinburgh-Scandinavia Stroke Scale (MESSS) scores (MD =-3.77, 95% CI: -4.98, -2.57). Furthermore, GV Ac could better improve activities of daily living (ADL) (MD =8.27, 95% CI: 4.29, 12.26) and neurological deficit scores (NIHSS: MD =-1.32, 95% CI: -2.18, -0.47; CSS/MESSS: MD =-4.63, 95% CI: -5.91, -3.35), when compared to the ordinary acupuncture. DISCUSSION: According to the current evidence, GV Ac for AIS's efficacy appears to be better than that of ordinary acupuncture. When combined with conventional treatment, GV Ac may increase the benefit. But limited by the methodological quality of the included studies, more strictly designed large-scale randomized controlled trials are needed. TRIAL REGISTRATION NUMBER: CRD42020203480.

TET2 Protects Against Vascular Smooth Muscle Cell Apoptosis and Intimal Thickening in Transplant Vasculopathy.

BACKGROUND: Coronary allograft vasculopathy (CAV) is a devastating sequela of heart transplant in which arterial intimal thickening limits coronary blood flow. There are currently no targeted therapies to prevent or reduce this pathology that leads to transplant failure. Vascular smooth muscle cell (VSMC) phenotypic plasticity is critical in CAV neointima formation. TET2 (TET methylcytosine dioxygenase 2) is an important epigenetic regulator of VSMC phenotype, but the role of TET2 in the progression of CAV is unknown. METHODS: We assessed TET2 expression and activity in human CAV and renal transplant samples. We also used the sex-mismatched murine aortic graft model of graft arteriopathy (GA) in wild-type and inducible smooth muscle-specific Tet2 knockout mice; and in vitro studies in murine and human VSMCs using knockdown, overexpression, and transcriptomic approaches to assess the role of TET2 in VSMC responses to IFNγ (interferon γ), a cytokine elaborated by T cells that drives CAV progression. RESULTS: In the present study, we found that TET2 expression and activity are negatively regulated in human CAV and renal transplant samples and in the murine aortic graft model of GA. IFNγ was sufficient to repress TET2 and induce an activated VSMC phenotype in vitro. TET2 depletion mimicked the effects of IFNγ, and TET2 overexpression rescued IFNγ-induced dedifferentiation. VSMC-specific TET2 depletion in aortic grafts, and in the femoral wire restenosis model, resulted in increased VSMC apoptosis and medial thinning. In GA, this apoptosis was tightly correlated with proliferation. In vitro, TET2-deficient VSMCs undergo apoptosis more readily in response to IFNγ and expressed a signature of increased susceptibility to extrinsic apoptotic signaling. Enhancing TET2 enzymatic activity with high-dose ascorbic acid rescued the effect of GA-induced VSMC apoptosis and intimal thickening in a TET2-dependent manner. CONCLUSIONS: TET2 is repressed in CAV and GA, likely mediated by IFNγ. TET2 serves to protect VSMCs from apoptosis in the context of transplant vasculopathy or IFNγ stimulation. Promoting TET2 activity in vivo with systemic ascorbic acid reduces VSMC apoptosis and intimal thickening. These data suggest that promoting TET2 activity in CAV may be an effective strategy for limiting CAV progression.

[Correlation between curative effect and 5-HTTLPR polymorphism in treatment of diarrhea-predominant irritable bowel syndrome with acupuncture for regulating shen and strengthening spleen].

OBJECTIVE: To compare the curative effect on diarrhea-predominant irritable bowel syndrome (IBS-D) between acupuncture for regulating shen and strengthening spleen and pinaverium bromide, and explore the relevant mechanism of curative effect of acupuncture in view of polymorphism of 5-hydroxytryptamine transporter gene-linked polymorphic region (5-HTTLPR). METHODS: A total of 231 patients with IBS-D were randomized into an acupuncture group (154 cases) and a western medication group (77 cases) at the ratio of 2 to 1. In the acupuncture group, acupuncture was applied to acupoint regimen for regulating shen and strengthening spleen, i.e. Baihui (GV 20), Yintang (GV 29), Tianshu (ST 25), Shangjuxu (ST 37) and Zusanli (ST 36), etc. The treatment was given once every 2 days, 3 times a week. In the western medication group, pinaverium bromide was prescribed for oral administration, 50 mg each time, 3 times daily. The duration of treatment was 6 weeks in each group. Separately, before treatment, after treatment and in 3-month follow-up, the IBS symptom severity scale (IBS-SSS) and IBS quality of life scale (IBS-QOL) scores were adopted in assessment. After treatment, the curative effect and safety were compared between the two groups. Before treatment, 5-HTTLPR genotypes were determined in the patients. RESULTS: After treatment and in follow-up, the total scores of IBS-SSS in the patients of the two groups were all reduced as compared with those before treatment (P<0.01) and the scores in the acupuncture group were lower than those in the western medication group (P<0.01). After treatment and in follow-up, the total scores of IBS-QOL in the two groups were all increased as compared with those before treatment (P<0.01) and the score in the acupuncture group was higher than the western medication group in follow-up (P<0.01). The total effective rate was 79.2% (122/154) in the acupuncture group, higher than 58.4% (45/77) in the western medication group (P<0.01). There was no severe adverse reaction found in the two groups. The difference in the total score of IBS-SSS before and after treatment in the patients with LS and SS genotypes was greater than that in the patients with LL in the acupuncture group (P<0.01). The difference in the total score of ISB-SSS before and after treatment in the patients with SS genotype was greater than that in the patients with LL in the western medication group (P<0.01). The difference in the total score of IBS-SSS before and after treatment in the patients with LS and SS genotypes in the acupuncture group was greater than that in the patients with the same genotypes in the western medication group (P<0.01). CONCLUSION: Acupuncture for regulating shen and strengthening spleen achieves the more curative effect on IBS-D as compared with pinaverium bromide. The acupuncture regimen effectively relieves the clinical symptoms and improves the quality of life in patients as well as presents a satisfactory long-term effect and safety. The clinical curative effect of acupuncture is correlated with 5-HTTLPR polymorphism, in which, the curative effect of acupuncture may be more effective in the patients with LS and SS genotypes.

Effect of Acupuncture in Patients With Irritable Bowel Syndrome: A Randomized Controlled Trial.

OBJECTIVE: To evaluate the effect and safety of acupuncture for the treatment of irritable bowel syndrome (IBS) through comparisons with those of polyethylene glycol (PEG) 4000 and pinaverium bromide. PATIENTS AND METHODS: This multicenter randomized controlled trial was conducted at 7 hospitals in China and enrolled participants who met the Rome III diagnostic criteria for IBS between May 3, 2015, and June 29, 2018. Participants were first stratified into constipation-predominant or diarrhea-predominant IBS group. Participants in each group were randomly assigned in a 2:1 ratio to receive acupuncture (18 sessions) or PEG 4000 (20 g/d, for IBS-C)/pinaverium bromide (150 mg/d, for IBS-D) over a 6-week period, followed by a 12-week follow-up. The primary outcome was change in total IBS-Symptom Severity Score from baseline to week 6. RESULTS: Of 531 patients with IBS who were randomized, 519 (344 in the acupuncture group and 175 in the PEG 4000/ pinaverium bromide group) were included in the full analysis set. From baseline to 6 weeks, the total IBS-Symptom Severity Score decreased by 123.51 (95% CI, 116.61 to 130.42) in the acupuncture group and 94.73 (95% CI, 85.03 to 104.43) in the PEG 4000/pinaverium bromide group. The between-group difference was 28.78 (95% CI, 16.84 to 40.72; P<.001). No participant experienced severe adverse effects. CONCLUSION: Acupuncture may be more effective than PEG 4000 or pinaverium bromide for the treatment of IBS, with effects lasting up to 12 weeks. TRIAL REGISTRATION: Chinese Clinical Trials Register, ChiCTR-IOR-15006259.

Broadening horizons: the case for capturing function and the role of health informatics in its use.

BACKGROUND: Human activity and the interaction between health conditions and activity is a critical part of understanding the overall function of individuals. The World Health Organization's International Classification of Functioning, Disability and Health (ICF) models function as all aspects of an individual's interaction with the world, including organismal concepts such as individual body structures, functions, and pathologies, as well as the outcomes of the individual's interaction with their environment, referred to as activity and participation. Function, particularly activity and participation outcomes, is an important indicator of health at both the level of an individual and the population level, as it is highly correlated with quality of life and a critical component of identifying resource needs. Since it reflects the cumulative impact of health conditions on individuals and is not disease specific, its use as a health indicator helps to address major barriers to holistic, patient-centered care that result from multiple, and often competing, disease specific interventions. While the need for better information on function has been widely endorsed, this has not translated into its routine incorporation into modern health systems. PURPOSE: We present the importance of capturing information on activity as a core component of modern health systems and identify specific steps and analytic methods that can be used to make it more available to utilize in improving patient care. We identify challenges in the use of activity and participation information, such as a lack of consistent documentation and diversity of data specificity and representation across providers, health systems, and national surveys. We describe how activity and participation information can be more effectively captured, and how health informatics methodologies, including natural language processing (NLP), can enable automatically locating, extracting, and organizing this information on a large scale, supporting standardization and utilization with minimal additional provider burden. We examine the analytic requirements and potential challenges of capturing this information with informatics, and describe how data-driven techniques can combine with common standards and documentation practices to make activity and participation information standardized and accessible for improving patient care. RECOMMENDATIONS: We recommend four specific actions to improve the capture and analysis of activity and participation information throughout the continuum of care: (1) make activity and participation annotation standards and datasets available to the broader research community; (2) define common research problems in automatically processing activity and participation information; (3) develop robust, machine-readable ontologies for function that describe the components of activity and participation information and their relationships; and (4) establish standards for how and when to document activity and participation status during clinical encounters. We further provide specific short-term goals to make significant progress in each of these areas within a reasonable time frame.

In vitro evaluation of the toxicity and underlying molecular mechanisms of Janus Fe3 O4 -TiO2 nanoparticles in human liver cells.

Recent studies show that Janus Fe3 O4 -TiO2 nanoparticles (NPs) have potential applications as a multifunctional agent of magnetic resonance imaging (MRI) and photodynamic therapy (PDT) for the diagnosis and therapy of cancer. However, little work has been done on their biological effects. To evaluate the toxicity and underlying molecular mechanisms of Janus Fe3 O4 -TiO2 nanoparticles, an in vitro study using a human liver cell line HL-7702 cells was conducted. For comparison, the Janus Fe3 O4 -TiO2 NPs parent material TiO2 NPs was also evaluated. Results showed that both Fe3 O4 -TiO2 NPs and TiO2 NPs decreased cell viability and ATP levels when applied in treatment, but increased malonaldehyde (MDA) and reactive oxygen species (ROS) generation. Mitochondria JC-1 staining assay showed that mitochondrial membrane permeability injury occurred in both NPs treated cells. Cell viability analysis showed that TiO2 NPs induced slightly higher cytotoxicity than Fe3 O4 -TiO2 NPs in HL7702 cells. Western blotting indicated that both TiO2 NPs and Fe3 O4 -TiO2 NPs could induce apoptosis, inflammation, and carcinogenesis related signal protein alterations. Comparatively, Fe3 O4 -TiO2 NPs induced higher signal protein expressions than TiO2 NPs under a high treatment dose. However, under a low dose (6.25 µg/cm2 ), neither NPs had any significant toxicity on HL7702 cells. In addition, our results suggest both Fe3 O4 -TiO2 NPs and TiO2 NPs could induce oxidative stress and have a potential carcinogenetic effect in vitro. Further studies are needed to elaborate the detailed mechanisms of toxicity induced by a high dose of Fe3 O4 -TiO2 NPs.

The systemic toxicity of heavy metal mixtures in rats.

To explore the health effects of multi-heavy metal exposure, Sprague Dawley (SD) rats were orally given one dose of heavy metal mixtures (HMMs). The eight most common detectable heavy metals in Ningbo area are zinc (Zn), copper (Cu), manganese (Mn), chromium (Cr), nickel (Ni), cadmium (Cd), lead (Pb) and mercury (Hg). In this study, mixtures of these eight heavy metals were prepared using the compounds zinc sulfate heptahydrate, cupric sulfate, manganese dichloride, potassium dichromate, nickel dichloride, cadmium dichloride, lead acetate, and methyl mercury chloride with ion mass proportions of 1070.0, 312.6, 173.1, 82.6, 30.0, 13.3, 6.6, and 1.0, respectively. The rats were randomly divided into four groups. Beside the control group, each rat received a corresponding dose of HMMs 215, 464 or 1000 mg per kg body weight (bwt), respectively. The rats were observed for 4 weeks. During the last week of observation, the Morris water maze test was used to investigate spatial learning and memory in the treated rats. The rats were exsanguinated under complete chloral hydrate anesthesia and organ coefficients were measured. Biochemical tests of blood and serum samples were carried out. The results showed abnormalities in the hematological system, decreased renal function, hepatic injury and disturbances in the electrolyte balance of the rats treated with a high dose of HMMs. Death of some rats was also observed. This paper analyzed how a one-time high dose oral administration of HMMs induced systemic toxicity.

[Intractable facial paralysis treated with different acupuncture and acupoint embedding therapies: a randomized controlled trial].

OBJECTIVE: To compare the clinical therapeutic effects on intractable facial paralysis among acupuncture, acupoint catgut embedding and PDS embedding. METHODS: Two hundred and seventy-nine patients of intractable facial paralysis were randomized into an acupuncture group, a catgut embedding group and a PDS embedding group, 93 cases in each one. Cuanzhu (BL 2), Yuyao (EX-HN 4), Taiyang (EX-HN 5), Xuanlu (GB 5), Dicang (ST 4), Jiache (ST 6), Quanliao (SI 18), Qianzheng (Extra), Xiaguan (ST 7) and Fengchi (GB 20) on the affected side and bilateral Hegu (LI 4) and Zusanli (ST 36) were selected in the three groups. In the acupuncture group, acupuncture was applied to those acupoints, once every two days; 10 treatments made one session; the successive three sessions were required. In the catgut embedding group and the PDS embedding group, catgut and PDS were embedded separately, once every 10 days; 3 treatments made one session and the successive two sessions were required. The therapeutic cycle was 2 months in the three groups. The therapeutic results were analyzed statistically 2 months later. The scores of Sunnybrook facial nerve grading system and the facial nerve electroneurography (ENoG) were used for the efficacy assessment before and after treatment in the three groups. RESULTS: After treatment, the score of Sunnybrook facial nerve grading system was improved apparently after treatment as compared with that before treatment in any of the three groups (all P < 0.05). The score in either of the embedding groups was better than that in the acupuncture group (both P < 0.05). The difference was not significant between the catgut embedding group and the PDS embedding group (P > 0.05). After treatment, ENoG wave ampli tude values in the frontal muscle and orbicularisoris muscle on the affected side were improved as compared with those before treatment in the three groups (all P < 0.05). Those in the catgut embedding group and the PDS embedding group were better than those in the acupuncture group (all P < 0.05), and had no significant difference as compared with those on the healthy side (P > 0.05). In the acupuncture group, ENoG wave amplitudes on the affected side were lower than those on the healthy side (both P < 0.05). CONCLUSION: Acupuncture, catgut embedding and PDS embedding at acupoints all achieve the therapeutic effects on intractable facial paralysis. However, the acupoint embedding therapy presents more advantages on the recovery of facial nerve function. The efficacy is similar between the catgut embedding and the PDS embedding.

Discovery and early clinical evaluation of BMS-605339, a potent and orally efficacious tripeptidic acylsulfonamide NS3 protease inhibitor for the treatment of hepatitis C virus infection.

The discovery of BMS-605339 (35), a tripeptidic inhibitor of the NS3/4A enzyme, is described. This compound incorporates a cyclopropylacylsulfonamide moiety that was designed to improve the potency of carboxylic acid prototypes through the introduction of favorable nonbonding interactions within the S1' site of the protease. The identification of 35 was enabled through the optimization and balance of critical properties including potency and pharmacokinetics (PK). This was achieved through modulation of the P2* subsite of the inhibitor which identified the isoquinoline ring system as a key template for improving PK properties with further optimization achieved through functionalization. A methoxy moiety at the C6 position of this isoquinoline ring system proved to be optimal with respect to potency and PK, thus providing the clinical compound 35 which demonstrated antiviral activity in HCV-infected patients.

Acupuncture-associated pneumothorax.

OBJECTIVES: This article reports on a case and reviews some articles on acupuncture- induced pneumothorax published in Chinese and English medical journals since 1980. CASE: A 35-year-old man presented with left chest pain and dyspnea after receiving acupuncture. The patient was later diagnosed with a 12% pneumothorax of the left lung. He was observed in an emergency room for 24 hours while being treated with oxygen, a painkiller, antibiotics, and bedrest. A follow-up computed tomography scan of his chest 1 week later showed complete resolution of the pneumothorax. CASE ANALYSIS AND DISCUSSION: Details of the case are analyzed. A general review of the incidence, causes, symptoms, and outcomes of acupuncture induced pneumothorax is presented. In addition, improved needling methods including needling depth and angle, together with corresponding precautions are also discussed. CONCLUSIONS: Pneumothorax caused by acupuncture therapy uncommon, but the consequences can be serious. It is important for practitioners to have adequate knowledge so they can implement better prevention of acupuncture-induced pneumothorax.