Effects of keto acid supplements on Chinese patients receiving maintenance hemodialysis: a prospective, randomized, controlled, single-center clinical study.

BACKGROUND: The effects of keto acid (KA) supplements on Chinese patients receiving maintenance hemodialysis (MHD) are unclear. This study aimed to evaluate the effects of KA supplementation on nutritional status, inflammatory markers, and bioelectric impedance analysis (BIA) parameters in a cohort of Chinese patients with MHD without malnutrition. METHODS: This was a prospective, randomized, controlled, single-center clinical study conducted in 2011 till 2014. Twenty-nine patients with MHD were randomly assigned to a control (n = 14) or a KA (n = 15) group. The control group maintained a dietary protein intake of 0.9 g/kg/day. The KA group received additional KA supplement (0.1 g/kg/day). BIA was used to determine the lean tissue mass, adipose tissue mass, and body cell mass. The patients' nutritional status, dialysis adequacy, and biochemical parameters were assessed at the ends of the third and sixth months with t test or Wilcoxon rank-sum test. RESULTS: The daily total energy intake for both groups was about 28 kcal/kg/day. After 6 months, the Kt/V (where K is the dialyzer clearance of urea, t is the dialysis time, and V is the volume of the distribution of urea) was 1.33 ±â€Š0.25 in KA group, and 1.34 ±â€Š0.25 in the control group. The median triceps skin-fold thickness in KA group was 12.00 and 9.00 mm in the control group. In addition, the median hand-grip strength in KA group was 21.10 and 25.65 kg in the control group. There were no significant differences between the groups with respect to the anthropometry parameters, dialysis adequacy, serum calcium and phosphorus levels, inflammatory markers, and amino-acid profiles, or in relation to the parameters determined by BIA. Both groups achieved dialysis adequacy and maintained nutritional status during the study. CONCLUSIONS: In this cohort of Chinese patients with MHD, the patients in the control group whose dietary protein intake was 0.9 g/kg/day and total energy intake was 28 kcal/kg/day, maintained well nutritional status during study period. The KA supplement (0.1 g/kg/day) did not improve the essential amino acid/non-essential amino acid ratio, nor did it change the patients' mineral metabolism, inflammatory parameters, or body compositions.

[Progress of fMRI Research on "Deqi" of Acupuncture and Our Considerations About Further Studies].

The objectification of "Deqi" of acupuncture is a hot topic in acupuncture research at present, and functional magnetic resonance imaging (fMRI) is one of the most frequently-used techniques for revealing its brain responses. We searched literature about "Deqi" from PubMed in recent 10 years by using key words "Deqi""acupuncture sensation""needling sensation" and fMRI, trying to expound the central mechanism of "Deqi" and to put forward our understandings. Acupuncture "Deqi" evoked deactivation of the limbic-paralimbic-neocortical network (LPNN)/ default mode network (DMN), including medial prefrontal cortex (frontal pole, anterior cingulate), temporal lobe (amygdala, hippocampus, parahippocampus gyrus, temporal pole), and apparent activation of brain regions as the somatosensory cortex, thalamic-somatosensory area-insular lobe, orbitofrontal cortex, etc., which may enhance the connectivity of brain networks and function in analgesia, anti-anxiety, anti-depression, etc., but the activated and deactivated brain regions are different from study to study possibly due to the stimulated different acupoints, subjects' psychophysical conditions, scanning parameters, image acquiring sequences, etc. It is recommended that the coming stu-dies should pay more attention to the influence of acupuncture "Deqi" on brain functions in subjects suffering from diseases, the brain response characteristics of the longer post-effects and the accumulated effects of acupuncture treatment.

[Effect of Electroacupuncture Stimulation of Sensitized Acupoints on Bowel Dysfunction in Rats with Diarrhea-predominant Irritable Bowel Syndrome].

OBJECTIVE: To investigate the effect of electroacupuncture(EA)stimulation of sensitized acupoints on bowel dysfunction in diarrhea-predominant irritable bowel syndrome(D-IBS)rats. METHODS: Fifty SD rats were randomly divided into control, model, EA sensitized acupoint and EA non-sensitized acupoint groups, with 20 rats in the model group and 10 rats in each of the other 3 groups. The D-IBS model was established by chronic restraint stress and intragastric administration of folium sennae (0.3 g/mL, 10 mL/kg), once daily for 2 weeks, followed by two weeks' restraint stress stimulation. The sensitized acupoints were determined by locating the extravasation points of Evans Blue (EB) dye after tail-intravenous injection, and stimulated with EA (2 mA, 2 Hz) for 30 min, once daily for 7 consecutive days. For rats of the EA non-sensitized acupoint group, bilateral BL 15 were stimulated with the same parameters and same stimulation duration. The rats' bowel mobility was evaluated by Bristol stool scale (BSS), loose stools rate and diarrhea index. RESULTS: After modeling, the BSS, loose stool rate, and diarrhea index were significantly increased in the model group relevant to the control group (P<0.05). After the treatment, the BSS, loose stool rate, and diarrhea index on day 7 were considerably lowered in the EA-BL 25 group (P<0.05) but not in EA-BL15 group (P<0.05), suggesting a better therapeutic effect of EA of the sensitized acupoint. No significant changes were found in the abovementioned 3 indexes on day 4 after the treatment relevant to the model group (P<0.05). CONCLUSIONS: EA stimulation of the sensitized acupoint can improve diarrhea in D-IBS rats.