Electroacupuncture stimulation enhances the permeability of the blood-brain barrier: A systematic review and meta-analysis of preclinical evidence and possible mechanisms.

An important cellular barrier to maintain the stability of the brain's internal and external environment is the blood-brain barrier (BBB). It also prevents harmful substances from entering brain tissue through blood circulation while providing protection for the central nervous system. It should be noted, however, that the intact BBB can be a barrier to the transport of most drugs into the brain via the conventional route of administration, which can prevent them from reaching effective concentrations for the treatment of disorders affecting the central nervous system. Electroacupuncture stimulation has been shown to be effective at opening the BBB in a series of experimental studies. This study systematically analyzes the possibility and mechanism by which electroacupuncture opens the BBB. In PubMed, Web of Science, VIP Database, Wanfang Database, and the Chinese National Knowledge Infrastructure, papers have been published for nearly 22 years aimed at opening the BBB and its associated structures. A comparison of EB content between electroacupuncture and control was selected as the primary outcome. There were also results on vascular endothelial growth factor (VEGF), nerve growth factor (NGF), P-Glycoprotein (P-gp), Matrix Metalloproteinase 9 (MMP-9), and glial fibrillary acidic protein (GFAP). We utilized Review Manager software analysis to analyze correlations between studies with a view to exploring the mechanisms of similarity. Evans Blue infiltration forest plot: pooled effect size of 2.04, 95% CI: 1.21 to 2.87, P < 0.01. These results indicate that electroacupuncture significantly increases EB penetration across the BBB. Most studies have reported that GFAP, MMP-9, and VEGF were upregulated after treatment. P-gp expression decreased as well. Electroacupuncture can open the BBB, and the sparse-dense wave is currently the most effective electroacupuncture frequency for opening the BBB. VEGF plays an important role in opening the BBB. It is also important to regulate the expression of MMP-9 and GFAP and inhibit the expression of P-gp.

Huangqi-Guizhi-Wuwu decoction regulates differentiation of CD4+ T cell and prevents against experimental autoimmune encephalomyelitis progression in mice.

BACKGROUND: Multiple sclerosis (MS) is a demyelination disorder caused by an overactive immune response. Its pathological characteristics include CNS inflammation, white matter demyelination, glial cell proliferation, and so on. Huangqi-Guizhi-Wuwu Decoction (HGWD), which is recorded in the Synopsis of the Golden Chamber, is used clinically for the therapy of MS, but its mechanism is still elusive. PURPOSE: This study was aimed to investigate the impact of HGWD on the classical animal model for MS, experimental autoimmune encephalomyelitis (EAE), and explore the underlying action mechanism. RESULTS: HGWD ameliorated the pathogenesis of EAE mice, and improved their neurobehavior and pathological tissue damage. Network pharmacology predictions revealed the action mechanism of HGWD in EAE mice might be related to its effect on the immune system of mice. HGWD effectively suppressed the inflammatory infiltration in CNS, while also preventing the elevation of CD4+T cells of mice with EAE. HGWD could increase the ratio of Treg cells, up-regulate the secretion of IL-10 and Foxp3 mRNA expression, inhibit the ratio of Th1 and Th17 cells, down-regulate the IFN-γ and IL-17 protein expression, as well as the RORγT and T-bet gene expression in EAE mice. In addition, HGWD-containing serum modulated Th1/Th17/Treg cell differentiation in vitro. Moreover, HGWD inhibited the p-JAK1, p-JAK2, p-STAT1, p-STAT3 and p-STAT4 proteins and elevated the p-STAT5 protein in lymphoid tissues of EAE mice. CONCLUSION: HGWD improved the progress of EAE by regulating the proportion of CD4+T cell subtype differentiation, which might be exerted through JAK/STAT signaling pathway, providing a pharmacological basis for the clinical treatment of MS.

Hybrid neuromorphic hardware with sparing 2D synapse and CMOS neuron for character recognition.

Neuromorphic computing enables efficient processing of data-intensive tasks, but requires numerous artificial synapses and neurons for certain functions, which leads to bulky systems and energy challenges. Achieving functionality with fewer synapses and neurons will facilitate integration density and computility. Two-dimensional (2D) materials exhibit potential for artificial synapses, including diverse biomimetic plasticity and efficient computing. Considering the complexity of neuron circuits and the maturity of complementary metal-oxide-semiconductor (CMOS), hybrid integration is attractive. Here, we demonstrate a hybrid neuromorphic hardware with 2D MoS2 synaptic arrays and CMOS neural circuitry integrated on board. With the joint benefit of hybrid integration, frequency coding and feature extraction, a total cost of twelve MoS2 synapses, three CMOS neurons, combined with digital/analogue converter enables alphabetic and numeric recognition. MoS2 synapses exhibit progressively tunable weight plasticity, CMOS neurons integrate and fire frequency-encoded spikes to display the target characters. The synapse- and neuron-saving hybrid hardware exhibits a competitive accuracy of 98.8% and single recognition energy consumption of 11.4 µW. This work provides a viable solution for building neuromorphic hardware with high compactness and computility.

Total Flavonoids of Astragalus Inhibit Activated CD4[Formula: see text] T Cells and Regulate Differentiation of Th17/Th1/Treg Cells in Experimental Autoimmune Encephalomyelitis Mice by JAK/STAT and NF[Formula: see text]B Signaling Pathways.

Multiple sclerosis (MS) is a neuroinflammatory disease characterized by CD4[Formula: see text] T cell-mediated immune cell infiltration and demyelination in the central nervous system (CNS). The subtypes of CD4[Formula: see text] T cells are T helper cells 1 (Th1), Th2, Th17, and regulatory T cells (Treg), while three other types of cells besides Th2 play a key role in MS and its classic animal model, experimental autoimmune encephalomyelitis (EAE). Tregs are responsible for immunosuppression, while pathogenic Th1 and Th17 cells cause autoimmune-associated demyelination. Therefore, suppressing Th1 and Th17 cell differentiation and increasing the percentage of Treg cells may contribute to the treatment of EAE/MS. Astragali Radix (AR) is a representative medicine with immunoregulatory, anti-inflammatory, antitumor, and neuroprotective effects.The active ingredients in AR include astragalus flavones, polysaccharides, and saponins. In this study, it was found that the total flavonoids of Astragus (TFA) could effectively treat EAE in mice by ameliorating EAE motor disorders, reducing inflammatory damage and demyelination, inhibiting the proportion of Th17 and Th1 cells, and promoting Tregs differentiation by regulating the JAK/STAT and NF[Formula: see text]B signaling pathways. This novel finding may increase the possibility of using AR or TFA as a drug with immunomodulatory effects for the treatment of autoimmune diseases.

Identification of factors influencing core competence promotion among professional nurses and midwives: A qualitative study using the COM-B model.

AIM: To identify factors influencing a behaviour of improving core competencies among nurses and midwives in the Maternity and Child Health Care Hospital using the capability, opportunity, motivation and behaviour (COM-B) model. BACKGROUND: With the increasing number of women with pregnancy complications and the COVID-19 pandemic, nurses and midwives are being challenged and enhancing their core competencies is imperative to ensure high-quality care. To develop effective intervention strategies, it is essential to systematically explore what influences nurses and midwives to improve their core competencies. To this end, this study applied the COM-B model of behavioural change. DESIGN: Qualitative study using the COM-B model. METHODS: This qualitative descriptive study was conducted in 2022 using face-to-face interviews, including 49 nurses and midwives. Topic guides for the interviews were developed based on the COM-B model. Transcribed verbatim interviews were analysed using deductive thematic analysis. RESULTS: The COM-B model captures several factors. Capability factors included clinical knowledge and self-directed learning abilities. Opportunity factors included professional education covering necessary clinical skills, adequate clinical practice, personalised training, available time, insufficient clinical learning resources, absence of scientific research resources and support from leadership. Motivational factors were access to long-term work, incentive policies based on individuals' work values and responses to upward social comparison. CONCLUSIONS: The findings of this study suggested that prior to developing intervention strategies to enhance the core competencies of nurses and midwives, processing barriers to nurses' and midwives' capabilities, opportunities and motivation can facilitate the implementation of interventions.

Total astragalosides promote oligodendrocyte precursor cell differentiation and enhance remyelination in cuprizone-induced mice through suppression of Wnt/ß-catenin signaling pathway.

ETHNOPHARMACOLOGICAL RELEVANCE: Radix Astragali is a traditional Chinese medicine with various pharmacological effects. Total astragalosides (TA), the main effective ingredients in Radix Astragali, exert properties including anti-oxidative stress, anti-neuroinflammation, and neuroprotection. We previously found that TA alleviated experimental autoimmune encephalomyelitis (EAE) progression, a widely used animal model of multiple sclerosis (MS). As a chronic demyelination disease, MS generally manifests myelin loss and fails to myelin regeneration. Regulation of oligodendrocyte progenitor cells (OPCs) differentiation and remyelination is the fundamental strategy for MS treatment. However, whether TA could directly promote OPCs differentiation and remyelination is still unknown. AIMS OF THE STUDY: This study was aimed to investigate pro-differentiation and myelin regeneration effects of TA on OPCs and Cuprizone (CPZ)-induced demyelination mice, an animal model of MS, and to explore mechanism underlying from regulation of OPCs differentiation and maturation. MATERIALS AND METHODS: Mice were orally given CPZ (400 mg/kg) daily for 4 weeks to induce myelin loss, and then treated with TA (25 and 50 mg/kg) daily for 1 week. Cell proliferation assay, Western blot, RT-PCR, immunocytochemistry and immunohistochemistry were performed to explore the mechanisms. The role of TA in oligodendrocyte differentiation and maturation was evaluated using MO3.13, a human oligodendrocytic hybrid cell line. RESULTS: TA was shown to mitigate behavioral impairment in CPZ-induced mice. It markedly ameliorated myelin loss and enhanced remyelination in the corpus callosum of mice, evidenced by increased expression of myelin basic protein (MBP) and the number of CC1+ newly generated oligodendrocytes (OLs). TA also enhanced the expression of MBP at both mRNA and protein levels in MO3.13 cells. In CPZ-induced mice and MO3.13 cells, TA remarkably promoted the activation of GSK3ß, repressed the phosphorylation of ß-catenin, reduced the expression of transcription factor 4 and inhibitor of DNA binding 2. The agonist of ß-catenin, SKL2001, partially abolished the pro-differentiation effect of TA in MO3.13 cells. CONCLUSIONS: Taken together, we clarified that TA could effectively enhance the differentiation and maturation of OPCs and accelerate remyelination in CPZ-induced mice through inhibition of Wnt/ß-catenin signaling pathway. This study provides new insight into the beneficial effect of TA in the treatment of MS.

Micro-CT and SEM investigation of sound absorption structure and chambers in the otoliths of Giant Panda fish species - Chinese Bahaba (Bahaba taipingensis).

As a critically endangered (CR) fish species, Chinese Bahaba is a unique "Giant Panda" fish species in China and has been listed among the national first-class wildlife protection animals and China's top 10 genetic resources of aquatic products since 2021. This fish species is of high commercial value because its swim bladder is commonly used in traditional Chinese medicine. Its otoliths are the sensory organs immersed in the endolymph for maintaining its balance and hearing. However, rare information has been reported on the sound absorption structure and chambers of otoliths of such "Giant Panda" fish. The big "C" groove was found in the fish's front sagittal otolith with the crystal cluster in the back sagittal otolith, the former of which is a 3D layered structure, that is constructed by elongated prismatic crystals. Besides, there are numerous small holes and adhesion material in this 3D layered structure, where many chambers were also found, indicating that some specific sounds may be captured by this structure and these chambers may then amplify such sounds at a certain wavelength. This finding could be of great importance for protecting and conserving this critically endangered species.

Ultra-HPLC-MS pseudo-targeted metabolomic profiling reveals metabolites and associated metabolic pathway alterations in Asian plum (Prunus salicina) fruits in response to gummosis disease.

Plum (Prunus spp.) is an economically and nutritionally important stone fruit that is grown worldwide. Gummosis disease (GD) is one of the most common limiting factors that adversely affects the yield and quality of stone fruits such as plum. Elucidating plum fruit metabolomics responses is essential to develop sustainable agricultural practices to combat GD in the future. Herein, an ultra-high-performance liquid chromatography coupled to mass-spectrometry (UHPLC-MS) pseudo-targeted metabolomic profiling was first performed to elucidate the overall metabolic alterations in Asian plum (Prunus salicina Lindl.) fruit in response to GD. The most pivotal differential metabolites, including certain amino acids and proanthocyanidins, in GD and control groups were identified by combining multivariate data analysis with strict statistical criteria. Metabolic pathway enrichment analysis showed that GD induced a series of coordinated defence responses and reprogramming of various metabolic pathways, including glucosinolate biosynthesis, 2-oxocarboxylic acid metabolism, valine, leucine and isoleucine degradation, and isoquinoline alkaloid biosynthesis pathways. Using UHPLC-MS-based pseudo-targeted metabolomic profiling, we systematically evaluated overall metabolic modifications in Asian plum fruits in response to GD for the first time. The identified metabolic pathway alterations helped to better understand the internal relationships and related metabolic networks.

Preventive Effects of Ilex Cornuta Aqueous Extract on High-Fat Diet-Induced Fatty Liver of Mice.

Objective: To investigate the preventive effects of Ilex cornuta aqueous extract (ICAE) on high-fat diet (HFD)-induced fatty liver of mice and its mechanisms. Materials and Methods: Twenty-six male KM (Kunming) mice were divided into 3 groups, including the control group (n = 9), fed with normal diet; HFD group (n = 9), fed with HFD; ICAE + HFD group (n = 8), fed with HFD and administered with ICAE (3 g·kg-1·d-1) at the same time for 10 weeks. Body weight, liver weight, intra-abdominal and subcutaneous fat weight, serum triglyceride (TG), total cholesterol (TC), and blood glucose were determined to evaluate the preventive effects of ICAE on obesity. The average 24 h food consumption of the mice was monitored for 5 times in the 9th week of the experiment to investigate the effects of ICAE on food intake. Serum alanine transaminase (ALT) and aspartate aminotransferase (AST) were assayed to observe the influences of HFD and ICAE on liver function. HE staining was adopted to observe the influence of ICAE on the morphology of adipose tissue and liver tissue. Hepatic TG and TC content assay and oil red O staining were used to evaluate the influences of ICAE on HFD-induced fatty liver, and the protein expression of peroxisome proliferator-activated receptors γ (PPARγ) and adipose differentiation-related protein (ADRP) in liver were examined by immunoblotting. Results: ICAE treatment significantly reduced the increase of body weight, intra-abdominal, and subcutaneous fat and liver weight induced by HFD (P < 0.001), but has no influence on food intake; ICAE treatment attenuated the elevation of serum TG, TC, and glucose, as well as serum ALT and AST (P < 0.01, P < 0.05, P < 0.001) and dramatically decreased the content of TG in liver (P < 0.01), but has no influence on hepatic TC content. HE staining and oil red O staining showed that ICAE significantly reduced HFD-induced white adipocyte hypertrophy and significantly inhibited lipid accumulation in liver. Immunoblotting showed that the protein levels of PPARγ and ADRP were significantly increased by HFD induction, which can be dramatically reduced by ICAE treatment (P < 0.05, P < 0.0001). Conclusion: ICAE has preventive effects on HFD-induced obesity and fatty liver in mice, exerted beneficial effects upon HFD-induced hepatic injury. The preventive effects of ICAE on fatty liver are concerned with the downregulation of PPARγ and ADRP protein expression in liver.

Old dog, new tricks: Polydatin as a multitarget agent for current diseases.

Polydatin (PD) is a natural single-crystal product that is primarily extracted from the traditional plant Polygonum cuspidatum Sieb. et Zucc. Early research showed that PD exhibited a variety of biological activities. PD has attracted increasing research interest since 2014, but no review comprehensively summarized the new findings. A great gap between its biological activities and drug development remains. It is necessary to summarize new findings on the pharmacological effects of PD on current diseases. We propose that PD will most likely be used in cardiac and cerebral ischaemia/reperfusion-related diseases and atherosclerosis in the future. The present work classified these new findings according to diseases and summarized the main effects of PD via specific mechanisms of action. In summary, we found that PD played a therapeutic role in a variety of diseases, primarily via five mechanisms: antioxidative effects, antiinflammatory effects, regulation of autophagy and apoptosis, maintenance of mitochondrial function, and lipid regulation.

Comparative Evidence for Intrahepatic Cholestasis of Pregnancy Treatment With Traditional Chinese Medicine Therapy: A Network Meta-Analysis.

Background: Intrahepatic cholestasis of pregnancy (ICP) seriously threatens the health of pregnant women and newborns. A various number of Chinese prescriptions and patent medicines combined with ursodeoxycholic acid (UDCA) are used for treating ICP in China. However, there are still many doubts in choosing the suitable therapeutic drugs for the treatment of ICP in clinical practice. Methods: Several electronic databases, including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBM), Wanfang, and VIP, were comprehensively searched from the database inception to February 22, 2021. Randomized controlled trials (RCTs) reporting the use of UDCA only, Chinese prescriptions plus UDCA, and patent medicine plus UDCA for the treatment of ICP were collected according to their inclusion and exclusion criteria. Cochrane Reviewers' Handbook version 5.2 was applied for the risk assessment of the included trials. STATA 16.0 software was used for network meta-analysis (NMA). The pruritus score and the serum levels of total bile acid (TBA), alanine aminotransferase (ALT), and aspartate transaminase (AST) in ICP patients served as the primary outcomes. Moreover, this study had been registered in PROSPERO (https://www.crd.york.ac.uk/PROSPERO/#joinuppage), and the registration number is CRD42020188831. Results: Thirty-eight RCTs comprising 3,841 patients meeting the inclusion criteria were included in the network meta-analysis. The NMA results showed that compared with UDCA used alone, Yinchenhao decoction (seven different Chinese prescriptions or patent medicines) plus UDCA dramatically alleviated the primary outcomes of ICP, including the pruritus score, as well as the serum levels of TBA, ALT, and AST. The NMA results showed that the optimal drug ratio for the treatment of ICP was different from the dosage ratio of traditional Yinchenhao decoction. Significantly, the intervention plan f (IP-f) group [the similar prescription of Yinchenhao decoction 2 (Artemisia capillaris Thunb >15 g, Gardenia >9 g, and Rhubarb <5 g) + UDCA] was the best therapeutics among the eight therapies. Conclusion: Overall, the combined use of Chinese prescriptions or patent medicine with UDCA was generally better than UDCA used alone. The dose of IP-f might be a beneficial therapeutic method for the clinical medication of ICP. Clinical Trail Registration: https://www.crd.york.ac.uk/, identifier CRD42020188831.

[Research advance of pharmacological effects of astragalosides on nervous system diseases].

Astragali Radix is a traditional Chinese herbal medicine with a long history, which has the functions of tonifying Qi and promoting urination and granulation. Astragalosides are the main effective components of Astragali Radix, and more than 40 triterpenoid saponins have been obtained from Astragalus membranaceus and its related plants, mainly including astragalosides Ⅰ-Ⅷ, isoastragalosides Ⅰ, Ⅱ, and Ⅳ, acetylastragalosides, and soyasaponins. Astragalosides have a wide range of biological activities, such as immunomodulation, antioxidation, and neuroprotection. Nervous system diseases seriously affect people's quality of life, threaten human physical and mental health, and impose a burden on families and society. As natural drugs, astragalosides have good preventive and therapeutic effects on central nervous system diseases. This paper reviews the main pharmacological effects and mechanisms of astragalosides in the treatment of multiple sclerosis, Parkinson's disease, Alzheimer's disease, and cerebral ischemic stroke and proposes the research prospects and potential problems, aiming to provide reference for the clinical application and basic research of astragalosides.

Effect of acupotomy in knee osteoarthritis patients: study protocol for a randomized controlled trial.

BACKGROUND: Symptomatic knee osteoarthritis (KOA) is common in China. Pharmacological therapy is not the first recommendation because of its safety issues. Nonpharmacological therapy, such as lifestyle adjustments, weight loss, muscle strengthening, and aerobic exercise programs, is strongly recommended for KOA. However, these approaches may fail due to poor patient compliance. There is a lack of high-quality randomized controlled trials of acupotomy, an effective treatment for KOA. This study was designed to investigate the efficacy of acupotomy in patients with KOA. METHODS: A total of 136 patients will be enrolled at the First Affiliated Hospital of Guangzhou University of Chinese Medicine and assigned to the acupotomy group or sham acupotomy group according to the block randomization scheme. Patients in the acupotomy group will receive 2 sessions of acupotomy for 2 weeks (once a week). Patients in the sham group will receive 2 sessions of sham stimulation for 2 weeks (once a week). All patients will use indomethacin cream externally. The primary outcome will be the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the secondary outcomes will be the visual analog scale (VAS) score, plantar pressure distribution test result, X-ray examination findings, musculoskeletal ultrasound findings, maximum knee circumference, joint mobility, and quality of life. Measurements will be taken at baseline, 1 week after the end of treatment, and at the 3- and 6-month follow-ups. DISCUSSION: To the best of our knowledge, this will be the first single-blind, sham-controlled study of acupotomy. The outcome assessors will also be blinded. The aim of this work is to demonstrate the efficacy of acupotomy in treating KOA. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2000033047 . Registered on 18 May 2020.

Au Catalyzing Control Release NO in vivo and Tumor Growth-Inhibiting Effect in Chemo-Photothermal Combination Therapy.

INTRODUCTION: Aim to obtain a NO donor that can control released NO in vivo with the high efficacy of tumor suppression and targeting, a nanoplatform consisting of FA-Fe3O4@mSiO2-Au/DOX was constructed. METHODS: In vitro, the nanoplatform catalyzed NO's release with the maximum value of 4.91 µM within 60 min at 43°C pH=5.0, which was increased by 1.14 times when the temperature was 37°C. In vivo, 11.7 µg Au in the tumor tissue was found to catalyze S-nitrosoglutathione continuously, and 54 µM NO was checked out in the urine. RESULTS AND DISCUSSION: The high concentration of NO was found to increase the apoptotic rate and to reduce tumor proliferation. In the chemo-photothermal combination therapy, the tumor inhibition rate was increased up to 94.3%, and Au's contribution from catalyzing NO release NO was 8.17%.

Mucosal Vaccination for Influenza Protection Enhanced by Catalytic Immune-Adjuvant.

Influenza poses a severe threat to global health. Despite the whole inactivated virus (WIV)-based nasal vaccine being a promising strategy for influenza protection, the mucosal barrier is still a bottleneck of the nasal vaccine. Here, a catalytic mucosal adjuvant strategy for an influenza WIV nasal vaccine based on chitosan (CS) functionalized iron oxide nanozyme (IONzyme) is developed. The results reveal that CS-IONzyme increases antigen adhesion to nasal mucosa by 30-fold compared to H1N1 WIV alone. Next, CS-IONzyme facilitates H1N1 WIV to enhance CCL20-driven submucosal dendritic cell (DC) recruitment and transepithelial dendrite(TED) formation for viral uptake via the toll-like receptor(TLR) 2/4-dependent pathway. Moreover, IONzyme with enhanced peroxidase (POD)-like activity by CS modification catalyzes a reactive oxygen species (ROS)-dependent DC maturation, which further enhances the migration of H1N1 WIV-loaded DCs into the draining lymph nodes for antigen presentation. Finally, CS-IONzyme-based nasal vaccine triggers an 8.9-fold increase of IgA-mucosal adaptive immunity in mice, which provides a 100% protection against influenza, while only a 30% protection by H1N1 WIV alone. This work provides an antiviral alternative for designing nasal vaccines based on IONzyme to combat influenza infection.

Evaluation on the effect of acupuncture on patients with sepsis-induced myopathy (ACU-SIM pilot study): A single center, propensity-score stratified, assessor-blinded, prospective pragmatic controlled trial.

BACKGROUND: Sepsis-induced myopathy (SIM) is a disease that causes motor dysfunction in patients with sepsis. There is currently no targeted treatment for this disease. Acupuncture has shown considerable efficacy in the treatment of sepsis and muscle weakness. Therefore, our research aims to explore the effects of acupuncture on the improvement of muscle structure and function in SIM patients and on activities of daily living. METHODS: The ACU-SIM pilot study is a single-center, propensity-score stratified, assessor-blinded, prospective pragmatic controlled trial (pCT) with a 1-year follow-up period. This study will be deployed in a multi-professional critical care department at a tertiary teaching hospital in Guangzhou, China. Ninety-eight intensive care unit subjects will be recruited and assigned to either the control group or the acupuncture group. Both groups will receive basic treatment for sepsis, and the acupuncture group will additionally receive acupuncture treatment. The primary outcomes will be the rectus femoris cross-sectional area, the Medical Research Council sum-score and time-to-event (defined as all-cause mortality or unplanned readmission to the intensive care unit due to invasive ventilation). The activities of daily living will be accessed by the motor item of the Functional Independence Measure. Recruitment will last for 2 years, and each patient will have a 1-year follow-up after the intervention. DISCUSSION: There is currently no research on the therapeutic effects of acupuncture on SIM. The results of this study may contribute to new knowledge regarding early muscle atrophy and the treatment effect of acupuncture in SIM patients, and the results may also direct new approaches and interventions in these patients. This trial will serve as a pilot study for an upcoming multicenter real-world study. TRIAL REGISTRATION: Chinese Clinical Trials Registry: ChiCTR-1900026308, registered on September 29th, 2019.

[Analysis of adverse reactions of acupoint catgut embedding therapy].

OBJECTIVE: To objectively evaluate the safety of acupoint catgut embedding therapy. METHODS: A total of 331 patients who received acupoint catgut embedding therapy were enrolled and summarized through the inpatient medical record system, follow-up record and adverse reaction report card. The statistical analysis was performed from the aspects of patients' gender, age, marital status, history of allergy, history of diabetes and the time, symptoms, duration and prognosis of adverse reactions, etc. RESULTS: Among 331 patients who received acupoint catgut embedding therapy, 70 patients had adverse reactions, which were divided into 9 types, including post-treatment discomfort, local hematoma or subcutaneous hemorrhage, local swelling, local induration, severe pain, thread-body rejection, local pruritus, post-treatment body temperature rising, local redness, swelling, fever and pain. The incidence rate of adverse events was 21.15%, and the incidence of serious adverse events was 0. Among the patients with adverse reactions, 58 patients (82.86%) relieved without treatment, and 12 patients (17.14%) received after symptomatic treatment; all patients had no sequelae. CONCLUSION: The acupoint catgut embedding therapy is relatively safe and the incidence of adverse reactions is low.

Effect of Fatigue Three-Needle acupuncture therapy in a patient with cancer-related fatigue: A case report.

RATIONALE: Cancer-related fatigue (CRF) is a persistent, subjective sense of tiredness or exhaustion experienced by cancer patients. Acupuncture is a safe and feasible optional method for adjunctive treatment for CRF. However, the therapeutic effect of the Fatigue Three-Needle acupuncture therapy in patients with CRF has not been well-investigated. PATIENT CONCERNS: A 53-year-old woman had been experiencing fatigue since the radical resection of sigmoid colon cancer 2 years ago, for which she underwent traditional Chinese medicine treatment. DIAGNOSIS: After some review, she was diagnosed with CRF. Although she underwent traditional Chinese medicine treatment, she continued experiencing fatigue symptoms. INTERVENTIONS: When she visited our hospital, she was treated with the Fatigue Three-Needle for 3 sessions a week, 30 minutes per session. OUTCOMES: After 4 weeks of treatment, the patient felt refreshed and relieved from the fatigue. LESSONS: The finding from this case provides further evidence for the therapeutic benefits of the Fatigue Three-Needle therapy for patients with CRF, suggesting that acupuncture treatment with the Fatigue Three-Needle is an effective option for patients with CRF.

Characteristic anti-inflammatory and antioxidative effects of enzymatic- and acidic- hydrolysed mycelium polysaccharides by Oudemansiella radicata on LPS-induced lung injury.

The present work investigated the antioxidative, anti-inflammatory and pulmonary protective effects of enzymatic- and acid- hydrolysed mycelia polysaccharides (En-MPS and Ac-MPS) from Oudemansiella radicata on LPS-induced acute lung injury (ALI) mice. The results demonstrated that both En-MPS and Ac-MPS showed potential pulmonary protective effects by decreasing serum levels of hs-CRP and C3, increasing pulmonary enzyme values of SOD, GSH-Px, CAT and the level of T-AOC; reducing the activity of MPO; and down-regulating the contents of MDA and LPO. In addition, the levels of TNF-ɑ, IL-1ß, and IL-6 in BALF of mice treated with En-MPS at a dosage of 400 mg/kg/d were significantly lower than those in the ALI mice. The in vitro antioxidant effects also showed that the En-MPS was more effective than Ac-MPS. Furthermore, the physical properties of polysaccharides were also investigated by GC, HPGPC, FT-IR and NMR. These results indicated that both En-MPS and Ac-MPS possessed potent antioxidant and anti-inflammatory activities, which could be used as an ingestible drug in preventing lung injury.

[Effects of maternal exposure to bisphenol A during pregnancy on puberty in advance and hypothalamo-pituitary gonadal axis hormones level in female offspring].

OBJECTIVE: To investigate the effect of maternal exposure to bisphenol A on puberty in advance and hypothalamus-pituitary-gonad axis( HPG axis) hormones level in female offspring. METHODS: A total of 105 pregnant CD-1 mice aged 8 weeks were daily administered with BPA at four different doses( 0, 8, 40 and 200 mg/kg) by gavage from gestational day( GD) 0 to 18. Offspring were weighed and determined sex by anal reproductive distance after birth. From postnatal day( PND) 21-34, the vaginal opening of female offspring and distinguished the estrous stage through vaginal smears wereobserved. The level of GnRH, FSH, LH and E2 hormone in serum were detected. RESULTS: The mean initial time of vaginal opening in 8 mg/kg group [( 28. 0 ± 0. 36)days], 40 mg/kg group [( 28. 0 ± 0. 33) days] and 200 mg/kg group [( 28. 0 ± 0. 61)days]was earlier than that in the control group [( 30. 0 ± 0. 27) days]. The vaginal opening in advance rate of BPA exposure group was higher than that of the control group and the first estrus occurrence was earlier than controls( P < 0. 05). The levels of GnRH[8 mg/kg:( 9. 78 ± 1. 07) pg/mL, 40 mg/kg:( 11. 55 ± 1. 38) pg/mL, 200 mg/kg:( 10. 09 ± 1. 51) pg/mL]with increased expressions compared with the controls [( 5. 18± 4. 63) pg/mL]. LH level in low dose group [( 1. 86 ± 0. 79) pg/mL] was significantly lower than that in control group [( 2. 37 ± 1. 56) pg/mL]. The above differences were statistically significant( P < 0. 05). CONCLUSION: These findings suggested that maternal exposure to BPA result in advancing puberty and increase the GnRH hormone level to affect the function of HPG axis in female offspring.