Safety and efficacy of high power shorter duration ablation for atrial fibrillation: A systematic review and meta-analysis.

BACKGROUND: Radiofrequency ablation in patients with atrial fibrillation (AF) is effective but hampered by pulmonary veins reconnection because of insufficient lesions. High power shorter duration ablation (HPSD) was seen to increase efficacy and safety. This analysis aimed to evaluate the clinical benefits of HPSD in patients with AF. METHODS: The Medline, PubMed, Embase, and the Cochrane Library databases were searched for studies comparing HPSD and Low power longer duration (LPLD) ablation. RESULTS: A total of seven trials with 2023 patients were included in the analysis. Pooled analyses demonstrated that HPSD showed a benefit of first-pass pulmonary vein isolation (PVI) [risk ratio (RR): 1.27; 95% confidence interval (CI): 1.18-1.37, P < .001]. HPSD could reduce recurrence of atrial arrhythmias (RR: 0.70; 95% CI: 0.50-0.98, P = .04). Additionally, HPSD was more beneficial in terms of procedural time [Weighted Mean Difference, (WMD): -44.62; 95% CI, -63.00 to -26.23, P < .001], ablation time (WMD: -21.25; 95% CI: -25.36 to -17.13, P < .001), and fluoroscopy time (WMD: -4.13; 95% CI: -7.52 to -0.74, P < .001). Moreover, major complications and esophageal thermal injury (ETI) were similar between two groups (RR: 0.75; 95% CI: 0.44-1.30, P = .31) and (RR: 0.64; 95% CI: 0.17-2.39, P = .51). CONCLUSION: HPSD was safe and efficient for treating AF with clear advantages of procedural features, it also showed benefits of higher first-pass PVI and reducing recurrence of atrial arrhythmias compared with the LPLD. Moreover, major complications and ETI were similar between two groups.

Novel calicivirus from a ferret badger (Melogale moschata) in China.

We describe the isolation and complete genome sequence of a new calicivirus, FBCV-JX12, isolated from a ferret badger (Melogale moschata). Comparison of FBCV-JX12 with other vesiviruses revealed that it shared the highest amino acid sequence identities of 71.6, 60.5, and 59.3% in the nonstructural protein, VP1, and VP2, respectively, with MCV-DL2007 (mink calicivirus). Phylogenetic analysis of the whole genomic sequence showed that it clustered most closely with MCV-DL2007 of the genus Vesivirus, but with low nucleotide similarity in the three open reading frames (62.1-68.5%).

Analysis on acupoint selection rules in the treatment of metabolism-associated fatty liver disease based on data mining. / åŸºäºŽæ•°æ®æŒ–æŽ˜æŠ€æœ¯åˆ†æžé’ˆç¸æ²»ç–—ä»£è°¢ç›¸å ³è„‚è‚ªæ€§è‚ç— çš„é€‰ç©´è§„å¾‹.

OBJECTIVES: To explore the rules of acupoint selection in the treatment of metabolic-associated fatty liver disease (MAFLD) with acupuncture and moxibustion by using data mining technology. METHODS: The clinical research literature on acupuncture treatment of MAFLD was collected from PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, VIP Database and China Biology Medicine from their inception to November 20, 2022. According to our inclusion and exclusion criteria, the literature was independently screened and re-screened by two research members, and the screened results were checked, followed by establishing an acupoint prescription database using Excel 2019. Descriptive statistics of acupoints applied frequency, involved meridians, locations and specific acupoints were perpormed. Then, SPSS Modeler18.0 software was used to conduct analysis about association rules, and the SPSS Statistics 26.0 software was used to perform cluster analysis on high-frequency acupoints, exploring the characteristics and rules of acupoint selection and combination in the treatment of MAFLD. RESULTS: Totally, 178 papers were collected, containing 130 acupoints, with a total application frequency of 1 305. The top five acupoints are Zusanli (ST36), Fenglong (ST40), Ganshu (BL18), Taichong (LR3) and Sanyinjiao (SP6). The commonly involved meridians are the Stomach Meridian of Foot Yangming, Bladder Meridian of Foot Taiyang, and Spleen Meridian of Foot Taiyin. The employed acupoints are mostly located in the lower limbs and abdomen, and the five Shu acupoints and crossing acupoints are in the majority. The association rule analysis of high frequency acupoints indicated that of the 16 qualified acupoint groups, the top 5 with close correlation degrees are ST36 and ST40, ST36 and LR3, ST36 and SP6, ST40 and LR3 and ST36, ST36 and SP6 and ST40. Further, 3 effective clusters were obtained by cluster analysis. CONCLUSIONS: Acupuncture and moxibustion treatment of MAFLD follows the therapeutic principles of soothing the liver, invigorating the spleen, tonifying the kidney, and resolving phlegm and removing dampness. The core acupoint group is ST36, ST40 and LR3, and the combination of acupoints is based on syndrome differentiation. These results may provide a useful reference for clinical practice.

Acupoint selection rules of acupuncture and moxibustion in treating neurogenic bladder based on data mining. / 基于数据挖掘技术分析针灸治疗神经源性膀胱的选穴规律.

OBJECTIVES: To explore the rules of acupoint selection in the treatment of neurogenic bladder (NB) with acupuncture and moxibustion by using data mining. METHODS: The clinical research literatures on acupuncture treatment of NB were collected from PubMed, Embase, Cochrane Library, CNKI, Wanfang Database, VIP Database and China Biology Medicine from retrieved to January 1, 2023. The acupoint prescription database was established using Excel 2019. SPSS Modeler 18.0 and SPSS Statistics 26.0 softwares were used to conduct the frequency, meri-dians, locations, specific acupoints analysis and association rules analysis, factor analysis, cluster analysis, etc., to explore the characteristics and rules of acupoint selection in acupuncture and moxibustion treatment of NB. RESULTS: Totally 313 papers were included, including 110 acupoints with a total frequency of 1 995. The high-frequency acupoints are Zhongji (CV3), Guanyuan (CV4), Sanyinjiao (SP6), etc. The commonly used meridians are the Bladder Meridian of Foot Taiyang and Conception Vessel. The involved acupoints are mostly located in the lumbosacral region and abdomen, and intersection acupoints, mu-front acupoints and back-shu acupoints are the majority in the specific acupoints. The core acupoints group was analyzed, and 17 groups of association rules, 7 factors and 6 effective cluster groups were obtained. CONCLUSIONS: Acupuncture and moxibustion treatment of NB follows the therapeutic principles of toni-fying the kidney, invigorating the spleen, and soothing the liver. The core acupoints group is CV3-CV4-SP6.

[Moxibustion at "Zusanli"(ST36) mitigates senescence in subacute aging rats via regulating SIRT1/p53 signaling pathway].

OBJECTIVE: To observe the effect of moxibustion at "Zusanli"(ST36) on the silent information regulator 1 (SIRT1) /p53 signaling pathway in subacute aging model rats, so as to reveal its mechanisms in delaying aortic aging. METHODS: Male SD rats were divided into blank group, model group, prevention group and treatment group, with 20 rats in each group. Subacute aging model was established by intraperitoneal injection of D-galactose(500 mg·kg-1·d-1). In the morning, rats in the prevention group received moxibustion at ST36 with 3 moxa cones after modeling operation, once every day for 42 d. From the day after the 42-day modeling, rats in the treatment group received the same moxibustion treatment as the prevent group for 28 d. Rats in the blank and model group were fixed in the similar way as the other two groups, for 5 min. Contents of serum SIRT1, p53, endothelial nitric oxide synthase(eNOS) and vascular endothelial growth factor(VEGF) were detected by ELISA. Histopathological changes of aortic tissue were observed after HE staining. Expressions of SIRT1 and p53 mRNAs and proteins in aortic tissue were detected by qPCR and Western blot. RESULTS: Compared with the blank group, the model group showed aging symptoms, the prevention group was similar to the blank group, and the treatment group was slightly better than the model group. Compared with the blank group, content of serum p53, expressions of p53 mRNA and protein in aortic tissues were significantly increased (P<0.05, P<0.01), while contents of serum SIRT1, VEGF, eNOS, and expressions of SIRT1 mRNA and protein in aortic tissues were significantly decreased (P<0.05, P<0.01) in the model group. Compared with the model group, content of serum p53, and expression of p53 mRNA and protein in aortic tissues were significantly decreased (P<0.05, P<0.01) in the prevention and treatment groups, while the contents of serum SIRT1, VEGF, eNOS, and the expressions of SIRT1 mRNA and protein in aortic tissues were significantly increased (P<0.05, P<0.01). Compared with the treatment group, rats in the prevention group displayed significant improvement of the above indexes (P<0.05). Compared with the blank group, the endothelial cells were disordered, the vessel wall was significantly thickened, and the senescent cells were increased in the model group; the blood vessel walls were thinner to varying degrees, and the senescent cells were reduced and unevenly distributed in the prevention and treatment groups. The histopathological lesion was improved more obviously in the prevention group than the treatment group. CONCLUSION: Moxibustion at ST36 can alleviate vascular endothelial injury and oxidative stress in subacute aging rats, which may be related to its effect in regulating the SIRT1/p53 signaling pathway.

[Moxibustion at Baihui combined with acupuncture for cervical vertigo: a Meta-analysis and trial sequential analysis].

OBJECTIVE: To evaluate the efficacy and safety of moxibustion at Baihui (CV20) combined with acupuncture in treatment of cervical vertigo. METHODS: From the databases, such as CNKI, VIP, WanFang, CBM, PubMed, Cochrane Library and Embase, the studies of randomized controlled trials (RCTs) on moxibustion at CV20 combined with acupuncture for cervical vertigo were searched from inception to September 15th, 2021. The Cochrane risk of bias assessment tool was utilized to evaluate the quality of the included literature. Using RevMan5.3, Stata12.0 and TSA0.9.5.0 10 Beta software, the Meta-analysis and trial sequential analysis (TSA) were performed. RESULTS: Seventeen RCTs with 1 232 patients were included. Meta-analysis showed that in the trial group (moxibustion at CV20 combined with acupuncture), the total effective rate (RR=1.17, 95%CI［1.12, 1.22］, P<0.000 1), the curative and remarkably-effective rate (RR＝1.28，95%CI［1.20，1.36］，P<0.000 1) and the score of cervical vertigo (WMD=2.88, 95%CI［1.87, 3.89］, P<0.000 1) were all better when compared with the control group (simple acupuncture or electroacupuncture group). The results of trial sequential analysis indicated that for the cumulative Z-score of each RCT, the Z-curve crossed the conventional test boundary and TSA boundary, which further confirmed the clinical efficacy of moxibustion at CV20 combined with acupuncture on cervical vertigo. CONCLUSION: The clinical efficacy of moxibustion at CV20 combined with acupuncture is determined in treatment of cervical vertigo.

[Effect of electroacupuncture combined with Zhuang-medicine-thread moxibustion on expression of apoptosis-related factors in gastric antrum of diabetic gastroparesis rats].

OBJECTIVE: To observe the effect of electroacupuncture (EA) combined with Zhuang-medicine-thread moxibustion on expression of apoptosis-related factors in gastric antrum of diabetic gastroparesis (DGP) rats, so as to explore its mechanism underlying improvement of DGP. METHODS: Male SD rats were randomly divided into normal, model, medication, EA, Zhuang-medicine-thread moxibustion (moxibustion) and EA+moxibustion (combination) groups (12 rats in each group). The DGP model was established by intraperitoneal injection of streptozotocin (STZ). Rats of the medication group were treated by gavage of 0.15 mg/mL mosapride citrate suspension （10 mL/kg）. EA (10 Hz/50 Hz, 2 mA, 20 min) or Zhuang-medicine-thread moxibustion (3 cones) was applied to "Zhongwan" (CV12), bilateral "Neiguan" (PC6) and bilateral "Sanyinjiao" (SP6) of the related groups, once a day for 3 weeks. The blood glucose, gastric emptying rate and intestinal propulsion rate of rats were measured. The apoptosis index of gastric antrum cells were observed by TUNEL staining. The protein and mRNA expressions of Caspase-3, B-cell lymphoma/leukemia-2 (Bcl-2) and Bcl-2 associated X protein (Bax) in gastric antrum were detected by Wes-tern blot and real-time quantitative PCR, respectively. RESULTS: Compared with the normal group, the blood glucose, the apoptosis index, the protein and gene expressions of Caspase-3 and Bax were significantly increased (P<0.01), and the gastric emptying rate, intestinal propulsive rate, the protein and gene expressions of Bcl-2 were considerably decreased (P<0.01) in the model group. In contrast to the model group, the blood glucose in the EA, moxibustion and combination groups, the apoptosis index in the 4 treatment groups, as well as Caspase-3 protein, Bax protein and mRNA expressions in the medication, EA and combination groups, Caspase-3 protein and mRNA, Bax mRNA expressions in the moxibustion group were significantly decreased (P<0.01, P<0.05); while the gastric emptying rate and intestinal propulsive rate in the 4 treatment groups, and Bcl-2 protein and mRNA expressions in the medication and combination groups, Bcl-2 mRNA expressions in the EA and moxibustion groups were obviously increased (P<0.01). The effects of EA+moxibustion were significantly superior to those of simple EA, moxibustion or medication in increasing gastric emptying rate and intestinal propulsive rate, and in lowering blood glucose (P<0.05, P<0.01). And the effects of the combination treatment were better than those of EA in lowering Caspase-3 protein and Bax mRNA expressions (P<0.01), and in increasing Bcl-2 protein and mRNA expressions (P<0.05, P<0.01). Also the effects of the combination treatment were better than those of moxibustion in lowering the apoptosis index, Caspase-3 protein, and Bax protein and mRNA expressions (P<0.01, P<0.05), and in increasing Bcl-2 protein expression (P<0.05). CONCLUSION: EA combined with Zhuang-medicine-thread moxibustion can reduce blood glucose and improve gastrointestinal motility in DGP rats, which may be related to its effect in regulating of Caspase-3, Bax and Bcl-2 expression.

[Effect of Herbal-cake-separated moxibustion on macrophage phagocytosis and activation of VEGF/VEGFR pathway in endometriosis rats].

OBJECTIVE: To observe the effect of herbal-cake-separated moxibustion on changes of vascular endothelial growth factor (VEGF)/VEGF receptor(VEGFR) in endometriosis (EMs) model rats, so as to analyze the regulatory mechanism of herbal-cake-separated moxibustion on EMs. METHODS: SD rats were randomly divided into sham operation, model, herbal-cake-separated moxibustion, and medication groups, with 30 rats in each group. The EMs rats model was established by removing the endometrium. Herbal-cake-separated moxibustion was applied to "Dazhui"(GV14) and "Mingmen"(GV4) for 6 moxa-cones every time. Rats of the medication group was treated by gavage of gestrinone (60 mg/kg). All the treatments were conducted once daily for 7 days. The ectopic endometrial volume was calculated and the pathological condition was observed by HE staining. The levels of vascular endothelial growth factor A (VEGFA), soluble VEGFR (sVEGFR) and tumor necrosis factor-α (TNF-α), interleukin (IL)-1, IL-2 and IL-6 in peritoneal fluid were measured by ELISA. The morphology of macrophages in peritoneal fluid was observed under microscope. The phagocytic capacity and activity of macrophages were detected by colorless malachite green colo-rimetry and MTT colorimetry, respectively. RESULTS: Compared with the sham operation group, the volume of endometriosis increased significantly and showed obvious angiogenesis; the expression levels of VEGFA, sVEGFR, TNF-α, IL-1, IL-2 and IL-6 in rats peritoneal fluid were significantly increased (P<0.05). The number and volume of macrophages, and the phagocytic function and activity of macrophages (P<0.05) were all decreased. After the treatment, all the indexes mentioned above were all significantly reversed in the herbal-cake-separated moxibustion and medication groups (P<0.05), and the effects of herbal-cake-separated moxibustion were superior to the gestrinone (P<0.05). CONCLUSION: Herbal-cake-separated moxibustion can inhibit the activation of VEGF/VEGFR, reduce the inflammatory response of EMs rats and enhance the phagocytosis of macrophages.

[Effect of electroacupuncture combined with Zhuang-medicine-thread moxibustion on oxidative stress in gastric antrum of diabetic gastroparesis rats].

OBJECTIVE: To observe the effect of electroacupuncture (EA) combined with Zhuang-medicine-thread moxibustion on oxidative stress-related indicators in diabetic gastroparesis (DGP) rats, so as to explore its mechanism underlying improvement of DGP. METHODS: Male SD rats were randomly divided into normal, model, medication, EA, Zhuang-medicine-thread moxibustion (moxibustion) and EA+Zhuang-medicine-thread moxibustion (combination) groups (15 rats in each group). The DGP model was established by intraperitoneal injection of streptozotocin (STZ). Rats of the medication group were treated by gavage of 0.15 mg/mL mosapride citrate suspension（10 mL/kg）. EA (10 Hz/50 Hz, 2 mA, 20 min) or Zhuang-medicine-thread moxibustion (3 cones) was applied to "Zhongwan" (CV12), bilateral "Neiguan" (PC6) and bilateral "Sanyinjiao" (SP6) of the related groups, once a day for 3 weeks. The body weight, blood glucose, gastric emptying rate and intestinal propulsion rate of rats were measured. The serum malondialdehyde (MDA) content was measured by thiobarbituric acid method, the serum supero-xide dismutase (SOD) activity was measured by xanthine oxidase method, and the serum reactive oxygen species (ROS) activity was detected by ELISA. HE staining was used to observe the pathological changes of gastric antrum. The expression of heme oxygenase-1 (HO-1), nuclear factor erythroid 2-related factor 2 (Nrf2), nicotin-amide adenine dinucleotide phosphate oxidases (NOX4), peroxisome proliferators activated receptor-gamma coactivator 1α(PGC-1α) proteins and mRNAs in gastric antrum was detected by Western blot and real-time quantitative PCR, respectively. RESULTS: Compared with the normal group, the body weight, gastric emptying rate, intestinal propulsion rate, serum SOD activity, the expressions of HO-1, PGC-1α, total Nrf2 proteins and mRNAs, and Nrf2 nuclear translocation in gastric antrum were decreased (P<0.01), while the blood glucose, serum MDA content and ROS activity, NOX4 protein and mRNA expressions in gastric antrum were increased (P<0.01) in the model group. Compared with the model group, the blood glucose was decreased in the EA, moxibustion and combination groups (P<0.01); the body weight, gastric emptying rate, intestinal propulsion rate, and the expressions of HO-1 and PGC-1α mRNAs in gastric antrum were all increased in the four treatment groups (P<0.01, P<0.05), while the serum MDA content and ROS activity, NOX4 protein and mRNA expressions in gastric antrum were all decreased (P<0.01); the serum SOD activity and total Nrf2 protein expression in gastric antrum were increased in medication, moxibustion and combination groups (P<0.01, P<0.05); the expressions of HO-1 and PGC-1α proteins, and Nrf2 nuclear translocation in gastric antrum were increased in medication and combination groups (P<0.05, P<0.01); the expression of Nrf2 mRNA was increased in the medication, EA and combination groups (P<0.01, P<0.05). Compared with the combination group, the body weight, gastric emptying rate and intestine propulsion rate were decreased in the medication, EA and moxibustion groups(P<0.01, P<0.05), and the blood glucose increased (P<0.01); the serum MDA content and ROS activity, NOX4 protein and mRNA expressions in gastric antrum were increased (P<0.01, P<0.05), serum SOD activity, and the expressions of total Nrf2 protein, PGC-1α protein and mRNA, HO-1 mRNA in gastric antrum were decreased (P<0.01, P<0.05) in the EA and moxibustion groups; the expression of Nrf2 mRNA was decreased in the moxibustion group (P<0.05). HE staining showed a large number of inflammatory cell infiltration in the lamina propria and submucosa, and the gastric glands in the lamina propria were significantly expanded, the submucosa was severely edematous in the model group, which were relative milder in the four treatment groups. CONCLUSION: EA combined with Zhuang-medicine-thread moxibustion can effectively improve the activity of antioxidant enzymes, reduce the production of lipid peroxide, and regulate the expression of antioxidant related proteins and genes, which may be one of the mechanisms in treating DGP.

Bioavailability and Safety of a New Highly Concentrated Midazolam Nasal Spray Compared to Buccal and Intravenous Midazolam Treatment in Chinese Healthy Volunteers.

INTRODUCTION: Buccal midazolam treatment is licensed in the European Union for prolonged acute convulsive seizures in children and adolescents, but the buccal pathway is often hampered by jaw clenching, hypersalivation, or uncontrolled swallowing. Midazolam formulations that are more secure, reliable, and faster for use are needed in the acute setting. Pharmacokinetics and comparative bioavailability of intranasally administered midazolam and two midazolam intravenous solutions administered buccally or intravenously in healthy adults were evaluated. METHODS: In this phase 1, open-label, randomized, single-dose, three-period, three-sequence crossover study, 12 healthy adults (19-41 years) were randomly assigned to receive 2.5 mg midazolam intranasally; 2.5 mg midazolam intravenously; 2.5 mg midazolam buccally. Blood samples were collected for 10 h post dose to determine pharmacokinetic profiles. Adverse events and vital signs were recorded. RESULTS: Intranasal administration of 2.5 mg midazolam demonstrated a more rapid median time to Cmax compared to buccal administration of midazolam (Tmax, 12.6 min vs. 45 min; Cmax, 38.33 ng/ml vs. 24.97 ng/ml). The antiepileptic effect of intranasal and buccal midazolam treatment lasted less than 4 h and generally did not differ from intravenously administered midazolam. No serious adverse events or deaths were reported, and no treatment-emergent adverse events led to study discontinuation. CONCLUSION: Intranasal administration of midazolam may be a preferable alternative to the currently approve buccal midazolam treatment for prolonged acute convulsive seizures in children and adolescents. TRIAL REGISTRATION: This study is registered at the Chinese Clinical Trial [ http://www.chictr.org.cn ] (ChiCTR2000032595) on 3 May, 2020.

[Efficacy and action mechanism of ZHU Lian inhibition type â acupuncture for acne with spleen-stomach dampness-heat].

OBJECTIVE: To observe the efficacy of ZHU Lian inhibition type Ⅰ acupuncture for acne with spleen-stomach dampness-heat, and to explore its possible action mechanism. METHODS: A total of 82 patients of acne with spleen-stomach dampness-heat were randomly divided into an observation group and a control group, 41 cases in each group. The patients in the control group were treated with danshentong capsules (1 g, 3 times per day) and 0.1% adapalene gel smear (once every night) for 4 weeks. The patients in the observation group were treated with ZHU Lian inhibition type Ⅰ acupuncture at Hegu (LI 4), Neiting (ST 44), Quchi (LI 11), Yangbai (GB 14), Sibai (ST 2), Qihai (CV 6), Xuehai (SP 10), Yinlingquan (SP 9) and skin lesions, once every other day, 7 times as a course of treatment, totaling for 2 courses of treatment. The skin lesion score of the global acne grading system (GAGS) and quality of life-acne (Qol-Acne) score as well as the serum levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were compared between the two groups before and after treatment; the clinical efficacy were compared between the two groups, and the recurrence rate was evaluated 4 weeks after treatment. RESULTS: After treatment, the skin lesion scores of GAGS in the two groups were reduced (P<0.05), and the score in the observation group was lower than that in the control group (P<0.05). After treatment, the Qol-Acne scores were increased in the two groups (P<0.05), and the score in the observation group was higher than that in the control group (P<0.05). The serum levels of TNF-αand IL-6 in the two groups were reduced after treatment (P<0.05), and those in the observation group were lower than the control group (P<0.05). The total effective rate was 95.1% (39/41) in the observation group, which was higher than 82.9% (34/41) in the control group (P<0.05). Four weeks after treatment, the recurrence rate of acne lesions was 10.3% (4/39) in the observation group, which was lower than 32.4% (11/34) in the control group (P<0.05). CONCLUSION: ZHU Lian inhibition type Ⅰ acupuncture is effective for acne with spleen-stomach dampness-heat, and the recurrence rate is low. Its mechanism may be related to the reduction of serum inflammatory factor TNF-α and IL-6.

[Effect of electroacupuncture combined with Zhuang-medicine-thread moxibustion on silent information regulator-1/nuclear factor κB signaling pathway in gastric antrum of diabetic gastroparesis rats].

OBJECTIVE: To observe the effect of electroacupuncture (EA) combined with Zhuang-medicine-thread moxibustion on silent information regulator-1 (SIRT1)/nuclear factor kappa B (NF-κB) signal pathway and inflammatory factor expression in gastric antrum tissue of diabetic gastroparesis (DGP) rats, so as to explore its mechanism underlying improvement of DGP. METHODS: Male SD rats were randomly divided into normal, model, medication, EA, Zhuang-medicine-thread moxibustion (moxibustion) and EA+moxibustion groups (n=12 per group). The DGP model was established by intraperitoneal injection of streptozotocin (STZ). Rats of the medication group were treated by gavage of 0.15 mg/mL mosapride citrate suspension. EA (10 Hz /50 Hz, 2 mA) or moxibustion (3 cones) or EA+moxibustion was applied to "Zhongwan"(CV12), bilateral "Neiguan"(PC6) and bilateral "Sanyinjiao"(SP6) of the related group for 20 min, once a day for 3 weeks. Blood glucose, gastric emptying rate and intestinal propulsion rate were measured. The levels of serum interleukin (IL)-6, IL-8, IL-10 and tumor necrosis factor-α(TNF-α) were detected by ELISA; the phosphorylation level of the phosphorylated inhibitor of nuclear factor κBα inhibitor (pIκ-Bα), the protein and mRNA expression of NF-κB p65 and SIRT1 in the gastric antrum tissue were detected by Western blot and real-time quantifitative PCR, respectively. RESULTS: (1) Compared with the normal group, the levels of blood glucose, serum IL-6, IL-8, TNF-α, and gastric pIκ-Bα and NF-κB p65 protein and mRNA expressions were significantly increased (P<0.01), and the gastric emptying rate, intestinal propulsion rate, serum IL-10 level, and SIRT1 protein and mRNA expressions were considerably decreased in the model group (P<0.01). (2) In contrast to the model group, the blood glucose in the EA, moxibustion and EA+moxibustion groups, serum IL-6, IL-8 and TNF-α levels in the 4 treatment groups, as well as NF-κB p65 protein expression in the medication and EA+moxibustion groups, and NF-κB p65 mRNA expression and pIκ-Bα protein and mRNA expression in the 4 treatment groups were significantly decreased (P<0.01, P<0.05); while the gastric emptying rate and intestinal propulsive rate and IL-10 content in the 4 treatment groups, and SIRT1 protein and mRNA expression in the medication and EA+moxibustion groups were obviously increased (P<0.05, P<0.01). (3) The effects of EA+moxibustion were significantly superior to those of simple EA and moxibustion in increasing gastric emptying rate, IL-10, SIRT1 protein expression (P<0.05, P<0.01), and in lowering IL-8 and TNF-α contents, pIκ-Bα protein and mRNA expression and NF-κB p65 mRNA expression (P<0.05, P<0.01). No significant differences were found among the 4 intervention groups in promoting the intestinal propulsive rate and among the EA, moxibustion and EA+moxibustion groups in lowering blood glucose (P>0.05). CONCLUSION: EA combined with Zhuang-medicine-thread moxibustion can effectively reduce the level of serum inflammatory factors and regulate SIRT1/NF-κB signal pathway in DGP rats, which may contribute to its function in improving gastrointestinal movement.

[Effect of moxibustion with ignited Zhuang-medicine medicated-thread on interstitial cells of Cajal in gastric antrum in diabetic gastroparesis rats].

OBJECTIVE: To observe the effect of Zhuang-medicine medicated-thread moxibustion therapy on interstitial cells of Cajal (ICC) in the gastric antrum of diabetic gastroparesis (DGP) rats, so as to investigate its mechanism underlying improving DGP. METHODS: Sprague-Dawley (SD) male rats were randomly divided into 3 groups: control (n = 30) , model (n = 30) and moxibustion (n = 30). The DGP model was established by intraperitoneal injection of streptozotocin (STZ) and by feeding the rats with high fat-sugar forage. Zhuang-medicine medicated-thread moxibustion was applied to "Zhongwan" (CV 12), bilateral "Pishu" (BL 20), "Weishu" (BL 21), "Neiguan" (PC 6) and "Zusanli" (ST 36) once per day, for 3 weeks except weekends. The gastrointestinal propulsion rate and weight of stool in 24 h were determined, and c-kit (a marker for ICC) expression of the gastric antrum tissue was measured by immunohistochemistry. RESULTS: The stool weight was significantly higher in the model group than in the control group (P < 0.01), but the rate of gastrointestinal propulsion and the rate of c-kit immunoreaction (IR) positive cells in the gastric antrum tissue were significantly lower in the model group than in the control group (P < 0.01). After moxibustion, the increased stool weight and the decreased gastrointestinal propulsion rate and decreased c-kit IR-positive cell rate were reversed (P < 0.01). CONCLUSION: Zhuang-medicine medicated-thread moxibustion therapy can improve gastrointestinal function in DGP rats, which may be associated with its effect in up-regulating the expression of c-kit IR-positive ICC.

Pulsed radiofrequency inhibits expression of P2X3 receptors and alleviates neuropathic pain induced by chronic constriction injury in rats / 中华医学杂志(英文版)

BACKGROUND@#Pulsed radiofrequency (PRF) is a minimally invasive interventional technique that provides a novel and effective treatment strategy for neuropathic pain (NP). PRF is advantageous because it does not damage nerves and avoids sensory loss after treatment. At present, animal studies have demonstrated that PRF is safe and effective for relieving the NP associated with sciatic nerve damage in rats with chronic constriction injury (CCI). However, the mechanism through which this effect occurs is unknown. An increasing body of evidence shows that the expression of the P2X ligand-gated ion channel 3 (P2X3) receptor is closely related to NP; this study was to investigate whether the expression of this receptor is involved in NP relief due to PRF.@*METHODS@#A total of 36 healthy adult male Sprague-Dawley (SD) rats were randomly divided into three groups: Sham group, CCI group, and PRF group. The right sciatic nerve was ligated in CCI group and PRF group to establish a CCI model; the right sciatic nerve was separated but not ligated in Sham group. On day 14 after the operation, PRF was administered to the ligated sciatic nerve in PRF group (42°C, 45 V, 2 min). A non-live electrode was placed at the exposed sciatic nerve for the rats in Sham and CCI groups. The hindpaw withdrawal threshold (HWT) and thermal withdrawal latency (TWL) were measured at the right hindpaw at different time points before and after PRF or sham therapy. On day 28 after treatment, the dorsal root ganglion (DRG) and spinal dorsal horn of the right L4-6 were harvested from each group to determine the mRNA and protein levels of the P2X3 receptor.@*RESULTS@#On day 28 after PRF treatment, the HWT (8.33 ± 0.67 g vs. 3.62 ± 0.48 g) and TWL (25.42 ± 1.90 s vs. 15.10 ± 1.71 s) were significantly higher in PRF group as compared to CCI group (P < 0.05). The mRNA expression of the P2X3 receptor in the DRG in PRF group was 23.7% lower than that in CCI group (P < 0.05), in the spinal dorsal horns in PRF group was 22.7% lower than that in CCI group (P < 0.05). The protein expression of the P2X3 receptor in the DRG in PRF group was 27.8% lower than that in CCI group (P < 0.05), in the spinal dorsal horns in PRF group was 35.6% lower than that in CCI group (P < 0.05).@*CONCLUSION@#PRF possibly reduces NP in CCI rats by inhibiting the expression of the P2X3 receptor in the L4-6 DRG and spinal dorsal horns.

Pulsed radiofrequency inhibits expression of P2X3 receptors and alleviates neuropathic pain induced by chronic constriction injury in rats / 中华医学杂志(英文版)

Background@#Pulsed radiofrequency (PRF) is a minimally invasive interventional technique that provides a novel and effective treatment strategy for neuropathic pain (NP). PRF is advantageous because it does not damage nerves and avoids sensory loss after treatment. At present, animal studies have demonstrated that PRF is safe and effective for relieving the NP associated with sciatic nerve damage in rats with chronic constriction injury (CCI). However, the mechanism through which this effect occurs is unknown. An increasing body of evidence shows that the expression of the P2X ligand-gated ion channel 3 (P2X3) receptor is closely related to NP; this study was to investigate whether the expression of this receptor is involved in NP relief due to PRF.@*Methods@#A total of 36 healthy adult male Sprague-Dawley (SD) rats were randomly divided into three groups: Sham group, CCI group, and PRF group. The right sciatic nerve was ligated in CCI group and PRF group to establish a CCI model; the right sciatic nerve was separated but not ligated in Sham group. On day 14 after the operation, PRF was administered to the ligated sciatic nerve in PRF group (42°C, 45 V, 2 min). A non-live electrode was placed at the exposed sciatic nerve for the rats in Sham and CCI groups. The hindpaw withdrawal threshold (HWT) and thermal withdrawal latency (TWL) were measured at the right hindpaw at different time points before and after PRF or sham therapy. On day 28 after treatment, the dorsal root ganglion (DRG) and spinal dorsal horn of the right L4–6 were harvested from each group to determine the mRNA and protein levels of the P2X3 receptor.@*Results@#On day 28 after PRF treatment, the HWT (8.33 ± 0.67 g vs. 3.62 ± 0.48 g) and TWL (25.42 ± 1.90 s vs. 15.10 ± 1.71 s) were significantly higher in PRF group as compared to CCI group (P < 0.05). The mRNA expression of the P2X3 receptor in the DRG in PRF group was 23.7% lower than that in CCI group (P < 0.05), in the spinal dorsal horns in PRF group was 22.7% lower than that in CCI group (P < 0.05). The protein expression of the P2X3 receptor in the DRG in PRF group was 27.8% lower than that in CCI group (P < 0.05), in the spinal dorsal horns in PRF group was 35.6% lower than that in CCI group (P < 0.05).@*Conclusion@#PRF possibly reduces NP in CCI rats by inhibiting the expression of the P2X3 receptor in the L4–6 DRG and spinal dorsal horns.

[A few questions on the major collateral of stomach].

It is held by some of the researches that the "16 collaterals" is composed of the "15 collaterals" and "the major collateral of stomach". And it is included into the textbook that Xuli, the major collateral of stomach, is the pulsation point at the cardiac region. Xuli is often explained as the empty portion of the human body by many researches. Through analysis and summarization of the related theory of the major collateral of stomach, the above mentioned opinion is discussed. And the understanding on the major collateral of stomach is deepened. As a result, it is concluded that count the major collateral of stomach into the 16 collaterals together with the 15 collaterals is inadvisable. The real pulsation point at the cardiac region locates under the left breast. And the real meaning of Xuli is "extending in all directions".

Long-term Effect of Pulsed Radiofrequency on Expression of Calcitonin Gene-related Peptide in Chronic Constriction Injured Rats / 中国康复理论与实践

@#Objective To investigate the long-term effect of pulsed radiofrequency on the expression of calcitonin gene-related peptide (CGRP) in dorsal root ganglion of rats with chronic constriction injury. Methods A total of 36 Sprague-Dawley rats were randomly divided into sham group (n=12), model group (n=12) and treatment group (n=12). The sciatic nerve was ligated in the model group and the treatment group, and the treatment group was treated with pulsed radiofrequency on the injured nerve for 120 seconds. Hindpaw withdrawl threshold (HWT) was measured before treatment, and seven days, 14 days, 21 days and 28 days after treatment. After HWT, the right L4-6 dorsal root ganglions were tested the CGRP expression using RT-qPCR and ELISA. Results HWT gradually increased in the treatment group after treatment, and was higher than that in the model group since seven days after treatment (P<0.05), similar to that of the sham group 21 days and 28 days after treatment (P>0.05). The transcription and translation levels of CGRP were both significantly lower in the treatment group than in the model group (P<0.01).Conclusion Pulsed radiofrequency might relieve the neuropathic pain through reducing CGRP expression in dorsal root ganglion in a long term.

[Effect of drug-paste separated moxibustion on expression of estrogen, progestogen and their endometrial receptor mRNA in rats with primary dysmenorrhea].

OBJECTIVE: To observe the effect of drug-paste separated moxibustion of "Mingmen" (GV 4) on the levels of serum estrogen (E2) and progesterone (P) and their endometrial receptor mRNA expression in rats with primary dysmenorrhea in order to investigate its mechanism underlying improvement of primary dysmenorrhea. METHODS: A total of 100 female SD rats were randomized into control, model, medication, acupuncture and moxibustion groups, with 20 rats in each group. Primary dysmenorrhea model was established by subcutaneous injection of Benzestrofol for 10 days and intraperitoneal injection of Oxytocin for 1 d. Rats of the medication group were fed with extractum leonuri inspissatum (8 g/100 g) and those of the moxibustion group treated with drug-paste separated moxibustion at "Mingmen" (GV 4). For rats of the acupuncture group, a filiform needle was inserted into GV 4, manipulated for a while and retained for 30 min. The treatment of the latter 3 groups was conducted once daily for 7 days. The rat's body-writhing latency and times during 30 min were recorded. The contents of serum E2 and P were detected by ELISA, and the expression of estrogen receptor (ER) mRNA and progesterone receptor (PR) mRNA in the endometrium was determined by quantitative real-time (RT)-PCR. RESULTS: (1) The body-writhing latency was shorter and the writhing times were more in the model group than in the control group (P < 0.01). Compared with the model group, the body-writhing latency was significantly increased and the writhing times were obviously decreased in the medication, acupuncture and moxibustion groups (P < 0.01). There were no significant differences among the medication, acupuncture and moxibustion groups in the body-writhing latency (P > 0.05), but the body-writhing numbers of the acupuncture and moxibustion groups were markedly lower than that of the medication group (P < 0.01). (2) Compared with the control group, serum E2 content and endometrial ER mRNA expression level were significantly increased, and serum P content and endometrial PR mRNA level evidently decreased in the model group (P < 0.01, P < 0.05). In comparison with the model group, serum E2 contents and endometrial ER mRNA expression levels were considerably down-regulated, and serum P contents and endometrial PR mRNA expression levels markedly up-regulated in the medication, acupuncture and moxibustion groups (P < 0.01, P < 0.05). The effects of the moxibustion group were significantly superior to those of the acupuncture and medication groups, and those of the acupuncture group were also significantly superior to those of the medication group in lowering E2 and endometrial ER mRNA levels, and raising serum P and endometrial PR mRNA expression levels (P < 0.01, P < 0.05). CONCLUSION: Drug-paste separated moxibustion of GV 4 is effective in relieving pain in primary dysmenorrheal rats, which is probably associated with its effects in down-regulating serum E2 content and endometrial ER mRNA expression, and up-regulating serum P and endometrial PR mRNA expression levels.

Carriage of drug resistance genes and homology of carbapenem-resistant Acinetobacter baumannii isolated from respiratory intensive care unit / 中国感染控制杂志

Objective To investigate drug resistance genes and epidemic characteristics of β-lactamase carried by carbapenem-resistant Acinetobacter baumannii (CRAB) in the respiratory intensive care unit(RICU) in a hospital.Methods Clinically isolated CRAB from RICU patients in October-December 2015 were collected.Five drug resistance genes (KPC-2,IMP,VIM,NDM-1,OXA-23) were specifically amplified by polymerase chain reaction (PCR),amplified products were performed agarose gel electrophoresis and sequencing analysis,the homology was analyzed with pulsed-field gel electrophoresis (PFGE).Results A total of 22 CRAB strains were isolated in October-December 2015,19 (86.36％) of which were isolated from sputum.The resistance rate of 22 CRAB strains to compound sulfamethoxazole was 59.09 ％,resistance rate to minocycline was 9.09 ％,all were sensitive to polymyxin B,resistance rates to other antimicrobial agents were more than 80％.Three kinds of resistance genes KPC-2,IMP and NDM-1 were not found by PCR amplification,positive rates of VIM and OXA-23 were both 100％.PFGE homology analysis revealed that 22 strains were divided into 13 different types,each type contained 1-5 strains,9 types(69.23％) contained only 1 strain respectively,the other 4 types (30.77％) contained 2-5 strains.A5,A7,and A8;A9,A11,A14,A19 and A22;A4,A10 and A12;A16 and A18 were of the same type respectively.Conclusion The main types of β-lactamase-resistant genes of CRAB in RICU are VIM and OXA-23.Homology analysis shows a small parts are of the same clone strains,which reveals epidemic of a small scale.

External Quality Analysis of Quality Indicators on Specimen Acceptability / 现代检验医学杂志

Objective To analyze the status of quality indicators(QI) on specimen acceptability and establish preliminary qual ity specification.Methods Web based External Quality Assessment system was used to collect data of laboratories partici pated in "Medical quality control indicators in clinical laboratory" from 2015 to 2017,including once in 2015 and 2017 and twice in 2016.Rate and sigma scales were used to evaluate incorrect sample type,incorrect sample container,incorrect fill level and anticoagulant sample clotted.The 25th percentile (P25) and 75th percentile (P75) of the distribution of each QI were employed to establish the high,medium and low specification.Results 5 346,7 593,5 950 and 6 874 laboratories sub mitted the survey results respectively.The P50 of biochemistry (except incorrect fill level),immunology and microbiology reach to 6σ.The P50 of clinical laboratory is 4 to 6σ except for incorrect sample container.There is no significant change of the continuous survey results.Based on results in 2017 to establish the quality specification,the P25 and P75 of the four QIs is 0 and 0.084 4 ％,0 and 0.047 6 ％,0 and 0.114 2 ％,0 and 0.078 4 ％,respectively.Conclusion According to the results of the survey,most laboratories had a faire performance in biochemistry,immunology and microbiology,and clinical laboratory needs to be strengthened.Laboratories should strengthen the laboratory information system construction to ensure the actual and reliable data collection,and make a long time monitoring to achieve a better quality.