Acupoints catgut embedding recovers leptin resistance via improving autophagy progress mediated by AMPK-mTOR signaling in obese mice.

Purpose: Leptin resistance represents a primary pathological manifestation in obesity. Investigating potential treatments and associated mechanisms to restore leptin sensitivity is crucial for effective obesity management. This study aimed to explore the therapeutic potential of acupoints catgut embedding (ACE) in addressing obesity and its associated leptin resistance. Methods: A simple obesity model was established by subjecting C57 male mice to a high-fat diet (HFD) for 12 weeks, followed by ACE treatment administered to half of the obese mice for a duration of 4 weeks. The levels of leptin and its receptor-lepRb, were assessed using enzyme-linked immunosorbent assay (ELISA) and Western blot analysis, respectively. Autophagy progression markers were evaluated through quantitative polymerase chain reaction (qPCR) and Western blot analysis. Also, the liver autophagosomes were photographed using electron microscopy. The role of autophagy in regulating leptin resistance was elucidated using an autophagy suppression model. Results: Comparative analyses demonstrated that ACE treatment resulted in a significant reduction in body weight and blood lipid levels compared to the HFD group. Furthermore, serum leptin levels decreased, while liver lepRb expression increased following ACE treatment. The mRNA and protein expression levels of autophagy in liver were adjusted by ACE treatment. Interestingly, the beneficial effects of ACE were attenuated upon the administration of an autophagy inhibitor. Additionally, ACE treatment led to the activation of the AMPK-mTOR signaling pathway, a crucial regulator of autophagy. Conclusion: These findings suggest that ACE therapy holds promise for recovering leptin resistance by enhancing autophagy progression, mediated via the AMPK-mTOR signaling pathway in liver.

A Case of Persistent Pityriasis Rosea Successfully Treated by a Short Course of Therapy with Abrocitinib.

Pityriasis rosea (PR) is a common inflammatory, erythematous and scaly skin condition that usually affects individuals aged from 20 to 40 years old. The disease often exhibits a self-limiting course up to 6-8 weeks. We report a 25-year-old female patient with a six-month history of red scaly rashes on the trunk and proximal limbs, accompanied by severe pruritus that has been remained ineffective conventional treatments. She was diagnosed as persistent pityriasis rosea. As abrocitinib has been proved to be effective for many inflammatory diseases, therefore in this case, we tried abrocitinib for the patient, and a good result had been achieved.

TREM2 deficiency impairs the energy metabolism of Schwann cells and exacerbates peripheral neurological deficits.

Triggering receptor expressed on myeloid cells-2 (TREM2) has been implicated in susceptibility to neurodegenerative disease. Schwann cells (SCs), the predominant glial cell type in the peripheral nervous system (PNS), play a crucial role in myelination, providing trophic support for neurons and nerve regeneration. However, the function of TREM2 in SCs has not been fully elucidated. Here, we found that TREM2 is expressed in SCs but not in neurons in the PNS. TREM2 deficiency leads to disruption of glycolytic flux and oxidative metabolism in SCs, impairing cell proliferation. The energy crisis caused by TREM2 deficiency triggers mitochondrial damage and autophagy by activating AMPK and impairing PI3K-AKT-mTOR signaling. Combined metabolomic analysis demonstrated that energic substrates and energy metabolic pathways were significantly impaired in TREM2-deficient SCs. Moreover, TREM2 deficiency impairs energy metabolism and axonal growth in sciatic nerve, accompanied by exacerbation of neurological deficits and suppression of nerve regeneration in a mouse model of acute motor axonal neuropathy. These results indicate that TREM2 is a critical regulator of energy metabolism in SCs and exerts neuroprotective effects on peripheral neuropathy. TREM2 deficiency impairs glycolysis and oxidative metabolism in Schwann cells, resulting in compromised cell proliferation. The energy crisis caused by TREM2 deficiency induces mitochondrial damage and autophagy by activating AMPK and impairing PI3K-AKT-mTOR signaling. Moreover, TREM2 deficiency disrupts the energy metabolism of the sciatic nerve and impairs support for axonal regeneration, accompanied by exacerbation of neurological deficits and suppression of nerve regeneration in a mouse model of acute motor axonal neuropathy (by FigDraw).

Acupuncture on "Huantiao" (GB30) and "Yanglingquan" (GB34) acupoints promotes nerve regeneration in mice model of peripheral nerve injury.

Objective: To investigate the effects of acupuncture on promoting nerve regeneration in mice with sciatic nerve crushed injury, an animal model of peripheral nerve injury (PNI). Methods: Acupuncture was performed on the "Huantiao" (GB30) and "Yanglingquan" (GB34) acupoints in PNI mice model for 2 weeks. Gait analysis, toe spreading test, electrophysiological test, toluidine blue staining and immunostaining of myelin basic protein (MBP), neurofilament-200 (NF200), p75 neurotrophin receptor (p75NTR), and growth associated protein-43 (GAP43) were respectively performed to investigate the effects of acupuncture on crushed sciatic nerve. Results: Acupuncture stimulation of "Huantiao" (GB30) and "Yanglingquan" (GB34) acupoints promoted the recovery of motor function and electrophysiological function in PNI mice model, which was indicated by a better gait level, toe spreading level and CMAP value in acupuncture group. The number of myelinated nerve fibers and the fluorescence intensity of MBP, NF200, p75NTR and GAP43 staining demonstrated that the acupuncture stimulation promoted the regeneration of injured nerves in PNI mice model. Conclusion: Acupuncture significantly promoted the functional and morphological recovery of crushed sciatic nerve via promoting the expression of p75NTR in Schwann cells.

Environmental Risk Factors, Protective Factors, and Biomarkers for Allergic Rhinitis: A Systematic Umbrella Review of the Evidence.

Many potential environmental risk factors, protective factors, and biomarkers of AR have been published, but so far, the strength and consistency of their evidence are unclear. We conducted a comprehensive review of environmental risk, protective factors, and biomarkers for AR to establish the evidence hierarchy. We systematically searched Embase, PubMed, Cochrane Library, and Web of Science electronic database from inception to December 31, 2022. We calculated summary effect estimate (odds ratio (OR), relative risk (RR), hazard ratio (HR), and standardized mean difference (SMD)), 95% confidence interval, random effects p value, I2 statistic, 95% prediction interval, small study effects, and excess significance biases, and stratification of the level of evidence. Methodological quality was assessed by AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews 2). We retrieved 4478 articles, of which 43 met the inclusion criteria. The 43 eligible articles identified 31 potential environmental risk factors (10,806,206 total population, two study not reported), 11 potential environmental protective factors (823,883 total population), and 34 potential biomarkers (158,716 total population) for meta-analyses. The credibility of evidence was convincing (class I) for tic disorders (OR = 2.89, 95% CI 2.11-3.95); and highly suggestive (class II) for early-life antibiotic use (OR = 3.73, 95% CI 3.06-4.55), exposure to indoor dampness (OR = 1.49, 95% CI 1.27-1.75), acetaminophen exposure (OR = 1.54, 95% CI 1.41-1.69), childhood acid suppressant use (OR = 1.40, 95% CI 1.23-1.59), exposure to indoor mold (OR = 1.66, 95% CI 1.26-2.18), coronavirus disease 2019 (OR = 0.11, 95% CI 0.06-0.22), and prolonged breastfeeding (OR = 0.72, 95% CI 0.65-0.79). This study is registered in PROSPERO (CRD42022384320).

DAP12 deletion causes age-related motor function impairment but promotes functional recovery after sciatic nerve crush injury.

DNAX activating protein of 12 kDa (DAP12)-deficiency mice showed impaired differentiation of oligodendrocytes and reduced myelin in the central nervous system. Whether DAP12 is expressed by Schwann cells and its roles in the peripheral nervous system (PNS) remains unknown. In this study, expression of DAP12 was detected in Schwann cells in vivo and in vitro. The DAP12-knockout (KO) mice showed age-related motor deficits and thinner myelin in the sciatic nerve than WT mice but significantly faster clinical recovery after sciatic nerve crush injury. In sciatic nerves of DAP12 KO and WT mice, proteomic profiles analysis identified 158 differentially expressed proteins (DEPs) at 8-week-old, 29 DEPs at 54-week-old and 33 DEPs at two weeks after crush injury. Typically, of the DEPs at 54-week-old, up-regulated Lgmn and down-regulated RecK and Yap1 were associated with myelin loss in the sciatic nerve of DAP12 KO mice. Upregulation of nicotinamide nucleotide transhydrogenase and haptoglobin were associated with the accumulation of macrophages in the crushed sciatic nerve of DAP12 KO mice. After crush injury, there were significantly more M1 macrophages at one-week and more M2 macrophages at two-week in sciatic nerve of DAP12 KO mice than WT mice, indicating that DAP12 deletion promotes the phenotype conversion of macrophages from M1 to M2. Collectively, our findings suggest that DAP12 may exert dual roles in the PNS including promoting the physiological myelin formation and maintenance of Schwann cells but delaying nerve repair after injury by modulating the recruitment of macrophages and phenotype conversion.

A Systematic Review of Patient Preferences, Expectations, and Values for the Management and Treatment of Hypertension.

Objective: To comprehensively summarize the evidence on the preferences, expectations, and values of hypertension management and treatment in hypertensive patients. Methods: From inception through January 2022, PubMed, Embase, Web of Science, EBSCO, and China National Knowledge Infrastructure were searched for studies with hypertension value, preference, or expectation. A qualitative retrospective analysis was performed. Results: A total of 24 studies involving 8701 participants were included. Although studies on the preferences of hypertensive patients are difficult to standardize, considerable convergence has occurred: 1) Patients preferred treatment regimens with lower incidence of comorbidities, faster response, lower cost, more frequent blood pressure monitoring, fewer side effects, and more convenient medication. 2) Patients have a crucial role in the treatment, and their physicians are expected to develop a shared patient-centered decision-making model. Conclusion: The results of this systematic review demonstrated that side effects, cost, and convenience are important factors for patients when selecting a treatment regimen for hypertension. Patients often obtain hypertension information from their physicians and prefer shared patient-centered decision-making.

[Acupuncture combined with western medication for ocular myasthenia gravis: a randomized controlled trial].

OBJECTIVE: To compare the clinical efficacy between acupuncture combined with western medication and simple western medication for ocular myasthenia gravis (OMG), and to explore its possible mechanism. METHODS: A total of 60 patients of ocular myasthenia gravis were randomized into an acupuncture combined with western medication group (30 cases, 1 case dropped off) and a western medication group (30 cases, 2 cases dropped off). Oral pyridostigmine bromide tablet and prednisone acetate tablet were given in the western medication group. On the basis of the treatment in the western medication group, Tongdu Tiaoqi acupuncture (acupuncture for unblocking the governor vessel and regulating qi ) was applied at Baihui (GV 20), Fengfu (GV 16), Hegu (LI 4), Zusanli (ST 36), etc. in the acupuncture combined with western medication group, once a day, 6 days a week. The treatment was given 8 weeks in both groups. Before and after treatment, the OMG clinical absolute score was observed, electrophysiological indexes of orbicularis oculi (value of mean jitter, percentage of jitter >55 µs and percentage of blocks) were measured by single-fiber electromyography (SFEMG), serum levels of acetylcholine receptor antibody (AChR-Ab), interferon-gamma (IFN-γ) and interleukin-4 (IL-4) were detected by ELISA method. RESULTS: After treatment, the OMG clinical absolute scores, values of mean jitter, percentages of jitter >55 µs, percentages of blocks and serum levels of AChR-Ab, IFN-γ and IL-4 were decreased compared before treatment in both groups (P<0.05), and those in the acupuncture combined with western medication group were lower than the western medication group (P<0.05). CONCLUSION: Acupuncture combined with western medication can effectively improve ptosis, palpebra superior fatigability, eye movement disorder and neuromuscular junction dysfunction in patients with ocular myasthenia gravis, the therapeutic effect is superior to simple western medication. Its mechanism may be related to down-regulating serum levels of AChR-Ab, IFN-γ and IL-4 and promoting the recovery of orbicularis oculi function.

A fast and efficient method for isolating Schwann cells from sciatic nerves of neonatal mice.

BACKGROUND: Schwann cells (SCs) isolation is one of the basic techniques for study of peripheral nervous system and peripheral neuropathy. A combined and effective method of isolating SCs from sciatic nerves of newborn mice with high yield and purity is still lacking. NEW METHODS: Sciatic nerves from neonatal mice aged 3-5 days serve as the source of SCs. Removal of adjacent connective tissue and epineurium, treatment with arabinoside hydrochloride and differential cell detachment technique were applied to eliminate fibroblast contamination and increase the purity of SCs. Combined use of collagenase/dispase and trypsin was chosen to increase the yield of SCs. Culture dishes precoated with poly-l-lysine and laminin, culture medium supplemented with heregulin ß-1 and forskolin, and reasonable cell seeding density were implemented to increase the growth and proliferation of cultured SCs. Immunostaining of S100ß and p75 neurotrophin receptor was used to identify the purity of SCs. RESULTS: Our method is able to obtain high-yield SCs with a purity of 90% within five days and a purity more than 99% within seven days from sciatic nerves of neonatal mice. COMPARISON WITH EXISTING METHODS: Previous SCs isolation mostly focused on rats or adult mice and have a few limitations due to fibroblasts contamination, low yield and time-consuming. Our method permits SCs isolation from neonatal mice with a high yield and purity of primary SCs within 7 days. CONCLUSION: We described a fast, efficient and step-by-step method of isolating SCs from sciatic nerves of neonatal mice with high yield and purity.

The Association between the Serum Uric Acid Level and Hypertension in Middle-Aged and Elderly Adults.

BACKGROUND: Studies on serum uric acid (sUA) levels and hypertension (HTN) are controversial. To investigate the association between the sUA level and the incident of HTN in middle-aged and elderly adults, we performed this study. METHODS: 6399 participants aged ≥40 years from the National Health and Nutrition Examination Survey (NHANES) were included. Weighted multiple logistic regression analysis was carried out to evaluate the relationship between the sUA level and the incident of HTN, exploring the potential nonlinear relationship using the fitted smoothing curves. If nonlinearity was observed, the inflection point was further calculated by a recursive algorithm. RESULTS: A positive relationship between the sUA level and the incident of HTN was found. However, it may differ in different race groups, nor between male and female. Moreover, the association between the sUA level and the incident of HTN followed a U-shaped curve in male (turning point: sUA 4.1 mg/dL) and Whites (turning point: sUA 7.9 mg/dL). CONCLUSIONS: The results revealed that the sUA level is positively correlated with the incident of HTN, in middle-aged and elderly adults. However, it followed a U-shaped curve in males and Whites.

Patient Preferences and Values in Decision Making for Migraines: A Systematic Literature Review.

Objective: To comprehensively summarize the evidence on the preferences and values of migraine patients. Methods: We searched PubMed, Embase, Web of Science, China National Knowledge Infrastructure, Sino-Med, Chongqing VIP, and Wanfang Data for studies on the preferences and values of migraine patients. A qualitative review was performed, but no quantitative synthesis. Results: Twenty-one studies were finally included, involving a total of 8701 participants. Patients expected a cure, to be symptom-free, a reduction in frequency of headaches, a reduction in severity of headaches, and an improved quality of life from their preventive treatment. Patients expected rapid pain relief, complete pain relief, return to normal activities, no recurrence, and no adverse events from their acute symptomatic treatment. Conclusion: Efficacy is the primary consideration in the treatment of migraine. Specifically, the most important embodiment of patient preferences and values is the reduced frequency of attacks with preventive treatment as well as prompt analgesia with acute symptomatic treatment.

Controlling the coordination environment of Co atoms derived from Co/ZIF-8 for boosting photocatalytic H2 evolution of CdS.

Regulating the coordination environment of metal-Nx species by replacing N with low electronegativity atoms is an approach of tuning the electrocatalytic performance of metal-based sites. However, such effects on the enhancement of photocatalytic H2 evolution over semiconductors are not discussed yet. Herein, we designed and prepared Co-based cocatalysts with controlled coordination environment via calcination Co/ZIF-8 loaded with triphenylphosphine followed by a sulfurization treatment. It was then used as cocatalyst to modify CdS. The effects of the coordination environment of Co atoms on the H2 evolution activity of CdS were discussed. The obtained Co was co-stabilized by N, P, and S atoms and embedded in graphitic carbon (denoted as Co-NxPS/C). Experimental results indicated that the Co-NxPS/C exhibited high activity in enhancing H2 evolution of CdS with a value of 1260 µmol after 5 h irradiation. The simultaneous replacement of N with P and S atoms in N-stabilized Co embedded in carbon could enhance light harvesting, accelerate the transfer of photogenerated electrons from CdS to carbon with increased electrons accumulation ability and conductivity, improve charge separation efficiency, and enhance proton reduction kinetics. It is believed that the results of this study could promote the development of other high performance MOF-derived atomically dispersed cocatalysts to increase photocatalytic H2 evolution.

In situ construction bismuth oxycarbonate/bismuth oxybromide Z-scheme heterojunction for efficient photocatalytic removal of tetracycline and ciprofloxacin.

Finely engineering the morphology and regulating the hybrid interface of each component in a heterojunction are important for facilitating charge carrier separation. In this study, a flower-like bismuth oxycarbonate/bismuth oxybromide (Bi2O2CO3/BiOBr, BOC/BiOBr) Z-scheme heterojunction was prepared via generation of BOC followed by in situ self-growth of BiOBr on just generated BOC. The obtained photocatalyst has an interlaced nanosheet structure with oxygen vacancies, which enhances light adsorption and facilitates the migration and separation of charge carriers. The highest apparent rate constants (k) in the degradation of tetracycline and ciprofloxacin using the BOC/BiOBr-2 photocatalyst under visible-light irradiation were 0.0282 and 0.0220 min-1, respectively; these values were 6.1 and 6.2 times, respectively higher than that achieved using BOC as a photocatalyst. The hybrid mode of BOC and BiOBr, and the Z-scheme electron transfer path and oxygen vacancies present in BOC/BiOBr are the factors responsible for its high photocatalytic activity.