Incidence of extrauterine growth retardation and its risk factors in very preterm infants during hospitalization: a multicenter prospective study / 中国当代儿科杂志

OBJECTIVES@#To investigate the incidence of extrauterine growth retardation (EUGR) and its risk factors in very preterm infants (VPIs) during hospitalization in China.@*METHODS@#A prospective multicenter study was performed on the medical data of 2 514 VPIs who were hospitalized in the department of neonatology in 28 hospitals from 7 areas of China between September 2019 and December 2020. According to the presence or absence of EUGR based on the evaluation of body weight at the corrected gestational age of 36 weeks or at discharge, the VPIs were classified to two groups: EUGR group (n=1 189) and non-EUGR (n=1 325). The clinical features were compared between the two groups, and the incidence of EUGR and risk factors for EUGR were examined.@*RESULTS@#The incidence of EUGR was 47.30% (1 189/2 514) evaluated by weight. The multivariate logistic regression analysis showed that higher weight growth velocity after regaining birth weight and higher cumulative calorie intake during the first week of hospitalization were protective factors against EUGR (P<0.05), while small-for-gestational-age birth, prolonged time to the initiation of total enteral feeding, prolonged cumulative fasting time, lower breast milk intake before starting human milk fortifiers, prolonged time to the initiation of full fortified feeding, and moderate-to-severe bronchopulmonary dysplasia were risk factors for EUGR (P<0.05).@*CONCLUSIONS@#It is crucial to reduce the incidence of EUGR by achieving total enteral feeding as early as possible, strengthening breastfeeding, increasing calorie intake in the first week after birth, improving the velocity of weight gain, and preventing moderate-severe bronchopulmonary dysplasia in VPIs.

Capsular Healing in Interportal and Periportal Capsulotomy Methods of Hip Arthroscopy.

OBJECTIVE: To evaluate the midterm outcomes and the capsular healing in patients who had interportal capsulotomy versus periportal capsulotomy of hip arthroscopy. METHODS: Retrospectively reviewed 33 patients with labral tear received hip arthroscopy, with an average age of 41 (27-67) years, including 13 cases of Cam deformity and three cases of Pincer deformity. All patients had positive sign of flexion adduction internal rotation or flexion abduction external rotation. With MRI and radiographic (CT, X plain) imageological examination. MRI showed that all patients had labral tear. Radiographic finding (CT, X plain) showed the pathological changes of acetabular and femoral neck osteophyte. One group with 23 patients were treated with periportal capsulotomy. Another group with 10 patients were treated with interportal capsulotomy. All patients did not close the capsule. Clinical outcomes were measured with the Hip Outcome Score Activities of Daily Living (HOS-ADL) and the modified Harris Hip Score (mHHS), patient satisfaction measured with visual analogue scale (VAS). The healing of the capsule was evaluated by MRI. MRI showed continuous capsular indicated healing, discontinuous capsular indicated unhealing. Postoperatively 6 months, mHHS and HOS-ADL were obtained. Randomized controlled trials were used in this study for analysis. RESULTS: All patients were followed up with average time of 9.3 months(3-29 months). The postoperative symptoms were obviously relieved, the VAS decreased from (4.9 ± 0.6) to (1.2 ± 0.2) after 3 months postoperative. Follow up 6 months post-operation, patients in the interportal group, the mHHS and HOS-ADL scores improvement were respectively 69.4 ± 9.3 & 70 ± 8.8 pre-operation, and 92.5 ± 5.0 & 86.6 ± 5.4 post-operation (P < 0.05); Patients in the periportal group, the mHHS and HOS-ADL scores improvement were respectively 69.9 ± 15.8, 68.1 ± 15.0 pre-operation, and 90.1 ± 9.3 & 86.7 ± 7.9 post-operation (P < 0.05).The differences were statistically significant. Six months after operation, MRI showed that 23 patients with periportal capsulotomy, the capsule have healed, without other complications. Three of the ten patients with interportal capsulotomy were healed and seven were not. CONCLUSION: Interportal and periportal capsulotomy had good outcomes. The technique of periportal capsulotomy had little damage to the joint capsule. Although the capsule did not close, the capsule healed well in postoperative follow-up. The nonunion rate of the joint capsule was high in the interportal capsulotomy without close the capsule.

[Clinical trials of treatment of woman menopause insomnia due to disharmony between heart and kidney by body and auricular acupuncture].

OBJECTIVE: To observe the therapeutic effect of body acupuncture combined with auricular acupuncture in the treatment of woman menopause insomnia induced by disharmony between the heart and kidney. METHODS: A total of 111 outpatients with menopausal insomnia were randomly divided into treatment group (n＝55, body acupoints plus auricular points) and control group (n＝56, body acupoints). For control group, Shenmen (HT7), Sanyinjiao (SP6), Anmian, Zhaohai (KI6), Shenmai (BL62), Sishencong (EX-HN1), Xinshu (BL15) and Shenshu (BL21) were needled with filiform needles, and HT7, SP6, Anmian, BL15 and BL21 were also stimulated with electroacupuncture (EA) for 30 min, once every other day, 3 times a week for 3 weeks. For the treatment group, auricular points as Kidney, Shenmen, Sympathetic and Endocrine around the ear canal and the ear cavity were punctured with filiform needles in combination with the same intervention methods mentioned above in the control group. The quality and efficiency of sleep were assessed by using Pittsburgh Sleep Quality Index (PSQI) scale before and after the treatment. The symptom scores of traditional Chinese medicine (TCM) and the therapeutic effect were determined according to the "Guide Principles for Clinical Research of New Drugs of TCM" (formulated by Chinese Ministry of Health, 1997). RESULTS: After the treatment, the scores of sleep quantity and effective rate of PSQI scale, and those of insomnia and dreaminess, dysphoria with feverish sensation in chest, palms and soles, paplpitation and irritability, fatigue and forgetfulness of TCM were reduced significantly in both groups compared with their own pre-treatment (P<0.05). Of the 56 and 55 cases in the control and treatment groups, 18 (32.1%) and 30 (54.5%) experienced a marked improvement in their symptoms, 28 (50.0%) and 22 (40.0%) were effective, and 10 (17.9%) and 3 (5.5%) failed, with the effective rate being 82.1% and 94.5%, respectively. The therapeutic effect of stimulation of the body acupoints plus auricular acupoints was significantly superior to that of stimulation of simple body acupoints in lowering scores of PSQI scale, insomnia and dreaminess, dysphoria with feverish sensation in chest, palms and soles, dizziness and tinninus, paplpitation and irritability, and tital fever and night sweating of TCM, as well as the effective rate (P<0.05). CONCLUSION: Both body acupuncture and body acupuncture combined with auricular acupuncture are effective in the treatment of woman menopause insomnia due to disharmony between the heart and kidney, and the two combined treatment was evidently better.

Anatomical Risk Factors of Anterior Cruciate Ligament Injury.

BACKGROUND: Nowadays, the anterior cruciate ligament (ACL) injury has been one of the most common diseases of the knee joint. The relationships between the ACL injury and the anatomical structures are still controversial. This study aimed to identify the anatomical risk factors of ACL injury by magnetic resonance imaging (MRI) of the knee. METHODS: This was a retrospective study of 125 patients undergoing primary ACL reconstruction between July 2013 and May 2017. Another 125 patients without any organic knee joint injury were served as controls. The shape of intercondylar notch, the intercondylar notch width index, the intercondylar notch height index, the α angle, the ß angle, and the medial and lateral tibial plateau slope were measured with MRI and compared. The data were compared by binary logistic regression to find the risk factors. RESULTS: The two groups differed in the proportion of male patients (70.4% vs. 52.0%, χ2 = 8.911, P = 0.003), but gender was excluded as a risk factor for ACL injury with regression analysis (odds ratio = 1.476, 95% confidence interval [CI]: 0.689-3.160, P = 0.317). The injured group was found to have a smaller notch width index (95% CI = 7.960E-23-2.154E-9, P < 0.001), a larger ß angle (95% CI = 1.311-1.785, P < 0.001), and a larger lateral tibial plateau slope (95% CI = 1.201-1.683, P < 0.001). The cutoff values of notch width index, ß angle, and the lateral tibial plateau slope were 0.252, 38.5°, and 7.5°, respectively. CONCLUSIONS: In this study, a narrow intercondylar notch (intercondylar notch width index <0.252), a larger lateral tibial slope (>7.5°), and larger ß angle (>38.5°) might be the factors associated with ACL injury. TRIAL REGISTRATION: ChiCTR-RRC-17014116; http://www.chictr.org.cn/showproj.aspx?proj=24119.

Study on preparation and storage stability of ginsenoside Re liposomes / 中草药

Objective To establish and optimize preparation technology of ginsenoside Re liposomes, therefore to improve storage stability. Methods Ginsenoside Re liposomes were prepared by the method of film dispersion-mechanical vibration, which were collected by separating liposome from disclosed free drug by dialysis method. Measure entrapment efficiency by HPLC. Prepare freeze-dried liposome preparations by freezing-drying technology. Taking entrapment efficiency as the main screening index, optimize liposome formulation and freezing-drying technology by orthogonal test design. Results The entrapment efficiency of ginsenoside Re lipidosomes prepared by the method of film dispersion-mechanical vibration is the highest. The best formulation technology is: Mass ratio of drug and phospholipid is 1∶30, mass ratio of phospholipid and cholesterol is 16∶1, ice-water bath ultrasound is 30 min, and double distilled water is hydration solution; The best freezing-drying technology is: Taking sucrose as the freeze-drying protective agent, mass ratio of disaccharide-water is 1∶10, pre-freezing temperature is −20 ℃, and normal saline of 0.9% is reconstitution solution. Conclusion The preparation technology of liposome is stable and practicable. The ginsenoside Re liposome prepared by taking the sucrose as the freeze-drying protective agent has good indexes, which can extend the storage period.

Effect of glutaryl-CoA dehydrogenase gene silencing and high-concentration lysine on the viability of BRL hepatocytes / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the effect of glutaryl-CoA dehydrogenase (GCDH) gene silencing and accumulation of lysine metabolites on the viability of hepatocytes.</p><p><b>METHODS</b>BRL cells were divided into normal control group, negative control group, and GCDH silencing group. The shRNA lentiviral vector for silencing GCDH gene was constructed, and the BRL hepatocytes in the GCDH silencing group and the negative control group were infected with this lentivirus and negative control virus respectively, and then cultured in a medium containing 5 mmol/L lysine. Immunofluorescence assay was used to measure the infection efficiency of lentivirus. Western blot was used to measure the expression of GCDH protein. MTT assay was used to evaluate cell viability. Hoechest33342 staining was used to measure cell apoptosis. Western blot was used to measure the expression of Caspase-3, an index of cell apoptosis.</p><p><b>RESULTS</b>The lentivirus constructed effectively silenced the GCDH gene in hepatocytes (P<0.01). MTT assay and Hoechest 33342 staining showed no significant differences in cell viability and apoptosis between groups (P>0.05). There was also no significant difference in the expression of Caspase-3 protein between groups (P>0.05).</p><p><b>CONCLUSIONS</b>GCDH gene silencing and accumulation of lysine metabolites may not cause marked hepatocyte injury.</p>

[Influence of electroacupuncture plus jasminoidia intervention on expression of OX-42 and nuclear factor-kappa B in hippocampus and amygdale in cerebral ischemia plus diabetes rats].

OBJECTIVE: To observe the changes of expression of OX-42 and nuclear factor-kappa B (NF-kappaB) transporter factor in the hippocampus and amygdale in diabetes and cerebral ischemia (CI) rats with learning and memory impairment after combined treatment with electroacupuncture (EA) plus Jasminaidia, so as to explore their mechanism underlying cerebral protection. METHODS: Sixty male Wistar rats were randomly divided into control, model, medication, EA, and EA + medication groups (12 rats/group). The diabetes mellitus model was established by intraperitoneal injection of Streptozotocin (60 mg/kg, for 3 days) and the CI model made by repeated occlusion and reperfusion of the bilateral carotid arteries. The rats' lear-ning-memory ability was measured via Morris water maze tasks. Rats of the medication group were fed with Jasminaidia (25 mg/kg), once a day for one week, and those of the EA group administrated with EA stimulation of "Baihui"(GV 20) and "Dazhui"(GV 14), once every other day for 20 days. For rats of the EA+medication group, both EA and Jasminaidia were given the same to those mentioned above. Three weeks later, changes in the number and optical density of OX-42 (microglial cell markers)-positive and NF-kappaB-positive cells in the hippocampus and amygdale were examined by immunohistochemistry. RESULTS: After the treatment, the diabetes + CI induced decrease of percentages of swimming distance and swimming time in the target quadrant were obviously increased in the EA, medication and EA+medication groups (P < 0.05), suggesting an improvement of the rats' memory ability. The number of OX-42 positive microglial cells and NF-kappaB-positive cells and their immu noactivity in the hippocampus and amygdale were significantly higher in the diabetes plus CI model rats than in the control rats (P < 0.01, P < 0.05). After the treatment, the number and expression levels of OX-42 marked microgliacytes and NF-kappaB-positive cells were significantly decreased in the EA, medication and EA + medication groups compared with the model group (P < 0.05). No significant differences were found among the 3 treatment groups in the number of OX-42 and NF-kappaB-positive cells and their expression levels (P > 0.05). CONCLUSION: EA combined with Jasminoidia intervention can improve the learning-memory ability and inhibit the microglial cell activity in diabetes+CI rats probably via down-regulation of NF-kappaB signaling pathway.

[Clinical observation on common peroneal nerve palsy treated with comprehensive therapy].

OBJECTIVE: To compare the difference of the clinical efficacy on common peroneal palsy between the comprehensive therapy of electroacupuncture, moxibustion and moving cupping method and western medication. METHODS: Ninety cases of common peroneal nerve palsy were randomized into a comprehensive therapy group and a western medication group, 45 cases in each one. In the comprehensive therapy group, electroacupuncture was applied to Yanglingquan (GB 34), Zusanli (ST 36), Xuanzhong (GB 39), Jiexi (ST 41), Taichong (LR 3), Zulinqi (GB 41) and the others, combined with warm moxibustion and moving cupping on the lateral side of the affected leg. The comprehensive therapy was used once a day. In the western medication group, vitamin B1 , 10 mg each time, 3 times a day; and mecobalamine, 0. 5 mg each time, three times a day were prescribed for oral administration. In the two groups, 15 days made one session, and the efficacy was observed after 2 sessions treatment. RESULTS: The total effective rate of the improvement of sensory function and motor nerve function was 97. 8% (44/45) in the comprehensive therapy group and was 82. 2% (37/ 45) in the western medication. The efficacy in the comprehensive therapy group was better than that of the western medication (P<0. 01). The electrophysiological examination showed that the amplitude of motor conduction of deep peroneal nerve and that of sensory conduction of surficial peroneal nerve after treatment were improved remarkably as compared with those before treatment in the comprehensive therapy group (both P<0. 05). The amplitude of motor conduction of deep peroneal nerve was improved significantly in the comprehensive therapy group as compared with that in the western medication group (P<0. 05). CONCLUSION: The comprehensive therapy of electroacupuncture, moxibustion and moving cupping method achieves the significant efficacy on common peroneal nerve palsy as compared with western medication.

Lateral patellar translation effects after arthroscopic partial meniscectomy of torn discoid lateral meniscus.

OBJECTIVE: To investigate the effects of arthroscopic partial meniscectomy of torn discoid lateral meniscus on patellar tracking. METHODS: In all, 112 patients (112 knees) who underwent arthroscopic partial meniscectomy participated in the study. All subjects were examined with standing weight-bearing magnetic resonance imaging (MRI) preoperatively and one month postoperation. Axial-plane images through the maximum width of the patella and the maximum dorsal area of the femoral condyles were superimposed and the bisect offset index used to quantify patellar translation. Differences between pre- and postoperation in the bisect offset indexes were calculated and compared by Student's paired t-test. P < 0.05 was considered statistically significant. RESULTS: Before surgery, the mean bisect offset index was 0.574 (0.437-0.692). One month postoperation, the mean bisect offset index was 0.622 (0.510-0.801). The postoperation bisect offset index increased by an average of 0.048 (-0.018 to 0.129) compared with the preoperation value; this difference is statistically significant result (t = 18.33, P < 0.01). CONCLUSION: After arthroscopic partial meniscectomy, the patella translates more lateral to the femoral trochlear groove. These results suggest that arthroscopic partial meniscectomy may result in patellar maltracking.

Observation of Pain-Sensitive Points along the Meridians in Patients with Gastric Ulcer or Gastritis.

This study aims to investigate the sensitization of human skin points along certain meridians related to visceral disease by using the pressure-pain threshold (PPT) as an indicator. We detected and compared the PPTs of people with and without gastric ulcer or gastritis on the related acupoints, abdomen area, and back area with von Frey detector and observed the similarities and differences under their respective physiological and pathological states. The results showed that (1) the PPTs of patients with gastric ulcer on related acupoints decreased significantly compared with the control group; (2) there was no significant difference in PPT between the chosen points of the measured meridian and the adjacent nonacupoints; (3) there was an apparent distribution of tender points on the relevant abdomen and back regions of patients with gastric ulcer or gastritis, but none was found on the control group; (4) the pain-sensitive points of gastric ulcer and gastritis patients were BURONG (ST19), LIANGMEN (ST21), and HUAROUMEN (ST24) of the stomach meridian on the abdominal region and PISHU (BL20), WEISHU (BL21), and WEICANG (BL50) on the back, among others The results suggest that the practical significance of acupoints may lie in its role as a relatively sensitive functional area. In a pathological state, the reflex points on the skin which are related to certain visceral organs become sensitive and functionally intensify.

[Clinical observation of the impacts and safety of electroacupuncture at Sanyinjiao (SP 6) on labor].

OBJECTIVE: To observe the impacts of electroacupuncture (EA) at Sanyinjiao (SP 6) on labor and assess its safety. METHODS: The random and single-blind method was adopted to divide 111 cases of the puerperas of natural delivery into an EA group (38 cases), a sham-acupuncture group (37 cases) and a blank control group (36 cases). In EA group, Sanyinjiao (SP 6) was selected and stimulated with Han's acupoint nerve stimulator (HANS). In the sham-acupuncture group, the puerperas were stimulated only with the needle tube, needle removed in advance and they felt subjectively to be needled. Afterward, the filiform needle was attached to Sanyinjiao (SP 6) with the needle tip wrapped with the adhesive plaster in advance, then HANS which one conducting wire was cut off in was connected. In the blank control group, no any treatment was applied, but the same indices were recorded at corresponding time points. The blood pressure and the heart rate of the puerperas as well as the heart rate of fetus were measured in 20 min of EA and 30 min after needle removal in three groups separately. The bleeding 24 h after labor and 1 min Apger score of the newborns were observed. RESULTS: In EA group, the active phase of the 1st labor stage ((4.38 +/- 1.76)h) was shorter than that ((5.28 +/- 2.41)h) in the blank control group and that ((5.38 +/- 2.36)h) in the sham-acupuncture group, presenting statistically significant differences (all P < 0.05). In the latent phase of the 1st labor stage and the 2nd and 3rd stages, in the comparison of the blood pressure and the heart rate of the puerperas as well as the heart rate of fetus after EA, the bleeding 24 h after labor and 1 min Apger score of the newborns among three groups, there were no statistically significant differences (all P > 0.05). CONCLUSION: EA at Sanyinjiao (SP 6) can shorten the duration of the active phase of the 1st labor stage. It is safe for either the puerpera or the fetus and can assist the parturition quality in clinic.

[Effects of acupuncture on the expression of Cx43 in different acupoints of rats].

OBJECTIVE: To observe the differences of the expression of Cx43 in rats' acupoints and sham-acupoint when needled blocks, and explore the relatively specificity of acupoints. METHOD: Twenty Wistar rats were randomly divided into two groups: an acupuncture group and a control group, ten in each group. The rats in the control group were not treated and sacrificed directly to by air embolism; the rats in the acupuncture group were needled at "Neiguan (PC 6)", "Zusanli (ST 36)", "Dazhui (GV 14)" and "Guanyuan (CV 4)", Sham-acupoints were on 1 cm next to each of the above acupoints and "Yongquan (KI 1)" were needled by hand manipulation, retented needles for 30 min, then all the rats were sacrificed by air embolism. With the rats fixed, the tissue blocks at the acupoints and sham-acupoints were collected, then quick-frozen and cut into sections. The sections were stained by immunohistochemical method (Cx43). RESULTS: The expression of the rats' Cx43 at the acupoints was significantly higher than that at the non-points in both groups (all P < 0.01). The expression of Cx43 at the acupoints in the acupuncture group was significantly higher than that in the control group (all P < 0.01). CONCLUSION: The expression of Cx43 at acupoints and non-points is significantly different, which indicates that the acupoints are actually existed and have relatively specificity.

[Effect of acupuncture of "Zusanli"(ST 36)on sexual hormone levels in spleen-deficiency syndrome rats].

OBJECTIVE: To study the underlying mechanism of acupuncture of "Zusanli" (ST 36) in clinical treatment of spleen deficiency syndrome (SDS). METHODS: Twenty-six adult male Wistar rats were randomized into normal control group (n=6), model group (n=8), saline + model (saline) group (n=6) and acupuncture + model (acupuncture) group (n=6). The spleen deficiency syndrome model was duplicated by intragastric perfusion of 50% alcohol (1 mL/100 g, once) and vinegar (pH 3, 1 mL/100 g, once daily for 10 d). Bilateral "Zusanli" (ST 36) was punctured with filiform needles which were manipulated for 1 min after insertion and retained for 20 min. The treatment was conducted once daily for 10 days. The contents of serum testosterone(T) and estradiol(E2)were detected by radioimmunoassay. The rats' physical strength was detected by exhausted swimming test in cool water. RESULTS: In comparison with the normal group, the duration of exhausted swimming, serum T and E2 contents and T/E, were decreased significantly in the model group (P < 0.05). Compared with the model group, the duration of exhausted swimming, serum T and E2 contents and T/E2 in the acupuncture group were upregulated significantly (P < 0.05). No significant differences were found between the saline and control groups (P > 0.05). CONCLUSION: Acupuncture of "Zusanli" (ST 36) is able to reverse SDS-induced decrease of sexual hormones in spleen deficiency syndrome rats, which may contribute to its effect in improving physical strength.

[Analysis and strategy report on overseas large-scale systematic evaluation on clinical effectiveness of acupuncture].

In recent years, studies of large-scale systematic evaluation on clinical effectiveness of acupuncture were carried out in overseas. The literatures were conducted in Cochrane Library and overseas journals about systematic review of clinical effectiveness of acupuncture. The Cochrane Library contained a series of systematic reviews for the treatment of 67 kinds of diseases by acupuncture in 2009. Preliminary evaluations of clinical effectiveness of acupuncture on 37 kinds of disease were conducted. The results indicated that acupuncture therapy was effective for 7 kinds of disease, such as idiopathic headache, neck disorders, glaucoma, rheumatoid arthritis, chemotherapy-induced nausea or vomiting, primary dysmenorrhoea with TENS and knee osteoarthritis with TENS. However, these studies still need improved research designs and sufficient research evidence. The results also indicated that acupuncture was indecisive for the other 30 kinds of disease because of insufficient evidence. Through analysis, results of most systematic reviews indicated that there were no significant difference between therapeutic effects of acupuncture treatment and pseudo-acupuncture treatment. Effect of acupuncture treatment was equivalent to therapeutic effect of placebo. The likely reasons may be that some important clinical factors are disregarded in these researches, such as selection of acupoints, treatment with syndrome differentiation, the angel and depth of needle insertion, the proper time for treatment and so on. Therefore, the large-scale systematic evaluation on clinical effectiveness of acupuncture was criticized by acupuncturists. Thus, the pressing problem is to establish a rational evaluation system of clinical acupuncture. The suggestions are strengthening the research on diagnosis and treatment standard, strengthening the quality control of clinical acupuncture and establishing sound acupuncture control group and placebo acupuncture group. The basic researches on the relationship between diseases and acupoints need to be strengthened in order to explore the mechanism of acupoints reaction on diseases.

[Morphological study on commonly-used acupoints for thyroid surgery under acupuncture anesthesia].

OBJECTIVE: To study the morphologic structure, afferent projections of "Neiguan" (PC6), "Hegu" (LI 4) and "Futu" (LI 18) acupoint regions so as to understand their underlying mechanisms in acupuncture anesthesia for thyroid surgery. METHODS: A total of 66 Wistar rats were used in the present study. (1) Horseradish peroxidase (HRP, 10%, 10 microL) was injected into PC 6, LI 4 and LI 18 acupoints and the thyroid area on the right side, respectively (n = 6). (2) Propidium iodide (PI, 10% 10 microL) or Bisbenzimide (Bb, 5%, 10 microL) was injected into above-mentioned 3 acupoints and the thyroid region on the right side, respectively (n = 6). The numbers and percentages of the labeled neurons in the dorsal root ganglia (DRGs, C 1 - C 8 and T 1) were observed under microscope. (3) Cutaneous connexin (Cx) 43 immunoactivity of LI 18, PC 6, LI 4 and "Zusanli" (ST 36) regions and their individual non-acupoint regions (about 0.5 cm lateral to LI 18, PC 6, LI 4, and ST 36, n = 12) was determined by immunohistochemistry. RESULTS: 1) HRP-labeled neurons after injection of HRP into LI 18 were found in DRGs of C 1 - C 5, predominantly C 2 - C 4, those from LI 4 found in DRGs of C 3 - C 8. mainly C 5 - C 7, those from PC 6 found in DRGs of C 3 -T 1, chiefly C 5 - C 8, and those from the thyroid region found in C 1 - C 6, predominantly C 2 - C 5, suggesting an overlap or convergence of afferent projections from the 3 acupoints and the thyroid regions being in C 3 - C 5. 2) After injection of PI into LI 18, LI 4 and PC 6. and Bb into the thyroid region, the percentages of PI- and Bb-labelted neurons in DRGs of C 1 - C 8 and T 1 were from 46.4% to 50.0% and the percentages of the double labeled neurons were 3.8% in the LI 18-thyroid group, 3.1% in the LI 4-thyroid group and 3.6% in the PC 6-thyroid group, respectively, suggesting a bifurcate innervation of DRG neurons between theseacupoints and the thyroid region. 3) In comparison with the individual non-acupuncture and non-acupoint subgroups, the immunoactivity of cutaneous Cx 43 in the LI 18, LI 4, PC 6, and ST 36 subgroups was upregulated considerably after acupuncture stimulation (P < 0.05). CONCLUSION: Neurons of DRGs of C 1-C 8 and T 1 innervating "Futu" (Ll 18), "Hegu" (LI 4) and "Neiguan" (PC 6) and the thyroid gland have an overlap or convergence in DRGs of C 3 - C 5 and a bifurcate innervation. Acupuncture stimulation may upregulate cutaneous Cx 43 expression in the acupoint regions.

Effects of PI3K inhibitor LY294002 on the differentiation of mouse preadipocytes and the expression of C/EBPα and PPARγ / 中国当代儿科杂志

<p><b>OBJECTIVE</b>This study examined the effects of PI3K inhibitor LY294002 on the differentiation of mouse preadipocytes and the expression of CCAAT enhancer binding protein α (C/EBPα) and peroxisome proliferation activated receptor γ (PPARγ), in order to study the possible roles of insulin receptor substrate (IRSs)/PI3K signal pathway in the differentiation of preadipocytes.</p><p><b>METHODS</b>The mouse 3T3-L1 cells were cultured normally and divided into experimental and control groups. 3T3-L1 cells in the experimental group were treated with PI3K inhibitor LY294002 (25 μmol/L) and those in the control group were treated with DMSO culture medium. 3-isobutyl-1-methylxanthine (IBMX) (0.5 mmol/L), dexamethasone (10-6 mol/L) and insulin (5 μg/mL) were used to induce the differentiation of 3T3-L1 preadipocytes in both groups. Before culture, and 2, 4 and 8 days after culture, the cells were collected to detect the expression of C/EBPα and PPARγ by real-time PCR and Western blot assays. The lipid droplets of 3T3-L1 preadipocytes were observed by oil-red O staining.</p><p><b>RESULTS</b>PI3K inhibitor LY294002 did not affect the expression of C/EBPα and PPARγ in un-induced 3T3-L1 preadipocytes (P>0.05), but decreased the expression of C/EBPα and PPARγ during the in vitro induced differentiation of 3T3-L1 preadipocytes compared with the control group (P<0.05 or 0.01). The lipid droplets count was greatly reduced by LY294002.</p><p><b>CONCLUSIONS</b>PI3K inhibitor LY294002 can inhibit the differentiation of mouse 3T3-LI preadipocytes and the expression of C/EBPα and PPARγ in the differentiation of 3T3-LI preadipoeytes, suggesting that IRSs/PI3K signal pathway may play an important role in the differentiation of 3T3-L1 preadipocytes by regulating the expression of C/EBPα and PPARγ.</p>

[Clinical observation on acupuncture for treatment of reflux esophagitis of heat stagnation of liver and stomach type].

OBJECTIVE: To observe the clinical therapeutic effect of acupuncture for treatment of reflux esophagitis of heat stagnation of liver and stomach type. METHODS: Sixty-one cases were randomly divided into an acupuncture group (31 cases) and a medication group (30 cases). The acupuncture group was treated with needles at Zusanli (ST 36), Zhongwan (CV 12), Weishu (BL 21) and Neiguan (PC 6) mainly, once a day; and the medication group was treated with oral administration of 20 mg Omeprazole, once a day. The scores of clincial symptoms, comprehensive therapeutic effect, results of gastroscopy and pathology as well as recurrence rate etc. were observed before and after treatment. RESULTS: After treatment, the scores of symptoms significantly decreased in the two groups (both P < 0.01). The total effective rate of the acupuncture group was 90.3% (28/31), and 90.0% (27/30 )in the medication group, there was no statistical difference between two groups (P > 0.05); results of gastroscopy and esophageal mucosa pathology showed no statistical difference between two groups (both P > 0.05), the recurrence rate 12 weeks after treatment of 9.1% in the acupuncture group was lower than that of 42.9% in the medication grou p (P < 0.05). CONCLUSION: Acupuncture has preferable short and long-term therapeutic effects for treatment of reflux esophagitis of heat stagnation of liver and stomach type.

[Segmental and regional innervation of acupoint "Taixi" (KI 3) area in the rat: a horseradish peroxidase method study].

OBJECTIVE: To study the peripheral and central neural involvements of acupoint "Taixi" (KI 3) by using Horseradish Peroxidase (HRP). METHODS: Ten male SD rats were used in the present study. 5 pL of 1% HRP was injected into the excavate site between the apex of medial malleolus and the Achilles tendon of the left hind foot, a corresponding site of acupoint "Taixi" (KI 3) in the human body. After 36 surviving hours, the rat's brain, spinal cord and dorsal root ganglia (DRG) of the lumbar segments (L) were dissected from the perfused experimental animals, and their tissue sections were examined with 3, 3', 5, 5' -tetramethyl-benzidine histochemistry for revealing HRP-labeling. RESULTS: All the HRP-labeling appeared ipsilaterally to the injection side. Numerous HRP-labeled neurons were detected in the DRGs of L4 - L6 segments with their number being L5> L4 >L6. A longitudinal column of HRP-labeled motoneurons was found in the dorsolateral and mediolateral portions of the spinal cord, distributing in the lamina IX from the caudal L4 to the rostral L6. Additionally, the transganglionic HRP-labeled central prolection axonal terminals were found to be dense in the central part of laminae I-II from L4 to the rostral L6, and to scatter in the central part of gracile nucleus. CONCLUSION: HRP-labeled primary afferent and efferent innervating acupoint "Taixi" (KI 3) are DRGs of L4-L6, the dorsolateral and mediolateral motoneuron columns of L4-L6, and the centrally projecting axonal terminals of laminae I-II of the spinal cord and the gracile nucleus.

[Mast cell and substance P are involved in the process of acupoint sensitization induced by acute gastric mucosal injury].

OBJECTIVE: To observe changes of mast cells (MCs) number and morphology, and substance P (SP) expression in Evans blue (EB) extravasated region around acupoint "Pishu" (BL 20) and "Weishu" (BL 21) after acute gastric mucosal injury (AGMI) so as to investigate the mechanism underlying visceral problems-induced acupoint activation. METHODS: Thirty adult Wistar rats were randomly divided into normal control (n = 15) and AGMI groups (n = 15). AGMI model was duplicated by perfusing the rats with 0.5 mol/L HCl (1 mL/100 g) after fasting for 20 h. Five hours after AGMI, the rats were treated by tail-intravenous injection of EB dye (5 mg/100 g, 50 mg/mL in normal saline) for inducing dye-plasma extravasation in the skin around BL 20, BL 21 regions, etc. at the back. The rats of the normal control group were treated with tail-intravenous injection of 0.9% NaCl. The skin and subcutaneous tissues (2 mmx 2 mm) of extravasated EB dye points (BL 20 or BL 21 region) and those 2 mm lateral to the extravasated EB dye points in the model group and the corresponding points in the normal control group were sampled (followed by fixing them in 4% paraformaldehyde), sectioned and stained by toluidine blue (for labeling MCs). The expression of SP in the extravasated EB dye skin and subcutaneous tissues was detected by immunohistochemistry (n = 5) and western blot (n = 5) respectively. The number of MCs in these samples was counted and the degranulation rate of MCs calculated. RESULTS: The total number of MCs and the number of degranulated MCs were significantly more in the EB extravasation points (corresponding to BL 20/BL 21 area) of AGMI group than those in the control spots of AGMI group and than those in the normal control group (P < 0.05, P < 0.001). The degranulation rate of MCs was significantly higher in the EB extravasation points of AGMI group than those in the control spots of AGMI group and in the normal control group (P < 0.01). In comparison with normal control group, the SP expression level was increased consideraly in the control spots of AGMI group and AGMI group (P < 0.01). CONCLUSION: After AGMI, the numbers of MCs and the degranulated MCs, and the SP expression level in BL 20/BL 21 area were increased significantly, suggesting an involvement of MCs and SP in the process of AGMI-induced activation of acupoints.

[Afferent nerve connection among "Hegu" (LI4), "Neiguan" (PC6), "Futu" (LI18) and thyroid gland region: fluorescent double labelling method].

OBJECTIVE: To observe the peripheral and central neural connection of acupoint "Hegu" (LI4), "Neiguan" (PC6), "Futu" (LI18) and the thyroid gland (TG) region with fluorescence double-labelling method. METHODS: Thirty male Wistar rats were divided into LI4-LI18 group, PC6-LI18 group, TG-LI 18 group, LI 4-TG group, and PC 6-TG group, with 6 rats in each. Fluorescence dyes Propidium Iodide (PI, 10 microL) and Bisbenzimide (Bb, 10 microL) were, separately, injected into those acupoints mentioned above and the TG region. Sixty hours after PI-injection and 12 hours after Bb-injection, the rats under deep anesthesia were transcardiacally perfused with PBS containing 4% polyoxymethylene, followed by taking the spinal cord and dorsal root ganglia (DRGs) of the cervical segments (C1-C8) and thoracic 1 (T1) segment. Fluorescent single- and dual-labeled cells of the sliced DRGs and cervical spinal cord were observed by fluorescence microscope. RESULTS: (1) All PI- and Bb-labeled cells were found to distribute in DRGs from C1-T1 segments. PI single-labeled cells from LI4 and PC6 mainly distributed in DRGs from C4 to C8. Bb single-labeled cells from LI18 and TG region distributed in DRGs from C1-C6. (2) Dual-labeled cells in the LI 4-LI 188 group, PC6-LI18 group, LI4-TG group, and PC6-TG group distributed in DRGs from C3 to C7, suggesting bifurcate peripheral processes of the cervical DRG neurons to innervate LI8, LI4, PC6 and the TG region. And the dual-labeled cells of the TG-LI 18 group distributed mainly in DRGs from C1 to C4. (3) A small number of single-labeled neurons(about 8% of total labeled cells in DRGs) and only several dual-labeled neurons were found in the anterior horn of the cervical spinal cord. CONCLUSION: LI18, LI4 and PC6 and the thyroid gland have the same peripheral cells in DRGs of C3-C7 segments, suggesting that the bifurcate peripheral innervation may provide an anatomic evidence for the analgesic effect of acupuncture of LI18, LI4 and PC6 on thyroidectomy.