Prognostic implication of residual inflammatory trajectories in acute type I aortic dissection: dual-center prospective cohort study.

BACKGROUND: Peripheral platelet-white blood cell ratio (PWR) integrating systemic inflammatory and coagulopathic pathways is a key residual inflammatory measurement in the management of acute DeBakey type I aortic dissection (AAD); however, trajectories of PWR in AAD is poorly defined. METHODS: Two AAD cohorts were included in two cardiovascular centers (2020-2022) if patients underwent emergency total arch replacement with frozen elephant trunk implantation. PWR data were collected over time at baseline and five consecutive days after surgery. Trajectory patterns of PWR were determined using the latent class mixed modelling (LCMM). Cox regression was used to determine independent risk factors. By adding PWR Trajectory, a user-friendly nomogram was developed for predicting mortality after surgery. RESULTS: 246 patients with AAD were included with a median follow-up of 26 (IRQ 20-37) months. Three trajectories of PWR were identified (cluster α 45[18.3%], ß105 [42.7%], and γ 96 [39.0%]). Cluster γ was associated with higher risk of mortality at follow-up (crude HR, 3.763; 95% CI, 1.126, 12.574; P=0.031) than cluster α. By the addition of PWR trajectories, an inflammatory nomogram, composed of age, hemoglobin, estimated glomerular filtration rate, and cardiopulmonary time was developed and internally validated, with adequate discrimination (the area under the receiver-operating characteristic curve 0.765, 95% CI [0.660-0.869]), calibration, and clinical utility. CONCLUSION: Based on PWR trajectories, three distinct clusters were identified with short-term outcomes, and longitudinal residual inflammatory shed some light to individualize treatment strategies for AAD.

Parallel evolution of morphological and genomic selfing syndromes accompany the breakdown of heterostyly.

Evolutionary transitions from outcrossing to selfing in flowering plants have convergent morphological and genomic signatures and can involve parallel evolution within related lineages. Adaptive evolution of morphological traits is often assumed to evolve faster than nonadaptive features of the genomic selfing syndrome. We investigated phenotypic and genomic changes associated with transitions from distyly to homostyly in the Primula oreodoxa complex. We determined whether the transition to selfing occurred more than once and investigated stages in the evolution of morphological and genomic selfing syndromes using 22 floral traits and both nuclear and plastid genomic data from 25 populations. Two independent transitions were detected representing an earlier and a more recently derived selfing lineage. The older lineage exhibited classic features of the morphological and genomic selfing syndrome. Although features of both selfing syndromes were less developed in the younger selfing lineage, they exhibited parallel development with the older selfing lineage. This finding contrasts with the prediction that some genomic changes should lag behind adaptive changes to morphological traits. Our findings highlight the value of comparative studies on the timing and extent of transitions from outcrossing to selfing between related lineages for investigating the tempo of morphological and molecular evolution.

Seroprevalence of Toxoplasma gondii infection among patients of a tertiary hospital in Guangzhou, Guangdong province, PR China.

PURPOSE: This study aimed to explore the prevalence of Toxoplasma gondii (T. gondii) among patients in Guangzhou city, South China, and to identify susceptible patient populations and analyze the causes of infection differences. METHODS: From May 2020 to May 2022, a total of 637 sera were collected from patients, and 205 sera were collected from health participants as health control. All sera were examined by colloidal gold kits to detect the positivity of antibodies against T. gondii. And the positivity of antibodies in sera was confirmed with ARCHITECT i2000SR system. RESULTS: The prevalence of T. gondii infection in patients was 7.06% (45/637), which was lower than the prevalence in health participants 4.88% (10/205). Among patients, 34 (5.34%) were positive only for IgG, 10 (1.57%) were only for IgM, and 1 (0.16%) was positive for both IgG and IgM. There was a significant difference in prevalence between male and female patients, but not among different age groups or diseases groups. The prevalence of T. gondii infection in diseases groups varied. The prevalence was relatively high in patients with the disorders of thyroid gland and the malignant neoplasms of digestive organs, which suggests that caution should be taken to avoid T. gondii infection in these patients. Surprisingly, the prevalence was quite low in diffuse Large B-cell Lymphoma (DLBC) patients. This may be due to the overexpression of TNF-α in tumor tissues of DLBC patients and the higher protein level of TNF-α in sera of DLBC patients. CONCLUSION: This study provides a systematic exploration of the prevalence of T. gondii infection in patients in a tertiary hospital. Our data contributes to a better understanding of the epidemic investigation of T. gondii among patients in South China, which can help the prevention and treatment of the disease caused by T. gondii infection.

Functional significance of novel variants of the MEF2C gene promoter in congenital ventricular septal defects.

Ventricular septal defect (VSD) is the most common congenital heart disease. Although the coding region of MEF2C is highly relevant to cardiac malformations, the role of MEF2C gene promoter variants in VSD patients has not been genetically investigated. We investigated the role of MEF2C gene promoter variants in 400 Han Chinese subjects (200 patients with isolated and sporadic VSD and 200 healthy controls). The promoter region of the MEF2C gene was sequenced that identified 10 variants. Expression vectors encompassing the variants and the firefly luciferase reporter gene plasmid (pGL3-basic) were constructed and subsequently transfected into HEK-293 cells. The luciferase activities were measured by Dual-luciferase reporter assay system. MEF2C gene promoter transcriptional activity was significantly reduced in 4 of the 10 variants in HEK-293 cells (P < 0.05). In addition, the JASPAR database was used to perform bioinformatics analysis, which showed that these variants disrupt the putative binding sites of transcription factors and affected the expression of MEF2C protein. This study for the first time identified the variants in the promoter of the MEF2C gene in Han Chinese population and revealed the role of these variants in the formation of VSD.

Effect of CPB glucose levels on inflammatory response after pediatric cardiac surgery.

BACKGROUND: Systemic inflammatory response syndrome (SIRS) is a common complication after cardiac surgery. There are no definite optimal glycemic threshold for pediatric patients receiving open-heart surgery with CPB. The study aimed to investigate the optimal cardiopulmonary bypass (CPB) glucose in patients undergoing cardiac surgery. METHODS: We enrolled children with congenital heart disease who underwent surgical repair between June 2012 and December 2020. We included only patients who underwent cardiac surgery with CPB. The primary outcome was severe SIRS. A two-piece-wise regression model was applied to examine threshold effect of CPB glucose on severe SIRS. RESULTS: A total of 7350 patients were enrolled in the present study, of whom 3895 (52.99%) are female. After potential confounders were adjusted, non-linear relationship was detected between CPB glucose and severe SIRS, whose turning point was 8.1. With CPB glucose < 8.1 mmol/L, the estimated dose-response curve was consistent with a horizontal line. However, the prevalence of severe SIRS increased with increasing glucose up to the turning point (Glucose > 8.1 mmol/L); the odds ratio (OR) of the Glucose was 1.35 (95% CI 1.21, 1.50). CONCLUSIONS: The present study indicates the association of CPB glucose with inflammatory response after pediatric cardiac surgery. The patients might have the best outcomes with the optimal CPB glucose no more than 8.1 mmol/L.

Effect of perfusate oxygenation on inflammatory response in congenital heart disease children from low versus high altitude.

OBJECTIVE: To examine the altitude differences in the optimal perfusate oxygenation (PpO2) in patients who underwent cardiac surgery. METHODS: We included children (aged 1 month to 18 years) with congenital heart diseases surgically repaired between 2012 and 2018. We included only patients who underwent cardiac surgery with arrested heart cardiopulmonary bypass. Primary outcome was severe systemic inflammatory response syndrome (SIRS). Logistic regression was used to evaluate the association between arterial PpO2 on continuous and categorical scales and severe SIRS by altitude. We established PpO2 thresholds that equated to a risk probability of roughly 0.185 or greater for developing severe SIRS in each group of altitude. RESULTS: Among 3918 patients from low altitudes and 2384 from high altitudes, high-altitude patients were older (median, 42.3 [interquartile range 22.8-75.8] vs 37.1 [17.7-69.1] months, P < .001) and had lower arterial PpO2 (289 [237-342] vs 301 [246-362] mm Hg, P < .001). Greater PpO2 was associated with increased risk of severe SIRS overall (adjusted odds ratio, 1.221 [95% confidence interval, 1.167-1.278] per standard deviation increase), with a stronger monotonic associations for low-altitude patients than for high-altitude patients (adjusted odds ratio, 1.302 [95% confidence interval, 1.229-1.379] vs adjusted odds ratio, 1.083 [95% confidence interval, 1.003-1.170] per standard deviation increase) (Pinteraction = .0003). A PpO2 level of 310 mm Hg identified low-altitude patients with a risk probability of roughly 0.185 or greater of severe SIRS, whereas the cutoffs ranged from 200 mm Hg to 325 mm Hg for high-altitude patients. CONCLUSIONS: This study suggests altitude differences in the association of arterial PpO2 with inflammatory response following pediatric cardiac surgery.

Loop isolation-based uploading preconditioning to protect heart from damage: a proof-of-concept study.

BACKGROUND: Little is known on the role of indirect clamp releasing in coronary artery bypass grafting (CABG). Loop isolation-based uploading preconditioning (LiuPhD) was modified to protect the heart from damage and the question of whether this can attenuate reperfusion injury after global myocardial ischemia was examined. METHODS: A post-hoc comparative analysis was conducted of a prospective single-arm trial on the use of the LiuPhD strategy for 60 multivessel-disease patients undergoing isolated first-time elective on-pump CABG versus 1:1 propensity score-matched patients from the historical database of the same center. RESULTS: A total of 120 matched patients had a median age of 62.0 (interquartile range [IQR] 55.8-69.0) years, 27 (22.5%) women, 35 (29.2%) with left main disease, and median follow-up of 18.5 (10.9-35.4) months. The LiuPhD group had shorter post-bypass times than conventional controls (10 [6-13] vs 14 [10-19] mins; p = 0.003). The LiuPhD group had similar needs in terms of composite cardiac-specific interventions (38/60 vs 44/60; p = 0.29). At follow-up of safety, the risk for composite major adverse cardiac and cerebrovascular events was similar between groups (event-free survival: 82.3% vs 73.8%; hazard ratio 1.00 [0.39, 2.54], p log-rank test = 0.99). CONCLUSION: The LiuPhD strategy is associated with short post-bypass times, comparable risk of myocardial injury, and similar safety compared with conventional direct clamp releasing.

Association Between Perfusate Oxygenation and Acute Lung Injury in Tetralogy of Fallot Surgery.

PURPOSE: Little is known regarding precise estimates of the association between perfusate oxygenation (PpO2) and acute lung injury (ALI) following tetralogy of Fallot repair. The objective is to investigate PpO2 and the risk of ALI following tetralogy of Fallot repair in pediatric patients. METHODS: We conducted a nested case-control study within a prospective Chinese TedaICH cohort including 134 ALI patients aged 1 month to 18 years undergoing complete repair of tetralogy of Fallot, and each was matched to two controls. We selected the highest PpO2 during aortic crossclamp as the exposure. Conditional logistic regression was used to quantify the association between PpO2 and overall ALI risk by covariates of interest. We identified and integrated the risk covariates to build ALI nomograms and internally validated the nomograms using bootstrapping. RESULTS: After adjusting for covariates, continuously and categorically higher PpO2 values were associated with ALI risk (all P < 0.05), especially for those with a z-score of pulmonary annulus < -4.0 (P = 0.002), McGoon ratio < 1.5 (P = 0.029), and major aortopulmonary collateral arteries (P = 0.005), despite no statistical heterogeneity (all P interaction >0.05). Younger age, lower oxyhemoglobin saturation, untreated minor aortopulmonary collateral arteries, transannular patch, larger transpulmonary gradient, major transfusion, and longer cardiopulmonary bypass time were independent risk factors for ALI (all P < 0.05). Combining the PpO2 nomogram provided further risk discriminative information on ALI diagnosis compared with the covariate-based nomogram alone in the training cohort (AUC 0.865, 95% CI [0.828-0.903] vs. 0.869 [0.832-0.906], respectively) with no statistical significance (P = 0.445). CONCLUSIONS: The findings suggested an association between high PpO2 and ALI risk, and more importance should be attached to independent risk factors for ALI.

Derivation and Validation of a Nomogram to Predict In-Hospital Complications in Children with Tetralogy of Fallot Repaired at an Older Age.

Background We aimed to develop and validate a prediction model for in-hospital complications in children with tetralogy of Fallot repaired at an older age. Methods and Results A total of 513 pediatric patients from the Tianjin data set formed a derivation cohort, and 158 pediatric patients from the Hefei and Xiamen data sets formed validation cohorts. We applied least absolute shrinkage and selection operator analysis for variable selection and logistic regression coefficients for risk scoring. We classified patients into different risk categorizations by threshold analysis and investigated the association with in-hospital complications using logistic regression. In-hospital complications were defined as death, need for extensive pharmacologic support (vasoactive-inotrope score of ≥20), and need for mechanical circulatory support. We developed a nomogram based on risk classifier and independent baseline variables using a multivariable logistic model. Based on risk scores weighted by 11 preoperative and 4 intraoperative selected variables, we classified patients as low, intermediate, and high risk in the derivation cohort. With reference to the low-risk group, the intermediate- and high-risk groups conferred significantly higher in-hospital complication risks (adjusted odds ratio: 2.721 [95% CI, 1.267-5.841], P=0.0102; 9.297 [95% CI, 4.601-18.786], P<0.0001). A nomogram integrating the ARIAR-Risk classifier (absolute and relative low risk, intermediate risk, and aggressive and refractory high risk) with age and mean blood pressure showed good discrimination and goodness-of-fit for derivation (area under the receiver operating characteristic curve: 0.785 [95% CI, 0.731-0.839]; Hosmer-Lemeshow test, P=0.544) and external validation (area under the receiver operating characteristic curve: 0.759 [95% CI, 0.636-0.881]; Hosmer-Lemeshow test, P=0.508). Conclusions A risk-classifier-oriented nomogram is a reliable prediction model for in-hospital complications in children with tetralogy of Fallot repaired at an older age, and strengthens risk/benefit-based decision-making.

[Clinical Value of Immunophenotype Detection and DNA Ploid Analysis by Flow Cytometry for Non-Hodgkin's Lymphoma Patients].

OBJECTIVE: To explore the clinical values of detecting immunophenotype and analyzing DNA ploid by flow cytometry for patients with non-Hogkin's lymphoma (NHL). METHODS: Eighty NHL patients admitted in our hospital from August 2007 years to March 2015 Years were included in the observation group, 20 patients with reactive lymphoid hyperplasias were selectod as control group. The immunophenotypes were detected and the DNA ploid was analyzed by flow cytometry. RESULTS: The detected rate of DNA aneuploidy, DAN index (DI) and SPF in observation group were higher than those in control group, there was signifificant difference (P < 0.05). The SPF and DI in patients with NHL-I, NHL-II had no statistical difference as compared with that in control group (P > 0.05); but the SPF and DI in pateints with NHL-III and patients with NHL-IV showed statistical significance as compared with that in control group (P < 0.05). The SPF and DI in patients with low malignancy group and middle malignancy group showed statistical significance as compared with control group (P < 0.05). The SPF and DI in middle malignancy group had statistical significance as compared with that in low malignancy group (P < 0.05). CONCLUSION: the immunophenotype detection and DNA ploid analysis by flow cytometry can reflect the tumor proliferation and deterioration of patients with Non-Hogkin's lymphoma, predicting the prognosis.

[Effect of Electroacupuncture on Expression of Cortical srGAP 1 and Cdc 42 in Rats with Focal Cerebral Infarction].

OBJECTIVE: To observe the effect of electroacupuncture (EA) intervention on the neurological function and the expression change of Slit-Robo GTPase-activating protein-1 (srGAP 1) and cell division-cycle 42 (Cdc 42) in the cortex of rats with cerebral ischemic injury (CIRI) , so as to explore the mechanism of EA in the management of cerebral infarction. METHODS: A total of 48 male Sprague Dawley (SD) rats were randomly and equally divided into control, model, non-acupoint EA and EA groups (n = 12/group). The CIRI model was established based on the modified Zea Longa method. EA intervention was applied for 30 min, once a day for 14 days. Modified neurologic severity scores (mNSS) were assessed on day 1,3,7 and 14 after mode- ling. Immunofluorescence assay was used to detect the immunoactivity and distribution of srGAP 1 and Cdc 42 in the cortical ischemic region. Western blot was employed to detect the expression of srGAP 1 and Cdc 42 in the affected cortex. RESULTS: The mNSS displayed that the neurological score in the EA group was significantly lower than that in the model group and non-acupoint EA group at the 7th d and 14th d (P<0. 01). Immunofluorescence results showed that cerebral srGAP 1 and Cdc 42 were ex- pressed mainly in the cytoplasm. The fluorescence intensity of srGAP 1 of the EA group was significantly lower than that of the model group and non-acupoint EA group(P<0. 01). Meanwhile the fluorescence intensity of Cdc 42 of the EA group was markedly higher than that in the model group and non-acupoint EA group(P<0. 01). Western blot assay indicated that the expression level of srGAP 1 in the model group was significantly higher than that of the control group( P<0. 01) ,and that of the EA group was much lower than those of the model group and non-acupoint EA group(P<0. 01). There was no significant difference of srGAP 1 expression levels between the non-acupoint EA group and the model group(P>0. 05). Additionally, the protein expression of Cdc 42 in the model group was slightly higher than that of the control group(P>0. 05), and that of the EA group was significantly higher than those of the model group and non-acupoint EA group(P<0. 01). There was no significant difference of Cdc 42 expression levels between the non-acupoint EA group and the model group(P>0. 05). CONCLUSION: Cerebral infarction induced increase of cerebral srGAP 1 and decrease of Cdc 42 can be reversed by acupoint EA intervention in CIRI rats, which may be responsible for its effect in improving impaired neurological function after cerebral infarction.

[Effect of electroacupuncture stimulation of back-shu points on expression of TNF-alpha and lipid peroxidation reaction in the liver tissue in non-alcoholic fatty liver disease rats].

OBJECTIVE: To observe the effect of electroacupuncture (EA) stimulation (EAS) of back-shu acupoints on expression of tumor necrosis factor-alpha (TNF-alpha) and lipid peroxidase reaction in the liver in non-alcoholic fatty liver disease (NAFLD) rats. METHODS: Wistar rats were randomly divided into normal group (n = 1), model group (n = 10), EAS group (n = 10) and medication group (n = 10). The NAFLD model was established by feeding the animals with high fat diet for 8 weeks. EAS was applied to bilateral "Pishu" (BL 20), "Geshu" (BL 17) and "Shenshu" (BL 23) for 20 min, once daily for 4 weeks. Rats of the medication group were treated by 1% Dongbao Gantai suspension (0.28 g/kg, 20 mL/kg) once daily for 4 weeks. Pathological changes of the liver tissue were observed by microscope after H. E. staining. Hepatic free fatty acid (FFA) content was assayed by using an automatic biochemistry analyzer, malondialdehyde (MDA) content and superoxide dismutase (SOD) activity were detected by penthiobarbituric acid colorimetric method and xanthine oxidase colorimetric method, respectively. The expression of liver TNF-alpha was detected by immunohistochemistry. RESULTS: Compared with the normal group, rats of the model group showed a moderate to severe fatty degeneration of liver cells, significant up-regulation of hepatic TNF-alpha expression, FFA and MDA contents (P < 0.01), and marked down-regulation of SOD activity (P < 0.01). Following 4 weeks' treatment, compared with the model group, liver fatty degeneration was reduced at different degrees in both EAS and medication groups; liver FFA and MDA contents and TNF-alpha expression were significantly down-regulated (P < 0.01, P < 0.05), and hepatic SOD activity was notably increased (P < 0.01, P < 0.05) in both EAS and medication groups, suggesting a reduction of hepatic lipid peroxidation. No significant differences between the EAS and medication groups in the liver FFA and MDA contents, SOD activity and TNF-alpha expression (P > 0.05). CONCLUSION: EA intervention can improve liver fatty degeneration, inhibit high fat induced up-regulation of hepatic TNF-a expression, FFA and MDA contents and down-regulation of SOD activity in non-alcohol fatty liver model rats, which may contribute to its effect in improving NAFLD.

[Effect of electroacupuncture on the expression of oligodendrocyte precursor cells in rats with compressed spinal cord injury].

OBJECTIVE: To investigate the effect of electroacupuncture on the expression of oligodendrocyte precursor cells in rats with compressed spinal cord injury (CSCI) and to explore the mechanism of remyelinization. METHODS: Thirty-six SD rats were randomly divided into a control group and three treatment groups with 3 d, 7 d and 14 d of treatment respectively. Acupuncture was given to rats in the treatment groups through jiaji point, double zusanli (ST36), and double taixi (KI3). Electroacupuncture (continuous wave, 2 Hz/1. 5 V, 30 min) was applied for the double zusanli (ST36) and double taixi (KI3). Ethological alterations of the rats were observed with quantitative assessment of neurologic function. The ultrastructure changes of nerve fibers in white matter were determined under electronic microscope. Expressions of NG2 protein, an OPC marker, was observed by Western blot. RESULTS: No significant changes in neurologic function and G-ratio were observed after three days and seven days of electroacupuncture treatment (P>0. 05). However, 14 d of electroacupuncture treatment made a significant change compared to the 7 d treatment group and the control group (P<0. 05). The electronic microscope showed axons with varied degree of swollen, degenerated and lost cell organelle in axoplasm, edema in myelin sheaths, disordered, thickened and even broken layers of myelin sheaths in the rats with CSCI. The rats in the treatment groups had milder swollen axons and more compacted layers of myelin sheaths compared to their controls. Western blot showed that the expression of NG2 was increased with time and the differences among the three treatment groups were statistically significant (P<0. 05). The rats in the treatment groups also had higher expressions of NG2 than their controls at 7 d and 14 d (P<0. 05). CONCLUSION: Electroacupuncture can improve inflammation and edema in the injured nerve fibers and up regulate NG2 expression and remyelination of the injured nerve fibers in rats with CSCI.

[Effect of electroacupuncture of "Neiguan" (PC 6) and "Zusanli" (ST 36) on expression of cerebral cortical slit 2/Robo 1 in the focal cerebral infarction rats ].

OBJECTIVE: To observe the effect of electroacupuncture (EA) intervention on expression of Slit 2 and its transmembrane receptor Robo 1 in the cortex tissue of cerebral infarction rats so as to study its mechanism underlying improvement of cerebral ischemia. METHODS: Ninety male Sprague Dawley rats were randomly divided into control group (n = 10), model group (n = 40) and EA group (n = 40), and the latter two groups were further randomized into four subgroups: 1 d, 3 d, 7 d, and 14 d (n = 10 in each subgroup) according to the cerebral ischemia duration. Cerebral infarction model was established by occlusion of the middle cerebral artery (MCAO). EA (80-100 Hz, 1-3 mA) was applied to bilateral "Neiguan" (PC 6) and "Zusanli" (ST 36) for 30 min, once daily for 1 d, 3 d, 7 d, and 14 d, respectively. The animals' neurological defect was assessed using Zea-Longa scoring. The expression of Slit 2 and Robo 1 proteins in the cerebral cortex on the ischemic side was assayed using immunohistochemistry and Western blotting, respectively. RESULTS: In comparison with the control group, the neurological score was significantly higher in the model group (P < 0.05), and reduced considerably on day 7 and 14 after MCAO in the EA group compared with the model group (P < 0.05). Immunohistochemical results showed that in comparison with the control group, the immunoactivity levels of cerebral Slit 2 and Robo 1 were remarkably upregulated on day 1, 3 and 7 after MCAO in the model group (P < 0.05, P < 0.01), and backed to the control levels on day 14 (P > 0.05). While compared with the model group, the immunoactivity levels of cerebral Slit 2 and Robo 1 were further obviously upregulated on day 1, 3, 7 and 14 after cerebral ischemia in the EA group (P < 0.05, P < 0.01). The results of Western blotting about the expression levels of cerebral Slit 2 and Robo 1 proteins were nearly the same to those of immunohistochemical outcomes in the 4 subgroups apart from that the expression levels of both Slit 2 and Robo 1 proteins were still obviously higher on day 14 after MCAO in the model group (P < 0.01). CONCLUSION: EA intervention can significantly improve cerebral ischemia rats' neurological function and obviously upregulate the expression of cerebral Slit 2 and Robo 1 proteins, which may be one of the mechanisms of EA therapy for relieving cerebral infarction in clinic.

[Influence of electroacupuncture intervention on serum retinol binding protein 4 and liver function in nonalcoholic fatty liver rats].

OBJECTIVE: To observe the influence of electroacupuncture (EA) intervention on liver function and retinol binding protein 4 (RBP 4) in nonalcoholic fatty liver disease (NAFLD) rats, so as to study its mechanisms underlying improving liver function. METHODS: A total of 44 SD rats were randomly allocated to normal control, model, EA and non-acupoint groups, with 11 rats in each group. NAFLD model was established by feeding the rats with high glucose and high fat forage for 5 weeks. EA (2 Hz, 1.5 V, 15 min) was applied to unilateral "Fenglong" (ST 40), "Zusanli" (ST 36), "Sanyinjiao" (SP 6) and "Taichong" (LR 3), once daily for 4 weeks. Serum RBP 4 content was assayed by enzyme-linked immunosorbent assay (ELISA), and serum glutamic-oxaloacetic transaminase (AST), alanine aminotransferase (ALT), total cholesterol (TC), and triglycerides (TG) contents were detected by chromatometry. RESULTS: Compared with the normal control group, serum AST, ALT, TC, TG and RBP 4 contents in the model group were increased significantly (P<0. 01), while in comparison with the model group, the levels of the abovementioned 5 serum indexes were down-regulated considerably in the EA group (P < 0.05) rather than in the non-acupoint group (P > 0.05). CONCLUSION: EA intervention can lower serum AST, ALT, TC, TG and RBP 4 contents in NAFLD rats, which may be responsible for its action in improving NAFLD in clinic.

[Impact of electro-acupuncture on lipid metalolism in rats with non-alcoholic fatty liver disease].

OBJECTIVE: To investigate the effect of electroacupuncture on lipid metabolism in rats with nonalcoholic fatty liver disease (NAFLD). METHODS: 44 rats were divided into blank group and NAFLD group. The rats in the NAFLD group were randomly selected to be given blank treatment (control) or electroacupuncture stimulation on acupoints (EA), non-acupoints (ENA). The EA pointed to "Feng long", "Zu sanli", "Tai chong" and "San yinjiao". The ENA pointed to four points in the middle one third of the rat tails without touching the veins. Four weeks after the treatment, serum levels of adipinectin (ADP), leptin (LEP), free fatty acids (FFA), high density lipoprotein (HDL), low density lipoprotein (LDL), total cholesterol (TC), triglycerides (TG) of the rats were tested with immunoreagent. RESULTS: Compared with controls, the rats with EA treatment had significantly lower levels of serum LEP, LDL, FFA, TC and TG, and higher levels of serum ADP and HDL (P<0.05). The rats with EA treatment also experienced less fatty degeneration in hepatic tissues. Such changes were not observed in the rats with ENA treatment (P>0.05). CONCLUSION: EA (Feng long, Zu sanli, Tai chong, San yinjiao) increases serum ADP and HDL, lowers LEP, LDL, FFA, TC and TG, and thereby reduces lipogenesis and liver fat deposition.

[Influence of electroacupuncture on hepatic cytochrome P450 1 A 1 expression and lipid peroxidation in nonalcoholic fatty liver rats].

OBJECTIVE: To study the effect of electroacupuncture (EA) on liver cytochrome P450 1 A 1 immunoactivity, superoxide dismutase (SOD) and malondialdehyde (MDA) contents in nonalcoholic fatty liver disease (NAFLD) rats. METHODS: Thirty male SD rats were randomized into normal control (n = 10), model (n = 10) and EA (n = 10) groups. NAFLD model was established by feeding the animal with high-fat forage for 8 weeks. EA (1.6-2 Hz, 1-4 mA) was applied to bilateral "Zusanli" (ST 36), "Fenglong" (ST 40), "Sanyinjiao" (SP 6) and "Taichong" (LR 3) for 15 min, once daily for 4 weeks. Then the rats anesthetized with ether were killed for collecting liver tissue. Following homogenate and centrifugalization of the partial liver tissue, the supernatant was collected for assaying superoxide dismutase (SOD) and malondialdehyde (MDA) contents by xanthinoxidase chromometry and thio-malonylurea chromometry respectively. The other partial liver tissue samples were fixed in 10% formalin, followed by paraffin imbedding and sectioning (4 microm), and staining with streptavidin-perosidase methods respectively for displaying hepatic pathological changes and cytochrom P450 1 A 1 immunoreaction. RESULTS: Compared with control group, hepatic SOD content of model group was significantly lower (P < 0.05), and MDA level and cytochrome P450 1 A 1 (CYP 1 A 1) integrated optic density (IOD) value were obviously higher in model group (P < 0.05). In comparison with model group, liver SOD level of EA group increased considerably (P < 0.05), while MDA level and CYP 1 A 1 IOD of EA group decreased evidently in EA group (P < 0.05). CONCLUSION: EA can effectively reduce lipid peroxidation and up-regulate CYP 1 A 1 expression in nonalcoholic fatty liver tissue, which may contribute to its effect in improving fatty liver.

[Influence of electroacupuncture on insulin-resistance in nonalcoholic fatty liver rats].

OBJECTIVE: To investigate the mechanism of electroacupuncture (EA) in treating nonalcoholic fatty liver disease (NAFLD) in rats. METHODS: Thirty male SD rats were randomized into normal control, NAFLD model and EA groups, with 10 cases in each. NAFLD model was established by feeding the rats with high-fat food for 8 weeks. EA (2 Hz, 4 mA) was applied to "Zusanli" (ST 36), "Fenglong" (ST 40), "Sanyinjiao" (SP 6), and "Taichong" (LR 3) for 15 min, once daily for 4 weeks. Fasting blood sugar (FBG) and serum free fatty acids (FFA) were detected with chromatometry; serum insulin (INS) was determined with radioimmunoassay; homeostasis model assessment insulin resistance (HOMA-IR) and liver index (LI) were calculated. Liver tissue was cut into sections for detecting pathological changes. RESULTS: Compared with normal control group, FBG, INS, FFA, HOMA-IR and LI of model group increased significantly (P<0.05), and hepatic diffuse steatosis with cellular necrosis and inflammatory cell infiltration was obvious. In comparison with model group, all the 5 indexes in EA group decreased significantly (P<0.05), and pathological changes as hepatic steatosis, etc. were significantly reduced. CONCLUSION: EA may be used to effectively improve NAFLD by lowering insulin resistance.