Acupuncture and the retrospect of its modern research.

Acupuncture is one of the oldest medical practices of Traditional Chinese Medicine (TCM). This method of treatment was discovered when primitive Chinese people discovered that pain in one part of the body can be alleviated if it stings in a particular area of the body. Acupuncture has achieved to a climax in Ming Dynasty (1368-1644 A.D.), when many famous doctors specialized in this field emerged with a lot of exclusive books on acupuncture, but the most important one was Compendium of Acupuncture and Moxibustion by Yang Jizhou, which represented a new milestone in the history of acupuncture's evolution. Yang Jizhou compiled a book that presents a complete and laborious description of the meridians, collaterals, acupuncture points, manipulating methods of acupuncture and their indications. According to the ancient description of the meridians and collaterals and the research on the anatomy of Western medicine, some scholars think the meridians and collaterals are closely related to the blood vessels. In recent years, many reports have showed that acupuncture has remarkable effect on the pituitary gland and adrenal cortex system, the sympathetic nerve and adrenal medulla system, the pituitary gland and thyroid gland system, the sexual glands, and the posterior pituitary system. Thus, some researchers put forth the theory of the meridians and collaterals associated with regulatory function of the neurohumoral system, and the action of acupuncture and moxibustion is brought about by the way of the nerves and body fluid.

Hypertensive cardiomyopathy - histopathological and immunohistochemical aspects.

Arterial hypertension (AH) represents the main cause of morbidity and mortality all over the world. Approximately 40% of the adults aged over 25 years old and about 90% of the persons aged over 80 years old suffer from AH. It is a multifactorial condition, in whose etiopathogeny there are involved numerous genetic, metabolic and environment factors. In its turn, AH is one of the most important risk factors for heart disease, stroke, heart failure, kidney disease and peripheral vascular diseases. In hypertensive patients, it progresses into the left ventricle hypertrophy, as a result of some major changes of the cardiomyocytes, but also of the extracellular conjunctive matrix (ECM). We evaluated some histopathological and immunohistochemical changes induced by AH on some fragments of myocardium from the left ventricle. There was observed an increase of the ECM quantity, manifested by the expansion of the intercellular spaces, fibrillar collagen synthesis and its deposit in the perivascular and interstitial spaces, a significant reduction of the number of microvessels in the myocardium, the alteration of cardiomyocyte structure, by reducing the quantity of desmin and of the intercellular connections, by reducing cluster of differentiation 56 (CD56) (neural cell adhesion molecule 1 - NCAM1) immunomarker.

Liver hydatid cyst - cause of violent death. Case presentation.

Liver hydatid cyst represents one of the most frequent localizations of Echinococcus granulosus tapeworm in humans. The disease progresses symptom-free in most patients, due to a slow growth rhythm of the cyst. When it reaches large sizes, the hydatid cyst causes discomfort or pain in the liver bed, low appetite, phenomena of hepatitis or cholangitis. The patients are most often diagnosed with liver hydatid cyst after imagistic investigations (radiological or ultrasound) for symptoms that, most commonly, are not related to a hydatid cyst. We present the case of an 11-year-old girl, with no pathological history, who presented forme fruste symptoms, not acknowledged by her parents, and deceased after an anaphylactic shock caused by the rupture of a liver hydatid cyst.

Ethical governance of the medical research: clinical investigation and informed consent under the new EU Medical Devices Regulation (2017∕745).

PURPOSE: The paper focuses on the ethical appraisal of the clinical investigations (CIs) and the informed consent within the new European Union (EU) legislation on medical devices (MDs). The Regulation (EU) 2017∕745 of the European Parliament and of the Council was adopted on 5 April 2017 and entered into force on 25 May 2017, repealing the Council Directives concerning Medical Devices 93∕42∕EEC and the Active Implantable Medical Devices 90∕385∕EEC. BACKGROUND: For the past thirty years, the EU legislation on MDs has been updated by several directives: Council Directive 90∕385∕EEC on Active Medical Devices (1990); Council Directive 93∕42∕EEC on Medical Devices (1993) and Council Directive 98∕79∕EC on In vitro Medical Devices (1998) aiming to frame the MDs market development. CONTENT: From the ethical perspective, the present article investigates the new rules concerning the CIs of the MDs for human use and accessories for such devices conducted in the EU by highlighting new regulatory aspects: (1) the framework of the clinical evaluation and CI; (2) the relevant definitions; (3) the ethical principles related to CIs; (4) the informed consent; (5) the role of the national ethics committees. CONCLUSIONS: Although the new guidelines enable an extension of the definition of "medical device" and the harmonization of the rules for "the placing on market and putting into service of the medical devices", it also regulates the MDs industry to ensure clinical benefits for patients and high standards of quality and safety.

Acupoints [corrected] and meridians: a histochemical study.

The aim of this study was to elucidate the relationship between the structural specificities of acupoints and meridians as well as their clinical effects. We processed 356 specimens, 287 of which from 48 adult and 2 newborn cadavers and the remaining 69 from living patients; samples were taken at three different levels: (1) beneath acupoints; (2) between meridians; (3) at a distance from meridians. We performed seven different staining to show the distribution of collagen fibers, reticular fibers, mucopolysaccharides (MPS), connective tissue, nerve threads, and blood vessels in specimens obtained from different areas. We found that some structural and biochemical discrepancies associated with acupoints and meridians including: (1) mucopolysaccharides (MPS), in particular acid MPS; (2) collagen fibers; (3) nerve endings. We discussed these findings from an anatomo-clinical point of view.

The relation between the acupoint structures and the clinical therapeutic effects.

We performed a histological study upon the acupuncture points and their effectiveness of clinical treatment; the background was the clinic evidence that a multitude of points are used in treating a disease, but only some of which may have an efficacy, since the others did not. After a comparative histological and anatomic study, it comes out that those points, which are more effective from a structural point of view, identify a neural fibrillar concentration, a well developed capillary network and an increased mucopolysaccharides (MPS) concentration, in particular, acid mucopolysaccharides. The present paper presents histological data, which demonstrate the difference in the structure of the acupuncture points, postulating their specific influence on clinical treatment.