Screening and genotyping of thalassemia in Ningbo / 中华地方病学杂志

Objective:To study the genotyping of thalassemia in Ningbo population and provide a reference basis for future prevention and control of thalassemia in Ningbo.Methods:Patients with suspected thalassemia attending Ningbo Women and Children's Hospital from January 2019 to March 2022 were selected for the study, and DNA was extracted from dried blood spot specimens by collecting peripheral blood, and detection of thalassemia hotspot variants was performed by fluorescence PCR melting curve analysis combined with Sanger sequencing or multiplex ligation-dependent probe amplification (MLPA).Results:A total of 2 680 cases were included in the patients with suspected thalassemia, and 1 426 cases of thalassemia gene carriers were detected, with an overall detection rate of 53.2%. Among them, 595 cases (41.7%) were α-thalassemia, with -- SEA/αα, αα/-α 3.7 and -- SEA/-α 3.7 being more common; 807 cases (56.6%) were β-thalassemia, with β IVS-Ⅱ-654/β N, β CD41-42/β N and β CD17/β N being more common; 24 cases (1.7%) were αβ-combined thalassemia. Among them, six rare variant types were included, including fusion gene (Fusion), -- FIL, HBA2:c.376C>T, CD8/9(+G), IVS-Ⅰ-2(T>C) and IVS-Ⅱ-1(G>A), all of which were reported for the first time in Ningbo. Conclusion:Among suspected thalassemia patients in Ningbo, the detection rate of thalassemia is high, and the types of gene variants are complex, so the awareness of thalassemia gene testing for anemic patients should be raised.

Effect of Electroacupuncture at “Fenglong”（ST 40） on Liver Lipid Synthesis and Insulin Resistance in Hyperlipidemic Model Rats / 中医杂志

ObjectiveTo explore the effect and possible mechanism of electroacupuncture （EA） at Fenglong （ST40） on liver lipid synthesis and insulin resistance （IR） in hyperlipidemic （HLP） rats. MethodEighteen rats were randomly divided into three groups， blank group， model group， and EA group， each consisting of six rats. The blank group rats were with fed a basic diet， while those in the model group and EA group were fed high-fat diet for 8 weeks. After modeling， the rats in the EA group received bilateral EA treatment at “Fenglong” （ST 40）. The rats in the model group underwent daily binding treatment， once a day， continuously 5 days a week， for a total of 4 weeks. Following the intervention， the levels of triglycerides （TG） and free fatty acids （FFA） in liver tissue was determined using ELISA. Serum TG， FFA， fasting insulin （FINS）， alanine transaminase （ALT）， aspartate Transaminase （AST）， tumor necrosis factor-ɑ （TNF-ɑ）and interleukin 6 （IL-6） were also measured. The fasting plasma glucose （FBG） assessed using a glucose meter and the homeostatic model assessment of insulin resistance （HOMA-IR） was calculated. Liver pathology was examined through HE staining and oil red O staining. The expression of hepatic sterol regulator binding protein 1c （SREBP1c）， recombinant fatty acid synthase （FASN） and stearoyl-CoA desaturase 1 （SCD1） were detected through immunofluorescence. The protein expression levels of liver insulin receptor substrate 1 （IRS1） and tyrosine-phosphorylated insulin receptor substrate 1 （p-IRS1-Tyr） were determined via Western blot. ResultsWhen compared to the blank group， the model group of rats exhibited elevated serum and liver tissue levels of TG and FFA， as well as increased serum levels of AST， ALT， TNF-α， IL-6， FBG， FINS， and HOMA-IR （P＜0.05）. HE staining revealed disordered arrangements of liver cells， indicating widespread fatty degeneration. Oil red O staining showed abundant bright red lipid droplets within liver cell cytoplasm， indicating severe lipid accumulation. The average fluorescence intensity of SREBP1c， FASN， and SCD1 in liver tissue significantly increased （P＜0.05）， while p-IRS1-Tyr protein expression levels significantly decreased （P＜0.05）. In comparison to the model group， the EA group of rats showed significantly reduced serum and liver tissue levels of TG and FFA， along with decreased serum levels of AST， ALT， TNF-α， IL-6， FBG， FINS， and HOMA-IR （P＜0.05）. HE staining indicated more regular arrangements of liver cells， and oil red O staining revealed a significant reduction in liver cell lipid droplets， indicating a less severe degree of lipid accumulation. The average fluorescence intensity of SREBP1c， FASN， and SCD1 in liver tissue significantly decreased （P＜0.05）， while p-IRS1-Tyr protein expression levels significantly increased （P＜0.05）， with no significant difference in IRS1 protein expression （P＞0.05）. ConclusionEA at “Fenglong” （ST 40） can significantly decrease serum lipid in HLP rats， improves liver fat accumulation， and also ameliorate insulin resistance. The mechanism may be related to the inhibition of hepatic lipid synthesis molecule expression， reduced serum inflammatory factors， and an increase in insulin substrate receptor phosphorylation levels.

Effects of electroacupuncture at Zusanli on duodenal Caspase-1 and GSDMD of rats with functional dyspepsia / 中华物理医学与康复杂志

Objective:To explore any effect of electroacupuncture (EA) at the Zusanli point on the scorch death of duodenal cells in rats with functional dyspepsia (FD) and possible mechanisms.Methods:Twenty-four 7-day-old Sprague-Dawley rats were randomly divided into a blank group, a model group and an EA group, each of 8. FD was induced in both the model and EA group rats using iodoacetamide gavage with tail-clip stimulation. After successful modeling the EA group was given acupuncture at the Zusanli point and then connected with a Korean acupuncture point nerve stimulator for 2 weeks. The other 2 groups were not given any intervention. The rats′ body weight was recorded before and after the modeling, as well as 7 and 14 days later. The gastric emptying rate and the small intestine propulsion rate of the three groups were detected right after the EA intervention, and the serum expression levels of interleukin-1β (IL-1β) and interleukin-6 (IL-6) were measured using enzyme-linked immunoassays. Real-time fluorescence quantitative polymerase chain reactions were used to detect the transcription levels of IL-1β and IL-6 in the rats′ duodenums, while western blotting was employed to assess the expression of caspase-1 P20 and dermatin D (GSDMD) in their duodenums.Results:After successful modeling, the average body weight of the rats in the model and EA groups was significantly different from that in blank group, and after 7 and 14 days the average body weight of the former groups was significantly different from that of the blank group, with significant differences between the two groups as well. After the EA intervention significant differences were observed in gastric reside and small intestine propulsion rate between the EA group and the model group, as well as between the model and the blank group. After the intervention, there were significant differences between the blank group and the other two groups in the average expression of IL-1β and IL-6 in serum, IL-1β and IL-6 mRNA in the duodenum, as well as the GSDMD and caspase-1 p20 proteins in the duodenum. There were significant differences between the model and EA groups in all of the above measurements.Conclusions:EA at the Zusanli point can significantly reduce the level of scorch death in the duodenum of FD rats, as well as relieve low-grade duodenal inflammation and the clinical symptoms of FD. Its mechanism may be related to the down-regulation of the expression of caspase-1 P20 and GSDMD-N protein, and of inflammatory factors such as IL-1β and IL-6, relieving low-grade duodenal inflammation.

Enlarged multicystic dysplastic kidneys with oligohydramnios during infancy caused by NPHP3 gene mutation / 中华医学遗传学杂志

OBJECTIVE@#To explore the clinical features and genomic abnorm ality of a fetus enlarged multicystic dysplastic kidneys with oligohydramnios caused by NPHP3 gene mutation.@*METHODS@#The fetuse was found to have multicystic dysplastic kidneys with oligohydramnios upon ultrasonography during the second trimester. Following induced abortion, fetal tissue was collected for the extraction of DNA, chromosomal microarray analysis (CMA) and whole exome sequencing (WES). Sanger sequencing was used to verify the suspected variants in the family.@*RESULTS@#Antenatal ultrasound examination at 19 weeks showed "polycystic" kidneys with Oligohydramnios. Delivery was by induced labour because of the critically low amniotic fluid volume. Testing of CMA was normal. WES showed a compound heterozygous mutation of c.1817G>A, p.W606X; c.432dupA, p.E145Rfs*18 mutations are novel mutations in this study.@*CONCLUSION@#The research may further expand the NPHP3 gene mutation spectrum. Enlarged multicystic dysplastic kidneys with oligohydramnios caused by NPHP3 gene mutation at least include one or two splice site mutation, frameshift mutation or nonsense mutation foetal poor prognosis.

Genetic variation of thalassemia in children in Ningbo City and its correlation with erythrocyte parameters / 中华地方病学杂志

Objective:To explore the type and composition of thalassemia gene variation in children in Ningbo City, and to analyze its correlation with erythrocyte parameters.Methods:From January 2019 to December 2020, 785 children who underwent thalassemia gene testing in Ningbo Women and Children's Hospital were selected as the retrospective research subjects to analyze the type and composition of thalassemia gene variation in local children. A total of 238 thalassemia gene mutation carriers and 100 healthy children (control group) who underwent physical examination during the same period were selected for routine blood test to analyze the correlation between thalassemia gene mutation types and serological indexes.Results:Among the 785 children who underwent thalassemia gene testing, 571 were confirmed as carriers of thalassemia gene mutation, with a detection rate of 72.7%, including 228 cases of α-thalassemia, 337 cases of β-thalassemia, and 6 cases of αβ-complex type thalassemia. It covered 17 variant types and 25 gene combinations. There were significant differences in red blood cell count (RBC), hematokrit (HCT), hemoglobin concentration (Hb), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), mean corpuscular volume (MCV) and red blood cell distribution width (RDW) between the control, α-thalassemia and β-thalassemia groups ( H/ F = 125.03, 86.24, 141.06, 192.99, 121.46, 198.63, 178.06, P < 0.001). And there were statistically significant differences in HCT, Hb, MCH, MCV and RDW among the four common genotypes (-- SEA/αα, β IVS-Ⅱ-654/β N, β CD41-42/β N and β CD17/β N) in this test ( F = 5.03, 3.34, 6.24, 10.33, 6.83, P < 0.05). Conclusion:The genotypes of children with thalassemia in Ningbo City are diverse, and the erythrocyte parameters are different among different genotypes.

Development of small molecule extracellular signal-regulated kinases (ERKs) inhibitors for cancer therapy

The mitogen-activated protein kinase (MAPK)/extracellular signal-regulated kinase 1/2 (ERK1/2) signaling pathway is widely activated by a variety of extracellular stimuli, and its dysregulation is associated with the proliferation, invasion, and migration of cancer cells. ERK1/2 is located at the distal end of this pathway and rarely undergoes mutations, making it an attractive target for anticancer drug development. Currently, an increasing number of ERK1/2 inhibitors have been designed and synthesized for antitumor therapy, among which representative compounds have entered clinical trials. When ERK1/2 signal transduction is eliminated, ERK5 may provide a bypass route to rescue proliferation, and weaken the potency of ERK1/2 inhibitors. Therefore, drug research targeting ERK5 or based on the compensatory mechanism of ERK5 for ERK1/2 opens up a new way for oncotherapy. This review provides an overview of the physiological and biological functions of ERKs, focuses on the structure-activity relationships of small molecule inhibitors targeting ERKs, with a view to providing guidance for future drug design and optimization, and discusses the potential therapeutic strategies to overcome drug resistance.

Clinical, endoscopic and histological characteristics of heterotopic gastric mucosa in upper esophagus / 中华消化内镜杂志

Objective:To study the clinical, endoscopic and histological characteristics of heterotopic gastric mucosa in upper esophagus (HGMUE).Methods:A Total of 177 patients who underwent gastroscopy and were diagnosed as having HGMUE at the Endoscopy Center of Wuhan Union Hospital from January 2017 to December 2017 were included in the study. According to the gastroesophageal reflux disease symptom questionnaire (GERD-Q) scores, patients were divided into the HGMUE group (GERD-Q<8, n=101) and GERD+HGMUE group (GERD-Q≥8, n=76). The data of clinical, endoscopic and histological characteristics were analyzed. Results:Among the 177 HGMUE cases, there were 111 males (62.71%) and 66 females (37.29%), 76 (42.94%) with GERD, and 101 (57.06%) without GERD. The most common symptom was continuous clearing throat [54.24% (96/177)], followed by foreign body sensations of throat [48.59% (86/177)], and gastroesophageal reflux symptoms such as heartburn, chest pain, indigestion, acid reflux [48.59% (86/177)]. In the HGMUE group, the occurrence rate of clearing throat was the highest [42.57% (43/101)], then foreign body sensations of throat accounted for 33.66% (34/101), and gastroesophageal reflux symptoms was 27.72% (28/101). In the HGUME+GERD group, the most common symptom was gastroesophageal reflux symptoms [76.32% (58/76)], then clearing throat [69.74% (53/76)] and foreign body sensations of throat [68.42% (52/76)]. Under gastroscopy, 177 heterotopic gastric lesions were found under gastroscopy with orange-red round, oval or elongated island like ones, most of which were flat and a few slightly protruded from the peripheral plane. There were 132 (74.58%) single-lesion cases, 38 (21.47%) 2-lesion, and 7 (3.95%) 3- or more-lesion cases; there were 37 (20.90%) small lesions (maximum diameter <0.5 cm), and 74 (41.81%) median-size lesions (maximum diameter of 0.5-1.0 cm), and 66 (37.3%) larger lesions (maximum diameter >1.0 cm). Among the 30 [16.95% (30/177)] samples of mucosal tissue, 15 [50.00% (15/30)] were mainly cardia gland, 8 [26.67% (8/30)] were mainly pyloric gland, 6 [20.00% (6/30)] were mixed type, and 1 [3.33% (1/30)] was squamous epithelium. In the immunohistochemical test, 20 cases [66.67% (20/30)] showed positive of H +/K +-ATPase, and 10 cases [33.33% (10/30)] were negative. Conclusion:HGMUE is more common in male patients, and may be combined with GERD. Among them, patients with combined GERD are more likely to develop laryngopharyngeal reflux. The heterotopic gastric mucosas lesions are orange-red round, oval or elongated island-like under gastroscopy, and most of them are flat, single and median- or large-sized. Histological types are mostly fundic glands, and H +/K +-ATPase positive is more common. It is speculated that acid secretion may be an important factor leading to throat symptoms.

Molecular probes of spike ectodomain and its subdomains for SARS-CoV-2 variants, Alpha through Omicron

Since the outbreak of the COVID-19 pandemic, widespread infections have allowed SARS-CoV-2 to evolve in human, leading to the emergence of multiple circulating variants. Some of these variants show increased resistance to vaccines, convalescent plasma, or monoclonal antibodies. In particular, mutations in the SARS-CoV-2 spike have drawn attention. To facilitate the isolation of neutralizing antibodies and the monitoring the vaccine effectiveness against these variants, we designed and produced biotin-labeled molecular probes of variant SARS-CoV-2 spikes and their subdomains, using a structure-based construct design that incorporated an N-terminal purification tag, a specific amino acid sequence for protease cleavage, the variant spike-based region of interest, and a C-terminal sequence targeted by biotin ligase. These probes could be produced by a single step using in-process biotinylation and purification. We characterized the physical properties and antigenicity of these probes, comprising the N-terminal domain (NTD), the receptor-binding domain (RBD), the RBD and subdomain 1 (RBD-SD1), and the prefusion-stabilized spike ectodomain (S2P) with sequences from SARS-CoV-2 variants of concern or of interest, including variants Alpha, Beta, Gamma, Epsilon, Iota, Kappa, Delta, Lambda, Mu, and Omicron. We functionally validated probes by using yeast expressing a panel of nine SARS-CoV-2 spike-binding antibodies and confirmed sorting capabilities of variant probes using yeast displaying libraries of plasma antibodies from COVID-19 convalescent donors. We deposited these constructs to Addgene to enable their dissemination. Overall, this study describes a matrix of SARS-CoV-2 variant molecular probes that allow for assessment of immune responses, identification of serum antibody specificity, and isolation and characterization of neutralizing antibodies.

Paired heavy and light chain signatures contribute to potent SARS-CoV-2 neutralization in public antibody responses

Understanding protective mechanisms of antibody recognition can inform vaccine and therapeutic strategies against SARS-CoV-2. We discovered a new antibody, 910-30, that targets the SARS-CoV-2 ACE2 receptor binding site as a member of a public antibody response encoded by IGHV3-53/IGHV3-66 genes. We performed sequence and structural analyses to explore how antibody features correlate with SARS-CoV-2 neutralization. Cryo-EM structures of 910-30 bound to the SARS-CoV-2 spike trimer revealed its binding interactions and ability to disassemble spike. Despite heavy chain sequence similarity, biophysical analyses of IGHV3-53/3-66 antibodies highlighted the importance of native heavy:light pairings for ACE2 binding competition and for SARS-CoV-2 neutralization. We defined paired heavy:light sequence signatures and determined antibody precursor prevalence to be ~1 in 44,000 human B cells, consistent with public antibody identification in several convalescent COVID-19 patients. These data reveal key structural and functional neutralization features in the IGHV3-53/3-66 public antibody class to accelerate antibody-based medical interventions against SARS-CoV-2. HighlightsO_LIA molecular study of IGHV3-53/3-66 public antibody responses reveals critical heavy and light chain features for potent neutralization C_LIO_LICryo-EM analyses detail the structure of a novel public antibody class member, antibody 910-30, in complex with SARS-CoV-2 spike trimer C_LIO_LICryo-EM data reveal that 910-30 can both bind assembled trimer and can disassemble the SARS-CoV-2 spike C_LIO_LISequence-structure-function signatures defined for IGHV3-53/3-66 class antibodies including both heavy and light chains C_LIO_LIIGHV3-53/3-66 class precursors have a prevalence of 1:44,000 B cells in healthy human antibody repertoires C_LI

Study on newborn screening for Duchenne muscular dystrophy and diagnostic strategy / 中华医学遗传学杂志

OBJECTIVE@#To establish a newborn screening system for Duchenne muscular dystrophy (DMD) through assessment of MM isoenzyme of creatine kinase (CK-MM) activity.@*METHODS@#The CK-MM level was detected using dry blood spot filter paper from 10 252 male newborns. The results were grouped based on their gestational age, sampling time and intervals between the experiments. The threshold value for CK-MM necessitating genetic testing was determined. Next-generation sequencing (NGS) was carried out for those with a CK-MM value over the threshold, and the result was verified by multiplex ligation-dependent probe amplification (MLPA).@*RESULTS@#Based on the result of non-parametric rank sum test, the median CK-MM concentration has increased with the gestational age, and was inversely correlated with the age of the newborns among unaffected specimens. CK-MM on dry blood spot filter paper can be stable for 14 days at 2-8℃. Statistical analysis of CK-MM value of the 10 252 neonates suggested that the threshold may be set as 700 ng/mL. Exonic deletions were found in 2 confirmed cases, whose CK-MM level was greater than 2000 ng/mL.@*CONCLUSION@#Detection of CK-MM in dry blood spot filter paper has provided an effective method for newborn screening of DMD. This simple and inexpensive method can be used for large-scale screening, which is of great value to the early intervention and treatment of the disease.

Structure-Based Design with Tag-Based Purification and In-Process Biotinylation Enable Streamlined Development of SARS-CoV-2 Spike Molecular Probes

Biotin-labeled molecular probes, comprising specific regions of the SARS-CoV-2 spike, would be helpful in the isolation and characterization of antibodies targeting this recently emerged pathogen. To develop such probes, we designed constructs incorporating an N-terminal purification tag, a site-specific protease-cleavage site, the probe region of interest, and a C-terminal sequence targeted by biotin ligase. Probe regions included full-length spike ectodomain as well as various subregions, and we also designed mutants to eliminate recognition of the ACE2 receptor. Yields of biotin-labeled probes from transient transfection ranged from [~]0.5 mg/L for the complete ectodomain to >5 mg/L for several subregions. Probes were characterized for antigenicity and ACE2 recognition, and the structure of the spike ectodomain probe was determined by cryo-electron microscopy. We also characterized antibody-binding specificities and cell-sorting capabilities of the biotinylated probes. Altogether, structure-based design coupled to efficient purification and biotinylation processes can thus enable streamlined development of SARS-CoV-2 spike-ectodomain probes.

Correlation of the oxidative stress indices and Cd exposure using a mathematical model in the earthworm, Eisenia fetida.

With the increase in heavy metal pollution, it is of great significance to evaluate the ecological security and early warning of cadmium (Cd) contaminated soil. In this paper, a mathematical model was established for the first time by combining the advantages of the factor analysis method and the analytic hierarchy process, and was used to screen and analyze the ecological indices of oxidative stress in earthworms under Cd exposure. The experiment lasted for 40 days, removing one earthworm every 10 days. The Cd2+ concentration gradient was set at 0, 1, 10, 20, 100, 200, 400 and 800 mg kg-1. The ecological indices measured were total protein (TP), peroxidase (POD), superoxide dismutase (SOD), glutathione peroxidase (GPX), glutathione-S-transferase (GST), catalase (CAT), acetylcholinesterase (AChE) and malondialdehyde (MDA) levels. The results showed that when the earthworm was exposed to Cd2+ for 10 days and 30 days, in the head tissues, the key indices to focus on for monitoring were both POD. At 20 days and 40 days, the key indices were both TP. For the tail tissue tests, under Cd exposure for 10 days, the key indicator focused on for monitoring was MDA. After 20 days of exposure, the key monitoring indicator was AChE. At 30 days, it was CAT, and at 40 days, it was TP. This study provides a theoretical basis for the prompt, inexpensive, accurate and scientific early warning of metal contaminated soils and establishes a foundation for application of the screening model for other ecological indicators.

Role of circadian clock genes in the development and progression of nonalcoholic fatty liver disease / 临床肝胆病杂志

Circadian clock is an inherent biological rhythm of organism which forms in the long process of evolution to adapt to the changes in light and temperature due to day-night alternation. Circadian clock in humans is accurately regulated by various circadian clock genes at the molecular level and are hierarchically regulated by the central clock and the peripheral clock at the anatomical level. Recent studies have found that circadian clock genes can participate in intracellular lipid metabolism by regulating downstream clock-controlled genes, and the disorder of circadian clock genes can result in abnormal lipid metabolism, oxidative stress, insulin resistance, and abnormal secretion of glucocorticoids and inflammatory factors, which are closely associated with the pathogenesis of nonalcoholic fatty liver disease (NAFLD). The disorder of circadian clock genes can also increase the susceptibility to fatty liver disease and thus acts as a bridge that connects circadian clock genes and NAFLD. The pathogenesis of NAFLD remains unclear at present, and therefore, this article summarizes the recent studies on the association between circadian clock genes and NAFLD, so as to provide a theoretical basis for further clarifying the pathogenesis of NAFLD.

Study of brainstem auditory evoked potentials in children with Bell's palsy / 中国小儿急救医学

Objective To evaluate the function of auditory nerve and brainstem in children with Bell's palsy by using brainstem auditory evoked potential ( BAEP) . Methods A retrospective study was car-ried in total of 69 patients with Bell's palsy admitted in the pediatric department of Shengjing Hospital of China Medical University from January 2017 to January 2018. There were 33 males and 36 females,aged 1 to 12 years old. Sixty healthy children served as control group. BAEP were determined in 69 patients and 60 healthy subjects. EEG and CT or MRI of brain were performed to exclud tumor,intracranial infection and so on. The patients in the case group were divided into 2 groups:1-3 years old group (38 cases) and 4-12 years old group (31 cases). Sixty healthy children were also divided into 2 groups:1-3 years old group (30 cases) and 4-12 years old group (30 cases). Results The hearing threshold was normal in the children of the control group. There was no significant difference not only in potential latency but also internal potential latency of BAEP between right and left ear. The abnormal rate of BAEP was 39. 1％ ( 27/69 ) in case groups,19 cases of them recovered(70. 4％,19/27) after 2 weeks of clinical treatment. Another 8 patients re-covered after 2 months. The abnormality rate of EEG was 5. 8％ (4/69),and the abnormality rate of CT or MRI in head was 14. 5％ (10/69). Both were nonspecific changes. In the two groups,Ⅰ-Ⅲinternal potential latency was significantly shortened ( P <0. 05 ) , and Ⅲ-Ⅴinternal potential latency was significantly pro-longed (P<0. 05)respectively,between the normal side and abnormal side. There were significant differences in the Ⅲ potential latency(P<0. 05),Ⅰ-Ⅲinternal potential latency (P<0. 01),and Ⅲ-Ⅴ internal poten-tial latency ( P <0. 01 ) respectively, between pretherapy and post-treatment. Conclusion Bell's palsy of children could cause abnormal of auditory nerve conduction,and BAEP could find the electro physiologic ab-normality in nervous system,and guide clinical intervention.

Progress of Research on Intestinal Mucosal Injury Induced by Acute Exposure to High Altitude / 胃肠病学

High altitude environment is a special ecological environmental system. The specificity of this environment is the main reason of gastrointestinal reaction caused by acute exposure to high altitude. With the development of economy, more and more people come to the plateau,and gastrointestinal reaction caused by acute exposure to high altitude has attracted wide attention by scholars. This article briefly reviewed the mechanism of intestinal mucosal injury induced by acute exposure to high altitude.

Manual acupuncture versus electroacupuncture for menopausal syndrome:a randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To compare the clinical therapeutic effects and safety on menopausal symptoms between manual acupuncture (MA) and electroacupuncture (EA).</p><p><b>METHODS</b>Fifty patients were randomized into an MA group (25 cases) and an EA group (25 cases). In the MA group, the regular needling technique and pseudo-EA were used at Guanyuan (CV 4), Zigong (EX-CA 1), Tianshu (ST 25) and Sanyinjiao (SP 6). In the EA group, the acupoints were the same as the MA group and stimulated with EA and pseudo-MA (no manipulation applied in treatment), with disperse-dense wave, 10 Hz/50 Hz, 0.5 to 1.0 mA. In the two groups, the needles were retained for 30 min. The treatment was given once every two days, three times a week, totally for 8 consecutive weeks. The results of the menopause rating scale (MRS), the menopause-specific quality of life (MENQOL), the self-rating anxiety scale (SAS) and the self-rating depression scale (SDS), follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E) as well as adverse reactions were evaluated before treatment, in 4 and 8 weeks of treatment separately.</p><p><b>RESULTS</b>Compared with those before treatment, the scores of MRS, MENQOL, SAS and SDS were all reduced in the 4 and 8 weeks of treatment in the two groups (all<0.05). The results in 8 weeks of treatment were lower than those in 4 weeks of treatment in the two groups (all<0.05). The differen-ces were not significant statistically between the two groups (all>0.05). Compared with those before treatment, the levels of FSH and LH reduced and Eincreased after treatment in the two groups, without significant differences (all>0.05). The differences were not significant statistically between the two groups (all>0.05). The severe adverse reactions were not found in the treatment of the two groups.</p><p><b>CONCLUSIONS</b>Both manual acupuncture and electroacupuncture relieve the symptoms of depression and anxiety in menopausal syndrome,improve the living quality and do not induce apparent changes in serological sex hormones in the patients.</p>

Effect of Annexin A1 on the Cardiac Function and Inflammatory Response of Diabetic Rats / 中国医科大学学报

Objective To study the effect of annexin A1 on cardiac function,tumor necrosis factorα(TNF?α),and interleukin 1β(IL?1β)in diabetic rats. Methods Twenty?four SD rats were randomly divided into normal control and diabetic groups. The type 2 diabetes model was in?duced with a high?glucose and high?fat diet and administration of low?dose streptozotocin.Left ventricular end?diastolic volume(LVEDV),left ven?tricular end?systolic volume(LVESV),peak velocity of early diastolic mitral?to?late diastolic peak velocity(e/a)ratio,left ventricular ejection frac?tion(LVEF),and stroke volume(SV)were measured by using color Doppler ultrasonography at the end of week 8. The expression levels of TNF?αand IL?1βin blood were measured by using enzyme?linked immunosorbent assay,and the expression level of annexin A1 in blood was measured at weeks 0,4,and 8 by using real?time polymerase chain reaction. Results Compared with the normal control group,the diabetic group had de?creased LVEDV,e/a,and SV(P<0.05).The annexin A1 expression level in the diabetic group decreased significantly after 8 weeks(P<0.01). The TNF?αand IL?1βlevels in the diabetic group were significantly higher than those in the normal control group(P<0.05)and increased signifi?cantly after 8 weeks(P<0.01). Annexin A1 level correlated with the TNF?αand IL?1βlevels in the diabetic group(P<0.01). Conclusion Annexin A1 expression shows an anti?inflammatory effect that improved the cardiac function of diabetic rats.

Spontaneous bilateral internal carotid artery dissection:a case report and literature review / 中华全科医师杂志

A patient with multiple ischemic stroke due to spontaneous bilateral internal carotid artery dissection (ICAD) was reported and the epidemiology, neuroimaging, clinical characteristics and treatment of spontaneous bilateral ICAD were reviewed.Spontaneous bilateral ICAD mostly occurs in young and middle-aged individuals and the clinical manifestations are mainly stroke(71.1%), headache and neck pain(62.2%), Horner's syndrome(15.6%) and cranial nerve palsy(11.1%).Cervical axial T1-weighted fat-suppressed image is an alternative to DSA to make the definite diagnosis.Antithrombotic therapy is regularly used and the general clinical outcome is good.Cervical arterial dissection is one of the most common causes of stroke in young and middle-aged patients.Cervical MRI T1-weighted fat suppressed image is crucial for timely diagnosis and initiation of appropriate clinical intervention.

Application of electromyography combined with magnetic resonance imaging in the diagnosis of brachial plexus injury in newborns / 中国小儿急救医学

Objective To investigate the characteristics of electromyography(EMG) and MRI in the diagnosis of brachial plexus injury in newborns.Methods First,the EMG examination was conducted in 30 newborns with brachial plexus injury,where the brachial plexus of the five major nerve conduction and muscle EMG activity were measured.Second,the brachial plexus MRI was conducted to compare with the first examination.Results EMG revealed that 25 cases of upper and middle trunk palsy(83.3%),4 cases of total plexus palsy(13.3%) and 1 case of lower trunk palsy(3.3%) in the 30 cases,as well as 6 cases of plexus pre-ganglionic injury(20.0%),7 cases of complete injury(23.3%),23 cases of incomplete injury (76.7%).MRI showed that 5 cases of upper and middle trunk palsy(16.7%),1 case of total plexus palsy (3.3%),1 case of lower trunk palsy(3.3%),and 7 cases of plexus pre-ganglionic injury(23.3%)in the whole 30 cases.Conclusion EMG and MRI are both helpful to localize the brachial plexus injury.But EMG performs better compared with MRI towards the slight incomplete injury.Therefore,the combination of both methods can provide an accurate guidance for diagnosis.

Anti-inflammatory and analgesia effects of electroacupuncture device of point injection on rats of inflammatory pain / 中国针灸

<p><b>OBJECTIVE</b>To explore the anti-inflammatory and analgesia mechanism of electroacupuncture (EA) device of point injection (PI) on rats of inflammatory pain.</p><p><b>METHODS</b>48 Sprague Dawley (SD) rats were randomly assigned into a control group, a model group, an EA+PI group, an EA device of PI (EAPI) group, an EA group and a PI group, eight rats in each one. The rats in the control group were subcutaneously injected with 50 μL of liquid paraffin oil solvent into the dorsum of left hindpaw, while rats in the remaining groups were treated with 50 μL of complete freund's adjuvant (CFA) at identical location to induce the model of inflammatory pain. After model establishment, the rats in the EA+PI group, EAPI group, EA group and PI group were treated with EA+PI,EA device of PI, EA and PI, respectively, once every other day (the 2nd day, 4th day and 6th day). Each treatment was given for 30 min. The mechanical withdrawal threshold, thermal withdrawal threshold and foot swelling before and 1 d to 6 d after model establishment were observed; the western blotting method was applied to measure IL-1β expression in inflammatory tissue of skin.</p><p><b>RESULTS</b>After model establishment, compared with the control group, the mechanical withdrawal threshold and thermal withdrawal threshold were reduced (all<0.05) and the foot swelling was increased in the rest groups (all<0.05). After treatment, the mechanical withdrawal threshold and thermal withdrawal threshold in the EAPI group were significantly increased compared with those in the EA+PI group, EA group and PI group (all<0.05), but the foot swelling was reduced (all<0.05). The IL-1β expression in the model group was higher than that in the control group (<0.05); after treatment, the IL-1β expression in the EAPI group was lower than that in the model group, EA group and PI group (all<0.05), but no significantly different from that in the EA+PI group (>0.05).</p><p><b>CONCLUSIONS</b>The efficacy of EA device of PI on inflammatory pain is superior to EA combined with PI, EA alone and PI alone, which is suitable for further popularization and application.</p>