A new form of familial platelet disorder caused by germline mutations in RUNX1 in a pedigree / 中华内科杂志

Objective: To investigate the clinical and biological characteristics of familial platelet disorder (FPD) with germline Runt-related transcription factor (RUNX) 1 mutations. Methods: Patients diagnosed with myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML) with RUNX1 mutations from February 2016 to December 2021 in Wuhan No.1 Hospital underwent pedigree analysis and were screened for gene mutations (somatic and germline). Patients diagnosed with FPD with germline RUNX1 mutations were enrolled and evaluated in terms of clinical characteristics and biological evolution. Bioinformatics analysis was used to assess the pathogenicity of mutations and to analyze the effect of mutated genes on the function of the corresponding protein. Results: Germline RUNX1 mutations were detected in three out of 34 patients suffering from MDS/AML who had RUNX1 mutations. A pedigree of FPD with RUNX1 (RUNX1-FPD) c.562A>C and RUNX1 c.1415T>C mutations was diagnosed, and the mutations were of patrilineal origin. Bioinformatics analysis indicated that the locus at positions 188 and 472 in the AML-1G type of RUNX1 was highly conserved across different species, and that variations might influence functions of the proteins. The mutations were evaluated to be highly pathogenic. Of the nine cases with germline RUNX1 mutations: two patients died due AML progression; one case with AML survived without leukemia after transplantation of hemopoietic stem cells; four patients showed mild-to-moderate thrombocytopenia; two cases had no thrombocytopenia. During the disease course of the proband and her son, mutations in RUNX1, NRAS and/or CEBPA and KIT appeared in succession, and expression of cluster of differentiation-7 on tumor cells was enhanced gradually. None of the gene mutations correlated with the tumor were detected in the four cases not suffering from MDS/AML, and they survived until the end of follow-up. Conclusions: RUNX1-FPD was rare. The mutations c.562A>C and c.1415T>C of RUNX1 could be the disease-causing genes for the family with RUNX1-FPD, and these mutations could promote malignant transformation. Biological monitoring should be carried out regularly to aid early intervention for family members with RUNX1-FPD.

Exploration on new role of ancient perilous but key acupoint of renying (ST 9) / 中国针灸

The specific functions, stimulating methods and ranges of clinical application of Renying (ST 9) are explored. Because Renying (ST 9) is located in the neck which is a dangerous area, it is perilous if the acupoint is stimulated, so it is mostly forbidden in the past dynasties. In recent years, the main stimulating methods for Renying (ST 9) include acupuncture and press. The keys of acupuncture are to apply correct technique of needle insertion and control the depth and direction of needle. The keys of press are focused on strength and time of press. Renying (ST 9) is effective for vertigo, palpitation, asthma, hemiplegia, aphasia, hysteria, acute attack of pain, hyperplasia of mammary, continuous hiccup, disorder of throat and so on. As long as the acupoint location is accurate, manipulation is careful and stimulating method is correct, not only the safety could be guaranteed, but also the function can be well-played in clinical application.

Innovative application of Yingxiang (LI 20) and Neiyingxiang (EX-HN 9) in acupuncture verses / 中国针灸

The ancient discussion and modern clinical application regarding Yingxiang (LI 20) and Neiyingxiang (EX-HN 9) in acupuncture verses are explored. Acupuncture verses are the summary of clinical experiences of acupuncture scholars in the past dynasties, of which the records on application of Yingxiang (LI 20) and Neiyingxiang (EX-HN 9) mainly focused on nasal, facial and head-eye diseases, which is characterized with overall summarization, brilliant exposition, simple language, and distinctive characteristics. Nowadays, based on the ancient usage, the clinical application about these two acupoints is continuously developing. If the ancient acupuncture verses could be understood thoroughly, the clinical practice could be better guided and its effects could be improved.

Application of Tiantu (CV 22) in emergency / 中国针灸

The operation and application of Tiantu (CV 22) in emergency are discussed in the paper. The stimulating methods at Tiantu (CV 22) are acupuncture and pressing technique. The correct insertion of needle and proper depth and direction of insertion are required during acupuncture. The pressing technique stress the pressing strength and pressing time. Acupuncture or pressing technique is suitable for the emergent measurement of asthma, asthmatic breathing, coma, blockage of phlegm, hiccup, sore throat, etc. It is indicated that Tiantu (CV 22) is the key point in the emergency and phlegm resolving. Based on the characteristics of the point as promoting qi circulation, reducing the reversed qi and resolving phlegm, in light of the proper points combination by different syndromes and in terms of the correct and safe stimulating methods, Tiantu (CV 22) can achieve the immediate therapeutic effects in the emergent situations.

Application of intensive moxibustion with ginger paste / 中国针灸

The manipulations, range of application and characteristics of intensive moxibustion with ginger paste are discussed in this article. Adjustment is made on the base of traditional moxibustion with ginger slice. Fresh ginger is smashed, and the ginger paste is applied on acupoints. Two to 3 moxa sticks are ignited together in moxibustion at each point, and long duration of treatment of 30 to 60 min is adopted. The effects of the above mentioned moxibustion on dysfunction of the internal organs, postpartum diseases, hyperplasia, furuncle and diseases of bones, joints and muscles are obviously better than that of the traditional way. Thus, it is concluded that the effect of intensive moxibution with ginger paste is remarkable in promoting qi and blood circulation, warming up yang qi and regulating the functions of zang-fu organs. The potency of ginger can reach a deeper part with the heat produced by moxibustion. The heat is even and easy to be controlled. Moreover, the manipulation is simple, practical, safe and effective.

Clinical application of the penetrating needling technique from Yemen (TE 2) to Zhongzhu (TE 3) / 中国针灸

The penetrating technique of acupuncture from Yemen (TE 2) to Zhongzhu (TE 3) acts on the extraordinary effect of promoting Shaoyang meridian qi. The technique is specially good for heat pattern/syndrome of the triple energizer and it is commonly used in the treatment of common cold, high fever, anhidrosis in heat pattern/syndrome, migraine, redness, swelling and pain of the eye, tinnitus, ear pain, swelling and pain of the teeth, ulcers in the mouth and tongue, sore throat, neck rigidity, etc. In the manipulation, the needle is inserted from Yemen (TE 2), going obliquely upward along the metacarpal interspace to Zhongzhu (TE 3). With this technique, the Ying-spring and Shu-stream acupoints can be stimulated simultaneously with one needle. This method is characterized as less acupoints, exquisite needling, strong sensation, easy and safe manipulation, remarkable immediate effect and high curative rate of single treatment. Hence, it is worthy of application in clinical practice.

Case analysis on problem-based learning of acupuncture: "a turning round before birth" / 中国针灸

"A turning round before birth" is a problem-based learning (PBL) case in Chinese medicine education. It focuses on malposition of fetus, through discussion on a series of questions, types and causative factors of malposition of fetus could be comprehended, diagnostic time and methods are set up, and manipulations of moxibustion at Zhiyin (BL 67) for malposition of fetus can be mastered. Mechanism on position correction is explored, and key points in application are clarified. Therefore, methods of position correction with easy, safe and effective manipulations can be popularized as well as the PBL methods in education of Chinese medicine.

Effects of moxibustion preconditioning on SOD and MDA in rats with global brain ischemia / 中国针灸

<p><b>OBJECTIVE</b>To reveal the mechanism of moxibustion preconditioning in preventive brain-protecting action.</p><p><b>METHODS</b>The rat model of global brain ischemia was made with 4-artery ligation method. 78 Wistar rats were randomly divided into 5 groups: normal control group, sham-operation group, brain ischemia group, brain ischemia preconditioning group and moxibustion preconditioning group. The brain was taken 24 h, 48 h and 72 h after operation in the all groups, respectively, for determination of SOD activities by xanthine oxidase method and MDA content by thibabituric acid method.</p><p><b>RESULTS</b>The SOD activity significantly increased, especially 24 h after the moxibustion preconditioning, and the MDA content decreased significantly with a very significant difference as compared with the ischemia group(P<0.01).</p><p><b>CONCLUSION</b>Moxibustion preconditioning exerts the protective action on the brain tissue of ischemia and anoxia through increasing the endogenous anti-oxidase activity.</p>