[Textual research on the evolution of therapeutic indications of Fenglong (ST 40): discussion on the related articles for "Fenglong (ST 40) for phlegm" published in Chinese Acupuncture and Moxibustion].

Based on Huangdi Neijing (Yellow Emperor's Internal Classic), combined with the Huangdi Mingtang Jing JiJiao (Compilation and Correction of Yellow Emperor's Mingtang Classic) and unearthed Tianhui Yijian (Tianhui Medical Bamboo Slips), it is recognized that the therapeutic indications of Fenglong (ST 40) were recorded repeatedly in many medical works of the Qin and Han dynasties; and the treatments mostly focus on "upward reversion of qi ". In Huangdi Mingtang Jing (Yellow Emperor's Mingtang Classic), a part of symptoms were re-described textually, which affects the understanding on the indications of Fenglong (ST 40) in the medical works of the later generations. On the basis of the construction of phlegm theory in the Sui and Tang dynasties, the scholars of Song, Jin and Yuan dynasties had placed the emphasis on the relationship between phlegm and qi movement. In acupuncture works by Dou Hanqing, Fenglong (ST 40) was selected in treatment of phlegm dampness and phlegm-induced asthma, which is also based on the pathogenesis, "upward reversion of qi ", rather than "phlegm" itself. This view can be understood by the proof of "reducing Zusanli (ST 36) for eliminating wind". The relationship between Fenglong (ST 40) and phlegm was emphasized in Yulong Ge (Jade Dragon Verse) and Zhenfang Liuji (Six Sets of Acupuncture Methods), after which, the understanding, " Fenglong (ST 40), the key point for phlegm disorders", had been formed gradually since the Ming dynasty. The formation and evolution of the therapeutic indications of Fenglong (ST 40) are influenced comprehensively by the errors in textual duplication, cultural background, changes in the term expressions of disorders, and the clinical experience of medical practitioners.

Multi-locus sequence typing, antimicrobials resistance and virulence profiles of Salmonella enterica isolated from bovine carcasses in Minas Gerais state, Brazil.

The aim of this study was to identify virulence and antimicrobial resistance profiles and determine the sequence type (ST) by multilocus sequence typing (MLST) of Salmonella enterica isolates from bovine carcasses from slaughterhouse located in Minas Gerais state, Brazil, and its relationship with bovine isolates obtained on the American continent based on sequence type profile. The MLST results were compared with all Salmonella STs associated with cattle on American continent, and a multi-locus sequence tree (MS tree) was built. Among the 17 S. enterica isolates, five ST profiles identified, and ST10 were the most frequent, grouping seven (41.2%) isolates. The isolates presented 11 different profiles of virulence genes, and six different antibiotics resistance profiles. The survey on Enterobase platform showed 333 Salmonella STs from American continent, grouped into four different clusters. Most of the isolates in the present study (13/17), were concentrated in a single cluster (L4) composed by 74 STs. As a conclusion, five different STs were identified, with ST10 being the most common. The isolates showed great diversity of virulence genes and antibiotics resistance profiles. Most of the isolates of this study were grouped into a single cluster composed by 74 STs formed by bovine isolates obtained on the American continent.

Incidence and Genomic Background of Antibiotic Resistance in Food-Borne and Clinical Isolates of Salmonella enterica Serovar Derby from Spain.

Salmonella enterica serovar Derby (S. Derby) ranks fifth among nontyphoidal Salmonella serovars causing human infections in the European Union. S. Derby isolates (36) collected between 2006 and 2018 in a Spanish region (Asturias) from human clinical samples (20) as well as from pig carcasses, pork- or pork and beef-derived products, or wild boar (16) were phenotypically characterized with regard to resistance, and 22 (12 derived from humans and 10 from food-related samples) were also subjected to whole genome sequence analysis. The sequenced isolates belonged to ST40, a common S. Derby sequence type, and were positive for SPI-23, a Salmonella pathogenicity island involved in adherence and invasion of the porcine jejune enterocytes. Isolates were either susceptible (30.6%), or resistant to one or more of the 19 antibiotics tested for (69.4%). Resistances to tetracycline [tet(A), tet(B) and tet(C)], streptomycin (aadA2), sulfonamides (sul1), nalidixic acid [gyrA (Asp87 to Asn)] and ampicillin (blaTEM-1-like) were detected, with frequencies ranging from 8.3% to 66.7%, and were higher in clinical than in food-borne isolates. The fosA7.3 gene was present in all sequenced isolates. The most common phenotype was that conferred by the tet(A), aadA2 and sul1 genes, located within identical or closely related variants of Salmonella Genomic Island 1 (SGI1), where mercury resistance genes were also present. Diverse IncI1-I(α) plasmids belonging to distinct STs provided antibiotic [blaTEM-1, tet(A) and/or tet(B)] and heavy metal resistance genes (copper and silver), while small pSC101-like plasmids carried tet(C). Regardless of their location, most resistance genes were associated with genetic elements involved in DNA mobility, including a class one integron, multiple insertion sequences and several intact or truncated transposons. By phylogenetic analysis, the isolates were distributed into two distinct clades, both including food-borne and clinical isolates. One of these clades included all SGI1-like positive isolates, which were found in both kinds of samples throughout the entire period of study. Although the frequency of S. Derby in Asturias was very low (0.5% and 3.1% of the total clinical and food isolates of S. enterica recovered along the period of study), it still represents a burden to human health linked to transmission across the food chain. The information generated in the present study can support further epidemiological surveillance aimed to control this zoonotic pathogen.

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.

[Re-discussion on "Fenglong (ST 40) for phlegm"].

After reading the article, Tracing Origin and Development of "Fenglong (ST 40) for Phlegm": Examination and Verification published in Chinese Acupuncture & Moxibustion, the authors collected the original evidences also for the effect of Fenglong (ST 40) on phlegm disorders by tracing from 9 ancient books of acupuncture and moxibustion, explored the standardized expressions of its indications and analyzed the changes of its indications. In that article, it was viewed that the effect of Fenglong (ST 40) started to be generalized in treatment of phlegm disorders since the Ming Dynasty. On contrary, we believes that Fenglong (ST 40) works on strengthening the spleen and resolving dampness for the disorders caused by the broad meaning of "phlegm/damp". Based on it, since the Ming Dynasty, the effect of Fenglong (ST 40) is extended specifically for the disorders caused by the visible sputum from the lung, the narrowing mean of "phlegm". Hence, if "Fenglong (ST 40) for phlegm" is considered as an academic point of view, it needs an adequate evidences to expound and prove.

Re-discussion on "Fenglong (ST 40) for phlegm" / 中国针灸

After reading the article, Tracing Origin and Development of "Fenglong (ST 40) for Phlegm": Examination and Verification published in Chinese Acupuncture & Moxibustion, the authors collected the original evidences also for the effect of Fenglong (ST 40) on phlegm disorders by tracing from 9 ancient books of acupuncture and moxibustion, explored the standardized expressions of its indications and analyzed the changes of its indications. In that article, it was viewed that the effect of Fenglong (ST 40) started to be generalized in treatment of phlegm disorders since the Ming Dynasty. On contrary, we believes that Fenglong (ST 40) works on strengthening the spleen and resolving dampness for the disorders caused by the broad meaning of "phlegm/damp". Based on it, since the Ming Dynasty, the effect of Fenglong (ST 40) is extended specifically for the disorders caused by the visible sputum from the lung, the narrowing mean of "phlegm". Hence, if "Fenglong (ST 40) for phlegm" is considered as an academic point of view, it needs an adequate evidences to expound and prove.

[Tracing origin and development of "Fenglong (ST 40) for phlegm": examination and verification].

From the perspective of academic history, the background and evolution of "Fenglong (ST 40) for phlegm" were systematically summarized. As a result, it was found that in the early period, Fenglong (ST 40) was used for "tangible phlegm" of respiratory tract, but in the later generations, due to the comprehensive effects of various factors, the phlegm treated by Fenglong (ST 40) was generalized. In modern clinical practice of acupuncture and moxibustion, Fenglong (ST 40) is widely used for phlegm-related diseases. In addition, the knowledge content represented by "Fenglong (ST 40) for phlegm" showed evolution and change in academic heritage of previous dynasties. It is necessary for modern acupuncture researchers to systematically sort out, test and discriminate the habitual knowledge in combination with the background of traditional Chinese medicine, so as to promote the contemporary inheritance and application of traditional acupuncture theory and knowledge.

Chromosomally Located fosA7 in Salmonella Isolates From China.

This study aimed to investigate the prevalence of fosfomycin fosA7 in Salmonella enterica isolates from food animals and retail meat products in China and the impact of fosA7 on bacterial fitness. A total of 360 Salmonella isolates collected from 11 provinces and cities in China were detected for fosA7. All fosA7-positive Salmonella isolates were determined minimum inhibitory concentrations (MICs) and sequenced by Illumina Hiseq. The fosA7 gene of S. Derby isolate HA2-WA5 was knocked out. The full length of fosA7 was cloned into vector pBR322 and then transformed into various hosts. MICs of fosfomycin, growth curves, stability, and fitness of fosA7 were evaluated. The fosA7 gene was identified in S. Derby (ST40, n = 30) and S. Reading (ST1628, n = 5). MICs to fosfomycin of 35 fosA7-positive isolates were 1 to 32 mg/L. All fosA7 were located on chromosomes of Salmonella. The deletion of fosA7 in HA2-WA5 decreased fosfomycin MIC by 16-fold and slightly affected its fitness. The acquisition of plasmid-borne fosA7 enhanced MICs of fosfomycin in Salmonella (1,024-fold) and Escherichia coli (16-fold). The recombinant plasmid pBR322-fosA7 was stable in Salmonella Typhimurium, S. Pullorum, S. Derby, and E. coli, except for Salmonella Enteritidis, and barely affected on the growth of them but significantly increased biological fitness in Salmonella. The spread of specific Salmonella serovars such as S. Derby ST40 will facilitate the dissemination of fosA7. fosA7 can confer high-level fosfomycin resistance and enhance bacterial fitness in Salmonella if transferred on plasmids; thus, it has the potential to be a reservoir of the mobilized fosfomycin resistance gene.

Tracing origin and development of "Fenglong (ST 40) for phlegm": examination and verification / 中国针灸

From the perspective of academic history, the background and evolution of "Fenglong (ST 40) for phlegm" were systematically summarized. As a result, it was found that in the early period, Fenglong (ST 40) was used for "tangible phlegm" of respiratory tract, but in the later generations, due to the comprehensive effects of various factors, the phlegm treated by Fenglong (ST 40) was generalized. In modern clinical practice of acupuncture and moxibustion, Fenglong (ST 40) is widely used for phlegm-related diseases. In addition, the knowledge content represented by "Fenglong (ST 40) for phlegm" showed evolution and change in academic heritage of previous dynasties. It is necessary for modern acupuncture researchers to systematically sort out, test and discriminate the habitual knowledge in combination with the background of traditional Chinese medicine, so as to promote the contemporary inheritance and application of traditional acupuncture theory and knowledge.

Genomic characterization of enteropathogenic Escherichia coli (EPEC) of avian origin and rabbit ileal loop response; a pet macaw (Ara chloropterus) as a possible zoonotic reservoir.

Enteropathogenic Escherichia coli (EPEC) constitutes one of the main causes of mortality in children in low- to medium-income countries. Diverse animal species have been linked as reservoirs, including birds. The aim of this study was to describe the genomic and phylogenetic features of an EPEC recovered from a pet macaw and further characterizing the macro and microscopic lesion in a rabbit ileal loop experimental model. The isolate was whole-genome sequenced (WGS) obtaining its genotypic and phenotypic in silico characteristics and inoculated in a rabbit experimental model with subsequently evaluating the strain's pathogenicity by scanning electron microscopy (SEM) and histopathology. The isolate was characterized as O109:H21-B1-ST40 typical EPEC, harboring several virulence factors of diarrheagenic E. coli. The macaw EPEC genome was located in a monophyletic clade of human and animal ST40 EPEC sequences. In vivo inoculation demonstrated severe hemorrhage with SEM and histopathological analysis confirming these lesions to be associated with intra-epithelial lymphocytes. Therefore, the isolate not only shared several genotypic and phylogenetic similarities with EPEC that affects humans and animals, but was able to induce severe tissue injury in a mammal model. These findings highlight the underrated role of pet birds as zoonotic reservoirs and the diversity in virulence factors being unraveled by new WGS studies.

Therapeutic Observation of Acupoint Injection at Fenglong (ST 40) with Promethazine for Posterior Circulation Ischemic Vertigo Due to Turbid Phlegm Obstructing the Middle / 上海针灸杂志

Objective To observe the clinical efficacy of acupoint injection at Fenglong (ST 40) with Promethazine in treating posterior circulation ischemic vertigo (PCIV) due to turbid phlegm obstructing the middle.Method Sixty-two patients with PCIV due to turbid phlegm obstructing the middle were randomized into a treatment group and a control group, 31 cases each. The two groups both received intravenous infusion of Vinpocetine injection, based on which, the treatment group was intervened by injection at Fenglong (ST 40) with Promethazine, while the control group was given gluteal intramuscular injection of Promethazine. The traditional Chinese medicine (TCM) syndrome score and Dizziness Handicap Inventory (DHI) were observed for the two groups before and after the treatment, and the clinical efficacies were also compared.Result The TCM syndrome and DHI scores were significant changed after the intervention in both groups (P<0.05). After the treatment, the TCM syndrome and DHI scores in the treatment group were significantly different from those in the control group (P<0.05). The total effective rate was 93.5％ in the treatment group versus 80.6％ in the control group, and the between-group difference was statistically significant (P<0.05).Conclusion Injection at Fenglong (ST 40) with Promethazine is an effective method in treating PCIV due to turbid phlegm obstructing the middle.

Therapeutic observation on electroacupuncture at Zusanli (ST 36) and Fenglong (ST 40) for senile dementia / 针灸推拿医学（英文版）

Objective: To explore the clinical effects of electroacupuncture (EA) at Zusanli (ST 36) and Fenglong (ST 40) in treating senile dementia. Methods:A total of74 patients were randomly divided into an EA group and a medication group based upon the random digital table, 37 cases in each group. EA at Zusanli (ST 36) and Fenglong (ST 40) was given in the EA group, once every day, for six treatments per week. Donepezil Hydrochloride Tablets were given to the medication group, 5 mg per time and once a day in the former four weeks, 10 mg per time and once a day after 4 weeks, oral administration before sleep at night. The courses of the treatment were 12 weeks in both groups. The scores of mini-mental state examination (MMSE) and Barthel index (BI) were observed before and after the treatment, for processing the comparative analysis of the clinical effects after the course of the treatment. Results:The total effective rate was 86.5% in the EA group and 70.3% in the medication group. The therapeutic effect was better in the EA group than that in the medication group, and the difference between the two groups was statistically significant (P<0.05). MMSE and BI scores after the treatment in the two groups were all elevated than those of the same groups before the treatment (P<0.05,P<0.01). The improving situation was obviously better in the EA group than that in the medication group, and the difference between the two groups was statistically significant (P<0.05). Conclusion:EA at Zusanli (ST 36) and Fenglong (ST 40) is affirmative in the therapeutic effect for senile dementia and can also improve the cognitive function and enhance the patients’ quality of life .

Study on cumulative effect of acupuncture on Fenglong (ST 40) to hemodynamics of PCA / 国际中医中药杂志

Objective To discuss the cumulative effect of acupuncture on left ST40 to hemodynamic of PCA.Methods Sixteen healthy young people were randomly chosen to be acupunctured on left ST40 and parameters of TCD such as Vs,Vd,Vm,PI and RI were managed to be recorded sequentially at the 5 points below to make out an statistical analysis:10 min before acupuncture; the time of inserting the needles; 15 min after retaining the needles; the time when taking the needles out; 10 min after the acupunture.Results The parameters of TCD Vs,Vd,Vm 10min after withdrawing the needle [Were ( 84.56± 19.72) cm/s、( 39.75 ±10.15 ) cm/s、(56.13 ± 14.73 ) cm/s each] all showed a decline compared with the parameters 10min before acupuncture(P＜0.05),while other parameters turned out to be almost the same (P＞0.05).Conclusion Acupuncture on left ST40 has cumulative effect on Vs,Vd and Vm,which suggest us the needle retention time should be noted.

Clinical Observation on Electroacupuncture for Nonalcoholic Steatohepatitis / 广州中医药大学学报

[Objective] To observe the therapeutic effect of electroacupuncture (EA) for nonalcoholic steatohepatitis (NASH). [Methods] One hundred and eight cases were randomized into two groups. Sixty NASH patients in EA group (group A) were treated by EA on Fenglong point with needie retaining for 10 min, once per day, breaking for one day after a 6-day treatment and repeating the treatment in the following weeks. Forty-eight in positive control group (group B) were given glucrolactone 0.2 g, tid and atorvastatin Tablets 10 mg, qd for 8 weeks. The therapeutic effect in the two groups was evaluated after treatment and the parameters of hepatic function, blood lipid and hepatic fibrosis, as well as the adverse reaction were observed before and after treatment. [Results] The total effective rate was 91.70% in EA group and 83.30% in the positive control group, the difference being significant (P