Association of Bone Morphogenetic Protein (BMP)/Smad Signaling Pathway with Fracture Healing and Osteogenic Ability in Senile Osteoporotic Fracture in Humans and Rats.

BACKGROUND To investigate the effect of the BMP/Smad signaling pathway on fracture healing and osteogenic ability in senile osteoporotic fracture on humans and rats. MATERIAL AND METHODS Sixty-two patients and well-matched normal controls were enrolled for clinical observation. A rat model of senile osteoporotic fracture was established. Serum BMP2 and Smad4 levels, as well as alkaline phosphatase (ALP) activity, were detected by ELISA. Fracture healing was observed by X-ray radiography and bone formation was analyzed by micro-CT. RESULTS Serum BMP2 and Smad4 levels in patients with senile osteoporotic fracture were significantly lower than those in normal controls (all P<0.01). BMP2 was highly positively correlated with Smad4 in patients with senile osteoporotic fracture (r=0.738). Compared with patients with low serum BMP2 and Smad4 levels, visual analog scale scores decreased, bone mineral density (BMD) increased, and duration of fracture healing was shortened in patients with high levels (all P<0.05). Compared with the Model group, serum BMP2 and Smad4 levels increased, fracture healing was improved, BMD, trabecular bone volume (TBV), tissue volume (TV), bone volume fraction (BV/TV), mean trabecular thickness (Tb. Th), and mean number of trabecular bone (Tb. N) were increased, and ALP activity increased in the BMP2 overexpression group (all P<0.05), while each index in the NC group showed no statistical difference relative to rats in the Model group (all P>0.05). CONCLUSIONS BMP2 overexpression can promote fracture healing and osteogenic ability in senile osteoporotic fractures through activating the BMP/Smad signaling pathway.

[WU Lian-zhong's experience in treating spasmodic torticollis by Kaiqiao Shunjin method].

Professor WU Lian-zhong's experience in treating spasmodic torticollis by Kaiqiao Shunjin method (resuscitation and regulating muscle) is summarized in this paper. The pathogenesis of spasmodic torticollis is the occluded brain orifices and delirium, qi disorder of meridian tendons, specifically divided into five categories: damp-heat, liver-yang hyperactivity, liver-kidney yin deficiency, deficiency of the governor vessel, excess of the governor vessel. The treatment should be based on the symptoms and the root causes, the symptoms should be the main treatment, and the root cause should be treated based on syndrome differentiation. The main treatment is Kaiqiao Shunjin method (resuscitation and regulating muscle), and to take the chief (five heart acupoints-Shuigou [GV 26], Laogong [PC 8], Yongquan [KI 1]), deputy (Yintang [GV 24+], Shangxing [GV 23] through Baihui [GV 20], Ximen [PC 4]), assistant (Fenglong [ST 40], Lianquan [CV 23], combined with tongue needle prick), envoy (Hanyan [GB 4]) as the basic main acupoints, at the same time cooperate with local acupoints to remove knots and accumulation. Finally, syndrome differentiation is adopted to dredge meridians and disperse knots, regulate the governor vessel, and nourish yin and dispel wind.

[Dynamic observation on therapeutic features of thalamic pain by mind calming, blood activating and pain relief acupuncture and carbamazepine].

OBJECTIVE: To observe therapeutic features of thalamic pain by mind Calming, blood activating and pain relief acupuncture and Carbamazepine. METHODS: Crossover trial design was adopted. Eleven patients with confirmed diagnosis of thalamic pain were randomly assigned to two groups according to the minimal unbalance index method, i.e., Group I (Six patients received acupuncture first and then Western medicine.) and Group II (Five patients received Western medicine first and then acupuncture). The therapeutic course for each group was ten days. There was a ten-day elution phase between the two therapeutic methods. The total therapeutic course was thirty days. Eleven patients were enrolled in the two groups for statistical analysis. The therapeutic efficacy was assessed with visual analogue scale (VAS) and the pain assessment scale of Anderson Cancer Center in the USA (MD Pain Evaluation value) respectively. The VAS and MD values of the two groups were recorded every day to get the dynamic curve. RESULTS: The VAS and MD values obviously decreased in the two groups after treatment (P<0.05). The pain curves of the two groups showed a declining trend during the treatment. A gradual and stable descending process was shown in the acupuncture group. But a greater decrease first appeared in the Western medicine group, then a comparatively greater decrease occurred after one platform stage, showing ladder-shaped curve. CONCLUSIONS: Cumulative potency may be the main analgesic effects of acupuncture. Western medicine may possibly play a role by rapid initiate effect.

[Professor WU Lian-zhong's clinical experience for treating post-stroke distal limb dyskinesia].

Professor WU Lian-zhong's experience for treating post-stroke distal limb dyskinesia is introduced from the aspects of syndrome differentiation principles, clinical acupoint selection and acupuncture manipulation. Professor WU proposes the original syndrome differentiation system of "ten factors" for stroke, and emphasizes the importance of spirit differentiation and syndrome differentiation. The syndrome differentiation focus on the three yang meridians and kidney meridian, as such, Quchi (LI 11), Shousanli (LI 10), Waiguan (TE 5), Hegu (LI 4), Zhongzhu (TE 3), Sidu (TE 9), Zusanli (ST 36), Fenglong (ST 40), Tengyue point, Taichong (LR 3), Xiangu (ST 43), Zulinqi (GB 41), Dazhong (KI 4), Genjian point, Zhaohai (KI 6), Fuliu (KI 7) and Taixi (KI 3) are selected. In addition, professor WU develops clear quantitative standards for acupuncture manipulation.

A Web of Science-based scientometric analysis about mammalian target of rapamycin signaling pathway in kidney disease from 1986 to 2020.

BACKGROUND: The mammalian target of rapamycin (mTOR) signaling pathway is vital for the regulation of cell metabolism, growth and proliferation in the kidney. This study aims to show current research focuses and predict future trends about mTOR pathway in kidney disease by the methods of scientometric analysis. METHODS: We referred to publications from the Web of ScienceTM Core Collection (WoSCC) Database. Carrot2, VOSviewer and CiteSpace programs were applied to evaluate the distribution and contribution of authors, institutes and countries/regions of extensive bibliographic metadata, show current research focuses and predict future trends in kidney disease's area. RESULTS: Until July 10, 2020, there are 2,585 manuscripts about mTOR signaling pathway in kidney disease in total and every manuscript is cited 27.39 times on average. The big name of course is the United States. Research hot spots include "diabetic nephropathy", "kidney transplantation", "autosomal dominant polycystic kidney disease", "tuberous sclerosis complex", "renal cell carcinoma" and "autophagy". Seven key clusters are detected, including "kidney transplantation", "autosomal dominant polycystic kidney disease", "renal transplantation", "renal cell carcinoma", "hamartin", "autophagy" and "tuberous sclerosis complex". CONCLUSIONS: Diabetic nephropathy, kidney transplantation, autosomal dominant polycystic kidney disease, tuberous sclerosis complex, renal cell carcinoma and autophagy are future research hot spots by utilizing scientometric analysis. In the future, it is necessary to research these fields.

[The essence of Professor Wu Lian-Zhong's acupuncture manipulation].

The painless needle insertion technique, summarized by Professor WU Lian-zhong during his decades of acupuncture clinical practice is introduced in this article, which is characterized as soft, flexible, fast, plucking and activating antipathogenic qi. The Sancai (three layers) lifting and thrusting manipulation technique is adopted by Professor WU for getting the qi sensation. And features of 10 kinds of needling sensation such as soreness, numbness, heaviness, distension, pain, cold, hot, radiation, jumping and contracture are summarized. Finger force, amplitude, speed and time length are also taken as the basis of reinforcing and reducing manipulations. Moreover, examples are also given to explain the needling technique on some specific points which further embodies Professor WU's unique experiences and understandings on acupuncture.

[A secondary discussion on acupoint characteristic].

With references of historical materials and modern literature regarding acupoint characteristic, a secondary analysis on the concept, origin, related factors and research methods in present research of acupoint characteristic is performed. The acupoint characteristic should be considered as an acupoint inherent attribute that could explain physiological and pathological manifestations at the same time, including location attribute and function attribute, which is related with time and treatment method. Some re-thinking on acupoint characteristic is proposed as well as advice on further research method and direction, hoping to promote the research development of acupoint characteristic.

[Acupuncture treatment of regulating spirit, activating blood and relieving pain for thalamic pain].

OBJECTIVE: To compare the clinical effect of acupuncture treatment and western medicine Carbamazepine for thalamic pain. METHODS: Crossover trial design was used, 11 cases diagnosed as thalamic pain were randomly divided into two groups according to the mini-unbalance-index method, group I (with 6 cases received acupuncture first and then western medicine) and group II (with 5 cases received western medicine first and then acupuncture). When the effects were evaluated, the two groups were named as acupuncture group and western medicine group, 11 cases in each group. The method of clearing away the heart fire, regulating the spirit, activating blood and relieving pain was adopted in acupuncture treatment, Ximen (PC 4), Yinxi (HT 6), Xuehai (SP 10) and Zhaohai (KI 6) were selected; the western medicine group was treated with oral administration of Carbamazepine, and one course as well as the eluting period were both 10 days. The effects were evaluated with visual analogue scale (VAS) and evaluation scale of Anderson Cancer Center pain in US (MD Pain Evaluation value) respectively. RESULTS: The VAS and MD value in two groups were obviously decreased after treatment (both P < 0.05), while there was no significant difference between two groups; the markedly effective rate of pain relieving in acupuncture group was 63.6% (7/11), which was higher than that of 36.4% (4/11) in western medicine group, but there was no significant difference between two groups. CONCLUSION: Acupuncture treatment of regulating spirit, activating blood and relieving pain has a better therapeutic effect for thalamic pain, and can reach to the same therapeutic effect with western medicine Carbamazepine.

[Treatment of spasmodic torticollis by differentiation of symptoms and signs].

Spasmodic torticollis belongs to local dysmyotonia and it is a difficult and complicated disease with unknown pathogenic factor. The clinical effects of medication and operation on it are not satisfactory and there is not a safe and effective therapy for this disease at home and abroad. The authors apply flexibly the theory of treatment based on syndrome differentiation and fully exert the advantages of TCM to analyze the disease from pathogenic factor, disease and syndrome, pathogenesis and so on, and originally create acupuncture at "Wu Xin Xue" for treatment of this disease with Kaiqiao Shunjin method (resuscitation and regulating muscle) as main, clinically attaining satisfactory therapeutic effect.

[Prof. WU Lian-zhong's 12 acupuncture analgesic methods].

Prof. WU Lian-zhong not only has great theoretical attainments and rich clinical experience, but also is good at summarization and study, especially, systematically and deep study on various kinds of pain from etiology, pathogenesis, characteristics, classification and syndrome differentiation, treatment method and point selection and other aspects, and sums up the 12 treatment methods such as regulating mental activities, removing obstruction in the channels, opposing needling, blood-letting puncture, sixteen cleft points, warming the channels, resistant needling, Su needling, surrounding needling, tripod needling, penetration needling and dragon-tiger contending method, which are of very important significance for guiding clinical acupuncture analgesia.

[Professor Wu Lian-zhong's experience on four needling methods at Fengchi (GB 20)].

The paper introduces the manipulation and different clinical application examines of the 4 needling methods, oblique needling, horizontal needling, deep needling and transversal needling summarized by Prof. Wu Lian-zhong on the basis of many years's clinical work.