Objective To assess the therapeutic efficacy of trigger points (TrPs) combined with acupoints by acupuncture for subjective tinnitus (ST);To discuss the correlation of TrPs acupuncture inactivation and the releasing of symptom. Methods Sixty patients with ST were randomly divided into trial group and control group, 30 cases in each group. Those in trial group were acupunctured by TrPs combined with acupoints, and those in control group received regular acupuncture treatment. The scores of tinnitus severity assessment were available for effect evaluation after 3 treatment course. The size and tenderness degree of TrPs contraction knots were checked, and TrPs local thermal infrared spectrum was compared by infrared camera. Results The post-treatment tinnitus severity scores had significant difference compared with pre-therapy in each group (P<0.01). The total effective percentage of trial group with 93.33%(28/30) was obviously higher than control group with 86.67%(26/30) (P<0.05). The post-treatment and pre-therapy contraction knots size, tenderness and temperature difference of TrPs within trial groups had a very significant difference (P<0.01), and difference of tenderness and temperature of patients’ TrPs had a positive correlation with the difference of tinnitus severity scores before and after treatment (P<0.01). The contraction knots area of TrPs had not significant correlation with the difference of tinnitus severity scores (P>0.05). Conclusion TrPs combined with acupoints by acupuncture for ST patients are better than conventional acupoints in improving clinical symptoms. The deactivation of TrPs is closely related to tinnitus symptoms, therefore, temperature and tenderness of TrPs can be employed to assist in the diagnosis, or evaluated the tinnitus severity and therapeutic efficacy.

Objective: To investigate the electrophysiological mechanism of acupuncture for the visual cortex plasticity during the sensitive period. Methods: Fifty 2-week-old Wistar rats were randomly divided into a blank control group, a model group, an early-stage acupuncture group, a middle-stage acupuncture group and a late-stage acupuncture group, 10 rats in each group. Monocular deprivation amblyopia models were prepared in rats except those in the blank control group by unilateral eyelid suture. After successful modeling, no treatment was applied to the rats in the model group. Rats in each acupuncture group were treated with acupuncture at bilateral Jingming (BL 1), Cuanzhu (BL 2), Fengchi (GB 20) and Guangming (GB 37), started from the 3rd day, 12th day or 21st day after modeling separately, once a day, for a total of 9 d treatment. The neuronal discharge frequency and action potential inter-spike interval (ISI) in the rat visual cortex area 17 of each group were measured by multi-channel microelectrode array nerve signal technique. Results: The discharge number of neurons in the visual cortex of the model group was significantly lower than that in the blank control group (P<0.05). After treatment, the discharge numbers in the early-stage acupuncture group and the middle-stage acupuncture group were significantly higher than that in the model group (P<0.05). There was no significant difference in the discharge numbers between the late-stage acupuncture group and the model group (P>0.05). The discharge number in the middle-stage acupuncture group was lower than that in the early-stage acupuncture group (P<0.05), and the discharge number of the late-stage acupuncture group was lower than that in the middle-stage acupuncture group (P<0.05). The ISI sequences of the visual cortex neurons were mainly distributed under 0.3 s in the blank control group, under 15 s in the model group, under 1 s in the early-stage acupuncture group, under 4 s in the middle-stage acupuncture group, and under 10 s in the late-stage acupuncture group, divergent in each group. Conclusion: The neuronal coding appears abnormality in the visual cortex area 17 of monocular deprivation rats, indicating that there is a plasticity change in the visual cortex neurons during the sensitive period. Acupuncture has a significant effect on the abnormal neural coding. The therapeutic efficacy is closely related to the stage to start the treatment. Early stage treatment in the sensitive period is the key to achieving the good efficacy.

Depressive disorder seriously affects people's physical and mental health.Acupuncture is a safe and effective treatment for depression,yet,its mechanism is unclear.Therefore,acupuncture's action mechanism in intervening depression was summarized from several perspectives,including morphology and ultrastructure of neurons in depression-related brain areas,function and structure of glial cells,brain functional and structural connectivity,and neuroelectrophysiology.It's discovered that acupuncture can repair the morphological and ultrastructural damage of neurons in the hippocampus and prefrontal lobe,mitigate the functional and structural injuries of glial cells in the hippocampus and prefrontal lobe,strengthen functional connectivity and heal structural connection,and promote neuroelectrophysiological activities,which possibly are the principal mechanisms of how acupuncture works in intervening depressive disorder.

Objective To study the immunologic mechanism of electroacupuncture at Sanyin points on chronic abacterial prostatitis rats. Methods Forty-eight male rats were divided randomly into normal group, model group, drug group and electroacupuncture group, 12 rats in each group. The animal model was made by SC purified prostate protein twice with immunologic adjuvant, and the rats in electroacupuncture group and drug group were treated by electroacupuncture at Sanyin points and feeding Cernilton for 15 days. The changes of prostate weight, index, pathology and contents of IgG, expressions of IL-2 and IL-8 in prostate homogenate were observed. Results Compared with normal group, the prostate weight and index were significantly increased in model group (P<0.05), the content of IgG was significantly increased (P<0.05), cytokine IL-2 and IL-8 were highly expressed (P<0.05, P<0.01), prostate tissue’s morphology and structure were significantly impaired in model group. Compared with model group, the prostate weight and index were significantly decreased in electroacupuncture group after treatment (P<0.05 or P<0.01), pathological changes reduced significantly, the content of IgG decreased significantly (P<0.05), the expressions of cytokine IL-2 and IL-8 were significantly decreased (P<0.05, P<0.01), and the pathological manifestation of chronic inflammation was significantly improved. Conclusion Electroacupuncture at Sanyin points can reduce the secretion of local prostate antibody IgG, regulate the expression of cytokine IL-2 and IL-8, protect the morphology and structure of prostate tissue from damage. Electroacupuncture at Sanyin points can adjust local immunologic function and promote the recovery of prostate.

Objective: To explore the abnormal changes in neuroelectric activity in the primary visual cortex of rats deprived of vision in one eye and to investigate the regulatory effect of acupuncture in the sensitive period on the abnormal coding and conduction of electrical signals of rats' optic neurons.Methods: Sixty 14-day-old Sprague-Dawley rats were randomly divided into a blank group, a model group, an early-stage acupuncture group, a middle-stage acupuncture group, and a late-stage acupuncture group, with 12 rats in each group. Rats in every group except the blank group received right eyelid suturing to create a monocular deprivation model in the sensitive period of visual development (from the day rats open their eyes to the 45th day after their birth). Rats in the three acupuncture groups started to undergo acupuncture respectively on the 3rd, 12th, and 21st days after the model replication was done, with each group receiving nine-day treatment. The activity level of the neuroelectrical signal of the primary visual cortex in each group, including the latency and amplitude of P100 wave, average discharge frequency and amplitude of neurons, the power spectral density (PSD), and interspike interval (ISI), were measured by neuroelectric evaluation technology after the acupuncture treatment was finished. Results: Compared with the blank group, the latency of P100 wave in the visual center of vision-deprived eyes was significantly prolonged, and the amplitude was significantly reduced (P<0.05); the average discharge frequency and amplitude of the neurons in the visual cortex also decreased significantly (P<0.05); PSD decreased and ISI was prolonged significantly (P<0.05). Compared with the model group, the abnormal electrical activity of optic neurons in the three acupuncture groups ameliorated, the latency of P100 shortened, and the amplitude of P100 increased (P<0.05), the discharge frequency and amplitude increased significantly (P<0.05), the PSD reduced, and the ISI shortened (P<0.05). In addition, among the three acupuncture groups, the early-stage acupuncture group had the best effect on various indicators. Conclusion: Abnormal electrophysiological activity is significant in the visual center of vision-deprived rats, and acupuncture treatment in the sensitive period of visual development can enhance the bioelectrical activity of visual nerve cells, improve the efficiency of optic nerve conduction, and regulate the inhibition and retardation of visual response caused by visual deprivation.

Objective To evaluate the application value of bedside noninvasive hemodynamic monitoring in the diagnosis and treatment of neonatal septic shock.Methods The purchase time and use of Ultrasound Cardiac Output Monitor (USCOM) to monitor hemodynamic status were taken as the grouping condition,and the infants admitted to Department of Neonatology in Shanghai Children's Hospital from March 2014 to December 2016 were divided into 3 groups,16 of USCOM's pre-purchased septic shock infants were taken as non-USCOM monitoring group,20 patients with septic shock received USCOM monitoring as USCOM monitoring group,the other 20 non-septic shock neonates were assigned as a control group,whose primary diseases were premature,neonatal jaundice or neonatal pneumonia.Systolic volume (SV),cardiac output (CO),heart rate (HR),cardiac index (CI) and systemic vascular resistance index (SVRI) in USCOM monitoring group and control group were recorded.The doses of dopamine,dobutamine,epinephrine or norepinephrine and the time of vasoactive drug administration were compared between the USCOM monitoring group and non-USCOM monitoring group.The data of 3 groups were analyzed statistically.Results Compared with the control group,the hemodynamic parameters of the USCOM monitoring group before treatment such as CO [(0.68 ± 0.44)L/min vs.(0.44 ± 0.17) L/min,t =3.306,P =0.004],CI [(4.40 ± 1.88) L/(min · m2) vs.(3.00 ±0.40) L/(min · m2),t =3.328,P =0.004],SV [(3.90 ±2.39) cm3 vs.(3.08 ±0.31) cm3,t =2.227,P =0.038]and HR [(166.09 ± 26.20) times/min vs.(145.35 ± 16.16) times/min,t =2.750,P =0.013] were increased,while the SVRI showed an obvious decline [(795.88 ± 450.19) d · s/(cm5 · m2) vs.(1 160.61 ± 49.59)d · s/(cm5 · m2),t =-2.898,P =0.009],and the differences were statistically significant.While in the USCOM monitoring group after treatment,the CO [(0.56 ± 0.28) L/min vs.(0.68 ± 0.44) L/min,t =2.456,P =0.024] and CI [(3.65 ± 1.10) L/ (min · m2) vs.(4.40 ± 1.88) L/ (min · m2),t =2.614,P =0.017] were decreased significantly compared with those in USCOM monitoring group before treatment.Compared with non-USCOM monitoring group,the doses of dopamine [(45.72 ± 28.80) mg/kg vs.(85.83 ± 69.33) mg/kg,t =2.352,P =0.005],dobutamine [(12.81 ±26.18) mg/kg vs.(85.83 ±69.33) mg/kg,t =4.351,P =0.002],epinephrine [(0.11 ±0.33) mg/kg vs.(0.90± 1.75) mg/kg,t=1.986,P =0.014],and the time of vasoactive drug use [(68.10 ±34.37) h vs.(167.75 ± 117.14) h,t =3.626,P =0.001] were decreased significantly in USCOM monitoring group.The doses of norepinephrine [(1.91 ± 3.79) mg/kg vs.(0.47 ± 0.90) mg/kg,t =-1.481,P =0.046] were increased significantly in USCOM monitoring group.Conclusion The noninvasive hemodynamic monitoring plays an important role in the diagnosis and treatment of septic shock in neonates by clarifying the hemodynamic status of shock and guiding the rational use of vasoactive drugs so as to improve the successful rescue rate.

Synapse is the key part of information transmission between neurons,which has certain plasticity.Glutamate receptor plays an important role in the synaptic plasticity of the central nervous system,and acupuncture can regulate the glutamate receptor to normal under pathological conditions,and its research is also deepening.This paper summarizes the recent research literature on the effects of two types of glutamate receptors,ionic glutamate receptor and metabotropic glutamate receptor,on synaptic plasticity,as well as acupuncture regulating the expression of ionic glutamate receptor and metabotropic glutamate receptor,in order to provide a theoretical basis for acupuncture regulating synaptic plasticity based on glutamate receptor expression,and provide reference for subsequent research.

Objective To investigate the diagnostic value of cerebrospinal fluid protein in the assess-ment of neurological outcome in preterm infants with sepsis. Methods A total of 80 preterm infants with sepsis were enrolled in the department of neonatology of Shanghai Children's Hospital from June 2014 to June 2016. The lumbar puncture was completed within 24 hours after diagnosis of sepsis,and the results of ce-rebrospinal fluid protein were obtained. The prognosis of neurological development was assessed according to Gesell Developmental Quotient ( DQ) at 6 months of adjusted gestational age. DQ> 85 was used as an indi-cator of good prognosis group. DQ≤85 was assigned to the poor prognosis group. The differences in protein content of cerebrospinal fluid between these two groups were retrospectively analyzed. The receiver operating characteristic ( ROC) curve was used to evaluate the diagnostic value of cerebrospinal fluid in evaluating the prognosis of preterm infants with sepsis. Results Cerebrospinal fluid protein content of poor prognosis group was higher than those in good prognosis group[(2005. 56 ± 582. 85)mg/L vs. (1367. 92 ± 362. 29)mg/L, t= -6. 019,P<0. 01]. The area under the ROC curve was 0. 819(95％CI 0. 711 -0. 927,P<0. 05). The optimal threshold of cerebrospinal fluid protein was 1560 mg/L with specificity of 75. 5％ and sensitivity of 81. 5％. Conclusion Cerebrospinal fluid protein content has certain diagnostic value on the assessment of sepsis premature neurological prognosis.

Objective:To study the early predictive value of urine neutrophil gelatinase-associated lipoprotein (NGAL) and kidney injury molecule-1 (KIM-1) for acute kidney injury (AKI) in neonates with severe asphyxia.Method:From January 2019 to June 2020, neonates with severe asphyxia admitted to our hospital within 6 hours after birth were enrolled in the study. The dynamic changes of urine NGAL and KIM-1 at admission, 24 h, 48 h and 1 w after birth were examined. Neonates were assigned into AKI group and non-AKI group according to the clinical practice guidelines for AKI issued by KDIGO (Kidney Disease: Improving Global Outcome). The sensitivity and specificity of NGAL and KIM-1 predicting AKI at different time points were evaluated using ROC curve and area under curve (AUC).Result:According to the diagnostic criteria of neonatal AKI, 9 cases were in the AKI group and 42 cases in the non-AKI group, and the incidence of AKI was 17.6%. Urine NGAL was significantly increased in AKI group at admission and 24 h after birth compared with the non-AKI group [(115.6±75.5) ng/ml vs. (49.8±29.0) ng/ml, (90.7±35.6) ng/ml vs. (55.6±30.7) ng/ml] ( P<0.05). No significant differences existed at 48 h and 1 w after birth between the two groups. At 24 h after birth, urine KIM-1 in the AKI group was significantly higher than the non-AKI group [(808.3±555.3) pg/ml vs. (318.4±234.0) pg/ml, P<0.05] and no significant differences existed between the two groups at admission, 48 h and 1 w after birth. The AUC of NGAL predicting AKI at admission, 24 h, 48 h and 1w after birth were 0.804 (95% CI 0.573~1.000), 0.792 (95% CI 0.580~1.000), 0.732 (95% CI 0.517~0.947) and 0.551(95% CI 0.371~0.730), respectively. The AUC of KIM-1 predicted AKI at admission, 24 h, 48 h and 1 w after birth was 0.860 (95% CI 0.676~1.000), 0.824 (95% CI 0.655~0.993), 0.768 (95% CI 0.622~0.914), 0.622 (95% CI 0.392~0.852), respectively. Conclusion:At admission, 24 h and 48 h after birth, urine NGAL and KIM-1, as kidney injury markers, may predict the occurrence of AKI after severe neonatal asphyxia.

Objective:To study the correlations of neonatal hemodynamic parameters with gestational age (GA) and birth weight (BW) using non-invasive ultrasound cardiac output monitor (USCOM).Method:From March to September 2019, neonates with stable hemodynamics admitted to the Department of Neonatology of our hospital were enrolled in this prospective study. According to their GA, they were assigned into <29 w group, 29~33 w group, 34~36 w group and ≥37 w group. According to their BW, they were assigned into <1 000 g group, 1 000~1 499 g group, 1 500~2 499 g group and ≥2 500 g group. Cardiac output (CO), cardiac index (CI), stroke volume (SV), myocardial contractility (inotropy, INO), flow time corrected (FTC), systemic vascular resistance index (SVRI) and heart rate (HR) were measured using USCOM. The univariate linear regression method was used to analyze the correlation of hemodynamic parameters with different GA and BW.Result:A total of 120 neonates with stable hemodynamics were enrolled, including 69 males and 51 females. The average GA was (34.2±3.8)w and the average BW was (2 221±860) g. SV ( r=0.489, P<0.001), CO ( r=0.681, P<0.001), CI ( r=0.348, P<0.001), FTC ( r=0.266, P=0.003), INO ( r=0.446, P<0.001)and HR ( r=-0.322, P<0.001) showed significant linear correlations with GA. No linear correlation existed between SVRI ( r=-0.052, P=0.574) and GA. SV ( r=0.603, P<0.001), CO ( r=0.852, P<0.001), CI ( r=-0.390, P<0.001), INO ( r=0.576, P<0.001) and HR ( r=-0.440, P<0.001) showed significant linear correlations with BW. No significant linear correlations existed between SVRI ( r=-0.076, P=0.409) or FTC ( r=0.090, P=0.329) and BW. Conclusion:USCOM can monitor neonatal hemodynamic parameters in real-time.Hemodynamic parameters including SV, CO, CI and INO are significantly different among newborns with different GA and BW and these parameters are linearly correlated with GA and BW.