Effects of acupuncture on spontaneous discharges of nerve cells in ventromedial neucleus of hypothalamus (VNH) and levels of monoamine neurotransmitters in rats of obesity were observed. Results indicated that levels of tyrosine (Tyr) and dopamine f DA) were decreased, and the levels of 5 -hydroxytryptamine (5 - HT) and 5 - hydroxyindole acetic acid (5 - HIAA) increased in VNH; The frequency of spontaneous discharges of nerve cells in VNH lowered significantly in the obesity group as compared with those in the normal group; When acupuncture attained effect of weight reduction, the frequency of spontaneous discharges of nerve cells in the VMH increased obviously; the levels of Tyr, DA, tryptamine , and 5 - HT/5 - HIAA increased, and 5 - HT level decreased in VMH tissue. It is suggested that the benign regulative action of acupuncture on VNH is possibly one of the crucial factors for acupuncture in reducing body weight.

The fasting blood sugar (FBS), blood insulin (INS), insulin sensitivity index (ISI) and resistant hormone of INS in 46 patients with NIDDM were observed before and after the treatment. It was showed that the good effect was achieved in the cases by acupuncture and moxibustion, while the contents of FBS and INS in plasma were all decreased and ISI was increased in the cases treated by acupuncture and moxibustion, the degree of decrease of FBS and INS, and increase of ISI being closely related to therapeutic effect. The level of resistant hormone of INS and lipid in patients tend to normal level. Acupuncture and moxibustion had a good regulatory effect on the function of endocrine,sugar and lipid metabolism. It suggests that IR can be corrected by acupuncture and moxibustion,which is a key to therapeutic effect.

Better therapeutic effects have been achieved in the treatment of 112 simple obesity cases,mainly with acupuncture therapy plus auxiliary treatment of acupuncture weight loss apparatus. The results showed that the effective rate was 85% in 112 cases by one course of the treatments, 92% in 84 cases by two courses of the treatments, and 98% in 43 cases by three courses of the treatments. The therapeutic effect in combination with acupuncture apparatus was better in long courses of the treatment than in the short courses of the treatments, in male than in female, in young age than in old age, in mild case than in severe condition, in short duration than in long duration, in excessive pattern than in deficient pattern, in those without complications than in those with complications, and in those without family history than in those with family history, indicating that early treatment and prolonged treatment can enhance the therapeutic effects in weight loss by acupuncture.

BACKGROUND: The abnormality of the function of arcuate nucleus may be an important factor of obesity. It has been known that the mechanisms of acupuncture in treating obesity are related to nervous and neurohumoral regulation. What is the regulating effect of acupuncture on the function of arcuate nucleus?OBJECTIVE: To study the effects of acupuncture on the function of arcuate nucleus of obese rats, and further investigate central nervous functional mechanism of reducing weight by acupuncture.DESIGN: Randomized controlled study based on the experimental animals.SETTING: Acupuncture institute in second clinical medical college of a university of traditional Chinese medicine, and a population management college.MATERIALS: This experiment was carried out in the Acupuncture Institute of Second Clinical Medical College, Nanjing University of Traditional Chinese Medicine between April and October 2002. One-month old male SD rats just in ablactation were selected.METHODS: Rats fed with ordinary wholesome rat-feed were in the normal group. The successfully established experimental obese rats models were randomly divided as control group and acupuncture group with 12 rats in each group. Rats in the acupuncture group were given acupuncture treatment for 14 days, and rats in the normal and control groups were put into rat fixation-machine for 15 minutes every day, lasting for 14 days. Body mass, Lee' s index, body lipid, level of central and peripheral leptin and insulin(INS) as well as the frequency of spontaneous discharge of nerve cell in the arcuate nucleus(ARC) of hypothalamus in obese rats were observed with nervous electrophysiological and nervous biochemical technology before and after acupuncture.MAIN OUTCOME MEASURES: ① Effect of acupuncture on obesity index, fat contents of pericardium, kidney and epididymis of experimental obese rats. ② Effect of acupuncture on the frequency of spontaneous discharge of ARC nerve cell of hypothalamus in obese rats. ③ Effect of acupuncture on the contents of hypothalamic and serum leptin and INS of rats in each groups. ④ Correlation of the frequency of spontaneous discharge of ARC nerve cell of hypothalamus with the level of hypothalamic leptin and INS.RESULTS: The body mass[(517.74±29.35) g], Lee' s index (319.85 ± 3.96) and body fat content of obesity rats [ (13.88 ± 1.32) g] were all significantly higher than those in the normal rats, the differences were significant(P ＜ 0.01); the frequency of spontaneous discharge of nerve cell in ARC of hypothalamus in obese rats [ (3.12 ± 1.92) Hz] were all markedly lower than those of the normal rats[ (8.99 ± 2.71 ) Hz], the differences were significant (P ＜ 0.01 ); the frequency of spontaneous discharge of nerve cell in ARC was negatively correlated with body mass, Lee' s index and body lipid( r = -0. 592, -0. 672, -0. 521 ) . Acupuncture significantly increased the frequency of spontaneous discharge of nerve cell in ARC of hypothalamus in obese rats [(9.75 ±2.02) Hz] as compared with the control group, the differences were significant( P ＜ 0. 01 ).CONCLUSION: The good regulating effect of acupuncture on the function of arcuate nucleus of hypothalamus might be one of mechanisms in the antiobesity of acupuncture.

Objective To investigate the clinical effect of rhG-CSF combined transplantation of autologous bone marrow mesenchymal stem cells on cerebral infarction. Methods 42 acute cerebral infarction patients were randomly divided into tow groups: Injection rhGCSF combined autologous bone marrow mesenchymal stem cells group(treatment group, n=20)and conventionality therapy group(control group, n=22).The efficacy was assessed by National Institutes of Health Stroke Scale(NIHSS), Barthel Index(BI)and diffusion-weighted imaging(DWI),perfusion-weighted imaging(PWI)at baseline and the 3rd month after treatment. Result The scores of NHISS and BI treatment group were 4.8±2.0 and 78.5±7.2 respectively. while were 7.2±2.4 and 56.1±6.3 in control group at the 3rd month after treatment. The difference were significant(P＜0.01).PWI in treatment group Was higher than that in control group. There was no significant side-effect in treatment group. Conclusion rHG-CSF combined autologous bone marrow mesenchymal stem cells is a safe, efficient treatment for acute cerebral infarction patients, which is a better way than conventionality therapy.

Objective:To observe the clinical effect of internal administration of Traditional Chinese Medicine (TCM) and external application of hot election bag combined with acupuncture on urinary retention after stroke with kidney qi deficiency type.Methods:A total of 106 patients admitted to Chengde Hospital of Traditional Chinese Medicine from January 2017 to December 2020 who met the inclusion criteria were randomly divided into 2 groups according to the random number table method, with 53 in each group. The control group was treated with conventional western medicine therapy and bladder function training, while the observation group was treated with TCM, acupuncture and external application on the basis of the control group. Both groups were treated for 28 days. Before and after treatment, TCM syndrome scores were performed, and the maximum urinary capacity and residual urine volume were recorded by abdominal B-ultrasound to evaluate the bladder function of the patients. The improvement time of urinary pain, first urination time, catheter indwelling time, length of hospital stay and adverse reactions during treatment were observed and recorded, and the clinical efficacy was evaluated.Results:The total effective rate was 96.2% (51/53) in the observation group and 84.9% (45/53) in the control group, and the difference between the two groups was statistically significant ( χ2=3.98, P=0.046). The residual urine volume of the observation group after treatment [(54.23±6.23) ml vs. (91.24±11.25) ml, t=20.95] was significantly lower than that of the control group ( P<0.01), and the maximum urinary bladder volume [(366.23±30.23) ml vs. (259.63±26.23) ml, t=19.39] was significantly higher than that of the control group ( P<0.01). After treatment, the TCM syndrome score of the observation group was significantly lower than that of the control group ( t=13.25, P<0.01), and the bladder function score of the observation group was significantly lower than that of the control group ( t=13.53, P<0.01). The improvement time of urinary pain, first urination time, catheter indwelling time and hospital stay in the observation group were significantly lower than those in the control group ( t=5.73, 17.91, 6.76, 9.67, all Ps <0.01). No adverse reactions occurred in the two groups during treatment. Conclusion:The combination of TCM, hot compress therapy and acupuncture plus routine therapy can treat the patients with urinary retention after stroke and kidney qi deficiency type with good bladder function, improved symptoms and fast recovery and safety.

Objective To explore the surgical feasibility and clinical efficacy of one-stage anterior-posterior approaches in treatment of severe fracture and dislocation of lower cervical spine in "beach chair position".Methods Sixteen male cases of severe fracture and dislocation of lower cervical spine and with a mean age of 49.8 years (range,36-78 years) treated surgically from May 2012 to May 2016 were analyzed retrospectively by using case series study.The segment of injury was C4-5 in 4 cases,C5-6 in 7 and C6-7 in 5.The degree of spinal cord injury according to the American Spine injury Association (ASIA) score was Grade A in 4 cases,Grade B in 7 and Grade C in 5.Sub-axial injury classification (SLIC) score was 8 points in 9 cases and 9 points in 7.After a general anesthesia,a ring with a hole was hanged on patient's head before the operation.Then,under the protection of hole traction,the upper of operating bed was swung up slowly,so that the patient was restricted in vertical "beach chair position" with traction on the halo in order to immobilize the head and partially reduce the kyphotic deformity.Routine cervical anterior-posterior approach was done with the exposure of damaged section of the front and rear structure.Pedicle screw system or lateral mass screw displacement was conducted.Anterior intervertebral discectomy or fracture vertebral was performed,using collaborative reset prying method before and after the road.In the front of intervertebral cage or titanium net support bone graft,rear pedicle screws or lateral mass screws fixation and bone graft fusion were implemented.The operation time and blood loss were recorded.The healing of the wound was observed.The recovery of neurological function was evaluated according to the ASIA grade.Postoperative review X-ray,CT and MRI were done to evaluate the reset and bone graft in position and fusion.Results All the surgeries were done well without aeroembolism and other related complications.The mean operative time was 153 minutes (range,150-180 minutes),and the mean amount of blood loss was 543 ml (range,400-800 ml).Sixteen cases were followed-up from 6 to 24 months (mean 13.7 months).All the incision were healed at Ⅰ stage.Spinal cord function did not aggravate.The ASIA grade was improved with an average of one to two Grades 6 months after surgery.Postoperative X-ray and CT confirmed that graft object position was favorable and cervical sequence was recovered well.The Cobb angle decreased from (23.6 ± 5.3) ° preoperatively to (4.0 ± 0.4)°postoperatively,and the translational displacement of vertebral body was restored into (2.7 ±0.4) mm (P ＜ 0.01) from (10.9 ± 1.6) mm before operation.The cervical spinal canal was not obstructed and the cervical spinal cord was relieved,showed by MRI.Conclusions One-stage anterior-posterior approaches for severe fracture and dislocation of lower cervical spine circumferential reconstruction in "beach chair position" is a beneficial and effective method,without the need of changing positions in a collaborative reduction and fixation.The method can reduce the interference of spinal cord,shorten the operation time and save anterior extra fixation.

Since the discovery of circulating hepatitis B virus (HBV) RNA in the peripheral blood of patients with chronic hepatitis B in 1996, a growing number of studies have focused on clarifying the biological characteristics and clinical application value of serum HBV RNA. This consensus mainly summarizes the research progress of serum HBV RNA existing profiles, quantitative detection methods, and current clinical applications. In order to better apply this indicator for the clinical management of patients with chronic HBV infection, recommendations on quantitative detection target regions, detection results, and clinical applications are put forward.

Diabetic nephropathy(DN)is one of the most important complications of diabetes.Its pathogenesis is com-plex and has not been fully elucidated.Epithelial-mesenchymal transition(EMT)plays an important role in the development of DN.Relevant data show that glycogen synthesis kinase-3β(GSK-3β)participates in the process of EMT through multiple sig-naling pathways and affects the occurrence and progression of DN.This article reviews the research progress of GSK-3β in-volved in EMT in DN.

Objective:To observe the clinical efficacy of angiotensin-receptor neprilysin inhibitors (ARNI) in the treatment of maintenance hemodialysis (MHD) with heart failure.Methods:The clinical data of heart failure patients who accepted MHD in Central China Fuwai Hospital were retrospectively collected. All patients accepted regular treatments of heart failure, and then the treatment group was treated with ARNI, while the control group was treated with valsartan. The treatment course was 6 months. The cardiac parameters: left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDD), left ventricular end-systolic dimension (LVESD), pulmonary artery pressure, right ventricular end-diastolic dimension (RVED), right atrial end-diastolic dimension (RAED), N-terminal pro-B-type natriuretic peptide (NT-pro BNP), and serum potassium were collected and compared between the two groups. Multivariate ordered logistic regression analysis was adopted to analyze the influencing factors of treatment effect.Results:A total of 60 MHD patients with heart failure were enrolled with age of (53.92±11.88) years old, 37 males (61.7%), dialysis age of (27.83±12.92) months, and blood pressure of (154.22±15.27) mmHg/(85.43±12.31) mmHg. (1) There was no significant difference of the clinical data and cardiac parameters between the treatment group ( n=30) and the control group ( n=30) before treatment (all P>0.05); (2) After treatment of 6 months, the total effective rate [28/30(93.3%)] in the treatment group was significantly higher than that in the control group [20/30(66.7%)] and the rehospitalization rate [2/30(6.7%)] in the treatment group was significantly lower than that in the control group [10/30(33.3%)] (both P<0.05); (3) After treatment of 6 months, LVEF, LVEDD, LVESD, pulmonary artery pressure, RVED, RAED, NT-pro BNP, and blood pressure were all improved significantly compared with the baseline in both groups (all P<0.05) and there was no significant difference of serum potassium and body weight before and after treatment in the two groups (all P>0.05); (4) After treatment of 6 months, LVEF in the treatment group was higher than that in the control group and LVEDD, LVESD, pulmonary artery pressure, NT-pro BNP, and blood pressure in the treatment group were lower than those in the control group (all P<0.05). There was no significant difference of RVED, RAED, serum potassium and body weight between the two groups after treatment (all P>0.05); (5)The difference values before and after treatment of LVEF, LVEDD, LVESD, NT-pro BNP, body weight, systolic blood pressure, and diastolic blood pressure were different between the two groups (all P<0.05); (6)Therapy method ( β=-1.863, 95% CI -2.948-0.777, P=0.001) and residual urine ( β=-1.686, 95% CI -3.079- -0.293, P=0.018) were independent influencing factors of treatment effect (the treatment effect of ARNI was better than that of valsartan; the treatment effect of patients with normal urine volume was better than that of patients with oliguria and anuria). Conclusions:ARNI can effectively improve cardiac function in MHD patients with heart failure, inhibit ventricular remodeling, and improve disease prognosis.