Objective To report the clinical, myopathological and genetic features of a patient with mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS)/Leigh syndrome (LS) overlap syndrome who carried m.10158 T>C mutation. Methods The patient′s clinical and imaging materials were collected. An open biopsy of right biceps brachii was performed. DNA samples were prepared from the patient and her mother′s blood. Direct sequencing of the complete mitochondrial genome was performed to detect the mtDNA mutation.Western blotting was used to estimate the content of respiratory complexes in the patient′s muscle. Results The patient was a 40-year-old female. She had seizures and lost consciousness for 9 months. Brain MRI findings consisted of asymmetrical lesions in the cerebral cortex of the frontal and temporal lobes, as well as symmetrical lesions bilaterally in the basal ganglia. Muscle biopsy showed typical ragged red fibers. Direct sequencing of the complete mitochondrial genome from blood and muscle of the patient revealed the T-to-C transition at nucleotide position 10158 in the MT-ND3 gene.The mutation rate was 9.31% and 70.0%, respectively.Western blotting demonstrated that the contents of complexes Ⅰ and Ⅳ were significantly lower in the patient′s muscle mitochondria compared with the normal controls (53.1%±1.2% vs 88.6%±1.7%, t=4.08, P<0.05;57.3%±2.4% vs 80.1%±2.1%, t=3.39,P<0.05).Conclusion We reported a case of MELAS/LS overlap syndrome who carried m.10158 T>C mutation in MT-ND3 gene and DNA test is very important for the diagnosis of the disease.

Objective To observe the clinical efficacy of yang-supplementing fire moxibustion in treating chronic obstructive pulmonary disease (COPD) in stable stage. Method Totally 120 COPD patients of yang deficiency type in stable stage were divided into 3 groups by the random number table, a yang-supplementing fire moxibustion group (yang-supplementing group), a dry mild moxibustion group (mild moxibustion group), and a regular Western medication group (regular group), 40 cases in each group, and 30-day treatment was taken as a course. They were treated and observed for a course, followed by a 3-month follow-up study. The pulmonary function indexes, yang-deficiency signs, quality of life, and comprehensive therapeutic efficacy were observed in the three groups. Result After treatment, the pulmonary function indexes, yang deficiency signs, quality of life, and comprehensive therapeutic efficacy were significantly improved in the three groups (P<0.01); the percent of predicted forced expiratory volume in one second (FEV1%) and yang deficiency signs were significantly improved after intervention in the mild moxibustion group (P<0.05); meanwhile, the quality of life was also significantly improved after intervention in the mild moxibustion group and regular group (P<0.01); the therapeutic efficacy of the yang-supplementing group was better than that of the mild moxibustion group and regular group, and the efficacy of the mild moxibustion group was better than that of the regular group. Conclusion Yang-supplementing fire moxibustion can improve the pulmonary function, postpone the progressive decrease of pulmonary function, significantly improve the yang deficiency constitution, enhance the quality of life and comprehensive therapeutic efficacy in treating yang-deficient COPD patients in stable stage.

To investigate the neurotoxic effect of human immunodeficiency virus (HIV) gp120 on cultured dorsal root ganglion (DRG)neurons in vitro, dissociated and organotypic mouse embryo's DRG cell culture models were established. Both dissociated and organotypic DRG cultures were treated with HIV gp120 in different concentration (250 pmol/L and 1 nmol/L, respectively, 2 times/7 days). For dissociated DRG cultural cells, microtubule-associated protein 2 (MAP2) immunofluorescent labeling was processed for observing the changes of neuronal cell body and neurites. The change of the ultrastructure in the organotypic cultured DRG was observed by electron microscopy.The difference of the number and length of neurites between the control group and HIV gp120 treated groups were significant (P＜0.001),whereas there was no significant difference in the diameter of neurons between them (P＞0.05). The ultrastructural changes included the decrease or loss of cristae in mitochondria and accumulation of many high densed particles between the microtubules and the neurofilaments by using both the concentrations of HIV gp120 treatment. The present results indicate that HIV gp120 had a directly neurotoxic effect on the cultured DRG neurons, especially more sensitive to mitochondria.

To further improve the diagnosis and treatment level of integrated traditional Chinese and Western medicine for the prevention and treatment of postoperative gastrointestinal disorder, and to promote the standardization of clinical practice guidelines for postoperative gastrointestinal disorder. It was initiated by the Chinese Society of Integrative Anesthesiology, and the " Clinical practice guidelines for prevention and treatment of postoperative gastrointestinal disorder by integrated traditional Chinese and Western medicine: a protocol" was jointly formulated by the institutions such as Gansu Province Clinical Research Center of Integrative Anaesthesiology, Center of Anesthesiology and Pain Medicine of Gansu Provincial Hospital of Traditional Chinese Medicine, World Health Organization Collaborating Center for Guidelines Implementation and Knowledge Translation, GRADE China Center, Industry Technology Centre for Medical Guidelines of Gansu Province, and Evidence-based Medicine Center of Lanzhou University. The Guidelines Formulation Committee followed the principles, methods and procedures of evidence-based guidelines formulation, assembled a multidisciplinary team of experts, and provided an evidence-based clinical practice guidelines using the GRADE method. This protocol mainly expounds the purpose and method of guidelines formulation and the publication, promotion, implementation and update of guidelines.

The clinical practice guidelines for prevention and treatment of postoperative gastrointestinal disorder with Integrated Traditional Chinese and Western Medicine (2023) issued by the Anaesthesia Committee and Perioperative Medicine Committee of the Chinese Society of Integrative Medicine is the first evidence-based guideline for postoperative gastrointestinal disorder in China. It covers the definition, aetiology and pathogenesis, diagnosis and treatment of postoperative gastrointestinal disorder. Compared with previous expert consensus, this guideline has advantages in terms of scientific and rigorous methodology and is quite representative. Interpreting this guideline can help strengthen clinicians′ understanding of postoperative gastrointestinal disorder and enhance clinical practitioners′ understanding of the methodology of this guideline, thus enabling a better integration of recommendations and evidence for clinical practice and hastening the implementation of the guidelines. It also accelerates the dissemination of the methodological development of guidelines in China, helps clinicians understand the connotation and value of the guidelines, and provides methodological guidance and references for formulating clinical practice guidelines based on the current situation in China and involving other clinical disciplines.

Objective To evaluate the efficacy of preoperative electroacupuncture intervention in promoting postoperative gastrointestinal functional recovery by meta-analysis.Methods The databases of PubMed,Cochrane Library,Web of Science,Embase,CBM,CNKI,VIP,and WanFang were searched systematically.The search period ranged from the inception of the databases to March 2024.Two researchers screened the literature independently,extracted the data,used Cochrane Risk of Bias tools to evaluate the quality of the inclusion study,and used RevMan 5.3 software for meta-analysis.Results Twelve RCTs were included,with 773 patients.There were 421 patients in the preoperative electroacupuncture group and 352 patients in the control group.The results of the meta-analysis showed that,time to first flatus(SMD=-0.56,95%CI-0.84 to-0.28,P＜0.001),time to first defecation(MD=-6.40 hours,95%CI-9.27 to-3.53,P＜0.001),time to bowel sound recovery(MD=-8.45 hours,95%CI-10.37 to-6.52,P＜0.001),time to first oral feeding(MD=-16.88 hours,95%CI-23.92 to-9.83,P＜0.001),the incidence of PONV(RR=0.75,95%CI 0.57 to 0.98,P=0.04)and length of hospital stay(MD=-0.78 d,95%CI-1.38 to-0.19,P=0.010)were significantly lower than the control group.Conclusion Electroacupuncture intervention before operation can effectively promote the recovery of post-operative exhaust,defecation,and bowel sound,shorten the time of fasting and drinking,reduce the inci-dence of PONV,shorten the length of hospital stay,and has good clinical value in promoting the recovery of postoperative gastrointestinal function.