@@

Objective To observe the cortical functioning of healthy volunteers during acupuncture as a way of exploring acupuncture's neural mechanisms.Methods Twenty healthy volunteers received acupuncture applied to the left hegu and waiguan acupoints while their cortical activity was examined using blood oxygenation level-dependent functional magnetic resonance imaging (BOLD-fMRI).Brain activation,especially of the regions related to motor function,were observed and analyzed.Results Acupuncture applied to the left hegu and waiguan acupoints was observed to significantly activate the left middle frontal gyrus and the inferior frontal gyrus,with many activated regions in the left insula and a few in the left cerebellum,the left precentral gyrus,the left postcentral gyrus,the left inferior parietal lobule,the left medial frontal gyrus,the left precuneus,the left anterior cingulate gyrus and the left claustrum.The right side of the brain was excited mainly in the right middle frontal gyrus and the right medial frontal gyrus.The right inferior parietal lobule and the right precentral gyrus were also activated to some extent.There was slight activation of the right middle temporal gyrus,the right superior temporal gyrus,the right insula,the right inferior frontal gyrus and the right postcentral gyrus.The negatively activated regions were mainly located on both sides of the limbic lobe,including the hippocampus,the parahippocampal gyrus and the cingulate gyrus.The left superior temporal gyrus,the left middle temporal gyrus and the right middle frontal gyrus also had small negative activation zones.Conclusions In brain regions associated with motor function,in addition to partial activation of the contralateral primary sensorimotor area,acupuncture at these two points clearly generates bilateral activation of secondary motor areas with some activation in the ipsilateral cerebellum.This may serve as a neuropathological basis for acupuncture treatment of motor dysfunction.BOLD-fMRI imaging displays the neural effects of acupuncture in an intuitive way.It can be a useful technique for further study of the neural effects of acupuncture on pathological conditions.

Objective To investigate the mechanism of motor recovery in hemiplegic patients after ischemic stroke using acupuncture-induced blood oxygenation level dependent functional magnetic resonance imaging (BOLD-fMRI) and diffusion tensor imaging (DTI).Methods A total of 20 patients with left hemiplegia after ischemic stroke were enrolled in the study. DTI raw data was used to reconstruct three dimensional image of pyramidal tract through post-processing of workstation,and the damage and recovery of the pyramidal tract were observed. SPM8 and other software were used to compare and analyze the acupuncture-induced BOLD-fMRI data, and the distribution differences in the brain activation areas were compared. Results The muscle strength grade and the Fugl-Meyer scale score at 6 months were significantly higher than those during 3-6 weeks after stroke onset. DTI showed that the right pyramidal tract had different degrees of damage, interrupt, compression, and displacement during 3-6 weeks after onset, and there were different degrees of repair, remodeling at 6 months after onset. Acupuncture-induced BOLD-fMRI showed that compared with 3-6 weeks after onset, the positive activated brain regions were mainly located in the motor related brain regions in bilateral frontal cortex and the left cerebellum, and the negative activated brain regions were mainly located in the limbic system, such as bilateral anterior cingulate cortex and parahippocampal gyrus. Conclusions The mechanism of motor recovery in hemiplegic patients after ischemic stroke may be mainly related to the regulation and compensation of motor related brain regions,as well as the regulation of muscular tension through the extrapyramidal system. The repair and reorganization of the damaged motor pathway may also be the mechanism of motor recovery in hemiplegic patients after ischemic stroke.

Objective:To evaluate the influence of telomerase reverse transcriptase (TERT) promoter mutation on radioiodine uptake status of radioactive iodine refractory papillary thyroid cancer (RAIR-PTC) and radioiodine therapy response by analyzing the mutation frequency of TERT promoter in RAIR-PTC.Methods:A total of 37 patients with RAIR-PTC (15 males, 22 females, age (49.8±16.1) years) and 40 PTC patients with effective radioiodine therapy (13 males, 27 females, age (39.8±10.9) years) between January 2005 and June 2020 in JiangYuan Hospital Affiliated to Jiangsu Institute of Nuclear Medicine were retrospectively analyzed. TERT promoter mutation and B-Raf proto-oncogene, serine/threonine kinase (BRAF) V600E mutation of patients were observed. The differences across genotype patterns on radioiodine uptake status and therapy response were compared. The Fisher′s exact test and independent-sample t test were used for data analysis. Results:The incidence rate of TERT promoter mutation in the RAIR-PTC group was 40.54% (15/37, all C228T), which was significantly higher than that in the effective radioiodine therapy group (0, 0/40; P<0.001). No statistically significant difference was found for the mutation rate of BRAF V600E between the RAIR group (64.86%, 24/37) and the effective radioiodine therapy group (72.50%, 29/40; P=0.858). Patients with TERT promoter mutation were older ( t=3.76, P=0.001) and the non-intake rate of radioiodine in distant metastases of those patients was higher ( P=0.037). Furthermore, 2/3 of patients who received targeted therapies and 3/4 deaths had TERT promoter mutation. Among 35 patients with negative thyroglobulin antibody (TgAb), 11/14 of patients with TERT mutation had a rising stimulated thyroglobulin (sTg), while the percentage of the non-TERT mutation group was 57.1% (12/21; P=0.357). Conclusion:The TERT promoter mutation rate is significantly increased in RAIR-PTC patients and can serve as a prognostic predictor in RAIR.