Objective To investigate the effect of blood hemoperfusion with resin adsorption connected in series to continuous veno-venous hemofiltration ( HP + CVVH) on plasma cytokines such as TNF-α,IL-1β,IL-6 as well as cellular immunity and prognosis of patients with multiple organ dysfunction syndromes (MODS). Methods It was a prospective,randomized clinical trial.A total of 30 patients diagnosed as MODS were randomly (random number) divided into routine treatment + HP + CVVH group (treatment group) and routine treatment + CVVH group (control group).In treatment group,patients received blood hemoperfusion with resin adsorption for 2 hours,and then CVVH for 10 hours every day for 3days.In control group,patients received CVVH for 12 hours every day for 3 days.The plasma samples of patients in treatment group were obtained 0 h,2 h,12 h,24 h,26 h,36 h,48 h,50 h,60 h,5 days,7 days and 10 days after renal replacement therapy.The plasma samples of patients in control group were obtained 0 h,12 h,24 h,36 h,48 h,60 h,5 days,7 days and 10 days after renal replacement therapy.All of these patients were monitored with APACHE Ⅱ score,T-lymphocytes subpopulations,blood lactate acid concentration,heart rate,respiration rate and oxygenation index. Results Plasma levels of TNF-α,IL-1β and IL-6 decreased dramatically after HP (P ＜ 0.01 ) and T-lymphocytes subpopulations CD3+,CD4 +,CD8 + and CD4 +/CD8 + increased after both HP + CVVH and CVVH.The differences in plasma levels of TNF-α,IL-1βand IL-6 of patients between two groups were not noticeably obvious at the intervals of 12 h,36 h,and 50 h after renal replacement therapy. But on the 5 th day after renal replacement therapy,plasma levels of TNF-α,IL-1βand IL-6 of patients in HP + CVVH group were lower than those in control group (P ＜ 0. 05 ).There were 5 fatal patients in HP + CVVH group and 6 patients died off in CVVH group during 28 days after treatment.Conclusions Both HP + CVVH and CVVH could lower the levels of plasma TNF-α,IL-1β and IL-6,and improve cellular immunity and clinical symptoms as well as signs.Compared with CVVH,plasma levels of TNF-α,IL- 1β and IL-6 were lower on the 5th day and increase rate of 28-day survival in HP + CVVH group.

OBJECTIVEFrictions of Lock-loose brackets with ligated main wings or all six wings were measured as they slid along archwires in dry and artificial saliva environments. The Lock-loose brackets were then compared with traditional brackets and self-ligating brackets.

METHODSThe surface states of the stainless steel archwires were observed with atomic force microscopy before and after mechanical traction. The Lock-loose brackets, traditional brackets, and self-ligating brackets used in this study were composed of 0.406 4 and 0.457 2 mm stainless steel round archwires and 0.457 2 mm x 0.634 9 mm and 0.482 6 mm x 0.634 9 mm stainless steel rectangular archwires. Two different ligating methods were applied to the Lock-loose brackets, i.e., main wings ligated and all six wings ligated. Frictions were measured by using an electronic universal testing machine.

RESULTSNo significant differences were found between the roughness of different archwires before and after mechanical traction in different brackets (P > 0.05). When the main wings of the Lock-loose brackets were ligated, the frictions of the four different stainless steel archwires were close to zero, and the difference with frictions of traditional brackets was significant (P < 0.05). When using 0.457 2 mm x 0.634 9 mm rectangular archwires, maximum friction (P < 0.05; significantly different from those of other brackets) was reached when all six wings of the Lock-loose brackets were ligated. Frictions in the dry state were higher than those in the wet state (P < 0.05).

CONCLUSIONThe Lock-loose brackets can adjust the friction efficiently with different ligating methods, thus solving the problem of low friction and strengthening anchorage.

Objective:To observe the effect of electroacupuncture (EA) and herbal cake-partitioned moxibustion on anxiety and depression in patients with Crohn’s disease (CD) in remission. Methods:Sixty CD cases were randomly allocated into an EA group (n=30) and an herbal cake-partitioned moxibustion group (n=30) using the random number table by the ratio of 1:1. In addition, 30 healthy subjects were included in a control group. Bilateral Tianshu (ST 25), Qihai (CV 6) and Zhongwan (CV 12) were used in the EA and herbal cake- partitioned moxibustion groups. The treatment was done 3 times a week, for a total of 12 weeks. The efficacy was evaluated using self-rating anxiety scale (SAS), self-rating depression scale (SDS) and traditional Chinese medicine (TCM) symptom scores. Results:Before treatment, the SAS and SDS scores in CD patients were remarkably higher than those in healthy subjects. After EA or herbal cake-partitioned moxibustion treatment, the SAS and SDS scores were significantly decreased in both groups, showing significant intra-group differences (P<0.05); the symptom scores of abdominal pain (severity, frequency and duration), bowel sounds/flatus and general fatigue were significantly decreased, showing significant intra-group differences (P<0.05); however, there were no between-group statistical differences (P>0.05). Conclusion:Both EA and herbal cake-partitioned moxibustion can significantly decrease abnormally high SAS and SDS scores in CD patients as well as TCM symptom scores. The two therapies share similar effects in alleviating common symptoms and improving anxiety and depression.

Objective:To evaluate and compare electroacupunctures (EA) with different parameters and moxibustion at different temperatures influencing the activation of mast cells (MC) in Tianshu (ST 25) regions of visceral hyperalgesia model rats. Methods:Rats (except for model group) respectively accepted 1 mA or 3 mA EA or moxibustion at 43 or 4 to℃℃stimulate Tianshu (ST 25) points after randomization of the fifty visceral hyperalgesia model rats, and then were compared with that in model and normal groups. Number, degranulation numbers, degranulation rates in Tianshu (ST 25) regions MC of rats in each group were observed using toluidine blue staining. Abdominal withdrawl reflex (AWR) score was used to evaluate the rat visceral hyperalgesia reactions. Results:Compared with the normal group and the model group, MC numbers (P<0.05,P<0.01,P<0.01,P<0.01), degranulation numbers and degranulation rates (P<0.01,P<0.01, P<0.05,P<0.01) of Tianshu (ST 25) MC in regions tissues in 43℃ and 4℃ moxibustion groups, and 1 mA and 3 mAEA groups all increased significantly. Compared with the model group, AWR scores were significantly lower in 43℃ and 4℃ moxibustion groups, and 1 mA and 3 mAEA groups under the stimulation of 20 mmHg, 40 mmHg, 0 mmHg or 80 mmHg colorectal distension (CRD) (P<0.05 in 1 mA and 3 mA EA groups under the stimulation of 20 mmHg,P<0.01 in the other groups). AWR scores in 43℃ and 4℃moxibustion groups under the stimulation of 20 mmHg, 40 mmHg, 0 mmHg or 80 mmHg CRD were not significantly different from those in the normal group (allP>0.05); AWR scores in 1 mA EA group under the stimulation of 0 mmHg or 80 mmHg were significantly higher than that in the normal group (P<0.01); AWR score in 3 mA EA group under the stimulation of 0 mmHg was significantly higher than that in the normal group (P<0.01), and AWR scores in 3 mA EA group under the stimulation of 20 mmHg or 80 mmHg were also higher than that in the normal group (P<0.05). AWR scores were higher in 1 mA EA group under the stimulation of 40 mmHg or 80 mmHg than that in 4℃ moxibustion group (P<0.05); AWR score was higher in 3 mA EA group under the stimulation of 40 mmHg than that in 4℃ moxibustion group (P<0.05). Conclusion:There are differences among EA of different parameters and moxibustion of different temperatures in activating on Tianshu (ST 25) regions MC of visceral hyperalgesia model rats, as well as in improving the visceral hyperalgesia reaction. The effect of 4℃ moxibustion is the most significant.

OBJECTIVE To observe the type of nosocomial infections in our comprehensive ICU,the prevalence and the vicissitude characteristic of infection strains,and the change of antibiotic-resistance.METHODS To summarize the 10 year results of the monitoring which were divided into three stages to compare the changes with time.RESULTS Gram-negative bacilli were 987(76.4%),Gram-positive cocci 216(16.7%) strains,and 89 strains were fungi(6.9%).The top six strains were in turn:Pseudomonas aeruginosa,Acinetobacter baumannii,Staphylococcus aureus,Klebsiella pneumoniae,Escherichia coli,and Stenotrophomonas maltophilia.Distribution of infection sites: 92.3% infection was in lungs,5.2% in urinary tract infection,2.5% in other sites included lungs,abdomene,CSF,blood etc.CONCLUSIONS The main nosocomial infective pathogens in our ICU are Gram-negative bacilli(75.0%),Gram-positive bacterial infection shows a slight increasing,whereas fungi infection decreasing.In addition to S.maltophilia,the great majority of Gram-negative bacilli,ESBL-producing K.pneumoniae and E.coli maintain a higher sensitivity to carbapenem antibiotic.All Gram-positive cocci to vancomycin and teicoplanin maintain a good sensitivity.In the fungal infection,Candida albicans infection ratio is decreased,while non-C.albicans increases.

This study was aimed to investigate the effect of visceral pain and water metabolism on irritable bowel syndrome with diarrhea (IBS-D) model rats by moxibustion and its products. A total of 40 SD rats were randomly di-vided into the normal group, model group, moxibustion group, non-smoke moxibustion group, and moxa smoke group. IBS-D model was induced by colorectal distension with an inflatable balloon. The general condition of rats was ob-served. Visceral pain was assessed by abdominal withdrawal reflex (AWR) scores. The immunohistochemical method was used in the detection of claudin-1, AQP3, AQP8 and Na+/K+-ATPase protein expression. The results showed that compared with the normal group, the AWR scores, claudin-1, AQP3, AQP8 and Na+/K+-ATPase protein expres-sion in the colon were decreased in the model group (P < 0.01). The stool was loose, which was on hair around the anus. After moxibustion, non-smoke moxibustion and moxa smoke stimulation, the stool conditions of IBS-D model rats were improved. The AWR scores were decreased in different degrees (P < 0.05 or P < 0.01). Except Na+/K+-ATPase, expressions of claudin-1, AQP3 and AQP8 in colon were increased in different degrees (P < 0.05 or P <0.01). The comprehensive therapeutic effect showed that moxibustion was better than non-smoke moxibustion; and non-smoke moxibustion was better than moxa smoke stimulation. It was concluded that the combination of warm stimulation, optical radiation and moxa smoke induced best effect in improving visceral pain and water metabolism on IBS-D model rats. Among them, warm stimulation and optical radiation may play the main role.

BACKGROUND:Grafts are often used to reconstruct the anterior cruciate ligament in clinical practice,while different types of grafts affect postoperative knee function and the development of rehabilitation programs. OBJECTIVE:To retrospectively analyze the effects of different graft types on muscle strength,joint stability,functional activities,and return to sports in patients after anterior cruciate ligament reconstruction. METHODS:Related studies were searched through PubMed,Web of Science,Cochrane,CNKI,and WANFANG databases.The Chinese and English key words were"anterior cruciate ligament reconstruction,autografts,allografts,artificial ligaments,bone-patellatendon-bone,quadriceps tendon autograft,hamstring tendon autograft,peroneus longus tendon autograft,rehabilitation,exercise,protocol,return to sport". RESULTS AND CONCLUSION:Patients with bone-patellar tendon-bone grafts should strengthen centrifugal contraction exercises of quadriceps muscle,and pay attention to the recovery of quadriceps muscle endurance and explosive power in the later stage of rehabilitation.Compared with bone-patellar tendon-bone grafts and hamstring tendon grafts,significantly fewer patients with quadriceps tendon grafts met regression criteria within 5-8 months,and a longer training plan should be developed,with the training cycle lasting as long as possible to more than 3 years.The selection of hamstring tendon grafts should strengthen the hamstring muscle strength training under multiple angles,especially the cycle of bending the knee above 60° until at least 18 weeks after surgery.Patients who choose peroneus longus tendon graft should strengthen the muscle strength around the ankle,mainly the plantar muscle strength.In the selection of allograft,attention should be paid to the reduction of tension resistance of 20%after the graft is disinfected by low-dose radiation,so attention should be paid to knee stability training.Patients who choose artificial ligament grafts can gradually enhance quadriceps and hamstring muscle strength training within 3-6 weeks,pay attention to early proprioceptive exercises,and conduct targeted training on balance,jumping,and flexibility.

Objective:To systematically assess the efficacy and safety of acupuncture therapy for essential hypertension.Methods:A computerized literature search of the Chinese National Knowledge Infrastructure(CNKI),Chongqing VIP Database(CQVIP),Wanfang Academic Journal Full-text Database(Wanfang),China Biology Medicine Disc(CBM),PubMed,Excerpta Medica Database(EMBASE),and Cochrane Library was conducted to retrieve randomized controlled clinical trials on acupuncture as the main intervention for the treatment of essential hypertension published from the inception of the database to 30 January 2021.The risk-of-bias assessment was carried out for each included study according to the Cochrane Handbook.Data analysis was performed using Review Manager 5.4.1 and Stata 15.0.Results:After the screening,46 randomized controlled trials involving a total of 3 859 subjects were included.Primary outcomes included changes in the diastolic blood pressure after intervention[eight studies showed that the acupuncture plus antihypertensive drug group was better than the antihypertensive drug monotherapy group[mean difference(MD)=1.45,95%confidence interval(CI)(0.48,2.43),P=0.004,fixed effects model;I2=39%]and changes in the systolic blood pressure after intervention{11 studies showed that the acupuncture plus antihypertensive drug group was better than the antihypertensive drug monotherapy group[MD=8.60,95%CI(7.12,10.07),P<0.00001,fixed effects model;I2=26%]}.The secondary outcome was antihypertensive efficacy,12 studies of acupuncture monotherapy group[risk ratio(RR)=1.20,95%CI(1.12,1.28),P<0.00001,fixed effects model;I2=36%]and 15 studies of acupuncture combined with antihypertensive drug group[RR=1.27,95%CI(1.20,1.34),P<0.00001,fixed effects model;I2=6%]showed better results than the antihypertensive drug monotherapy group in antihypertensive efficacy.In terms of the adverse events,four studies showed that the acupuncture monotherapy group had fewer adverse events than the antihypertensive drug monotherapy group[RR=0.10,95%CI(0.04,0.25),P<0.00001,fixed effects model;I2=0%].Conclusion:Acupuncture combined with antihypertensive drugs is superior to antihypertensive drugs alone in reducing blood pressure,and acupuncture therapy is effective and safe for the treatment of essential hypertension with fewer side effects.However,there is still a lack of high-quality multicenter randomized double-blinded controlled trials in this field.Rigorous large-sample clinical trials are needed to validate these findings.

Objective:To explore the mechanism of acupuncture and moxibustion for ulcerative colitis(UC)from the perspective of the P2X7 receptor(P2X7R)-nucleotide-binding oligomerization domain(NOD)-like receptor protein 3(NLRP3)inflammasome pathway. Methods:Sprague-Dawley rats were randomly assigned to a normal(N)group,a model(M)group,a herb-partitioned moxibustion(HM)group,and an electroacupuncture(EA)group.For modeling,the rats drank 4%dextran sulfate sodium for 7 d.Rats in the HM group and EA group received 7 consecutive days of HM or EA at bilateral Tianshu(ST25),respectively.The histopathological change in colon tissue was observed by hematoxylin-eosin(HE)staining;immunofluorescence staining was used to detect the protein expression of related molecules in the colon tissue,and enzyme-linked immunosorbent assay was used to detect the concentrations or contents of related molecules in the serum and colon tissue.Wild-type(WT)and P2X7R gene knockout(KO)mice were used to construct UC models,histopathological changes in the colon tissue were observed by HE staining,and the NLRP3 protein expression in the colon tissue was observed by immunohistochemistry. Results:Compared with the N group,the colon histopathological score in the M group was significantly increased,and the protein expression of P2X7R,NLRP3,apoptosis-associated speck-like protein containing CARD(ASC),Caspase-1,interleukin-1β(IL-1β),and interleukin-18(IL-18)in the colon tissue and the protein levels of IL-1β and IL-18 in the serum were significantly increased(P<0.05).Compared with the M group,the histopathological scores of the colon in the HM group and the EA group were significantly decreased,and the protein expression levels of P2X7R,NLRP3,ASC,Caspase-1,IL-1β,and IL-18 in the colon tissue and the protein level of IL-18 in the serum were significantly decreased(P<0.05).After UC modeling,the colonic mucosal epithelial damage and inflammatory cell infiltration in P2X7R KO mice were less than those in WT mice,and the NLRP3 protein expression in the colon was also decreased compared with that in WT mice(P<0.05). Conclusion:HM and EA at Tianshu(ST25)may inhibit the protein activities of P2X7R,NLRP3,ASC,and Caspase-1 in the colon tissue of rats with UC,thereby reducing the downstream molecules IL-1β and IL-18 in the P2X7R-NLRP3 inflammasome pathway to relieve UC inflammation.

METHODS:A computer-based online research of PubMed, CNKI and VIP databases was performed with the key words of “epigenetic; inflammatory bowel disease; Crohn’s disease; ulcerative colitis; DNA methylation; histone modification; miRNA; moxibustion” in Chinese and English. RESULTS AND CONCLUSION:The correlation of epigenetic modification with inflammatory bowel disease occurrence and development is elaborated. The mechanisms in inflammatory bowel disease have been related from DNA methylation, histone modifications and miRNA targets. The mechanism of moxibustion on inflammatory bowel disease is primarily associated with immune regulation, and its anti-inflammatory mechanism may be affected by epigenetic regulation of inflammatory cytokines.