In order to understand the resistance against common antibiotics in clinic and macrolide antibiotic-resistant mechanism of Streptococcus pneumoniae (S.pneumoniae) isolates in Zhejiang area,both K-B slip method and E-test were applied to determine the sensitivity of 138 S.pneumoniae isolates to nine antibiotics,and the ermB and mefE genes in those isolates which associated with macrolide antibiotics-resistance closely were detected by PCR.Subsequently,correlation among ermB and mefE genes and the erythromycin resistance were analyzed.For these 138 S.pneumoniae isolates,93.5% (129/138) of the strains were resistant to erythromycin,but only 2.9%～4.3% strains were resistant to cefotaxim,cefuroxime,amoxicillin and levofloxacin.The positive rate of ermB gene in the isolates (91.3%,126/138) was significantly higher than that of mefE gene (33.3%,46/138) (P<0.05).Both of these two genes existed in 27.5 % (38/138) of the strains and all of the strains without ermB and mefE genes were sensitive to erythromycin.The erythromycin resistance rate (62.5%) of mefE gene positive strains was remarkably lower than that of the mefE&ermB gene positive strains (100%) and the ermB gene positive strains (97.7%) (P<0.05).All the data mentioned above demonstrated that erythromycin is not an appropriate antibiotic to treat the infectious diseases caused by S.pneumoniae.Moreover,ermB is the predominant erythromycin resistance gene in S.pneumoniae isolates and ermB gene could inspire stronger erythromycin resistance than mefE gene.

The purpose was to investigate the research achievements over the past two decades on moxa smoke produced in the process of moxibustion, in terms of its clinical studies, chemical compositions, safety assessment as well as the mild smoke or smoke-free moxibustion, for revealing the recent dynamic and developing orientation, and promoting its further application, succession and innovation.

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.

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.

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.

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.

BACKGROUND:Moxibustion products produced in moxibustion, such as moxa smoke, are one of hotspots in moxibustion research. Metabonomics can be used to more comprehensively and systematicaly study the effects of moxibustion products on the body.
OBJECTIVE:To investigate the efect of diferent concentrations of moxibustion products on urine metabonomics of rats.
METHODS:Forty Sprague-Dawley rats were randomly divided into normal control group, low-dose moxibustion products group, middle-dose moxibustion products group, high-dose moxibustion products group, high-dose moxibustion products recovery group. In the latter four groups, rats from each group were exposed to the mixture of moxibustion products and pure gas at ratios of 0.4:2.0, 0.8:2.0, 1.6:2.0, 1.6:2.0, respectively, 4 hours daily, 5 days weekly, totaly for 60 days. After 60-day high-dose moxibustion products stimulation, rats in the high-dose moxibustion products recovery group were raised in normal air for 21 days. Rats in the normal control group were raised in normal air for 60 days without any moxibustion products. Then we analyzed the changes of urine metabonomics in al group rats.
RESULTS AND CONCLUSION: Totaly 108 metabolites were identified in the urine of rats using gas chromatography/time-of-flight mass spectrometry, and 64 metabolites were verified by standard library. There were some positive correlations between changes of typical metabolites and moxibustion product concentrations. The metabolites in the urine were most different between the high-dose moxibustion products group and normal control group. Twenty-two differential metabolites, such as glucuronic acid and vitamin C were mainly involved in 15 sugar and amino acid metabolic pathways, such as ascorbate and aldarate metabolism. These findings indicated that energy metabolism, detoxification and anoxidation increased in rats stimulated by moxibustion products.

Objective:To observe the effect of moxibustion on learning and memory abilities, corticosterone and glucocorticoid receptor (GR) in subacute aging rats. Methods:Twenty four Sprague-Dawley (SD) rats were randomly divided into a normal group, a model group and a moxibustion group, 8 rats in each group. Rats in the model group and the moxibustion group were subcutaneously injected with 25% D-galactose [125 mg/(kg·bw)] for 40 d continuous; rats in the normal group were injected with saline at the same position for 40 d continuous. Rats in the moxibustion group were given mild moxibustion at bilateral Shenshu (BL 23) at the same time of modeling; rats in the normal group and the model group were only identically grabbed without moxibustion for 40 d. The learning and memory abilities of rats were observed using the Morris water maze at the end of the experiment. Abdominal aorta blood and thymus were collected after water maze experiment. Enzyme-linked immunosorbent assay (ELISA) was used to detect serum corticosterone level, and immunohistochemical method was used to detect the expression of thymus GR. Results:Compared with the normal group, rats in the model group showed that a significantly longer escape latency time (P<0.01) on the third and the fourth days; number of times crossing the platform in 70 s significantly reduced (P<0.01); activity times in the fourth quadrant significantly decreased (P<0.05); serum corticosterone levels increased (P<0.01); thymus GR expression decreased (P<0.05). Compared with the model group, rats in the moxibustion group showed that the escape latency times were significantly shorter on the third, the fourth and the fifth days (P<0.01,P<0.05); number of times crossing the platform in 70 s significantly increased (P<0.05); activity times in the fourth quadrant significantly increased (P<0.05); serum corticosterone levels decreased (P<0.05); thymus GR expression increased (P<0.05). Conclusion:Moxibustion could improve the learning and memory abilities of subacute aging rats, down-regulate serum corticosterone levels, and increase thymus GR content.

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.