The development of TCM acupuncture represents a internationalized and modern trend. A recent study with the title of "Acupuncture for chronic knee pain: a randomized clinical trial" published in Journal of the American Medical Association on October 1st, 2014, which raised doubts on acupuncture efficacy as well as traditional manipulation and acupoint theory, makes some negative impact and challenges on the development of acupuncture. From the view of future development of acupuncture, the potential influence of this research on acupuncture development is proposed, and by combining acupuncture theory, some discussions and doubts on the research design and outcome explanations are made. Additionally, enlightenments of this research on further clinical research are summarized.
Acupuncture Therapy ; Chronic Pain ; therapy ; Female ; Humans ; Low-Level Light Therapy ; Male

Apoptosis refers to the programmed death process of cells modulated by genes. It plays an important role in promoting the evolution of organisms, regulating the development of multiple systems, and maintaining the stability of internal environment. The major apoptosis pathways include mitochondrial pathways, death receptor pathways, and endoplasmic reticulum pathways. With the rapid development of the scientific research on acupuncture, it’s revealed that cell apoptosis should be closely related to the action of acupuncture. So far, the major apoptosis factors involved in relevant researches are P53, Bcl-2 family, Cyt-C, Caspase, Fas/Fasl, TNFR1/TNF-?, and FADD-Caspase8, and PERK, etc. Via influencing these apoptosis factors or genes, acupuncture can produce various effects in improving tissue ischemia, protecting neural cells, reducing inflammation, and correcting endocrine disorders. This article summarized and reviewed the apoptosis pathways and key factors related to the action of acupuncture, to provide some beneficial references for future studies.

Objective To investigate the effects of anti-adhesion treatment and high-strength suture technique on the treatment of extensor tendon rupture by animal experiments and clinical application.Methods Twenty-eight leg-born chickens were randomly divided into four groups(7 each).Double cross suture was applied in group A,while double cross suture combined with sodium hyaluronate spraying in group B,cross-finger-like micro-braided suture in group C,and cross-finger-like micro-braided suture combined with sodium hyaluronate spraying in group D.The animals were sacrificed 6 weeks after operation,morphological,histological and biomechanics were observed and compared among the groups.One hundred and sixteen patients were treated with the surgical method in group D(89 males,27 females,aged 20-55 with an average of 36 years;73 with extensor tendon rupture,38 with strain/chalasis,5 with firearm injuries;56 on back of hand,48 on central slip,12 on lateral fixing chorda;82 with one-stage operation,and 34 with second-stage operation),and then followed-up for 2-5 years to observe the therapeutic effects.Results The repaired tendons in group D was in good contour,most tendon cells arranged regularly in bunches.The maximum load was significantly higher in group D(70.9?5.7N) than in group A(48.4?5.7N),Group B(51.3?3.2N) and Group C(68.3?2.8N,P

Objective To explore an effective method of isolating and culturing the vascular endothelial cells of rat thoracic aorta.MethodThe thoracic aorta was harvested under aseptic condition from the thorax of a Wistar rat.The peripheral connective tissue and fat of the thoracic aorta were stripped and disposed,and then the thoracic aorta was turned inside out to expose the intima.The thoracic aorta was ligated with silk and cauterized on both ends with heated forceps.Then the thoracic aorta was cultured in medium DMEM/F12 containing 20% newborn calf serum in a 50 ml culture bottle which was already blanketed with rat tail collagen.The thoracic aorta was discarded and the new culture medium was added into the culture bottle six days later.The migrating cells were differentially digested by 0.125% pancreatic enzyme for serial subcultivation.The cells were identified by immunohistochemical method with anti-Ⅷ factor antibody.ResultA small amount of cells were seen to migrate from the aorta and adhered to the bottom of culture bottle 6 days after cultivation;the migrating cells spread to cover most part of the bottom of culture bottle 12-14 days later.About 70% of the migrated cells were in a confluent monolayer.The confluent cells grew rapidly after being digested with pancreatic enzyme,and they showed a typical cobblestone appearance.The cells were identified as endothelial cells with 100% expression of Ⅷ factor,which was regarded as the marker of endothelial cells.ConclusionThe method established in the present study is simple and easy to handle,it does not need collagen enzyme and endothelial cell growth promoting substrate,and it is economical and applicable.It is especially suitable for isolation and cultivation of vascular endothelial cells of vessels of small caliber.

Objective To identify the main etiologies of emergency room (ER) patients with chest pain or equivalent syndrome.Methods This was a prospective and cross-sectinal survey of ER patinets with chest pain or equivalent syndrome in 17 medical centre in Beijing,China from July to August 2009.Data was collected by structured interviews and medical record reviews.The mean follow up period was 30 days.Results A total of 5666 patients were enrolled in the study (2663 males and 3303 females) and the mean age was 58.1 ± 18.4years.Their final diagnoses were:coronary heart disease 1506 ( 27.4％ ),acute heart failure 149 ( 2.6％ ),pericarditis 4 ( 0.1％ ),pulmonary embolism 11 ( 0.2％ ),aortic dissection 8 ( 0.1％ ),acute cerebrovascular disease 431 ( 7.6％ ) and non-cardic chest pain 2538 ( 44.9％ ).Thirty-seven cased died and 275 cases hospitalized again 30 days later,4.9％ patients with cornary heart disease had symptoms at their presentation.Conclusion Special vigilance and thorough coronary artery evaluation are needed for all patients with chest discomfort or respiratory distress in the ER,even for patients without chest pain.

OBJECTIVETo observe the protective effect of tectorigenin on the vascular endothelial cells(VEC) injured by oxidant low density lipoprotein-cholesterol and the expression of MCP-1 and ICAM-1 mRNA, and explore the mechanism of anti-atherosclerosis.

METHODThe VEC of rat was cultured in vitro and the 100 mg x L(-1) ox-LDL inducing oxidant injured model was used in this study. Different dosage tectorigenin was added into VEC and the activity of VEC was observed by MTT colorimetry. The expression of MCP-1 and ICAM-1 mRNA in VEC was detected by RT-PCR.

RESULTTectorigenin had significantly protective effect on the VEC injured by ox-LDL and obviously inhibited the excessive expression of MCP-1 and ICAM-1 mRNA in VEC.

CONCLUSIONIt was the critical mechanism of anti-atherosclerosis that tectorigenin prevented the VEC oxidant injured and inhibited the excessive expression of MCP-1 and ICAM-1.

Animals ; Atherosclerosis ; drug therapy ; genetics ; metabolism ; Cells, Cultured ; Chemokine CCL2 ; genetics ; metabolism ; Disease Models, Animal ; Endothelial Cells ; drug effects ; metabolism ; Gene Expression ; drug effects ; Humans ; Intercellular Adhesion Molecule-1 ; genetics ; metabolism ; Isoflavones ; pharmacology ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Wistar

Objective:To investigate the efficacy and safety of ixazomib-based therapy for multiple myeloma.Methods:The data of 32 patients with multiple myeloma treated with isazomib-based regimen in the Affiliated Hospital of Jining Medical University from December 2020 to December 2021 were retrospectively analyzed. Among 32 patients, 17 cases were relapsed/refractory, and the remaining 15 cases had initial treatment. The treatment regimens included ID (isazomib + dexamethasone), IRD (isazomib + lenalidomide + dexamethasone) and ICD (isazomib + cyclophosphamide + dexamethasone). The short-term curative effect and adverse reactions of relapsed/refractory patients and patients at initial onset were analyzed.Results:The overall response rate (ORR) of relapsed/refractory patients was 52.9% (9/17), of which 6 cases achieved complete remission (CR), 2 cases achieved very good partial remission (VGPR) and 1 case achieved partial remission (PR). The ORR of refractory patients receiving bortezomib therapy was 40.0% (4/10). The ORR of patients at initial onset who could be evaluated the curative effect was 100.0% (14/14), including 9 cases of CR, 2 cases of VGPR and 3 cases of PR. After treatment, 2 patients (6.2%) had grade Ⅲ-Ⅳ adverse events (1 case of herpes zoster and 1 case of thrombocytopenia), and none of the patients had grade Ⅲ-Ⅳ peripheral neuropathy.Conclusion:Isazomib is effective and safe in the treatment of initially treated and relapsed/refractory multiple myeloma.

Objective:To explore the factors leading to communication disorders in ICU patients during mechanical ventilation from the perspective of both patients and medical staff, and to use the theoretical framework of acceptability to identify the barriers that can be improved by intervention.Methods:Using the method of descriptive phenomenology from July to August 2022, 11 patients with mechanical ventilation and 8 medical staff in the comprehensive ICU of a Yuhuangding Hospital in Yantai were selected for interviews by the purpose sampling method, combined with participatory observation. The interviews of patients were conducted off ventilator. With Nvivo12.0 Plus software, the seven-step analysis method of Colaizzi phenomenology was adopted to summarize the theme and the theoretical framework of acceptability was used to identify the obstacle factors that could be improved by intervention.Results:The age of 11 patients was 18-46 years old, the duration of mechanical ventilation was 9.5-312.3 h. The age of 8 medical staff was 26-54 years old, the length of service in ICU was 2-30 years. A total of 14 themes were extracted. For patients: defensive mood, difficulty in presenting information, introverted personality, communication tools are hard to use, emergency treatment conflict, deny the ability to communicate, thought slowness. For medical staff: defensive mood, cognitive load, high time cost, lack of humane communication strategies, poor training, other priorities, loss of confidence in effective communication, awareness of the importance of communication was not enough.Conclusions:There are many factors that can be improved for patients with mechanical ventilation in ICU. It is suggested to speed up the research and development of high-tech and personalized alternative communication tools in China, reduce negative communication between doctors and patients and nurses and patients, and implement evidence-based multi-mode and progressive communication intervention strategies.

OBJECTIVE：To eva luate content constituent characteristics and antiviral activity of main flavonnoids in genuine and non-genuine Scutellaria baicalensis ，and to investigate quality-efficiency relationship and effective substance. METHODS ： Totally 8 batches of S. baicalensis from different origins （S1-S8）were collected to prepare its water extract lyophilized powder. UPLC method was used to determine the contents of baicalin ，wogonoside，baicalein and wogonin ，and calculate their content constituent ratio. According to the content constituent ratio of flavonoids in S. baicalensis from different origins ，the mixture of the above four components was prepared as the corresponding simulated sample of flavonoids （E1-E8）. Using ribavirin as positive control，MTT assay and CPE method were used to investigate half toxic concentration （TD50）of the water extract from 8 batches of S. baicalensis and their corresponding simulated samples to human laryngeal carcinoma cell Hep-2 and their half inhibition concentration（IC50）to respiratory syncytial virus （RSV）；treatment indexes （TI）were calculated. Pearson correlation analysis for the content of baicalin ，wogonoside，baicalein and wogonin with their anti-RSV activity （IC50）was performed by SPSS 17.0 software. RESULTS ：The contents of baicalin and wogonoside in sample S 4（from Hebei Chengde ）were the highest ，and the contents of baicalein and wogonin in sample S 6（from Inner Mongolia- 2）were the highest. The contents of above 4 components were the lowest in sample S 6，S6，S7（from Beijing ），S4. The contents of flavonoid glycosides in sample S 4 were relatively higher， while those of corresponding glycosides were relatively lower ；the content constituent ratio of baicalin ， wogonoside，baicalein and wogonin was 1∶0.224∶0.111∶0.013. The contents of flavonoid glycosides in sample S6 wererelatively lower ，while those of glycosides were relatively 126.com higher；the content constituent ratio of above 4 components was 1∶0.241∶0.713∶0.106. TC 50 of S. bai calensis water extracts from different origins to Hep- 2 cells was all higher than 50 μg/mL， IC50 to RSV was 11.11-51.74 μg/mL；TI was 1.86-5.20. TC 50 of corresponding simulated samples of flavonoids was 23.11-52.23 μg/mL，while IC 50 to RSV was 4.87-14.61 μg/mL；TI was 1.85-4.75. The anti-RSV effects of water extract of S 4 from genuine origins（Hebei Chengde ）and its corresponding simulated sample E 4 were the strongest. Correlation analysis showed that the correlation coefficient between the contents of 4 flavonoids and antiviral activity was less than 0.5，and there was no significant correlation between them. CONCLUSIONS ：When the content constituent ratio of 4 main flavonoids in S. baicalensis was 1∶0.224∶ 0.111 ∶ 0.013，it has a strong inhibition effect on RSV. S. baicalensis from genuine origins has better constituent characteristics of flavonoids，which may be the important material basis for the best antiviral effect of genuine medicinal material.

Objective To investigate the metabolic characteristics,body composition and dietary intake in elderly sarcopenia patients with type 2 diabetes(T2DM).Methods A total of 652 T2DM patients(327 males and 325 females)aged over 60 years were selected from endocrinology department of nine different hospitals in Beijing.Body composition was measured by bioimpedance analysis,and the appendicular skeletal mass index(ASMI)was calculated.Sarcopenia was defined as body height-adjusted skeletal muscle mass (ASMI)below the lower quintile of the young reference group.The diagnostic cutoff points for sarcopenia were 7.18 kg/m2 for men and 5.73 kg/m2 for women.All patients were divided into the sarcopenia group versus the control group(below vs.not below 7.18 kg/m2 for men and 5.73 kg/m2 for women).The anthropometric parameters,body composition,biochemical laboratory results and dietary intake were compared between the two groups.The blood glucose target levels were less than 7 mmol/L of fasting plasma glucose(FPG)or less than 7％ of haemoglobin A1c(HbA1c).The obesity ratio was calculated according to body fat percentage more than 25％ in men and more than 30％ in women as obesity.Results There were 116 (17.8％)patients in the sarcopenia group (men/women,82/34),and 536 (82.2 ％) patients in the control group (men/women,245/291).Age was higher in the sarcopenia group than in the control group(t =4.385,P =0.000),and body mass index and waist hip ratio(WHR)were lower in the sarcopenia group than in the control group(t =11.724 and 4.173,P=0.000 and 0.000).FPG[(7.5±2.4) mmol/L vs.(8.5±2.5)mmol/L,t =-3.450,P=0.001]and HbA1c[(7.0±1.6) ％ vs.(8.2± 1.7) ％,t =-5.745,P =0.000] were higher in male sarcopenia group than in male control group.The control rate of FPG (127.0％ or 51.8％ vs.27.0％ or 32.9％,x2=8.817,P=0.003)and HbA1c(131.0％ or 53.5％ vs.23.0％ or 28.0％,x2 =15.934,P=0.000)were lower in the sarcopenia group than in the control group.The red blood cell counts,hemoglobin and serum albumin levels,estimated glomerular filtr ationrate(eGFR)were lower in male sarcopenia group than in the male control group(P＜0.05).eGFR was lower in female sarcopenia group than in female control group(t =4.090,P =0.000).Both in men and women,ASMI,grip power,fatless circumference on upper arm,bone mineral content and basal metabolic rate were lower in the sarcopenia group than in the control group(P＜0.05).The total daily intake of energy,carbohydrate,protein and fat were lower in male sarcopenia group than in male control group(P＜ 0.05).Conclusions Compared with the control group,sarcopenia patients are older with worse glycemic control and lower levels of BMI,WHR,renal function,muscle mass and muscle strength.Sarcopenia patients are more prone to osteoporosis.Furthermore,they have poorer nutritional status with an imbalance of dietary intake.Appropriate increase of protein especially high quality protein intake should be recommended to sarcopenia patients with T2DM.