ObjectiveTo observe the efficacy of wrist-ankle acupuncture plus auricular point sticking in treating pre-exam anxiety syndrome.MethodSixty patients with pre-exam anxiety syndrome were randomized into a treatment group to receive wrist-ankle acupuncture plus auricular point sticking (30 cases, 11 cases dropped out) and a control group to receive auricular point sticking (30 cases, 1 dropped out). In the treatment group, the bilateral Upper 1 zones were punctured regarding the wrist-ankle acupuncture, and for the auricular point sticking, Heart (CO 15), ear Shenmen (TF 4), Endocrine (CO 18), Adrenal Gland (TG 2p), Subcortex (AT 4) were selected. In the controlgroup, the same auricular points were treated. For both groups, the intervention began from 1 week prior to the exam, 3 d as a treatment course, and the therapeutic efficacy was evaluated after 2 successive courses. The Sarason Test Anxiety Scale (TAS) and autonomic function test were used to assess the anxiety severity before and after treatment. ResultThe total effective rate was 84.2% (16/19) in the treatment group versus 82.8% (24/29) in the control group, and the difference was statistically insignificant (P>0.05). The TAS score dropped significantly in the control group after intervention (P<0.01).ConclusionWrist-ankle acupuncture plus auricular point sticking and auricular point sticking alone both can effectively improve the symptoms of pre-exam anxietysyndrome.

Objective To study the diagnosis value of giant cell temporal arteritis with high frequency ultrasonography and magnetic resonance imaging.Methods The total of 29 cases testified as giant cell temporal arteritis clinically were assessed by high frequency ultrasonography and magnetic resonance imaging.The 29 cases were assessed by high frequency ultrasonography,the 11 cases were assessed by magnetic resonance imaging,mural thickness and lumen diameter of temporal arteries were examined,and were compared with the biopsy specimens.Meanwhile 30 healthy volunteers were randomly selected as control group,the ultrasonography of normal temporal arteries were analyzed.Results All temporal arteries were diaplayed clearly.27 cases were diagnosed for giant cell temopral arteritis by high frequency ultrasonography in 29 cases,the diagnostic accuracy was 93.1％.The 11 cases were diagnosed by magnetic resonance imaging,the diagnostic accuracy was 100％.The imaging features were mural thickness,the lumen stenosis,and partial temporal arteries occluded,the mural was contrasted by Gd-DTPA.Conclusions High frequency ultrasonography and magnetic resonance imaging are noninvasive methods for giant cell temporal arteritis diagnosis,it is important clinical value for therapy.

Objective To evaluate the role of necroptosis in liver injury induced by intestinal ischemia-reperfusion (I/R) in rats.Methods Thirty-two healthy adult male Sprague-Dawley rats,weighing 250-300 g,were divided into 4 groups (n=8 each) using a random number table:sham operation group (S group),I/R group,specific necroptosis inhibitor necrostatin-1 group (N group) and dimethyl sulfoxide (DMSO) group (D group).Intestinal I/R was produced by occlusion of the superior mesenteric artery for 1.5 h followed by 6 h of reperfusion.The superior mesenteric artery was only isolated but not ligated in group S.At 30 min before ischemia,necrostatin-1 1 mg/kg (diluted to 200 μl in DMSO) was intraperitoneally injected in group N,while the equal volume of DMSO was given instead in group D.The animals were sacrificed at the end of reperfusion,livers were removed for examination of the pathological changes with a light microscope,and the severity of liver injury was evaluated using the Eckhoff's scale score.Blood samples were collected from the cardiac apex for determination of serum alanine transaminase (ALT) concentrations by enzyme-linked immunosorbent assay.The expression of receptor-interacting protein kinase 1 (RIP1),RIP3 and high-mobility group box 1 protein (HMGB1) in cytoplasm of hepatocytes was detected by Western blot.The location of RIP1 and RIP3 in liver tissues was determined by immunohistochemistry,and the translocation of HMGB1 from nucleus to cytoplasm was tested by immunofluorescence.Results Compared with group S,the Eckhoff's scale score of liver tissues and serum ALT concentration were significantly increased,the expression of RIP1,RIP3 and HMGB1 in liver tissues was up-regulated (P＜0.05),and the hepatocytes in which RIP1 and RIP3 were highly expressed in the portal area were increased in group I/R.Compared with group I/R,the Eckhoff's scale score of liver tissues and serum ALT concentration were significantly decreased,the expression of RIP1,RIP3 and HMGB1 in liver tissues was down-regulated (P＜0.05),and the hepatocytes in which RIP1 and RIP3 were highly expressed in the portal area were decreased in group N,and no significant changes were found in the variables mentioned above in group D (P＞0.05).HMGB1 was expressed in the nucleus of hepatocytes in the portal area in group S;a large number of HMGB1 in hepatocytes in the portal area was translocated to cytoplasm in I/R and D groups;a small number of HMGB1 in hepatocytes in the portal area was translocated to cytoplasm in group N.Conclusion Necroptosis is involved in intestinal I/R-induced liver injury in rats.

Diarrhea-predominant irritable bowel syndrome （IBS-D） is a chronic functional bowel disorder characterized by abdominal pain and diarrhea， with visceral hypersensitivity and abnormal gastrointestinal dynamics as the pathophysiological basis. The brain-gut interaction plays a role in pain-related functional gastrointestinal disorders， especially IBS-D. 5-Hydroxytryptamine （5-HT）， as an important brain-gut peptide regulating gastrointestinal function， affects brain activity， gastrointestinal motility， pain perception， mucosal inflammation， and immune response through brain-gut interaction and is associated with the occurrence and development of IBS-D. In recent years， traditional Chinese medicine （TCM） has shown great potential to mitigate gastrointestinal symptoms and improve the quality of life with its holistic view and treatment based on syndrome differentiation. Studies have shown that TCM treats IBS-D by regulating the 5-HT signaling pathway. With a focus on syndrome differentiation in TCM， this paper systematically describes the efficacy and mechanism of TCM in treating different TCM syndromes of IBS-D via the 5-HT signaling pathway， aiming to provide a scientific basis for TCM treatment of this disease.

Objective:To investigate the pathological characteristics and the clinical significance of novel coronavirus (2019-nCoV)-infected pneumonia (termed by WHO as coronavirus disease 2019, COVID-19).Methods:Minimally invasive autopsies from lung, heart, kidney, spleen, bone marrow, liver, pancreas, stomach, intestine, thyroid and skin were performed on three patients died of novel coronavirus pneumonia in Chongqing, China. Hematoxylin and eosin staining (HE), transmission electron microcopy, and histochemical staining were performed to investigate the pathological changes of indicated organs or tissues. Immunohistochemical staining was conducted to evaluate the infiltration of immune cells as well as the expression of 2019-nCoV proteins. Real time PCR was carried out to detect the RNA of 2019-nCoV.Results:Various damages were observed in the alveolar structure, with minor serous exudation and fibrin exudation. Hyaline membrane formation was observed in some alveoli. The infiltrated immune cells in alveoli were majorly macrophages and monocytes. Moderate multinucleated giant cells, minimal lymphocytes, eosinophils and neutrophils were also observed. Most of infiltrated lymphocytes were CD4-positive T cells. Significant proliferation of type Ⅱ alveolar epithelia and focal desquamation of alveolar epithelia were also indicated. The blood vessels of alveolar septum were congested, edematous and widened, with modest infiltration of monocytes and lymphocytes. Hyaline thrombi were found in a minority of microvessels. Focal hemorrhage in lung tissue, organization of exudates in some alveolar cavities, and pulmonary interstitial fibrosis were observed. Part of the bronchial epithelia were exfoliated. Coronavirus particles in bronchial mucosal epithelia and type Ⅱ alveolar epithelia were observed under electron microscope. Immunohistochemical staining showed that part of the alveolar epithelia and macrophages were positive for 2019-nCoV antigen. Real time PCR analyses identified positive signals for 2019-nCoV nucleic acid. Decreased numbers of lymphocyte, cell degeneration and necrosis were observed in spleen. Furthermore, degeneration and necrosis of parenchymal cells, formation of hyaline thrombus in small vessels, and pathological changes of chronic diseases were observed in other organs and tissues, while no evidence of coronavirus infection was observed in these organs.Conclusions:The lungs from novel coronavirus pneumonia patients manifest significant pathological lesions, including the alveolar exudative inflammation and interstitial inflammation, alveolar epithelium proliferation and hyaline membrane formation. While the 2019-nCoV is mainly distributed in lung, the infection also involves in the damages of heart, vessels, liver, kidney and other organs. Further studies are warranted to investigate the mechanism underlying pathological changes of this disease.