The development of ulcerative colitis(UC)is closely related to genetic and environmental factors,impaired intestinal mucosal barrier function,intestinal immunological disorders and dysbiosis of intestinal bacterial flora.Acupuncture and moxibustion treatment has been emphasized for improving intestinal inflammation in UC.In this article,the mechanism of acupuncture and moxibustion in alleviating UC was reviewed from the aspects of immune cells,inflammatory factors and intestinal flora,and believed that acupuncture may exert therapeutic effects by improving the immune homeostasis among T-lymphocytes,inhibiting the expression of pro-inflammatory factors including IL-1β,IL-6 and IL-8,regulating the abundance of different species of intestinal flora,modulating macrophage polarization,and inhibiting oxidative stress.The possible mechanism of acupuncture and moxibustion in the treatment of UC was summarized to provide reference for the related research of inflammatory bowel disease.

The development of ulcerative colitis(UC)is closely related to genetic and environmental factors,impaired intestinal mucosal barrier function,intestinal immunological disorders and dysbiosis of intestinal bacterial flora.Acupuncture and moxibustion treatment has been emphasized for improving intestinal inflammation in UC.In this article,the mechanism of acupuncture and moxibustion in alleviating UC was reviewed from the aspects of immune cells,inflammatory factors and intestinal flora,and believed that acupuncture may exert therapeutic effects by improving the immune homeostasis among T-lymphocytes,inhibiting the expression of pro-inflammatory factors including IL-1β,IL-6 and IL-8,regulating the abundance of different species of intestinal flora,modulating macrophage polarization,and inhibiting oxidative stress.The possible mechanism of acupuncture and moxibustion in the treatment of UC was summarized to provide reference for the related research of inflammatory bowel disease.

Objective To observe the effect of electroacupuncture(EA)on the immune balance between helper T cell 17(Th 17)/regulatory T cells(Treg)in the spleens of mice with dextran sulfate sodium(DSS)-induced ulcerative colitis(UC)by modulating the interleukin-6(IL-6)/signal transducer and activator of transcription 3(STAT3)signaling pathway,and to explore part of the mechanism of EA on treating UC.Methods Male C57BL/6N mice were randomly divided into UC model group,EA group,and sham acupuncture(SA)group,with 10 mice in each group,and 10 mice in the blank control group.After establishing the UC model mice by DSS free-drinking method,bilateral"Tianshu(ST25)"and"Shangjiuxu(ST37)"were selected for EA or SA treatment for 20 min each time,with a total of 10 times.The general condition and disease activity index(DAI)of the mice in each group were observed,the pathological changes of colon tissue were observed by HE staining,the levels of IL-6,IL-10 and IL-17 in serum were detected by ELISA,and the protein expression levels of IL-6,STAT3,retinoic acid-related orphan receptor gamma t(RORγt)and Forkhead box protein P3(FoxP3)were detected by Western blot in the colon tissue.Results Compared with the blank group,mice in the model group had significantly higher DAI scores(P＜0.01),with colonic mucosal rupture and massive inflammatory cell infiltration.Significant increases were detected in serum IL-6 and IL-17 levels(P＜0.01),with significant reductions in IL-10 levels(P＜0.01).Significant increases were detected in the expression of IL-6,STAT3,and RORγt in colonic tissues(P＜0.01),with the decreased expression of FoxP3(P＜0.05).The percentage of Th17 cells in the spleen was increased and the percentage of Treg cells was decreased(P＜0.05).Compared with the model group,mice in the EA group had lower DAI scores(P＜0.05),with reduced colonic injury,decreased inflammatory infiltration.Decreased serum IL-6 and IL-17 levels,with increased IL-10 levels(P＜0.05)were detected.Significantly lower IL-6,STAT3,and RORγt expression in the colonic tissues(P＜0.01),and increased FoxP3 expression(P＜0.05)were detected,as well as the decreased percentage of Th17 cells and increased percentage of Treg cells in spleen(P＜0.05).However,the colonic injury of mice in the SA group did not show any improvement,and no statistical difference was observed in these indexes compared with the model group.Conclusion EA may exert a therapeutic effect on UC by down-regulating the IL-6/STAT3 signaling pathway and promoting the restoration of immune balance by Th17/Treg,thereby diminishing intestinal inflammation in UC mice.

Objective To observe the effect of electroacupuncture(EA)on the immune balance between helper T cell 17(Th 17)/regulatory T cells(Treg)in the spleens of mice with dextran sulfate sodium(DSS)-induced ulcerative colitis(UC)by modulating the interleukin-6(IL-6)/signal transducer and activator of transcription 3(STAT3)signaling pathway,and to explore part of the mechanism of EA on treating UC.Methods Male C57BL/6N mice were randomly divided into UC model group,EA group,and sham acupuncture(SA)group,with 10 mice in each group,and 10 mice in the blank control group.After establishing the UC model mice by DSS free-drinking method,bilateral"Tianshu(ST25)"and"Shangjiuxu(ST37)"were selected for EA or SA treatment for 20 min each time,with a total of 10 times.The general condition and disease activity index(DAI)of the mice in each group were observed,the pathological changes of colon tissue were observed by HE staining,the levels of IL-6,IL-10 and IL-17 in serum were detected by ELISA,and the protein expression levels of IL-6,STAT3,retinoic acid-related orphan receptor gamma t(RORγt)and Forkhead box protein P3(FoxP3)were detected by Western blot in the colon tissue.Results Compared with the blank group,mice in the model group had significantly higher DAI scores(P＜0.01),with colonic mucosal rupture and massive inflammatory cell infiltration.Significant increases were detected in serum IL-6 and IL-17 levels(P＜0.01),with significant reductions in IL-10 levels(P＜0.01).Significant increases were detected in the expression of IL-6,STAT3,and RORγt in colonic tissues(P＜0.01),with the decreased expression of FoxP3(P＜0.05).The percentage of Th17 cells in the spleen was increased and the percentage of Treg cells was decreased(P＜0.05).Compared with the model group,mice in the EA group had lower DAI scores(P＜0.05),with reduced colonic injury,decreased inflammatory infiltration.Decreased serum IL-6 and IL-17 levels,with increased IL-10 levels(P＜0.05)were detected.Significantly lower IL-6,STAT3,and RORγt expression in the colonic tissues(P＜0.01),and increased FoxP3 expression(P＜0.05)were detected,as well as the decreased percentage of Th17 cells and increased percentage of Treg cells in spleen(P＜0.05).However,the colonic injury of mice in the SA group did not show any improvement,and no statistical difference was observed in these indexes compared with the model group.Conclusion EA may exert a therapeutic effect on UC by down-regulating the IL-6/STAT3 signaling pathway and promoting the restoration of immune balance by Th17/Treg,thereby diminishing intestinal inflammation in UC mice.

Objective To explore the application value of aspirin and clopidogrel dual antiplatelet treatment combined with ABCD3-Ⅰ scores in treatment of transient ischemic attack (TIA).Methods Risk factors were evaluated and imaging was performed in 48 h in one hundred and twenty patients with first attack of TIA [magnetic resonance imaging (MRI),magnetic resonance angiography (MRA),diffusion weighted imaging (DWI) scan].According to the ABCD3-Ⅰ evaluation method,the patients were divided into low risk group,moderate risk group and high risk group.Single resistance group was given aspirin 100 mg/d; double resistance group was given aspirin 100 mg/d combined with clopidogrel 75 mg/d.Then the incidence of ischemic stroke in each group within 7 days was observed,and the effects of dual anti-platelet and aspirin monotherapy were compared.Results Within 7 d after TIA,low-risk single resistance group and low-risk double resistance group had no stroke; 9 cases (42.9％,9/21) had stroke in moderate-risk single resistance group,2 cases (2/19) had stroke in moderate-risk double resistance group,and there was significant difference (P ＜ 0.05) ; 9 cases (9/18) had stroke in high-risk single resistance group,3 cases (15.0％,3/20) had stroke in high-risk double resistance group,and there was significant difference (P ＜ 0.05).Three patients in single resistance group and 4 cases in double resistance group showed gastrointestinal adverse reactions such as nausea,acid reflux,and there was no significant difference between 2 groups (P ＞ 0.05).Each group during treatment showed no bleeding tendency,and liver and kidney function in patients was normal.Conclusion In patients of the moderate risk and high risk of ABCD3-Ⅰ scores,dual anti-platelet may have an advantage over single druge in the prevention of ischemic stroke.

Objective To explore the value of ABCD3-Ⅰ score in predicting prognosis of transient ischemic attack (TIA).Methods A total of 106 TIA patients were evaluated according to ABCD2,ABCD3 and ABCD3-Ⅰ criteria.The occurrence of cerebral infarction within 7 d and 90 d was observed.The patients with ABCD3-Ⅰ 0-3 scores were as low risk group (36 cases),the patients with ABCD3-Ⅰ 4-7 scores were as moderate risk group (36 cases),the patients with ABCD3-Ⅰ 8-13 scores were as high risk group (34 cases).Results The occurrence of cerebral infarction within 7 d and 90 d in high risk group was lower than that in low risk group and moderate risk group [within 7 d:23.5％(8/34) vs.2.8％(1/36) and 5.6％ (2/36),within 90 d:38.2％ (13/34) vs.2.8％ (1/36) and 11.1％ (4/36)],and there was significant difference (P ＜0.01).Symptom duration time ≥10 min in ABCD3-Ⅰ score,concomitant diabetes,double TIA,ipsilateral carotid artery stenosis ≥50％,high sign in diffusion weighted imaging were the risk factors for the occurrence of cerebral infarction within 7 d and 90 d in TIA patients (P ＜ 0.05).The area under the receiveroperating characteristic curve for predicting the occurrence of cerebral infarction within 7 d and 90 d in TIA patients by ABCD3-Ⅰ score was higher than that by ABCD2 and ABCD3 score (0.914 vs.0.614 and 0.877,0.869 vs.0.633 and 0.773).Conclusion The ABCD3-Ⅰ score is a simple and effective way to judge the short-term prognosis of TIA and can help to identify the different risk levels,so it is helpful in stratification treatment.

OBJECTIVE: To evaluate the efficacy and safety of thread-dragging through fistula method in treating patients with simple anorectal fistula. METHODS: In this multi-centered, prospective, and randomized controlled clinical trial, 244 patients with simple low or high anorectal fistula were randomly divided into study group (with the method of thread-dragging through fistula) and control group (with the method of incision or thread-drawing). The healing time and curative rate of anorectal fistula, and the integral calculus of clinical symptom and life quality evaluations before and after treatment were all examined. The maximal anal canal squeeze pressure was measured to compare the therapeutic safety between these two groups. The health economical benefits were also assessed to determine which therapeutic method was more economical. RESULTS: The curative rate of simple low and high anorectal fistula were of no significant differences between the study group and the control group. The healing time of simple low anorectal fistula in the study group and the control group were (22.26+/-8.67) d and (31.41+/-11.39) d respectively, while the healing time of simple high anorectal fistula in the study group and the control group were (24.73+/-8.15) d and (32.20+/-12.60) d respectively, and there revealed significant differences between these two groups. Each integral calculus of clinical symptom evaluation in the study group was not obviously different from those in the control group besides the integral calculus of anal sphincter function. The integral calculus of life quality between the study group and the control group of simple low anorectal fistula had no significant differences. The integral calculus of anal sphincter function and confidence in treatment in the study group of high anorectal fistula were better than those in the control group. The hospitalization expense of the study group was remarkably lower than that of the control group. The maximal anal canal squeeze pressure in the study group after treatment was not reduced obviously as compared with that in the same group before treatment, while it was decreased significantly in the control group after treatment as compared with those in the same group before treatment and in the study group after treatment. CONCLUSION: The method of thread-dragging through fistula in treating simple low and high anorectal fistula can shorten the course of the disease, save the hospitalization expenses, improve the life quality of the patients, and protect the anal sphincter function.