Science of Meridians and Acupoints is the bridge between basic medicine and clinical medicine of acupuncture and moxibustion. This teaching practice was conducted in reference to the teaching mode of problembased learning (PBL), in association with the clinical design problems, by taking as the students as the role and guided by teachers. In order to stimulate students' active learning enthusiasm, the writers implemented the class teaching in views of the typical questions of clinical design, presentation of study group, emphasis on drawing meridian running courses and acupoint locations, summarization and analysis, as well as comprehensive evaluation so that the comprehensive innovative ability of students and the teaching quality could be improved.
Acupuncture ; education ; Acupuncture Points ; Humans ; Meridians ; Problem-Based Learning ; Science ; education ; Teaching

Objective To evaluate clinical remission in patients with small bowel Crohn's disease (SBCD) who have received infliximab(IFX) therapy and to evaluate capsule endoscopy combined with ileocolonoscopy for mucosal healing at 14th week of IFX therapy.Methods Clinical data of 23 SBCD patients who received IFX were retrospectively analyzed.Laboratory indices [routine blood tests,C-reactive protein (CRP)and albumin],Crohn's disease activity index (CDAI),Lewis score (LS),Crohn's disease simplified endoscopic score (SES-CD),side effects and complications were compared before IFX treatment and at 14th week of IFX therapy.Results In 23 SBCD patients,both CDAI and CRP levels significantly decreased (P＜0.01) while body mass index (BMI) and albumin levels increased at 14th week (P＜0.05),compared with those before treatment.The clinical remission rate at 14th week was 91.3％ (21/23).There were 8/23 (34.8％)SBCD patients achieving mucosal healing in small bowel,12/21 (57.1％) in terminal ileum and colon,and 7/21 (33.3％) in both small bowel and colon.Twelve patients achieved both clinical remission and biochemical remission at 14th week and all of them achieved mucosal healing in both terminal ileum and colon (SES-CD ≤ 2).However,there were 5 (41.7％) of them still with small bowel inflammation (LS＞ 135).Conclusion IFX plays a role in promoting clinical remission and mucosal healing in SBCD patients.Mucosal healing of CD patients in terminal ileum and other parts of small intestine are not synchronized.For CD patients with small bowel and colon involved,the evaluation of the whole gastrointestinal tract by capsule endoscopy combined with ileocolonoscopy is recommended on condition that they have no intestinal obstruction or severe stricture.

Objective To detect the osteopontin (OPN) autocrine function of the osteoclasts in neurofibromatosis type 1 heterozygote (Nfl+/-) and wild type (Nfl+/+) mice.Test the osteoclasts function of neurofibromatosis type 1 heterozygote (Nfl+/-) and wild type (Nil+/+) mice with exogenous neutralizing OPN antibody,analysis the role of autocrine OPN in the hyperfunction of osteoclast in neurofibromatosis type 1.Methods Culture the low density bone marrow cells from Nfl heterozygote (Nfl+/-) and wild type (Nfl+/+) mice (4-6 weeks old) with macrophage colony-stimulating factor (M-CSF) and receptor activator of NF-κB ligand(RANKL),Measure.the OPN concentration in osteoclast culture superenant with ELISA.Culture the low density bone marrow cells from Nf1+/-and Nf1+/+ mice with or without exogenous neutralizing antibody for OPN.The function of osteoclasts and osteoclast progenitors in formation,migration,adhesion,and bone absorption were tested.Results A significantly higher concentration of OPN was detected in the Nf1+/-osteoclast culture media as compared to that of wild type.In control,Osteoclast functions,including migration,adhesion,and bone resorption of Nf1 +/-were higher than that of wild type.Addition OPN neutralizing antibody to the Nf1+/-OCL significantly reduced OCL formation.Neutralizing OPN antibody diminished both wild type and Nf1+/-OCL adhensiontion,Anti-OPN minimized OCL migration in both wild type and Nf1 +/-OCL cultures as measured by the transwell assays.Neutralizing OPN antibody diminished both wild type and Nf1+/-OCL pit formation,P＞0.05 for comparing Nfl+/-vs.wild type OCLs with anti-OPN antibody.Conclusion The hyperfunction of osteoclast in Nf1 heterozygote is related with autocrine osteopontin,inhibition of OPN may be an effective treatment for bone destruction of neurofibromatosis type 1.

This study was aimed to establish determination method of content and related substances of piperaquine in A rtemisinin and Piperaquine Tablets, and to set the limit of related substance. HPLC was adopted on a SHISEIDO CAPCELL PAK C18 (4.6 mm í 250 mm, 5 μm) using an isocratic mobile phase consisted of acetonitrile: 0.1%trichloroaceticacid:triethylamine (18:82:0.2, V:V:V, pH 2.5) with a flow rate of 1.0 mL·min-1. The column tempera-ture was kept at 30oC and the detection wavelength was set at 216 and 237 nm, separately for the determination of related substance and content. The results showed that piperaquine and its related impurity can be separated effec-tively. The concentration-response relationship was linear over the range of 0.01-0.2 mg·mL-1 (R2=0.999 9). The av-erage recovery rate was 98.14% (RSD=0.77%, n=9). The minimum detection limit was 0.06 μg·mL-1. The solution was stable for 12 h. It was concluded that the method was specific, accurate, sensitive and suitable for the determi-nation of content and related substances of piperaquine in A rtemisinin and Piperaquine Tablets.

Infrared (IR) spectroscopy was employed to identify the Artemisinin and Piperaquine Tablets. Artemisinin and piperaquine was extracted separately by different solvents, and IR spectra were collected. IR absorption spectrum of the extract was concordant with the reference spectrum recorded in the Atlas of Infrared Spectra of Drugs, except for a group of small absorptions at 1 574 cm-1 for the artemisinin extract. It was concluded that IR method is stable and accurate, which can be used to identify the Artemisinin and Piperaquine Tablets.

Objective: To carry out multipath cytogenetic analysis of a rare case of acute myeloid leukemia (AML) with 11q23 aberration and D13S319 deletion. Methods: G+ R banding technique was used to analyze the chromosomal karyotype of the patient after 24 h of cell culture. Combined interphase and metaphase fluorescence in situ hybridization (FISH) was used to detect specific chromosomal sites for complex translocations and minor missing fragments. Results: The patient was found to harbor MLL-AF10 fusion gene due to rearrangement of the mixed lineage leukemia (MLL) gene in conjunct with deletion of the D13S319 locus on chromosome 13. Conclusion Whether MLL gene rearrangement and absence of D13S319 locus has a double impact on AML should attract more attention. For AML patient with clonal abnormalities such as 13q-, del (13)(q14), -13 or der (13), FISH assay should be proof and considered to determine the size of missing fragment so as targeted therapy may be implemented.

Objective To study the relationship between jejunal-ileum lesions and terminal ileum lesions of patients with isolated small intestinal Crohn disease, and to compare the clinical and endoscopic features of patients having normal terminal ileum with those having abnormal terminal ileum in isolated small intestinal Crohn disease. Methods The data of patients diagnosed as having isolated small intestinal Crohn disease and successively receiving colonoscopy and small bowel capsule endoscopy in Nanfang Hospital of Southern Medical University from January 2008 to October 2015 were retrospectively analyzed. The patients were divided into normal terminal ileum group and abnormal terminal ileum group according to the result of colonoscopy. The clinical and endoscopic features of the two groups were compared. Results The data of 62 patients were collected, and jejunal-ileum lesions were found in all of the patients under small bowel capsule endoscopy. According to the result of colonoscopy, 40 patients ( 64. 5%) were grouped to the abnormal terminal ileum group and 22 patients ( 35. 5%) to the normal group. The patients in the normal terminal ileum group had a shorter disease duration than those of the abnormal group [ 68. 2%( 15/22) VS 12. 5%( 15/40) , P=0. 021] . The sex and age distribution, smoking history, clinical feature, upper gastrointestinal involvement, perianal lesion, disease behavior, Crohn disease activity index, inflammation markers and nutriture between the two groups had no statistical difference ( P>0. 05) . Conclusion The terminal ileum lesions found by colonoscopy cannot predict small bowel lesions for Crohn disease. Small bowel capsule endoscopy is helpful for the detection of small intestinal lesions in Crohn disease. We should pay more attention to evaluating the small bowel lesions when the patients with Crohn disease have a short duration and normal terminal ileum.

Objective To assess the protective effect of rabbit serum paraoxonase-1 (PON-1) on renal injury induced by dichlorvos in rats.Methods Totally 30 healthy S-D rats were randomly divided into 5 groups:control group (group A,n =6),exposure group (group B,n =6),PON-1 pretreatment group (group C,n =6),traditional atropine,pralidoxime treatment group (group D,n =6) and combination therapy group (group E,n =6).The rats of group A were given normal saline in equal volume of dichlorvos injected into abdominal cavity to make a false model of dichlorvos poisoning.In rats of groups B,C,D and E,9 mg/kg dichlorvos was administered.In rats of groups C and E,PON-1 4 500 units/kg was injected into vein of the tails half an hour before dichlorvos administration.After dichlorvos exposure,rats in group D and E were treated with 45 mg/kg iodoprofen and 10 mg/kg atropine by intraperitoneal injection.The activity of blood urea nitrogen (BUN) was assayed with urease.Serum creatinine (Cr) were measured by picric acid colorimetry.Serum Cys-C,KIM-1 and NAG in urine were determined by ELISA.Ultrastructural changes in renal tissues of rats were examined by light microscopy.The differences in laboratory findings between groups were compared.Results The creatinine level in group B was significantly higher than that in other groups (P ＜0.05).The levels of Cys-C,KIM-1 and NAG in group B and group D were significantly higher than those in group A (P ＜ 0.01).But there were no significant differences in above biomarkers among group C,group E and group A.There were no significant differences in above biomarkers between group B and group D.In group B,inflammatory cells infiltrated extensively in renal tissues and,the renal cells were congested and edematous,the lumen was obliterated and the border of the brush disappeared.The tubular structures were not clearly distinct found in group B,but edema and inflammatory cell infiltration with lesser degree were found in group D than those in dichlorvos exposure groups.The clearly distinct structure of the tube without completely occluded lumen in group D,and the most serious lesions were found in distal convoluted tubules.In group C,and group E,there were only mild congestion and edema without significant cell degeneration and necrosis.In group A,the structure of renal tubular epithelium was clearly distinct with brush-shaped margin,and without tubular or necrotic cell debris in the lumen.Conclusion The rabbit serum PON-1 can protect the renal tissue of rats after dichlorvos exposure.

Objective To explore whether the use of purified rabbit serum paraoxonase 1 (PON1) for the treatment of dichlorvos-induced liver injury in rats is superior to traditional method.Methods Thirty male SD rats were randomly divided into the followint 5 groups,with 6 rats in each group:control group (A group),dichlorvos group (B group),traditional treatment group (C group),PON 1 treatment group (D group),combined treatment group (E group).Rats in groups B,C,D and E were adminstered dichlorvos by intraperitoneal injection 9 mg/kg.In group C,atropine 10 mg/kg and iodine solution 45 mg/kg were injected intraperitoneally within 2 min after dichlorvos administration.In group D,PON1 was injected intravenously at a dose of 9 600 U/kg,30 min prior to poisoning.In group E,PON1 was injected intravenously at a dose of 9 600 U/kg,30 min prior to poisoning,followed by in travenous injection of atropine 10 mg/kg and iodine solution 45 rng/kg within 2 min after poisoning.Rats in A group received normal saline.Blood was collected at different time points to examine the acetyl cholinesterase (AChE)-levels by ELISA method.Liver tissue were collected at 12 hours after model establishment to observe the pathological changes.The expression of 4 hydroxy 2-nonenal (4-HNE) in the liver tissue was detected by immunohistochemistry and Western blotting.Results In group B,AChE levels decreased significantly,liver cells showed severn fatty degeneration,karyopyknosis and other pathological changes,and 4-HNE expression increased.The pathological changes of group D and group E were less obvious than those of group C,and the 4-HNE expression in the group D and group E were significantly different from that in the group C (P＜ 0.05).Conclusion PON1 plays a protective role in dichlorvos-induced liver injury in rats,and this protection is better than that offered by traditional treatment.

Pancreatitis is one of the most common inflammatory diseases of the pancreas caused by autodigestion induced by excessive premature protease activation. However, recognition of novel pathophysiological mechanisms remains a still challenge. Both genetic and environmental factors contribute to the pathogenesis of pancreatitis, and the gut microbiota is a potential source of an environmental effect. In recent years, several new frontiers in gut microbiota and genetic risk assessment research have emerged and improved the understanding of the disease. These investigations showed that the disease progression of pancreatitis could be regulated by the gut microbiome, either through a translocation influence or in a host immune response manner. Meanwhile, the onset of the disease is also associated with the heritage of a pathogenic mutation, and the disease progression could be modified by genetic risk factors. In this review, we focused on the recent advances in the role of gut microbiota in the pathogenesis of pancreatitis, and the genetic susceptibility in pancreatitis.