Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Burning Mouth Syndrome ; therapy ; Female ; Humans ; Male ; Middle Aged ; Tongue ; anatomy & histology ; immunology

By means of global budget,the disease-specific scoring method was put in place for both settlement and payment in Huaian,Jiangsu province,for the purpose of cost control by the hospitals.This reform consists of total cost accounting,rational performance-based distribution system,multi-approached regulation of medical behaviors,and individual disease management to regulate medical behavior.These efforts aim at aligning with medical insurance payment reform,so as to improve hospital management,operation quality and socio-economic outcomes.Problems found in practice were also reviewed.

Objective To investigate the effects of granulocyte-macrophage colony-stimulating factor (GM-CSF) on the generation of human myeloid derived suppressor cells (MDSCs) relied on peripheral blood monocytes,and to establish efficient induction system in vitro of MDSCs.Methods Kidney transplantation recipients between January and March 2017 were included in this study.Purified CD14 + cells isolated from peripheral blood were cultured in the presence of GM-CSF with different concentrations for 7 days.Phenotypes and immunosuppressive abilities of induced MDSCs (iMDSCs) were investigated with FACS analyses.Inducible nitric oxide synthase (iNOS) mRNA expression was detected by qRT-PCR to determine the influence of iNOS-pathway on the immunosuppressive abilities of iMDSCs.Results A total of 11 recipients were included in this study.HLA-DR expression decreased sharply after the culture with GM-CSF.iMDSCs showed the similar phenotype characteristics with monocytic-MDSCs (M-MDSCs) as well as significant ability to suppress T cells proliferation and cytokines production.iMDSCs expressed higher levels of iNOS than monocytes,and the inhibitor effects of iMDSCs were significantly reduced after treatment with L-NMMA (1 mmol/L).The variations of phenotype and suppressive ability were concentrationdependent,and more significant changes could be revealed in the group of 10 μg/L GM-CSF.Conclusion GM-CSF-treated peripheral blood monocytes can be efficiently transformed to M-MDSCs,and suppress T cells proliferation and cytokines secretion via iNOS-dependent pathway.These results may contribute to establish MDSCs induction system,which would provide a basis for the clinical application of MDSCs.

Objectives To observe the changes of apoptosis-related proteins during the development of sarcopenia and to explore the effect and mechanism of long-term aerobic exercises and heat shock protein 70 (HSP70) on those changes for the natural aging C57BL/6 mice.Methods After 1 week of acclimatization,50 27-week-old male C57BL/6 mice were randomly divided into a young sedentary control (YS) group,an old sedentary control (OS) group and an old exercises (OE) group.After the gripstrength was measured the mice from group YS were sacrificed at the age of 28 weeks.The mice from group OE exercised on a fiat treadmill at 12rn/minute for 50 min 3 or 4 times a week for 30 weeks with the intensity of 75％ VO2max.At the age of 60 weeks,the mice of group OS and OE were killed after their grip-strength was measured.The gastrocnemius muscle of each group were isolated and weighted,and the sarcopenia index (SI) was measured.Then the total protein of the gastrocnemius muscle was extracted.HSP70 and cleaved caspase-9 expression were examined.The binding rate of HSP70 and Apaf-1 was measured using Co-Immunoprecipitation.TUNEL staining was performed to detect the apoptosis of the gastrocnemius muscle.Results (1) Compared with group YS,SI of group OS decreased significantly by 23.09％,but significant increase was observed in group OE compared to group OS by 30.48％.(2) The grip strength per gram of body weight of group OS decreased significantly by 42.74％ compared to group YS,while that of group OE increased significantly by 21.51％ compared to group OS.(3) The apoptosis index increases by 475.28％ with age.However,the index decreased by 46.41％ in group OE over group OS.(4) Western blotting showed that the expression of cleaved caspase-9 increased significantly by 45.4％ in group OS compared to group YS,while that of group OE decreased significantly by 33.4％ compared to group OS.(5) The binding rate of HSP 70 with Apaf-1 of group OS decreased significantly by 67.11％ compared to group YS,while that of group OE increased significanlty by 306.31％ compared to group OS.Conclusions (1) Gastrocnemius atrophy occurring to mice of 60 weeks can be significanlty delayed through 30-week exercises training.(2) The increasing apoptosis may be involved in the development of age-related sarcopenia and 30-week exercises can significantly attenuate such apoptosis in rodent skeletal muscle.(3) Aerobic exercises increases HSP70/Apaf-1 interaction,which might play an important role in reducing age-related cellular damage and cell death in the skeletal muscle of rats.

Objective To investigate the effect of 6-week high-intensity interval training(HIIT) on the body composition and the autophagy activation in skeletal muscle of C57BL/6 mice,and explore the underlying role of adenosine 5'-monophosphate(AMP)-activated protein kinase(AMPK)α2 in this process.Methods Thirty-six 4-week old male mice with the genotype AMPKα2+/+(n=12),AMPKα2+/-(n=12) and AMPKα2-/-(n=12),were randomly divided into a control(n=6) and an HIIT group(n=6) respectively.The mice from the HIIT group exercised on a motor-driven rodent treadmill for 5 days a week,lasting 6 weeks.The procedure of HIIT included the intensity of 85％ VO2max(20m/min) for 2 min/day and 50％ VO2max(8m/min) for 1 min/day with 12 cycles alternately.The body weight,body mass index(BMI),total body water and fat mass were measured and analyzed after the 6-week exercise.The protein expression of AMPKα2,pAMPK-Thr172,LC3Ⅱ/Ⅰ,Beclin1 and p62 in the skeletal muscle tissue were detected using Western blotting.Results Before exercise,there was no significant difference between the mice of the same genotype in the body weight.However,a significant decrease was observed in the body weight of all the HIIT mice,and BMI of the AMPKα2+/+ and AMPKα2+/-mice undergoing HIIT.There were no significant differences in the total body water between the control and HIIT groups of the same genotype after the intervention.There was significant decrease in the body fat mass in the HIIT group of AMPKα2+/+ and AMPKα2+/-mice after the intervention,while the decrease was not significant in the HIIT AMPKα2-/-mice.The protein expression of pAMPK-Thr172,LC3Ⅱ/Ⅰ and Beclin1 increased significantly,and that of p62 decreased significantly in the skeletal muscle of the AMPK+/+ and AMPK+/-mice after HIIT intervention,but not the AMPK-/-mice.Conclusion HIIT can improve health indicators(i.e,body weight,BMI and fat mass) and enhance autophagy activation in the skeletal muscle through increasing the phosphorylation of AMPKot2.

AIM:Increasing evidence indicates that inflammation contributes to the initiation and perpetuation of atrial fibrillation ( AF) .Al-though tumor necrosis factor ( TNF)-αlevels are increased in patients with AF , the role of TNF-αin the pathogenesis of AF remains unclear.Recent research has revealed that T-type Ca2+currents ( ICa,T ) play an important role in the pathogenesis of AF .METH-ODS:In this study , we used the whole-cell voltage-clamp technique and biochemical assays to explore the role of TNF-αin the regula-tion of ICa,T in atrial myocytes.RESULTS:We found that compared with sinus rhythm (SR) controls, T-type calcium channel (TCC) subunit mRNA levels were decreased , while TNF-αexpression levels were increased , in human atrial tissue from patients with AF .In murine atrial myocyte HL-1 cells, after cultured for 24 h, 12.5, 25 and 50 μg/L TNF-αsignificantly reduced the protein expression levels of the TCC α1G subunit in a concentration-dependent manner .The peak current was reduced by the application of 12.5 or 25μg/L TNF-αin a concentration-dependent manner [from ( -15.08 ±1.11) pA/pF in controls to ( -11.89 ±0.83) pA/pF and (-8.54 ±1.55) pA/pF in 12.5 and 25 μg/L TNF-αgroups, respectively].TNF-αapplication also inhibited voltage-dependent inactivation of ICa,T shifted the inactivation curve to the left .CONCLUSION:These results suggest that TNF-αis involved in the path-ogenesis of AF, probably via decreasing ICa,T function in atrium-derived myocytes through impaired channel function and down -regula-tion of channel protein expression .This pathway thus represents a potential pathogenic mechanism in AF .

Comprehensive geriatric assessment (CGA) is widely used for creating tailored individual care plans for seniors who usually are suffering from multiple diseases,frailty,disability and cognition decline.Skilled communicators are of importance for high-quality clinical data collection.Communication skills used in CGA are summarized in this article by reviewing related references and combining practical experiences in the process of applying international resident assessment instruments (interRAI).

Objective:To analyze the epidemiological and clinical characteristics of patients with imported corona virus disease 2019 (COVID-19) in Beijing City.Methods:A case-control study was performed to retrospectively analyze 69 cases of imported COVID-19 from abroad and 147 cases of domestic confirmed COVID-19 from China as a control group from January 20 to March 20, 2020 admitted to Beijing Ditan Hospital, Capital Medical University.The epidemiological and clinical characteristics were compared.Statistical analysis were performed by t test, Mann-Whitney U test, chi-square test and Fisher exact test. Results:The main sources of the cases in the import group were from the United Kingdom, Italy, Spain and other European countries, with 44.9%(31/69) of the overseas students entering the country by air. The age of the imported group (27(21, 40) years) was lower than the domestic group (43 (32, 59)years), the difference between the two groups was statistically significant ( U=2 828.500, P<0.01). Compared with the domestic group, the proportion of cases with contact history of confirmed cases in the imported group was lower (30.4%(21/69) vs 68.0%(100/147)), the interval between onset and admission ≤seven days was higher (81.2%(56/69) vs 66.0%(97/147)), the proportion of cases with underlying diseases was lower (21.7%(15/69) vs 44.2%(65/147)). The differences between the two groups were all statistically significant ( χ2=26.935, 5.233 and 10.175, respectively, all P<0.05). The proportion of mild cases in the imported group was higher than that in the domestic group (42.0%(29/69) vs 10.9%(16/147)). Seventeen cases with olfactory abnormality and 12 cases with taste abnormality were found in the imported group, while no olfactory and taste abnormality was found in the domestic group. The proportions of fever, weakness, muscle soreness and dyspnea were all lower than those of the domestic group, the differences between the two groups were all statistically significant ( χ2=13.851, 8.118, 9.730 and 16.255, respectively, all P<0.01). The proportions of cases with decreased lymphocyte absolute numbers (37.7%(26/69) vs 67.3%(99/147)) and increased C reactive protein level (15.9%(11/69) vs 51.8%(72/139)) were both lower than the domestic group, and the differences between the two groups were both statistically significant ( χ2=18.015 and 24.722, respectively, both P<0.01). The proportions of cases with ground glass shadow and consolidation of chest computed tomography were lower than those of the domestic group and the differences between the two groups were all statistically significant ( χ2=11.961 and 5.099, respectively, all P<0.05). In terms of complications, the proportions of cases with acute respiratory distress syndrome and acute myocardial injury were lower (2.9%(2/69) vs 10.9%(16/147) and 4.3%(3/69) vs 14.0%(16/114), respectively), and there were statistically significant differences between the two groups ( χ2=4.017 and 4.335, respectively, both P<0.05). There were no cases received mechanical ventilation and extracorporeal membrane oxygenation in the imported group, and the proportions of patients received oxygen therapy and antibiotic treatment were significantly lower than those in the domestic group (13.0%(9/69) vs 26.5%(39/147) and 13.0%(9/69) vs 39.5%(58/147), respectively) and the differences between the two groups were statistically significant ( χ2=4.942 and 15.797, respectively, both P<0.05). Conclusions:The majority of imported COVID-19 cases are mainly from European countries, mostly young and middle-aged, and mostly mild and ordinary types.The symptoms of olfactory and taste abnormality are found for the first time.