The essence of twirling reinforcing-reducing method is discussed to provide theoretical guidance for clinical application of reinforcing-reducing method. Through retrospection on historical literature of twirling reinforcing-reducing method, records and explanatory notes are thoroughly explored. Several existing opinions are analyzed and explained for instance twirling method has connection with circulation direction of channels; twirling method is subdivided into right and left, male and female, hand and foot; twriling method is related to quantity of stimulus and operation time; twriling method belongs to spiral motion and so on. As a result, it is found that the key of twirling reinforcing-reducing method is the posture of needle-holding hand that defines three-dimensional motion. If twirling method is subdivided into right and left, male and female, hand and foot and so on, steric effects of lifting-thrusting movement that come along with twirling method could be ignored at the same time. It is that the essence of twirling reinforcing-reducing method is close to the principle of lifting-thrusting reinforcing-reducing method, enriching effect with slow insertion and fast withdrawal of needle while reducing effect with fast insertion and slow withdrawal, which is recorded in Miraculous Pivot: Nine needle and Twelve Yuan. With this principle as guide, manipulation could be avoided to become a mere formality and illusory metaphysics during clinical application of twirling reinforcing-reducing method.
Acupuncture Therapy ; history ; instrumentation ; methods ; China ; History, Ancient ; Humans ; Medicine in Literature ; Needles ; history

Objective To investigate the role of miR‐26a in ox‐LDL‐mediated apoptosis of HAECs in endothelial cells and its mechanism .Methods Various concentrations of ox‐LDL were added in HAECs culture .Cell cytotoxicity and apoptosis were moni‐tored by MTT and TUNEL assay ,and expression level of miR‐26a examined by qRT‐PCR .Overexpression of miR‐26a mimic in HAECs ,MTT and TUNEL staining were used to detect the activity and apoptosis of ox‐LDL .The 3′UTR of luciferase reporter vector pMIR‐PTEN was constructed and the predicted target gene of miR‐26a was identified by luciferase activity assay .QRT‐PCR and Western blot were used to detect the mRNA and protein expression of PTEN .Results ox‐LDL could mediate the toxic death and apoptosis of HAECs cells ,and decrease the expression level of miR‐26a in HAECs cells .Overexpression of miR‐26a mimic could inhibit the cytotoxicity and apoptosis of ox‐LDL cells after HAECs .Transfection of miR‐26a mimics significantly inhibited lu‐ciferase activity (P<0 .05) .The expression of mRNA and protein in HAECs cells was significantly down regulated by transfection of miR‐26a analog (P<0 .05) .Conclusion MiR‐26a can inhibit the cytotoxicity and apoptosis of ox‐LDL cells after HAECs inhibi‐tion ,and the possible mechanism of action is to down regulate the expression of PTEN .The study suggests that miR‐26a may be a potential target for the treatment of atherosclerosis related to apoptosis .

Objective To observe the clinical effect of blood transfusion on earthquake victims from Wenchuan earthquake area, Sichuan province.Methods The blood routine, electrolyte and coagulation function of earthquake victims were detected.Results A total of 41(27.5%) victims received blood transfusion. The average volume of blood transfusion was 1 233 ml, and the average volume of plasma was 1 550 ml. No patient was found to have adverse transfusion reaction. There was no significant difference between the electrolytes before and after the transfusion.Conclusion Blood transfusion is important in the care of earthquake victims.

A ?-mannanase gene (TM_1227) from Thermotoga maritima MSB8 was cloned and expressed in E.coli. The recombinant ?-mannanase was purified and characterized. The gene consists of 2010 bp, and the translated protein encodes 669 amino acids and its molecular mass is approximately 76.827 kD. Homology analysis of the deduced amino acid sequences showed that the enzyme shared 99% identity with ?-mannanase from Thermotoga sp. RQ2. The mannanase activity was up to 39.7 U/mg after the recombinant E. coli BL21 was induced by IPTG. Crude enzyme solution was purified to homogeneity by Ni-NTA agarose. Its optimum temperature and pH was 95?C and pH 8.0 respectively for LBG. The enzyme remained over 50% activity after treated at 85?C for 30 min. The above properties showed great potential of its application in paper industry. The mannanase hydrolyzed copra mannan and LBG to give various sizes of oligosaccharides, and almost no mannose was detected by TLC, which was suitable for mannooligosaccharides production.

A xylanase producing strain was screened with xylan as the only carbon source. The strain was identified as Streptomyces cirratus. The effects of different factore on the enzyme production were studied. Corncobs xylan (water insoluble) and tryptone were the best C and N sources, respectively. The enzyme activity was increased to about 2.5 times by addition of 0.5% Tween 80 in the medium. The highest xylanase activity was up to 623u/mL.

Objective To investigate the effects of Yindan Xinnaotong Capsule on the osteoponin(OPN)expression in myocardium tissue of the rats after acute myocardial infarction(AMI)and to clarify the mechanism of Yindan Xinnaotong Capsule in alienating rat AMI.Methods 90 Wistar rats were used to establish AMI models by ligating of the left anterior descending coronary artery.The AMI model rats were randomly divided into AMI model group, highdoseofYindan(16g·kg-1·d-1)group,lowdoseofYindan(0.08g·kg-1·d-1)group,positivedrug control captopril(5 mg·kg-1 ·d-1 )group(n=12);at the same time sham operation group(n=10)was set up, the rats in sham operation group was treated with wearing without ligation. All the rats were administrated for 4 weeks,then the myocardium tissue samples were obtained.The histological changes of myocardium tissue were observed by HE and Masson staining;the DNA fragments of apoptotic cells were detected by TUNEL staining and the apoptotic index(AI)was calculated.The expression of OPN mRNA in non-infarction area was measured by RT-PCR.Results Compared with sham operation group,the AI of the rats in model group was significantly increased (P<0.05);compared with model group,the AI of the rats in Yindan groups and captopril group were markedly decreased(P<0.01 );compared with captopril group, the AI of the rats in high dose of Yindan group was significantly decreased(P<0.05).Compared with sham operation group,the expression level of OPN mRNA in non-infarction area of the rats in model group was significantly increased(P<0.01);compared with model group, the expression levels of OPN mRNA in non-infarction area of the rats in Yindan groups and captopril group were also decreased significantly(P<0.01);compared with captopril group,the expression level of OPN mRNA non-infarction area of the rats in high dose of Yindan group was significantly decreased(P<0.05).Conclusion Yindan Xinnaotong Capsule could obviously alleviate the apoptosis of myocardium tissue of the rats after acute myocardial infarction and decrease the expression of OPN mRNA in non-infarction area of left ventricle, which indicates that Yindan Xinnaotong Capsule may protect myocardium tissue through decreasing the OPN mRNA expression.

Objective To prepare Paracetamol (APP) multiloculated implant loaded with poly-lactide-co-glycolide acid (PLGA) and to study the drug release profile in vitro. Methods APP multiloculated implant was fabricated by micro-electro-mechanical system (MEMS), and high-performance liquid chromato graphy (HPLC) measurement was used to investigate in vitro drug release profile. HPLC analysis was carried out by employing C18 column and a mixture of methanol-water (15∶85) as mobile phase. The detection wavelength was 215nm and flow rate was 0.8mL/min. Results With different multiloculated shape, the rate of the drug release in vitro was varied significantly. Moreover, the releasing of APP multiloculated implant with ecto-tetragonum ento-hexagon in vitro conformed to Higuchi equation. Conclusion The technology of the preparations is feasible, and the structural and morphological characteristics of the multiloculated implant have a significant impact on the release speed of the drug delivery system.

OBJECTIVE To explore the outcomes of CO2 laser assisted stapedotomy with artificial stapes prostheses in the treatment of advanced otosclerosis. METHODS Between January 2010 and January 2014, 15 patients (16 ears) diagnosed as advanced otosclerosis accepted CO2 laser assisted stapedotomy with artificial stapes implantation in our department. The averaged preoperative air conduction threshold of the speech frequency was 70.21 dB HL, the averaged bone conduction threshold was 38.49 dB HL, the averaged air-bone gap (ABG) was 31.72 dB HL. All cases were followed up for more than 6 months after operation. RESULTS All cases accepted auditory follow up after 6 months postoperatively. The speech frequency average air conduction threshold was 43.7 dB HL, the average bone conduction threshold was 28.95 dB HL, the average ABG was 14.75 dB HL. The ABG≤20 dB was achieved in 9 ears (56.3%) and ABG closure (≤10 dB) was achieved in 6 ears (37.5%). No cases appeared intractable vertigo, sensorineural hearing loss, secondary facial paralysis and other serious complications. CONCLUSION CO2 laser assisted technique reduced the probability of serious complications of stapedotomy, most patients with hearing level improved significantly. It's a safe, practical, relatively economical choice for advanced otosclerosis.

Objective To investigate the risk factors of pulmonary hypertension (PH) after rapid ascent to high altitude in healthy young Chinese men .Methods A total of 552 non high altitude natives ( healthy young Chinese men ) were recruited in the study between June to August in 2012.The subjects were delivered to high altitude (3700 m) in 2 h by plane from low altitude (450 m).Demographic data including smoking , alcohol consumption , high altitude exposure histo-ry, body mass index (BMI) and age were collected within 24 h after arrival at 3700 m.Furthermore, the oxygen saturation ( SaO2 ) , blood pressure , heart rate , pulmonary artery systolic pressure were measured using the echocardiography system . Analysis of risk factors of PH was performed by logistic regressions .Results The incidence of PH was 23.10%.SaO2 was significantly lower in the higher-pulmonary artery systolic pressure group (higher-PASP)[(86.10 ±3.34)%] than that in the normal-PASP group [(89.09 ±2.65)%, P<0.01].Smoking, alcohol consumption, high altitude exposure history, BMI, age, systolic blood pressure , diastolic blood pressure , heart rate were not significantly different between the two groups mentioned above .Logistic regressions revealed that lower SaO 2 (OR:0.711,95% CI:0.647-0.782, P<0.01) was an independent risks factor of PH .Conclusion Low SaO2 is an independent risk factor of PH upon rapid arrival at 3700 m in healthy young Chinese men .However, smoking, alcohol consumption , high altitude exposure history , BMI, age, blood pressure and heart rate are not risk of PH .These observations will provide valuable clues to theoretical studies on PH and prevention of PH .

Objective To investigate the effect and mechanism of pulmonary artery pressure on exercise capacity after acute high altitude exposure .Methods A total of 231 persons were recruited in this study , whose vital signs,SaO2 and physical working capacity ( PWC170 ) exercise capacity were collected .The difference between groups with normal and increased MPAP was observed .Results mean pulmonary artery pressure ( MPAP ) and right ventricle ( RV )-Tei index increased substantially after acute high altitude exposure ,while PWC170 was remarkably decreased .Furthermore,it was found that those whose MPAP increased(MPAP≥25 mmHg)had higher RV-Tei and lower PWC170(P<0.01) in acute high altitude exposure group .Correlation analysis suggested that there were different levels of correlation between MPAP, RV-Tei and PWC170(P<0.01).Conclusion After acute high altitude exposure , the increased pulmonary artery pressure is one of the main causes of lowered exercise capacity .The mechanism may be associated with the decrease of right heart functions .