Professor WU Lianzhong's experience of neck acupoints application is introduced. The characteristics,locations, acupuncture manipulations ,efficiency and main functions of neck acupoints including Tiandixue (Extra), Jingbixue (Extra), and cervical Jiaji (EX-B 2) are stated. According to the TCM thought of treatment based on syndrome differentiation,WU Lianzhong's special theory of neck acupoints application is explained so as to provide experience for improving acupuncture effects.
Acupuncture Points ; Acupuncture Therapy ; Aged ; Dizziness ; therapy ; Female ; Humans ; Neck ; anatomy & histology ; Qi

Obejective To evaluate the accuracies of ten commercial total 25-hydroxyvitamin D [25(OH) D] immnoassays.Methods NIST 25 (OH) D reference material SRM 972a,which consisted of four vials of frozen serum with different concentration levels of different 25 (OH) D types,and two human serumsamples provided by our lab (BIMT),which had different concentration levels of 25 (OH) D3,were analyzed by ten total 25-hydroxyvitamin D immnoassays from Biomerieux,Mindray,Maccura,Chemclin,Abbott (2),Siemens,SNIBE (2),Roche,and by isotope-dilution liquid chromatography-tandem mass spectrometry(ID-LC/MS/MS) founded by BIMT.For the measurements of SRM 972a,the biases between tested values and certified values were calculated as a evaluating indicator,meanwhile the test biases between immnoassays and ID-LC/MS/MS were used as a evaluating indicator for the measurements of BIMT 25(OH) D3 serum samples.Test bias lower than 10％ was deemed acceptible.Results The ID-LC/MS/MS exhibited low biases at (1.6％-2.8％) in the measurements of all levels of SRM 972a.8 immnoassays showed low biases at(1.5％-3.5％) in the measurements of level 1 of SRM 972a,which had a high 25(OH) D3 concentration level,but only 2 immnoassays gave low biases at (3.6％-3.7％)in the measurements of high 25 (OH)D2 concentration sample (level 3).While,5 immnoassays gave low biases at (-0.3％-9.0％) in the measurements of high 3-epi-25 (OH) D3 concentrationsample (level 4).It seems that,when SRM 972a were analyzed,only one of the ten commercial total 25 (OH)D immnoassays were in good accuracy and analytical specificity agrements with ID-LC/MS/MS.When two human serum25(OH) D3samples from BIMT were tested,most immunoassays were overall in relative good agreement with ID-LC/MS/MS at high 25 (OH) D3concentration level.Conclusion The test biases in the total 25 (OH) D measurements are differences between differentimmnoassays and ID-LC/MS/MS,and the specificities of current commercial total 25 (OH) D immnoassays should be improved,especially the performance on the equivalent recognition of 25 (OH) D2 and 25 (OH) D3.

Objective To investigate the current status and influencing factors of self-efficacy for oral self-care in patients with chronic periodontitis. Methods A total of 357 patients with chronic periodontitis were investigated with the self-designed questionnaire, Self-Efficacy Scale for Self-care (SESS), Dental Fear Scale(DFS) and Medical Coping Modes Questionnaire(MCMQ). Results The total score of SESS was(58.66±7.27)points,which was at the medium level.In the scores of each dimension, self-efficacy for dietary habits was the highest,(20.42 ± 2.88)points,and self-efficacy for brushing of the teeth was the lowest,(18.37 ± 2.94)points.Multiple linear regression analysis showed that age,dental fear and medical coping mode were influencing factors of self-efficacy for oral self-care,which explained 53.6% of the variance. Conclusions Medical staff should pay more attention to the patients who are in low level of self-efficacy for self-care.Oriented by each dimension and influencing factors,specific psychological intervention should be given to reduce dental fear,improve medical coping style,enhance the level of self-efficacy for oral self-care and promote oral self-care behaviors and somatopsychic health.

Objective:To observe the changes of glyeemia, urine protein, serum creatinine, blood urea nitrogen and glycosylated hemoglobin in diabetic nephropathy rats and treating effects of Xiaokekang. Methods: Streptozotocin (STZ) was abdominally administered and was feeded by high lipid diet to establish diabetic nephropathy model in rats. Animals were divided into three groups: model group, Xiaokekang treatment group and normal group. Changes in glycemia, serum lipids, serum creatinine, blood urea nitrogen were measured at the 8th, 12th and 16th week after STZ injection. Glycosylated hemoglobin was measured at the 16th weeks after STZ injection. Results: Glycemia, serum lipids, serum creatinine were higher at the 8th, 12th and 16th week compared with normal group. Serum creatinine was higher at the 12th and 16th week, and glycosylated hemoglobin was also highter than that of the normal group. Xiaokekang reduced these changes. Conclusion: Xiaokekang can reduce glycemia, serum lipids and protect renal function.

Objective:To investigate the mechanism of Sulfo-N-succinimidyloleate (SSO) regulating lipid metabolism disorder induced by silicon dioxide (SiO 2) . Methods:In March 2023, Rat alveolar macrophages NR8383 were cultured in vitro and randomly divided into control group (C), SSO exposure group (SSO), SiO 2 exposure group (SiO 2) and SiO 2+SSO exposure group (SiO 2+SSO). NR8383 cells were exposure separately or jointly by SSO and SiO 2 for 36 h to construct cell models. Immunofluorescence and BODIPY 493/ 503 staining were used to detect cluster of differentiation (CD36) and intracellular lipid levels, the protein expression levels of CD36, liver X receptors (LXR), P-mammalian target of rapamycin (P-mTOR) and cholinephosphotransferase 1 (CHPT1) were detected by Western blot, respectively, and lipid metabolomics was used to screen for different lipid metabolites and enrichment pathways. Single-factor ANOVA was used for multi-group comparison, and LSD test was used for pair-to-group comparison. Results:SiO 2 caused the expression of CD36 and P-mTOR to increase ( P=0.012, 0.020), the expression of LXR to decrease ( P=0.005), and the intracellular lipid level to increase. After SSO treatment, CD36 expression decreased ( P=0.023) and LXR expression increased ( P=0.000) in SiO 2+SSO exposure group compared with SiO 2 exposure group. Metabolomics identified 87 different metabolites in the C group and SiO 2 exposure group, 19 different metabolites in the SiO 2 exposure group and SiO 2+SSO group, and 5 overlaps of different metabolites in the two comparison groups, they are PS (22∶1/14∶0), DG (O-16∶0/18∶0/0∶0), PGP (i-13∶0/i-20∶0), PC (18∶3/16∶0), and Sphinganine. In addition, the differential metabolites of the two comparison groups were mainly concentrated in the glycerophospholipid metabolism and sphingolipid metabolism pathways. The differential gene CHPT1 in glycerophospholipid metabolic pathway was verified, and the expression of CHPT1 decreased after SiO 2 exposure. Conclusion:SSO may improve SiO 2-induced lipid metabolism disorders by regulating PS (22∶1/14∶0), DG (O-16∶0/18∶0/0∶0), PGP (i-13∶0/i-20∶0), PC (18∶3/16∶0), SPA, glycerophospholipid metabolism and sphingolipid metabolism pathways.

Objective To investigate the expression of IL-10 in serum of patients with type 2 diabetic mellitus (T2DM) and its relationship with carotid atherosclerosis.Methods Totally 168 cases of T2DM patients treated in our hospital from May 2013 to December 2016 were retrospectively analyzed.According to the IMT value,the patients were divided into the normal group,the thickening of the group and carotid atherosclerosis plaque formation group.In addition,65 cases of healthy volunteers in our hospital physical examination center at the same period were treated as control group.The levels of serum inflammation index,blood glucose,blood lipid and other indicators of all subjects were compared,at the same time,the correlation between IL-10 and other detection index was analyzed.Additionally,the risk factors of T2DM patients with carotid atherosclerosis were analyzed.Results Compared with the control group,the levels of IL-6,blood glucose,blood lipid and other indicators in T2DM patients increased significantly(P＜0.05),while the level of IL-10 decreased significantly(P＜0.05);with the increase of IMT,the levels of IL-6,blood glucose,blood lipid and other indicators in T2DM patients increased significantly,but the level of IL-10 decreased significantly,meanwhile the differences between the groups were statistically significant (P＜0.05).Compared with normal group,the levels of IL-6,blood glucose,blood lipid and other indicators of patients in thickening group and plaque group significantly elevated,but the level of IL-10 decreased significantly;the levels of IL-6,blood glucose,blood lipid and other indicators of patients in plaque group were obviously higher than those of thickening group,and IL-10 level was significantly lower than thickening group,and the differences were statistically significant (P＜0.05);the levels of IL-10 in the serum were negatively correlated with blood glucose,blood lipid and other indicators (P＜0.05);multifactor non-conditional Logistic analysis showed that IL-6,Hcy and UA were the risk factors for atherosclerosis in T2DM patients,and IL-10 was the protective factor.Conclusion The level of IL-10 of patients with T2DM is closely related to the occurrence and development of carotid artery atherosclerosis,which provides a new target for clinical treatment.

Objective To develop an isotope dilution liquid chromatography tandem mass spectrometry (ID-LC-MS/MS) method for determining the concentration of 5-methyltertrahydrofolate (5MT) in human serum.Methods After qualitative analysis of 5MT reference,its purity was identified by two methods with different principle,i.e.,mass balance and quantitative nuclear magnetic resonance.The definite value and uncertainty of 5MT concentrations in 6 serum samples containing same level of 5MT were assessed by ultra performance liquid chromatography-triple quadrupole tandem mass spectrometer equipped with electrospray ionization in monitoring mode of multiple reactions,in which 13C5-5MT was used as the internal standard.The precision,accuracy,limit of detection (LOD) and limit of quantification (LOQ) of the method were also evaluated.Results After qualitative analysis for confirming the principal component in the sample,the purity of 5MT reference was measured as 76.65％ by mass balance and quantitative nuclear magnetic resonance method.The definite value of 5MT in the serum sample was 8.22 ng/mL,the extended uncertainty was 0.54 ng/mL,LOD was 0.05 ng/mL,LOQ was 0.50 ng/mL and the repeatability and inter-batch precision CV were within 5.0％.The accuracy of measured results was verified by using NIST SRM 1955 since all the values of 3 levels were within the range of certified value with the extended uncertainty.Conclusion A accurately quantitative determination for the concentration of 5 MT in human serum with high specificity and sensitivity was established by using ID-LC-MS/MS method.

Objective:To evaluate the proper blood collection time and calculation formula by measuring the iohexol plasma clearance as a representative of glomerular filtration rate at the same time of routine enhanced computed tomography (CT) examination.Methods:The prospective study method was applied, and 9 subjects with normal renal function, who admitted in Civil Aviation General Hospital from September 2018 to June 2019, were included. A single bolus of a standard dose (5 ml) (iodine concentration: 350 mgI/ml) was injected. The concentration of iohexol was measured from heparin plasma at fasting state of the subject and at nine different times after the injection, respectively. More than 24 hours after the injection of the standard dose, an enhanced CT-level dose (50 ml) of iohexol was injected to the subject and the concentration of iohexol was measured at similar time points as the standard dose. Using a multi-point method of a standard dose as the standard, the clearance rate was calculated by three kinds of formulas including Groth and Aasted formula, Jacobsson formula and Fleming formula with the single-point method to assess iohexol plasma clearance at 0.5 to 8.0 hours post injection of enhanced CT-level dose. The correlation consistency and accuracy of the multi-point method and the single-point method, as well as the dual-point method and the single-point method were compared, and the proper blood collection time and calculation formula of the single-point method at regular enhanced CT-level dose were evaluated. The correlation between the multi-point method and the single-point method, as well as the dual-point method and the single-point method were assessed using Pearson correlation coefficient; the consistency between the multi-point method and the single-point method, as well as the dual-point method and the single-point method were assessed by bias using mean±standard deviation ( SD) and 95% confidence interval ( CI) of mean difference and so on. We assessed the concordance of GFR using GFR±5% ( P5),±10% ( P10) and 1±30% ( P30) intervals. Results:Compared with the multi-point method, the mean deviation of iohexol plasma clearance obtained by the three single-point methods increased gradually from 5 hours after the injection of iohexol ( P<0.05). Compared with the multi-point method, only 3 h results, which was calculated by the Groth and Aasted formula, reached a P value greater than 0.05, a correlation coefficient of 0.938, a mean deviation of (-5.2±8.8) ml·min -1·1.73 m -2, and the concordances were 100% corresponding to P30,77.8% corresponding to P10, and 66.7% corresponding to P5; the 2, 3 and 4 hours results, which was calculated by the Jacobsson formula, reached P values greater than 0.05, when the blood collection time was 3 hours, the correlation coefficient was 0.938, and the mean deviation was the smallest, which was (1.5±6.2) ml·min -1·1.73 m -2, and the concordances were 100% corresponding to P30, 88.9% corresponding to P10, and 66.7% corresponding to P5; the 2 and 3 hours results, which was calculated by the Fleming formula, reached P values greater than 0.05, when the blood collection time was 2 h, the correlation coefficient was 0.956, and the mean deviation was the smallest, which was (-4.5±8.8) ml·min -1·1.73 m -2, and the concordances were 100% corresponding to P30, 77.8% corresponding to P10, and 55.6% corresponding to P5,Compared with the dual-point method, when Groth or Aasted formula was used, the mean deviation was the smallest at 3 hours, which was (-5.3±5.7) ml·min -1·1.73 m -2; when Jacobsson formula was used, the mean deviation was the smallest at 2 hours, which was (1.6±1.6) ml·min -1·1.73 m -2; when Fleming formula was used, and the mean deviation was the smallest at 2 hours, which was (-4.6±4.0) ml·min -1·1.73 m -2. Conclusion:At a regular enhanced CT-level dose, one blood collection can accurately measure the glomerular filtration rate, the proper time for blood collection can be 3 hours after iohexol injection, and the appropriate calculation formula can be Jacobsson formula.

Objective:To investigate the mechanism of Sulfo-N-succinimidyloleate (SSO) regulating lipid metabolism disorder induced by silicon dioxide (SiO 2) . Methods:In March 2023, Rat alveolar macrophages NR8383 were cultured in vitro and randomly divided into control group (C), SSO exposure group (SSO), SiO 2 exposure group (SiO 2) and SiO 2+SSO exposure group (SiO 2+SSO). NR8383 cells were exposure separately or jointly by SSO and SiO 2 for 36 h to construct cell models. Immunofluorescence and BODIPY 493/ 503 staining were used to detect cluster of differentiation (CD36) and intracellular lipid levels, the protein expression levels of CD36, liver X receptors (LXR), P-mammalian target of rapamycin (P-mTOR) and cholinephosphotransferase 1 (CHPT1) were detected by Western blot, respectively, and lipid metabolomics was used to screen for different lipid metabolites and enrichment pathways. Single-factor ANOVA was used for multi-group comparison, and LSD test was used for pair-to-group comparison. Results:SiO 2 caused the expression of CD36 and P-mTOR to increase ( P=0.012, 0.020), the expression of LXR to decrease ( P=0.005), and the intracellular lipid level to increase. After SSO treatment, CD36 expression decreased ( P=0.023) and LXR expression increased ( P=0.000) in SiO 2+SSO exposure group compared with SiO 2 exposure group. Metabolomics identified 87 different metabolites in the C group and SiO 2 exposure group, 19 different metabolites in the SiO 2 exposure group and SiO 2+SSO group, and 5 overlaps of different metabolites in the two comparison groups, they are PS (22∶1/14∶0), DG (O-16∶0/18∶0/0∶0), PGP (i-13∶0/i-20∶0), PC (18∶3/16∶0), and Sphinganine. In addition, the differential metabolites of the two comparison groups were mainly concentrated in the glycerophospholipid metabolism and sphingolipid metabolism pathways. The differential gene CHPT1 in glycerophospholipid metabolic pathway was verified, and the expression of CHPT1 decreased after SiO 2 exposure. Conclusion:SSO may improve SiO 2-induced lipid metabolism disorders by regulating PS (22∶1/14∶0), DG (O-16∶0/18∶0/0∶0), PGP (i-13∶0/i-20∶0), PC (18∶3/16∶0), SPA, glycerophospholipid metabolism and sphingolipid metabolism pathways.

Objective To investigate the characteristics of peroperative blood pressure and heart rate in patients with normotensive incidental pheochromocytomas in order to provide the basis for peroperative treatment. Methods This retrospective study collected the data of 104 patients with a pathological diagnosis of unilateral pheochromocytoma at PLA General Hospital during January 2011 to December 2016. They were divided into normotensive incidental pheochromocytomas(NIP) group (n＝50) if the patients were normotensive and HIP group ( n＝54) if the patients were with hypertension. The clinical features, imaging features and peroperative hemodynamics were analyzed. Results ( 1) The age, urinary norepinephrine, daily dosage and duration of phenoxybenzamine in NIP group were less than those of HIP group (all P<0.05). (2) Preinduction blood pressure, maximum blood pressure, and total fluid intake in NIP group were lower than those in HIP group(all P<0.05). The blood pressure range, heart rate range, increased blood pressure, minimum mean arterial pressure, vasoactive medication were without statistical significance between these two groups. ( 3) The times and rate of intraoperative systolic blood pressure more than 30% baseline, 200 mmHg (1 mmHg＝0.133 kPa), 180 mmHg, 160 mmHg, intraoperative tachycardia, bradycardia, intraoperative hypotension and postoperative hypotension were without statistical significance between these two groups. (4) Stratified analysis of age (50 years), phenoxybenzamine (40 mg/d), tumor diameter (50 mm) and preinduction blood pressure (130/80 mmHg) showed that intraoperative blood pressure and heart rate were without statistical significance between these two groups. ( 5) There was no correlation between phenoxybenzamine ( daily dosage or duration ) and peroperative hypotension. Applying phenoxybenzamine or vasoactive medication was not correlated with peroperative hypotension in NIP group. Conclusion The peroperative blood pressure and heart rate of patients with NIP are similar to those of patients with HIP. Adequate peroperative treatment should be applied to NIP to avoid hemodynamic instability.