OBJECTIVE: To observe the effects of electroacupuncture (EA) at changbing fang (prescription for intestinal disease) on autophagy of colonic cells and gut microbiota in rats with ulcerative colitis (UC), and to explore the mechanism of EA in the treatment of UC. METHODS: Thirty-two SD male rats were randomly divided into a control group, a model group, an EA group and a sham-EA group, with 8 rats in each group. Except the control group, the UC rat model was established by free drinking of 5% dextran sulfate sodium solution for 7 days in the other groups. In the EA group, changbing fang was adopted, in which, EA was applied at "Tianshu" (ST25) and "Shangjuxu" (ST37), at disperse-dense wave and frequency of 10 Hz/50 Hz, for 20 min in each intervention. In the sham-EA group, shallow transcutaneous puncture was performed at the sites, 5 mm away from the points as the EA group, with the same parameters as the EA group. The intervention was delivered once daily for 3 consecutive days. The body weight was measured daily and the disease activity index (DAI) score was calculated before and after intervention. After intervention completion, the colon length was measured. Using HE staining, the colon morphology was observed and the score of colonic pathology was assessed. With ELISA adopted, the contents of tumor necrosis factor (TNF-α), interleukin (IL)-1β, IL-2 and IL-10 in the serum of the rats were detected. The ultrastructure of the colon tissue was observed under electron microscopy. Using Western blotting, the protein expression was detected for microtubule-associated protein 1 light chain 3 (LC3)Ⅱ, LC3Ⅰ, autophagy-related genes (ATG) 5, ATG12, sequestosome 1 (p62), phosphatidylinositol 3-kinase (PI3K), phosphorylated protein kinase B (p-AKT), protein kinase B (AKT), and phosphorylated mammalian target of rapamycin (p-mTOR), mammalian target of rapamycin (mTOR) in the colon tissue. The mRNA expression of PI3K, AKT and m-TOR in the colon tissue was detected by real-time fluorescence quantitative PCR. The 16S rRNA gene sequencing was used to analyze the structure of gut flora in the feces of rats. RESULTS: From day 1 to day 7, compared with the control group, the body weight decreased in the model group, EA group, and SEA group (P<0.05, P<0.01). From day 9 to day 10, the EA group showed an increase in body weight compared with the model group and SEA group (P<0.05, P<0.01). Before intervention, the DAI score in the model group, EA group, and SEA group was higher than the score of the control group, respectively (P<0.01). After intervention, the DAI score in the EA group was reduced compared with the model group and SEA group (P<0.01). Compared with the control group, in the model group, the colon length of rats was shorter (P<0.01); it showed the distorted crypts, thinner mucosal layer, reduced goblet cells, inflammatory cell infiltration and the disarranged histological structure; and the pathological score of the colon tissue increased (P<0.01); the serum contents of TNF-α and IL-1β increased (P<0.01), and those of IL-2 and IL-10 decreased (P<0.01). The structure of colon epithelial cells was disarranged, with cilia pelt off, and a large number of vacuoles in the cytoplasm; the mitochondria were swollen, with unclear structure and cristae partially disappeared; and few autophagosomes were observed. The value of LC3Ⅱ/LC3Ⅰand the protein expression of ATG5 and ATG12 in the colon tissues were reduced (P<0.01), the protein expression of p62 and PI3K, and the values of p-AKT/AKT, and p-mTOR/mTOR increased (P<0.01), and mRNA expression of PI3K, AKT and mTOR was elevated (P<0.01). The indexes of Chao1, Ace and Shannon decreased (P<0.01). At the phylum level, the relative abundance of Firmicutes decreased (P<0.05), that of Bacteroidetes and Proteobacteria increased (P<0.05, P<0.01). At the genus level, the relevant abundance of Lactobacillus decreased (P<0.05), while that of Lachnospiraceae_NK4A136_group and Phascolarctobacterium increased (P<0.01, P<0.05 ). Compared with the model group and SEA group, in the EA group, the colon length increased (P<0.01), the infiltration of inflammatory cells was reduced, the arrangement of intestinal epithelial cells was arranged regularly, with a small amount of shedding, and the pathological score of the colon tissue decreased (P<0.01). The serum contents of TNF-α and IL-1β decreased (P<0.01), and those of IL-2 and IL-10 increased (P<0.01). The colonic epithelial cells were arranged relatively, the morphology of organelles was basically normal, and autophagosomes were visible. The value of LC3Ⅱ/LC3Ⅰand the protein expression of ATG5 and ATG12 in colon tissue increased (P<0.01, P<0.05), the protein expression of p62 and PI3K, and the values of p-AKT/AKT, and p-mTOR/mTOR decreased (P<0.01); and mRNA expression of PI3K, AKT, m-TOR was reduced (P<0.01). The indexes of Chao1, Ace and Shannon increased (P<0.01). At the phylum level, the relative abundance of Firmicutes increased (P<0.01), while that of Bacteroidetes decreased (P<0.01). At the genus level, the relative abundance of Lactobacillus increased (P<0.05), whereas that of Lachnospiraceae_NK4A136_group decreased (P<0.01). When compared with the model group, the relative abundance of Proteobacteria decreased (P<0.05), and that of Phascolarctobacterium was reduced (P<0.05) in the EA group. CONCLUSION EA at changbingfang alleviates UC symptoms probably through inhibiting the PI3K/AKT/mTOR signaling pathway to regulate colonic autophagy and improve the intestinal flora.
Animals ; Electroacupuncture ; Colitis, Ulcerative/metabolism* ; Male ; Rats ; Gastrointestinal Microbiome ; Rats, Sprague-Dawley ; Colon/metabolism* ; Humans ; Autophagy ; Acupuncture Points ; Tumor Necrosis Factor-alpha/genetics* ; Interleukin-10/genetics*

Objective To explore the effect of prominent cortical vein(PCV)sign on the clinical prognosis of patients undergoing endovascular recanalization for acute anterior circulation cerebral infarction.Methods A total of 102 patients with acute anterior circulation large-vessel occlusion in Zhongshan Municipal Hospital of Tradiontional Chinese Medicine from January 1,2020 to December 21,2022,who received endovascular recanalization,were enrolled in this study.The clinical data and radiographic materials were collected.According to whether PCV sign was present or not,the patients were divided into PCV group and non-PCV group.The clinical data were compared between the two groups.Logistic regression analysis was used to analyze the correlation between the postoperative 90-day mRS score and the occurrence of PCV.Results Compared with non-PCV group,in PCV group the incidence of atrial fibrillation was even higher,and the good rate of collateral compensation was even lower,and the postoperative(7±2)-day NIHSS score was even lower;the differences in above indexes between the two groups were statistically significant(all P＜0.05).Ninety days after treatment,the proportion of patients having modified Rankin Scale(mRS)score ≤2 points in the non-PCV group was 76.3％,which was higher than 58.6％in the PCV group,but the difference was not statistically significant(P=0.074).Logistic regression analysis indicated that a positive correlation existed between the presence of PCV sign and atrial fibrillation(OR=9.679,95％CI=1.264-74.364)and a negative correlation existed between the presence of PCV sign and good collateral compensation(OR=0.015,95％CI=0.033-0.331).No relationship existed between the postoperative 90-day good prognosis and the presence of preoperative PCV sign(OR=2.078,95％CI=0.680-6.348),but patient's age,preoperative intravenous thrombolysis were negatively correlated with the preoperative Alberta Stroke Program Early CT(ASPECT)score(P＜0.005).Conclusion In patients with anterior circulation acute ischemic stroke(AIS),the occurrence of PCV sign is associated with the impaired collateral compensation and atrial fibrillation,but its impact on the clinical outcomes of patients after receiving reperfusion therapy remains uncertain.PCV sign may be used as a potential evaluation indicator for inadequate cerebrovascular collateral compensation.

Objective:To investigate the risk factors for futile recanalization in patients with acute anterior circulation large vessel occlusion after endovascular mechanical thrombectomy (EMT), and establish a nomogram model predicting futile recanalization in these patients.Methods:One hundred and eighty-eight patients with acute anterior circulation large vessel occlusion after EMT were enrolled from Department of Neurology, Zhongshan Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine from January 2018 to December 2021. Patients were divided into futile recanalization group and effective recanalization group according to whether futile recanalization occurred; futile recanalization was defined as successful recanalization showed by immediate postoperative DSA (modified thrombolysis in cerebral infarction [mTICI] ≥2b), but poor functional outcome (modified Rankin Scale [mRS] scores>2 90 d after surgery). The clinical data were compared between futile recanalization group and effective recanalization group. Multivariate Logistic regression analysis was used to screen the risk factors for futile recanalization. R software was used to establish a nomogram model for futile recanalization. C-index was used to evaluate the differentiation of the model, and correction curve was used to evaluate the accuracy of the line graph model prediction. Receiver operating characteristic (ROC) curve was used to evaluate the predictive efficiency of the nomogram model.Results:Ninety-two patients had futile recanalization. Compared with the effective recanalization group, futile recanalization group had significantly older age, significantly higher hemoglobin A1c on admission, significantly longer time from puncture to vascular recanalization, significantly higher proportions of patients with hypertension history and poor collateral circulation, and significantly different severities of stroke and white matter hyperintensities (WMHs) and distribution of occlusive sites ( P<0.05). Multivariate Logistic regression analysis showed that age, history of hypertension, time from puncture to vascular recanalization, poor collateral circulation, severe WMHs, and moderate-severe stroke were independent risk factors for futile recanalization after EMT in patients with acute anterior circulation large vessel occlusion ( P<0.05). A nomogram model of futile recanalization was established according to the above 6 factors, with C-index of 0.862 ( 95%CI: 0.809-0.914); the calibration curve of the model was highly coordinated to the ideal model curve; area under the ROC curve of futile recanalization was 0.862 ( 95%CI: 0.809-0.914, P<0.001). Conclusions:Acute anterior circulation large vessel occlusion patients with older age, history of hypertension, longer time from puncture to vascular recanalization, poor collateral circulation, severe WMHs, and moderate-severe stroke trend to have futile recanalization after EMT. This nomogram can predict futile recanalization after EMT.

Objective:To investigate the safety and effectiveness of Solitaire FR with intracranial support catheter for mechanical thrombectomy (SWIM) in the treatment of cerebral venous sinus thrombosis (CVST).Methods:Patients with progressive CVST treated with SWIM technology in the Neurology Department, Zhongshan Hospital of Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine from June 2019 to March 2022 (including 4 patients with intracranial hemorrhage) were retrospectively included. The venous sinus recanalization after procedure and during follow-up was observed. The modified Rankin Scale (mRS) was used to evaluate the outcome at 3 months after procedure.Results:A total of 9 patients with progressive CVST were treated with SWIM technology, including 6 males with a median age of 37.0 years (range, 15-78). Immediately post-procedural angiography showed complete recanalization of the venous sinuses in 6 cases and partial recanalization in 3 cases. At 3 months after procedure, the mRS score showed that 3 cases was 0, 3 cases was 1, 2 cases was 2, and 1 case was 4.Conclusion:SWIM technology may be a safe and effective method in the treatment of progressive CVST.

Objective To explore expression of HMGB1 and TLR4 in epileptogenic focus brain tissue of temporal lobe intractable epilepsy patients, and analyze its significance in epileptic seizures. Methods 85 tempo-ral lobe intractable epilepsy patients were included in the research. Patients underwent resection of epileptogenic focus in Neurosurgery Department of The Fifth Affiliated Hospital of Zhengzhou University during January 2011 to January 2012. Epileptogenic focus brain tissue during operation were studied. 20 patients underwent intracranial decompression were selected as control group. Normal brain tissue during operation were studied. Immunohisto-chemical method was applied to detect HMGB1 and TLR4 expression level in epileptogenic focus brain tissue of ex-perimental group patients and normal brain tissue of control group patients. Correlation of HMGB1 and TLR4 expres-sion level and epileptic seizures was analyzed. Results Positive expression rate of HMGB1 (χ2= 74.375, P =0.000) and TLR4(χ2= 57.495, P = 0.000) in epileptogenic focus brain tissue of experimental group patients are both higher than that in normal brain tissue of control group patients. Expression of HMGB1 and TLR4 in epilepto-genic focus brain tissue is correlated with course of epilepsy (χ2= 25.798, P = 0.000), (χ2= 10.548, P = 0.001) preoperative epileptic seizure duration(χ2=8.403, P=0.004),(χ2=10.564, P= 0.001) and preoperative epilep-tic seizure frequency (χ2=4.912, P=0.027), (χ2=5.567, P=0.018). Conclusions HMGB1-TLR4 passageway may become new direction to study pathogenesis, diagnosis, and treatment of intractable epilepsy.

Objective To explore expression of HMGB1 in glioma tissue of glioma-related epilepsy patients. Methods Immunohistochemistry was used to detect the expression of HMGB1 in the tissues from 82 glioma-related epi?lepsy patients (glioma-related epilepsy group), 80 glioma patients (glioma without epilepsy group), 80 intractable epilepsy patients (epilepsy control group) epileptogenic foci tissue and 20 normal controls (negative control group). Results HMGB1 in glioma tissue of glioma-related epilepsy group was significantly higher than that in glioma tissue of glioma without epilepsy grou p (χ2=16.944, P<0.001), especially in low pathological grade glioma tissue. HMGB1 was higher in glioma tissue of glioma-related epilepsy group than in epileptogenic foci tissue of epilepsy control group (χ2=26.094, P<0.001). Expression of HMGB1 in glioma tissue of glioma without epilepsy group (χ2=32.273, P<0.001) and epileptogenic foci tissue of epilepsy control group ( χ2=22.236,P<0.001) was higher than in normal brain tissue of negative control group. In glioma-related epilepsy group, HMGB1 was positively correlated with seizures duration(r=0.365,P=0.001), sei? zures frequency (r=0.531,P=0.000) and pathological grade of glioma tissue (r=0.265,P=0.016). Conclusions HMGB1 is highly expressed in glioma tissues of glioma-related epilepsy; HMGB1 expression is closely related with seizures; and HMGB1 in glioma tissue may contribute to the formation of glioma-related epilepsy.

Objective To investigate the expressions and significance of erythropoietin producing hepatocellular cell line receptor A2 (EphA2) in pediatric brain glioma.Methods Seventy-eight fresh pediatric glioma specimens with a defined histological grade were collected in the Fifth Affiliated Hospital of Zhengzhou University from Jan.2009to Mar.2013,which included 36 of low grade glioma(Ⅰ-Ⅱ grade),42 of high grade glioma(Ⅲ-grade),another 33 cases with brain trauma line pressure to remove children brain tissues were collected as control group.The expressions of EphA2 mRNA and protein were detected by reverse transcription-polymerase chain reaction (RT-PCR),Western blot and immunohistochemistry.Results 1.RT-PCR and Western blot showed that EphA2 did not express in control brain tissue,but the expression levels of EphA2 mRNA were over-expressed in pediatric brain glioma,and the difference was statistically significant(F =36.271,P ＜ 0.05) ;the expression levels of EphA2 protein were significantly higher in high-grade pediatric glioma group than in low-grade pediatric glioma group,and the difference was statistically significant(F =42.839,P ＜ 0.05).2.Immunohistochemistry showed that EphA2 expression was negative in control group,the positive expression in low-grade glioma group was 88.57％,and the positive expression in high-grade glioma group was 100.00％.Moreover,the higher the grade glioma,distribution of EphA2 expression was stronger,and the difference was statistically significant(Z =4.962,P ＜ 0.05).Conclusions The mRNA and protein expression levels of EphA2 were significantly high in pediatric brain glioma which were associated with the grade of glioma.Therefore,EphA2 may participate in the development and progression of pediatric brain glioma.

[Objective]To investigate the key points of treatment and effect of schmannomas in brachial plexus and peripheral nerves.[Method] Thirty-eight cases of schwannomas in brachial plexus and peripheral nerves were verified with pathology and clinical from 1999 to 2007.There were one case in accessory nerve,2 cases in cervical plexus cutaneous nerve,6 cases in brachial plexus,2 cases in lumbar plexus,17 cases in upper extremity,10 cases in lower extremity.Microsurgical removal of the tumors was done in 37 cases.They were monitored with negro-electro phsiology in operation.The other one case was repaired for nerve grafting after the tumor was cut off.The complexed parts were all examined with MRI before surgery,and all tumors were verified for schwannoma with pathyology.[Result]In 38 cases,there were no function deficit and recurrence over a period of follow up from 6 months to 7 years in 36 cases.The partial intrinsic muscle palsy was present postoperatively in one case of the schwannomas in ulnar nerve with microsurgery of tumor,and recovered after 10 days.After the schwannoma in L4 nerves were cut off and the nerves was grafted,the myodynamia of quadriceps femoris were decreased two degree below,the treatment effect of nerve grafting were being followed up. [Conclusion](1)The technique of microsurgery was used under the microscopic operating,the tumors should be cut off for the most degree to decrease the recurrence possibility,remain the normal neuro-function.(2) The MRI examination should be carried out before the schwannoma operating in the complex pares of the crans,brachial plxus,lumbar plexus and etc.(3) All the schwannoma should be verified by pathyology after surgery.

Objective:To explore and sum up diagnostic features and therapy for colorectal carcinoma with hepatic metastasis.Methods:48 cases of colorectal carcinoma with hepatic metastasis treated from Oct.1989 to Oct.1997.Results:The accuracy rates of ultrasound and CT were 18.2%,53.3% respectively.Of the 48 cases,10 cases underwent hepatectomies,10 cases ethanol injected to lives metastatic,8 cases chemotherapy via portal vein synchronously,8 cases intercurrent X-ray,12 cases abandon treatment.Conclusions:Colorectal carcinoma with hepatic metastasis is very difficult to diagnosis before operation,ultrasound and accuracy found on operation were the secure methods for diagnosis of colorectal carcinoma with hepatic metastasis.Hepatectoming is the first way for treating colorectal carcinoma with hepatic metastasis,others way are ethanol inject,chemotherapy via portal vein synchronously,interventional radiotogy,et al.

Objective: TO verify through animal experiment the validity of chemical cholecystectomy . Methods: The experimental objects seven healthy juvenile pigs,hardener was infused into the gallbladder,after infusion the samples were collected by pathoiogical examination , according to the different duration under anesthestize. Reslts:The mucous destructive and digestive process remained with one week, the inflammatory reacton in two weeks,the chronic inflatoy reaction compained a a great deal of granu lation tissue and scar formation occurred in 4th-8th week,10 weeks latter,the inflmmatory reaction reduced ,and scar tissue formed. Conclusion: Chemical cholecystectomy is safe and reliable in clinical.