Objective:To observe the effects of acupuncture and moxibustion on phosphatase and PTEN-induced putative kinase 1(PINK1)/Parkin signaling pathway in the midbrain substantia nigra of Thy1-α synuclein(αSyn)transgenic model mice with Parkinson disease(PD). Methods:Twenty-four Thy1-αSyn transgenic mice were randomly divided into a model group,an acupuncture group,an acupuncture + moxibustion group,and a Western medicine group.Six wild-type mice in the same litter were used as the wild-type group.In the acupuncture group,Baihui(GV20)and Yanglingquan(GB34)were selected for acupuncture.In the acupuncture + moxibustion group,Guanyuan(CV4)was added on the basis of the acupuncture group.The Western medicine group was given rapamycin intraperitoneal injection at a dose of 10 mg/(kg·bw).The wild-type group and the model group were fixed without intervention.The overall rod performance(ORP)score of mice was observed in each group.The immunohistochemical method was used to detect the tyrosine hydroxylase(TH)positive neurons in the substantia nigra of mice in each group.The αSyn was detected by the immunofluorescence chemical method.The expression levels of αSyn,microtubule-associated protein 1 light chain 3(LC3)-Ⅱ/LC3-Ⅰ,autophagy protein sequestosome-1/protein 62(SQSTM-1/p62),PINK1,Parkin,and ubiquitin-specific protease 30(USP30)proteins were detected by Western blotting assay.The expression levels of LC3B,p62,PINK1,Parkin,and USP30 mRNAs were detected by fluorescence quantitative polymerase chain reaction. Results:Compared with the wild-type group,the ORP score,the p62,PINK1,and Parkin protein expression levels decreased significantly(P<0.01),the PINK1 mRNA expression level decreased(P<0.05),while the protein and mRNA expression levels of USP30 increased(P<0.05)in the model group.Compared with the model group,the ORP score in the acupuncture group and the acupuncture + moxibustion group increased(P<0.05);the expression level of LC3-Ⅱ/LC3-Ⅰ protein in the acupuncture + moxibustion group and the Western medicine group increased(P<0.05);the protein expression levels of p62,PINK1,and Parkin increased(P<0.05),while the USP30 protein expression level decreased significantly(P<0.01)in the acupuncture group,the acupuncture + moxibustion group,and the Western medicine group;the Parkin mRNA expression level in the acupuncture group and the acupuncture + moxibustion group increased(P<0.05);the USP30 mRNA expression level in the acupuncture + moxibustion group decreased(P<0.05). Conclusion:Acupuncture and moxibustion regulate the related molecule expression levels of PINK1/Parkin signaling pathway in the Thy1-αSyn transgenic PD model mice and promote the autophagy degradation of αSyn to exert the protective effect of dopaminergic neurons.

The outbreak of COVID-19 has spread quickly across 114 countries/territories/areas in six continents worldwide and has been announced as a pandemic by WHO. This study analyzed global COVID-19 epidemiological trends, examined impact of the pandemic on global health security, diplomacy, and social environment in China, and provided short- and long-term strategic policy recommendations for China’s subsequent preparedness and responses.

During the Coronavirus Disease 2019 (COVID-19) pandemic, practices of gastrointestinal procedures within the digestive tract require special precautions due to the risk of contraction of severe acute respiratoy syndrome coronavirus-2 (SARS-CoV-2) infection. Many procedures in the gastrointestinal motility laboratory may be considered moderate to high-risk for viral transmission. Healthcare staff working in gastrointestinal motility laboratories are frequently exposed to splashes, air droplets, mucus, or saliva during the procedures. Moreover, some are aerosol-generating and thus have a high risk of viral transmission. There are multiple guidelines on the practices of gastrointestinal endoscopy during this pandemic. However, such guidelines are still lacking and urgently needed for the practice of gastrointestinal motility laboratories. Hence, the Asian Neurogastroenterology and Motility Association had organized a group of gastrointestinal motility experts and infectious disease specialists to produce a position statement paper based-on current available evidence and consensus opinion with aims to provide a clear guidance on the practices of gastrointestinal motility laboratories during the COVID-19 pandemic. This guideline covers a wide range of topics on gastrointestinal motility activities from scheduling a motility test, the precautions at different steps of the procedure to disinfection for the safety and well-being of the patients and the healthcare workers. These practices may vary in different countries depending on the stages of the pandemic, local or institutional policy, and the availability of healthcare resources. This guideline is useful when the transmission rate of SARS-CoV-2 is high. It may change rapidly depending on the situation of the epidemic and when new evidence becomes available.

Neuron-antibody mediated movement disorders are a class of movement disorders caused by abnormal immune responses to nerve auto-antigens,which could be paraneoplastic,infectious or idiopathic.The clinical manifestations of nervous system symptoms varied,and movement disorders can be used as part of various phenotypes,including chorea,dystonia,Parkinson's syndrome,myoclonus,stiffness syndrome,autoimmune encephalitis and cerebellar ataxia and so on.The clinical diagnosis of this disease is mainly based on the positive specific anti-central or peripheral nerve autoantibodies in serum or cerebrospinal fluid.The specificity of antibodies helps to predict associated cancer and its response to immunotherapy.Early and accurate diagnosis is very important because of the good therapeutic effect of early immunization.

Objective · To explore the correlation of serum S100B protein with depressive episode of bipolar disorder (BD) and its prognosis.Methods· Based on BD criteria of Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-Ⅳ),80 patients with depressive episode of BD (case group) and 42 healthy controls (control group) were enrolled.Patients were randomly assigned into quetiapine group who were treated with lithium and quetiapine and modified electroconvulsive therapy (MECT) group who received lithium and MECT.The serum S100B level and Hamilton Rating Scale for Depression (HAMD) were assayed before and after 4-week treatment.Results· The serum S100B levels before treatment in patients with depressive episode of BD were significantly higher than those in healthy controls (P=0.000).The levels of S100B in both drug and MECT groups decreased after 4-week treatment.The HAMD score after treatment significantly decreased than that before treatment (P=0.000).Pearson correlation analysis showed that the change of S 100B level was positively correlated with the change of HAMD score before and after treatment in case group (r=0.33,P=0.013).Conclusion· S100B may be associated with depressive episode of BD and its prognosis.

Objective To explore the relationship among the prevertebral soft tissue swelling, surgical extent, surgical segments, and complications and to investigate the clinical significance of lateral radiographs for evaluating the postoperative prevertebral soft tissue swelling. Methods 123 patients who underwent anterior cervical fusion with plate augmentation for cervical spondylosis were included in this study. The postoperative prevertebral soft tissue swelling was measured by lateral radiographs. The data were analysed according to surgical extent and surgical segments. Patients were divided into the swelling group (61cases, >9. 98 mm) and the non-swelling group (62 cases, <9. 98 mm) based on the degree of prevertebral soft tissue swelling. The incidences of complications, such as dyspnea and dysphagia, were ana-lysed. Results The rate of dyspnea was 21. 3% in swelling group, which was higher than 8. 1% in non-swelling group (P<0. 05). The rate of dysphagia was 83. 6% in swelling group, which was higher than 25. 8% in non-swelling group (P<0. 05). In addition, postoperative prevertebral soft tissue swelling was 8. 29 mm averagely after one-level fusion, which was less than that after two or more levels fusion (11. 55 mm and 10. 40 mm) (P<0. 05). Postoperative prevertebral soft tissue swelling was 10. 94 mm after high-level fusion (above C4), which was more than that low-level fusion (below C5) (8. 63 mm) (P<0. 05). Conclusion After anterior cervical fusion for cervical spondylosis, when the degree of prevertebral soft tissue swelling is greater the incidences of complications such as dyspnea and dysphagia might be higher. In addition, prevertebral soft tissue swelling increments are significantly greater in patients who had undergone multi-level or high-level fusion ( above C5 ) . Evaluation of prevertebral soft tissue swelling using lateral radiographs is a clinically meaningful procedure.

Objective To evaluate the efficacy of dezocine for prevention of postoperative cognitive dysfunction (POCD) in elderly patients undergoing total knee arthroplasty under remifentanil-based anesthesia.Methods Sixty-eight patients of both sexes, aged 65-85 yr, weighing 48-78 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , undergoing elective unilateral total knee arthroplasty under general anesthesia, were randomly divided into 2 groups (n =34 each) using a random number table: control group (group C) and dezocine group (group D).After induction of anesthesia, the patients were tracheally intubated and mechanically ventilated.Anesthesia was maintained with iv infusion of propofol 0.05-0.06 mg · kg-1 · min-1 and remifentanil 0.05-0.10 μg · kg-1 · min-1, and intermittent iv boluses of vecuronium 0.04 mg/kg.Dezocine 0.1 mg/kg was injected intravenously at 30 min before skin incision in group D.At 1 day before operation (T0) , and 1, 3, 5, 7 days after operation (T1 , T2, T3 , T4) , the blood samples from the central vein were collected for determination of serum cortisol (Cor), neuron specific enolase (NSE) and S-100β protein concentrations.Before operation, and 5 and 7 days after operation, the patients' cognitive function was assessed using Mini-Mental State Examination, and the occurrence of POCD was recorded.Results Compared with the baseline value at T0, the serum Cor, NSE and S-100β protein concentrations were significantly increased at T1-3, and MMSE scores were decreased at T3,4 in the two groups.Compared with group C, the serum Cot, NSE and S-100β protein concentrations were significantly decreased at T1-4, and Mini-Mental State Examination scores were increased at 5 and 7 days after operation, and the incidence of POCD was decreased in group D.Conclusion Dezocine 0.1 mg/kg intravenously injected at 30 min before skin incision can prevent the occurrence of POCD in elderly patients undergoing total knee arthroplasty under remifentanil-based anesthesia.

Objective To observe the regulatory effect of bFGF and TGF-β1 for the proliferation of mesenchymal progenitor cells ( MPCs) derived from primary osteoarthritis cartilage, and to provide theoretical evidence in preventing and curing primary OA. Methods Different concentrations of bFGF and TGF-β1 ( alone or combined) were used to treat primary OA cartilage and their effects on proliferation of MPCs were tested by MTT method. Results Either bFGF (10. 0~50. 0 ng/mL) or TGF-β1 (0. 1 ~1. 0 ng/mL) alone can significantly promote the proliferation of MPCs derived from primary OA cartilage (P<0. 05). But with their increased concentration,the proliferation rate was of no significant changes (P>0. 05). The combination of 10. 0 ng/mL bFGF and 1. 0 ng/mL TGF-β1 significantly increased the prolifer-ation of MPCs from primary OA (P<0. 05). Conclusion Both bFGF and TGF-β11 play important roles in the proliferation of MPCs in primary OA cartilage,and they can increase the proliferation in different degree with different concentrations. There must be feasible methods of gene technology to promote cell proliferation and differentiation of MPCs for repairing articular car-tilage injury.

BACKGROUND:Three-dimensional visualization technique has been widely used in clinical treatment. Preoperative visualization technique al ows safe demonstration on the complex spine fracture models, and also prepare screw placement scheme according to three-dimensional model of patients.
OBJECTIVE:To discuss the clinical result of treating short-segment lumbar vertebrae fracture with pedicle screw visualization.
METHODS:A total of 32 patients with lumbar vertebrae fracture were treated with 182 pedicle screws. Before the screw implantation, the structure of bilateral pedicle was observed using Mimics software and the implantation parameters were measured. The operation methods and related complications were told to the patients through the reconstructed three-dimensional images. The satisfaction of the patients, operation time, and the position of pedicle screws by postoperative CT scan were assessed. The percentages of anterior vertebral height and Cobb’s angle were measured before operation, 2 weeks after operation and 8 months after operation.
RESULTS AND CONCLUSION:The excellent satisfaction rate of the patients was 100%, the mean operation time was 185 minutes, and 173 pedicle screws (95.1%) were total y inserted within the pedicle. Al patients were fol owed up for 7-22 months. The results showed that the fracture healed wel . The percent of anterior vertebral height and Cobb’s angle at 2 weeks after operation were significantly decreased compared with them before operation (P<0.05). There were no significant difference about the percent of anterior vertebral height and Cobb’s angle between 2 weeks and 8 months fol ow-up (P>0.05). Single-segment lumbar vertebrae fracture was wel treated by the pedicle screw visualization technique. This method assists to make up preoperation plan, increase the rate of patients’ satisfaction, shorten operation time, and increase the accuracy of pedicle screw insertion.

This study was aimed to explore the clinical effect of San-Jiao (SJ) acupuncture combined with Chinese medicine and Cisapride tablets in the treatment of senile constipation. A total of 118 patients were selected according to the inclusion criteria. According to the visiting sequence, patients were randomly divided into the acupuncture with Chinese medicine group of 60 cases and drug group of 58 cases. In the acupuncture with Chinese medicine group, SJ acupuncture was combined with Huang-Di (HD) powder in the treatment. In the drug group, Cisapride tablets were applied. Both groups were treated for 20 times. The scale was used in the comprehensive evaluation of integral effect evaluation of main symptoms, psychological evaluation before and after the treatment. The results showed that there was significant difference on the integral before and after treatment in both groups (P< 0.01). The posttreatment integral showed that the acupuncture with Chinese medicine group was better than the drug group (P<0.01). There was no significant difference on total effective rate between two groups. However, comparison on good improvement rate showed that the acupuncture with Chinese medicine group was better than the drug group (χ2 =28.25, P < 0.01). It was concluded that the acupuncture with Chinese medicine group had better effect on the im-provement of clinical symptom integral, psychological integral, and comprehensive effect evaluation. SJ acupuncture combined with HD powder was a safe treatment method with good effect.