This article reports a case of multiple cranial nerve injury after gamma knife radiosurgery treated with acupuncture and moxibustion combined with rehabilitation therapy. The patient presented with weakness of facial and tongue muscles, hoarseness, choking on water, and swallowing difficulties. The syndrome was attributed to qi and blood deficiency, and blood stasis obstructing the collaterals. The treatment principle focused on replenishing qi and blood, promoting blood circulation and unblocking collaterals. Yintang (GV24⁺), Lianquan (CV23), Qihai (CV6), Guanyuan (CV4), and Cuanzhu (BL2), Yangbai (GB14), Jingming (BL1), Sizhukong (TE23), Yingxiang (LI20), Sibai (ST2), Juliao (ST3), Quanliao (SI18), Dicang (ST4), Jiache (ST6), Xiaguan (ST7), Taiyang (EX-HN5) on the affected side, bilateral Jinjin (EX-HN12), Yuye (EX-HN13), Hegu (LI4), Zusanli (ST36), Sanyinjiao (SP6), Tianshu (ST25) were selected. Among these, bilateral Jinjin (EX-HN12) and Yuye (EX-HN13) were treated with pricking, Dicang (ST4) and Jiache (ST6) on the affected side were connected to an electroacupuncture device, and warming acupuncture was applied at Guanyuan (CV4). Rehabilitation therapy and electromyographic biofeedback were also incorporated. The treatments were given 2-3 times a week. After 18 months of intermittent treatment, the patient reported significant improvement, House Brackmann (H-B) facial nerve function grade was Ⅳ, and Sunnybrook facial nerve rating scale score was 53 points. After 2-month of follow-up, the patient reported normal swallowing ability and restored social engagement.
Humans ; Acupuncture Points ; Acupuncture Therapy ; Cranial Nerve Diseases/therapy*

This article reports a case of adult scoliosis with limb tremor treated with electroacupuncture. The patient presented with neck stiffness accompanied with limb tremor as the primary symptoms. The pattern was attributed to yang qi deficiency, and the treatment principle focused on unblocking the governor vessel, warming yang, and regulating qi. Acupuncture was applied to Dazhui (GV14), below the spinous processes of C₄-C₆ and bilateral C₄-C₆ Jiaji (EX-B2) points, Feishu (BL13), Xinshu (BL15), Pishu (BL20), Ganshu (BL18), Shenshu (BL23), Dachangshu (BL25). After achieving deqi sensation, bilateral C₄ Jiaji (EX-B2) and C₆ Jiaji (EX-B2) points were separately connected to an SDZ-Ⅴ electroacupuncture device, with continuous wave, 2 Hz of frequency, intensity should be within the tolerance of the patient, the needles were retained for 20 min. For the first 5 months, the treatment was 1-2 times a week, then reduced to 1-2 times a month thereafter. After 30 times of treatment, the patient's bilateral lower limb tremor resolved, the clinical rating scale for tremor (CRST) score was 13 points, the scoliosis showed improvement with about 10° reduction in Cobb angle. At 1-month follow-up, the condition remained stable without progression of scoliosis.
Adult ; Humans ; Acupuncture Points ; Electroacupuncture ; Scoliosis/physiopathology* ; Tremor/complications*

This article reports 2 cases of urinary retention in Alzheimer's disease with agitation treated by acupuncture. Based on patients' clinical symptoms, the etiology and pathogenesis were determined, and acupuncture was applied to Baihui (GV20), Sishencong (EX-HN1), Shenting (GV24), and bilateral Ciliao (BL32), Zhongliao (BL33), Fengchi (GB20), Taiyang (EX-HN5), etc. to regulate the mind and promote water metabolism. The positive and negative electrodes of the SDZ-Ⅴ type electroacupuncture device were attached to ipsilateral Ciliao (BL32), Zhongliao (BL33) respectively, with continuous wave, at the frequency of 15 Hz, and the current of 3 to 10 mA, depending on patients' tolerance. The needles were retained for 20 min. The treatment was delivered once every other day, 3 interventions a week and 12 interventions as 1 course. Both patients reported the micturition desire after 1 intervention with acupuncture and the catheter was removed on the same day. The urination was ameliorated without dysuresia after 1-2 courses of treatment, and the agitated behavior was alleviated. It can be the reference for the clinical treatment of urinary retention in patients with Alzheimer's disease with agitation.
Humans ; Alzheimer Disease/psychology* ; Acupuncture Therapy ; Urinary Retention/etiology* ; Male ; Female ; Aged ; Acupuncture Points ; Psychomotor Agitation/complications*

Objective:Explore the protective effect and mechanism of methyl badosolone (CDDO-Me) on rats with traumatic brain injury (TBI).Methods:A total of 72 SPF-grade SD rats aged 8 weeks were randomly (random number) divided into 4 groups ( n=18) using the random number table method: Sham, TBI, TBI+Vehicle, and TBI+CDDO-Me. The rat TBI model was established using the hydraulic impact head injury method. The TBI+CDDO-Me group was administered CDDO-Me (dissolved in 1% DMSO, at a dose of 10 mg/kg) via intraperitoneal injection 30 minutes after modeling, twice a day for a total of 3 days. On the third day after modeling, brain tissue was collected for pathological and water content detection after mNSS scoring. Immunofluorescence double staining was used to detect the expression of nuclear factor erythroid2 related factor 2 (Nrf2); immunohistochemical staining was used to detect the expression of ionized calcium binding adapter molecule-1(Iba-1); ELISA was used to detect the levels of tumor necrosis factor-α(TNF-α), interleukin (IL)-1β, and IL-18 in serum; kits were used to detect the levels of malondialdehyde (MDA) and reactive oxygen species (ROS); Western blot was used to detect the expression of the Nrf2 pathway, B-cell lymphoma-2 (BCL-2), and BCL-2 associated X protein (BAX). Results:(1) Compared with the Sham group, the mNSS scores and water content in the injured cortex of the TBI group rats were significantly increased (both P<0.05), and both significantly decreased after CDDO-Me intervention (both P<0.05). (2) Compared with the Sham group, the proportion of Nissl-stained injured neurons and apoptotic positive cells in the TBI group rats were significantly increased (both P<0.05), and both significantly decreased after CDDO-Me intervention (both P<0.05), accompanied by a decrease in BAX protein expression and upregulation of BCL-2 protein expression (both P<0.05). (3) Immunofluorescence and Western blot results showed that compared with the Sham group, the expression of total Nrf2, nuclear Nrf2, HO-1, and NQO1 proteins in the TBI group were all increased (all P<0.05), and the increase was more significant after CDDO-Me intervention (all P<0.05). (4) Immunohistochemistry and ELISA results showed that compared with the Sham group, the levels of MDA, ROS, Iba-1 in brain tissue and the levels of TNF-α, IL-1β, and IL-18 in serum in the TBI group rats were all significantly increased (all P<0.05), and all significantly decreased after CDDO-Me intervention (all P<0.05). Conclusion:CDDO-Me helps to reduce oxidative stress and inflammatory responses in TBI rats, and the mechanism may be related to the activation of the Nrf2/HO-1 antioxidant stress pathway.

Objective To explore the value of free mitochondrial deoxyribonucleic acid(DNA)and micro ribonucleic acid(miRNA,miR)-146a expression in peripheral blood in assessing short-term prognosis of sepsis.Methods Totally 145 patients with sepsis admitted to the hospital from March 2021 to February 2023 were selected to detect the free mitochondrial DNA and miR-146a expression in peripheral blood.The incidence of poor prognosis after 28 days was counted,and the patients were then divided into poor prognosis group and good prognosis group.The general data and the free mitochondrial DNA and miR-146a expression in peripheral blood of the two groups were compared.Logistic regression analysis was used to explore the influencing factors of poor prognosis in patients.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive efficacy of free mitochondrial DNA and miR-146a expressionin assessing the short-term prognosis of sepsis.Results The incidence of poor short-term prognosis in the 139 patients who completed the study was 28.78％.Concurrent diabetes(OR=1.765,95％CI:1.181～2.637),acutephysiology and chronic health evaluation(APACHE Ⅱ)score(OR=1.972,95％CI:1.317～2.953),free mitochondrial DNA in peripheral blood(OR=2.416,95％CI:1.524-3.829),and miR-146a expres-sion(OR=2.462,95％CI:1.431～4.237)were risk factors for poor short-term prognosis of patients with sepsis(P＜0.05).The sensitivity,specificity and area under curve(AUC)of free mitochondrial DNA and miR-146a expression in peripheral blood to predict poor short-term prognosis were higher than those of APACHE Ⅱ score(P＜0.05),and the sensitivity and AUC of free mitochondrial DNA and miR-146a expressions in peripheral blood to predict poor short-term prognosis were higher than those of both alone(P＜0.05).Conclusions Free mitochondrial DNA and miR-146a expression in peripheral blood are related to poor short-term prognosis of sepsis.The efficacy of both of them in assessing poor short-term prognosis of sepsis is better than that of APACHE Ⅱ score,and their combined prediction efficacy is even better.

Objective To explore the value of free mitochondrial deoxyribonucleic acid(DNA)and micro ribonucleic acid(miRNA,miR)-146a expression in peripheral blood in assessing short-term prognosis of sepsis.Methods Totally 145 patients with sepsis admitted to the hospital from March 2021 to February 2023 were selected to detect the free mitochondrial DNA and miR-146a expression in peripheral blood.The incidence of poor prognosis after 28 days was counted,and the patients were then divided into poor prognosis group and good prognosis group.The general data and the free mitochondrial DNA and miR-146a expression in peripheral blood of the two groups were compared.Logistic regression analysis was used to explore the influencing factors of poor prognosis in patients.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive efficacy of free mitochondrial DNA and miR-146a expressionin assessing the short-term prognosis of sepsis.Results The incidence of poor short-term prognosis in the 139 patients who completed the study was 28.78％.Concurrent diabetes(OR=1.765,95％CI:1.181～2.637),acutephysiology and chronic health evaluation(APACHE Ⅱ)score(OR=1.972,95％CI:1.317～2.953),free mitochondrial DNA in peripheral blood(OR=2.416,95％CI:1.524-3.829),and miR-146a expres-sion(OR=2.462,95％CI:1.431～4.237)were risk factors for poor short-term prognosis of patients with sepsis(P＜0.05).The sensitivity,specificity and area under curve(AUC)of free mitochondrial DNA and miR-146a expression in peripheral blood to predict poor short-term prognosis were higher than those of APACHE Ⅱ score(P＜0.05),and the sensitivity and AUC of free mitochondrial DNA and miR-146a expressions in peripheral blood to predict poor short-term prognosis were higher than those of both alone(P＜0.05).Conclusions Free mitochondrial DNA and miR-146a expression in peripheral blood are related to poor short-term prognosis of sepsis.The efficacy of both of them in assessing poor short-term prognosis of sepsis is better than that of APACHE Ⅱ score,and their combined prediction efficacy is even better.

OBJECTIVE To investigate the protective effects and potential mechanism of penehyclidine hydrochloride(PHC)on myocardial ischemia-reperfusion(I/R)injury in mice through the macrophage migration inhibitory factor(MIF)/adenosine monophosphate-activated protein kinase(AMPK)signaling pathways.METHODS Male C57BL/6 mice were randomly divided into sham operation group,I/R group,I/R+PHC group(PHC 20 μg/kg),I/R+ISO-1 group(MIF inhibitor 35 mg/kg),I/R+PHC+ISO-1 group(with the same dosage as each single drug group),with 8 mice in each group.Except for the sham operation group,the myocardial I/R injury model was prepared by coronary artery ligation.Thirty minutes before ligation,mice in each drug group were injected with 1 mL of the corresponding drug solution through the tail vein.After 120 min of reperfusion,the levels of cardiac function indexes[heart rate,stroke volume,ejection fraction,cardiac output,left ventricular posterior wall thickness in systole(LVPWs),left ventricular posterior wall thickness in diastole(LVPWd)],serum inflammatory factors[interleukin-6(IL-6),IL-10,tumor necrosis factor-α(TNF-α)]in mice were detected in each group;the pathological changes and ultrastructure of myocardial tissue were observed,and the protein expressions of B cell lymphoma-2(Bcl-2),phosphorylated AMPKα(p-AMPKα)and MIF in myocardial tissue were detected.RESULTS Compared with the sham operation group,the myocardial cells in the I/R group were loosely arranged,with severe infiltration of inflammatory cells and obvious mitochondrial damage.Serum levels of IL-6 and TNF-α and protein expression of p-AMPKα in myocardial tissue were significantly increased or upregulated,while heart rate,stroke volume,ejection fraction,cardiac output,LVPWd and serum level of IL-10 were significantly decreased(P＜0.05).Compared with the I/R group,the myocardial tissue lesions in the I/R+PHC group were alleviated;serum levels of IL-6 and TNF-α were decreased significantly,while heart rate,stroke volume,ejection fraction,cardiac output,LVPWs,LVPWd,serum level of IL-10,and protein expressions of Bcl-2,p-AMPKα and MIF in myocardial tissue were significantly increased or upregulated(P＜0.05).However,myocardial tissue lesions of mice in the I/R+ISO-1 group worsened,with most quantitative indicators significantly deteriorating(P＜0.05);MIF inhibitor could generally reverse the protective effect of PHC on I/R mice(P＜0.05).CONCLUSIONS PHC can improve cardiac function,reduce myocardial inflammation,and restore the ultrastructure of myocardial tissue in I/R mice.These effects may be related to the activation of the MIF/AMPK signaling pathway.

Objective:To investigate the neuroprotective effect of histone deacetylase 3 (HDAC3) specific inhibitor RGFP966 on traumatic brain injury (TBI) and its mechanism in rats.Methods:Forty-eight SD rats were randomly divided into sham-operated group, TBI group, TBI+vehicle group and TBI+RGFP966 group ( n=12). Rats in the later 3 groups accepted hydraulic impact brain injury to establish TBI models; and then, RGFP966 (dissolved in 1% DMSO at a dose of 10 mg/kg) was injected intraperitoneally 30 min after modeling, twice a day for 3 d, in TBI+RGFP966 group; same amount of DMSO was injected into TBI+vehicle group at the same time. Three d after modeling, neurological function was tested by modified neurological severity score (mNSS), water content of brain tissues was detected by dry-wet weight method, proportion of injured neurons at the frontal cortical tissues on the affected side was detected by Nissl staining, expressions of HDAC3 and pyroptosis related proteins were detected by immunohistochemical staining and Western blotting, and serum content of inflammatory factors was detected by ELISA. Results:Three d after modeling, compared with the TBI+vehicle group, the TBI+RGFP966 group had significantly decreased mNSS scores (9.83±0.75 vs. 6.67±0.82), water content of the injured cerebral cortex (82.73%±0.36% vs. 80.92%±0.66%), proportion of damaged neurons (75.60%±7.44% vs. 55.87%±4.10%), and HDAC3 protein expression (0.67±0.09 vs. 0.51±0.07), and significantly increased acetylated H3 (Ace-H3) and acetylated H4 (Ace-H4) protein expressions (0.81±0.02 vs. 1.22±0.02; 0.74±0.01 vs. 1.07±0.02), and statistically decreased protein expressions of nuclear factor-κB (NF-κB, 1.20±0.05 vs. 0.94±0.04), NOD-like receptor thermal protein domain associated protein 3 (NLRP3, 0.72±0.02 vs. 0.40±0.03), Caspase-1 containing cysteine (Caspase-1), dermatin D N-terminal fragment (GSDMD-N, 0.71±0.03 vs. 0.52±0.01), significantly decreased NF-κB and NLRP3 immunohistochemical staining scores, and significantly decreased serum contents of tumor necrosis factor-α, interleukin(IL)-1β and IL-18 ( P<0.05). Conclusion:Early intervention with RGFP966 after TBI can reduce the pyroptosis and inflammatory reaction of nerve cells and play neuroprotective role, whose mechanism may be related to inhibited activation of NF-κB/NLRP3/GSDMD pathway.

Objective:To investigate the effects of positive end-expiratory pressure (PEEP) setting of mechanical ventilation guided by esophageal pressure in the treatment of patients with traumatic craniocerebral injury combined with acute respiratory distress syndrome (ARDS).Methods:The retrospective cohort study was conducted. From June 2016 to June 2018, 55 patients with traumatic craniocerebral injury combined with ARDS who met the inclusion criteria were admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University. According to PEEP setting method, 28 patients were allocated to esophageal pressure group (17 males and 11 females, aged (40±13) years) and 27 patients were allocated to PEEP-fractional concentration of inspired oxygen (FiO 2) table group (18 males and 9 females, aged (38±10) years). Patients in the 2 groups were treated with mechanical ventilation guided by lung protective ventilation strategy, and the optimal PEEP at 0 (immediately), 24, 48, and 72 h after treatment was determined according to esophageal pressure and PEEP-FiO 2 table, respectively. The mechanical ventilation parameters in the 2 groups were adjusted according to the optimal PEEP. The transpulmonary end-expiratory pressure, pulmonary compliance, oxygen index, central venous pressure, mean arterial pressure, and intracranial pressure at 24, 48, and 72 h after treatment were recorded. Data were statistically analyzed with analysis of variance for repeated measurement, chi-square test, independent sample t test, and Bonferroni correction. Results:The optimal PEEP of patients in esophageal pressure group at 0, 24, 48, and 72 h after treatment was (12.4±3.9), (11.2±3.5), (13.4±2.6), and (13.2±3.6) cmH 2O (1 cmH 2O=0.098 kPa), respectively, which was significantly higher than (8.2±2.5), (7.4±2.2), (8.3±2.3), and (8.5±2.5) cmH 2O in PEEP-FiO 2 table group, respectively ( t=4.702, 4.743, 7.849, 5.623 , P<0.01). The transpulmonary end-expiratory pressure and pulmonary compliance at 24, 48, and 72 h after treatment and oxygen index at 48 and 72 h after treatment of patients in esophageal pressure group were significantly higher than those in PEEP-FiO 2 table group ( t=17.852, 20.586, 19.532, 4.752, 5.256, 7.446, 2.342, 4.178, P<0.05 or P<0.01). The central venous pressure of patients in esophageal pressure group at 24, 48, and 72 h after treatment was significantly higher than that in PEEP-FiO 2 table group ( t=12.632, 5.247, 8.994, P<0.01), and there was no statistically significant difference in mean arterial pressure of patients between the 2 groups at 24, 48, and 72 h after treatment ( P>0.05). The intracranial pressure of patients in esophageal pressure group was higher than that in PEEP-FiO 2 table group at 24, 48, and 72 h after treatment, but there was no statistically significant difference between the 2 groups ( P>0.05). Conclusions:For patients with traumatic craniocerebral injury combined with ARDS, the optimal PEEP can be set under the guidance of esophageal pressure method, and the mechanical ventilation parameters adjusted according to the optimal PEEP can improve lung compliance and accelerate recovery of lung function more effectively, with no adverse effect in mean arterial pressure and intracranial pressure.

Objective:To prepare nanosilver-hybridized polylactic acid-glycolic acid copolymer (PLGA) microspheres loaded with simvastatin (SIM), and to evaluate its sustained release effect in vitro. Methods:The emulsification-solvent evaporation method was used to prepare SIM-loaded PLGA microspheres. Silk fibroin (SF) was used to modify the surface of SIM-loaded PLGA microspheres by hydrophobic interaction. Then, the microspheres were continually modified by electrostatic adsorption to chitosan (CTS) and nano-silver (AgNPs) to prepare SF-AgNPs-CTS-SF-SIM-PLGA microspheres. Scanning electron microscope, Fourier transform infrared spectrometer, energy spectrometer, Zeta potential meter were used to analyze the SIM-loaded microspheres. The external release properties of the SIM-loaded microspheres were also investigated.Results:The average diameter of the prepared PLGA microspheres was about 9.67 μm. The results of Fourier transform infrared spectroscopy and energy spectroscopy showed that the AgNPs-CTS-SF-SIM-PLGA microspheres have been successfully constructed. The Zeta potential results indicated that the SIM-loaded microspheres were all in a stable state. The in vitro release results showed that the SF-AgNPs-CTS-SF-SIM-PLGA microspheres had a good in vitro release effect, could delay the drug release rate and prolong the drug release time. Conclusions:The SF-AgNPs-CTS-SF-SIM-PLGA microspheres have antibacterial and osteogenic effects, and exhibit a good in vitro release effect. They can be used for local sustained-release administration in the oral cavity, which make makes them potentially useful in the treatment of periodontitis.