Objective To explore the pathogenic roles of miR-21, estrogen (E2), and estrogen receptor (ER) in adenomyosis. Methods We examined the expression levels of miR-21 in specimens of adenomyotic tissue and benign cervical lesions using qRT-PCR. In primary cultures of cells isolated from the adenomyosis lesions, the effect of ICI82780 (an ER inhibitor) on miR-21 expression levels prior to E2 activation or after E2 deprivation were examined with qRT-PCR. We further assessed the effects of a miR-21 mimic or an inhibitor on proliferation, apoptosis, migration and autophagy of the cells. Results The expression level of miR-21 was significantly higher in adenomyosis tissues than in normal myometrium (P<0.05). In the cells isolated from adenomyosis lesions, miR-21 expression level was significantly higher in E2 activation group than in ER inhibition+E2 activation group and the control group (P<0.05);miR-21 expression level was significantly lower in cells in E2 deprivation+ER inhibition group than in E2 deprivation group and the control group (P<0.05). The adenomyosis cells transfected with miR-21 inhibitor showed inhibited proliferation and migration, expansion of mitochondrial endoplasmic reticulum, increased lysosomes, presence of autophagosomes, and increased cell apoptosis, while transfection of the cells with the miR-21 mimic produced the opposite effects. Conclusion MiR-21 plays an important role in promoting proliferation, migration, and anti-apoptosis in adenomyosis cells by altering the cell ultrastructure, which may contribute to early pathogenesis of the disease. In addition to binding with E2, ER can also regulate miR-21 through other pathways to participate in the pathogenesis of adenomyosis, thus having a stronger regulatory effect on miR-21 than E2.

Objective To explore the pathogenic roles of miR-21, estrogen (E2), and estrogen receptor (ER) in adenomyosis. Methods We examined the expression levels of miR-21 in specimens of adenomyotic tissue and benign cervical lesions using qRT-PCR. In primary cultures of cells isolated from the adenomyosis lesions, the effect of ICI82780 (an ER inhibitor) on miR-21 expression levels prior to E2 activation or after E2 deprivation were examined with qRT-PCR. We further assessed the effects of a miR-21 mimic or an inhibitor on proliferation, apoptosis, migration and autophagy of the cells. Results The expression level of miR-21 was significantly higher in adenomyosis tissues than in normal myometrium (P<0.05). In the cells isolated from adenomyosis lesions, miR-21 expression level was significantly higher in E2 activation group than in ER inhibition+E2 activation group and the control group (P<0.05);miR-21 expression level was significantly lower in cells in E2 deprivation+ER inhibition group than in E2 deprivation group and the control group (P<0.05). The adenomyosis cells transfected with miR-21 inhibitor showed inhibited proliferation and migration, expansion of mitochondrial endoplasmic reticulum, increased lysosomes, presence of autophagosomes, and increased cell apoptosis, while transfection of the cells with the miR-21 mimic produced the opposite effects. Conclusion MiR-21 plays an important role in promoting proliferation, migration, and anti-apoptosis in adenomyosis cells by altering the cell ultrastructure, which may contribute to early pathogenesis of the disease. In addition to binding with E2, ER can also regulate miR-21 through other pathways to participate in the pathogenesis of adenomyosis, thus having a stronger regulatory effect on miR-21 than E2.

Objective:To investigate the diagnostic accuracy of serological indicators and evaluate the diagnostic value of a new established combined serological model on identifying the minimal hepatic encephalopathy (MHE) in patients with compensated cirrhosis.Methods:This prospective multicenter study enrolled 263 compensated cirrhotic patients from 23 hospitals in 15 provinces, autonomous regions and municipalities of China between October 2021 and August 2022. Clinical data and laboratory test results were collected, and the model for end-stage liver disease (MELD) score was calculated. Ammonia level was corrected to the upper limit of normal (AMM-ULN) by the baseline blood ammonia measurements/upper limit of the normal reference value. MHE was diagnosed by combined abnormal number connection test-A and abnormal digit symbol test as suggested by Guidelines on the management of hepatic encephalopathy in cirrhosis. The patients were randomly divided (7∶3) into training set ( n=185) and validation set ( n=78) based on caret package of R language. Logistic regression was used to establish a combined model of MHE diagnosis. The diagnostic performance was evaluated by the area under the curve (AUC) of receiver operating characteristic curve, Hosmer-Lemeshow test and calibration curve. The internal verification was carried out by the Bootstrap method ( n=200). AUC comparisons were achieved using the Delong test. Results:In the training set, prevalence of MHE was 37.8% (70/185). There were statistically significant differences in AMM-ULN, albumin, platelet, alkaline phosphatase, international normalized ratio, MELD score and education between non-MHE group and MHE group (all P<0.05). Multivariate Logistic regression analysis showed that AMM-ULN [odds ratio ( OR)=1.78, 95% confidence interval ( CI) 1.05-3.14, P=0.038] and MELD score ( OR=1.11, 95% CI 1.04-1.20, P=0.002) were independent risk factors for MHE, and the AUC for predicting MHE were 0.663, 0.625, respectively. Compared with the use of blood AMM-ULN and MELD score alone, the AUC of the combined model of AMM-ULN, MELD score and education exhibited better predictive performance in determining the presence of MHE was 0.755, the specificity and sensitivity was 85.2% and 55.7%, respectively. Hosmer-Lemeshow test and calibration curve showed that the model had good calibration ( P=0.733). The AUC for internal validation of the combined model for diagnosing MHE was 0.752. In the validation set, the AUC of the combined model for diagnosing MHE was 0.794, and Hosmer-Lemeshow test showed good calibration ( P=0.841). Conclusion:Use of the combined model including AMM-ULN, MELD score and education could improve the predictive efficiency of MHE among patients with compensated cirrhosis.

Objective:To compare the differences in the prevalence of mild micro-hepatic encephalopathy (MHE) among patients with cirrhosis by using the psychometric hepatic encephalopathy score (PHES) and the Stroop smartphone application (Encephal App) test.Methods:This prospective, multi-center, real-world study was initiated by the National Clinical Medical Research Center for Infectious Diseases and the Portal Hypertension Alliance and registered with International ClinicalTrials.gov (NCT05140837). 354 cases of cirrhosis were enrolled in 19 hospitals across the country. PHES (including digital connection tests A and B, digital symbol tests, trajectory drawing tests, and serial management tests) and the Stroop test were conducted in all of them. PHES was differentiated using standard diagnostic criteria established by the two studies in China and South Korea. The Stroop test was evaluated based on the criteria of the research and development team. The impact of different diagnostic standards or methods on the incidence of MHE in patients with cirrhosis was analyzed. Data between groups were differentiated using the t-test, Mann-Whitney U test, and χ2 test. A kappa test was used to compare the consistency between groups. Results:After PHES, the prevalence of MHE among 354 cases of cirrhosis was 78.53% and 15.25%, respectively, based on Chinese research standards and Korean research normal value standards. However, the prevalence of MHE was 56.78% based on the Stroop test, and the differences in pairwise comparisons among the three groups were statistically significant (kappa = -0.064, P < 0.001). Stratified analysis revealed that the MHE prevalence in three groups of patients with Child-Pugh classes A, B, and C was 74.14%, 83.33%, and 88.24%, respectively, according to the normal value standards of Chinese researchers, while the MHE prevalence rates in three groups of patients with Child-Pugh classes A, B, and C were 8.29%, 23.53%, and 38.24%, respectively, according to the normal value standards of Korean researchers. Furthermore, the prevalence rates of MHE in the three groups of patients with Child-Pugh grades A, B, and C were 52.68%, 58.82%, and 73.53%, respectively, according to the Stroop test standard. However, among the results of each diagnostic standard, the prevalence of MHE showed an increasing trend with an increasing Child-Pugh grade. Further comparison demonstrated that the scores obtained by the number connection test A and the number symbol test were consistent according to the normal value standards of the two studies in China and South Korea ( Z = -0.982, -1.702; P = 0.326, 0.089), while the other three sub-tests had significant differences ( P < 0.001). Conclusion:The prevalence rate of MHE in the cirrhotic population is high, but the prevalence of MHE obtained by using different diagnostic criteria or methods varies greatly. Therefore, in line with the current changes in demographics and disease spectrum, it is necessary to enroll a larger sample size of a healthy population as a control. Moreover, the establishment of more reliable diagnostic scoring criteria will serve as a basis for obtaining accurate MHE incidence and formulating diagnosis and treatment strategies in cirrhotic populations.

Jiaji points have been widely used in the treatment of cerebral palsy, spinal cord injury, stroke, cervical spondylosis, lumbar disc herniation, ankylosing spondylitis, herpes zoster and other diseases, and shown good curative effect. The treatment methods for Jiaji points are rich, including acupuncture, electroacupuncture, moxibustion, percussion, fire needle, acupoint injection, warm acupuncture, and bloodletting. And acupuncture and electroacupuncture are the most application treatment methods. But the treatment shows narrow, scope of diseases, like internal medicine, pediatrics, and gynecology. Such treatment of Jiaji points are seldomly combined with other acupoints. Though Jiaji point treatment has good curative effect for insomnia, depression, uterine fibroids and other diseases, clinical application is few.

, the famous medical scholar of the Northern Song Dynasty, compiled (, hereinafter referred to as ) based on the acupuncture achievements before the Song Dynasty. In reference to the records in , two acupuncture bronze figures were made and all of the text was inscribed on the stele. 's academic characteristics on acupuncture are reflected through these three different forms, including 4 aspects. ① Establishing the supplementation and classification of the numbers of acupoints; ② elaborating the indications of meridians and application of acupoints; ③ stressing the contraindication and nursing of prognosis; ④ revising acupuncture atlas and bone proportional measurement. , the bronze figure and the stele represent the eminent academic achievements of acupuncture in the Song Dynasty and have become the treasure of acupuncture history in China.
Acupuncture Therapy ; China ; Meridians

school of acupuncture and moxibustion is the important component of the medicine of school, especially medical scholars. Through collecting and digging the medical books and literature of medical scholars in dynasties, the contribution to acupuncture academic development in Shandong region was introduced briefly so as to provide the references to the study on the regionalism of acupuncture school. The results showed that there was a long history of acupuncture from the Dynasty to the present and many medical scholars and medical books were sprung up. The systematic analysis on medical scholars, acupuncture works and literature as well as academic thoughts are conductive to the great-leap-forward development of school of acupuncture and moxibustion.

Objective To investigate the innovation ability status of undergraduate students in Third Military Medical University,and put forward some effective suggestions.Methods A questionnaire was applied to survey the innovation ability status of undergraduate students in Third Military Medical University.A total of 210 valid questionnaires were collected.The questionnaires covered five aspects including undergraduate students' basic information,innovative consciousness,innovation thinking,innovation skills and basic knowledge.The results were assessed by using SPSS 19.0 statistical software for t-test or ANOVA of students from different grades,majors and academic years.Inspection level was α=0.05.Results The total score of innovation ability in undergraduates was (70.5 ± 8.2) point,and no significant difference was observed in the total score of undergraduates' innovation ability within different grades (P=0.435).However,the innovation thinking ability of undergraduates in Grade Four was significantly higher than that in Grade Two [(77.0 ± 10.7) vs.(72.6 ± 10.9),P=0.030)],and the score of basic knowledge of undergraduates in Grade One was significantly higher than that in Grade Four [(76.2 ± 6.0) vs.(69.3 ± 8.7),P=0.014)].The total score of innovation ability of undergraduates from clinical medicine was significantly higher that of undergraduates from preventive medicine and other majors [(72.5 ± 8.8) vs.(69.9 ± 7.5),P=0.035;(72.5 ± 8.8) vs.(66.7 ± 7.9),P=0.004].There were no significant differences in total score of innovation ability or score of any first level index of undergraduates between eight-and five-year system of preventive medicine (P＞0.05).Conclusion The overall innovation ability of undergraduates in military medical university was relatively high,and undergraduates from different grades,majors and academic years have their own special advantages in innovative consciousness,innovation thinking,innovation skills and basic knowledge,and it is necessary to carry out more researches focusing on educational and training mechanism of innovation ability according to the personality of undergraduates in military medical universities.

By sorting out 2005-2015's literature on the mechanism of acupuncture and moxibustuion treatment for lumbar intervertebral disc herniation, this article concludes that the studies focused mainly on six aspects: improvement in nail fold microcirculation, improvement in neural ultrastructure, regulation of bodily autoimmunity, improvement in hemorheological indicators, regulation of neuroelectrophysiology and regulation of chemical neuroinflamma- tory mediators. A summary is made from the six aspects.

The CNKI database was searched using the keywords premature ovarian failure and acupuncture. Ninety-eight related articles published from 2006 to 2015 were retrieved and 17 with randomized controlled trials were sifted out. The recent 10 years' research situation of the mechanism of acupuncture treatment for premature ovarian failure was systematically summarized through literature review and collation. A retrospective summary was made from five aspects: improvement in ovarian endocrine function, acceleration of ovulation, effect on immunologic system, improvement in ovarian reserve function and regulation of ovarian microenvironment. It is put forward on this basis that future studies on the mechanism of acupuncture treatment for premature ovarian failure can be further into higher gene and protein levels; and no matter what kind of acupuncture manipulation is used, arrival of qi is necessary; only arrival of qi can produce an effect.