OBJECTIVE: To propose a machine learning-based method for predicting the trajectories during manual acupuncture manipulation (MAM), aiming to improve the precision and consistency of acupuncture practitioner' operation and provide the real-time suggestions on MAM error correction. METHODS: Computer vision technology was used to analyze the hand micromotion when holding needle during acupuncture, and provide a three-dimensional coordinate description method of the index finger joints of the holding hand. Focusing on the 4 typical motions of MAM, a machine learning-based MAM trajectory predictive model was designed. By integrating the changes of phalangeal joint angle and hand skeletal information of acupuncture practitioner, the motion trajectory of the index finger joint was predicted accurately. Besides, the roles of machine learning-based MAM trajectory predictive model in the skill transmission of acupuncture manipulation were verified by stratified randomized controlled trial. RESULTS: The performance of MAM trajectory predictive model, based on the long short-term memory network (LSTM), obtained the highest stability and precision, up to 98%. The learning effect was improved when the model applied to the skill transmission of acupuncture manipulation. CONCLUSION The machine learning-based MAM predictive model provides acupuncture practitioner with precise action prediction and feedback. It is valuable and significant for the inheritance and error correction of manual operation of acupuncture.
Humans ; Acupuncture Therapy/instrumentation* ; Machine Learning ; Adult ; Male ; Female

To understand the pathogenicity and drug resistance of swine-derived E.coli and its bio-logical characteristics in some areas in Hebei,E.coli was isolated and identified from diarrheal fe-ces of piglets collected from swine farms,and the isolated strains were subjected to drug sensitivity test,detection of the ability to form biofilm,pathogenicity test,virulence gene test,drug resistance gene test,and identification of phylogenetic subgroups.The results showed that a total of 35 patho-genic E.coli strains were isolated from the feces of diarrheic piglets,and most of the isolates were multidrug-resistant,and were resistant to at least three antibiotics,including amoxicillin(88.57％),ampicillin(88.57％),doxycycline(88.75％),sulfisoxazole(77.17％),lincomycin(100％),and chloramphenicol(100％);the isolates were severely resistant.The isolates all carried virulence genes,with a total of five virulence genes detected,namely,EAST1(77.14％),eaeA(17.14％),stx2e(5.71％),LT(2.86％),and STb(2.86％),and the isolates also carried multi-re-sistance genes,with a total of five virulence genes detected,namely,bla TEM-1(65.71％),bla CTX-M(20.00％),tetA(82.86％),tetB(14.29％),aadA2(17.14％),aac(6')-Ib(14.29％),qnrS(17.14％),sul 1(40.00％),sul2(34.29％),and floR(60.00％);the phylogenetic grouping showed that the isolates had a high proportion of group B1 and group A;and all 35 isolates showed differ-ent pathogenicity after infection of mice.This study provides a reference for the selection of effec-tive therapeutic drugs and the development of prevention and control programs for swine-origin pathogenic E.coli in Hebei Province.

This case report highlights the successful treatment of moderate-to-severe thyroid-associated ophthalmopathy(TAO) with teprotumumab in a patient who had previously failed multiple therapies, including intravenous steroid pulse therapy, local thyroid injections of cyclophosphamide, octreotide and dexamethasone, tocilizumab treatment, total thyroidectomy, and orbital radiation. Despite these interventions, there was no improvement in TAO. Following treatment with teprotumumab, the patient experienced a reduction of 5 mm in left eye proptosis and 4 mm in right eye proptosis, a 6-point decrease in the clinical activity score(CAS), a 2-point reduction in the diplopia score, and a significant improvement in quality of life, with sustained effects lasting 72 weeks. The treatment was well tolerated, with mild side effects including muscle spasm, fatigue, and dryness of the skin and nasal mucosa. This case report aims to raise clinical awareness regarding efficacy and safety of teprotumumab.

Objective We explored the anti-depressant activity and mechanism of arecoline in vivo in a mouse model of depression induced by chronic unpredictable mild stress.The aim was to explore the possible mechanisms of action,providing experimental evidence for further research into the health benefits of arecoline and theoretical support for the scientific development and utilization of this resource.Methods Sixty quarantine-qualified SPF C57BL/6J mice were divided randomly into a control group,model group,fluoxetine group(20 mg/kg),and arecoline low-,medium-,and high-dose groups(10,20,and 40 mg/kg,respectively)according to body mass(n=10 mice per group).The effects of arecoline on the behavior of the mice were evaluated by open-field,tail-suspension,and forced-swimming tests.Serum corticosterone and serum and brain levels of superoxide dismutase(SOD)were detected by enzyme-linked immunoassay.Malondialdehyde(MDA),catalase(CAT),5-hydroxytryptamine(5-HT),and norepinephrine(NE)levels in brain tissue,and dopamine(DA),gamma-aminobutyric acid(GABA),tumor necrosis factor(TNF-α),interleukin(IL)-10,IL-1β,brain-derived neurotrophic factor(BDNF),tropomyosin receptor kinase B(TrkB),and cAMP-response element binding protein(CREB)were detected by Western Blot.Results Arecoline significantly reduced the total distance and average speed of the model mice in open field tests and increased activities,and significantly reduced the immobility time in the tail suspension and forced swimming tests.Arecoline also significantly decreased serum corticosterone levels,increased SOD and CAT,and decreased MDA levels.5-HT,DA,NE,and GABA levels were significantly increased,and the cytokines TNF-α,IL-6,and IL-1β were significantly decreased.Expression levels of BDNF,TrkB,and CREB in the brain tissue were significantly increased.Conclusions Research has found that arecoline has a significant antidepressant ability,and its mechanism may be achieved by reducing oxidative stress damage,inhibiting neuroinflammation,regulating neurotransmitter balance,and regulating the BDNF/TrkB/CREB signaling pathway..This study explored the antidepressant efficacy of arecoline and preliminarily revealed its possible regulatory mechanism,which can provide data support for the neuroactivity of arecoline and lay a theoretical foundation for the development of arecoline as medicine.

To understand the pathogenicity and drug resistance of swine-derived E.coli and its bio-logical characteristics in some areas in Hebei,E.coli was isolated and identified from diarrheal fe-ces of piglets collected from swine farms,and the isolated strains were subjected to drug sensitivity test,detection of the ability to form biofilm,pathogenicity test,virulence gene test,drug resistance gene test,and identification of phylogenetic subgroups.The results showed that a total of 35 patho-genic E.coli strains were isolated from the feces of diarrheic piglets,and most of the isolates were multidrug-resistant,and were resistant to at least three antibiotics,including amoxicillin(88.57％),ampicillin(88.57％),doxycycline(88.75％),sulfisoxazole(77.17％),lincomycin(100％),and chloramphenicol(100％);the isolates were severely resistant.The isolates all carried virulence genes,with a total of five virulence genes detected,namely,EAST1(77.14％),eaeA(17.14％),stx2e(5.71％),LT(2.86％),and STb(2.86％),and the isolates also carried multi-re-sistance genes,with a total of five virulence genes detected,namely,bla TEM-1(65.71％),bla CTX-M(20.00％),tetA(82.86％),tetB(14.29％),aadA2(17.14％),aac(6')-Ib(14.29％),qnrS(17.14％),sul 1(40.00％),sul2(34.29％),and floR(60.00％);the phylogenetic grouping showed that the isolates had a high proportion of group B1 and group A;and all 35 isolates showed differ-ent pathogenicity after infection of mice.This study provides a reference for the selection of effec-tive therapeutic drugs and the development of prevention and control programs for swine-origin pathogenic E.coli in Hebei Province.

Objective We explored the anti-depressant activity and mechanism of arecoline in vivo in a mouse model of depression induced by chronic unpredictable mild stress.The aim was to explore the possible mechanisms of action,providing experimental evidence for further research into the health benefits of arecoline and theoretical support for the scientific development and utilization of this resource.Methods Sixty quarantine-qualified SPF C57BL/6J mice were divided randomly into a control group,model group,fluoxetine group(20 mg/kg),and arecoline low-,medium-,and high-dose groups(10,20,and 40 mg/kg,respectively)according to body mass(n=10 mice per group).The effects of arecoline on the behavior of the mice were evaluated by open-field,tail-suspension,and forced-swimming tests.Serum corticosterone and serum and brain levels of superoxide dismutase(SOD)were detected by enzyme-linked immunoassay.Malondialdehyde(MDA),catalase(CAT),5-hydroxytryptamine(5-HT),and norepinephrine(NE)levels in brain tissue,and dopamine(DA),gamma-aminobutyric acid(GABA),tumor necrosis factor(TNF-α),interleukin(IL)-10,IL-1β,brain-derived neurotrophic factor(BDNF),tropomyosin receptor kinase B(TrkB),and cAMP-response element binding protein(CREB)were detected by Western Blot.Results Arecoline significantly reduced the total distance and average speed of the model mice in open field tests and increased activities,and significantly reduced the immobility time in the tail suspension and forced swimming tests.Arecoline also significantly decreased serum corticosterone levels,increased SOD and CAT,and decreased MDA levels.5-HT,DA,NE,and GABA levels were significantly increased,and the cytokines TNF-α,IL-6,and IL-1β were significantly decreased.Expression levels of BDNF,TrkB,and CREB in the brain tissue were significantly increased.Conclusions Research has found that arecoline has a significant antidepressant ability,and its mechanism may be achieved by reducing oxidative stress damage,inhibiting neuroinflammation,regulating neurotransmitter balance,and regulating the BDNF/TrkB/CREB signaling pathway..This study explored the antidepressant efficacy of arecoline and preliminarily revealed its possible regulatory mechanism,which can provide data support for the neuroactivity of arecoline and lay a theoretical foundation for the development of arecoline as medicine.

This case report highlights the successful treatment of moderate-to-severe thyroid-associated ophthalmopathy(TAO) with teprotumumab in a patient who had previously failed multiple therapies, including intravenous steroid pulse therapy, local thyroid injections of cyclophosphamide, octreotide and dexamethasone, tocilizumab treatment, total thyroidectomy, and orbital radiation. Despite these interventions, there was no improvement in TAO. Following treatment with teprotumumab, the patient experienced a reduction of 5 mm in left eye proptosis and 4 mm in right eye proptosis, a 6-point decrease in the clinical activity score(CAS), a 2-point reduction in the diplopia score, and a significant improvement in quality of life, with sustained effects lasting 72 weeks. The treatment was well tolerated, with mild side effects including muscle spasm, fatigue, and dryness of the skin and nasal mucosa. This case report aims to raise clinical awareness regarding efficacy and safety of teprotumumab.

Studies have suggested that the nucleus accumbens (NAc) is implicated in the pathophysiology of major depression; however, the regulatory strategy that targets the NAc to achieve an exclusive and outstanding anti-depression benefit has not been elucidated. Here, we identified a specific reduction of cyclic adenosine monophosphate (cAMP) in the subset of dopamine D1 receptor medium spiny neurons (D1-MSNs) in the NAc that promoted stress susceptibility, while the stimulation of cAMP production in NAc D1-MSNs efficiently rescued depression-like behaviors. Ketamine treatment enhanced cAMP both in D1-MSNs and dopamine D2 receptor medium spiny neurons (D2-MSNs) of depressed mice, however, the rapid antidepressant effect of ketamine solely depended on elevating cAMP in NAc D1-MSNs. We discovered that a higher dose of crocin markedly increased cAMP in the NAc and consistently relieved depression 24 h after oral administration, but not a lower dose. The fast onset property of crocin was verified through multicenter studies. Moreover, crocin specifically targeted at D1-MSN cAMP signaling in the NAc to relieve depression and had no effect on D2-MSN. These findings characterize a new strategy to achieve an exclusive and outstanding anti-depression benefit by elevating cAMP in D1-MSNs in the NAc, and provide a potential rapid antidepressant drug candidate, crocin.

Objective:To observe the effects of Zhulian stimulant type Ⅰ acupuncture on the expression of brain-derived neurotrophic factor (BDNF) and its receptor TrkB and tissue homogenate cyclic adenosine phosphate (cAMP) in rats with diabetic bladder (DCP); To explore the mechanism of Zhulian stimulant type Ⅰacupuncture on DCP.Methods:Totally 50 SD rats were divided into control group, model group, Western medicine group, ordinary acupuncture group, Zhulian stimulant type Ⅰ acupuncture treatment group (acupuncture treatment group) according to random number table method, with 10 rats in each group. DCP rat model was prepared by intraperitoneal injection of streptozotocin (STZ), except for the control group. The Western medicine group was given mecobalamine for gavage; acupoints of "Zhongji", "Sanyinjiao", "Liechou" and "Taichong" were selected. The ordinary acupuncture group was treated with ordinary acupuncture technique, and the acupuncture treatment group was treated with Zhulian stimulant type Ⅰ acupuncture, 1 time/d, 30 minutes/time. Samples were taken after 4 weeks of treatment. The maximum bladder volume, residual urine volume and wet weight of the bladder were detected. The morphology of rat bladder was observed by HE staining. The expression level of BDNF was detected by immunohistochemistry. The expression of cAMP was detected by Western blot. The level of TrkB was determined by ELISA. Real-time fluorescence quantitative PCR (RT-PCR) was used to detect the mRNA expressions of BDNF and cAMP.Results:Compared with model group, maximum bladder volume, residual urine volume and wet weight of bladder in Western medicine group, ordinary acupuncture group and acupuncture treatment group decreased ( P<0.01), and those in Western medicine group and acupuncture treatment group were lower than those in ordinary acupuncture group ( P<0.01). The expressions of BDNF mRNA and protein, cAMP mRNA and protein in Western medicine group, ordinary acupuncture group and acupuncture treatment group increased ( P<0.05), and the level of TrkB increased, and the Western medicine group and acupuncture treatment group were higher than that in ordinary acupuncture group ( P<0.05). Conclusions:Zhuliping stimulant type Ⅰ acupuncture has a protective effect on the bladder function of diabetic rats. The mechanism may be related to the up-regulation of BDNF and mRNA, TrkB, cAMP and mRNA expressions.

OBJECTIVE To provide reference for the rational use of antiemetic drugs in tumor chemotherapy patients. METHODS The data of tumor patients who were given antiemetic drugs were collected from 9 departments of our hospital with hospital information system from Oct. 1st to Nov. 30th in 2022， such as oncology department， radiotherapy department， gynecology department， and gastroenterology department. The application of chemotherapy drugs and the use of antiemetic drugs were analyzed statistically， and the irrational use of antiemetic drugs was analyzed. RESULTS A total of 520 patients were included， involving 248 （47.69%） using chemotherapy drugs with a moderate emetogenic risk level and 135 （25.96%） with a high emetogenic risk level. A total of 461 cases （73.06%） of 5-hydroxytryptamine 3-receptor antagonists were used， including palonosetron in 333 cases， ondansetron in 106 cases， tropisetron in 15 cases and granisetron in 7 cases， and only 148 cases of patients were prioritized for the use of nationally procured medicines and national essential medicines （32.10%）. Neurokinin-1 receptor antagonists were used in 170 cases （26.94%）， including fosaprepitant in 112 cases and aprepitant in 58 cases. The use of antiemetic drugs was unreasonable in 162 patients （31.15%）； among the types of irrational drugs， the antiemetic regimen was unreasonable in the largest number of cases （22.40%）， followed by the irrational pharmacoeconomics （19.13%）. CONCLUSIONS The emetogenic risk levels of chemotherapy drugs used for tumor patients in our hospital are primarily moderate to high， and there is irrational use of antiemetic regimen and pharmacoeconomics. Clinicians， nurses， pharmacists and hospital departments should collaborate as multiple teams to strengthen full supervision of the standardization of antiemetic drugs， reasonably select antiemetic drugs based on emetogenicity rating， and improve the compliance of doctors with the guidelines to ensure the safety， effectiveness， and cost-effective of patient medication.