1.The Clinical Mechanism of Improvement of Cognitive Impairment After Ischemic Stroke through Tongdu Xingshen Acupuncture by Regulating Gut Microbes
Zhuan LYU ; Yulong CHEN ; Yamin WANG ; Ruidong LIU ; Kaiqi SU ; Shuai YIN ; Jing GAO ; Ruiqing LI ; Mingli WU ; Ming ZHANG ; Xiaodong FENG
World Science and Technology-Modernization of Traditional Chinese Medicine 2025;27(2):545-555
Objective To explore the mechanism of Tongdu Xingshen acupuncture,the clinical efficacy,systemic inflammatory response,blood-brain barrier and intestinal flora in patients with cognitive impairment after ischemic stroke(IS)were studied.Methods Thirty patients(3 cases shedding)with cognitive impairment after IS were included as the disease group,including patients before treatment as the disease group,patients after Tongdu Xingshen acupuncture treatment as the electroacupuncture group,and 30 healthy controls(3 cases shedding)were included as the healthy group.In the electroacupuncture group,on the basis of the basic treatment,Tongdu Xingshen acupuncture was applied,which was 30 min each time,once a day for 14 days.The MMSE,MoCA and MBI scores of the three groups were observed.The fecal and serum samples from all study subjects were collected,and 16S rDNA sequencing technology and ELISA were used to detect the changes of proinflammatory factors IL-6,IL-1β,TNF-α and S100β in serum in intestinal flora and feces.Results Compared with the healthy group,the MMSE,MoCA,and MBI score of patients in the disease group decreased significantly(P<0.05),serum proinflammatory factors and S100β protein content increased significantly(P<0.05),and the Shannon index(P<0.01)and Simpson index(P<0.001)increased significantly.Compared with the disease group,the MMSE,MoCA,and MBI score of the EA group increased significantly(P<0.05),the serum levels of proinflammatory factors and S100β decreased significantly(P<0.05),Shannon index and Simpson index decreased(P>0.05).The dominant bacterial flora in the healthy group mainly included Bacteroides,Bifidobacterium,Bacteroides,Faecalibacterium,Bifidobacteriaceae,Ruminococcaceae,and Bacteroides and other beneficial bacteria(P<0.05).The dominant flora in the disease group included Proteobacteria,Enterobacteriaceae,Escherichia,Klebsiella and other opportunistic bacteria(P<0.05),while the dominant flora in the EA group was consistent with the healthy group,the relative abundance of beneficial bacteria increased significantly(P<0.05),and the relative abundance of opportunistic bacteria decreased significantly(P<0.05).Spearman correlation analysis found that beneficial bacteria were positively correlated with clinical efficacy related indicators,but with serum proinflammatory factors and the content of S100β was negatively correlated.Conclusion Tongdu Xingshen acupuncture can regulate the diversity of intestinal flora to increase the abundance of Bacteroides,Bifidobacterium,Faecalibacterium,and other beneficial bacteria,regulate the intestinal microecological balance,Thereby regulating systemic inflammation and blood-brain barrier function,which plays a role in improving cognitive function.
2.The Clinical Mechanism of Improvement of Cognitive Impairment After Ischemic Stroke through Tongdu Xingshen Acupuncture by Regulating Gut Microbes
Zhuan LYU ; Yulong CHEN ; Yamin WANG ; Ruidong LIU ; Kaiqi SU ; Shuai YIN ; Jing GAO ; Ruiqing LI ; Mingli WU ; Ming ZHANG ; Xiaodong FENG
World Science and Technology-Modernization of Traditional Chinese Medicine 2025;27(2):545-555
Objective To explore the mechanism of Tongdu Xingshen acupuncture,the clinical efficacy,systemic inflammatory response,blood-brain barrier and intestinal flora in patients with cognitive impairment after ischemic stroke(IS)were studied.Methods Thirty patients(3 cases shedding)with cognitive impairment after IS were included as the disease group,including patients before treatment as the disease group,patients after Tongdu Xingshen acupuncture treatment as the electroacupuncture group,and 30 healthy controls(3 cases shedding)were included as the healthy group.In the electroacupuncture group,on the basis of the basic treatment,Tongdu Xingshen acupuncture was applied,which was 30 min each time,once a day for 14 days.The MMSE,MoCA and MBI scores of the three groups were observed.The fecal and serum samples from all study subjects were collected,and 16S rDNA sequencing technology and ELISA were used to detect the changes of proinflammatory factors IL-6,IL-1β,TNF-α and S100β in serum in intestinal flora and feces.Results Compared with the healthy group,the MMSE,MoCA,and MBI score of patients in the disease group decreased significantly(P<0.05),serum proinflammatory factors and S100β protein content increased significantly(P<0.05),and the Shannon index(P<0.01)and Simpson index(P<0.001)increased significantly.Compared with the disease group,the MMSE,MoCA,and MBI score of the EA group increased significantly(P<0.05),the serum levels of proinflammatory factors and S100β decreased significantly(P<0.05),Shannon index and Simpson index decreased(P>0.05).The dominant bacterial flora in the healthy group mainly included Bacteroides,Bifidobacterium,Bacteroides,Faecalibacterium,Bifidobacteriaceae,Ruminococcaceae,and Bacteroides and other beneficial bacteria(P<0.05).The dominant flora in the disease group included Proteobacteria,Enterobacteriaceae,Escherichia,Klebsiella and other opportunistic bacteria(P<0.05),while the dominant flora in the EA group was consistent with the healthy group,the relative abundance of beneficial bacteria increased significantly(P<0.05),and the relative abundance of opportunistic bacteria decreased significantly(P<0.05).Spearman correlation analysis found that beneficial bacteria were positively correlated with clinical efficacy related indicators,but with serum proinflammatory factors and the content of S100β was negatively correlated.Conclusion Tongdu Xingshen acupuncture can regulate the diversity of intestinal flora to increase the abundance of Bacteroides,Bifidobacterium,Faecalibacterium,and other beneficial bacteria,regulate the intestinal microecological balance,Thereby regulating systemic inflammation and blood-brain barrier function,which plays a role in improving cognitive function.
3.Correlation between Vitamin B12 and Mental Health in Children and Adolescents: A Systematic Review and Meta-analysis
Yongjun TAN ; Li ZHOU ; Kaiqi GU ; Caihong XIE ; Yuhan WANG ; Lijun CHA ; Youlin WU ; Jiani WANG ; Xiaosong SONG ; Xia CHEN ; Hua HU ; Qin YANG
Clinical Psychopharmacology and Neuroscience 2023;21(4):617-633
To conduct the association between vitamin B12 and mental health in children and adolescents. Five databases were searched for observational studies in any language reporting on mental health and vitamin B12 levels or intake in children and adolescents from inception to March 18, 2022. Two authors independently extracted data and assessed study quality. Qualitative and quantitative analysis of data were performed. The review was registered in the PROSPERO database (CRD42022345476). Fifty six studies containing 37,932 participants were identified in the review. Vitamin B12 levels were lower in participants with autism spectrum disorders (ASD) (standardized mean difference [SMD], −1.61;95% confidence interval [95% CI], −2.44 to −0.79; p < 0.001), attention deficit hyperactivity disorders (SMD, −0.39; 95% CI, −0.78 to −0.00; p = 0.049) compared with control group. Vitamin B12 intake were lower in participants with ASDs (SMD, −0.86; 95% CI, −1.48 to −0.24; p = 0.006) compared with control group, but showed no difference between depression group (SMD, −0.06; 95% CI, −0.15 to 0.03; p = 0.17) and the control group. Higher vitamin B12 intake were associated with lower risk of depression (odds ratio [OR], 0.79; 95% CI, 0.63−0.98; p = 0.034) and behavioral problems (OR, 0.83; 95% CI, 0.69−0.99; p = 0.04). The vast majority of included studies supported potential positive influence of vitamin B12 on mental health, and vitamin B12 deficiency may be a reversible cause for some mental health disorders in children and adolescents.
4.Effect of Tongdu Xingshen Needling Method (通督醒神针刺法) on Expression of AMPA Receptors and Their Accessory Proteins in the Hippocampus of Rats with Learning Memory Impairment After Cerebral Ischaemia-Reperfusion
Xiaodi RUAN ; Jing GAO ; Zhuan LYU ; Qi LI ; Kaiqi SU ; Yiming GU ; Mingyue YU ; Shikui QI ; Meng LUO ; Mingli WU ; Huiling WANG ; Xin SHEN ; Xiaodong FENG
Journal of Traditional Chinese Medicine 2023;64(23):2435-2442
ObjectiveTo explore the possible mechanism of Tongdu Xingshen needling method (通督醒神针刺法) on post-stroke cognitive impairment. MethodsSD rats were randomly divided into a normal group (n=12), a sham surgery group (n=12), a model group (n=12), and a electroacupuncture group (n=13). The rats in the model group and electroacupuncture group were subjected to the wire bolus method to establish the rats model with learning memory impairment after cerebral ischaemia-reperfusion. After successful modelling, the rats in the electroacupuncture group were given electroacupuncture interventions at “Shenting (GV 24)” and “Baihui (GV 20)” once a day for 30 minutes for 14 days. The other three groups did not receive other interventions but grasp. A 5-day localisation navigation experiment was conducted on the 9th day of intervention, and a spatial exploration experiment was conducted on the 14th day of intervention to evaluate the learning and memory abilities of the rats. After the spatial exploration experiment, hippocampal tissues were taken from each group of rats, and the changes in the volume of cerebral infarction were observed by TTC staining; the changes in the morphology of pyramidal neurons and the density of dendritic spines in the CA1 area of the hippocampus were observed by Golgi staining; protein immunoblotting was used to detect the relative protein expression of the subunits of the α-amino-3-carboxy-5-methylisoxazole-4-propionic acid (AMPA) receptor including glutamate receptor 1 (GluR1), glutamate receptor 2 (GluR2), glutamate receptor 3 (GluR3) and auxiliary proteins TARPγ2, TARPγ8 in hippocampal tissues of rats in each group; the real-time fluorescence quantitative PCR was used to detect GluR1, GluR2, GluR3 mRNA levels in the hippocampal tissues of rats. ResultsIn the localisation navigation experiment, compared with the normal group and sham surgery group, the escape latency and total distance of rats in the model group were significantly extended (P<0.05) at day 1, 2, 3, 4, and 5; and the escape latency and total distance of rats in the electroacupuncture group tended to be significantly shorter than those in the model group (P<0.05). In the spatial exploration experiment, compared with the normal group and the sham surgery group, the number of rats crossing the platform in the model group was significantly reduced (P<0.05), and the number of crossings of the platform in the electroacupuncture group increased significantly (P<0.05). The results of TTC staining showed that the volume of cerebral infarction increased clearly in the model group compared with the sham surgery group (P<0.05), and apparently decreased in the electroacupuncture group compared with the model group (P<0.05). Golgi staining showed that the number of dendritic branches of pyramidal neurons and dendritic spines in hippocampal CA1 region significantly decreased in the model group compared with the normal group and the sham surgery group (P<0.05). The number of dendritic branches of pyramidal neurons and the density of dendritic spines in hippocampal CA1 region significantly increased in the electroacupuncture group compared with the model group (P<0.05). The protein relative expression levels of GluR1, GluR2, GluR3, TARPγ2 and TARPγ8, and the mRNA levels of GluR1, GluR2 and GluR3 in hippocampus decreased in the model group compared with the normal group and the sham surgery group (P<0.05). The protein relative expression levels of GluR1, GluR2, GluR3, TARPγ2 and TARPγ8, and the mRNA levels of GluR1, GluR2 and GluR3 in hippocampus increased in the electroacupuncture group compared with model group (P<0.05). ConclusionThe Tongdu Xingshen needling method can improve learning memory impairment after cerebral ischaemia-reperfusion, which may be related to up-regulation of the expression of AMPA receptor and their auxiliary protein TARP, and promoting the synaptic plasticity of hippocampal tissues.
5.Association between the presence of solid or micropapillary components and survival outcome in stage ⅠA lung adenocarcinoma cases: a retrospective cohort study
Kaiqi JIN ; Yingran SHEN ; Yimu WU ; Jie DAI ; Xiaogang LIU ; Jiaqi LI ; Linsong CHEN ; Gening JIANG
Chinese Journal of Surgery 2022;60(6):587-592
Objectives:To examine the influence of the proportion of pathological subtypes on the prognosis of stage ⅠA lung adenocarcinoma cases, and to explore the association between the presence/absence of solid or micropapillary (S/M) components and survival outcome.Methods:Totally 321 patients with stage ⅠA lung adenocarcinoma who received complete surgical resection at Department of Thoracic Surgery, Tongji University Affiliated Shanghai Pulmonary Hospital from January 2011 to December 2013 were retrospectively analyzed. There were 130 males and 191 females, aging 59(11) years ( M(IQR)) (range: 55 to 66 years). The diagnostic value of the proportion of each pathological growth subtype on relapse-free survival (RFS) and overall survival (OS) were analyzed by using receiver operator characteristic curve. Patients were firstly divided into two groups according to the presence or absence of S/M components. And patients without S/M components were farther divided into two groups according to predominant growth pattern. There were three groups in total: with S/M components (group S/M +), without S/M components and lepidic growth pattern predominant (group S/M -LPA), without S/M components and papillary or acinar growth pattern predominant (group S/M -P/A). Kaplan-Meier method were used to draw the survival curves of the three groups, and Log-rank test were used to compare RFS and OS among the three groups. Cox proportional risk model was used to verify whether the presence of S/M components was a prognostic factor on RFS. Results:The proportion of S/M components had no diagnostic value for recurrence (solid: area under curve (AUC)=0.588, P=0.095; micropapillary: AUC=0.566, P=0.106) and death (AUC=0.589, P=0.104; AUC=0.607, P=0.056). The 5-year RFS rate of group S/M -LPA, S/M -P/A and S/M + were 92.4%, 82.3% and 77.3%, respectively (all P<0.05), while the 5-year OS rate were 97.4%, 94.5% and 83.2%, respectively (all P<0.05). Multivariable analysis showed that the 3 groups were independent predictors of recurrence (S/M -P/A vs. S/M - LPA: HR=2.691, 95% CI: 1.249 to 5.799, P=0.011; S/M +vs. S/M -LPA, HR=6.763, 95% CI: 3.050 to 14.996, P<0.01). Conclusions:The proportion of S/M components in stage ⅠA lung adenocarcinoma with complete resection cases did not affect survival outcome. New grouping method based on the presence or absence of S/M components were significantly associated with patient survival outcomes: S/M + patients had the worst prognosis and S/M -LPA patients had the best prognosis.
6.Association between the presence of solid or micropapillary components and survival outcome in stage ⅠA lung adenocarcinoma cases: a retrospective cohort study
Kaiqi JIN ; Yingran SHEN ; Yimu WU ; Jie DAI ; Xiaogang LIU ; Jiaqi LI ; Linsong CHEN ; Gening JIANG
Chinese Journal of Surgery 2022;60(6):587-592
Objectives:To examine the influence of the proportion of pathological subtypes on the prognosis of stage ⅠA lung adenocarcinoma cases, and to explore the association between the presence/absence of solid or micropapillary (S/M) components and survival outcome.Methods:Totally 321 patients with stage ⅠA lung adenocarcinoma who received complete surgical resection at Department of Thoracic Surgery, Tongji University Affiliated Shanghai Pulmonary Hospital from January 2011 to December 2013 were retrospectively analyzed. There were 130 males and 191 females, aging 59(11) years ( M(IQR)) (range: 55 to 66 years). The diagnostic value of the proportion of each pathological growth subtype on relapse-free survival (RFS) and overall survival (OS) were analyzed by using receiver operator characteristic curve. Patients were firstly divided into two groups according to the presence or absence of S/M components. And patients without S/M components were farther divided into two groups according to predominant growth pattern. There were three groups in total: with S/M components (group S/M +), without S/M components and lepidic growth pattern predominant (group S/M -LPA), without S/M components and papillary or acinar growth pattern predominant (group S/M -P/A). Kaplan-Meier method were used to draw the survival curves of the three groups, and Log-rank test were used to compare RFS and OS among the three groups. Cox proportional risk model was used to verify whether the presence of S/M components was a prognostic factor on RFS. Results:The proportion of S/M components had no diagnostic value for recurrence (solid: area under curve (AUC)=0.588, P=0.095; micropapillary: AUC=0.566, P=0.106) and death (AUC=0.589, P=0.104; AUC=0.607, P=0.056). The 5-year RFS rate of group S/M -LPA, S/M -P/A and S/M + were 92.4%, 82.3% and 77.3%, respectively (all P<0.05), while the 5-year OS rate were 97.4%, 94.5% and 83.2%, respectively (all P<0.05). Multivariable analysis showed that the 3 groups were independent predictors of recurrence (S/M -P/A vs. S/M - LPA: HR=2.691, 95% CI: 1.249 to 5.799, P=0.011; S/M +vs. S/M -LPA, HR=6.763, 95% CI: 3.050 to 14.996, P<0.01). Conclusions:The proportion of S/M components in stage ⅠA lung adenocarcinoma with complete resection cases did not affect survival outcome. New grouping method based on the presence or absence of S/M components were significantly associated with patient survival outcomes: S/M + patients had the worst prognosis and S/M -LPA patients had the best prognosis.

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