OBJECTIVE: To elucidate the rules of temporal and spatial variations in distal skin potential at Hegu (LI4) under different stimulation modes by extracting nonlinear characteristic parameters from array multichannel data and adopting multivariate statistical analysis. METHODS: Seven healthy subjects were selected and the surface potential at the left Quchi (LI11) was collected using 14×9 array multichannel electrodes. Using Hegu (LI4) on the left as the stimulation point, four stimulation modes were applied, i.e. being quiescent, point pressing, moxibustion, and manual needling manipulation. Electrical signals were collected for 30 s in each mode, with a 5-min interval between operations, and a sampling frequency of 16 384 Hz. The data was denoised using ensemble empirical mode decomposition (EEMD), and sample entropy (SaEn) features were extracted. Statistical analysis was conducted on these data using factor analysis and multivariate analysis of variance. RESULTS: The SaEn values of most electrode channels were higher under point pressing, moxibustion and manual needling manipulation compared with those under quiescent condition. Under manual needling manipulation, the SaEn value of the electrode channel reached the peak in the first time interval (1-5 s) and it was declining thereafter. Factor analysis showed that the specificity of activation channels was concentrated at the left Quchi (LI11) (loading capacity ≥0.90). Analysis of variance indicated that the significant differences were presented in average sample entropy (SaEn()) values of activation channels among different stimulation modes at Hegu (LI4) (P<0.001), but there was no statistically significant interaction effect between groups and time intervals (P>0.05). CONCLUSION Through nonlinear characteristic parameter extraction and multivariate statistical analysis, we have uncovered the complex temporal and spatial dynamical rules of distal skin potential at Hegu (LI4) under various stimulation modes and successfully identified the specific activation characteristics at Quchi (LI11).
Humans ; Moxibustion ; Acupuncture Points ; Male ; Adult ; Female ; Young Adult ; Acupuncture Therapy/instrumentation*

OBJECTIVE: To explore the pain-location interaction between pressure-sensitive points on the body surface and traditional acupoints in patients with chronic non-specific low back pain (CNLBP) under different disease courses, using Euclidean distance and multivariate statistical analysis. METHODS: A pressure-sensitive point detection was performed on 30 CNLBP patients with varying disease courses. A constant pressure was applied using an FDK20 algometer within a designated lumbar area, a total of 50 points were tested, and the tested points were numbered; the visual analogue scale (VAS) pain score was recorded simultaneously. MatlabR2022a9.12. software was used to extract the positions of pressure-sensitive points, and preprocessing and normalization of point location and VAS scores data were conducted. Under constraint conditions (VAS≥8.0 ∩ Euclidean distance to acupoint≤0.5), the proportion of pressure-sensitive points within the Euclidean distance threshold to each acupoint (PVD_acupoint) was calculated, followed by multivariate statistical analysis. RESULTS: ①Constrained analysis of PVD_acupoint showed that PVD_{Qihaishu (BL24)} and PVD_{Dachangshu (BL25)} were positively correlated with disease course (r=0.55, P<0.01). ②Factor analysis and silhouette analysis revealed that PVD_{Shenshu (BL23)} and PVD_{Dachangshu (BL25)} exhibited trends consistent with disease course progression (P>0.05), with different degree (P<0.01). CONCLUSION The PVD_acupoint value based on Euclidean distance can characterize the pressure sensitivity features of traditional acupoints associated with disease. Multivariate statistical analysis of PVD_acupoint confirms that selecting the acupoint combination of Shenshu (BL23) and Dachangshu (BL25) for CNLBP is associated with the distribution of surrounding pressure-sensitive points and the pathological characteristics of the condition.
Humans ; Acupuncture Points ; Low Back Pain/physiopathology* ; Male ; Female ; Middle Aged ; Adult ; Aged ; Acupuncture Therapy ; Young Adult ; Pressure

Cells and exosomes derived from them are extensively used as biological carrier systems. Cells demonstrate superior targeting specificity and prolonged circulation facilitated by their rich array of surface proteins, while exosomes, due to their small size, cross barriers and penetrate tumors efficiently. However, challenges remain, cells' large size restricts tissue penetration, and exosomes have limited targeting accuracy and short circulation times. To address these challenges, we developed a novel concept termed exosomal spheres. This approach involved incorporating platelet-derived exosomes shielded with phosphatidylserine (PS) and linked via pH-sensitive bonds for drug delivery applications. The study demonstrated that, compared with exosomes, the exosomal spheres improved blood circulation through the upregulation of CD47 expression and shielding of phosphatidylserine, thereby minimizing immune clearance. Moreover, the increased expression of P-selectin promoted adhesion to circulating tumor cells, thereby enhancing targeting efficiency. Upon reaching the tumor site, the hydrazone bonds of exosome spheres were protonated in the acidic tumor microenvironment, leading to disintegration into uniform-sized exosomes capable of deeper tumor penetration compared to platelets. These findings suggested that exosome spheres addressed the challenges and offered significant potential for efficient and precise drug delivery.

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

OBJECTIVE To investigate the effect of Huangqi-Ezhu-Chonglou combination on macrophage polarization and its mechanism of inhibiting colorectal cancer(CRC)cells proliferation and migration.METHODS THP-1 cells were stimulated with phorbol 12-myristate 13-acetate(PMA)and interleukin-4(IL-4)to establish M2 macrophage polarization model.The experiment was divided into M0 group(PMA treatment),M2 group(PMA+IL-4 treatment),and M2+ Huangqi-Ezhu-Chonglou combination group(PMA+IL-4+Huangqi-Ezhu-Chonglou combination treatment).The effect of Huangqi-Ezhu-Chonglou combination freeze-dried powder on the viability of macrophage was detected by CCK-8 method.The expression of macrophage polarization markers,glu-taminase(GLS)mRNA and protein was detected by qPCR and Western blot.The levels of interleukin-10(IL-10),transforming growth factor-β(TGF-β)and tumor necrosis factor-α(TNF-α)in cell supernatant were detected by ELISA.CCK-8 method and Tr-answell assays were used to detect the proliferation and migration of HCT116 cells intervened by the supernatant of macrophage culture treated with Huangqi-Ezhu-Chonglou combination,namely conditioned medium(CM).RESULTS Compared with the M0 group,the expression levels of IL-10,mannose receptor(CD206),arginase 1(ARG1),and GLS mRNA and protein in the M2 group were significantly increased(P<0.01,P<0.001),the levels of IL-10 and TGF-β secreted by macrophages were significantly increased(P<0.01,P<0.001);compared with the M2 group,the M2+ Huangqi-Ezhu-Chonglou combination group had significantly reduced IL-10,CD206,ARG1,and GLS mRNA and protein expression(P<0.05,P<0.01),the mRNA and protein levels of TNF-α and in-ducible nitric oxide synthase(iNOS)were significantly increased(P<0.05,P<0.01,P<0.001),the interleukin-1β(Interleukin-1β,IL-1β)mRNA expression significantly increased(P<0.01),and the contents of IL-10 and TGF-β in the cell supernatant sig-nificantly decreased(P<0.05,P<0.01),while TNF-α content significantly increased(P<0.01).CCK-8 and Transwell results showed that compared with the M0-CM group,the M2-CM promoted the proliferation and migration of HCT116 cells(P<0.01,P<0.001),the M2+ Huangqi-Ezhu-Chonglou-CM group significantly inhibited HCT116 cell proliferation and reduced cell migration compared to the M2-CM group(P<0.01,P<0.001).CONCLUSION Huangqi-Ezhu-Chonglou combination can inhibit colorectal cancer cells proliferation and migration by regulating macrophage polarization,and its mechanism may be related to the changes in the expression of GLS,a key enzyme in glutamine metabolism.

Objective To observe the effect of deglycerolized red blood cells suspended in MAP on preservation and ex-plore the most effective preservation method.Methods Concentrated red blood cells were prepared by centrifuging 400 mL of whole blood on the third day after collection.40%compound glycerol solution was added using the ACP 215 automatic blood cell analyzer,and the resulting mixture was stored in an ultra-low temperature refrigerator at-65℃for 30 days.After thawing and washing,it was equally separated into two bags.The control group received 0.9%sodium chloride solution,while the experimental group received MAP.Both groups were stored at 2-6℃.Hematological parameters,hemolysis inde-xes and cell metabolism indexes were measured on day 0,1,3,5,7 and 14 after storage.The quality changes of both groups were observed during the 14-day storage period.Results The quality of red blood cells in both groups was assessed through a panel of quality tests,including volume,hemoglobin content,free hemoglobin content,white blood cell residue,glycerin residue and sterility.These results met the Quality Requirements outlined in the"Quality Requirements of Whole Blood and Component Blood"(GB18469-2012),Hematocrit,red blood cell count,Hb recovery rate after washing and MCV meet the detection limit outlined in the"Expert Consensus on Quality Evaluation Indicators for Frozen Red Blood Cells",and the residual amount of platelets exceeds the detection limit(≤1%).There were no significant differences in RBC,Hct,MCV and hemoglobin between the two groups during the 14 day storage period.The level of free hemoglobin,hemolysis rate and K+value increased in both groups over time.Significant differences in free hemoglobin were found on day 3,5,7 and 14 between the two groups(P<0.05).Hemolysis rate was significantly different on days 3,5,7 and 14,while K+value was significantly different only on day 14(P<0.05).On day 14,the osmotic fragility of red blood cells was higher in the control group than in the experimental group(P<0.05);The ATP and pH values of both groups decreased as storage time in-creased,and significant differences in ATP and pH value were found on day 3,5,7 and on day 1,3,5,7 and 14,respec-tively(P<0.05).Conclusion Deglycerolized red blood cells suspended in MAP additive solution can extend the storage period of blood to 7 days.This study provides a reference for the formulation of relevant standards.

Objective To investigate the prevalence of zika virus(ZIKV),dengue virus(DENV)and chikungunya virus(CHIKV)infections in blood donors in Kunming,China.Methods A total of 10 662 samples from blood donors in Kunming from August 2022 to October 2023 were randomly collected,and ZIKV RNA,DENV RNA and CHIKV RNA were detected by real-time fluorescence quantitative reverse transcription polymerase chain reaction(RT-qPCR).Results Effec-tive test results were obtained from 10 554 samples,and no positive case of ZIKV RNA,DENV RNA and CHIKV RNA was found in this investigation.Conclusion The risk of ZIKV,DENV and CHIKV infections among blood donors in Kunming is low,and there is no immediate need for routine screening for these viruses among blood donors in this region.

Objective To establish ecological suitability zone of Forsythia suspensa(Thunb.)Vahl in Shanxi Province;To study the quality regionalization of Forsythia suspensa(Thunb.)Vahl from different producing areas in Shanxi Province;To provide reference for reasonable planting and wild tending of Forsythia suspensa(Thunb.)Vahl.Methods Maximum entropy(MaxEnt)model and ArcGIS software were used to study the ecological suitability of Forsythia suspensa(Thunb.)Vahl in Shanxi Province;By screening the main environmental factors and combining them with the content of forsythoside and forsythoside A in Forsythia suspensa(Thunb.)Vahl of different regions,a quality zoning of Forsythia suspensa Thunb.Vahl medicinal materials in Shanxi Province based on forsythoside,forsythoside A and environmental factors was constructed.Results The ecological suitable areas of Forsythia suspensa Thunb.Vahl in Shanxi Province were mainly distributed in the southern part of Shanxi Province,mainly in Linfen,Yuncheng,Changzhi,and Jincheng.The general contents of forsythoside and forsythoside A in the Forsythia suspensa(Thunb.)Vahl medicinal material were gradually reduced from southern part to northern part of Shanxi Province.The comprehensive quality was high in southern part of Shanxi Province,mainly in Linfen,Changzhi,Yuncheng and Jincheng.Conclusion The results of this study are consistent with the actual survey.The southern part of Shanxi province is a suitable planting area for high quality Forsythia suspensa(Thunb.)Vahl,which provides a reference for the standardized planting and wild tending of Forsythia suspensa(Thunb.)Vahl.

Objective:To explore the clinical efficacy of chemoembolization with doxorubicin-infused gelatin sponge microparticles in the amelioration of arterioportal shunting (APS) in patients afflicted with hepatocellular carcinoma (HCC).Methods:A retrospective investigation was conducted on 9 HCC patients admitted between January 2020 and December 2022 with concomitant moderate-to-severe APS who underwent GSM-transarterial chemoembolization (TACE). Hepatic artery digital subtraction angiography (DSA) was employed to ascertain the magnitude of improvement in arteriovenous shunts, utilization of modified response evaluation criteria in solid tumors facilitated the appraisal of short-term clinical outcomes. Follow-up records documented survival duration, along with quantitative parameters such as the longest diameter of tumor lesions and serum alpha-fetoprotein (AFP) levels before and after treatment. The Wilcoxon rank-sum test was utilized to compare the differences of these quantitative parameters before and after treatment.Results:The APS amelioration rates were 100% and 88.9% at immediate and recent postoperatively, respectively. The oncological response rate was 77.8% (7/9), and the complete necrosis rate was 22.2% (2/9) at three months postoperatively, the 1-year survival rate was 100%. Following treatment, a significant reduction was observed in the tumor′s longitudinal diameter [4.32(3.88,6.63)cm] and serum AFP levels [13.50 (7.55, 29.60) μg/L], compared to the pre-treatment values of the tumor′s longitudinal diameter [5.20(4.58,8.57)cm] and serum AFP levels [524.30 (320.65, 1 046.15) μg/L] ( P<0.05 for all). Conclusion:Doxorubicin-infused GSM-TACE is both feasible and efficacious in the first treatment of HCC concomitant with APS and represents a better clinical alternative.

Objectives:To report a novel mutation site in the pathogenic gene TTR of transthyretin cardiac amyloidosis(ATTR-CA),and to identify family members at risk,and provide suitable clinical diagnosis and treatment. Methods:A retrospective analysis was conducted on the clinical data of the proband with ATTR-CA who visited the Department of Cardiology,the First Affiliated Hospital of Zhengzhou University in March 2021.The proband underwent whole exome sequencing using high-throughput methods to detect mutation genes.Sanger sequencing was used to test candidate pathogenic loci in suspected family members,and relevant literature was reviewed. Results:Among 51 individuals spanning 5 generations in the pedigree,10 family members(including the proband)carried the heterozygous TTR gene c.163A>G mutation,resulting in the amino acid residue at position 55 changing from lysine(Lys)to glutamic acid(Glu).This mutation follows an autosomal dominant inheritance pattern,with early onset in adulthood,rapid progression,and presenting as a mixed-type ATTR-CA.Five mutation carriers had different clinical manifestations,while the remaining 5 mutation carriers,who are at younger age,have not yet shown symptoms.Within the pedigree,7 individuals died(the proband's uncle[Ⅱ-1]who died from stroke at 65 years old,the rest 6 family members died from heart disease before the age of 50). Conclusions:According to the American College of Medical Genetics and Genomics guidelines,TTR gene Lys55Glu mutation is classified as likely pathogenic,this mutation site has not been reported in the literature before.Present study adds clinical evidence that might broaden the spectrum of TTR mutations.