OBJECTIVE: Acupuncture therapies are known for their effectiveness in treating a variety of gastric diseases, although the mechanisms underlying these effects are not fully understood. This study tested the effectiveness of electroacupuncture (EA) at acupoints Zhongwan (RN12) and Weishu (BL21) for managing gastric motility disorder (GMD) and investigated the underlying mechanisms involved. METHODS: A GMD model was used to evaluate the impact of EA on various aspects of gastric function including the amplitude of gastric motility, electrogastrogram, food intake, and the rate of gastric emptying. Immunofluorescence techniques were used to explore the activation of spinal neurons by EA, specifically examining the presence of cholera toxin B subunit (CTB)-positive neurons and fibers emanating from acupoints RN12 and BL21. The stimulation of γ-aminobutyric acid (GABA)-ergic neurons in the spinal dorsal horn, the inhibition of sympathetic preganglionic neurons in the spinal lateral horn, and their collective effects on the activity of sympathetic nerves were examined. RESULTS: EA at RN12 and BL21 significantly improved gastric motility compromised by GMD. Notably, EA activated spinal neurons, with CTB-positive neurons and fibers from RN12 and BL21 being detectable in both the dorsal root ganglia and the spinal dorsal horn. Further analysis revealed that EA at these acupoints not only stimulated GABAergic neurons in the spinal dorsal horn but also suppressed sympathetic preganglionic neurons in the spinal lateral horn, effectively reducing excessive activity of sympathetic nerves triggered by GMD. CONCLUSION EA treatment at RN12 and BL21 effectively enhances gastric motility in a GMD model. The therapeutic efficacy of this approach is attributed to the activation of spinal neurons and the modulation of the spinal GABAergic-sympathetic pathway, providing a neurobiological foundation for the role of acupuncture in treating gastric disorders. Please cite this article as: Zhang MT, Liang YF, Dai Q, Gao HR, Wang H, Chen L, Huang S, Wang XY, Shen GM. A spinal neural circuit for electroacupuncture that regulates gastric functional disorders. J Integr Med. 2025; 23(1): 56-65.
Electroacupuncture ; Animals ; Male ; Acupuncture Points ; Stomach Diseases/physiopathology* ; Rats, Sprague-Dawley ; Gastrointestinal Motility ; Rats ; Gastric Emptying ; Neurons ; Spinal Cord ; Stomach/physiopathology*

Objective:To describe the body mass index (BMI) level and long-term trends of Chinese older adults aged 65 and above.Methods:Older adults aged 65 and above from six waves (2002-2018) of the China Longitudinal Healthy Longevity Survey were selected as the study population. Multiple cross-sectional design with six survey waves conducted in 2002, 2005, 2008, 2011, 2014, and 2018 was adopted, enrolling 15 647, 15 358, 15 622, 9 166, 6 302, and 12 417 participants, respectively. Additionally, a total of 13, 755 participants were included in the cohort study design. Relevant information was collected through questionnaires and physical examinations. The χ2 trend test was used to compare the changes in the rates of underweight and overweight/obesity over the years, and the linear mixed-e?ects model (LMM) was used to fit trajectory curves of BMI changes with advancing age in older adults. Results:The baseline ages of the participants included in 2002, 2005, 2008, 2011, 2014, and 2018 were (85.16±11.26), (84.23±11.83), (84.99±12.16), (81.10±11.86), (78.89±11.30), and (83.08±12.42) years, respectively, with a relatively high proportion of females and rural residents. In the cohort study, the 13 755 participants had a median ( Q1, Q3) follow-up time of 6.5 (5.2, 10.0) years, with a cumulative follow-up duration of 109 041 person-years. In each wave, males had higher BMI than females, urban residents had higher BMI than rural residents, and BMI gradually decreased with increasing age (all P<0.001). The mean BMI of older adults in China increased from (19.37±3.80) kg/m2 in 2002 to (22.04±4.01) kg/m2 in 2018 ( P<0.001). Across all survey years, the prevalence of underweight was consistently higher in women than in men and in rural areas than in urban areas, with an upward trend as age increased (all P<0.001). In 2018, the underweight rates in the 65-79, 80-89, 90-99, and ≥100-year-old age groups were 8.0%, 16.7%, 26.2%, and 35.5%, respectively. Meanwhile, the prevalence of overweight/obesity was higher in men than in women and in urban areas than in rural areas, showing a declining trend with advancing age (all P<0.001). The prevalence of underweight among the older adults decreased significantly from 45.2% in 2002 to 18.9% in 2018 ( P<0.001), while the prevalence of overweight/obesity increased from 11.0% in 1998 to 29.6% in 2018 ( P<0.001). The trajectory curves fitted by the LMM model showed that individuals born in later decades had higher BMI levels at the same age compared to earlier cohorts. Conclusion:From 2002 to 2018, the BMI level among Chinese older adults showed an increasing trend. The prevalence of underweight showed a declining trend, while the rates of obesity and overweight increased. However, the underweight rate remained notably high among the oldest old.

Objective:To examine the information processing patterns of college students with high and low procrastination in intertemporal decision-making.Methods:A total of 29 high procrastination college students[Irra-tional Procrastination Scale(IPS)score＞27]and 29 low procrastination college students(IPS score≤27)were recruitted.A 2(group:high/low procrastination)×2(amount:￥100,￥1 000)×5(delay:10/30/90/180/360 days)mixed experimental design was employed.Behavioral measures(delay discounting rates,Payne index)and eye-tracking measures(option/dimension fixation time ratios)were collected.Results:The delay discounting rate had the main effects of group,amount and delay(F=6.62,25.38,121.31,Ps＜0.05).The delay discounting rates were higher in the high procrastination group than in the low procrastination group.The delay discounting rates were higher for a amount of 1 000 yuan than 100 yuan.The delay discounting rate was the highest when the delay was 10 days.The option fixation time ratios were higher in the high procrastination group than in the low procrastination group(P＜0.01),and there were interaction effects between group and amount and between group and delay(F=5.67,2.52,Ps＜0.05).The dimension fixation time ratios were lower for a amount of 1 000 yuan than 100 yuan(P＜0.01).Conclusion:College students with high procrastination exhibit a higher delay discounting rate and stronger attentional bias toward immediate options during intertemporal decision-making.However,both groups pri-oritized the monetary dimension in their information processing strategies.

OBJECTIVES: To explore the underlying pharmacological mechanisms and its potential effects of Chinese medicine herbal formula Sini Powder (SNP) on hepatocellular carcinoma (HCC). METHODS: The active components of SNP and their in vivo distribution were identified using ultraperformance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry. Construction of component-target-disease networks, protein-protein interaction network, Gene Ontology function and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis, and molecular docking were employed to analyze the active components and anti-HCC mechanisms of SNP. Cell viability assay and wound healing assay were utilized to confirm the effect of SNP-containing serum (2.5%, 5.0%, 10%, 20%, and 40%), isoprenaline or propranolol (both 10, 100, and 1,000 µ mol/L) on proliferation and migration of HepG 2 or Huh7 cells. Meanwhile, the effect of isoprenaline or propranolol on the β 2 adrenergic receptor (ADRB2) mRNA expression on HepG2 cells were measured by real-time quantitative reverse transcription (RT-qPCR). Mice with subcutaneous tumors were either subjected to chronic restraint stress (CRS) followed by SNP administration (364 mg/mL) or directly treated with SNP (364 mg/mL). These two parallel experiments were performed to validate the effects of SNP on stress responses. Stress-related proteins and hormones were quantified using RT-qPCR, enzyme-linked immunosorbent assay, and immunohistochemistry. Metagenomic sequencing was performed to confirm the influence of SNP on the gut microbiota in the tumor-bearing CRS mice. RESULTS: The distribution of the 12 active components of SNP was confirmed in various tissues and feces. Network pharmacology analysis confirmed the anti-HCC effects of the 5 active components. The potential anti-HCC mechanisms of SNP may involve the epidermal growth factor receptor (EGFR), proto-oncogene tyrosine-protein kinase Src (SRC) and signal transducer and activator of transcription 3 (STAT3) pathways. SNP-containing serum inhibited the proliferation of HepG2 and Huh7 cells at concentrations of 2.5% and 5.0%, respectively, after 24 h of treatment. Furthermore, SNP suppressed tumor progression in tumor-bearing mice exposed to CRS. SNP treatment also downregulated the expressions of stress-related proteins and pro-inflammatory cytokines, primarily by modulating the gut microbiota. Specifically, the abundance of Alistipes and Prevotella, which belong to the phylum Bacteroidetes, increased in the SNP-treated group, whereas Lachnospira, in the phylum Firmicutes, decreased. CONCLUSION SNP can combat HCC by alleviating stress responses through the regulation of gut microbiota.
Animals ; Gastrointestinal Microbiome/drug effects* ; Liver Neoplasms/microbiology* ; Carcinoma, Hepatocellular/microbiology* ; Humans ; Drugs, Chinese Herbal/therapeutic use* ; Powders ; Cell Proliferation/drug effects* ; Mice ; Molecular Docking Simulation ; Cell Line, Tumor ; Hep G2 Cells ; Receptors, Adrenergic, beta-2/genetics* ; Stress, Physiological/drug effects* ; Cell Movement/drug effects* ; Male ; Protein Interaction Maps/drug effects* ; Cell Survival/drug effects* ; Proto-Oncogene Mas

Objective:To examine the information processing patterns of college students with high and low procrastination in intertemporal decision-making.Methods:A total of 29 high procrastination college students[Irra-tional Procrastination Scale(IPS)score＞27]and 29 low procrastination college students(IPS score≤27)were recruitted.A 2(group:high/low procrastination)×2(amount:￥100,￥1 000)×5(delay:10/30/90/180/360 days)mixed experimental design was employed.Behavioral measures(delay discounting rates,Payne index)and eye-tracking measures(option/dimension fixation time ratios)were collected.Results:The delay discounting rate had the main effects of group,amount and delay(F=6.62,25.38,121.31,Ps＜0.05).The delay discounting rates were higher in the high procrastination group than in the low procrastination group.The delay discounting rates were higher for a amount of 1 000 yuan than 100 yuan.The delay discounting rate was the highest when the delay was 10 days.The option fixation time ratios were higher in the high procrastination group than in the low procrastination group(P＜0.01),and there were interaction effects between group and amount and between group and delay(F=5.67,2.52,Ps＜0.05).The dimension fixation time ratios were lower for a amount of 1 000 yuan than 100 yuan(P＜0.01).Conclusion:College students with high procrastination exhibit a higher delay discounting rate and stronger attentional bias toward immediate options during intertemporal decision-making.However,both groups pri-oritized the monetary dimension in their information processing strategies.

Objective:To describe the body mass index (BMI) level and long-term trends of Chinese older adults aged 65 and above.Methods:Older adults aged 65 and above from six waves (2002-2018) of the China Longitudinal Healthy Longevity Survey were selected as the study population. Multiple cross-sectional design with six survey waves conducted in 2002, 2005, 2008, 2011, 2014, and 2018 was adopted, enrolling 15 647, 15 358, 15 622, 9 166, 6 302, and 12 417 participants, respectively. Additionally, a total of 13, 755 participants were included in the cohort study design. Relevant information was collected through questionnaires and physical examinations. The χ2 trend test was used to compare the changes in the rates of underweight and overweight/obesity over the years, and the linear mixed-e?ects model (LMM) was used to fit trajectory curves of BMI changes with advancing age in older adults. Results:The baseline ages of the participants included in 2002, 2005, 2008, 2011, 2014, and 2018 were (85.16±11.26), (84.23±11.83), (84.99±12.16), (81.10±11.86), (78.89±11.30), and (83.08±12.42) years, respectively, with a relatively high proportion of females and rural residents. In the cohort study, the 13 755 participants had a median ( Q1, Q3) follow-up time of 6.5 (5.2, 10.0) years, with a cumulative follow-up duration of 109 041 person-years. In each wave, males had higher BMI than females, urban residents had higher BMI than rural residents, and BMI gradually decreased with increasing age (all P<0.001). The mean BMI of older adults in China increased from (19.37±3.80) kg/m2 in 2002 to (22.04±4.01) kg/m2 in 2018 ( P<0.001). Across all survey years, the prevalence of underweight was consistently higher in women than in men and in rural areas than in urban areas, with an upward trend as age increased (all P<0.001). In 2018, the underweight rates in the 65-79, 80-89, 90-99, and ≥100-year-old age groups were 8.0%, 16.7%, 26.2%, and 35.5%, respectively. Meanwhile, the prevalence of overweight/obesity was higher in men than in women and in urban areas than in rural areas, showing a declining trend with advancing age (all P<0.001). The prevalence of underweight among the older adults decreased significantly from 45.2% in 2002 to 18.9% in 2018 ( P<0.001), while the prevalence of overweight/obesity increased from 11.0% in 1998 to 29.6% in 2018 ( P<0.001). The trajectory curves fitted by the LMM model showed that individuals born in later decades had higher BMI levels at the same age compared to earlier cohorts. Conclusion:From 2002 to 2018, the BMI level among Chinese older adults showed an increasing trend. The prevalence of underweight showed a declining trend, while the rates of obesity and overweight increased. However, the underweight rate remained notably high among the oldest old.

Objective To study the pharmacokinetic characteristics of the test formulation of compound lidocaine cream and reference formulation of lidocaine and prilocaine cream in Chinese healthy subjects and to evaluate whether there is bioequivalence between the two formulations.Methods A single-center,single-dose,randomized,open-label,two-period,two-sequence,crossover design was used.This study included 40 healthy subjects,and in each period,test formulation or reference formulation 60 g was applied to the skin in front of both thighs(200 cm2 each side,a total of 400 cm2)under fasting conditions,and the drug was left on for at least 5 h after application.The concentrations of lidocaine and prilocaine in plasma were determined using liquid chromatography-tandem mass spectrometry(LC-MS/MS)method.Pharmacokinetic parameters were calculated using WinNonlin 8.0 software to evaluate the bioequivalence of the two formulations.Results After the application of the test formulation compound lidocaine cream and the reference formulation lidocaine and prilocaine cream on both thighs of the subjects,the pharmacokinetic parameters of lidocaine in plasma were as follows:Cmax were(167.27±91.33)and(156.13±66.86)ng·mL-1,AUC0-t were(1 651.78±685.09)and(1 636.69±617.23)ng·mL-1·h,AUC0-∞ were(1 669.85±684.65)and(1 654.37±618.30)ng·mL-1·h,the adjusted geometric mean ratios were 104.49％,101.88％and 101.89％,respectively,with 90％confidence intervals of 98.18％-111.20％,97.80％-106.13％and 97.87％-106.07％,all within the range of 80.00％-125.00％.The pharmacokinetic parameters of prilocaine in plasma were as follows:Cmax were(95.66±48.84)and(87.52±39.16)ng·mL-1,AUC0-t were(790.86±263.99)and(774.14±256.42)ng·mL-1·h,AUC0_m were(807.27±264.67)and(792.84±254.06)ng·mL-1 h,the adjusted geometric mean ratios were 107.34％,103.55％and 102.98％,respectively with 90％confidence intervals of 101.69％-113.31％,99.94％-107.30％and 99.65％-106.43％,all within the range of 80.00％-125.00％.Conclusion The test formulation compound lidocaine cream and the reference formulation lidocaine and prilocaine cream are bioequivalent.

Objective To understand the application of skin disinfectant in neonatal intensive care units(NICUs)nationwide.Methods From April to May 2023,application of skin disinfectant in 93 NICUs nationwide was sur-veyed with convenience sampling method by a self-designed questionnaire.Questionnaire contents included types of disinfectant,disinfection tools,cleaning and disinfection frequency,disinfectant drying status,removal of disinfec-tant,and adverse reactions caused by disinfectant.Results A total of 93 nursing units in 71 medical institutions from 25 provinces/municipalities were included in this study.In NICUs,three most commonly used disinfectants were ethanol(79.57％),iodophor(74.19％),and anerdian(62.37％).In nursing units for neonates＜2 months of age,chlorhexidine was prohibited in 28 units(30.11％),used with caution in 23 units(24.73％),allowed in 9 units(9.68％),and there was no unified requirement in 33 units(35.48％).When using ethanol,staff only wiped once in 13(17.57％)nursing units.In some nursing units,there was no unified requirements on the wiping fre-quency of disinfectant.As for the removal of residual iodine,saline was used in 29(42.03％)nursing units,ethanol in 8(11.59％),and 19(27.54％)did not have unified requirements.The adverse reactions of disinfectant mainly included rash and contact dermatitis.Disinfectants that caused adverse reactions included ethanol,iodophor,aner-dian,and chlorhexidine.Conclusion In clinical practice,unified standards for the use of neonatal skin disinfectant remain absent.Selection and use of neonatal skin disinfectant vary considerably.Neonatal skin disinfectants have common adverse reactions.It is necessary to strengthen the training of health care workers on the standardized use of disinfectant,as well as carry out large-scale and rigorous randomized controlled trial designs to provide scientific basis for the correct selection of disinfectant.

Objective To explore whether the locus coeruleus(LC)mediates the pain in mice with depressive-like behaviors and underlying mechanisms.Methods Male C57BL/6J mice were randomly divided into two groups,in-cluding control and chronic restraint stress(CRS)group.Novelty-suppressed feeding test,tail suspension test and forced swimming test were used to assess the formation of depressive-like behaviors and the establishment of CRS model.The mechanical pain threshold of mice was detected by Von Frey brush test.LC neuronal activity was de-tected by c-Fos immunofluorescence staining.Neuronal excitability in LC was detected using electrophysiology of i-solated brain slices.The influence on pain and depressive-like behaviors was identified by chemogenetics in LC.Results Compared with the Control group,CRS mice displayed significant depressive-like behavior after 3 weeks of CRS(CRS 3W),and the model was successful;CRS 3W mice showed a significant decrease in mechanical pain threshold and developed mechanical pain sensitivity.A lot of c-Fos+cells of LC was observed in CRS 3W mice,90％ of them were noradrenergic neurons.Compared with the Control group,the neuronal excitability of noradren-ergic neurons decreased in LC of CRS 3W mice.Compared with the Control group,chemogenetic activation of the LC noradrenergic neurons significantly reduced mechanical pain sensitization in CRS 3W mice.Conclusion The excitability of noradrenergic neurons in LC of CRS 3W mice decreases,and chemogenetic activation of noradrener-gic neurons in LC can relieve pain sensitization in CRS 3W mice.

Objective:To investigate the clinical characteristics and predisposing factors associated with preoperative anemia in adult femoral shaft fractures.Methods:A retrospective analysis of clinical data from 157 patients presenting with femoral shaft fractures admitted to the department of orthopedics at Nanjing Drum Tower Hospital between June 2018 and June 2022 was conducted. The study cohort comprised 106 males and 51 females, with an average age of 45.06 ± 14.32 years (range: 18-65 years). Based on hemoglobin levels measured within 2 days of admission, patients were stratified into two groups: anemia group (Hb<120 g/L in adult males and Hb<110 g/L in adult females) and non-anemia group. General demographic information, AO fracture types, and clinical characteristics, as well as the results of laboratory examinations for both groups were collected. Subsequently, univariate and multivariate logistic regression analyses were conducted.Results:Out of the 157 patients with femoral shaft fractures, 118 (75.2%) exhibited preoperative anemia (the anemia group). Among them, 75 cases were male, and 43 cases were female, with an average age of 45.84±14.23 years (range: 18-65 years). In terms of fracture AO type, 41 cases were classified as 32A, 19 as 32B, and 58 as 32C. Regarding fracture location, 14 were situated in the upper 1/3 of the femoral shaft, 67 in the middle 1/3, and 37 in the lower 1/3. The causes of injury included 63 cases of motor vehicle accidents, 5 cases of blunt trauma, 40 cases of falls, and 10 cases of other falls, with 65 cases involving multiple injuries. Conversely, 39 patients (24.8%) did not exhibit preoperative anemia (the non-anemia group). Of these, 31 were male, and 8 were female, with an average age of 42.72 ± 14.51 years (range: 19-65 years). In terms of fracture AO type, 24 cases were classified as 32A, 5 as 32B, and 10 as 32C. Regarding fracture location, 3 were situated in the upper 1/3 of the femoral shaft, 19 in the middle 1/3, and 17 in the lower 1/3. The causes of injury included 13 cases of motor vehicle accidents, 5 cases of blunt trauma, 20 cases of falls, and 1 other fall, with 8 cases involving multiple injuries. Univariate analysis revealed statistically significant differences between preoperative anemia and AO fracture type, mechanism of injury, multiple injuries, time from injury to hospital admission, albumin levels, and age ( P< 0.05). Multifactorial logistic regression analysis identified AO type 32C ( OR=3.12, P=0.020), blunt trauma injuries ( OR=0.13, P=0.021), reduced albumin levels ( OR=9.90, P=0.037), and multiple injuries ( OR=3.65, P=0.016) as risk factors for preoperative anemia. Multifactorial logistic regression further revealed that multiple injuries ( OR=5.20, P=0.004) and reduced albumin levels ( OR=5.47, P=0.001) were risk factors for the severity of anemia. Conclusion:AO type 32C fractures, blunt trauma injuries, reduced albumin levels, and multiple injuries were identified as potential contributors to the development of preoperative anemia, with multiple injuries and reduced albumin levels exacerbating the severity of anemia. Clinicians should be vigilant for the occurrence of preoperative anemia in adult femoral shaft fracture patients, particularly those with blunt trauma injuries, multiple injuries, hypoalbuminemia, and AO type 32C fractures.