OBJECTIVE: To explore the effect and mechanism of acupuncture at "Weizhong" (BL40) on microcirculation of paravertebral skeletal muscle in rats with chronic blunt injury of lumbar muscle based on the insulin-like growth factor-1 (IGF-1)/phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) pathway. METHODS: Forty-eight SPF-grade SD rats were randomized into a blank group (8 rats) and a modeling group (40 rats). Chronic blunt injury model was established by weight impact method in the modeling group. Forty rats were successfully modeled, and were randomly divided into a model group, an acupuncture at Weizhong group (Weizhong group), an acupuncture at non-acupoint group (non-acupoint group), an inhibitor group, and an inhibitor+acupuncture at Weizhong group (inhibitor+Weizhong group), 8 rats in each group. In the Weizhong group and the inhibitor+Weizhong group, acupuncture was applied at bilateral "Weizhong" (BL40). In the non-acupoint group, acupuncture was applied at non-acupoints, i.e. points 0.5 cm inward from bilateral "Weizhong" (BL40). The acupuncture intervention was delivered 20 min each time, once a day for continuous 2 weeks. In the inhibitor group and the inhibitor+Weizhong group, intraperitoneal injection of IGF-1 receptor (IGF-1R) inhibitor was given once a day, at a dosage of 2 mg/100 g, for continuous 2 weeks. Before modeling and on the 1st, 7th and 14th days of intervention, the body mass was measured. Before and after modeling, and after intervention, the limb grip strength and paw withdrawal threshold (PWT) were measured. After intervention, the morphology of psoas muscle was observed by HE staining; the ultrastructure of psoas muscle capillaries was observed by electron microscopy; the levels of serum vascular endothelial growth factor (VEGF) and endothelial nitric oxide synthase (eNOS) were detected by ELISA; and the protein and mRNA expression of IGF-1, IGF-1R, PI3K, AKT of psoas muscle was detected by Western blot and real-time PCR. RESULTS: Compared with the blank group, in the model group, the body mass on the 7th and 14th days of intervention, the limb grip strength, and the PWT of left and right hind feet were decreased (P<0.001, P<0.01); the skeletal muscle cells showed enlarged intercellular space, loosely arranged and irregularly shaped, the capillaries in the psoas muscle tissues were edematous, and the lumen of the blood vessels was obviously atrophied; the levels of serum VEGF and eNOS were decreased (P<0.001); in psoas muscle, the protein expression of IGF-1 and IGF-1R, as well as the p-PI3K/PI3K, p-AKT/AKT values were decreased (P<0.001), the mRNA expression of IGF-1, IGF-1R, PI3K and AKT was decreased (P<0.001, P<0.05). Compared with the model group, in the Weizhong group, the body weight was increased on the 7th and 14th days of intervention (P<0.001), the limb grip strength and the PWT of the left and right hind feet were increased (P<0.001, P<0.01); the arrangement of the skeletal muscle cells was relatively tight and the intercellular space was reduced, the blood vessels tended to be regular and the structure of the basement membrane was continuous, while the lumens of blood vessels were collapsed locally; the levels of serum VEGF and eNOS were increased (P<0.001); in psoas muscle, the protein expression of IGF-1 and IGF-1R, as well as the p-PI3K/PI3K, p-AKT/AKT values were increased (P<0.001), the mRNA expression of IGF-1, IGF-1R, PI3K and AKT was increased (P<0.001, P<0.01). Compared with the model group, in the inhibitor group, the body mass was decreased on the 7th and 14th days of intervention (P<0.05, P<0.01); the limb grip strength and the PWT of the left hind foot were decreased (P<0.01, P<0.001); the intercellular space of skeletal muscle cells was larger, the nuclei of the cells and erythrocytes were scattered in the intercellular space, the damage of the capillaries in the muscular tissues was serious, the collagen fibers were sparsely distributed and disorganized; the levels of serum VEGF and eNOS were decreased (P<0.001, P<0.01); in psoas muscle, the protein expression of IGF-1 and IGF-1R, as well as the p-PI3K/PI3K and p-AKT/AKT values were decreased (P<0.01, P<0.05, P<0.001), the mRNA expression of IGF-1, IGF-1R, PI3K, and AKT was decreased (P<0.01, P<0.001, P<0.05). Compared with the Weizhong group, in the non-acupoint group and the inhibitor+Weizhong group, the body mass was decreased on the 7th and 14th days of intervention (P<0.001, P<0.01), the limb grip strength was decreased (P<0.001); the morphology of muscle cell was relatively poor, with generally irregular, there was mild collapse and atrophy in the vascular lumen, and mild edema in the endothelial cells; the levels of serum VEGF and eNOS were decreased (P<0.001); in psoas muscle, the protein expression of IGF-1 and IGF-1R, as well as the p-PI3K/PI3K and p-AKT/AKT values were decreased (P<0.01, P<0.001), the mRNA expression of IGF-1, IGF-1R, PI3K, and AKT was decreased (P<0.001, P<0.01, P<0.05). Compared with the Weizhong group, the PWT of the left hind foot was decreased in the non-acupoint group (P<0.001), and PWT of the left and right hind feet was decreased in the inhibitor+Weizhong group (P<0.001). CONCLUSION Acupuncture at "Weizhong" (BL40) promotes lumbar muscle repair in chronic low back pain, its mechanism may be related to the activation of the IGF-1/PI3K/AKT pathway, thereby improving the microcirculation.
Animals ; Insulin-Like Growth Factor I/genetics* ; Acupuncture Therapy ; Rats, Sprague-Dawley ; Rats ; Proto-Oncogene Proteins c-akt/genetics* ; Male ; Humans ; Muscle, Skeletal/metabolism* ; Signal Transduction ; Phosphatidylinositol 3-Kinases/genetics* ; Wounds, Nonpenetrating/metabolism* ; Acupuncture Points

This consensus will introduce the characteristics of fillers used in the surgical cavities of domestic nasal surgery patients based on relevant literature and expert opinions. It will also provide recommendations for the selection of cavity fillers for different nasal diseases, with chronic sinusitis as a representative example.
Humans ; Nasal Cavity/surgery* ; Nasal Surgical Procedures ; China ; Consensus ; Sinusitis/surgery* ; Dermal Fillers

In general, bioassay-guided fractionation and isolation of bioactive constituents from botanical materials frequently ended up with the reward of a single compound. However, botanical materials typically exert their therapeutic actions through multi-pathway effects due to the intrinsic complex nature of chemical constituents. In addition, the content of bioactive compounds in botanical materials is largely dependent on humidity, temperature, soil, especially geographical origins, from which rapid and accurate identification of plant materials is pressingly needed. These long-standing obstacles collectively impede the deep exploitation and application of these versatile natural sources. To address the challenges, a new paradigm integrating biogravimetric analyses and machine learning-driven origin classification (BAMLOC) was developed. The biogravimetric analyses are based on absolute qHNMR quantification and in vivo zebrafish model-assisted activity index calculation, by which bioactive substance groups jointly responsible for the bioactivities in all fractions are pinpointed before any isolation effort. To differentiate origin-different botanical materials varying in the content of bioactive substance groups, principal component analysis, linear discriminant analysis, and hierarchical cluster analysis in conjunction with supervised support vector machine are employed to classify and predict production areas based on the detection of volatile organic compounds by E-nose and GC-MS. Expanding BAMLOC to Codonopsis Radix enables the identification of polyacetylenes and pyrrolidine alkaloids as the bioactive substance group for immune restoration effect and accurately determines the origins of plants. This study advances the toolbox for the discovery of bioactive compounds from complex mixtures and lays a more definitive foundation for the in-depth utilization of botanical materials.

Objective To observe the effects of acupuncture at"Weizhong"on angiogenesis of chronic blunt injury of lumbar muscle in rats;To explore the possible mechanism of acupuncture in the treatment of chronic lumbar skeletal muscle injury based on PI3K/AKT/HIF-1α signaling pathway.Methods A total of 24 SD male rats were established chronic blunt injury of lumbar muscle model,and were randomly divided into model group,Weizhong group and non-acupoint group,with 8 rats in each group.Another 8 rats of the same age were selected as the blank group.In the Weizhong group,acupuncture intervention was performed on both sides of"Weizhong",while in the non-acupoint group,acupuncture intervention was performed on both sides of"Weizhong"inwardly by 0.5 cm,once a day for 20 minutes each time,for 2 consecutive weeks.The blank group and model group adopted the same grasping fixed posture without any intervention.The body mass and limb grip strength of each group were measured,the lumbar muscle tissue morphology was observed by HE staining,the content of NO in lumbar muscle tissue was detected by ELISA,the expression of VEGF in lumbar muscle tissue was observed by immunofluorescence,the expression of PI3K/AKT/HIF-1α pathway protein in lumbar muscle tissue was detected by Western blot.Results Compared with the blank group,body mass and limb grip strength of model group decreased(P<0.01),cell structure of waist skeletal muscle was loosely arranged,red blood cells and nuclear exudation were observed,NO content and positive expression of VEGF in lumbar muscle tissue decreased(P<0.01),and the protein expressions of p-PI3K/PI3K,p-AKT/AKT and HIF-1α in lumbar muscle tissue were down-regulated(P<0.01).Compared with the model group,the body mass and limb grip strength of rats in Weizhong group increased(P<0.05,P<0.01),the arrangement of skeletal muscle cells in the waist was more compact and orderly,and the content of NO and positive expression of VEGF in lumbar muscle tissue were increased(P<0.01),the protein expressions of p-PI3K/PI3K,p-AKT/AKT and HIF-1α in lumbar muscle tissue were up-regulated(P<0.01).The effects of Weizhong group was better than those in non-acupoint group(P<0.05,P<0.01).Conclusion Acupuncture at"Weizhong"can effectively promote the repair of chronic blunt injury of lumbar muscle in rats.The mechanism may be related to activating the PI3K/AKT/HIF-1α pathway to regulate angiogenesis and improve vascular injury.

Objective Using the Traditional Chinese Medicine Inheritance Assistance Platform V2.5 software,to analyze medical cases and prescription medication patterns of multiple system atrophy-orthostatic hypotension,and provide reference for clinical diagnosis and treatment of multiple system atrophy.Methods Relevant literature on the effectiveness of traditional Chinese medicine in treating multiple system atrophy-orthostatic hypotension was collected from China National Knowledge Infrastructure,Wanfang Data Knowledge Service Platform,VIP,Chinese Medical Journal Full Text Database,and China Biomedical Literature Database.A database of medical cases and prescriptions was established on the Traditional Chinese Medicine Inheritance Assistance Platform.The software used mathematical algorithms based on association rules and entropy clustering to analyze the symptom ranking,symptom patterns,symptom clustering,and network display of medical cases,as well as the properties,taste,meridian tropism,frequency of application,and drug pair combinations of drugs in prescriptions.The core drugs were identified and the rules of diagnosis and treatment were explored.Results Through the Traditional Chinese Medicine Inheritance Assistance Platform V2.5 software,47 medical cases of multiple system atrophy were analyzed,including 73 symptoms.Among them,there were 8 symptoms with a frequency of ≥5,among which the most frequent symptom was pulse sinking,which appeared 8 times.And included 11 syndromes,the most frequent symptom was insufficient Qi syndrome,which appeared 12 times.The drug symptom network diagram,drug symptom network diagram,and drug symptom network diagram of multiple system atrophy-orthostatic hypotension medical cases were also drawn,which is the first time in the study.There are a total of 47 prescriptions for multiple system atrophy,including 106 types of drugs.Through analysis,the drugs used are mainly warm,cold,and flat,with less use of hot and cool drugs.The flavors are mainly sweet,spicy,and bitter,and the meridian tropism is mainly focused on the spleen,lungs,liver,heart,kidneys,and stomach.The top 10 drugs with the highest frequency of occurrence are Huangqi,Danggui,Shengma,Baizhu,Dangshen,Chenpi,Renshen,Chaihu,Fuzi,and Zhigancao.Among them,Huangqi has the highest frequency of occurrence,appearing 31 times,and has evolved into 66 core combinations of drugs and 3 new formulas.Conclusion The objective display of the medical case characteristics and medication features of multiple system atrophy-orthostatic hypotension through data mining has certain guiding significance for the research and clinical medication of this disease.

Objective To investigate the effect and underlying mechanism of miR-137 on athero-sclerosis(AS)plaques in apolipoprotein E(ApoE)gene knockout(ApoE)mice.Methods Sixty ApoE-/-mice were fed with high-fat diet for 12 weeks to establish an AS model.Then they were assigned into AS group,negative control group,miR-137 group,Ad negative control group,and combination group,with 12 mice in each group;Another 12 wild-type C57BL/6 mice fed with chow diet were subjected as the Control group.Fully automated biochemical analyzer was applied to detect serum lipid levels,including total cholesterol(TC),triglycerides(TG),low-density lipo-protein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C).ELISA was con-ducted to detect the levels of serum inflammatory factors,including TNF-α,IL-4,IL-6,and IL-10.HE staining was used to observe the morphological changes of mouse aortic tissue.Oil red O stai-ning was employed to observe the overall formation of aortic plaques.Immunofluorescence stai-ning was utilized to detect the expression of inducible nitric oxide synthase(iNOS)and arginase-1(Arg-1)in the aortic tissue.Real-time qPCR was applied to detect the mRNA expression of miR-137 and sex determining region Y box protein 4(SOX4)in the aorta.Results The miR-137 group has significantly lower serum levels of TG,TC,LDL-C,TNF-α and IL-6,and higher levels of HDL-C,IL-10 and IL-4 when compared with the AS group and negative control group(P＜0.05).The combination treatment resulted in increased serum levels of TG,TC,LDL-C,TNF-αand IL-6,while decreased levels of HDL-C,IL-10 and IL-4 in comparison with the Ad negative control group(P＜0.05).Larger aortic plaque area,more severe overall aortic plaque injury and stronger iNOS fluorescence intensity were observed in the AS group than the control group(P＜0.05).Treatment of miR-137 reversed above histological changes,resulting in smaller aortic plaque area,attenuated overall aortic plaque injury,decreased iNOS fluorescence intensity,and elevated Arg-1 fluorescence intensity when compared with the AS group and negative control group(P＜0.05).Compared with the Ad negative control group,the aortic plaque area,overall aortic plaque injury and iNOS fluorescence intensity were increased,while the Arg-1 fluorescence intensity was significantly decreased in the combined group(P＜0.05).Double luciferase assay showed that the luciferase activity of SOX4-containing wild-type cells was significantly decreased after transfection of miR-137 mimics when compared with transfection of mimics negative control(0.37±0.05 vs 1.00±0.08,P＜0.05).Conclusion Overexpression of miR-137 inhibits the activa-tion of rat sarcoma/mitogen-activated protein kinase pathway probably by down-regulating SOX4 expression,and then suppress M1 macrophage polarization and promote M2 macrophage polariza-tion,reduces inflammatory response and the formation of AS plaques.

Objective Two-sample Mendelian randomization(MR)analysis was used to explore the causal relationship between hyperthyroidism/hypothyroidism and insomnia.Methods A two-sample MR method was adopted.The exposure factors were hyperthyroidism/hypothyroidism,and the outcome was insomnia.The instrumental variables were screened.Inverse variance weighting(IVW)was mainly used to analyze the causal relationship between hyperthyroidism/hypothyroidism and insomnia.Meanwhile,MR-Egger,weighted mode,weighted median,and simple mode were used to supplement the IVW analysis results.Cochran's Q test was used to determine the statistical heterogeneity among single nucleotide polymorphism(SNP),and the intercept term of MR-Egger was used to evaluate whether SNP had horizontal pleomorphism.The influence of a single SNP on the IVW analysis results was evaluated by the retention of one method.To avoid reverse causality,insomnia was taken as the exposure factor and hyperthyroidism/hypothyroidism as the outcome event for reverse MR analysis.Results A total of 11 SNP strongly related to hyperthyroidism were screened out.After eliminating the palindromic sequences,9 SNP strongly related to hyperthyroidism were finally included.The IVW analysis results showed that hyperthyroidism increased the risk of insomnia(OR=1.01,95％CI:1.00-1.01,P=0.012).A total of 68 SNP strongly related to hypothyroidism were screened out.After removing the palindromic sequences,61 SNP highly related to hypothyroidism were finally included.The IVW analysis results showed that hypothyroidism increased the risk of insomnia(OR=1.01,95％CI:1.00-1.01,P=0.021).The results of Cochran's Q test showed that there was no heterogeneity in the instrumental variable hyperthyroidism(P=0.60).The MR-Egger intercept analysis indicated that studies with hyperthyroidism/hypothyroidism as exposure and insomnia as the outcome did not have horizontal pleiotropy(P＞0.05).Reverse MR analysis revealed that exposure factors such as insomnia had no causal relationship with hyperthyroidism(OR=1.57,95％CI:0.55-4.50,P=0.40)or hypothyroidism(OR=1.09,95％CI:0.74-1.61,P=0.66).Conclusion Hyperthyroidism/hypothyroidism can increase the risk of insomnia.

Objective:To explore the differences in the standardized z-score amplitude of low-frequency fluctuations (zALFFs) across different brain regions between children with global developmental delay (GDD) and healthy children (HC) using functional near-infrared spectroscopy (fNIRS), and correlating zALFF values with the subjects′ Gesell Developmental Scale (GDS) scores.Methods:Thirty-one children aged 2-4 years with GDD and 29 HC of the same age were studied. fNIRS was used to record both groups′ brain activity in response to natural stimuli and to measure any changes in oxygenated hemoglobin (HbO) levels in cerebral blood flow. zALFF values were calculated and the values of 44 channels were compared between the two groups. The correlations between zALFF values and GDS scores were computed.Results:The zALFF values of the children with GDD were significantly lower than those of the HC in the right frontal pole (channel 10) and the right pre-motor and supplementary motor areas (channel 43). In contrast, the zALFF values in the left pre-motor and supplementary motor areas (channels 24 and 26) were significantly higher in the children with GDD compared to the HC. Spearman ranked correlation analysis revealed that the zALFF values in the right pre-motor and supplementary motor areas (channel 43) were positively correlated with socialization scores on the GDS ( r=0.37, P≤0.05). Conclusions:The delays in cognitive and motor development in children with GDD may be associated with functional abnormalities in the right frontal polar region and the bilateral premotor and supplementary motor areas. zALFF values from the right premotor and supplementary motor areas are positively correlated with social skills.

Objective To observe the effects of acupuncture at"Jiaji"on angiogenesis in rats with lumbar muscle aging based on AMPK/SIRT1/PGC-1α signaling pathway;To explore its possible mechanism of improving lumbar muscle aging atrophy.Methods Totally 30 SPF male SD rats were randomly divided into model group,acupuncture group and non-acupoint group,with 10 rats in each group.Subcutaneous injection of D-galactose(300 mg/kg)into the neck and back of rats was used to prepare a subacute lumbar muscle aging rat model.Another 10 rats were selected as the blank group,and an equal amount of normal saline was subcutaneously injected into the neck and back.Intervention began in the 9th week of modeling.The acupuncture group received acupuncture at bilateral L3-L5"Jiaji",while the non-acupoint group received bilateral non-meridian and non-acupoint acupuncture,each time for 30 minutes,once a day,6 times a week,for 4 consecutive weeks.β-galactosidase staining was used to observe the morphology of rat lumbar muscle tissue;TUNEL staining was used to detect apoptosis of lumbar muscle tissue cells;ELISA was used to detect the contents of nitric oxide(NO)and endothelin-1(ET-1)in lumbar muscle tissue;immunofluorescence staining was used to detect CD31 expression and microvascular density in lumbar muscle tissue;Western blot was used to detect protein expressions of p-AMP activated protein kinase(AMPK),silencing information regulatory factor 1(SIRT1)and peroxisome proliferator activated receptor gamma co activator factor 1α(PGC-1α)in lumbar muscle tissue.Results Compared with the blank group,the positive cells of β-galactosidase staining in lumbar muscle tissue of the model group increased significantly,the apoptosis rate significantly increased(P<0.001),the NO content in lumbar muscle tissue significantly decreased(P<0.001),the ET-1 content significantly increased(P<0.001),the expression of CD31 and microvascular density significantly decreased(P<0.001),and the protein expressions of p-AMPK,SIRT1 and PGC-1α significantly decreased(P<0.01,P<0.001).Compared with the model group,the positive cells of β-galactosidase staining in lumbar muscle tissue of rats in the acupuncture group was significantly reduced,the apoptosis rate was significantly decreased(P<0.001),NO content significantly increased(P<0.001),ET-1 content was significantly reduced(P<0.01),CD31 expression and microvascular density significantly increased(P<0.01,P<0.001),and the protein expressions of p-AMPK,SIRT1,PGC-1α significantly increased(P<0.05,P<0.01).Conclusion Acupuncture at"Jiaji"can promote angiogenesis in lumbar skeletal muscle,and then improve the aging atrophy of lumbar muscle,and its mechanism may be related to the activation of AMPK/SIRT1/PGC-1α signaling pathway.

BACKGROUND:The biomechanical analysis of scoliosis cases is limited,with only independent analysis focusing on the spine or lower limbs,thus lacking a comprehensive evaluation of the multidimensional body.As a result,it becomes challenging to reflect the movement relationship between the trunk and lower limbs during daily activities,which hinders comprehensive clinical treatment guidance. OBJECTIVE:To explore the relationship between different segments of the spine and the kinematics/kinetics of the lower limbs during gait activities by measuring spinal kinematics in scoliosis patients,to provide a comprehensive and multi-level assessment of the biomechanical differences between scoliosis patients and the normal population,consequently offering evidence-based guidance for the prevention and treatment of scoliosis. METHODS:A cross-sectional study was conducted from July 2020 to June 2021 at the Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine in Fuzhou University City.A total of 28 scoliosis patients and 28 normal individuals in the same age group were included.Three-dimensional motion capture system was used to capture gait kinematic data at a sampling frequency of 100 Hz.Two force plates(AMTI 400600,sampling frequency 1 500 Hz)were embedded in a 10-meter-long 2.4-meter-wide level ground walkway(with an effective data collection length of 4 m)to collect kinetic data.The differences in spatial-temporal parameters,kinematics,and kinetics of gait between the two groups were compared.Immediately after inclusion,all subjects underwent full spinal X-ray measurements to compare the differences between the scoliosis and normal groups. RESULTS AND CONCLUSION:(1)Patients with scoliosis exhibited reduced relative rotational range of motion between the shoulder and trunk,as well as between the thorax and pelvis,compared to the normal group(P<0.05).However,the rotational range of motion in the pelvis was larger in patients with scoliosis compared to the normal group(P<0.05).(2)Patients with scoliosis showed decreased range of motion in the hip and knee joints,as well as reduced peak torque in hip joint flexion and extension,and lower peak values of ground reaction forces in the concave and convex directions,in comparison to the normal group(P<0.05).(3)Patients with scoliosis demonstrated greater asymmetry indices in knee joint range of motion,relative rotational range of motion between the shoulder and trunk,and between the thorax and pelvis,when compared to the normal group(P<0.05).(4)These findings illustrate a rigid movement pattern among the shoulder,thorax,and pelvis in patients with scoliosis during level walking.There is a reduction in range of motion in the hip and knee joints,as well as decreased peak torque values in hip joint flexion and extension,and ground reaction forces in the concave and convex directions.These characteristics can serve as foundational elements for assessing rehabilitation and developing treatment plans.