1.Hei Xiaoyaosan Ameliorates Cognitive Impairment in Rat Model of Alzheimer's Disease by Clearing Peripheral Aβ via AMPK/SREBP2/PCSK9/LRP-1 Signaling Pathway
Zifan NIE ; Yingchuan MA ; Wenli PEI ; Yumei HAN ; Jiao YANG ; Ruixue JIN ; Qian WANG ; Huping WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(22):61-73
ObjectiveTo investigate the mechanism of Hei Xiaoyaosan (HXS) in ameliorating cognitive impairment in the rat model of Alzheimer's disease (AD) by regulating the adenosine 5'-monophosphate-activated protein kinase (AMPK)/sterol regulatory element-binding protein 2 (SREBP2)/proprotein convertase subtilisin/kexin type 9 (PCSK9)/low-density lipoprotein receptor-related protein 1 (LRP-1) signaling pathway to clear amyloid-β (Aβ) from the peripheral circulation. MethodsNinety 8-week-old specific pathogen-free (SPF)-grade male Sprague-Dawley (SD) rats were acclimatized for 1 week. After acclimatization, 10 rats were randomly selected as the blank control group, and the remaining 80 rats were prepared for surgical modeling. Among the 80 rats for modeling, 70 were anesthetized and injected with 1 μL of amyloid-β1-42 (Aβ1-42) solution into the bilateral hippocampal CA1 region for the modeling of AD, and the remaining 10 were assigned to the sham operation group, which received an injection of 1 μL normal saline at the same anatomical site. The successfully modeled rats were randomly assigned into 6 groups (n=10 per group): a model group, a donepezil hydrochloride group, an acadesine (AICAR, an AMPK agonist) group, and high-, medium-, and low-dose HXS groups. After 42 consecutive days of administration intervention, the Morris water maze test and T-maze test were performed to evaluate the learning and memory abilities of rats. Fluoro-Jade B (FJB) staining was conducted to observe pathological changes of neurons in the rat hippocampus, and thioflavin S staining to quantify the area of Aβ deposition in the hippocampal region. Immunofluorescence double staining (IF-DS) was performed to detect the expression of LRP-1 and Aβ signals in the liver tissue. Enzyme-linked immunosorbent assay (ELISA) was employed to measure the levels of Aβ1-42 and soluble LRP-1 (sLRP-1) in the serum. Western blot was performed to determine the protein levels of AMPK, phosphorylated AMPK (p-AMPK), SREBP2, PCSK9, and LRP-1 in the liver tissue. Real time polymerase chain reaction(Real-time PCR) was adopted to assess the mRNA levels of AMPK, SREBP2, PCSK9, and LRP-1 in the liver tissue. ResultsCompared with the blank control group, the model group showed increased total swimming distance on day 6 and path length in the target quadrant on day 7 (P<0.01), a decreased correct alternation rate in the T-maze test (P<0.01), disarrangement of hippocampal neurons, increased FJB-positive cells (P<0.01), enlarged area of Aβ deposition (P<0.01). reduced LRP-1 fluorescence signals and enhanced Aβ fluorescence signals in the liver tissue (P<0.01), elevated serum level of Aβ1-42, declined serum level of sLRP-1 (P<0.01), downregulated protein levels of p-AMPK and LRP-1 as well as mRNA levels of AMPK and LRP-1, and upregulated protein and mRNA levels of SREBP2 and PCSK9 in the liver tissue (P<0.01). Compared with the model group, the high-dose HXS group, donepezil hydrochloride group, and AICAR group exhibited reduced total swimming distance and target quadrant path length (P<0.05, P<0.01), an increased correct alternation rate in the T-maze test (P<0.05), decreased FJB-positive cells (P<0.01), reduced Aβ deposition (P<0.01) in the hippocampal tissue, enhanced LRP-1 signals and weakened Aβ signals in the liver tissue (P<0.01), a declined serum level of Aβ1-42 and an elevated serum level of sLRP-1 (P<0.01), upregulated protein levels of p-AMPK and LRP-1 as well as mRNA levels of AMPK and LRP-1, and downregulated protein and mRNA levels of SREBP2 and PCSK9 in the liver tissue (P<0.01). ConclusionHei Xiaoyaosan can regulate the AMPK/SREBP2/PCSK9/LRP-1 signaling pathway to enhance the clearance of peripheral Aβ by the liver tissue and reduce Aβ deposition in the brain, thereby improving the learning and memory abilities of AD rats.
2.Hei Xiaoyaosan Inhibits AEP to Prevent and Treat Alzheimer's Disease
Yumei HAN ; Wenli PEI ; Zifan NIE ; Yingchuan MA ; Jiao YANG ; Huping WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(22):74-82
ObjectiveTo investigate the role and mechanism of Hei Xiaoyaosan in regulating asparaginyl endopeptidase (AEP) to inhibit tau protein (tau) phosphorylation, amyloid-beta protein (Aβ) deposition, and neuroinflammation in the prevention and treatment of Alzheimer's disease (AD). MethodsNinety SPF-grade SD male rats of 8 weeks old were selected and randomly grouped as follows: 10 rats in the blank group, 10 rats in the sham group (bilateral hippocampus injected with 1 μL normal saline), and 70 rats in the modeling group (bilateral hippocampus injected with 1 μL Aβ1-42 solution for the modeling of AD). Fifty successfully modeled rats were selected and randomly assigned into the model, donepezil hydrochloride (positive control, 0.45 mg·kg-1), and high-, medium-, and low-dose (15.30, 7.65, and 3.82 g·kg-1, respectively) Hei Xiaoyaosan groups. Rats were administrated with corresponding agents by gavage once a day for 42 days. Morris water maze and Y maze tests were carried out to assess the cognitive abilities of rats. Hematoxylin-eosin (HE) staining was employed to observe morphological changes in hippocampal neurons, and immunohistochemistry (IHC) was employed to assess phosphorylation (p)-tau and Aβ expression in the hippocampal tissue of rats. Enzyme-linked immunosorbent assay (ELISA) was employed to measure the levels of interleukin-1 beta (IL-1β), interleukin-18 (IL-18), and Aβ1-42 in the hippocampal tissue. Western blot was employed to determine the protein levels of AEP, tau, phosphorylated tau (p-tau), α-Syn (α-Syn), phosphorylated α-Syn (p-α-Syn), Toll-like receptor 2 (TLR2), and NOD-like receptor thermal protein domain associated protein 3 (NLRP3). Real time polymerase chain reaction (Real-time PCR) was employed to determine the mRNA levels of AEP, tau, α-Syn, TLR2, and NLRP3. ResultsCompared with the blank group, the model group showed prolonged escape latency, a decreased percentage of time spent in the platform quadrant, and a decreased alternation rate (P<0.01), a reduced number, shrinkage, and increased vacuoles of hippocampal neurons, increased expression of p-tau and Aβ in the hippocampus (P<0.01), elevated levels of IL-1β, IL-18, and Aβ1-42, up-regulated protein and mRNA levels of AEP, tau, α-Syn, TLR2, and NLRP3, and up-regulated protein levels of p-tau and p-α-Syn (P<0.01). Compared with the model group, the positive control group and the high-dose Hei Xiaoyaosan group exhibited shortened escape latency (P<0.01), an increased percentage of retention time in the target quadrant, an increased alternation response rate (P<0.05, P<0.01), alleviated neuronal shrinkage, regular morphology and arrangement of neurons in the hippocampal tissue, lowered levels of p-tau and Aβ in the hippocampal tissue (P<0.05, P<0.01), declined levels of IL-1β, IL-18, and Aβ1-42, downregulated mRNA and protein levels of AEP, tau, α-Syn, TLR2, and NLRP3, and downregulated protein levels of p-tau and p-α-Syn (P<0.05, P<0.01). ConclusionHei Xiaoyaosan can protect hippocampal neurons and ameliorate cognitive impairment in the rat model of AD. Specifically, it may inhibit AEP to regulate tau phosphorylation, Aβ deposition, and neuroinflammation.
3.Hei Xiaoyaosan Reduces Neuroinflammation in APP/PS1 Mice via CX3CL1-CX3CR1 Signaling Axis
Yujie LYU ; Jiao YANG ; Yunyun HU ; Zhipeng MENG ; Yiqin CHEN ; Wenli PEI ; Yumei HAN ; Huping WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(22):83-90
ObjectiveTo investigate the effects of Hei Xiaoyaosan on neuroinflammation in APP/PS1 mice and decipher the mechanism based on the C-X3-C chemokine ligand 1 (CX3CL1)-CX3CL1 receptor 1 (CX3CR1) signaling axis. MethodsSixty 16-week-old male APP/PS1 mice were selected and acclimatized for one week, and they were then randomly allocated into a model group, a CX3CL1 group (bilateral hippocampal injection of CX3CL1 at 0.5 g·L-1), and high-, medium-, and low-dose (22.10, 11.05, and 5.53 g·kg-1, respectively) Hei Xiaoyaosan groups, with 12 mice in each group. Twelve age-matched male C57BL/6J mice served as the blank group (bilateral hippocampal injection of an equal volume of PBS). The high-, medium-, and low-dose Hei Xiaoyaosan groups received corresponding drugs via gavage, while the blank group received an equal volume of normal saline, with an intervention period of 90 days. Morris water maze was used to assess learning and memory abilities. Nissl staining was performed to observe the pathological changes in neurons of the hippocampal CA1 region. Immunohistochemistry was adopted to detect amyloid-β1-42 (Aβ1-42) deposition in the hippocampal CA1 region. The immunofluorescence assay was employed to detect the expression of M1 and M2 microglial markers, including cluster of differentiation 86 (CD86)/ionized calcium-binding adapter molecule 1 (Iba-1) and arginase-1 (Arg1)/Iba1. Enzyme-linked immunosorbent assay (ELISA) was employed to measure the levels of interleukin-8 (IL-8) and interleukin-13 (IL-13) in the hippocampal tissue. Western blot was employed to determine the protein levels of CX3CL1, CX3CR1, CREB-binding protein (CBP), cyclic AMP response element-binding protein (CREB), phosphorylated (p)-CREB, and brain-derived neurotrophic factor (BDNF) in the hippocampal tissue. ResultsCompared with the blank group, the model group exhibited prolonged escape latency on day 5 and a reduced swimming distance in the target quadrant (P<0.01), disarrangement of hippocampal neurons, with a reduced number of cells and uneven Nissl body staining, increased CD86/Iba1 expression, decreased Arg1/Iba1 expression (P<0.01), enhanced Aβ expression (P<0.01), an elevated IL-8 level and a declined IL-13 level (P<0.01), and downregulated protein levels of CX3CL1, CX3CR1, CBP, p-CREB, and BDNF (P<0.01). Compared with the model group, all treatment groups showed shortened escape latency on day 5 and an increased swimming distance in the target quadrant (P<0.05, P<0.01), regular arrangement of neurons with an increased number and increased Nissl bodies, reduced CD86/Iba1 expression, increased Arg1/Iba1 and decreased Aβ expression (P<0.01), and a declined IL-8 level and an elevated IL-13 level (P<0.05, P<0.01). In the CX3CL1 group and the high- and medium-dose Hei Xiaoyaosan groups, the relative expression levels of CX3CL1, CX3CR1, CBP, and p-CREB were upregulated (P<0.01). In the low-dose Hei Xiaoyaosan group, the relative expression levels of CX3CL1, CX3CR1, CBP, p-CREB/CREB, and BDNF were upregulated (P<0.05, P<0.01). ConclusionHei Xiaoyaosan can improve learning and cognitive abilities in APP/PS1 mice. Specifically, it may regulate the CX3CL1/CX3CR1 signaling axis to activate the CREB/BDNF signaling pathway for the subsequent release of BDNF, modulation of microglial polarization, reduction of inflammatory cytokine levels, and attenuation of Aβ deposition.
4.Hei Xiaoyaosan Ameliorates Cognitive Impairment in Rat Model of Alzheimer's Disease by Activating Autophagy Through Regulating AMPK/ULK1 Signaling Pathway
Wenli PEI ; Yumei HAN ; Zifan NIE ; Yingchuan MA ; Ruixue JIN ; Qian WANG ; Jiao YANG ; Huping WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(22):91-101
ObjectiveTo investigate the effect and mechanism of Hei Xiaoyaosan in preventing and treating Alzheimer's disease (AD) by activating autophagy through regulating the adenosine monophosphate-activated protein kinase (AMPK)/UNC-51 like autophagy activating kinase 1 (ULK1) signaling pathway. MethodsNinety 8-week-old male SPF-grade SD rats were selected and randomized into two groups: a blank control group (n=10) and a modeling group (n=80). From the modeling group, 10 rats were randomly assigned as a sham group (bilateral hippocampal injection of 1 μL normal saline), while the remaining 70 rats were injected with 1 μL Aβ1-42 solution bilaterally into the hippocampus to replicate the AD model. The Morris water maze test was conducted to screen the successfully modeled rats, which were then randomly allocated to the model, donepezil hydrochloride, 5-aminoimidazole-4-carboxamide 1-β-D-ribofuranoside (AICAR, an AMPK agonist), and high-, medium-, and low-dose Hei Xiaoyaosan groups, with 10 rats per group. After 42 days of drug intervention, the Morris water maze and open field tests were conducted to assess learning and memory abilities and motor function. Pathological changes in the hippocampal tissue were observed by Nissl staining, and autophagy-related pathological damage was examined via transmission electron microscopy (TEM). The expression of LC3 in the hippocampus was observed by immunofluorescence staining. The protein levels of AMPK, phosphorylate (p)-AMPK, ULK1, p-ULK1, p62, and autophagy related 7 (Atg7) were determined by Western blot, while the mRNA levels of AMPK and ULK1 were measured by Real-time polymerase chain reaction (Real-time PCR). ResultsCompared with the blank control group, the model group showed increased escape latency (P<0.01) and decreased platform crossings (P<0.01) on day 6 in the water maze test, reduced total distance traveled and average speed in the open field test (P<0.01), disarranged neurons with Nissl body loss and evident autophagic damage, weakened LC3 fluorescence signal (P<0.01), downregulated protein levels of p-AMPK, p-ULK1, and Atg7 and mRNA levels of AMPK and ULK1 in the hippocampus (P<0.01), and upregulated protein level of p62 (P<0.01). Compared with the model group, the positive drug group, high-dose Hei Xiaoyaosan group, and AICAR group showed decreased escape latency (P<0.05, P<0.01) and increased platform crossings (P<0.01) on day 6, and increased total distance traveled and average speed in the open field test (P<0.05). The positive drug group, high- and medium-dose Hei Xiaoyaosan groups, and the AICAR group showed alleviated cellular structural damage, regular neuronal arrangement, increased Nissl bodies, and orderly distribution of autophagosomes. Furthermore, the LC3 fluorescence intensity was enhanced in the positive drug group, high- and medium-dose Hei Xiaoyaosan groups, and the AICAR group (P<0.01). The positive drug group, high-dose Hei Xiaoyaosan group, and the AICAR group exhibited upregulated protein and mRNA levels of p-AMPK and p-ULK1 (P<0.05, P<0.01), upregulated protein level of Atg7 (P<0.05, P<0.01), and downregulated protein level of p62 (P<0.01). ConclusionHei Xiaoyaosan can improve learning and memory abilities and alleviate pathological status in the rat model of AD by regulating the AMPK/ULK1 signaling pathway, enhancing cellular autophagy, and repairing damaged nerve cells.
5.Correlation between type 2 diabetes and hepatitis B virus infection
Wu LIU ; Tianshuo ZHAO ; Liguo YANG ; Genxia GAO ; Wenli MIAO ; Tongxia ZENG ; Yonglan CHEN ; Lina ZHANG ; Xiaoyan CHE ; Lihong WANG ; Junhan ZHANG ; Bingfeng HAN ; Fuqiang CUI
Chinese Journal of Epidemiology 2025;46(5):833-839
Objective:To analyze the latent prevalence of hepatitis B and type 2 diabetes and their correlation through an observational study.Methods:This study used a case-control design. The cases with diabetes were recruited through the diabetes management system and village doctors, while the controls without diabetes were screened from volunteers recruited by village health clinics. Capillary blood samples were collected from the study participants for the measurement of real-time blood glucose level, and venous blood samples were taken from them for the detections of HBV serological markers. Firth logistic regression model was used to fit the relationship between HBsAg positive status and diabetes status.Results:The study included 1 218 diabetes patients, 62 patients with impaired fasting glucose and 491 cases without diabetes. In the cases without diagnosis of diabetes, 11.15% had impaired fasting blood glucose and 4.43% had diabetes. Among those who reported no or unknown diagnosis of hepatitis B, 1.73% were positive for HBsAg, while 18.80% were positive for both HBV core antibody and surface antibody, indicating latent infection of hepatitis B virus. In the non-diabetes group, 0.81% reported hepatitis B history, and in the diabetes group, 2.76% reported hepatitis B history. After adjustment, the HBsAg positive rate was higher in the diabetes group ( OR=2.90, 95% CI: 1.21-6.91). Conclusions:Both diabetes and hepatitis B exhibited a high degree of latent prevalence. The HBsAg positive rate was significantly higher in those with diabetes than in those without diabetes, indicating a potential correlation. These findings highlighted the importance of strengthened screening and management of comorbidities.
6.Association of cadmium internal exposure levels with blood lipid in adults aged 18 to 79 years in China
Haocan SONG ; Saisai JI ; Zheng LI ; Yawei LI ; Feng ZHAO ; Yingli QU ; Yifu LU ; Yingying HAN ; Junxin LIU ; Jiayi CAI ; Tian QIU ; Wenli ZHANG ; Xiao LIN ; Junfang CAI ; Yuebin LYU ; Xiaoming SHI
Chinese Journal of Preventive Medicine 2025;59(8):1254-1263
Objective:To explore the association of blood and urinary cadmium levels with lipid profile levels and dyslipidemia in Chinese adults aged 18 to 79 years.Methods:Based on the China National Human Biomonitoring (CNHBM) program, a cross-sectional survey was conducted from 2017 to 2018 using a multi-stage stratified random sampling method, including a total of 10 713 adults aged 18 to 79 years. Data was obtained through questionnaires, physical examinations, biological sample collection, and laboratory testing. Multiple linear mixed effect model (MLMM) and generalized linear mixed effect model (GLMM) were used to analyze the association of blood and creatinine-corrected urinary cadmium levels with lipid profile levels as well as dyslipidemia among adults.Results:The age of 10 713 participants was (47.23±0.24) years, with 5 372 males accounting for 61.3% of the national population. The weighted mean±standard error (SE) of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) was (5.21±0.03), (1.86±0.03), (2.96±0.03), and (1.43±0.01) mmol/L, respectively. The prevalence rate of hypercholesterolemia, hypertriglyceridemia, mixed hyperlipidemia, low HDL-C, and high LDL-C was 16.0%, 21.6%, 6.6%, 13.5%, and 10.0%, respectively. MLMM showed that, after adjusting for relevant confounders, log-transformed blood cadmium levels were positively associated with increased levels of TC, TG and LDL-C ( P<0.05). When blood cadmium levels were categorized into quartiles, compared to the lowest exposure group ( Q1), participants in the highest blood cadmium exposure group ( Q4) had increases of 0.19 (95% CI: 0.06, 0.32) mmol/L in TC and 0.25 (95% CI: 0.08, 0.43) mmol/L in TG. GLMM indicated that, after adjusting for confounders, higher blood cadmium exposure levels were associated with increased risks of hypercholesterolemia, hypertriglyceridemia, mixed hyperlipidemia, and high LDL-C ( P<0.05). Further analysis by quartiles showed that, compared to the blood cadmium Q1 exposure group, the OR value (95% CI) for the Q4 group was 1.53 (1.12, 2.08) for hypercholesterolemia, 1.54 (1.09, 2.17) for hypertriglyceridemia, 2.24 (1.47, 3.40) for mixed hyperlipidemia, and 1.49 (1.07, 2.09) for high LDL-C. Conclusion:The cadmium internal exposure levels are associated with blood lipid profile levels as well as the incidence of dyslipidemia in Chinese adults aged 18 to 79.
7.Expert consensus on the clinical strategies for orthodontic treatment with clear aligners.
Yan WANG ; Hu LONG ; Zhihe ZHAO ; Ding BAI ; Xianglong HAN ; Jun WANG ; Bing FANG ; Zuolin JIN ; Hong HE ; Yuxin BAI ; Weiran LI ; Min HU ; Yanheng ZHOU ; Hong AI ; Yuehua LIU ; Yang CAO ; Jun LIN ; Huang LI ; Jie GUO ; Wenli LAI
International Journal of Oral Science 2025;17(1):19-19
Clear aligner treatment is a novel technique in current orthodontic practice. Distinct from traditional fixed orthodontic appliances, clear aligners have different material features and biomechanical characteristics and treatment efficiencies, presenting new clinical challenges. Therefore, a comprehensive and systematic description of the key clinical aspects of clear aligner treatment is essential to enhance treatment efficacy and facilitate the advancement and wide adoption of this new technique. This expert consensus discusses case selection and grading of treatment difficulty, principle of clear aligner therapy, clinical procedures and potential complications, which are crucial to the clinical success of clear aligner treatment.
Humans
;
Consensus
;
Orthodontic Appliance Design
;
Orthodontic Appliances, Removable
;
Tooth Movement Techniques/methods*
;
Malocclusion/therapy*
;
Orthodontics, Corrective/instrumentation*
8.Correlation between type 2 diabetes and hepatitis B virus infection
Wu LIU ; Tianshuo ZHAO ; Liguo YANG ; Genxia GAO ; Wenli MIAO ; Tongxia ZENG ; Yonglan CHEN ; Lina ZHANG ; Xiaoyan CHE ; Lihong WANG ; Junhan ZHANG ; Bingfeng HAN ; Fuqiang CUI
Chinese Journal of Epidemiology 2025;46(5):833-839
Objective:To analyze the latent prevalence of hepatitis B and type 2 diabetes and their correlation through an observational study.Methods:This study used a case-control design. The cases with diabetes were recruited through the diabetes management system and village doctors, while the controls without diabetes were screened from volunteers recruited by village health clinics. Capillary blood samples were collected from the study participants for the measurement of real-time blood glucose level, and venous blood samples were taken from them for the detections of HBV serological markers. Firth logistic regression model was used to fit the relationship between HBsAg positive status and diabetes status.Results:The study included 1 218 diabetes patients, 62 patients with impaired fasting glucose and 491 cases without diabetes. In the cases without diagnosis of diabetes, 11.15% had impaired fasting blood glucose and 4.43% had diabetes. Among those who reported no or unknown diagnosis of hepatitis B, 1.73% were positive for HBsAg, while 18.80% were positive for both HBV core antibody and surface antibody, indicating latent infection of hepatitis B virus. In the non-diabetes group, 0.81% reported hepatitis B history, and in the diabetes group, 2.76% reported hepatitis B history. After adjustment, the HBsAg positive rate was higher in the diabetes group ( OR=2.90, 95% CI: 1.21-6.91). Conclusions:Both diabetes and hepatitis B exhibited a high degree of latent prevalence. The HBsAg positive rate was significantly higher in those with diabetes than in those without diabetes, indicating a potential correlation. These findings highlighted the importance of strengthened screening and management of comorbidities.
9.Postoperative Day 1 ambulation in patients undergoing posterior lumbar interbody fusion surgery: current status and influencing factors
Bing HAN ; Xiaoxia KANG ; Wenli ZHU ; Fangfang DUAN ; Da HE ; Jiayuan WU
Chinese Journal of Modern Nursing 2025;31(15):2065-2071
Objective:To investigate the current status of postoperative Day 1 ambulation in patients undergoing posterior lumbar interbody fusion (PLIF) surgery under an enhanced recovery after surgery (ERAS) protocol, analyze the influencing factors of successful ambulation on postoperative Day 1, and explore the impact of early ambulation on postoperative recovery.Methods:Data from 397 patients who underwent PLIF surgery at Beijing Jishuitan Hospital, Capital Medical University, from September 2023 to July 2024 were retrospectively collected. Patients were divided into two groups based on whether they successfully ambulated on postoperative Day 1: the successful ambulation on Day 1 group and the delayed ambulation group. Binary Logistic regression was used to analyze the factors influencing successful ambulation on postoperative Day 1. Postoperative recovery indicators, including catheter removal time, hospital length of stay, drainage volume on postoperative Day 3, and pain scores for the low back and legs, were compared between the two groups.Results:A total of 378 patients were included in the analysis. Among them, 316 patients (83.6%) successfully ambulated on postoperative Day 1, while 62 patients (16.4%) had delayed ambulation. Logistic regression analysis indicated that postoperative Day 1 hemoglobin classification and pre-ambulation low back pain score in the supine position were independent factors influencing successful ambulation on Day 1 ( P<0.05). The successful ambulation group had a shorter catheter removal time and hospital stay compared to the delayed ambulation group, with statistically significant differences ( P<0.05). There were no significant differences between the two groups in postoperative drainage volume, low back pain scores, leg pain scores, or Oswestry Disability Index scores before discharge (all P>0.05) . Conclusions:Postoperative Day 1 hemoglobin levels and pre-ambulation low back pain scores are independent factors influencing the success of ambulation on postoperative Day 1 in patients undergoing PLIF surgery. Early ambulation on postoperative Day 1 helps reduce catheter removal time and length of hospital stay without increasing postoperative drainage or pain levels.
10.Effect of moxibustion on small intestinal mucosal immune barrier in rats with diarrhea-predominant irritable bowel syndrome.
Kuiwu LI ; Haoran CHU ; Ling ZOU ; Jingru RUAN ; Lumin LIAO ; Xiaoyu HAN ; Wenli MA ; Ming FANG ; Jingwei ZHU ; Yucheng FANG ; Ziye WANG ; Tingting TONG
Chinese Acupuncture & Moxibustion 2025;45(7):935-944
OBJECTIVE:
To observe the effect of moxibustion on small intestinal mucosal immune barrier in rats with diarrhea-predominant irritable bowel syndrome (IBS-D) and explore its underlying mechanisms.
METHODS:
Of 38 newborn rats from 4 healthy SPF pregnant rats, 12 neonatal rats were randomly selected in a normal group. IBS-D model was prepared by the combined measures for the rest rats, including neonatal maternal separation, acetic acid enema and chronic restraint stress. Twenty-four successfully-modeled rats were randomized into a model group and a moxibustion group, 12 rats in each one. In the moxibustion group, suspending moxibustion was delivered at bilateral "Tianshu" (ST25) and "Shangjuxu" (ST37), 20 min each time, once daily and for 7 consecutive days. Separately, before acetic acid enema (aged 35 days), after modeling (aged 45 days) and after intervention (aged 53 days), the body mass, loose stool rate (LSR) and and the minimum volume threshold when abdominal withdrawal reflex (AWR) scored 3 were observed in the rats of each group. After intervention (aged 53 days), using HE and PAS staining, the morphology of duodenum was observed, the length of villus and the depth of crypt were measured, the ratio of the length of villus to the depth of crypt was calculated; and the numbers of mucosal intraepithelial lymphocytes (IELs) and goblet cells were counted. With ELISA adopted, the contents of γ-interferon (IFN-γ), interleukin-4 (IL-4) and secretory immunoglobulin A (sIgA) in duodenal mucosa of rats were detected. The proportion of T cell subsets in duodenal mucosa was detected using flow cytometry. The microvilli and tight junctions of duodenal mucosal epithelial cells were observed by transmission electron microscopy, and the integrity of duodenal mucosa observed by scanning electron microscopy.
RESULTS:
Compared with the normal group, for the rats in the model group, the body mass, the minimum volume threshold when AWR scored 3, the length of duodenal villus and the the ratio of the length of villus to the depth of crypt, as well as the proportion of CD8+ T subset were all reduced (P<0.01, P<0.05), the counts of goblet cells in duodenal mucosa decreased (P<0.01); LRS, the proportion of CD4+ T subset and CD4+/CD8+, as well as the contents of IFN-γ, IL-4 and sIgA in duodenal mucosa and IFN-γ/IL-4 were all elevated (P<0.01); and the numbers of IELs rose (P<0.01). The morphology of duodenal mucosa was irregular, the villi got shorter, sparse and scattered, with uneven density. The morphology of epithelial cells was destroyed and the tight junctions damaged, with larger spaces. When compared with the model group, in the moxibustion group, the body mass, the minimum volume threshold when AWR scored 3, the length of duodenal villus and the ratio of the length of villus to the depth of crypt, as well as the counts of goblet cells in duodenal mucosa increased (P<0.01); LRS, the proportion of CD4+ T subset, and CD4+/CD8+, as well as the contents of IFN-γ, IL-4 and sIgA in duodenal mucosa and IFN-γ/IL-4 were reduced (P<0.01); and the numbers of IELs was dropped (P<0.01). The morphology of duodenal mucosa was more regular, the villi were grew, got longer and arranged regularly, with even density. The morphology of epithelial cells was slightly destroyed, and the tight junctions partially damaged.
CONCLUSION
Moxibustion at "Tianshu" (ST25) and "Shangjuxu" (ST37) can reduce visceral hypersensitivity in IBS-D rats and relieve abdominal pain, diarrhea and other symptoms. Its effect mechanism may be related to the repair of small intestinal mucosal immune barrier and the improvement in the immune function in IBS-D.
Animals
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Irritable Bowel Syndrome/immunology*
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Rats
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Moxibustion
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Intestinal Mucosa/immunology*
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Female
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Diarrhea/therapy*
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Intestine, Small/immunology*
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Male
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Humans
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Rats, Sprague-Dawley
;
Disease Models, Animal

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