The randomized controlled trials (RCTs) regarding acupuncture direction published from January 1st, 2013, to November 7th, 2023 were searched in China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, and VIP Chinese Journal Database. As a result, 21 RCTs were included. The problems identified included conceptual misunderstandings regarding acupuncture direction, incomplete selection strategies, confounding research factors, and inaccuracies in reporting. Based on the findings, four strategic approaches for enhancing therapeutic efficacy through acupuncture direction were summarized: aligning needle direction with the meridian pathway, directing the needle toward the lesion site, orienting the needle toward adjacent acupoints, and targeting special anatomical structures. Two additional strategies were proposed for optimizing the procedure: simplifying acupuncture operations and directing the needle toward safe anatomical sites. Recommendations were made to improve the rationality of research factor settings and the completeness of acupuncture operation reporting. Furthermore, three methods for reporting acupuncture direction were discussed: reporting the tip-pointed position, reporting the insertion angle and orientation, and reporting azimuth and polar angles, aiming to promote greater standardization and completeness in acupuncture practice and reporting.
Acupuncture Therapy/standards* ; Humans ; Acupuncture Points ; Randomized Controlled Trials as Topic ; Meridians

Objective:To discuss the effects of microRNA(miR)-199a-5p overexpression on cell migration and apoptosis in the glioblastoma U251 cells,and to clarify the targeting regulatory relationship between miR-199a-5p and caveolin-1(CAV-1).Methods:The glioblastoma U251 cells and oligodendroglioma Hs683 cells were cultured in vitro.Western blotting method was used to detect the expression levels of CAV-1 protein in 2 kinds of cells;real-time fluorescence quantitative PCR(RT-qPCR)method was used to detect the expression levels of miR-199a-5p in 2 kinds of cells.The U251 cells were divided into blank group(non-transfection),mimics NC group(transfected with empty vector),and miR-199a-5p mimics group(transfected with miR-199a-5p mimics).The Hs683 cells were divided into blank group(no transfection),inhibitor NC group(transfected with empty vector),and miR-199a-5p inhibitor group(transfected with miR-199a-5p inhibitor).RT-qPCR method was used to detect the transfection efficiency of the cells in various groups;Western blotting method was used to detect the expression levels of CAV-1 protein in the cells in various groups.TargetScan database was used to predict the binding sites between miR-199a-5p and CAV-1 in the 3'untrans lated region(3'UTR);psiCHECKTM-2-CAV-1-WT and psiCHECKTM-2-CAV-1-Mut were co-transfected with miR-199a-5p mimics and mimics NC into the U251 cells,respectively,forming psiCHECKTM-2-CAV-1-WT+mimics NC group,psiCHECKTM-2-CAV-1-WT+miR-199a-5p mimics group,psiCHECKTM-2-CAV-1-Mut+mimics NC group,and psiCHECKTM-2-CAV1-Mut+miR-199a-5p mimics group;dual-luciferase reporter gene assay was used to verify the targeting relationship between miR-199a-5p and CAV-1;cell scratch assay was used to detect the scratch healing rates of the U251 cells in various groups;flow cytometry was used to detect the apoptotic rates of the U251 cells in various groups.Results:The Western blotting and RT-qPCR results showed that compared with Hs683 cells,the expression level of CAV-1 protein in the U251 cells was significantly decreased(P<0.05);compared with U251 cells,the expression level of miR-199a-5p in the Hs683 cells was significantly increased(P<0.01).Compared with blank group and mimics NC group,the expression level of miR-199a-5p in the U251 cells in miR-199a-5p mimics group was significantly increased(P<0.01),the expression level of CAV-1 protein in the U251 cells in miR-199a-5p mimics group was significantly decreased(P<0.05).Compared with blank group,the expression levels of miR-199a-5p in the Hs683 cells in inhibitor NC group and miR-199a-5p inhibitor group were significantly decreased(P<0.01).No significant differences were observed in the expression levels of CAV-1 protein in the Hs683 cells among various groups(P>0.05).The dual-luciferase reporter gene assay results showed that psiCHECKTM-2-CAV-1-wild type(WT)and psiCHECKTM-2-CAV-1-mutant(Mut)expression vectors were successfully constructed;compared with psiCHECKTM-2-CAV-1-WT-mimics NC group,the relative luciferase activity of WT CAV-1 in the U251 cells in psiCHECKTM-2-CAV-1-WT-miR-199a-5p mimics group was significantly decreased(P<0.01).The cell scratch assay results showed that at 12,24,and 48 h after transfection,compared with blank group,the scratch healing rate of the U251 cells in miR-199a-5p mimics group was significantly decreased(P<0.05 or P<0.01).The flow cytometry results showed that compared with blank group and mimics NC group,the apoptotic rate of the U251 cells in miR-199a-5p mimics group was significantly increased(P<0.01).Conclusion:Transfection of mature miR-199a-5p mimics into the glioblastoma U251 cells can reduce the expression of CAV-1 protein,inhibit glioma cell migration,promote apoptosis,and suppress tumorigenesis and development.The targeting relationship between miR-199a-5p and CAV-1 may represent a potential mechanism for glioma development and could serve as a potential diagnostic and therapeutic target for glioma.

Objective To investigate the ameliorative effect of deferoxamine(DFO)on cognitive impairment in a rat model of type 1 diabetes mellitus(T1DM)and to elucidate the molecular mechanisms underlying cerebral iron overload in T1DM rats.Methods Thirty-six healthy male SD rats(weighing 180～250 g)were randomly assigned into a blank control group(Ctrl),a T1DM model group and a DFO group,with 12 rats in each group.A single dose of 65 mg/kg streptozotocin(STZ)was intraperitoneally injected to the rats to establish a T1DM model,and those with fasting blood glucose≥16.7 mmol/L at 3 d later were designated as the T1DM group.Intracerebroventricular administration of DFO(5 μg/kg·d)was given to the DFO group for 28 consecutive days since 21 d after STZ injection.Morris water maze test was carried out to assess the spatial learning and memory abilities.Nissl staining and immunofluorescence assay were applied to observe neuronal morphology and number in the hippocampus and cortex.The iron content in the hippocampus was measured with inductively coupled plasma mass spectrometry(ICP-MS).The expression levels of iron metabolism related proteins were detected with Western blotting.Results In the T1DM group,significant declines in learning and memory abilities(P<0.01)and impaired neuronal morphology and reduced neuronal counts in the hippocampal CA1 region(P<0.01),CA3 region(P<0.01),and cortex(P<0.05)were observed when compared with those in the Ctrl group.ICP-MS analysis showed a marked increase in the hippocampal iron content in the T1DM group(P<0.01).Western blot results demonstrated that T1DM rats exhibited obviously up-regulated expression of iron storage proteins FTH and FTL in both the hippocampus(P<0.01,P<0.05)and the cortex(P<0.05,P<0.01),enhanced expression of iron import protein DMT1 in both the hippocampus and the cortex(P<0.05),while decreased expression of iron export protein FPN1 in the hippocampus(P<0.01)and the cortex(P<0.05).DFO treatment significantly ameliorated all above abnormalities.Conclusion The declines in learning and memory in T1DM rats are closely associated with neuronal damage induced by cerebral iron overload.Iron import protein DMT1 and export protein FPN1 jointly regulate cerebral iron content in T1DM rats.DFO reduces brain iron levels and mitigates iron overload-mediated neuronal injury by modulating the expression of DMT1 and FPN1.

Objective:To investigate the current situation and influence factors of prehospital thrombolysis treatment for ST segment elevation myocardial infarction (STEMI) in China, to analyze the main factors affecting prehospital thrombolysis implementation, and optimize the pre-hospital thrombolysis strategy for STEMI to reduce mortality.Methods:A multicenter cross-sectional survey was conducted. 21 cities from six major geographical regions in China were selected by using convenient sampling method. An anonymous online electronic questionnaire was used to investigate the current situation and influence factors of prehospital emergency physicians and grassroots physicians implementing prehospital thrombolysis treatment for STEMI patients. Chi-square test was used to analyze the differences in count data between groups, and multivariate logistic regression was used to analyze the factors affecting prehospital thrombolysis in STEMI.Results:A total of 5 163 prehospital emergency physicians and physicians from grassroots township health centers/community health service centers or village clinics participated in this survey. Among them, 3208 (62.13%) have never implemtent thrombolysis, and 1 955 (37.87%) have did it before. The results of the multivariate logistic regression analysis indicated that physicians with 5-10 years of experience ( OR=1.41, 95% CI: 1.18-1.69, P<0.01), 11-20 years of experience ( OR=1.25, 95% CI: 1.03-1.52, P=0.02), those working in village clinics ( OR=1.30, 95% CI: 1.05-1.61, P=0.02), those in pre-hospital emergency medical institutions/departments ( OR=3.19, 95% CI: 2.80-3.64, P<0.01), those whose units are equipped with remote ECG transmission capabilities ( OR=1.72, 95% CI: 1.50-1.96, P<0.01), or ECG AI-assisted diagnostic tools ( OR=1.31, 95% CI: 1.15-1.49, P<0.01), and those who believe that thrombolysis is highly effective and should be widely adopted ( OR=2.55, 95% CI: 2.09-3.12, P<0.01) or consider it somewhat effective but warranting caution ( OR=2.11, 95% CI: 1.73-2.59, P<0.001), were more likely to make pre-hospital thrombolysis decisions for STEMI patients. To improve the current situation of pre-hospital thrombolysis for STEMI, the top four measures prioritized by pre-hospital emergency and grassroots physicians were enhancing the rescue capabilities of primary care doctors (92.22%), strengthening guidance from higherlevel hospitals (84.99%), increasing support for information technology (83.37%), and improving public health education (74.75%). Conclusions:The implementation rate of prehospital thrombolysis for STEMI in China still needs to be improved. Optimizing the prehospital thrombolysis strategy for STEMI, strengthening the allocation of basic medical resources and information technology support, and improving the referral mechanism are conducive to the implementation of prehospital thrombolysis for STEMI.

Humans ; Staphylococcus lugdunensis/genetics* ; Peptides, Cyclic ; Chromosomes ; Operon/genetics* ; Staphylococcal Infections/genetics* ; Bacterial Proteins/genetics* ; Anti-Bacterial Agents

Objective To investigate the effect of diurnal temperature difference on hospitalization volume of patients with cardiovascular and cerebrovascular diseases in Urumqi City. Methods The daily hospitalization data for cardiovascular and cerebrovascular diseases in Urumqi City from 2019-2021, and meteorological and pollutant data for the same period were collected. The relationship between diurnal temperature range and hospitalizations for cardiovascular and cerebrovascular diseases was analyzed using a distribution lag non-linear model (DLNM), controlling for the long-term trends, the day-of-week effects and other factors. Results The greater the diurnal temperature range, the longer the lag time, and the higher the risk of hospitalization for cardiovascular and cerebrovascular diseases. The lag effect increased significantly when the maximum diurnal temperature range reached 21.0°C. The risk effect appeared on the day of exposure and lasted until day 20, with a maximum RR of 1.266 (95% CI: 1.129-1.421) at a lag of 13 days. At very high diurnal temperature range, the risk of hospitalization for cardiovascular and cerebrovascular diseases was higher in the cold season than that in the warm season. Results after stratified analysis by sex and age showed that men and people aged ≥65 years were more susceptible to diurnal temperature range. Conclusion Extremely high diurnal temperature range is a potential trigger for hospitalization for cardiovascular and cerebrovascular diseases in Urumqi. Men and people aged ≥65 years are more vulnerable to the impact of diurnal temperature range. In the cold season, more attention should be paid to protecting vulnerable people from the impact of the extremely high diurnal temperature difference.

Antrodia cinnamomea is extensively used as a traditional medicine to prevention and treatment of liver cancer. However, its comprehensive chemical fingerprint is uncertain, and the mechanisms, especially the potential therapeutic target for anti-hepatocellular carcinoma (HCC) are still unclear. Using UPLC‒Q-TOF/MS, 139 chemical components were identified in A. cinnamomea dropping pills (ACDPs). Based on these chemical components, network pharmacology demonstrated that the targets of active components were significantly enriched in the pathways in cancer, which were closely related with cell proliferation regulation. Next, HCC data was downloaded from Gene Expression Omnibus database (GEO). The Cancer Genome Atlas (TCGA) and DisGeNET were analyzed by bioinformatics, and 79 biomarkers were obtained. Furtherly, nine targets of ACDP active components were revealed, and they were significantly enriched in PI3K/AKT and cell cycle signaling pathways. The affinity between these targets and their corresponding active ingredients was predicted by molecular docking. Finally, in vivo and in vitro experiments showed that ACDPs could reduce the activity of PI3K/AKT signaling pathway and downregulate the expression of cell cycle-related proteins, contributing to the decreased growth of liver cancer. Altogether, PI3K/AKT-cell cycle appears as the significant central node in anti-liver cancer of A. Cinnamomea.