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

Objective: To investigate the expression and therapeutic effects of miR-34a in mice with allergic rhinitis. Methods: 10 mice were selected as blank control group, and 30 mice were used to construct mouse allergic rhinitis model with ovalbumin. They were randomly divided into model group, miR-34a inhibitor group and negative control group(NC group) with 10 cases each. 100 μl of physiological saline, 100 μl of negative transfection plasmid, and 100 μl of miR-34a inhibitor carrier mixed solution were injected into the tail vein respectively. The behavioral changes of mice after 1 week of intervention were observed; ELISA was used to detect the level of ovalbumin-specific IgE in mouse serum; qRT-PCR was used to detect interleukin(IL)-6, IL-8, IL-10, and IL-35, the relative expression of matrix metalloproteinase(MMP)-2, MMP-9 and vascular cell adhesion molecule(VCAM)-1 mRNA. The content of CD3+, CD4+, CD8+T cells in peripheral blood was detected by flow cytometry. Results: The serum level of miR-34a mRNA in model mice was significantly higher than that in the blank group(P<0.05). Compared with the negative control group, the total behavioral score of mice after miR-34a inhibitor intervention was significantly reduced(P<0.05). The concentration of ovalbumin-specific IgE was significantly reduced(P<0.05), while IL-6, IL-8, IL-10, MMP-2, MMP-9 and VCAM-1 mRNA were significantly reduced(P<0.05), IL-35 increased significantly(P<0.05), and CD3+, CD4+/CD8+increased significantly(P<0.05). Compared with the blank control group, the levels of IL-2 and IFN-γ in the model group decreased(P<0.05); compared with the model group, the levels of IL-2 and IFN-γ in the miR-34a inhibitor group and NC group increased(P<0.05); those indexes of miR-34a inhibitor group and NC group were compared,and there were statistically significant differences(P<0.05); there was no difference between the model group and NC group. Conclusion miR-34a is highly expressed in mice with allergic rhinitis. Inhibition of miR-34a expression can significantly reduce the symptoms and inflammation of model mice, and improve immune function.

Objective To summarize the experience in nursing patients with gut leak after liver transplantation. Methods Two patients with recurrent gut leakafter liver transplantation underwent surgical repair. The nursing measures included strict observation of postoperative disease, observation of drainage fluid and abdominal signs, early nutritional support, good psychological nursing and health education. Results Gut leak occurred in the two cases again after liver transplantation.One case was treated with repair again and the other with end-stage ileotomy and ileostomy. The patients were discharged after medication and nursing care. Conclusions The close postoperative observation of the disease, observation of drainage fluid and abdominal signs can prompt the discovery of intestinal re-perforation.The early nutritional support plays an important role in the rehabilitation of patients with gut leak after liver transplantation.Mental care and health education can enhance patient's confidence in treatment.

AIM To establish the UPLC fingerprints of Bushen Qiangshen Tablets (Epimedii Folium,Cuscutae Semen,Rosae Laevigatae Fructus,etc.).METHODS The analysis of 50％ ethanol extract of this drug was performed on a 40 ℃ thermostatic Agilent SB-C18 column (100 mm ×4.6 mm,2.7 μm),with the mobile phase comprising of acetonitrile-0.1％ phosphoric acid flowing at 0.5 mL/min in a gradient elution manner,and the detection wavelength was set at 215 nm.Then the fringerprints were evaluated by cluster analysis,principal components analysis and orthogonal partial least squares discriminant analysis.RESULTS There were twenty common peaks in the UPLC fingerprints of twelve batches of samples,nine of which (protocatechuic acid,salidroside,chlorogenic acid,hyperin,specnuezhenide,epimedin C,icariin,kaempferide and baohuoside Ⅰ) were identified,with the similarities of 0.843-0.970.Twelve batches of samples could be divided into three types,and four differential markers,including specnuezhenide and chlorogenic acid,were found out.CONCLUSION This simple and reliable method can be used for the quality control of Bushen Qiangshen Tablets.

Objective To explore depression and anxiety in nasopharyngeal carcinoma (NPC) patients in Chaoshan region and investigate their influencing factors. Methods Two hundred and one patients newly diagnosed with NPC were included in this study. The status of depression and anxiety during their hospital stay were evaluated using the self-rating depression scale (SDS) and the self-rating anxiety scale (SAS). Data including sex, age, education, history of smoking, course of disease, sleeping quality and oral pain were also collected and their relationships with depression and anxiety were analyzed as well. Results They had significantly higher mean SAS score (36.41 ± 7.41) and SDS score (48.42 ± 7.19), as compared with the healthy population. Single factor analysis indicated that age, education, history of smoking, course of disease, sleeping quality, and oral pain had significant impact on the scores of SAS and SDS. Multivariate logistics regression analysis indicated that age, education, history of smoking, course of disease, sleeping quality, and oral pain had significant impact on their anxiety and depression. Conclusions Depression and anxiety are common psychological problems in NPC patients. Patients at the middle to elderly age and with low education, history of smoking, bad sleeping quality and oral pain are more susceptible to depression and anxiety.

Objective:To introduce a novel ridge preservation technique with micro-titanium plate avoiding the use of bone grafting materials,and evaluate the potential horizontal bone preservation effect of this new technique,applied on single maxillary central incisors after tooth extraction for future implant restoration.Methods:Nine patients (six women and three men),mean age (26.0 ±5.7)years(from 1 8 to 34 years)referred to the Department of Oral Implantology,Peking University School and Hospital of Stomotology,were selected and diagnosed with unsalvageable single middle incisor with fine general con-ditions,no signs of acute local inflammation,no ongoing or previous periodontitis,healthy neighboring teeth and intact buccal bone walls.Tooth extraction,delayed implant placement and implant-supported single crown restoration were selected as treatment plan.The teeth were extracted atraumatically with lo-cal anesthesia,followed by a reflection of a minor flap to exposed 2-3 mm of the buccal bone plate.Af-ter that,a micro-titanium plate was trimmed and bended to fit the convexity of the labial bone and fixed by two mini pins with intent to support the labial soft tissue.The flap was then repositioned over the micro titanium plate and secured with two single sutures.No bone grafting materials or releasing incisions were needed.The sockets were left to heal without any intention of primary wound closure.Cone-beam compu-ted tomographic (CBCT)scans were obtained before and four months after tooth extraction.Horizontal ridge widths were measured with CBCT software,and the preservation effects were calculated and recor-ded by the percentage of horizontal ridge alteration.Results:The nine extraction sockets were healed un-eventfully.The average socket width before extraction was (7.51 ±0.48)mm (6.92-7.82 mm).The average alveolar ridge labial-palatal width at the control point of the edentulous area was (6.81 ±0.44) mm (6.04-7.38 mm)4 months after tooth extraction,the mean percentage of ridge width preserved was 90.87%±2.91%(87.28%-95.60%).Conclusion:This novel ridge preservation method by the usage of a micro-titanium plate did not interfere with the natural socket healing process,and at the same time,largely preserved the width of alveolar ridge without any bone grafting procedures.Long term results remain to be seen.

Objective To investigate the different components of Acorus tatarinowii and Polygala tenuifolia(volatile oil, aqueous extract)on the expression of phosphorylated Tau protein at site Ser396 and Tau-5 in the hippocampus of rats with Alzheimer′s disease(AD). Methods Male Sprague Dawley rats were randomly divided into 8 groups:normal control group, model control group,low-,middle-,and high-dose groups of volatile oil of Acorus tatarinowii and Polygala tenuifolia,and low-, middle-,and high-dose groups of aqueous extract of Acorus tatarinowii and Polygala tenuifolia. The subacute aging model was established by intraperitoneal injection of D-galactose( D-gal). Rats were given different components of Acorus tatarinowii and Polygala tenuifolia(crude drug dosage,0.6,1.2,1.8 g·kg-1 )in experimental groups,and 0.9% sodium chloride solution in normal control group and model control group,by gavage for 28 days.The levels of phosphorylated Tau protein at site Ser396 and Tau-5 were detected in hippocampal tissues by Western blotting and immunohistochemistry. Results The levels of phosphorylated Tau protein at site Ser396 were significantly enhanced in the model control group,as compared with those in normal control group (P<0.01).The relative expression levels of Tau protein Ser396 were 3.83±0.10,3.35±0.01,3.11±0.01,2.75±0.03,2.93±0.01,2.55± 0.07,and 2.23±0.08 in model control group,low-,middle-,and high-dose groups of volatile oil of Acorus tatarinowii and Polygala tenuifolia,and low-,middle-,high-dose groups of aqueous extract of Acorus tatarinowii and Polygala tenuifolia,respectively.Two components of Acorus tatarinowii and Polygala tenuifolia could dephosphorylate Tau protein Ser396 to vary degrees in a dose-dependent manner.The aqueous extract component was slightly better than the volatile oil component,especially in the high-dose group(P<0.01).But Tau-5 did not change significantly after treatment with Acorus tatarinowii and Polygala tenuifolia(P>0.05). Conclusion Acorus tatarinowii and Polygala tenuifolia could promote the dephosphorylation of Ser396 site of Tau protein in the hippocampus of AD rats,with the aqueous extract component having better effects.

Objective to provide the evidence for inducing the SAP model in rats with proper concentration of sodium taurocholate.Methods 60 SD rats were divided into sham operated group, group of 1.5% in concentration, group of 3.5% in concentration and group of 5% in concentration randomly, while the SAP model was induced by the sodium taurocholate concentration of 1.5%,3.5% and 5% with the method of retrograde injection into the biliopancreatic duct.To calculate the mortality of different groups, measure the serum amylase, tumor necrosis factor -α(TNF -α) and interleukin -6 (IL -6),and to observe the pancreatic pathological scores of HE staining in rats.Results The mortality in group of 5% in concentration has a significant ascending compared with group of 1.5% in concentration, while the serum amylase, tumor necrosis factor -α(TNF -α) , interleukin -6( IL -6), pathological score of hemorrhage and acinar necrosis in group of 5% in concentration have a significant ascending compared with group of 1.5% in concentration and group of 3.5% in concentration.Conclusions A better SAP model may be induced by sodium taurocholate with the concentration of 5% by the method of retrograde injection into the biliopancreatic duct, which may accord with the physiological and pathological manifestation of SAP.

Objective To evaluate the clinical outcome of maxillary sinus augmentation and implant placement following removal of a maxillary antral cyst.Methods In this study 32 patients with 33 maxillary antral cysts were enrolled.The partial wall of cyst was removed through a small lateral sinus approach and cyst spontaneous shrink was expected when wall of cyst was destroyed for open drainage.Three to six months later the secondary sinus approach 1.5 mm circling the first approach for augmentation was undertaken.Dental implants were placed simultaneously or later.All patients finished prosthetic rehabilitation in the study and were followed up for (30.9±11.5) months.The intraoperative and postoperative complications were recorded.The survival rate of the implants was calculated.Results In this study,33 maxillary antral cysts of 32 patients were removed.Maxillary sinus augmentation was performed after a mean of (4.5± 1.5) months(range,2-8 months).Sixty-two implants were inserted and all patients finished prosthetic rehabilitation after a mean of (10.8±2.7) months(range,5-17 months).The survival rate of implants was 95％ (59/62).Three implants failed before their prosthesis delivered due to failure of osseointegration and were reinserted later.No recurrence of cyst was observed until the last recall.In this study,24 specimens were mucosal cysts.Five specimens were mucoceles and 4 specimens were not certain in pathology.Conclusions Maxillary sinus cysts have a negative effect on maxillary sinus augumentation if not removed.The present preliminary data of the study suggests that the clinical result of maxillary sinus augmentation and implant placement following removal of a maxillary antral cyst is predictable.

Objective To investigate the effect of ridge preservation with Bio-Oss Collagen and Bio-Gide in posterior sites.Methods From May 2010 to July 2013,16 patients with bilateral posterior teeth planned to be extracted and replaced by implants were enrolled.One of the sockets was randomly selected and presserved with Bio-Oss Collagen and Bio-Gide (intervention group).The contralateral socket was left to heal spontaneously (control group).Cone-beam(CBCT) scans were performed immediately after the extraction and 6 month later.The bone cores were collected during the implant placement surgery and analyzed by micro-computed tomography.Results After 6 month healing,the vertical and horizontal dimensional alteration of the treatment group were (0.55±1.05) mm and (-0.99±0.94) mm respectively,while the vertical and horizontal change of control group were (-0.71 ± 1.41) mm and (-2.26 ± 1.29) mm respectively.The micro-computed tomography results showed that there was no significant difference in new bone volume between control and intervention groups.Conclusions Applying Bio-Oss Collagen and Bio-Gide for ridge preservation in posterior sites resulted in less vertical and horizontal bone resorption of sockets following extraction.