OBJECTIVE: To investigate the regulatory effect of electroacupuncture (EA) at "Neiguan" (PC6) on mitochondrial autophagy in rats with myocardial ischemia-reperfusion injury (MIRI) at different phases (ischemia and reperfusion phases), and to explore the bidirectional regulatory effects of EA at "Neiguan" (PC6) and its potential mechanism. METHODS: Forty-five male SD rats were randomly divided into 6 groups according to the random number table method, namely, sham-operation group (n=9), model-A group (n=6), model-B group (n=9), EA-A1 group (n=6), EA-B1 group (n=6), and EA-B2 group (n=9). Except the rats in the sham-operation group, the MIRI model was established in the other groups with the physical ligation and tube pushing method. In the model-A group, the samples were collected directly after ligation, and in the model-B group, the samples were collected after ligation and reperfusion. In the EA-A1 group, EA was delivered while the ligation was performed, and afterwards, the samples were collected. In the EA-B1 group, while the ligation was performed, EA was operated at the same time, and after reperfusion, the samples were collected. In the EA-B2 group, during ligation and the opening of the left anterior descending branch of the coronary artery, EA was delivered, and after reperfusion, the samples were collected. EA was performed at bilateral "Neiguan" (PC6), with a disperse-dense wave, a frequency of 2 Hz/100 Hz, a current of 1 mA, and a duration of 30 min. HE staining was employed to observe the morphology of cardiomyocytes, TUNEL was adopted to detect the apoptosis of cardiomyocytes, transcriptome sequencing was to detect the differentially expressed genes in the left ventricle, JC-1 flow cytometry was to detect the mitochondrial membrane potential (MMP) of cardiomyocytes, Western blot was to detect the protein expression of phosphatase and tensin homolog-induced kinase 1 (Pink1), Parkin and p62 in the left ventricle of rats, and ELISA was to detect the levels of serum creatine kinase isoenzyme (CK-MB) and cardiac troponin I (cTn-I) in the rats. RESULTS: Compared with the sham-operation group, the cardiomyocytes of rats in the model-B group were severely damaged, with disordered arrangement, unclear boundaries, broken muscle fibers, edema and loose distribution; and the cardiomyocytes in the EA-B2 group were slightly damaged, the cell structure was partially unclear, the cells were arranged more regularly, and the intact cardiomyocytes were visible. Compared with the sham-operation group, the apoptosis of cardiomyocytes increased in the model-B group (P<0.001); and when compared with the model-B group, the apoptosis alleviated in the EA-B2 group (P<0.001). The differentially expressed genes among the EA-B2 group, the sham-operation group and the model-B group were closely related to cell autophagy and mitochondrial autophagy. Compared with the sham-operation group, MMP of cardiomyocytes was reduced (P<0.001), the protein expression of Pink1, Parkin, and p62 of the left ventricle and the levels of serum CK-MB and cTn-I were elevated in the model B group (P<0.001). In comparison with model-A group, the MMP of cardiomyocytes and the levels of serum CK-MB and cTn-I were reduced (P<0.001, P<0.05), and the protein expression of Pink1 in the left ventricle rose in the EA-A1 group (P<0.01). Compared with the model-B group, MMP of cardiomyocytes increased (P<0.001), the protein expression of Pink1, Parkin, and p62 of the left ventricle, and the levels of serum CK-MB and cTn-I decreased (P<0.001) in the EA-B1 group and the EA-B2 group. When compared with the EA-A1 group, MMP of cardiomyocytes increased (P<0.001), and the protein expression of Pink1, Parkin, and p62 of the left ventricle, and the levels of serum CK-MB and cTn-I decreased in the EA-B1 group (P<0.01). CONCLUSION EA at "Neiguan" (PC6) can ameliorate MIRI in rats, which may be achieved through the Pink1/Parkin-mediated mitochondrial autophagy pathway. EA can alleviate myocardial injury by enhancing mitochondrial autophagy at the ischemia phase, and it can reduce reperfusion injury by weakening mitochondrial autophagy at the reperfusion phase.
Animals ; Electroacupuncture ; Male ; Myocardial Reperfusion Injury/metabolism* ; Rats, Sprague-Dawley ; Rats ; Acupuncture Points ; Autophagy ; Humans ; Mitochondria/genetics*

Objective:To investigate the clinical features, characteristics under white-light endoscopy and endoscopic ultrasonography, and treatment strategies of gastritis cystica profunda (GCP) accompanied with or without neoplastic lesions.Methods:Clinical data of 35 patients, who were pathologically diagnosed as having GCP after endoscopic or surgical resection in Beijing Friendship Hospital, Capital Medical University from January 2015 to February 2021, were retrospectively collected, including 27 patients with neoplastic lesions. The demographic information, clinical manifestations, endoscopic features, treatment methods, and pathological results of GCP were summarized.Results:Thirty-five patients with GCP were 68.26±8.08 years old, and mostly male (80.00%, 28/35). The most common symptom was upper abdominal pain, accounting for 31.43% (11/35), and 25.71% (9/35) had no symptoms. Other symptoms included acid reflux, heartburn, abdominal distension, anemia, and choking sensation after eating. The most common site of GCP was cardia (51.43%, 18/35), and the main endoscopic manifestations of GCP were flat mucosal lesions (68.57%, 24/35), mainly 0-Ⅱa and 0-Ⅱa+Ⅱc type lesions, accounting for 66.67% (16/24). The second common endoscopic manifestation was polypoid eminence (20.00%, 7/35). Endoscopic ultrasonography was performed in 15 patients, with main manifestations of uniform hypoechoic with or without cystic echo (73.33%, 11/15). Among the GCP cases, 33 patients received endoscopic resection, and 2 received surgical treatment. The treatment processes were all successfully completed, and en-bloc resection was accomplished for all lesions receiving endoscopy, with the mean endoscopic operation time of 86.13 min. One patient suffered postoperative delayed bleeding after ESD which was stopped by endoscopic hemostasis. Final pathological results showed that the proportion of GCP complicated with neoplastic lesions was 77.14% (27/35), 68.57% (24/35) with early gastric cancer or precursor. Twenty-three cases achieved R0 resection. One case showed positive basal resection margin and vascular invasion, and recurrence happened in situ at the 5th month of follow-up, surgical resection was then performed. The endoscopic complete resection rate was 95.83% (23/24).Conclusion:GCP usually occurs in middle-aged and elderly male, often located in cardia, manifested mainly as flat mucosal lesions and polypoid changes. Endoscopic ultrasonography shows a high diagnostic value for GCP, and endoscopic treatment is safe and effective minimally invasive treatment for GCP.

Objective To explore the relationship between frailty and osteoporosis in elderly hospitalized patients.Methods A total of 163 elderly patients hospitalized in Wuhan Fourth Hospital from August 2022 to January 2023 were selected as the study objects.The Edmonton frail scale(EFS)was used to evaluated frailty,and they were divided into non-frailty group(n=21)and frailty group(n=142)based on the results.General data of the subjects were collected,bone mineral density was measured,Pearson correlation analysis was used to understand the correlation between bone mineral density and EFS score,and Logistic regression analysis was performed to evaluate the influencing factors of frailty.Results The prevalence of osteoporosis in frailty group was significantly higher than that in non-frailty group(P<0.05).The EFS scores of patients with different bone mineral density were significantly different(F=24.010,P<0.001).Bone mineral density of vertebra,right femur and left femur were negatively correlated with EFS score(r=-0.426,-0.353,-0.424,P<0.05).Logistic regression analysis showed that old age,multiple complications and osteoporosis were independent risk factors for frailty in the elderly(P<0.05).Conclusion There is a significant correlation between frailty and osteoporosis,which is one of the risk factors of frailty.

Objective:To construct a Discharge Preparation Service Demand Assessment Scale for Psychiatric Patients with Depression.Methods:Convenience sampling was used to select 25 experts from fields such as psychiatric nursing, psychiatric management, and rehabilitation treatment as the subject of the consultation. On the basis of literature review and clinical experience, the research group used the Delphi method to conduct two rounds of consultation with 25 experts, forming a Discharge Preparation Service Demand Assessment Scale for Psychiatric Patients with Depression. The enthusiasm of experts was evaluated using the effective response rate of the questionnaires. The authority level of experts was assessed using an authority coefficient. The concentration of expert opinions was evaluated using the mean of item importance assignment and coefficient of variation. The degree of coordination of expert opinions was represented by the Kendall coordination coefficient.Results:The effective response rates of the two rounds of consultation questionnaires were all 100%, with expert authority coefficients of 0.890 and 0.904, and the Kendall coordination coefficients of expert opinions of 0.247 and 0.203 ( P<0.05) . The Discharge Preparation Service Demand Assessment Scale for Psychiatric Patients with Depression was constructed, which included 10 dimensions and 38 items. Conclusions:The Discharge Preparation Service Demand Assessment Scale for Psychiatric Patients with Depression is scientific and reliable, which can provide a basis for clinical nurses to evaluate the discharge preparation service demands of psychiatric patients with depression.

Objective:To investigate the effects of total-body PET/CT imaging with short acquisition time on image quality and lesion detectability in lungs and parenchymal organs.Methods:Sixty patients (31 males, 29 females, age (61.1±11.8) years) with pulmonary nodules (PN) and 53 patients (29 males, 24 females, age (56.7±17.2) years) with parenchymal organ lesions (POL) who underwent total-body PET/CT imaging in the First Affiliated Hospital of Shandong First Medical University between October 2021 and April 2022 were retrospectively analyzed. The acquisition time with PET was 600 s, and the reconstructed images were divided into 6 groups based on different duration (30, 60, 120, 180, 300 and 600 s), namely G30, G60, G120, G180, G300 and G600 groups. The subjective analysis was carried out with the 5-point Likert scale in 3 aspects: the overall impression of image quality, noise, and lesion conspicuity. The objective analysis indicators included the SUV mean of the mediastinal blood pool (MBP); the SUV mean, standard deviation (SD) and signal-to-noise ratio (SNR) of the liver; SUV max and target-to-background ratio (TBR) of the lesions. Differences of the indicators among 6 groups were analyzed by Friedman test with Bonferroni correction. G600 served as the reference for the other 5 groups to test their lesion detectability. Results:The subjective image quality of different groups for PN and that of G120, G180, G300 groups for POL could meet the needs of clinical diagnosis in terms of the overall image quality, noise, and lesion conspicuity (all scores>3). There was no significant difference in the SUV mean of MBP among different time groups (median for PN: 1.52-1.56, median for POL: 1.35-1.47; χ2 values: 10.23, 11.02, both P>0.05). Difference was not found in SUV mean of the liver either (median for PN: 2.51-2.56, median for POL: 2.33-2.40; χ2 values: 8.35, 8.93, both P>0.05). The liver SD significantly increased along with the shortened acquisition time ( χ2 values: 400.99, 400.00, both P<0.001; z values: from -16.90 to -3.15, all P<0.003). The SNR significantly decreased along with the shortened acquisition time ( χ2 values: 397.32, 400.00, both P<0.001; z values: 2.98-16.90, all P<0.003). The SUV max (median for PN: 3.55-4.01, median for POL: 5.77-6.08; χ2 values: 8.58, 3.02, both P>0.05) and TBR (median for PN: 2.42-2.81, median for POL: 2.36-2.45; χ2 values: 9.83, 3.69, both P>0.05) of lesion were not significantly different among 6 groups. Taking G600 group as a reference, the lesion detection rates were 100% in G30 group and other 4 groups for PN (81/81) and in G120, G180, G300 groups for POL (80/80). Conclusion:Total-body PET/CT imaging with acquisition time of 30 s for lungs and that with acquisition time of 120 s for parenchymal organs are feasible for clinical use, with the PET image quality and lesion detectability maintained.

Objective:To examine the concordance between bioelectrical impedance analysis (BIA) and dual energy X-ray absorptiometry (DXA) in determining body composition of children aged between 3 and 6.Methods:A total of 230 children aged 3-6 from a kindergarten in Jinnan, Tianjin were enrolled in this study from November 16 th to December 8 th, 2017.The soft lean mass (SLM) and the body fat mass (BFM) of the children were measured by using BIA and DXA.The children were divided into several groups by sex, age and body mass index (BMI). The consistency of the body composition results between BIA and DXA in each group was analyzed. Results:The SLM and BFM assessed by BIA were significantly correlated with those measured by DXA ( R2=0.951, 0.947, all P<0.001). The Bland-Altman plots suggested that the SLM measured by BIA was 0.70 kg(95% CI: -1.78-0.38) higher in that by DXA, and the BFM measured by BIA was 1.36 kg (95% CI: 0.19-2.52) lower in that by DXA.A similar trend could be seen in children stratified by age, sex and BMI.The SLM of boys and girls measured by BIA was 0.57 kg (95% CI: -1.63-0.49) and 0.84 kg (95% CI: -1.88-0.20) higher than those by DXA, respectively.The BFM of boys and girls measured by BIA was 1.23 kg (95% CI: 0.11-2.36) and 1.49 kg (95% CI: 0.34-2.64) lower than that by DXA, respectively.The SLM measured by BIA was 0.67 kg (95% CI: -1.74-0.41), 0.76 kg (95% CI: -1.65-0.13), 0.69 kg (95% CI: -1.85-0.47) and 0.67 kg (95% CI: -1.75-0.41) higher than those by DXA in the 3 to 6-year-old groups, respectively.The BFM measured BIA was 1.09 kg (95% CI: -0.12-2.30), 1.44 kg (95% CI: 0.60-2.28), 1.39 kg (95% CI: 0.15-2.64)and 1.43 kg(95% CI: 0.38-2.48)lower than that by DXA in the 3 to 6-year-old groups, respectively.Moreover, the smallest difference of the SLM and BFM were observed between BIA and DXA in the obese child.The SLM deviation between BIA and DXA was estimated within ± 0.39 kg and the BFM deviation was within ± 0.93 kg. Conclusions:There is high consistency between BIA and DXA in the assessment of the SLM and BFM of children aged from 3 to 6.

Objective:To explore the evolution of imaging findings on dynamic chest high resolution CT（HRCT） in patients with mild COVID-19.Methods:The data of epidemiology, clinical data and continuous dynamic chest high-resolution CT images of the patients with mild COVID-19 were analyzed retrospectively. Twenty-five patients (including 24 common type and 1 mild) were enrolled in the group, including 14 males and 11 females, with age of （42±12） years and hospital stay of （19±5） days. The basic images and dynamic images of HRCT were analyzed and compared by the radiologists.Results:The clinical manifestations were fever (22 cases), cough (18 cases), expectoration (8 cases), pharyngeal pain (6 cases). Most laboratory tests lacked specificity. There were no significant abnormalities on chest CT of one mild patient. HRCT findings of the common type were as follows: (1) the distribution of the lesions: most of the multiple lesions involved both lungs (19 cases), with average of 3 (3±1) lobes, located in the peripheral pulmonary zone near the pleura (22 cases); (2) the morphology and density of the lesions: most of the lesions were ground glass density foci (22 cases), which were patchy and massive (18 cases), nodular (10 cases) and arc broadband (7 cases); with the development of the disease, the density of some lesions increased with localized pulmonary consolidation (10 cases), accompanied by air bronchus sign (5 cases) and halo sign (5 cases). Dynamic changes of HRCT images in the chest: the positive manifestations were found on the 5th (5, 6) day after the onset of the disease, the progressive time of CT lesions was 5 (5, 7) days, the peak time of CT lesions was 11 (10, 13) days, and the turning time of CT lesions was 9 (8, 11) days.Conclusions:Dynamic chest HRCT can monitor the basic evolution process of the disease in patients with mild COVID-19, and provide a more intuitive basis for clinical early diagnosis and treatment.

Objective　To evaluate the efficacy of QSM combined with DKI in the treatment of Parkinson’s disease. Methods　In June 2016 to December 2018 in the Beihua University neurology patients diagnosed with Parkinson’s disease of 60 cases and 20 healthy volunteers as control group. All patients taking Madopar，UPDRS score，magnetic sensitive quantitative imaging （QSM），and diffusion kurtosis imaging （DKI） were performed before and six months after treatment to evaluate the changes of patients’ condition. All volunteers underwent magnetic sensitivity quantitative imaging （QSM） and diffusion kurtosis imaging （DKI） examination. Two doctors manually drew the range of ROI for the deep nuclear masses of both cerebral hemispheres：substantia nigra，red nucleus，putamen，caudate nucleus，thalamus and globule，and measured the mean kurtosis （MK） value of DKI parameters and the value of magnetic susceptibility. Statistical analysis was performed on the relevant data. Results　There were no lateral differences in the magnetic susceptibility and MK values of each nuclear group before and after treatment （P>0.05），The patient was treated with madopar for six months，the UPDRS score of the patients was （17.0±0.87），significantly lower than that of （19.0±0.68） before treatment，and the difference was statistically significant （P<0.05），Before treatment，the magnetic susceptibility of bilateral substantia nigra，red nucleus，shell nucleus，caudate nucleus and globus pallidus was significantly higher than that of normal control group （P<0.05），the magnetic susceptibility values of bilateral substantia nigra and putamen decreased compared with that before treatment，and the difference was statistically significant （P<0.05），the MK values of bilateral substantia nigra，left red nucleus，left caudate nucleus and bilateral colliculus before treatment were significantly higher than those of normal group （P<0.05），after treatment，the MK values of the left melanocytes，red nuclei and right melanocytes were 0.936±0.430，0.883±0.377 and 1.017±0.474，respectively，which were significantly higher than that before treatment （0.588±0.216，0.581±0.235 and 0.603±0.210），with statistically significant differences （P<0.05）. Finally，when comparing the correlations of UPDRS score with MK value and susceptibility value，the susceptibility value of the patient’s left putamen was significantly correlated with the patient’s UPDRS score （P<0.05）. Conclusion　Madopar has a good effect in the treatment of Parkinson’s disease. QSM combined with DKI provides an objective basis for the detection of Madopar efficacy，among which the magnetization value of the left putamen has a significant correlation with UPDRS score.

Objective To study the significance of Th17 cells in patients with myelodysplastic syndrome (MDS) and iron overload.Methods A total of 77 patients with MDS admitted to Guangzhou First People's Hospital were enrolled from January 2017 to December 2018,who were divided into iron overload group (37 cases) with serum ferritin (SF) over 1000 μg/L and non-ferrous overload group(40 cases).CD4+T cells in peripheral blood (PB) and bone marrow (BM) were sorted by flow cytometry.The ratio of Th17 cells and cells with abnormal karyotype were compared.IL-17 and IL-6 protein and RNA expression were detected by ELISA and quantitative real-time PCR(qRT-PCR).Results The proportions of Th17 cells in PB and BM in iron overload group were significantly higher than those in non-iron overload group [(41.06± 0.96)％ vs.(26.80± 1.21)％;(47.39± 1.60)％ vs.(34.29± 1.03)％;P＜0.01].The Th17 positive cells with abnormal karyotype in iron overload group were more than those in non-iron overload group[(4.96±0.53)％ vs.(3.67±0.12)％ in PB;(10.06±1.67)％ vs.(4.36±0.43)％ in BM;P＜0.01].Similarly,the protein levels as well as mRNA expression of IL-6 and IL-17 in patients with iron overload were significantly higher than those in non-iron overload group (P＜0.01 both in PB and BM).Conclusions As hematopoietic regulators secreted by Th17 cells,the expression of IL-6 and IL-17 in MDS patients with iron overload are elevated.This may predict the influence of these factors to the differentiation of Th 17 cells.