OBJECTIVE: To explore the relationship between the effect of acupuncture and layered localization of computed tomography (CT) in treatment of lumbar disc herniation. METHODS: Based on the CT layered localization, the herniated lumbar discs were positioned in 5 layers, A, B, C, D and E among 300 patients with lumbar disc herniation. Combined with the horizontal and the frontal planes, the three-dimensional location was formed. Acupuncture was delivered at acupoints including bilateral Shenshu (BL23), Dachangshu (BL25), and Huantiao (GB30), Weizhong (BL40) on the affected side. One intervention of acupuncture was 30 min, once daily; 1 course of treatment was composed of 10 interventions and 2 courses were required. Before and after treatment, Japanese orthopaedic association (JOA) score was recorded, and the effect was evaluated. The curative effect was classified and compared with the CT layered localization. RESULTS: Of 300 patients, 226 cases were effective and the effective rate was 75.33%. The JOA scores of all patients, and in the effective group and the non-effective group were higher compared with the scores before treatment (P<0.05). With the layered localization considered, acupuncture was more effective on the cases positioned in C layer. Regarding the horizontal plane, the effect was better on the cases with zone 1 and zone 1-2 involved. In terms of the grade of frontal plane, acupuncture was more effective on the cases graded Ⅰ and Ⅱ. CONCLUSION The clinical effect of acupuncture on lumbar disc herniation is related with the layer and the horizontal zone of herniated disc positioned, as well as to the grade of the frontal plane.
Humans ; Acupuncture Therapy ; Intervertebral Disc Displacement/diagnostic imaging* ; Male ; Female ; Middle Aged ; Adult ; Tomography, X-Ray Computed ; Lumbar Vertebrae/diagnostic imaging* ; Acupuncture Points ; Aged ; Young Adult ; Treatment Outcome

Objective To investigate the mechanism underlying the effect of intra-articular injection of ozonated water on cartilage repair in knee osteoarthritis(KOA)rats via the miR-214-3p/nuclear factor(NF)-κB signaling pathway,to provide a theoretical basis for the clinical application of ozonated water.Methods Sixty male Sprague-Dawley rats were divided randomly into ozonated and experimental groups.Rats in the experimental group were further divided randomly into model,ozonated water,ozonated water+AAV-NC,and adeno-associated virus with ozonated water+AAV-miR-214-3p inhibitor groups.The articular cartilage repair status was evaluated after the respective treatments,using articular cartilage surface gross scoring,hematoxylin/eosin staining,and modified Mankin's score.Expression levels of interleukin(IL)-1β,tumor necrosis factor(TNF)-α,and matrix metalloproteinase(MMP)-13 were detected by enzyme-linked immunosorbent assay(ELISA).Protein expression levels of IκB kinase(IKK)β,p65,and phospho(p)-IκBα were detected in cartilage tissues by Western blot,and gene expression levels of IKKβ,p65,IκBα,and miR-214-3p were detected by real-time polymerase chain reaction(RT-PCR).Results Rats in all groups showed different degrees of cartilage damage compared with the control group,and the scores were significantly lower in the ozonated water and ozonated water+AAV-NC groups compared with the ozonated water+AAV-miR-214-3p inhibitor group(P＜0.05).IL-1β,TNF-α,and MMP-13 levels detected by ELISA were significantly lower in cartilage tissues from rats in the ozonated water and ozonated water+AAV-NC groups compared with the model and ozonated water+AAV-miR-214-3p inhibitor groups(P＜0.05).According to RT-PCR,IKKβ and p65 mRNA levels were significantly down-regulated while IκBα mRNA was significantly up-regulated in cartilage tissues from rats in the ozonated water and ozonated water+AAV-NC groups compared with the model and ozonated water+AAV-miR-214-3p inhibitor groups(P＜0.05).Similarly,IKKβ,p65,and p-IκBα protein expression levels detected by Western blot were significantly down-regulated while IκBα protein expression levels were up-regulated in cartilage tissues from rats in the ozonated water and ozonated water+AAV-NC groups compared with the model and ozonated water+AAV-miR-214-3p inhibitor groups(P＜0.05).Conclusions Ozone hydrotherapy significantly ameliorated cartilage damage in KOA rats,possibly via inhibiting activation of the NF-κB signaling pathway through up-regulation of miR-214-3p expression and promoting cartilage repair in KOA rats.

Objective To investigate the mechanism underlying the effect of intra-articular injection of ozonated water on cartilage repair in knee osteoarthritis(KOA)rats via the miR-214-3p/nuclear factor(NF)-κB signaling pathway,to provide a theoretical basis for the clinical application of ozonated water.Methods Sixty male Sprague-Dawley rats were divided randomly into ozonated and experimental groups.Rats in the experimental group were further divided randomly into model,ozonated water,ozonated water+AAV-NC,and adeno-associated virus with ozonated water+AAV-miR-214-3p inhibitor groups.The articular cartilage repair status was evaluated after the respective treatments,using articular cartilage surface gross scoring,hematoxylin/eosin staining,and modified Mankin's score.Expression levels of interleukin(IL)-1β,tumor necrosis factor(TNF)-α,and matrix metalloproteinase(MMP)-13 were detected by enzyme-linked immunosorbent assay(ELISA).Protein expression levels of IκB kinase(IKK)β,p65,and phospho(p)-IκBα were detected in cartilage tissues by Western blot,and gene expression levels of IKKβ,p65,IκBα,and miR-214-3p were detected by real-time polymerase chain reaction(RT-PCR).Results Rats in all groups showed different degrees of cartilage damage compared with the control group,and the scores were significantly lower in the ozonated water and ozonated water+AAV-NC groups compared with the ozonated water+AAV-miR-214-3p inhibitor group(P＜0.05).IL-1β,TNF-α,and MMP-13 levels detected by ELISA were significantly lower in cartilage tissues from rats in the ozonated water and ozonated water+AAV-NC groups compared with the model and ozonated water+AAV-miR-214-3p inhibitor groups(P＜0.05).According to RT-PCR,IKKβ and p65 mRNA levels were significantly down-regulated while IκBα mRNA was significantly up-regulated in cartilage tissues from rats in the ozonated water and ozonated water+AAV-NC groups compared with the model and ozonated water+AAV-miR-214-3p inhibitor groups(P＜0.05).Similarly,IKKβ,p65,and p-IκBα protein expression levels detected by Western blot were significantly down-regulated while IκBα protein expression levels were up-regulated in cartilage tissues from rats in the ozonated water and ozonated water+AAV-NC groups compared with the model and ozonated water+AAV-miR-214-3p inhibitor groups(P＜0.05).Conclusions Ozone hydrotherapy significantly ameliorated cartilage damage in KOA rats,possibly via inhibiting activation of the NF-κB signaling pathway through up-regulation of miR-214-3p expression and promoting cartilage repair in KOA rats.

Objective To explore the effect of ozone water acupoint injection combined intra-articular irrigation on pain and related factors in the patients with knee osteoarthritis(KOA).Methods Sixty-four eld-erly patients with KOA in the Third Affiliated Hospital of Henan University of Traditional Chinese Medicine from June to December 2023 were selected as the study subjects and divided into the observation group and control group by adopting the random number table method,32 cases in each group.The control group adopt-ed the ozone water acupoint injection,and the observation group was combined with ozone water intra-articu-lar irrigation on the basis of the control group.The both groups were treated once a week for 4 consecutive weeks.The Visual Analogue Scale(VAS)score,Lysholm knee function score,clinical effect and the levels of joint fluid PGE2,IL-1β and IL-6 before and after treatment were compared between the two groups.Results The VAS score,Lysholm knee function score and the levels of PGE2,IL-1β and IL-6 levels after treatment in the two groups were significantly improved compared with before treatment(P＜0.05),moreo-ver the improvement in the observation group was more significant than that in the control group(P＜0.05).The multiple linear regression analysis showed that the VAS score before treatment was related with the PGE2 level(P＜0.05)and had no relation with the age and level of IL-6 and IL-1β(P＜0.05).The total ex-cellence and good rate in the observation group was significantly higher than that in the control group(P＜0.05).The no adverse reactions such as fainting during acupuncture treatment,skin infection at injection site,symptom increase and joint discomfort appeared during the treatment process.Conclusion The ozone water acupoint injection combined intra-articular irrigation in treating KOA has better effect,which may improve the pain symptom by regulating the induced pain factors and inflammatory factors levels.

Objective: To investigate whether acupoint penetration acupuncture (APA) could regulate chondrocyte autophagy and apoptosis via the PI3K/Akt-mTOR signaling pathway to reduce cartilage degeneration in knee osteoarthritis (KOA) rats. Methods: KOA was induced in rats via intra-articular injection of sodium iodoacetate resolution. Forty male Sprague-Dawley rats were randomly assigned to blank control, model, APA, electro-acupuncture (EA), and sham model groups (n = 8) and those in the APA and EA groups received their respective therapies. Following completion of the treatment course, histological examinations of cartilage and muscle were conducted. Levels of apoptosis- and autophagy-related factors, including Bax, Bcl-2, mTOR, ULK-1, and Beclin-1 protein, and mRNAs were assessed. Additionally, β-endorphin (β-EP) concentrations in the brain and serum were measured. Results: Histological analysis revealed that APA alleviated cartilage and muscle damage compared with the model group. APA inhibited cartilage degeneration by modulating the expression of apoptosis- and autophagy-related proteins and mRNA, thus preventing chondrocyte apoptosis. In the APA group, Bax and mTOR protein levels were significantly lower than those in the model group (both P = .024). Conversely, the Bcl-2 expression level was significantly higher than that in the EA group (P = .035). Additionally, ULK-1 expression was significantly lower than that in the EA group (P = .045). The mRNA level of Bax was significantly higher than that in the blank control group (P < .001). However, Beclin-1 levels were significantly higher than those in both the model and EA groups (both P < .001). ELISA results showed a significant decrease in the concentration of β-EP in the brains of the rats in the APA group compared with those in the model group (P = .032). Conclusions APA reduced osteoarthritis-related pain and alleviated cartilage damage by upregulating chondrocyte autophagy and down-regulating apoptosis via signaling pathways involving PI3K/Akt-mTOR in KOA rats.

Objective:To construct three image recognition models of manikin′s glottis using visual laryngoscopy based on deep-learning algorithm.Methods:The tracheal intubation manikin′s epiglottis was visualized using a videolaryngoscope, and then epiglottis was elevated to expose the glottis and acquire glottic images. A total of 149 images were obtained from various angles and orientations and randomly divided into training set and test set, and the annotation of image data was completed. Three glottal image recognition models of CenterNet, YOLOv3 and YOLOv4 were developed. The training set was used to complete the training of the models, and finally the test set was used to evaluate the model performance.Results:CenterNet, YOLOv3 and YOLOv4 three models were successfully constructed, the mean average precision of CenterNet, YOLOv3 and YOLOv4 was 92.33%, 89.52% and 89.02% respectively, the recall rates were 87.50%, 90.00% and 90.00% respectively, the precision rates reached 97.22%, 94.74% and 94.74% respectively, and the accuracy rates were 90.91%, 85.11% and 88.89% respectively. All three algorithms demonstrated an identical F1 score of 91.00%.Conclusions:The CenterNet, YOLOv3 and YOLOv4 models are successfully constructed, and three recognition models can accurately identify the glottis in the image, with the CenterNet model demonstrating the highest recognition precision.

OBJECT IVE To provide reference for the improvement of the quality standard for Niushanggui capsules. METHODS Based on the previous quality standard ，thin-layer chromatography （TLC）identification methods were established for Angelicae dahurica and Anemarrhenae asphodeloides . High performance liquid chromatography （HPLC）method was established to determine the contents of 5 components simultaneously ，such as mangiferin ，prim-O-glucosylcimifugin，naringin，neohesperidin and 5-O-methylvisammioside. The limits were confirmed. RESULTS TLC chromatogram of Niushanggui capsules showed the same color spots in the same position as the corresponding （mixed）substance control or reference medicinal material of A. dahuricae and A. asphodeloides ，while the negative samples had no interference. The linear range of mangiferin ，prim-O-glucosylcimifugin， naringin，neohesperidin and 5-O-methylvisammioside were 7.98-127.63，6.74-107.84，53.06-848.96，39.31-628.90，13.54-216.62 μg/mL，respectively（all r＝0.999 9）. RSDs of precision ，stability（24 h）and repeatability tests were all no more than 1.20％（n＝ 6）. The average recoveries were 95.00％，105.16％，97.16％，101.00％ and 104.97％（RSD≤1.50％，n＝6）. In 4 batches of samples，the average contents of the above 5 components were 0.842，0.696，6.951，5.755 and 1.106 mg/g respectively ；the limits of A. asphodeloides ，Saposhnikovia divaricata and Citrus aurantium were based on the contents of mangiferin ，the total content of prim-O-glucosylcimmifugin and 5-O-methylvisammioside，naringin and neohesperidin ，which would not be less than 0.42，0.90 and 6.36 mg/grain，respectively. CONCLUSIONS TLC identification methods of A. dahurica and A. asphodeloides and the content determination methods of 5 components as mangiferin in Niushanggui capsules are established in this study ，and the limits of A. asphodeloides ，S. divaricata and C. aurantium are confirmed.

Objective:To observe the repairing effect of ozone water injection in the articular cavity for the treatment of knee osteoarthritis (KOA) on articular cartilage and to explore its repair mechanism.Methods:48 rats were randomly divided into fourgroups, the normal, model, normal saline and ozone water group, each group had 12 rats. The rats were injectied into the joint cavity with papain to establish a KOA model other than the normal group. After confirming the success of the model, the ozone water group and normal saline group was treated with ozone water and normal saline injection into the joint cavity once a week for a total of 3 treatments, the normal group and the model group are all raised routinely. Before and after the treatment, the ratknee joint behavioral score MG score was conducted; after the treatment articular cartilage surface gross score, hematoxylin and eosin (HE) staining and modified Mankin score of articular cartilage pathological changes was measured, and Western blot and Rt-PCR to measure the level of protein and mRNA expression of NF-κB p65, IKKβ and IκBα in articular cartilage tissues.Results:Compared with before the treatment, the rat knee joint behavioral score of the ozone water group was significantly lower (all P<0.05); after the treatment, the gross articular cartilage surface score and the modified Mankin score of the ozone water group were significantly reduced compared with the model and normal saline group (all P<0.05); Compared with the model and normal saline group, the protein and mRNA expression levels of NF-κB p65 and IKKβ in the ozone water group are significantly lower (all P<0.05), and the levels of IκBα are significantly higher (all P<0.05). Conclusion:Ozone water injection in the articular cavity can effectively repair damaged articular cartilage. The repair mechanism may be achieved by inhibiting the activation of NF-κB signaling pathway.

Objective:To evaluate the effect of intra-articular injection of different concentrations of ozonated water on articular cartilage of rabbits with osteoarthritis (OA).Methods:Twenty-four clean-grade New Zealand white rabbits of both sexes, weighing 2.0-3.0 kg, aged 6 months, were divided into 4 groups ( n=6 each) using a random number table method: control group (group C), OA group, low concentration ozonated water group (L group) and high concentration ozonated water group (H group). The OA model was established by intra-articular injection of papain.At 2 weeks after the model was successfully established, 10.0 and 20.0 μg/ml ozonated water 1.0 ml was injected into the knee joint of rabbits in L and H groups, respectively, and 0.9% sodium chloride solution 1.0 ml was injected once a week, 3 times in total in OA group.At 1 week after the last injection, the cartilage tissue of the knee joint was removed and stained with toluidine blue for evaluation of Mankin score (under light microscope). The activity of caspase-3 in chondrocyte was detected by enzyme-linked immunosorbent assay. Results:Compared with group C, the Mankin score and caspase-3 activity were significantly increased in the other 3 groups ( P<0.05). Compared with group OA, the Mankin score and caspase-3 activity were significantly decreased in group L and group H ( P<0.05). Compared with group L, the Mankin score was significantly increased, and the activity of caspase-3 was decreased in group H ( P<0.05). Conclusion:Injecting ozonated water 10.0 μg/ml and 20.0 μg/ml into the knee joint cavity both can inhibit the apoptosis in chondrocytes and reduce the damage to articular cartilage, however, high concentration of ozonated water can cause the denaturation of the articular cartilage matrix in rabbits with OA.

Objective To evaluate the effects of ozoned water on the synovial inflammation in rabbits with knee osteoarthritis.Methods Thirty-two rabbits were randomly and evenly divided into four groups by random number method.All the rabbits were made into osteoarthritis models except those in groups A and D.After the osteoarthritis models were made successfully,rabbits in groups C and D received intra-articular injection of ozoned water of 20 μg/ml (2 ml)once a week for three weeks,and the other two groups did not.The morphology of synovium was observed and the expres-sion levels of IL-6 and TNF-α in the synovium were compared among the four groups.Results In group A,there was no hyperemia,edema or cell hyperplasia in the synovium,and the synovium re-mained normol tissue structure.In group B,the synovial structure was damaged,with serious cell hyperplasia,masses of inflammatory cells invading,vascular proliferation and hyperemia,and signifi-cantly increased synovium thickness compared with the normal.In group C,synovial hyperemia and edema were improved,the inflammatory cells reduced,and the synovium thickness was thinner than that in group B.And the group D had no synovitis phenomenon.Compared with group A,the expres-sions of IL-6 and TNF-αwere slightly higher in group D,and they were significantly increased (P <0.05)in the other two groups.Compared with group B,the IL-6 and TNF-α contents of synovium were reduced (P < 0.05)in group C.Conclusion Injecting 2 ml ozoned water of 20 μg/ml into artic-ular cavity can significantly improve synovial inflammation and reduce the expression of IL-6 and TNF-αin the synovium,which does no damage normal synovium.