ObjectiveTo explore the potential mechanism of Shenqi Jianxin Formula （参芪健心方） in the treatment of chronic heart failure （CHF） from the perspective of regulating mitochondrial autophagy via the PTEN-induced kinase 1 （PINK1）/E3 ubiquitin ligase （Parkin） pathway. MethodsMale SD rats were subjected to abdominal aortic constriction to establish the CHF model. Twenty-four successfully modeled rats were randomly divided into the model group， sacubitril/valsartan group， and low- and high-dose Shenqi Jianxin Formula groups， with 6 rats in each group. Six other rats were set as the sham surgery group， which were only separated the abdominal aorta and then closed the abdomen. Rats in the low-dose and high-dose Shenqi Jianxin Formula groups were given intragastric administration of Shenqi Jianxin Formula suspension at doses of 4.41 g/（kg·d） and 17.64 g/（kg·d）， respectively； the sacubitril/valsartan group received intragastric administration of sacubitril/valsartan sodium tablet suspension at 10 mg/（kg·d）； the sham surgery group and the model group were given normal saline at 10 ml/（kg·d） via intragastric gavage. The intervention lasted for 4 consecutive weeks. Cardiac function indices including left ventricular ejection fraction （LVEF） and left ventricular fractional shortening （LVFS） were detected， and serum brain natriuretic peptide （BNP） content was measured. HE staining and Masson staining were used to observe myocardial histopathological changes. Transmission electron microscopy was employed to examine the ultrastructure of cardiac tissues. Quantitative real-time polymerase chain reaction （Rt-qPCR） was performed to determine the mRNA expressions of PINK1/Parkin pathway-related factors and autophagy-associated proteins including Beclin-1， p62， and microtubule-associated protein 1 light chain 3 （LC3） in myocardial tissues. ResultsCompared with the sham surgery group， the model group showed significant decreases in LVEF and LVFS levels， an increase in serum BNP content， down-regulated mRNA and protein expressions of PINK1， Parkin and Beclin-1 in cardiac tissues， up-regulated mRNA and protein expressions of p62， as well as significant reductions in LC3B mRNA expression， phosphorylated PTEN-induced kinase 1 （p-PINK1） and phosphorylated E3 ubiquitin ligase （p-Parkin） protein levels， and the ratio of microtubule-associated protein 1 light chain 3-Ⅱ to microtubule-associated protein 1 light chain 3-Ⅰ （LC3Ⅱ/LC3Ⅰ） （P＜0.05）. Pathological results revealed obvious myocardial cell edema， necrosis and degeneration， increased disorder of myocardial fiber arrangement， extensive inflammatory cell infiltration， moderate to severe mitochondrial swelling， a few mitochondrial vacuolar changes， and no obvious autophagy in the field of vision in the model group. Compared with the model group， all the above indicators were significantly improved in the high-dose Shenqi Jianxin Formula group and the sacubitril/valsartan group （P＜0.05）. Moreover， the improvement of each index in the high-dose Shenqi Jianxin Formula group was superior to that in the low-dose group （P＜0.05）. In the high-dose Shenqi Jianxin Formula group， myocardial myofibrils were arranged regularly with orderly orientation， the striated structure was clear， and necrotic cells significantly reduced. ConclusionShenqi Jianxin Formula can activate the PINK1/Parkin signaling pathway in myocardial tissues， enhance mitochondrial autophagy， and clear dysfunctional mitochondria， thereby improving cardiac function and delaying the progression of CHF.

OBJECTIVE: To observe the clinical effect of Tiaoshen Guben holistic therapy of acupuncture and moxibustion (holistic treatment with acupuncture and moxibustion by adjusting the mind and consolidating the root) on comorbidity of depression and insomnia. METHODS: Twenty-four patients with comorbidity of depression and insomnia were included and treated with Tiaoshen Guben holistic therapy of acupuncture and moxibustion. Acupuncture was applied to Baihui (GV20), Guanyuan (CV4), bilateral Neiguan (PC6), etc. The refined moxibustion therapy was delivered at Zhongwan (CV12), Qihai (CV6), bilateral Yongquan (KI1), etc. Subcutaneous embedding therapy with thumb-tack needle was adopted at bilateral Xinshu (BL15), bilateral Pishu (BL20), etc. The intervention was operated once every other day, 3 treatments a week, and for 6 consecutive weeks. Before and after treatment completion, and in 1 month after treatment, Pittsburgh sleep quality index (PSQI) and Hamilton's depression scale (HAMD-17) were adopted to assess sleep quality and depression symptoms in the patients, respectively. Before and after treatment completion, using functional magnetic resonance imaging (fMRI), the functional connectivity (FC) of locus coeruleus (LC) in brain regions was evaluated; and the levels of serum norepinephrine (NE), cortisol (CORT), adrenocorticotropic hormone (ACTH) and corticotropin releasing hormone (CRH) were detected. RESULTS: Compared with the scores before treatment, PSQI and HAMD-17 scores after treatment completion and in 1 month after treatment were reduced (P<0.01); and strengthened FC was revealed between the right LC and the pars opercularis of the left inferior frontal gyrus, as well as the lateral occipital lobe region. After treatment completion, serum NE was elevated (P<0.01), the levels of CORT, ACTH and CRH were reduced (P<0.01). Before and after treatment completion, the difference in FC between the right LC and the pars opercularis of the left inferior frontal gyrus was negatively correlated with the differences in PSQI score (r = -0.484, P = 0.016) and HAMD-17 score (r = -0.233, P = 0.027). CONCLUSION Tiaoshen Guben holistic therapy of acupuncture and moxibustion can effectively alleviate depression symptoms and improve sleep quality in the patients with comorbidity of depression and insomnia, which is obtained probably through reducing the levels of serum CORT, ACTH and CRH, increasing serum NE, strengthening the FC of the right LC with the pars opercularis of the left inferior frontal gyrus and the lateral occipital lobe region.
Humans ; Moxibustion ; Sleep Initiation and Maintenance Disorders/therapy* ; Male ; Female ; Middle Aged ; Adult ; Acupuncture Therapy ; Depression/complications* ; Aged ; Young Adult ; Acupuncture Points ; Comorbidity

Objective To evaluate the quality of the reports of randomized controlled trials(RCT)on acupuncture treatment of dysmenorrhea.Methods RCT English and Chinese literature about acupuncture for the treatment of dysmenorrhea was systematically retrieved from PubMed,EMbase,Cochrane Library,CNKI,SinoMed,Wanfang Data and VIP from the establishment of the databases to March 31,2024.Based on the CONSORT statement,STRICTA,and SHARE,RCTs for acupuncture treatment of dysmenorrhea that met the inclusion criteria were evaluated and statistically analyzed.Results Totally 28 RCTs were included.According to the analysis and statistics,although the reporting rate of the basic implementation points of RCT was satisfactory,reporting rates of the CONSORT statement,STRICTA and SHARE related to the implementation details of blind method,the demarcation of outcome indicators and statistical analysis,the determination method of sample size,the rationality analysis of sham acupuncture and the implementation details were still below 50%or even 0%.Among them,the items with a reporting rate less than 30%were mainly the identification of the title,the integrity of the trial design,the comprehensiveness of the outcome indicators,the comprehensiveness of the statistical analysis,the rationality analysis of acupuncture treatment,the operation details of false acupuncture,and the full report of the trial information.Conclusion At present,the quality of RCT reports on the treatment of dysmenorrhea with sham acupuncture as control at home and abroad is generally low,especially in the rationality of sham acupuncture,implementation methods and statistical analysis of outcome indicators,etc.It is suggested that the CONSORT statement,STRICTA and SHARE should be strictly followed when designing clinical trial protocols in the future,with multi-stage self-evaluation,timely adjustment and improvement of the program design,in order to improve the safety,authenticity and scientificity of the program.

Objective:To improve the resazurin reduction method for rapid clinical detection of eravacycline susceptibility of Acinetobacter baumannii. Methods:The susceptibility of 103 Acinetobacter baumannii strains to eravacycline was tested using the modified resazurin method and compared with the results from the broth microdilution method to evaluate the effectiveness of the improved method. Results:All results were obtained after about 5.5 h of incubation. The testing procedure was simple and saved 10-14 h compared with the broth microdilution method. The consistency in susceptibility result with the broth microdilution method was 99.03%. The very major error rate was 0.97%(1/103), with one resistant strain misclassified as sensitive (minimum inhibitory concentration of 2 μg/ml), and the major error rate was 0. This method could rapidly and accurately screen for eravacycline-resistant Acinetobacter baumannii strains in clinical settings. Conclusions:The modified resazurin method, due to its simplicity, rapidity, and ease of execution, has the potential to become a convenient method for the rapid clinical screening of eravacycline-resistant strains, providing a reference for early clinical treatment.

Objective:To explore the imaging characterization of mandibular third molar (M3) and mandibular second molar (M2) and their associated areas using cone beam CT (CBCT).Methods:A total of 226 images of patients with concomitant mandibular second and third molars in the Department of Oral and Maxillofacial Medical Imaging of Nanjing Stomatology Hospital were selected to retrospectively analyze their clinical information and imaging manifestations from January 2020 to January 2024, and their clinical information and imaging performances were analyzed. Clinical information included patient′s age, gender, and chief complaint; dental tissues (crowns, roots) and periodontal tissues (periodontium, alveolar bone) of the mandibular second molar were evaluated based on their CBCT, and the position (high, medium, low), type of obstruction, dental tissues, periodontal tissues and bone margins of the alveolar bone between them, extent (concave, oblique, flat) and depth of bone defects, and periodontal membrane imaging changes of the mandibular third molars etc.Results:There were 104 cases of mandibular M2 and M3 as the main complaints and 122 cases of non-main complaints in this study. According to the imaging aspects, the mandibular M2 and M3 associated regions with abnormal CBCT imaging manifestations were mainly categorized into six sagittal representation phenotypes (types Ⅰ-Ⅵ); among them, middle-aged and elderly patients≥45 years of age more often showed abnormal imaging phenotypes (75%), and the peripheral bone defects were more severe. The correlation between the type and height of the mandibular M3 obstruction (high:medium:low=42∶110∶74) and the imaging typology of the mandibular M2 and M3 association regions was statistically significant ( P<0.001). The bone defects between mandibular M2 and M3 of the young patients≤25 years of age were predominantly of the oblique type of resorption (41/69 cases), and the least of the flat type (1/69 cases), whereas flat type could reached 27.8% in the middle-aged and elderly patients≥45 years of age, and the circumferential angle of the peripheral bone defects in the mandibular M2 and M3 regions showed strong correlation with age ( P<0.001), typology ( P<0.001), and the height of the obstruction ( P=0.004). The correlation between defect depth and obstruction height for the same fractal type was statistically significant in the age groups≤25 years and 26-44 years ( P≤25 years=0.0385, P26~44 years=0.032). There was a significant correlation between mandibular M3 with different types of obstruction, especially proximal-medial (34/43 cases) and horizontal obstruction (8/43 cases), and neighboring M2 suffering from caries ( P=0.004). The correlation between obstruction height (median 46.3%, low 50.0%) and M2 extra-root resorption (80 cases) was statistically significant ( P<0.001). Conclusions:In this study, we explored the imaging characteristics of the mandibular M2 and M3 association region using CBCT, and established a six-type sagittal classification system for the M2 and M3 association area, providing a reproducible framework for the systematic assessment of the overall status of this region. Further analysis revealed that the incidence of radiographic abnormalities in the bone tissue of this area significantly increased with age. Concurrently, the study confirmed that the impaction status of mandibular M3 is associated with an elevated risk of dental and periodontal diseases affecting M2. These specific findings provide important insights into the pathological relationships within the mandibular M2\M3 region and support clinical decision-making.

OBJECTIVE: To investigate the clinical characteristics and genetic etiology in a fetus with 12q14 microdeletion syndrome. METHODS: A fetus diagnosed with 12q14 microdeletion syndrome at Wenzhou People's Hospital in July 2019 was selected as the study subject. The fetus was from a twin pregnancy by in vitro fertilization-embryo transfer, with ultrasound findings including growth restriction, cleft lip/palate, ventricular septal defect, tricuspid regurgitation, and pericardial effusion. Clinical data and family history were collected. Amniotic fluid sample was collected from both twins, and peripheral blood samples were obtained from their parents. Amniocytic karyotyping analysis and chromosomal microarray analysis (CMA) were performed, and familial validation was conducted. This study was approved by the Medical Ethics Committee of Wenzhou People's Hospital (Ethics No.: KY-202408-034). RESULTS: Prenatal ultrasound showed no significant abnormality in one of the twins, whilst the other twin exhibited severe growth restriction accompanied by cleft lip/palate, ventricular septal defect, tricuspid regurgitation, and pericardial effusion. Karyotyping and CMA analyses of first twin showed no abnormalities, whilst the second twin had a chromosomal karyotype of 46,XN,t(3;12)(q26.3;q14), and CMA revealed a 4.9 Mb deletion in the 12q14.3-q15 region (arr[hg19]12q14.3q15(65,574,059_70,488,106)x1). Karyotyping and CMA analyses of both parents revealed no abnormalities, confirming that the fetus deletion was de novo in origin. Literature review suggested that prenatal diagnosis of 12q14 microdeletion syndrome has been extremely rare. CONCLUSION The fetus was diagnosed with 12q14 microdeletion syndrome. This de novo deletion may have dervied from chromosomal translocation. As a first-tier prenatal diagnostic technique, CMA can effectively detect microdeletion/microduplications missed by conventional karyotyping analysis.
Humans ; Female ; Pregnancy ; Chromosome Deletion ; Chromosomes, Human, Pair 12/genetics* ; Karyotyping ; Adult ; Prenatal Diagnosis ; Chromosome Disorders/diagnosis* ; Ultrasonography, Prenatal ; Fetus ; Male

Objective: To analyze the space time characteristics of poor vision among primary and secondary school students in Chengdu, in order to provide the reference for formulating myopia prevention and control policies for students. Methods: The data relating to poor vision among primary and secondary school students in Chengdu from 2021 to 2023 were sourced from the Sichuan Students Physical Health Big Data Center. The districts and counties of Chengdu were divided into three circles, including the main urban area, suburban districts and counties, and suburban districts and counties. The Chi square test was used for inter group comparison, and the Cochran-Armitage test was used to analyze the trend of changes. Global and local Moran s I were used to analyze spatial clustering. Results: The detection rates of poor vision among primary and secondary school students in Chengdu from 2021 to 2023 were 62.47%, 61.61% and 60.78%, respectively, showing a decreasing trend ( Z=-32.01, P <0.01). For each year, the higher detection rate of poor vision among students was detected in the higher level of education, and differences were statistically significant ( χ 2=161 549.47, 173 471.87, 233 459.09, P <0.01). The rate of poor vision among primary and secondary school students gradually decreased from the central districts and counties of Chengdu to the surrounding districts and counties for each year, and the differences were statistically significant ( χ 2=299.20, 776.22, 633.16, P <0.01). The spatial autocorrelation analysis showed that the first circle of Chengdu City was mainly characterized by high-high agglomeration ( P <0.01), with the rate of poor vision among primary school students in Wuhou District in 2023 exhibiting a low-high anomaly. The third circle was mainly characterized by low-low aggregation ( P <0.01), while the spatial clusterings of the second circle was not significant ( P >0.05). Conclusions The myopia prevention and control work in Chengdu has achieved preliminary results. It should continue to consolidate existing achievements and implement targeted myopia prevention and control measures based on regional characteristics.

Objective:To explore the imaging characterization of mandibular third molar (M3) and mandibular second molar (M2) and their associated areas using cone beam CT (CBCT).Methods:A total of 226 images of patients with concomitant mandibular second and third molars in the Department of Oral and Maxillofacial Medical Imaging of Nanjing Stomatology Hospital were selected to retrospectively analyze their clinical information and imaging manifestations from January 2020 to January 2024, and their clinical information and imaging performances were analyzed. Clinical information included patient′s age, gender, and chief complaint; dental tissues (crowns, roots) and periodontal tissues (periodontium, alveolar bone) of the mandibular second molar were evaluated based on their CBCT, and the position (high, medium, low), type of obstruction, dental tissues, periodontal tissues and bone margins of the alveolar bone between them, extent (concave, oblique, flat) and depth of bone defects, and periodontal membrane imaging changes of the mandibular third molars etc.Results:There were 104 cases of mandibular M2 and M3 as the main complaints and 122 cases of non-main complaints in this study. According to the imaging aspects, the mandibular M2 and M3 associated regions with abnormal CBCT imaging manifestations were mainly categorized into six sagittal representation phenotypes (types Ⅰ-Ⅵ); among them, middle-aged and elderly patients≥45 years of age more often showed abnormal imaging phenotypes (75%), and the peripheral bone defects were more severe. The correlation between the type and height of the mandibular M3 obstruction (high:medium:low=42∶110∶74) and the imaging typology of the mandibular M2 and M3 association regions was statistically significant ( P<0.001). The bone defects between mandibular M2 and M3 of the young patients≤25 years of age were predominantly of the oblique type of resorption (41/69 cases), and the least of the flat type (1/69 cases), whereas flat type could reached 27.8% in the middle-aged and elderly patients≥45 years of age, and the circumferential angle of the peripheral bone defects in the mandibular M2 and M3 regions showed strong correlation with age ( P<0.001), typology ( P<0.001), and the height of the obstruction ( P=0.004). The correlation between defect depth and obstruction height for the same fractal type was statistically significant in the age groups≤25 years and 26-44 years ( P≤25 years=0.0385, P26~44 years=0.032). There was a significant correlation between mandibular M3 with different types of obstruction, especially proximal-medial (34/43 cases) and horizontal obstruction (8/43 cases), and neighboring M2 suffering from caries ( P=0.004). The correlation between obstruction height (median 46.3%, low 50.0%) and M2 extra-root resorption (80 cases) was statistically significant ( P<0.001). Conclusions:In this study, we explored the imaging characteristics of the mandibular M2 and M3 association region using CBCT, and established a six-type sagittal classification system for the M2 and M3 association area, providing a reproducible framework for the systematic assessment of the overall status of this region. Further analysis revealed that the incidence of radiographic abnormalities in the bone tissue of this area significantly increased with age. Concurrently, the study confirmed that the impaction status of mandibular M3 is associated with an elevated risk of dental and periodontal diseases affecting M2. These specific findings provide important insights into the pathological relationships within the mandibular M2\M3 region and support clinical decision-making.

Objective To evaluate the quality of the reports of randomized controlled trials(RCT)on acupuncture treatment of dysmenorrhea.Methods RCT English and Chinese literature about acupuncture for the treatment of dysmenorrhea was systematically retrieved from PubMed,EMbase,Cochrane Library,CNKI,SinoMed,Wanfang Data and VIP from the establishment of the databases to March 31,2024.Based on the CONSORT statement,STRICTA,and SHARE,RCTs for acupuncture treatment of dysmenorrhea that met the inclusion criteria were evaluated and statistically analyzed.Results Totally 28 RCTs were included.According to the analysis and statistics,although the reporting rate of the basic implementation points of RCT was satisfactory,reporting rates of the CONSORT statement,STRICTA and SHARE related to the implementation details of blind method,the demarcation of outcome indicators and statistical analysis,the determination method of sample size,the rationality analysis of sham acupuncture and the implementation details were still below 50%or even 0%.Among them,the items with a reporting rate less than 30%were mainly the identification of the title,the integrity of the trial design,the comprehensiveness of the outcome indicators,the comprehensiveness of the statistical analysis,the rationality analysis of acupuncture treatment,the operation details of false acupuncture,and the full report of the trial information.Conclusion At present,the quality of RCT reports on the treatment of dysmenorrhea with sham acupuncture as control at home and abroad is generally low,especially in the rationality of sham acupuncture,implementation methods and statistical analysis of outcome indicators,etc.It is suggested that the CONSORT statement,STRICTA and SHARE should be strictly followed when designing clinical trial protocols in the future,with multi-stage self-evaluation,timely adjustment and improvement of the program design,in order to improve the safety,authenticity and scientificity of the program.

Objective:To improve the resazurin reduction method for rapid clinical detection of eravacycline susceptibility of Acinetobacter baumannii. Methods:The susceptibility of 103 Acinetobacter baumannii strains to eravacycline was tested using the modified resazurin method and compared with the results from the broth microdilution method to evaluate the effectiveness of the improved method. Results:All results were obtained after about 5.5 h of incubation. The testing procedure was simple and saved 10-14 h compared with the broth microdilution method. The consistency in susceptibility result with the broth microdilution method was 99.03%. The very major error rate was 0.97%(1/103), with one resistant strain misclassified as sensitive (minimum inhibitory concentration of 2 μg/ml), and the major error rate was 0. This method could rapidly and accurately screen for eravacycline-resistant Acinetobacter baumannii strains in clinical settings. Conclusions:The modified resazurin method, due to its simplicity, rapidity, and ease of execution, has the potential to become a convenient method for the rapid clinical screening of eravacycline-resistant strains, providing a reference for early clinical treatment.