Effect of Acupuncture on Histology of Thymus and Expressions of ANP and NPR-A in Anxiety Rats / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore possible mechanism of electroacupuncture (EA) for regulating immune function in anxiety disorder (AD) rats by observing the effect of acupuncture on the histology of thymus and expressions of atrial natriuretic peptide (ANP) and natriuretic peptide receptor type A (NPR- A) in thymus.</p><p><b>METHODS</b>Totally 34 SD healthy rats were randomly divided into the blank control group (n = 10), the model group (n = 12), the EA group (n = 12). Anxiety model was established in rats of the model group and the EA group by using chronic unpredictable stress (CUS) stimulation. EA (15/25 Hz) at Neiguan (PC6) and Shenmen (HT7) was performed in the EA group, with 15-min needle retaining, once every other day, 15 days in total. Needle was fixed at same acupoints for 15 min without electric stimulus in the other two groups. Anxiety-like behavior was measured by elevated plus-maze (EPM) test. Pathological changes of thymus tissue were observed by optical microscope. Expressions of ANP and NPR-A in thymus were measured by immunohistochemical assay.</p><p><b>RESULTS</b>The thymus tissue in the model group was severely atrophied, with unclear structure of thymic lobules, unclear margin of thymic medulla, loosely arranged lymphocytes ,and obviously enlarged volume of thymic corpuscle. The thymus tissue in the EA group was mildly atrophied, with existent structure of thymic lobules, clear margin of thymic medulla, densely arranged lymphocytes in cortical region, and widened medullary area. Com- pared with the blank control group, the percentage of open-arms entries (OE%) in the total QE times ob- viously decreased in the model group (P < 0.05), ANP expression obviously increased (P < 0.05), and NPR-A expression obviously decreased (P < 0.01). Compared with the model group, OE% was obviously elevated (P < 0.05), ANP expression obviously decreased (P < 0.05), and NPR-A expression obviously increased (P < 0.01) in the EA group.</p><p><b>CONCLUSION</b>EA not only could reduce anxiety of rats, but also could improve chronic stress induced thymus injury through intervening synthesis and secretion of ANP, as well as the expression of NPR-A (a specific receptor of ANP).</p>

Clinical analysis of pulmonary embolism in a child with Mycoplasma pneumoniae pneumonia / 中华儿科杂志

<p><b>OBJECTIVE</b>To explore the essential points for diagnosis of pulmonary embolism in children with mycoplasma pneumonia.</p><p><b>METHOD</b>Retrospective analysis of the clinical and laboratory data of a pediatric case who developed pulmonary embolism after mycoplasma pneumonia was performed for the key points for diagnosis.</p><p><b>RESULT</b>A-six-year old boy was admitted with chief complaint of fever and cough for half a month, combined with chest pain and mild labored breath. Vital signs were stable. Breathing movement of the left side weakened and there was left lower lobe percussion dullness. Breath sound was found weakened in the left lung, and a few fine crackles were audible. The results of laboratory tests were as follows: mycoplasma antibody (IgM) 1:128, cold agglutinin test 1:1024, blood D dimer 14.81 mg/L; anticardiolipin antibody was positive; plasma protein C activity was 60% (normal range 70% - 130%). Pulmonary artery computed tomographic angiography revealed a mass opaque shadow in left lower lobe, the branch of left lower bronchial artery was partially obstructed. Echocardiography showed tricuspid valve mild regurgitation, estimated pulmonary pressure was 5.1 kPa. Single-photon emission computed tomography indicated that radioactivity distribution was apparently sparse in the dorsal segment, anterior basal segment, outer basal segment and inferior lingular segment of the left lung. The preliminary diagnosis on admission was mycoplasma pneumonia with pleural effusion, pulmonary embolism. Intravenous erythromycin combined with meropenem were administered. Anticoagulation therapy was initiated with low molecular weight heparin and then oral warfarin tablets. Pleural effusion disappeared soon, D dimer descended to 0.38 mg/L, and pulmonary artery pressure declined. After 3-month follow-up, anti-cardiolipin antibody was negative, plasma protein C activity recovered, and lung lesions were absorbed.</p><p><b>CONCLUSION</b>When mycoplasma pneumonia is accompanied by chest pain or dyspnea and there are bloody pleural effusion, pulmonary hypertension, positive antiphospholipid antibody and elevated D dimer, pulmonary embolism should be considered. Diagnosis could be clarified by the result of pulmonary artery computed tomographic angiography.</p>