Professor SUN Shen-tian's experience in acupuncture treatment of depression based on "psychosomatic medicine" / 中国针灸

This paper introduces professor SUN Shen-tian's clinical thoughts and his characteristics of acupuncture techniques for the treatment of depression based on "psychosomatic medicine". Professor SUN, the master of traditional Chinese medicine, believes that depression refers to comorbidity of "heart mind" and "body", resulting from the "body-mind" disharmony, specially dominated by the emotional disorder. This disease is located in the brain, with the injury of mind and closely related to the heart and liver dysfunction. In pathogenesis, the dysfunction of brain mind and the unhealthy conditions of body and mind are involved. The treatment should focus on "regulating the mind, improving the intelligence, co-modulating the abdominal and brain functions and treating the physical and mental disorders". Baihui (GV 20), Ningshen (Extra) and emotional area on the head are selected as the main points to benefit the intelligence and calming down the mind; the abdominal region 1 and region 8 of "Sun's abdominal acupuncture" are used as the main points of the abdomen to regulate the brain functions. The point prescription is modified according to the symptoms and etiologies. The repeated transcranial acupuncture stimulation and electroacupuncture at low frequency (2 Hz) are crucial to the therapeutic effect. Reliving anxious emotions is specially considered before acupuncture, and the mind is protected and deqi is consolidated during acupuncture.

Research hotspots and trends of artificial intelligence in diabetic retinopathy based on bibliometrics and high-impact papers / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze research hotspots and trends of artificial intelligence in diabetic retinopathy(DR)based on bibliometrics and high-impact papers.METHODS: Papers on artificial intelligence in DR research published in the Web of Science Core Collection(WoSCC)from January 1, 2012, to December 31, 2022 were retrieved. The data was analyzed by CiteSpace software to examine annual publication number, countries, institutions, source journal, research categories, keywords, and to perform an in-depth analysis of high-impact papers.RESULTS: A total of 1 009 papers on artificial intelligence in DR from 79 countries were included in the study, with 272 papers published in 2022. Notably, China and India contributed 287 and 234 papers, respectively. The United Kingdom exhibited a centrality score of 0.31, while the United States boasted an impressive H-index of 48. Three prominent institutions in the United Kingdom(University of London, Moorfields Eye Hospital, and University College London)and one institution in Egypt(Egyptian Knowledge Bank)all achieved a notable H-index of 14. The primary academic disciplines associated with this research field encompassed ophthalmology, computer science, and artificial intelligence. Burst keywords in the years 2021～2022 included transfer learning, vessel segmentation, and convolutional neural networks.CONCLUSION: China emerged as the leading contributor in terms of publication number in this field, while the United States stood out as a key player. Notably, Egyptian Knowledge Bank and University of London assumed leading roles among research institutions. Additionally, IEEE Access was identified as the most active journal within this domain. The research focus in the field of artificial intelligence in DR has transitioned from AI applications in disease detection and grading to a more concentrated exploration of AI-assisted diagnostic systems. Transfer learning, vessel segmentation, and convolutional neural networks hold substantial promise for widespread applications in this field.

Retrospective Study of Clinical Features and Traditional Chinese Medicine Syndrome Characteristics on HBV-ACLF Patients with Bacterial Infection / 中国实验方剂学杂志

Objective::Through the retrospective study of Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) patients, the clinical features and the characteristics of traditional Chinese medicine (TCM) syndrome distribution of HBV-ACLF complicated with bacterial infection were preliminarily expounded, so as to provide the corresponding theoretical basis for the diagnosis and treatment of HBV-ACLF secondary bacterial infection. Method::A unified data collection form for patients with slow plus acute liver failure was designed by the retrospective epidemiological investigation method. The clinical data of 307 patients with HBV-ACLF who were hospitalized at the Hepatology Institute of the First Affiliated Hospital of Hunan University of Chinese Medicine were collected in strict accordance with the inclusion and exclusion standards, and the main symptoms and the TCM symptoms were screened. Then, according to whether or not there was a bacterial infection, the patients were divided into a combined bacterial infection group and a non-combined bacterial infection group. The distribution characteristics of the main symptoms and the TCM symptoms in two groups were compared, and the distribution characteristics of TCM symptoms of HBV-ACLF with bacterial infection were obtained. Result::Compared with patients with uncombined bacterial infection, patients with combined bacterial infection had significantly increased abdominal distension, puffiness, purple and dark tongue color, abdominal varicose tendons, subcutaneous stasis spots, and tooth marks on the side of the tongue. Compared with patients with combined bacterial infections, patients with uncombined bacterial infections mainly showed bright yellow head, yellow tongue coating, and significantly increased dry mouth (P<0.05, P<0.01). The main symptoms of patients with combined bacterial infections was the combination of syndrome (93.6%), and more spleen deficiency syndrome (81.6%), patients with uncombined bacterial infections mainly suffered from a single syndrome (53.5%), which was mostly damp-heat syndrome (51.9%), patients of concurrent syndrome with combined bacterial infections mostly suffered from false and real syndrome (94.4%), which was significantly higher than those with uncombined bacterial infections (58.9%). Conclusion::The patients with HBV-ACLF without bacterial infection mainly suffered from damp-heat symptoms and signs. With the combination of bacterial infection, the symptoms and signs of spleen deficiency and blood stasis gradually worsened. HBV-ACLF patients with bacterial infection mainly suffered from spleen deficiency and blood stasis, while patients with unincorporated bacterial infection mainly suffered from the single damp-heat symptoms and signs.

Expression of Treg/Th17 Cells in Patients with HBV-ACLF in Different Traditional Chinese Medicine Syndrome " Yanghuang-Yinyanghuang-Yinhuang" / 中国实验方剂学杂志

Objective::To detect the expression levels of peripheral blood Treg/Th17 cells and related cytokines in patients with Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) with different traditional Chinese medicine (TCM) syndrome " Yanghuang-Yinyanghuang-Yinhuang" , in order to explore the cellular immunological characteristics of different TCM syndromes of liver failure. Method::The 32 cases of patients with HBV-ACLF in early, middle and late stages in line with the " Yanghuang-Yinyanghuang-Yinhuang" TCM syndrome grouping were selected. Flow cytometry was used to detect the frequency expression of Treg/Th17 cells in peripheral blood. The expression levels of interleukin-10(IL-10), transforming growth factor-β(TGF-β), interleukin-17A(IL-17A), tumor necrosis factor-α(TNF-α) and interleukin-23(IL-23) were detected by cytometric bead array (CBA). The expressions of transcription factor forkhead box P3(FoxP3) and retinoid-related orphan nuclear receptor-γt(ROR-γt) mRNA were detected by Real-time PCR. The SPSS 20.0 software was applied in data statistics and processing to analyze the expression characteristics of Treg/Th17 cells and related cytokines in patients with different TCM syndrome types of HBV-ACLF. Result::The patients with HBV-ACLF Yanghuang syndrome were mainly distributed in the early stage of liver failure, those with Yinyanghuang syndrome were mainly distributed in the middle stage, and those with Yinhuang syndrome were distributed in the late stage. From Yanghuang syndrome, Yinyanghuang syndrome to Yinhuang syndrome, the frequency of Treg and Th17 cells gradually increased, and the differences among the groups were statistically significant (P<0.05). From Yanghuang syndrome, Yinyanghuang syndrome to Yinhuang syndrome, Treg cytokines IL-10, TGF-β gradually increased, and the differences among the groups were statistically significant (P<0.05). Th17 cytokines IL-17A, TNF-α, IL-23 gradually increased, of which IL-17A were differences between Yanghuang syndrome and the Yinyanghuang syndrome, as well as Yanghuang syndrome and Yinhuang syndrome (P<0.05). From Yanghuang syndrome, Yinyanghuang syndrome to Yinhuang syndrome, the expression of FoxP3 was gradually decreased, while that of ROR-γt was gradually increased, and the differences among the groups were statistically significant (P<0.01). Conclusion::There is a certain correlation between the different course of early, middle and late stages of HBV-ACLF and the distribution of TCM syndromes. The frequency of Treg and Th17 cells and the correlation of IL-17A, TGF-β and IL-10 with TCM syndrome differentiation are related, suggesting that Treg and Th17 cells have a certain reference value for the diagnosis of patients with HBV-ACLF and the syndrome differentiation of TCM syndromes.

Effect of Warming and Heat-clearing Method on Expressions of FoxP3 and ROR-γt in Colon Tissue of Rats with Intestinal Endotoxemia Caused by Acute-on-chronic Liver Failure / 中国实验方剂学杂志

Objective::To study the effect of warming and heat-clearing method (Wenyang Jiedu Huayu decoction) on the expressions of Forkhead box P3 (FoxP3), Retinoic acid-related orphan receptor gamma t (ROR-γt) in colon tissue of mice with acute-on-chronic liver failure (ACLF), in order to explore the possible regulatory mechanism on intestinal endotoxemia (IETM) in liver failure mice. Method::The 130 SD rats were randomly divided into normal group (10 rats) and model group (120 rats). The ACLF mice model was established through the subcutaneous injection with bovine serum albumin and the intraperitoneal injection with D-galactosamine(D-Gal) and lipopolysaccharide (LPS). The model mice were randomly divided into model group, heat-clearing group (Yinchenhao decoction, 6.68 g·kg-1), warming group (Yinchen Zhufu decoction, 7.09 g·kg-1) and warming and heat-clearing group (Wenyang Jiedu Huayu decoction, 19.53 g·kg-1). The normal group and the model group were given distilled water by gastric lavage, while the other groups were given equal volume of corresponding Chinese herbal medicines for a week. The value of each index at 1, 12 and 24 h was measured. The ratio of Treg/Th17 cell in peripheral blood were detected and calculated by flow cytometry. Real-time fluorescence quantitative PCR (Real-time PCR) was used to detect the expressions of FoxP3 and ROR-γt in colon tissues of mice at different time points. In situ hybridization and immunohistochemistry were used to observe the expressions of FoxP3 and ROR-γt genes and proteins. Result::Compared with normal group, the ratio of Treg/Th17 in the model group decreased significantly at each time point (P<0.01). Compared with the model group, the Treg/Th17 ratio increased only in the warming and heat-clearing method group (P<0.05). Compared with normal group, the expression of ROR-γt in the model group was significantly higher (P<0.01), and the expression of ROR-γt in the model group was higher than FoxP3.Compared with the model group, the expressions of FoxP3 and ROR-γt mRNA in the heat-clearing group and the warming group decreased at each time point (P<0.05), and the expressions of FoxP3 and ROR-γt in the warming and heat-clearing method group decreased significantly (P<0.01). The expressions of FoxP3 and ROR-γt mRNA in warming and heat-clearing group decreased compared with those in the warming group and heat-clearing group (P<0.05). Conclusion::The mechanism of the warming and heat-clearing method on IETM in liver failure may be related to the regulation of FoxP3 and ROR-γt expressions.

Effect of Isopimpinellin on Expression of Inhibitory Neurotransmitter and Receptor Genes in Primary Hippocampal Neurons / 中国实验方剂学杂志

Objective:To observe the effect of isopimpinellin on primary hippocampal neuron cells γ-aminobutyric acid (GABA), 5-hydroxytryptamine (5-HT) and receptor genes expressions, in order to explore its hypnotic mechanism. Method:The primary hippocampal neurons of neonatal Sprague-Dawley rats were cultured in vitro. And subsequent experiments were conducted in the optimal state of cell growth, and the purity was identified by immunohistochemistry of neuron-specific enolase. Hippocampal neurons were randomly divided into five groups, namely blank control group, diazepam group (25 mg·L-1), and low-dose (5 mg·L-1), moderate-dose (10 mg·L-1) and high-dose (20 mg·L-1) isopimpinellin groups. Early apoptosis of hippocampus neuron cells were detected using flow cytometry technique after 24 h administration, and the changes in the levels of GABA and 5-HT were detected using enzyme-linked immunosorbent. The changes in mRNA expressions of receptor genes relating to gamma-aminobutyric acid type A receptor(GABAA) genes GABRA1,GABRA5,GABBR1, gamma-aminobutyric acid type B receptor genes (GABAB) GABRB2, 5-hydroxytryptamine 1A receptor (5-HT1A)5-HT1A(A),5-HT1A(B),5-HT1A(C) were detected by real-time quantitative PCR(Real-time PCR). Result:On the 7th day, the hippocampal neurons grew in a good condition, and the purity was above 90%. Apoptosis rates of hippocampal neurons in the low-dose and moderate-dose groups were significantly lower than that in the blank control group (PP1,GABRA5,5-HT1A(A),5-HT1A(C) in the moderate-dose and high-dose isopimpinellin groups were significantly higher than those in the blank control group (PP1,5-HT1A(B) in the low-dose, moderate-dose and high-dose isopimpinellin groups were significantly higher than those in the blank control group (PPConclusion:The hypnotic mechanism of isopimpinellin may be related to the inhibition of hippocampal neuron apoptosis, the increase of the content of inhibitory neurotransmitter GABA, and the up-regulation of GABA and 5-HT-related receptor genes.

Role of Epithelium Sodium Channel in Bone Formation / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To review the recent developments in the mechanisms of epithelium sodium channels (ENaCs) induced bone formation and regulation.</p><p><b>DATA SOURCES</b>Studies written in English or Chinese were searched using Medline, PubMed and the index of Chinese-language literature with time restriction from 2005 to 2014. Keywords included ENaC, bone, bone formation, osteonecrosis, estrogen, and osteoporosis. Data from published articles about the structure of ENaC, mechanism of ENaC in bone formation in recent domestic and foreign literature were selected.</p><p><b>STUDY SELECTION</b>Abstract and full text of all studies were required to obtain. Studies those were not accessible and those did not focus on the keywords were excluded.</p><p><b>RESULTS</b>ENaCs are tripolymer ion channels which are assembled from homologous α, β, and γ subunits. Crystal structure of ENaCs suggests that ENaC has a central ion-channel located in the central symmetry axis of the three subunits. ENaCs are protease sensitive channels whose iron-channel activity is regulated by the proteolytic reaction. Channel opening probability of ENaCs is regulated by proteinases, mechanical force, and shear stress. Several molecules are involved in regulation of ENaCs in bone formation, including nitride oxide synthases, voltage-sensitive calcium channels, and cyclooxygenase-2.</p><p><b>CONCLUSION</b>The pathway of ENaC involved in shear stress has an effect on stimulating osteoblasts even bone formation by estrogen interference.</p>

Functions of T lymphocytes mediated by in vitro dendritic cells of chronic HBV infection patients in different immune states: a clinical research / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the improvement of dendritic cells' (DCs) functions in chronic hepatitis B (CHB) patients by two different drugs plasma, i.e., Shen supplementing and detoxification (SSD) and Pi invigorating and detoxification (PID), thus comparing which method was more effective to activate DCs to improve T lymphocyte functions.</p><p><b>METHODS</b>Totally 30 CHB outpatients were recruited. They were assigned to the immune tolerant group and the immune clearance group, 15 in each group. Totally 60 mL peripheral blood was extracted to isolate and develop mature DCs. Chinese compound containing (Liuwei Ganlu Syrup for SSD) and (Sijun Ganlu Syrup for PID) plasma were added to promote the maturation of DCs on the 7th day. Besides, non-drug plasma was taken as the control. On the ninth day, HBV core 18-27 loaded core peptide and its own T lymphocyte were co-cultivated for 72 h. Then T lymphocytes were collected. The expression levels of CD3, CD28, CD4, and CD8, programmed death-1 (PD-1) were detected using flow cytometry.</p><p><b>RESULTS</b>Compared with non-drug plasma, the expression levels of CD3, CD4, and CD28 could be improved, and the expression levels of CD8 and PD-1 could be reduced by the two methods, showing statistical difference (P < 0.05). Besides, SSD containing plasma showed better effect in improving the molecular CD28 expression rate, and reducing the molecular PD-1 expression rate on the T cell surface, showing statistical difference when compared with that of PID containing plasma (P < 0.05).</p><p><b>CONCLUSIONS</b>In vitro intervention of DCs by SSD and PID containing plasmas combined co-cultivation of its own T lymphocytes could promote the activation of DCs to improve the function of T cells and the expression of T cell surface molecules. Besides, SSD showed more significant effect on infection immune of HBV patients in the tolerance stage.</p>

Auxiliary treatment of HBV correlated hepatic failure by Chinese herbs: a systematic review of randomized controlled trials / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To evaluate the effectiveness and safety of Chinese herbs as an adjuvant treatment for hepatitis virus B (HBV)-related hepatic failure.</p><p><b>METHODS</b>Data were retrieved through the Cochrane Hepato-Biliary Group Controlled Trials Register, The Cochrane Library, PubMed, CNKI, VIP, Wanfang Database, and ChiCTR by key words or free words such as hepatic failure, severe hepatitis, HBV, Chinese medicine, randomization, and control. Appendix references of related papers were taken as supplementary indices. According to requirement for Cochrane systematic evaluation, randomized clinical trials on assessing the effectiveness and safety of Chinese herbs as main or adjuvant treatment in treating HBV-related hepatic failure were methodologically assessed, data extracted and analyzed.</p><p><b>RESULTS</b>Totally 21 trials on Chinese herbal medicine therapy versus standard medical therapy (involving 1 881 patients) were included. Most trials had unclear risk bias. In 5 studies on the mortality, 3 trials showed that the mortality was lower in the test group than in the control group [RR 0.40, 95% CI (0.20, 0.79), P = 0.0002]. In 6 randomized control trials, totally 20 papers reported the control of complications. Eight results showed Chinese herbal medicine therapy had better effect in controlling complications. The recurrence rate and assessment of the survival quality were reported. Considering secondary indicators, four trials showed Chinese herbal medicine therapy had better effect in lowering the ineffective rate, decreasing total bilirubin (TBIL), and elevating prothrombin activity (PTA). Other prescriptive analyses found that the overall effect on secondary indicators was better in the test group than in the control group, but not all the indicators were statistically different. Adverse reactions were only reported in two papers, showing no severe adverse reaction.</p><p><b>CONCLUSION</b>According to present evidence, till now, we could not judge whether Chinese herbs, as an adjuvant treatment, could do any favor for lowering the incidence and recurrence of hepatic failure patients, and improving their survival qualities.</p>

Medium Optimization for Antitumor Agent Mycoepoxydiene by Marine Lignicolous Fungi Diaporthe sp / 微生物学通报

Mycoepoxydiene is a novel antitumor agent extracted from marine lignicolous fungi HLY-2, which is Diaporthe phaseolorum by molecule identification. The medium optimization for mycoepoxydiene by orthogonal design and the comparison of submerged fermentation and solid state fermentation were studied. The rusult is that the maximal yield of the compound is 543mg/L, which is 43 times compared to the customary half-seawater PD medium and 15 times to the best submerged condition. This optimum culture medium included potato 250g/L, seawater 300mL/L, glucose 30g/L, lactose 50g/L, KH_ 2 PO_ 4 0.65mmol/L and (NH_ 4 )_ 2 SO_ 4 1g/L in the solid state condition. Differentiation analysis between submerged and solid state fermentation, and antitumor activity of these ferment products were also studied. The antitumor activity of products of the optimum medium approached the pure compound.

A CYTOCHEMICAL STUDY OF B CELLS IN GERMINAL CENTER OF HUMAN LYMPH NODE AND TONSIL / 解剖学报

Several specific monoclonal antibodies for B, T and natural killer (NK) cell were used to investigate the B cell localization and the expression of their phe- notype in lymphoid nodules on frozen and paraffin sections of human tonsil and lymph node by means of an immunocytochemical ABC technic. The results indi- cate that monoclonal antibodies reactive with germinal centers in tonsil and ly- mph node gave a simlar results and the results indicate that transformation and germination of germinal center cells involve phenotype changs but except T-200. For example, in the lower zone of germinal center, the lymphoblasts are weakly stained for IgM andLN-2 antibodies, but not for OKB-2 and BA-1, while in th upper zone the centrocytes are intense staining for IgM, LN-2, OKB-2 and BA-1 antibodies arelight or moderate staining separately Further charaterization of B cells in upperzone is frenquently observed clcavages on their nuclear memb- rane. In the mantle zone, the lymphocytes are strongly reacted with OKB-2 and BA-1, middle staining for LN-2 and light staining for sIgM. Plasma cell is only reactive with T-200 and IgM antibodies.