Noise reduction in low-dose computed tomography with noise equivalent image and deep learning / 中华放射医学与防护杂志

Objective:To investigate the method of simulating low-dose CT (LDCT) images using routine dose level scanning mode to generate LDCT images with correspondence to the routine dose CT (RDCT) images in the training sets for deep learning model, which would be used for LDCT noise reduction.Methods:The CT images reconstructed by different algorithms in Philips CT Big Core had different noise levels, where the noise was larger with iDose 4 algorithm and lower with IMR(knowledge-based iterative model reconstruction)algorithm. A new method of replacing LDCT image with noise equivalent reconstructed image was proposed. The uniform module of CTP712 was scanned with the exposure of 250 mAs for RDCT, 35 mAs for LDCT. The images were reconstructed using IMR algorithm for LDCT images and iDose 4 algorithm at multiple noise reduction levels for RDCT images, respectively. The noise distribution of each image set was analyzed to find the noise equivalent images of LDCT. Then, RDCT images, those selected images were used for training cycle-consistent adversarial networks (CycleGAN)model, and the noise reduction ability of the proposed method on real LDCT images of phantom was tested. Results:The RDCT images generated with iDose 4 level 1 could substitute the LDCT images reconstructed with IMR algorithm. The radiation dose was reduced by 86% in low dose scanning. Using CycleGAN model, the noise reduction degree was 45% for uniform module, and 50%, 13%, 7% for CIRS-SBRT 038 phantom in the specific regions of brain, spinal cord, bone, respectively. Conclusions:Equivalent noise level reconstructed images could potentially serve as the alternative of LDCT images for deep learning network training to avoid additional radiation dose. The generated CT images had substantially reduced noise relative to that of LDCT.

Artificial dermis combined with KCI negative pressure suction device in repair of skull exposure after scalp malignant tumor surgery / 中华医学美学美容杂志

Objective:To investigate the effect of artificial dermis combined with KCI negative pressure suction device in the repair of scalp defect with skull exposure after the operation of scalp malignancy.Methods:From January 2016 to June 2018, 18 patients with scalp defect and skull exposure after scalp malignant tumor surgery were treated with artificial dermis combined with KCI negative pressure suction device.Results:Eighten patients had good wound healing after the first stage of surgery, and no infection occurred. The time for artificial dermis to complete granulation was 10-14 days, with an average of 12.1 days. After the second stage of skin grafting, the skin graft had a survival rate of 100%, with uniform color and good elasticity, without obvious scar hyperplasia or contracture. The postoperative follow-up period was 6 to 2 months, all the patients healed well without tumor recurrence, with good skin elasticity and friction-resistant, and they were satisfied.Conclusions:Artificial dermis combined with KCI negative pressure suction device is an effective and simple method to repair the scalp defect with skull exposure after tumor surgery.

Application of visual feedback coaching bar in deep inspiration breath holding during left breast cancer radiotherapy / 中华放射肿瘤学杂志

Objective:To evaluate the application of visual feedback coaching method, which is embedded in an optical surface monitoring system, in deep inspiration breath holding during the radiotherapy in left breast cancer patients after breast-conserving surgery.Methods:Thirty patients with left breast cancer, who were scheduled to receive the whole breast radiotherapy after breast-conserving surgery, met the requirements of deep inspiration breath holding after respiratory coaching with the visual feedback coaching module in the optical surface monitoring system. Active breathing control equipment was used to control breath-holding state and CT simulation was performed. During treatment, optical surface monitoring system was used to guide radiotherapy. All patients were randomly divided into two groups. In group A ( n=15), visual feedback respiratory training method was utilized and not employed in group B ( n=15). In group A, the visual feedback coaching bar of the optical surface monitoring system was implemented, while audio interactive method was employed to guide patients to hold their breath. Real-time data of optical body surface monitoring were used to compare the interfraction reproducibility and intrafraction stability of breath holding fraction between two groups. Besides, the number of breath holding and treatment time per fraction were also compared. GraphPad prism 6.0 software was used for data processing and mapping, and SPSS 21.0 software was used for analyzing mean value and normality testing. Results:Compared with the control group, the reproducibility in the experiment group was reduced from 1.5 mm to 0.7 mm, the stability was reduced from 1.1 mm to 0.8 mm, the mean number of breath holding required per fraction was decreased from 4.6 to 2.4, the mean beam-on time per fraction from 336 s to 235 s, and the treatment time per fraction was shortened from 847 s to 602 s (all P<0.05), respectively. Conclusions:The application of visual feedback coaching method can improve the reproducibility and stability of breath holding during radiotherapy for left breast cancer, and it can also effectively reduce the number of breath holding and shorten the treatment time per fraction.

Advances of optimized neoadjuvant therapy in the treatment of locally advanced rectal cancer / 中华胃肠外科杂志

Neoadjuvant chemoradiotherapy is the current standard of care for locally advanced rectal cancer. However, this modality is facing more and more challenges. The research progress on this issue around the world can be summarized into three aspects. The first is to increase the intensity of treatment to obtain better tumor regression, such as adding a second drug during the neoadjuvant chemoradiotherapy, prolonging the interval and receiving sufficient chemotherapy before surgery. Current research data are not sufficient to support strategies for adding drugs or receiving sufficient chemotherapy before surgery, but it may be worth looking forward to adding irinotecan during neoadjuvant chemoradiotherapy, and an appropriate extension of the interval before surgery may also be a good option. Secondly, we can reduce the intensity of treatment to improve the quality of life of patients with a non-inferior clinical outcome, such as non-surgical approach, local excision rather than total mesorectal excision and removal of preoperative radiotherapy. The data of the International Watch & Wait Database (IWWD) suggest that patients with a Watch & Wait strategy have similar long-term survival outcomes as those who have undergone surgery and have pathologic complete response, meanwhile the data are still inadequate to support using local excision instead of total mesorectal excision, or removal of preoperative radiotherapy strategies. Finally, to achieve a precise individual treatment, some potential biomarkers are investigated via genomics, metabolomics and radiomics. But so far, there is no recognized biomarker for clinical treatment in the field of neoadjuvant therapy for rectal cancer. This article summarizes the clinical research progress of locally advanced rectal cancer in recent years from the above three aspects.

Fudan experience of neoadjuvant treatment for rectal cancer / 中华胃肠外科杂志

Neoadjuvant chemoradiotherapy is the standard treatment for locally advanced rectal cancer. Fudan University Shanghai Cancer Center has carried out multiple series of studies to explore the optimization of the neoadjuvant therapy since 2005. On the one hand, the "addition" method refers to a higher intensity treatment at the neoadjuvant stage to obtain better tumor regression. On the other hand, the "subtraction" method reduces some unnecessary treatment from the current triad of surgery, radiotherapy and chemotherapy to improve the quality of life of patients. However, locally advanced rectal cancer is associated with great heterogeneity, and therefore, any single treatment mode will not be optimal for all. Notably, the treatment decision-making should be based on clinical presentations, imaging findings, and molecular biology to precisely stratify patients. Besides, the scheme should be dynamically adjusted according to the therapeutic response, so as to realize the dual goals of prolonging patients′ life and improving their quality of life. Meanwhile, the treatment decision-making for target population under the guidance of biomarker should be dynamically and self-adaptively adjusted based on the therapeutic effect. This approach will become the future development direction and objective for the precise medical treatment for rectal cancer.

Effect of inhibitor of differentiation 1 deficiency on ocular neovascularization / 上海交通大学学报（医学版）

Objective · To study the effect of inhibitor of differentiation 1 (ID1) on ocular neovascularization. Methods · The oxygen-induced retinal neovascularization (OIR), laser-induced choroidal neovascularization (CNV) and over-expression of vascular endothelial growth factor (VEGF) (Rho-VEGF) transgenic mice were established. The localization and mRNA level of ID1 in retina of OIR mice and Rho-VEGF transgenic mice were determined by immunofluorescence staining and quantitative real-time PCR. Mice deficient in ID1 (ID1-/-) were used to induce retinal neovascularization in accordance with the above three models, and to compare the changes of ID1 on the number of retinal, subretinal and choroidal neovascularization areas. In order to explore the role ID1 in neovascularization, the numbers and areas of retinal, subretinal and choroidal neovascularization in the mice models with or without ID1 deficiency were compared. Its effect on the related factors, i.e. hypoxia-inducible factor-1α (HIF-1α), VEGF and vascular endothelial growth factor receptor 1/2 (VEGFR1/2) were also observed. Results · Mice deficient in ID1 showed a significant reduction in the area of neovascularization in these three models (P＜0.05). Mice lacking ID1 showed reduced levels of HIF-1α, VEGF and VEGFR 1. Conclusion · ID1 promotes the expression of HIF-1α, VEGF and VEGFR1 in the retina and choroidal neovascularization during hypoxia and oxidative injury.

Clinical analysis of the correlation between transverse sinus drainage dominance and aneurysm formation and rupture / 中国神经精神疾病杂志

To investigate the clinical correlation between transverse sinus classification and variation and aneurysm formation and rupture and to determine the risk factors of intracranial aneurysm rupture. Methods A retrospective data analysis was conducted on a total of 345 cases of intracranial aneurysms from January to December 2018. Clinical characteristics were compared between ruptured aneurysm group (RAG, n=230) and unruptured aneurysms group (URAG, n=115). Logistic regression analysis was performed to analyze the anatomy of venous sinus and clinical features including smoking history, hypertension, diabetes, location and size of the aneurysm in patients with intracranial aneurysm rupture. Results There were significant differences in had statistical significance with the patients' drinking history, smoking history, hypertension, diabetes, location and size of the aneurysm, as well as the dominant venous sinus on the same side as the aneurysm between rupture of intracranial aneurysm group and unruptured aneurysms group (P＜0.05). Multivariate logistic regression analysis suggested that diabetes (OR=10.567), anterior communication (OR=2.214), posterior communication (OR=2.932), small aneurysms (OR=3.841), dominant venous sinus on the same side as the aneurysm (OR=1.736) were independent risk factors for rupture of the unruptured aneurysm. In addition, the dominant side of transverse sinus were more likely to form intracranial aneurysms (P＜0.001). Conclusion The predisposing factors for rupture of intracranial aneurysms are anterior communication, posterior communication, small aneurysms and dominant lateral venous sinuses on the same side as aneurysms. Ipsilateral aneurysms are more likely to form in patients with dominant venous sinuses and can be used to accurately predict aneurysm rupture.

Killing effect of CIK cells combined with Gemcitabine on QBC939 cells / 中国现代普通外科进展

Objective:To investigate the anti-tumor effects of cytokine-induced kill cells(CIK)methods combined with chemotherapeuticdrug Gemcitabine against Cholangiocarcinoma cancer cell lines QBC-939.Methods:Peripheral blood mononuclear cells(PBMC) of healthy people were stimulated by different cytokines,and were induced into CIK cells.CIK cells were cultured for 14 days as effector cells.The phenotype of CIK cells were analyzed by flow cytometer.QBC939 cells were cultured with the CIK cells at different effector-target ratio or various concentrations of Gemcitabine for 24 and 48 hours.The antitumor effects were measured by CCK8 methods.The expression of Bax was detected by using Western blot.Results:The CD3+CD4+,CD3+CD8+,CD3+HLA-DR+,CD3+CD56+,CD4+CD25+ double positive cel1 was up to 10.89％,60.27％,71.82％,9.03％ and 4.01％ after 14 days' cultivation.The killing effect of CIK and Gemcitabine increased with the increase of effector-target ratio and drug concentration or the extension of time.The killing effect of combination of CIK and Gemcitabine was obviously higher than that of each single factor.The protein levels detected hints of CIK cells and gemcitabine can up-regulated the expression of Bax,and the joint action of both is more significant.Conclusions:CIK cells have strong anti-tumor effect against QBC939 cells by inducing apoptosis of QBC939 cells,and it can enhance the anti-tumor effects of Gemcitabine against QBC939 cells when CIK and Gemcitabine are combined together.

Application of laparoscopic simulators in the teaching of breast augmentation with endoscope assis-tant / 中华医学教育探索杂志

Objective To explore the effects of application of laparoscopic simulators in teaching of plastic surgery. Methods 10 plastic surgeons and 20 standardized training surgical residents with 2 to 4 years' experience were tested about their proficiency in moving beans, pinching, suturing and tying by timing and counting. After they were trained with laparoscopic simulators 3, 6, 9 times with each time for 90 min, tests were taken. SPSS 19.0 was used to make single factor variance analysis of the related data or conduct q test. Result There was significant difference before and after the residents' training of moving beans, pinching, suturing and tying (P0.05). Conclusion Application of laparoscopic simulator training can significantly improve the operation skills of the novices with some clinical experience in the short term, which is conducive to the endoscope assisted breast augmentation surgery, and is worthy of promotion.

Construction of Traditional Chinese Medicine preventive health care service system in Changning District / 上海预防医学

Under the guidance of State Administration of Traditional Chinese Medicine, Shanghai Municipal Commission of Health and Family Planning and Shanghai Municipal Office for Development of Traditional Chinese Medicine, Traditional Chinese Medicine( TCM) preventive health care service system was started to construct in 2011 in Changning District of Shanghai.The system was residents'needs orien-ted.After five years of effort, TCM preventive health care service system characterized with integration of prevention and treatment, multicultural atmosphere, supported by TCM featured services was formed.The new model of community health management provided a positive and beneficial practice for the Healthy City construction with Chinese and Shanghai characteristics.

The accuracy of Computed Tomography Angiography (CTA) in diagnosis of multiple intracranial aneurysms / 中国神经精神疾病杂志

Objective The purpose of this study is to explore the clinical value of CT angiography( CTA) in the diagnosis of multiple intracranial aneurysms.Methods The data of CTA and DSA from 74 patients with multiple intracra-nial aneurysms from July 2011 to March 2015 were reviewed retrospectively.Results One hundred seventy-seven aneu-rysms were detected by DSA, and 175 aneurysms were detected by CTA.Among the aneurysms identified by CTA, 4 aneu-rysms were false positive and the correct detection rate of CTA was 96.6%.One hundred sixty-five aneurysms identified by CTA were confirmed by DSA and the correct diagnostic rate of CTA was 96.5%.CTA failed to detect 6 aneurysms and mis-diagnosed 10 aneurysms.Conclusions The correct detection rate and diagnostic rate of CT angiography ( CTA) in multiple intracranial aneurysms is relatively high.But previous surgery, spasm of the vessels, the size and number of aneurysms, radiologists'experience can influence the accuracy of ( CTA) in the diagnosis of multiple intracranial aneurysms, indicating that we should combine CTA with DSA to avoid the misdiagnosis and missed diagnosis.

Establishment of risk prediction model and risk score for in-hospital mortality after adult rheumatic heart valve surgery / 中华胸心血管外科杂志

Objective To establish a surgical risk prediction model for in-hospital mortality of adult rheumatic heart disease.Methods The study sample comprised of 3 889 patients with adult (is, or older than 18 years) rheumatic heart valve surgery only.All patients were divided into three subgroups according to the surgery site of left atrioventricular valve: mitral valve surgery group;aortic valve surgery group;and mitral and aortic valve surgery group.The data was splited into development(60％) and validation(40％) data sets, and then the risk model was developed by using a logistic regression model according to the data in development data set.Model calibration was analyzed by Hosmer-Lemeshow goodness-of-fit statistic, and model discrimination was tested by calculating the area under the receiver operating characteristic(ROC) curve.Risk score was finally set up according to the coefficient β and rank of variables in logistic regression model.Results The general in-hospital mortality of the whole group is 4.2％ (165/3 889).We established a risk prediction model and found seven risk factors: heart function in NYHA functional class ≥ Ⅱ grade (OR =3.36, 95％ CI: 2.42-4.67) , preoperative creatinine ＞ 110 mmoL/L (OR =2.69, 95％ CI: 1.51-4.79) , history of previous chest pain(OR =2.33, 95％ CI: 1.07-5.11) , surgical status(OR =2.32, 95 ％ CI: 0.94-5.73) , previous history of hypertension (OR =2.24, 95 ％ CI: 1.19-4.23), preoperative critical state (OR =2.14, 95％ CI: 1.27-3.60) and age ＞ 50 years (OR =1.57, 95 ％ CI: 1.18-2.09).Our risk model showed good calibration and discriminative power for the development data set, validation data set, and three subgroup in which Hosmer-Leme-show test' s P value were greater than 0.05 and the area under the ROC curve were greater than 0.70.Scoring methods: age 51-60years: 1 point, age 61-70 yeas: 2 points, age ＞70 years: 3 points;history of hypertension: 1 point;creatinine ＞ 110 umol/L: 4 points;NYHA class stage Ⅱ : 2 points, NYHA class stage Ⅲ: 4 points;NYHA class stage Ⅳ: 6 points;history of previous chest pain: 1point;preoperative critical condition: 2 points;urgent surgery: 2 points: emergency surgery: 4 points.Conclusion We have created a new risk prediction model and risk score, which can accurately predicts outcomes in patients undergoing heart valve surgery for our center.Furthermore, our risk model can also enable benchmarking and comparisons between multicenter in a meaningful way in the future.

Construction of“Platform for Regional Traditional Chinese Medicine Preventive Healthcare Service”under the Linkage between Medical Institutions and Social Healthcare Institutions ;in Changning District of Shanghai / 中国中医药信息杂志

As the first national“preventive treatment of disease”preventive healthcare service pilot, Changning District in Shanghai has carried out the construction of TCM preventive healthcare service platform under the guidance of district leaders from 2009. By introducing the construction process and implementation key points of the pilot linkage patten of medical institution and social healthcare institutions in Changning District, this article put forward the construction ideas of “Platform for Regional Traditional Chinese Medicine Preventive Healthcare Service”, and further proposed challenges and opportunities for deepening reforms.

Prognostic value and sensitivity to chemotherapy of microsatellite instability in advanced colorectal cancer / 中国癌症杂志

Background and purpose:Microsatellite instability (MSI) status is commonly applied to predict the prognosis and chemosensitivity in stage Ⅱ and stage Ⅲ colorectal cancer patients. However, researches of its function on metastasis colorectal cancer are limited. This study investigated its value on prognosis and chemosensitivity in metastatic colorectal cancer (CRC) patients.Methods:We retrospectively investigated tumor tissues from metastasis CRC patients who were treated with oxaliplatin and 5-FU-based therapy regimens (FOLFOX and XELOX). Immunostaining of proteins of the mismatch repair genehMLH1,hMSH2,hMSH6 andhPMS2 was performed. Prognostic value and chemosensitivity in patients with MSI status were also determined.Results:Clinical features from 113 patients were analyzed. No cor-relation of overall survival (OS) and chemosensitivity with MSI status was found. We further investigated 79 patients with synchronous metastasis and palliatively tumor resection. Median progression free survival (PFS) from 22 MSI patients was significant longer than that in 57 MSS patients (19.9 monthsvs 7 months,P=0.005). No significant difference was seen in OS comparison (P=0.07). MSI status was also an independent prognostic factors of PFS by Cox multivariate analysis (MSS/MSI,HR=2.079,P=0.043). Moreover, in this group, MSI patients had improved disease control rate (59.1%vs 31.6%, P=0.025) in chemosensitivity analysis than MSS patients.Conclusion:A better PFS in MSI patients with synchronous metastasis and palliative tumor resection was found after treated with oxaliplatin and 5-FU-based therapy and a better chemosensitivity in MSI patients was also found.

Effects of quickening blood and beautifying skin decoction on female's qi-stagnation and blood-stasis constitution / 中华医学美学美容杂志

Objective To expolre the clinical effects of quickening blood and beautifying skin decoction on 20-50-year-old females with physical constitution of qi-stagnation and blood stasis.Methods According to the 2010 enactment of the Chinese Medical Association's Classification and Assessment of Chinese Constitution the standard identification of the physical object and physical scale iden tification,55 cases of 20 50 years old of Qi-stagnation and blood-stasis constitutions were collected and quickening blood and beautifying skin decoction treatment was given.25 g of the decoction were administrated each time,2 times a day,for 2 months.After that,the identification of physical constitution fitness was conducted,to find if this kind of beauty-keeping decoction could improves women's physical constitutions and some beauty-harm related physical symptoms.Results After taking the herbal decoction before and after treatment,the quality of Qi-stangnation and blood-stasis constitutions and factor of the beauty-harmful relevant symptoms were statistically significant differences (P＜0.005).The total score of Qi-stangnation and blood-stasis constitutions and beauty-harm relevant symptoms showed that the total effective rate reached 61.82％.Conclusions The result indicates this quickening blood and beautifying skin decoction has a certain effect in improving the quality of qistangnation and blood-stasis situation and treating the beauty-harm relevant symptoms.The traditional Chinese medicine decoction has a certain effect on improving physical constitution which is abnormal.

Effect of Curcumin on Cholesterol Metabolism of Nonalcoholic Fatty Liver Disease Cells / 浙江中医药大学学报

[Objective]To study the effect of curcumin on the cholesterol metabolism of nonalcoholic fatty liver disease(NAFLD) cells model induced in vitro and its potential mechanism. [ Methods]The cellmodel of nonalcoholic fatty liver disease(NAFLD) was established by oleic acid and treated with curcumin. The method of oil red O staining was used to observe accumulation of intracellular lipid while the intracellular content of TG, FC and TC was detected by enzymatic method. Meanwhile, the mRNA levels of SR-BΙand HMGCR were detected with qPCR.[ Results] The NAFLD cellmodel was successful y established by culturing with 30 μg·mL-1 oleic acid. After curcumin intervention, TG, FC and intracellular lipid accumulation levels were significantly reduced in NAFLD cellmodel. Meanwhile, curcumin can reduce HMGCR mRNA expression and raise SR-BΙ mRNA expression. [Conclusion] Curcumin can decrease FC level in NAFLD cellmodel and the mechanism might be related with its capacity of restraining endogenous cholesterol biosynthesis and promoting foreign cholesterol transfer into the liver cells for metabolism.

Electroacupuncture at Feishu (BL13) and Zusanli (ST36) down-regulates the expression of orexins and their receptors in rats with chronic obstructive pulmonary disease / 中西医结合学报

Inflammation and lung function decline are the main pathophysiological features of chronic obstructive pulmonary disease (COPD). Acupuncture can improve lung function in patients with COPD, but the underlying mechanisms are not well understood. Orexins (OXs), which are found in peripheral plasma, are neuropeptides that regulate respiration and their levels are related to COPD. Therefore, we hypothesized that acupuncture might alter OXs, reduce lung inflammation and improve lung function in COPD.

Plastic surgery treatment of recurrent scalp dermatofibrosarcoma protuberans / 中华医学美学美容杂志

Objective To explore the surgical procedures and effects for recurrent scalp dermatofibrosarcoma protuberans (DFSP).Methods Retrospective review was conducted in 7 scalp recurrent DFSP cases in the past 3 years.Intraoperative frozen section analysis of surgical margins was performed.Wide local excision with margins of 3 cm or more was applied,and excision of the skull external lamina or the entire layer of the cranial bones was performed once the skulls under the tumors were invaded.Frozen section analysis was again performed on all the margins.Secondary wound was repaired with local skin flap or fascial pedicled flaps.Surgically removed tumor was paraffin-embedded for HE-staining and immunohistochemical analysis.Results All of 7 tumor specimens were proved recurrent DFSP with histologic findings of intraoperation or postoperation.7 patients were all performed with wide local excision with margins of 3 cm or more,also with skull excision (5 cases with excision of skull external lamina and 2 cases with excision of the entire layer of skull).Negative margins were confirmed with intraoperative frozen sections or postoperative paraffin-embedded sections analysis were confirmed.Immunohistochemical analysis demonstrated that Ki-67 was all positive and CD34 was partially positive in 7 cases.No tumor recurrence or metastasis had been observed in any of our patients after a median follow-up duration of 17 months (range 15-41).Conclusions Wide local excision together with the skull invaded by tumors completely is effective surgical treatments for recurrent scalp DFSP; Use of scalp transferring technique could improve wound repair after complete tumor excision.

Effect of ligustrazine on reverse cholesterol transport in foam cells / 中国中药杂志

<p><b>OBJECTIVE</b>To discuss the intervention effect of ligustrazine on ox-LDL-induced foam cells from the perspective of reverse cholesterol transport.</p><p><b>METHOD</b>RAW264.7 cultured in vitro was induced with 20 mg x L(-1) ox-LDL to establish the foam cell model, and intervened with ligustrazine. The lipid accumulation in cells was observed by the oil red O dyeing. The changes in total cholesterol and cholesterol ester in the cells were detected with the colorimetric method. The fluorescent quantitative PCR and Western blot were used to detect the mRNA expressions of PPARgamma, LXRalpha and ABCA1.</p><p><b>RESULT</b>Ligustrazine could reduce total cholesterol and cholesterol ester in foam cells, inhibit the lipid accumulation, and increase the mRNA and protein expressions of PPARgamma, LXRalpha and ABCA1.</p><p><b>CONCLUSION</b>Ligustrazine can promote the reverse cholesterol transport by increasing the gene expressions of PPARgamma, LXRalpha and ABCA1.</p>

Electroacupuncture at Feishu (BL13) and Zusanli (ST36) down-regulates the expression of orexins and their receptors in rats with chronic obstructive pulmonary disease / 中西医结合学报

<p><b>OBJECTIVE</b>Inflammation and lung function decline are the main pathophysiological features of chronic obstructive pulmonary disease (COPD). Acupuncture can improve lung function in patients with COPD, but the underlying mechanisms are not well understood. Orexins (OXs), which are found in peripheral plasma, are neuropeptides that regulate respiration and their levels are related to COPD. Therefore, we hypothesized that acupuncture might alter OXs, reduce lung inflammation and improve lung function in COPD.</p><p><b>METHODS</b>COPD was induced in rats by exposure to cigarette smoke for 8 weeks and injecting with lipopolysaccharide twice. Electroacupuncture (EA) was performed at Feishu (BL13) and Zusanli (ST36) for 30 min/d for 2 weeks. Rat lung function and morphology were assessed after EA. The levels of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) in bronchoalveolar lavage fluid (BALF) and orexin A and B levels in the lung tissue were detected by enzyme-linked immunosorbent assay. OX receptor mRNA levels and immunopositive cells were assessed with real-time polymerase chain reaction and immunohistochemical methods, respectively. The relationships among lung function, cell factors, and OX levels were analyzed by Pearson correlation analyses.</p><p><b>RESULTS</b>Compared with the control group, lung function was significantly decreased in the rats with COPD (P<0.05). There were increases in TNF-α and IL-1β levels in BALF (P<0.05 and P<0.01, respectively), orexin A level in lung tissue (P<0.01; but not orexin B) and mRNA expressions of OX (OXR1) and OX 2 (OXR2) in lung tissue (P<0.05 and P<0.01, respectively); the integrative optical densities (IODs) of both receptors were greater in the COPD group (P<0.05). For rats with COPD subjected to EA, lung function was improved (P<0.05). There were notable decreases in TNF-α and IL-1β levels (P<0.05 and <0.01, respectively) in BALF. Orexin A, but not orexinB, levels in lung tissue also decreased (P<0.01), as did mRNA expression of OX1R and OX2R in lung tissue (P<0.05 and P<0.01, respectively). Receptor IODs were also reduced after EA treatment (P<0.05). Furthermore, orexin A levels and ratio of forced expiratory volume in 0.3 s to forced vital capacity were strongly negatively correlated (P<0.01), and orexin A was positively correlated with TNF-α and IL-1β (P<0.001 and P<0.05, respectively).</p><p><b>CONCLUSION</b>EA at Zusanli and Feishu improved lung function of rats with COPD and had an anti-inflammatory effect, which may be related to down-regulation of OXA and its receptors.</p>