Effect and Mechanism of Total Saponins from Panax Japonicus on White Adipose Tissue Browning/Brown Adipose Tissue Activation in High-fat Diet-induced Mice / 中国实验方剂学杂志

ObjectiveTo investigate the effect and mechanism of total saponins from Panax japonicus （TSPJ） on white adipose tissue （WAT） browning/brown adipose tissue （BAT） activation in C57BL6/J male mice fed on a high-fat diet （HFD）. MethodThirty-two C57BL6/J male mice （8-week-old） were randomly divided into a normal group， a model group， a low-dose TSPJ group， and a high-dose TSPJ group. The mice in the low-dose and high-dose TSPJ groups were given TSPJ for four months by gavage at 25， 75 mg·kg-1·d-1， respectively， and those in the other groups were given 0.5% sodium carboxymethyl cellulose （CMC-Na） accordingly. After four months of feeding， all mice were placed at 4 ℃ for acute cold exposure， and the core body temperature was monitored. Subsequently， all mice were sacrificed， and BAT and inguinal WAT （iWAT） were separated rapidly to detect the corresponding indexes. Hematoxylin-eosin （HE） staining was used to observe the morphological changes in each group. The effect of TSPJ on the mRNA expression of uncoupling protein 1 （UCP1）， fatty acid-binding protein 4 （FABP4）， cytochrome C （CytC）， PR domain-containing protein 16 （PRDM16）， elongation of very long chain fatty acids protein 3 （ELOVL3）， peroxisome proliferator-activated receptor γ （PPARγ）， and peroxisome proliferator-activated receptor-γ coactivator-1α （PGC-1α） in iWAT and BAT was detected by Real-time polymerase chain reaction （Real-time PCR）. Western blot was also used to detect the protein expression of UCP1， PRDM16， PPARγ， and PGC-1α in BAT and iWAT of each group. The effect of TSPJ on UCP1 expression in BAT and iWAT was detected by immunohistochemistry. Result① Compared with the model group， TSPJ could decrease the body weight and proportions of iWAT and BAT in the HFD-induced mice （P<0.05， P<0.01）. ② The body temperature of mice in the model group decreased compared with that in the normal group in the acute cold exposure tolerance test （P<0.05）. The body temperature in the high-dose TSPJ group increased compared with that in the model group （P<0.01）. ③ Compared with the normal group， the model group showed increased adipocyte diameter in iWAT and BAT and decreased number of adipocytes per unit area. Compared with the model group， the TSPJ groups showed significantly reduced cell diameter and increased number of cells per unit area， especially in the high-dose TSPJ group. ④ Compared with the normal group， the model group showed decreased mRNA expression of FABP4， UCP1， CytC， PRDM16， ELOVL3， PGC-1α， and PPARγ in adipose tissues of mice （P<0.05， P<0.01）. Compared with the model group， after intervention with TSPJ， the mRNA expression was significantly up-regulated （P<0.05， P<0.01）. ⑤ Compared with the normal group， the model group showed decreased protein expression of UCP1， PRDM16， PPARγ， and PGC-1α in adipose tissues of mice （P<0.05， P<0.01）. Compared with the model group， after intervention with TSPJ， the protein expression increased significantly （P<0.05， P<0.01）. ConclusionTSPJ could induce the browning of iWAT/BAT activation and enhance adaptive thermogenesis in obese mice induced by HFD. The underlying mechanism may be attributed to the activation of the PPARγ/PGC-1α signaling pathway.

Research Ideas and Methods for Standardization of Traditional Chinese Medicine Syndrome Differentiation / 中医杂志

Syndrome differentiation and treatment is a unique mode of diagnosis in traditional Chinese medicine （TCM）. The establishment of scientific and standardized syndrome diagnosis standards is an important link to evaluate the clinical efficacy of TCM objectively and systematically， and also a prerequisite for the promotion and development of TCM to obtain international recognition. This article reviewed the basic modes and existed problems of the current syndrome diagnosis criteria， and proposed to construct a multidimensional core information set integrating the minimized core symptoms， the artificial intelligence signs， the multi-modal laboratory indicators， and multi-omics specific markers， so as to present syndrome characteristics from multiple perspectives systematically. This paper also described the basic mode， constructure， as well as the process and methodology to be adopted in the establishment of the standardized diagnostic research method. The core information set of diagnostic symptoms not only took into account the specificity of the disease， but also improved the inconsistency due to the complexity and subjectivity of the syndrome differentiation， thereby providing a methodological basis for the standardization of TCM syndrome differentiation in clinical research.

Research progress on neoadjuvant chemoradiotherapy combined with immunotherapy in locally advanced rectal cancer / 中华放射肿瘤学杂志

For locally advanced (T 3-4/N +M 0) rectal cancer (LARC), neoadjuvant chemoradiotherapy (nCRT) followed by total mesorectal excision (TME) is the standard treatment, which have been demonstrated to decrease the local recurrence rate and increase the tumor response grade. However, the distant metastasis remains an unresolved issue. Radiotherapy and immunotherapy can supplement each other and the combination of the two treatments has a good theoretical basis. Recently, multiple clinical trials are ongoing in terms of the combination of nCRT and immunotherapy in LARC. These trials have achieved promising short-term efficacy in both microsatellite instability-high (MSI-H) and microsatellite stable (MSS) rectal cancers, which could further improve the rate of tumor response and rate of pathological complete response, increase the possibility of organ preservation and "watch and wait" approach. Large-scale clinical trials need to be performed in the future to demonstrate these findings and to improve long-term prognosis.

Development and test of new software for automatic acquisition of radiodiagnostic medical procedure frequency / 中华放射医学与防护杂志

Objective:To develop and test a software which can get and count the medical exposure frequency automatically.Methods:This study was based on the investigation of the frequency of radiodiagnostic medical procedures in China over the past by reference to the experience gained from the Electronic Medical Record Sharing and Reporting System in Beijing. The core elements for collecting the number of medical procedures and radiodiagnostic categories were determined. The collection process was then designed and the collection program software was written in a way for deployment on the front-end computer system of a general hospital for trial.Results:The field table to collect the number of medical procedures and the corresponding data structure were generated, and the data collection and statistics of the above fields were realized based on the survey data of DR and CT diagnostic examination frequency in a hospital in 2021. It took 15 s on average, and the statistical result are consistent with the manual statistical result using RIS source table.Conclusions:The software can realize the automatic acquisition and reporting of the number of radiodiagnostic medical procedures in hospital on a regular basis, which is worth promoting.

Determination of lead isotope ratios by inductively coupled plasma mass spectrometry and comparison of lead isotope ratios among different samples / 环境与职业医学

background The lead isotope ratios (LIR) differ among different sourced samples. Previous domestic and oversea studies on source tracing by LIR in human blood or urine mainly focused on the comparison of blood or urine samples from the same or different individuals, while few comparisons between biological and environmental samples, and the reported relative standard deviations (RSDs) of the main LIR (207/206Pb and 208/206Pb) fluctuate widely from 0.3% to 1%. Objective To optimize inductively coupled plasma mass spectrometry (ICP-MS), obtain a better RSD, and determine LIRs of human blood, urine, and related environmental samples. Methods The ICP-MS was optimized for operating conditions and parameters according to the sensitivity and RSD of LIR. The study subjects were 40 lead-exposed workers in a lead-acid battery factory and 2 lead poisoned children in a hospital. The samples included 40 blood and 40 urine samples from the workers before shift, 4 dust samples and 2 water samples in the workplace on the same day before shift, 2 blood and 3 urine samples from the children before hospital admission due to lead-poisoning, and 4 urine samples after medical treatment. After heating and acid digestion, the LIR (207/206Pb and 208/206Pb) of biological and environmental samples were determined by the optimized ICP-MS method. t-test and two-dimensional traceability graphics were adopted to analyze the detection results. Results The calibrated RSDs of the LIR (207/206Pb and 208/206Pb) of lead isotope standard solution were 0.11% and 0.08% respectively, and the NIST-SRM-981 actual values were 0.91531±0.00097 and 2.1670±0.0017, respectively. When the total concentration of lead was greater than 5 μg·L−1, the RSD of each isotope ratio was stable gradually; when the total concentration of lead was between 10-80 μg·L−1, the RSD was below 0.20%. There were statistically significant differences in the blood and urine LIR (207/206Pb and 208/206Pb) of the lead-exposed workers (t=5.831, P<0.001; t=21.021, P<0.001), the LIR (207/206Pb and 208/206Pb) between workplace dust samples and workers’ urine samples (t=−6.879, P=0.038; t=12.521, P<0.001), and the 208/206Pb between workplace dust samples and workers’ blood samples (t=−10.46, P<0.001), except the 207/206Pb between workplace dust samples and workers’ blood samples (t=−0.12, P=0.912). In the patients afflicted with lead poisoning, the projection points of LIR of blood and urine samples from the same individual were not at the same level in the two-dimensional model, nor was the LIR of urine samples before and after medical treatment of the same individual. Conclusion The optimized ICP-MS can control the RSD of main LIR (207/206Pb and 208/206Pb) below 0.20%. There are differences in the LIR distributions of different samples.

Establishment of Fingerprint and Multivariate Statistical Analysis of Compatible Herb Pairs with Polygonum multiflorum as the Core / 中国药房

OBJECTIVE：To establish UPLC fin gerprint of 32 compatible herb pairs with Polygonum multiflorum as the core ， and to conduct multivariate statistical analysis. METHODS ：UPLC method was adopted. Using P. multiflorum and single decoction pieces of compatible herb as reference ，UPLC fingerprints of 32 compatible herb pairs of P. multiflorum were drawn. Common peaks were confirmed by relative retention time and UV absorption spectrum. Non-supervised PCA and supervised OPLS-DA were conducted by using SPSS 19.0 software and SIMCA 13.0 software. RESULTS ：There were totally 12 common peaks in UPLC fingerprints of 32 compatible herb pairs of P. multiflorum . The results of non-supervised PCA showed that the accumulative variance contribution rate of primary 6 principal components was 84.633％. The results of cluster analysis of PCA comprehensive score showed that single decoction piece of P. multiflorum ，compatible herb pairs of P. multiflorum with Lycium barbarum ，Rehmannia glutinosa，Paeonia lactiflora ，Codonopsis pilosula ，Eclipta prostrate ，Angelica sinensis ，Glycyrrhiza uralensis ，Astragalus membranaceus and Ophiopogon japonicus were clustered into one category ；others were clustered into one category. Results of supervised OPLS-DA analysis showed that eigen values of 4 principal components were 2.32，2.61，1.58 and 0.90，respectively. There were differences in the contents of 12 common components in the compatibility of P. multiflorum with tonic medicine and non-tonic medicine. The changes of the content of the components after compatibility with tonic medicine were similar. Common peak 7，4，6，3 were main reasons for the differences （variable importance projection value were all higher than 1）. CONCLUSIONS：Established fingerprint is simple in operation ，and can be combined with multivariate statistical analysis to evaluate the content changes of common components of 32 compatible herb pairs with P. multiflorum as the core.

Establishment of Checking TPN Prescription Algorithm Based on Excel vba Technology / 中国药房

OBJECTIVE： To improve the efficiency and accuracy of checking total parenteral mutrition （TPN） prescription. METHODS： Excel vba technology was used to edit vba code and construct TPN prescription algorithm. The key indicators and standard of TPN prescription checking were determined. Established algorithm was used to check the prescriptions from PIVAS of our hospital in May 2018， results of which was compared with the results of manual checking （using potassium concentration， monovalent cation concentration and alanyl-glutamine combined with amino acid as indexes）. RESULTS： TPN prescription algorithm was established through confirming 17 key indicators as glycolipid ratio， heat-nitrogen ratio， monovalent cation concentration， the checking standard was set as. It took 15 seconds to check 2 638 TPN prescriptions received within one month in PIVAS of our hospital； 449 irrational prescriptions （excessive dose， incompatibility， inappropriate proportion and volume of nutrition） of them and reasons had been marked out. By comparing 3 evaluation indexes， 1， 1， 0 irrational prescriptions were checked by manually and 4， 12， 4 checked by established algorithm， respectively. CONCLUSIONS： TPN prescription algorithm can check prescription in batches based on Excel vba technology， and mark out the substandard prescription automatically. Hereby， it improves the efficiency and accuracy of TPN prescriptions by PIVAS.

Roles of macrophages in formation and progression of intracranial aneurysms / 浙江大学学报·医学版

Studies have shown that chronic inflammatory response plays a key role in intracranial aneurysms (IA) formation and progression, and macrophages regulate the formation and progression of IA through a variety of pathways. Bone marrow monocyte-derived macrophages and resident-tissue macrophages infiltrate the vessel wall, after infiltration macrophages are polarized into various polarization phenotypes dominated by M1-like and M2-like cells. Polarized phenotypes of macrophages can regulate the formation and progression of intracranial aneurysms by releasing cytokines and regulating the inflammatory response of other immune cells, as well as release different cytokines to regulate the process of extracellular matrix remodeling. Some important progresses have been made in the clinical detection and treatment in targeting macrophages. This review provides a summary on the pathogenesis of IA and potential drug targets to prevent the formation and rupture of intracranial aneurysms.

Study on Habitat Processing Technology of Isatis tinctoria Slices / 中国药房

OBJECTIVE: To screen the habitat processing technology of Isatis tinctoria slices, and provide basis for its quality.METHODS: Appearance score, the contents of moisture, ash, extract and main component (R, S) -goitrin in I. tinctoria slices prepared by 4 kinds of dried degree [A. 60 ℃ drying after cutting; B. cutting after natural drying; C. cutting after natural drying (13-15 d), drying at 60 ℃ again; D. cutting after natural drying (30-50 d), drying at 60 ℃ again]from fresh harvested sample. RESULTS: Appearance score was in descending order with C>D>A>B; the content of moisture was in descending order with B>A>D>C. There was little difference in the content of ash among different methods. The contents of extract and (R, S)-goitrin were in descending order with C>A>B>D. CONCLUSIONS: The quality of I. tinctoria slices prepared by 4 processing technologies are different, and the quality of I. tinctoria slices prepared by cutting after natural drying (about 15 d)and drying at 60 ℃ again is relatively best.

A preliminary interview on counselor's decision making of breaking confidentiality about self-inflicted injury and suicide in college situation / 中国心理卫生杂志

Objective: To investigate the ethical decision-making process of breaking confidentiality when counselors dealing with self-inflicted injury and suicide issues in college situation. Methods: A semi-structural interview was addressed to 10 counselors from 7 college counseling centers in Beijing, among whom with (10 ± 8) years of experience on average in this field. Content analysis method was used to transcription of the interviewing data. Results: Totally 8 counselors had received ethical training more or less, and attached great importance to ethical codes. There were still some conflicts between school regulations and confidentiality rules in 7 university counseling centers. Different counselors varied greatly in decision-making on breaking confidentiality when facing college students' self-inflicted injury and suicide. Faced with conflicts between college demands and confidentiality principles, counselors could take the professional standpoint and consider more of the interests of students. Conclusion: The decision-making process on self-inflicted injury and suicide confidentiality breakthrough needs to be standardized. College's attention and support to the counseling work should be strengthen and enhance ethical awareness.

A voxel-based diffusion kurtosis imaging study of whole-brain in alcohol dependent patients / 中华放射学杂志

Objective To study the changes of micro structure of white matter and gray matter in alcohol dependent patients by using diffusion kurtosis imaging(DKI) based on the method of voxel-based analysis.Methods Thirty alcohol dependent individuals and twenty healthy control volunteers,matched in gender, age, handedness and education, were enrolled as the alcohol dependent group and control group from September 2016 to June 2017.Michigan alcoholism screening test(MAST)was done for all subjects.All the subjects underwent DKI data acquisition by MR scanning. The relevant parameters were obtained by DKE software, including fractional anisotropy(FA), mean diffusivity(MD), axial diffusivity(AD), radial diffusivity(RD), mean kurtosis(MK), axial kurtosis(AK), radial kurtosis(RK), FA of kurtosis(FAK). Independent sample t test was performed to evaluate the significant difference of DKI parameters of two groups,meanwhile,the correlation analysis was conducted in DKI parameter values of different brain regions and MAST scores. Results Compared with the healthy control group, the FA value, MK value and RK value were decreased while the RD value was increased in alcohol dependence group, and there was significant difference between the two groups respectively(P<0.001). There was no significant difference between the two groups in the other parameters (AD, MD, AK, FAK). Compared with the healthy control group,the FA values of left lingual gyrus(164 voxels,t=-5.582)and left hippocampus(38 voxels,t=-3.664) increased;the MK value of left cerebellum posterior lobe(71 voxels,t=-4.004)reduced;the RK value of left cerebellum posterior lobe(67 voxels, t=-4.174), left middle cingulum(32 voxels, t=-3.925), left superior parietal gyrus(36 voxels,t=-3.812)reduced;and the RD value of the left inferior parietal gyrus(31 voxels,t=3.731)increased in alcohol dependence group.There was no correlation between MAST score and the value of DKI parameters. Conclusions There are dominant areas of brain injury in patients with alcohol dependence. The DKI parameters can reflect the changes of the whole brain microstructure of alcohol dependent patients and provide imaging basis in the diagnosis of alcohol dependence.

The Benefits of Indirect Exposure to Trauma: The Relationships among Vicarious Posttraumatic Growth, Social Support, and Resilience in Ambulance Personnel in China

OBJECTIVE: Ambulance personnel who witness trauma experienced by patients have been reported to experience positive changes, known as vicarious posttraumatic growth (VPTG). We examined VPTG and its relationship with social support and resilience among ambulance personnel. METHODS: The sample (n=227) was recruited from six emergency centers in China. The measures included the Posttraumatic Growth Inventory (PTGI), the Social Support Rating Scale (SSRS), and the 10-item Connor-Davidson Resilience Scale (CD-RISC-10). Structure Equation Modeling (SEM) and the bootstrapping procedure were used to examine indirect effects. RESULTS: The participants' mean score for VPTG was 68.96 (SD=15.51). Social support had significant direct effects on resilience (β=0.51, p < 0.001) and VPTG (β=0.25, p=0.001), and resilience (β=0.58, p < 0.001) had a significant direct effect on VPTG. Furthermore, social support had a significant indirect effect (0.51×0.58=0.30, p < 0.001) on VPTG through resilience. CONCLUSION: Although the nature of the work of ambulance personnel is not expected to change, the negative effects of the trauma they encounter can be reduced by providing them with more support resources and interventions to foster their resilience, which in turn, promote VPTG.

Absorption Characteristics of Isoimperatorin from Notopterygium in Different Parts of Rat's Intestines / 医药导报

Objective To study the absorption features of isoimperatorin in intestine of rat.Methods Establish a single-pass intestinal perfusion model of rat,take phenolsulfonphthalein as a marker for the detection of isoimperatorin concentration from crude extracts of notopterygium,and observe the absorption features of isoimperatorin and its reference substance in intestine of rat.Results The content of isoimperatorin in crude extracts was (0.43±0.02)% (n=5).The absorption parameters of duodenum,jejunum,ileum,colon were (5.28±0.82),(4.47±0.56),(4.17±0.94),(4.32±0.68)×10-5 cm·s-1,respectively.There were no significant differences among them (P>0.05).Compared with the reference substance of isoimperatorin,crude extracts showed better absorption features.Conclusion Isoimperatorin from crude extracts have better characteristics of absorption.This study can provide theoretical basis for design of notopterygium oral formulation.

Clinical observation of metformin in treatment of endocrine resistance and postmenopausal hormone receptor positive advanced breast cancer / 实用医学杂志

Objective To evaluate the efficacy and security of metformin in the treatment of endocrine resistance and postmenopausal hormone receptor positive advanced breast cancer. Methods 60 cases of postmenopausal HR+advanced breast cancer whose first-line or second-line endocrine therapy failed were randomly divided into study group(n=30),treated with metformin combined with AI and control group(n=30),treated with placebo combined with AI. Standard RECIST guidelines were used to evaluate the clinical response. The objective response rate(ORR),clinical benefit rate(CBR),progression-free survival,and adverse reactions of two groups were compared. Results The ORR of two groups were 16.7%and 10%respectively and the difference was not statistically significant(P > 0.05). But CBR in study group was significantly higher than that in control group (63.3%vs 36.7%),and the difference was statistically significant(P<0.05). The median PFS in study group was slightly longer than that in control group (3.7 m vs 4.2 m),but there was no statistical difference. Multivariate regression analysis showed that PFS was only associated with the previous endocrine therapy. No serious adverse reactions occurred in two groups. Conclusion Metformin is expected to improve secondary endocrine resistance in breast cancer,but large prospective clinical studies are needed to confirm it.

Research progress of radiotherapy and molecular classifications of gastric cancer / 中国医师杂志

Adjuvant radiotherapy (RT) can improve the rate of loco-regional control for patients with gastric cancer (GC),while the selection of patients plays a key role.As the research moves along,several relatively comprehensive molecular classifications emerged such as the TCGA classification and the ACRG classification.Studies have demonstrated that molecular classifications are closely related to the clinicopathologic characteristics,prognosis and treatment response.However,there is not recognized molecular classification of GC presently.It is a great challenge for radiation oncologists to make use of the individual bioinformation and accurately select patients who would benefit from RT.Meanwhile,precision RT could also be achieved with the prediction of radiosensitivity,combination of RT with targeted therapy and the application of ctDNA within the field of RT.

Transplantation of mesencephalon progenitor cells in treatment of Parkinsonian rats / 第二军医大学学报

Objective:To explore the feasibility of mesencephalon progenitor cells as dopamine neuron's graft in treatment of Parkinson disease(PD) in rats. Methods: Animal model of PD were established in SD rats by 6 hydroxydopamine. Mesencephalon progenitor cells were obtained from 13 day old fetal rats. After in vitro proliferation and differentiation, the cells were planted into PD rat striatum. Results: Progenitor cells were expanded in an undifferentiated state with endothelia growth factor and basic fibroblast growth factor as mitogens. IL 1 and striatal culture media further increased the number of TH immunoreactive cells. Transplantation of these neurons relieved the rotation symptom of PD rats. Conclusion: Transplantation of mesencephalon progenitor cells has certain effects on PD rats.

Effective of Basic Fibroblast Growth Factor on Fetal Rat Brain Damage / 中华围产医学杂志

Objective To investigate if basic fibroblast Growth factor (bFGF) can penetrate placental barrier, alleviate rat brain damage and stimulate fetal rat neurons proliferation. Methods BFGF labeled with 125 I was injected peritoneally to pregnant rats, and tissue distribution of radioactivity of 125 I in different organs was detected. Thirty two of pregnant Waister rats were randomly divided at 15 d of gestational age into four groups: normal control, uteri distressed control, bFGF treatment, and bFGF prevention. Fetal rats in the latter three groups suffered from distress in uteri in an animal model of perinatal asphyxia. Proliferated neurons in fetal rat brains were counted in each group. Results 125 I bFGF has been found in fetal brain, heart, lung and spleen, etc. Under high power microscope, proliferated neurons in fetal rat brains were counted in each group, they are: (4.5 ?2.4), (5.8?3.1), (17.2?5.4); (18.1?5.8), ( F=128,P

The potential role of neurotrophic factor in the pathogenesis and therapy of Parkinson's disease / 中国病理生理杂志

Parkinson's disease is characterized by degeneration and dysfunction of dopaminergic neurons in the mid-brain substantia nigra, neurons that project to the caudate putamen. The clinical symptoms are caused by the loss of dopamine and the consequent dysfunction of the nigrostriatal pathway. Neurotrophic factors that may prevent nigrostriatal degeneration by improving the function of remaining dopaminergic neurons has the potential to be a useful therapy for Parkinson's disease. Neurotrophic factors and their specific receptors could play an important role in the progress of Parkinson's disease. The neuroprotective effects of neurotrophic factors GDNF, BDNF, IL-6 on dopaminergic neurons in vivo and in vitro , and the potential therapeutic use in treating Parkinson's disease were discussed in this paper.

DISTRIBUTION OF THE DICHOTOMIZING BRANCHES OF PERIPHERAL PROCESSES OF CAUDAL LUMBAR DORSAL ROOT GANGLION NEURONS IN THE RAT——A DOUBLE FLUORESCENCE LABELLING STUDY / 解剖学报

The technique of double labelling with fluorescent tracers(FB-NY,PI-Bb)has.been used in the following three groups of experiments:1.in 5 rats,one fluorescenttracer was injected into the tibial nerve and the other was injected into the peronealnerve;2.in 14 rats,one fluorescent tracer was injected into the sural cutaneousnerve and the other was injected into the branches to the soleus and gastrocnemiusmuscles;3.in 13 rats,one tracer was injected into the tibial nerve and the otherinto the bladder wall.The sections of the L_(3-6),S_(1-3) dorsal root ganglion were stu-died with a olympus fluorescence microscope using UG-1 excitation filter system.In the first and second groups,double labelled neurons were observed in L_(4-6) dorsalroot ganglion.But in the third group,the double labelled neurons were found onlyin the L_6 segment.The type of the double labelled neurons was mainly small-sized(33.1%)and small-medium sized(40.9%).The findings indicated that,the primary afferent fibers branched towards theperiphery and supplied,with different branches,either two somatic areas or skinand deep structures,or,especially,visceral and somatic sensory fields.This resultsuggests that the peripheral dichotomization of these dorsal root ganglion cells mightconverge sensory inputs from the somatic(tibial nerve)and the visceral(bladderwall)fields and thus provides one of the structural basis for the referred pain andthe neuronal mechanism of acupunctural therapy by which stimulation of somaticstructures could regulate the activities of visceral organs.