Effect of the transdifferentiation of BECs into myofibroblasts on the pathogenesis of secondary cholestatic hepatic fibrosis.

The present study investigated the effect of the transdifferentiation of bile duct epithelial cells (BECs) into myofibroblasts on the pathogenesis of secondary cholestatic hepatic fibrosis and examined the underlying mechanisms. A total of 60 male rats with hepatic fibrosis were randomly divided into two groups: A secondary cholestatic hepatic fibrosis model group induced by ligation of the bile duct (BDL) and a sham group, which only underwent segregation of the choledochus. Rats in the BDL group were dynamically observed after week 1, 2, 3 and 4 post-BDL, and the remaining rats were sacrificed after week 5 to determine histological changes and hydroxyproline content. The cellular co-localization of cytokeratin (CK)7/α-smooth muscle actin (SMA) or α-SMA/desmin was detected by immunofluorescence staining and laser confocal microscopy, while the protein expression levels of CK7, α-SMA and desmin were determined by western blot analysis. Sirius red staining was also performed and quantified. The results revealed a significant correlation between the protein expression of CK7 and α-SMA (r=0.9692, P<0.01). Furthermore, a predominant correlation between the number of cells stained for CK7/α-SMA and collagen deposition in liver tissues was identified, while the correlation of cells with co-localized α-SMA and desmin was less pronounced. The transdifferentiation of BECs into myofibroblasts may be a key pathological factor in secondary cholestatic hepatic fibrosis formation.

[Observation on therapeutic effect of acupuncture of five Shu-points of the liver meridian combined with bloodletting for depression patients and concomitant changes of blood rheology].

OBJECTIVE: To observe the clinical efficacy of acupuncture of five Shu-points of the Liver Meridian plus bloodletting for depression patients and its effect on hemorheology. METHODS: Thirty depression outpatients were randomly and equally divided into medication and acupuncture + bloodletting groups. Patients of the medication group were treated with Fluoxetine (20 mg/d, PO. in the morning) and those of the acupuncture + bloodletting group treated by acupuncture of Xingjian (LR 2), Taichong (LR 3), Zhongfeng (LR 4) and Ququan (LR 5) first, followed by pricking Dadun (LR 1) to let a little bit of blood out. The treatment was given once every other day, two months altogether. The therapeutic effect was assessed by using Hamilton Depression Rating Scale (HAMD) and the Clinical Global Impression Scale for Severity of Illness (CGI-SI) before and 1, 2, 4, 6, and 8 weeks after the treatment, respectively. Changes of hemorheology were detected by using a blood rheology detector. RESULTS: Of the 15 outpatients in both medication and acupuncture + bloodletting groups, 6 (40.00%) and 6 (40.00%) were cured basically, 5 (33.34%) and 4 (26.67%) experienced marked improvement, 2 (13.33%) and 3 (20.00%) were improved, and 2 (13.33%) and 2 (13.33%) invalid, respectively. No significant difference was found between the two groups in the therapeutic effect (P > 0.05). On the 6th and 8th weeks of the treatment, the CGI-SI score of the acupuncture + bloodletting group was significantly lower than that of the medication group (P < 0.05), suggesting a better therapeutic effect of the acupuncture + bloodletting group. The low and high shear viscosity of whole blood, erythrocyte aggregation index and rigidity index, and fibrinogen levels of the two groups were decreased significantly after the treatment (P < 0.05). No significant difference was found between the two groups in the changes of hemorheology indexes following the treatment (P > 0.05). CONCLUSION: Acupuncture of the five Shu-points of the Liver Meridian combined with bloodletting is effective in relieving depression symptoms and improving blood rheology in depression patients.

[Comparative study of heat-sensitive moxibustion in the treatment of knee osteoarthritis].

OBJECTIVE: To verify the clinical efficacy of heat-sensitive moxibustion in treatment of knee osteoarthritis (KOA). METHODS: Sixty cases of KOA were randomly divided into a heat-sensitive moxibustion group and a conventional moxibustion group, 30 cases in each one. Dubi (ST 35), Yanglingquan (GB 34), Zusanli (ST 36) and Heding (EX-LE 2) on the affected side were selected in two groups. In heat-sensitive moxibustion group, the techniques of circling moxibustion, sparrow-pecking moxibustion, moving moxibustion and mild moxibustion were applied. In conventional moxibustion group, the mild moxibustion was used, 2 to 3 cm far from the skin of the acupoints selected. Lysholm scale for the assessment of knee joint function was adopted to evaluate the efficacy. The scores of joint pain, morning stiffness, joint swelling and walking ability were compared before and after treatment in two groups. RESULTS: The scores of joint pain, morning stiffness, joint swelling and walking ability after treatment were all apparently improved as compared with those before treatment in either group (all P < 0.05). The improvement in the above-mentioned indices in heat-sensitive moxibustion group was much more apparent as compared with that in conventional moxibustion group (all P < 0.01). The effective rate was 90.0% (27/30) in heat-sensitive moxibustion group and was 73.3% (22/30) in conventional moxibustion group. The effective rate in heat-sensitive moxibustion group was obviously superior to that in conventional moxibustion group (P < 0.01). CONCLUSION: The efficacy of heat-sensitive moxibustion is superior to that of conventional moxibustion in the treatment of KOA. This therapy can more significantly improve the symptoms and physical signs of the patients with KOA.

[Effect of scalp acupuncture combined with body acupuncture on limb function in subacute stroke patients].

OBJECTIVE: To observe the effect of acupuncture stimulation of scalp- and body-acupoints on limb function in subacute stroke patients. METHODS: A total of 110 stroke inpatients were randomly and equally divided into acupuncture group and control group. Patients of the acupuncture group were treated by acupuncture stimulation of scalp acupoint Dingnie Qianxiexian (MS 6) and body acupoints Neiguan (PC 6), Jianyu (LI 15), Sanyinjiao (SP 6), etc. once daily for 20 days and routine neurological therapies, including drugs for controlling blood pressure, blood sugar, water-electrolyte balance, anticoagulation, encephaledema reduction, intracranial pressure reduction, anti-inflammation, neurofunction protection, etc. The stroke patients of the control group were treated with the routine neurological therapies only. The Fugl-Meyer assessment (FMA), US National Institutes of Health Stroke Scale (NIHSS) were used to assess the patients' limb function and nerve functional lesion severity before and after the treatment, and the ratio of mortality/disability and recurrence rate were used to assess the efficacy of acupuncture at the end of 3 and 6 months' follow-up. RESULTS: After the treatment, the FMA scores were increased significantly and NIHSS scores decreased considerably in both groups (P < 0.01), and the effects of acupuncture group were obviously superior to those of the control group (P < 0.05). There were no significant differences between two groups in the ratios of mortality/disability and recurrence rates at the end of 3 and 6 months' follow-up (P > 0.05). CONCLUSION: Scalp acupuncture combined with body acupuncture can evidently improve limb movement function and reduce the nerve function damage in stroke patients.

[Correlation between the liver meridian and the frontal lobe in depression by needling at taichong (LV3): a resting-state fMRI study].

OBJECTIVE: To explore the mechanism of depression treatment by needling at Taichong (LV3) and the correlation between the liver meridian and the frontal lobe. METHODS: Forty-two patients with moderate depression at the first attack in line with Diagnostic and Statistical Manual of Mental Disorders (4th ed) by American Psychiatric Association were assigned to the fluoxetine group, the needling + fluoxetine group, and the needling group, 14 in each. The therapeutic course for them all was one month. Resting fMRI scanning was performed before and after treatment using 3.0 T magnetic resonance. Data were analyzed using fractional amplitude of low frequency fluctuations (fALFF). Paired t-test was used for comparison. Correlation analysis was performed in the fALFF images after treatment and Hamilton's depression scale. RESULTS: Compared with before treatment, fALFF values in the left frontal lobe (BA6, BA9, BA48), the right frontal lobe (BA4, BA46), the bilateral inferior parietal lobules (BA40, BA48), the precuneus (BA7), the posterior cingutate (BA31), the left occipital lobe (BA17), and the right occipital lobe (BA18) of the needling +fluoxetine group were lowered (P<0.05). fALFF values in the right inferior parietal lobule (BA40) and the right occipital lobe (BA17) of the fluoxetine group were lowered (P<0.05). fALFF values in the left frontal lobe (BA10), the right frontal lobe (BA45), the left occipital lobe (BA19), the right occipital lobe (BA17), the left precuneus (BA7), and the posterior cingutate (BA31) were lowered in the needling group (P<0.05). Hamilton's depression scale was positively correlated with the fALFF value in the left frontal lobe of the needling +fluoxetine group and the needling group, while Hamilton's depression scale was positively correlated with the fALFF value in the left middle frontal gyrus, the left parietal lobe, and the left occipital lobe in the fluoxetine group. CONCLUSIONS: Combination of needling and antidepressive agents was superior to needling or antidepressive agents alone. Changes of the frontal lobe functions were correlated with the severity of depression. More extensive correlation existed between the liver meridian and the frontal lobe, which might be the antidepressive mechanism of needling Taichong (LV3).

A novel biomimetic polymer as amphiphilic surfactant for soluble and biocompatible carbon nanotubes (CNTs).

Novel amphiphilic diblock copolymer, cholesterol-end-capped poly(2-methacryloyloxyethyl phosphorylcholine) (CPMPC), which has poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC) as hydrophilic segment and cholesterol as hydrophobic segment, was specially designed as amphiphilic surfactant to achieve water-soluble and biocompatible carbon nanotubes (CNTs). The pristine CNTs were facilely dispersed via non-covalently binding the zwitterionic phosphorylcholine-based amphiphile onto the surfaces of the CNTs. It is interesting to find that CPMPC shows better CNTs solubilizing ability compared with the surfactant of pyrene-end-capped poly(2-methacryloyloxyethyl phosphorylcholine) (PPMPC). The biocompatibility of the CPMPC stabilized CNTs was evaluated using cholesterol-end-capped poly(2-(dimethylamino) ethyl methacrylate) (CPDMAEMA), cholesterol-end-capped poly(acrylic acid) (CPAA) and cholesterol-end-capped poly(ethylene oxide) (CPEG) as surfactants for CNTs as controls. While CPDMAEMA stabilized CNTs and CPAA stabilized CNTs showed obvious cytotoxicity, cytotoxicity of this novel zwitterionic phosphorylcholine-based amphiphile stabilized CNTs was not observed as indicated by cell culture. The biocompatible CNTs represent an excellent nano-object for potential biomedical applications.

[Hypothesis on "all the 12 channels entering the brain"].

Out of the 20 channels in the channel and collateral system, only 5 enter the brain, with unclear circulation pathway in the brain. Electrophysiologic and imaging studies indicate that the signal induced by acupuncture at acupoints can enter the brain no matter whether the channel connecting the acupoint enters the brain. Therefore, the authors put forward the hypothesis of "all the 12 channels enter the brain", i.e., the hypothesis of "channels and collaterals in brain". In the theory system of channels, less channels enter the brain with unclear circulation pathway. This possibly is related with that sensation is main way for descovery of channels. In future, we should adopt modern scientific and technical ways and strengthen the study on circulation of channels in the brain, so as to perfect the channel theory.

[Study on corresponding areas the liver and lung channels in brain with fMRI].

OBJECTIVE: To explore distribution of the Liver and Lung Channels in the brain so as to provide imaging basis for construction of channel theory in the brain. METHODS: Sixty healthy student volunteers were randomly divided into a Liver Channel group (I) and a Lung Channel group (II), and the each group was further divided into five subgroups with 6 volunteers in each subgroup, based on five-shu-point principles which, were Dadun (LR 1, I 1), Xingjian (LR 2, I 2), Taichong (LR 3, I 3), Zhongfeng (LR 4, I 4), Ququan (LR 8, I 5), Shaoshang (LU 11, II 1), Yuji (LU 10, II 2), Taiyuan (LU 9, II 3), Jingqu (LU 8, II 4), and Chize (LU 5, II 5), respectively. In order to observe the brain activating patterns during acupuncture at the different acupoints, functional magnetic resonance imaging (fMRI) technique was adopted. All image data were then analyzed with SPM 2 software. The statistical parameter gram was composed of the pixel P < 0.01, and anatomic location was made according to Talairach coordinate, attaining experimentally activated areas, and the commonly activated area of five-shu-point of each channel was considered as the brain distribution of the Liver and Lung Channels. RESULTS: The common areas activated by the five-shu-points of the Liver Channel were homolateral Brodmann area (BA) 34, BA 47, red nucleus, contralateral BA 19, BA 30, BA 39, the superior parietal lobule, cerebellum decline, and bilateral BA 3 and culmen. The common areas activated by the five-shu-points of the Lung Channels included homolateral BA 2, BA 18, BA 35, and contralateral BA 9 and substania nigra. CONCLUSION: There are relatively specific corresponding brain areas for the Liver and Lung Channels, indicating that there is possible relatively specific connection between channels and the brain.

[A quantitative study of the relationship between levels of liver fibrosis markers in sera and fibrosis stages of liver tissues of patients with chronic hepatic diseases].

OBJECTIVES: To study the quantitative relationship between the levels of serum liver fibrosis markers and fibrosis stages of liver tissues in patients with chronic hepatic diseases. METHODS: In 118 patients with chronic hepatitis, fatty liver or cirrhosis, their Serum levels of LN, HA, PCIII and CIV were investigated by EIA and their liver histological changes were studied. The relationship between the levels of serum LN, HA, PCIII and CIV and the degrees of liver tissue fibrosis was analyzed quantitatively by using the SPSS11.0. RESULTS: A correlation between the levels of serum LN, HA, PCIII and CIV and the histologically assessed grades of inflammatory activity was found (r = 0.394, 0.449, 0.443, 0.351, respectively, P <0.01). The correlation between the levels of serum LN, HA, PCIII and CIV and the histological assessed stages of liver fibrosis was strong (r = 0.456, 0.564, 0.476, 0.421 respectively, P <0.01). The levels of serum LN, HA, PCIII and CIV of the patients with a stage 2 liver fibrosis were 110 ng/ml, 110 ng/ml, 100 ng/ml and 70 ng/ml respectively, with sensibilities of diagnosing stage 2 liver fibrosis at 70%, 79%, 79% and 74% respectively. Their specificities in diagnosing stage 2 liver fibrosis were 68%, 72%, 64% and 73% respectively. The levels of LN, HA, PCIII and CIV in serum of these patients diagnosing cut-off value in stage 4 liver fibrosis (early cirrhosis) were 130 ng/ml, 140 ng/ml, 120 ng/ml and 70 ng/ml respectively. Their sensibility of diagnosing liver cirrhosis was 79%, 93%, 79% and 86% respectively. Their specificity of diagnosing liver cirrhosis was 66%, 82%, 72% and 61% respectively. As shown by the ROC curves in these patients, differentiating patients with cirrhosis or without cirrhosis, serum HA level was more valuable than LN, PCIII, CIV (the areas under the curves = 0.938 vs 0.775, 0.787, 0.791 ) When serum HA was higher than 190 ng/ml, the veracity of diagnosing liver cirrhosis was 93%. CONCLUSIONS: There is a certain quantitative relationship between the levels of LN, HA, PCIII and CIV in serum and the degrees of liver tissue fibrosis. The level of HA in serum is an important reference datum for early diagnosing liver cirrhosis.