OBJECTIVE:Electroacupuncture (EA) at Neiguan (PC6) acupoint confers protection against myocardial injury, though its precise neuroimmune mechanisms are not well understood. This study investigates whether EA-mediated attenuation of cardiac inflammation occurs through localized sympathetic and splenic regulation. METHODS:Acute myocardial infarction was induced in mice by coronary artery ligation. Preoperative EA was administered bilaterally at PC6 (2/15 Hz, 1 mA, 20 min/d for 3 d). Cardiac function was assessed by echocardiography. Myocardial inflammation was evaluated by hematoxylin and eosin staining, and infarct size was measured by 2,3,5-triphenyltetrazolium chloride staining. Macrophage recruitment and polarization (toward M2) were analyzed using flow cytometry. Serum norepinephrine, acetylcholine and pro-inflammatory cytokines were measured using enzyme-linked immunosorbent assay, whereas myocardial cytokines were evaluated using immunohistochemistry staining. Splenic sympathetic activity was indexed through tyrosine hydroxylase expression via immunofluorescence staining. The neural pathways were dissected through chemical sympathectomy, splenic denervation, and adoptive splenocyte transfer. RESULTS:EA at PC6 significantly attenuated myocardial inflammation by suppressing cardiac sympathetic activity, downregulating pro-inflammatory cytokines interleukin-6, interleukin-1β and tumor necrosis factor-α, and promoting M2 macrophage polarization. These effects correlated with reduced infarct size, diminished immune cell infiltration and improved cardiac function. Chemical sympathectomy mimicked EA's cardioprotective profile. Splenic denervation exacerbated systemic inflammation but did not impair EA-driven macrophage phenotypic switching. Adoptive splenocyte transfer, regardless of donor EA pretreatment, facilitated cardiac repair, arguing against a splenocyte-mediated mechanism for EA-induced cardioprotection. CONCLUSION:EA at PC6 exerts its cardioprotective effect primarily through modulating local cardiac sympathetic hyperactivity, which rebalances macrophage polarization toward the M2 phenotype and mitigates inflammation-induced injury. While the spleen contributes to systemic immunity, it plays a minimal role in EA-driven myocardial repair. Please cite this article as: Jiang MJ, Peng R, Lu XH, Yan YH, Qian DY, Zou LY, Liu XE, Chen LY, Bai H, Zhuang Y, Yu ML, Lu SF. Cardiac-specific sympathetic modulation, not splenic innervation, mediates PC6 electroacupuncture-induced cardioprotection via M2 macrophage polarization in mice with acute myocardial infarction. J Integr Med. 2026; 24(4):573-584.

Accumulating evidence suggests a significant link between dyslipidaemia—characterized by an imbalance in circulating lipids and lipoproteins—and the pathogenesis and progression of various chronic respiratory conditions. However, their mechanistic role in idiopathic pulmonary fibrosis (IPF) pathogenesis has yet to be fully elucidated. This study aimed to explore the associations of idiopathic pulmonary fibrosis (IPF) with TG/HDL-C and TC/HDL-C in Chinese adults. This study included 129 patients in the stable phase of IPF, 85 patients with acute exacerbation (AE-IPF), and 130 non-IPF controls. The evaluation included routine blood tests (encompassing the lipid profile) and pulmonary function assessments. Additionally, a follow-up with a median duration of 5.84 months was conducted in 183 IPF patients. Compared with values observed in stable cases or control subjects, the levels of both TG/HDL-C and TC/HDL-C were markedly elevated in subjects with AE-IPF. Following adjustment for potential confounders, logistic regression models revealed that both TG/HDL-C and TC/HDL-C were independent factors positively correlated with the presence of AE-IPF. In assessing the predictive power for AE-IPF, the area under the ROC curve corresponding to TG/HDL-C exceeded that of TC/HDL-C and all other conventional lipid levels. During a median follow-up of 5.84 months, 81 IPF patients passed away. Nonsurvivors had higher baseline TG/HDL-C and TC/HDL-C levels than survivors did. Multivariate Cox regression analysis adjusted for age, sex, and oxygenation index revealed that the adjusted hazard ratios for overall survival with each 1-SD increase in TG/HDL-C and TC/HDL-C were 1.809 (95

Background:The association of interstitial lung disease (ILD) with lung cancer (LC) has generated increased research interest in recent years. We aimed to characterize the clinical features and prognostic factors of patients with ILD and LC and to develop a 1-year mortality risk prediction model for these patients. Methods:The retrospective study enrolled patients with ILD and LC admitted to Nanjing Drum Tower Hospital from 2017 to 2022. The demographic data, histological type and staging of LC, high-resolution computed tomography (HRCT) patterns of ILD, laboratory examinations, and therapeutic and follow-up information were collected. The primary endpoint for the prediction model was all-cause 1-year mortality. Logistic regression analysis was used to identify risk predictors and further establish a nomogram to predict 1-year mortality. Area under the curve (AUC), calibration curves, and decision curves were used to assess the utility of the nomogram. Results:A total of 206 patients with concurrent ILD and LC were included. Adenocarcinoma was the most common pathological subtype (94/206, 45.6%), followed by squamous cell carcinoma (55/206, 26.7%) and small-cell lung cancer (SCLC) (42/206, 20.4%). Moreover, 43.7% (90/206) of tumors were located inside ILD lesions. Among the patients with non-small cell lung cancer (NSCLC), 90 were diagnosed with advanced-stage disease (> stage IIIA) while 28 patients with SCLC were at the extensive phase. The most common HRCT pattern of ILD was usual interstitial pneumonia (UIP) (102/206, 49.5%). The all-cause 1-year mortality rate was 41.3%. The prediction model incorporated age, sex, neutrophil count, and lactate dehydrogenase (LDH) and albumin (Alb) levels. The AUC values in training and internal validation sets were 0.775 and 0.716 respectively. Calibration curves indicated strong consistency, and decision curves confirmed the clinical net benefit achievable at different risk thresholds. Conclusions:We developed a 1-year mortality risk prediction model for patients with concurrent ILD and LC to identify those with high risk of death and facilitate precise management. Future multicenter studies are needed for further external validation.

BACKGROUND Nocardia infection is a relatively uncommon disease, with no reports among patients with interstitial pneumonia. Due to its atypical clinical symptoms and chest computed tomography (CT) findings and the frequent yielding of negative results by conventional cultures, it poses challenges for timely diagnosis and treatment. CASE SUMMARY A 63-year-old female patient presented to our hospital in July 2022 with a 3-mo history of intermittent cough and poor appetite, accompanied by a 2-wk long duration of headaches. She had a previous medical history of interstitial pneumonia and was on oral prednisone and cyclosporine. Chest CT revealed the presence of newly developed round nodules. The diagnosis of Nocardia cyriacigeorgica infection was confirmed through metagenomic next-generation sequencing (mNGS) performed on bronchoalveolar lavage fluid. Targeted anti-infection therapy was initiated, resulting in symptom improvement and radiological resolution, further validating the mNGS results. CONCLUSION Nocardia cyriacigeorgica infection is a clinically rare condition that is primarily observed in immunocompromised patients. Its clinical and radiological manifestations lack specificity, but mNGS can aid in rapidly obtaining pathogenic information. Early initiation of targeted antimicrobial therapy based on mNGS results can improve patient prognosis.

The liver metastasis is the primary factor attributing to the poor prognosis of colorectal cancer (CRC). Moxibustion has been used clinically against multiple malignancies. In this study, we explored the safety, efficacy, and the potential functional mechanisms of moxibustion in modulating the liver metastasis of CRC by using GFP-HCT116 cells-derived CRC liver metastasis model in Balb/c nude mice. The tumor bearing mice were randomly divided into model control and treatment groups. Moxibustion was applied to the BL18 and ST36 acupoints. CRC liver metastasis was measured by fluorescence imaging. Furthermore, feces from all mice were collected, and 16S rRNA analysis was used to assess their microbial diversity, which was analyzed for its correlation with liver metastasis. Our results indicated that the liver metastasis rate was decreased significantly by moxibustion treatment. Moxibustion treatment also caused statistically significant changes in the gut microbe population, suggesting that moxibustion reshaped the imbalanced gut microbiota in the CRC liver metastasis mice. Therefore, our findings provide new insights into the host-microbe crosstalk during CRC liver metastasis and suggest moxibustion could inhibit CRC liver metastasis by remolding the structure of destructed gut microbiota community. Moxibustion may serve as a complementary and alternative therapy for the treatment of patients with CRC liver metastasis.

目的:分析感染后咳嗽模型大鼠神经肽P物质(SP)、神经激肽-1受体(NK-1R)在祛风止咳方的作用下发生的改变,探究在感染后咳嗽方面,该方的作用机理.方法:将大鼠(40只)随机分成4组:西药治疗组,中药治疗组、模型组、空白对照组,构建PIC模型:雾化吸入辣椒素、脂多糖(LPS)滴鼻模拟感染革兰氏阴性菌,各组大鼠给予灌胃处理7d后,获取肺组织,研究其病理学变化,采用ELLSA法检测SP含量,免疫组化法、半定量评分研究肺组织中SP改变,肺组织中表达的NK-1R用Western-Blot进行检测.结果:①SP含量的分析:模型组较空白对照组具有更高的SP含量(P＜0.05);无论是中药治疗组还是西药治疗组肺组织中较模型组具有更低的SP含量,下降显著的是中药治疗组(P＜0.05);②SP免疫组化结果:中药治疗组和西药治疗组较模型组表达更低的SP蛋白,降低更明显的是中药治疗组(P＜0.05);③NK-1R的Western-Blot检测结果:中药治疗组和西药治疗组肺组织较模型组表达更低的NK-1R蛋白,降低更显著的是中药治疗组.结论:祛风止咳方能够降低大鼠肺组织中SP及NK-1受体蛋白的表达,通过NK-1-SP途径来降低感染后咳嗽的气道神经源性炎症.

Background: Acute bilirubin encephalopathy (ABE) is a significant cause of neonatal mortality and disability. Early detection and treatment of ABE can prevent the further development of ABE and its long-term complications. Due to the limited classification ability of single-modal magnetic resonance imaging (MRI), this study aimed to validate the classification performance of a new deep learning model based on multimodal MRI images. Additionally, the study evaluated the effect of a spatial attention module (SAM) on improving the model’s diagnostic performance in distinguishing ABE. Methods: This study enrolled a total of 97 neonates diagnosed with ABE and 80 neonates diagnosed with hyperbilirubinemia (HB, non-ABE). Each patient underwent three types of multimodal imaging, which included T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), and an apparent diffusion coefficient (ADC) map. A multimodal MRI classification model based on the ResNet18 network with spatial attention modules was built to distinguish ABE from non-ABE. All combinations of the three types of images were used as inputs to test the model’s classification performance, and we also analyzed the prediction performance of models with SAMs through comparative experiments. Results: The results indicated that the diagnostic performance of the multimodal image combination was better than any single-modal image, and the combination of T1WI and T2WI achieved the best classification performance (accuracy = 0.808 ± 0.069, area under the curve = 0.808 ± 0.057). The ADC images performed the worst among the three modalities’ images. Adding spatial attention modules significantly improved the model’s classification performance. Conclusion: Our experiment showed that a multimodal image classification network with spatial attention modules significantly improved the accuracy of ABE classification.

Purines and their derivatives, extensively distributed in the body, act as a class of extracellular signaling molecules via a rich array of receptors, also known as purinoceptors (P1, P2X, and P2Y). They mediate multiple intracellular signal transduction pathways and participate in various physiological and pathological cell behaviors. Since the function in myocardial ischemia-reperfusion injury (MIRI), this review summarized the involvement of purinergic signal transduction in diversified pathological processes, including energy metabolism disorder, oxidative stress injury, calcium overload, inflammatory immune response, platelet aggregation, coronary vascular dysfunction, and cell necrosis and apoptosis. Moreover, increasing evidence suggests that purinergic signaling also mediates the prevention and treatment of MIRI, such as ischemic conditioning, pharmacological intervention, and some other therapies. In conclusion, this review exhibited that purinergic signaling mediates the complex processes of MIRI which shows its promising application and prospecting in the future.

Objective. The efficacy of tofacitinib (TOF) in the early diagnosis of melanoma differentiation-associated gene 5 (MDA5)-related interstitial lung disease (ILD) has been described. However, whether TOF exposure is associated with a reduced 1-year mortality rate remains undetermined.Methods. Patients diagnosed with MDA5-ILD receiving TOF or tacrolimus (TAC) treatment were included. A Cox proportional hazards model, which was adjusted for age, sex, smoking history, anti-MDA5 antibody titers, and concurrent use of other steroid-sparing agents, was performed to compare all-cause mor-tality and to investigate the risk factors predicting 1-year mortality rates in the 2 treatment groups.Results. During the study period, 26 patients were treated with TOF and 35 were treated with TAC. The 6-month (38.5% vs 62.9%; P = 0.03) and 1-year (44.0% vs 65.7%; P = 0.03) mortality rates in the TOF group were significantly lower than those in the TAC group. There were 13 patients diagnosed with rapidly progressive ILD (RP-ILD) in the TOF group and 22 in the TAC group. The majority of deaths occurred in patients with RP-ILD. The 6-month (76.9% vs 95.5%; P = 0.02) and 1-year (84.6% vs 100.0%; P = 0.02) mortality rates of patients with RP-ILD in the TOF group were also lower than those in the TAC group, respectively. The adjusted model showed that TOF exposure was associated with a lower risk for 1-year mor-tality (hazard ratio 0.44, 95% CI 0.20-0.96; P = 0.04). However, the incidence of adverse events (73.1% vs 74.3%; P > 0.99) and medication discontinuation rates (23.1% vs 14.3%; P = 0.50) in the TOF and TAC groups were similar, respectively. Conclusion. Our observational study showed that TOF use might have a potential effect on improving the outcomes of MDA5-ILD. Future clinical trials are needed to assess the long-term efficacy and tolerability of TOF.

目的:采用文献计量学方法对针灸治疗踝关节扭伤的中英文文献进行分析,了解该领域的研究现状、发展水平以及趋势,为临床和科研提供思路和参考依据.方法:检索中国知网、维普数据库、万方医药卫生数据库、中国生物医学文献数据库和Pubmed中收录的针灸治疗踝关节扭伤的临床文献,检索时间为自数据库建立至2019年2月,从文献发表年代、文献发表地域、文献发表机构、期刊分布、样本含量、疗效评定、腧穴选用、刺灸方法等8个维度进行分析.结果:共纳入符合标准的文献112篇,文献研究总体呈上升趋势,广东省的研究机构及发文总量最多,《上海针灸杂志》《中国针灸》刊登文献最多,适宜样本量研究占比少,无客观统一的疗效评定标准,阿是穴为最常选用的穴位,综合疗法是常用治法.结论:针灸治疗踝关节扭伤有较好的疗效,但因选穴、针灸方法及疗效评定等均没有统一的标准,故无法客观、准确地评定其疗效,应尽快加强针灸治疗踝关节扭伤的标准化进程.

目的 探讨抗信号识别粒子抗体阳性的间质性肺炎(anti-signal recognition particle antibody positive interstitial pneumonia,SRP-IP)患者的临床特点,并与抗Jo-1抗体阳性的间质性肺炎(anti-Jo-1 antibody positive interstitial pneumonia,Jo1-IP)患者相比较.方法 回顾性分析2017年5月-2021年5月南京大学医学院附属鼓楼医院呼吸与危重症医学科收治的SRP-IP住院患者的临床资料,包括临床表现、实验室检查、肺功能结果、影像学类型等,并与同期收住的Jo1-IP患者相比较.结果 SRP-IP患者年龄大于Jo1-IP患者(P=0.044),在临床表现和肺功能方面,两组患者各项没有显著统计学差异.SRP-IP患者中合并存在抗EJ抗体(P＜0.001)、核周型抗中性粒细胞抗体(P=0.028)阳性比例显著高于Jo1-IP患者,合并抗Ro-52抗体阳性比例显著低于Jo1-IP患者(P=0.009).SRP-IP患者的红细胞沉降率快于Jo1-IP患者(P=0.026),血清IgM水平(P=0.039)和外周血NK细胞计数(P=0.013)明显低于Jo1-IP患者.SRP-IP患者胸部CT表现类型以机化性肺炎型最为常见,寻常型间质性肺炎型的比例高于Jo-IP患者(P=0.032).高滴度(++～+++)SRP抗体的间质性肺炎患者的肌酸激酶(P=0.010)、肌酸激酶同工酶(P=0.025)、谷丙转氨酶(P=0.045)水平均高于低滴度(+)SRP抗体的间质性肺炎患者.SRP-IP和Jo1-IP患者的治疗方案以糖皮质激素联合/不联合免疫抑制剂为主,两组在治疗方案的选择上无显著差异.Jo1-IP患者疗效评估为好转的比例明显高于SRP-IP患者(P=0.005),而SRP-IP患者疗效评估为稳定的比例明显高于Jo1-IP患者(P=0.035).SRP-IP患者3个月内病死率显著高于Jo1-IP患者(P=0.028).结论 SRP-IP与Jo1-IP患者相比,患者年龄更大,红细胞沉降率更快,更易合并存在其他自身抗体,血清IgM水平和外周血NK细胞计数更低,寻常型间质性肺炎型影像学表现更多见,短期预后更差.

BackgroundNumerous studies showed that insulin resistance (IR) was associated with cancer risk. However, few studies investigated the relationship between IR and non-small cell lung cancer (NSCLC). The aim of this study is to explore the association of triglyceride glucose (TyG) index, a simple surrogate marker of IR, with NSCLC risk.Methods791 histologically confirmed NSCLC cases and 787 controls were enrolled in the present study. Fasting blood glucose and triglyceride were measured. The TyG index was calculated as ln [fasting triglycerides (mg/dl) ×fasting glucose (mg/dl)/2]. Logistic regression analysis was performed to estimate the relationship between NSCLC risk and the TyG index.ResultsThe TyG index was significantly higher in patients with NSCLC than that in controls (8.42 ± 0.55 vs 8.00 ± 0.45, P < 0.01). Logistic regression analysis showed that the TyG index (OR = 3.651, 95%CI 2.461–5.417, P < 0.001) was independently associated with NSCLC risk after adjusting for conventional risk factors. In addition, a continuous rise in the incidence of NSCLC was observed along the tertiles of the TyG index (29.4 vs 53.8 vs 67.2%, P < 0.001). However, there were no differences of the TyG index in different pathological or TNM stages. In receiver operating characteristic (ROC) curve analysis, the optimal cut-off level for the TyG index to predict incident NSCLC was 8.18, and the area under the ROC curve (AUROC) was 0.713(95% CI 0.688–0.738).ConclusionsThe TyG index is significantly correlated with NSCLC risk, and it may be suitable as a predictor for NSCLC.

OBJECTIVE:To observe the influence of acupuncture on microcirculation perfusion of the pericardium meridian and heart in acute myocardial ischemia (AMI) rats and evaluate whether acupuncture can simultaneously affect the meridians and corresponding viscera. Additionally, acupoints at different meridians were compared and whether they exert the same effects was discussed. METHODS:Totally 32 Sprague-Dawley rats were subjected to left anterior descending (LAD) ligation to develop an AMI model. Rats were divided into 4 groups, including AMI, acupuncture Neiguan (PC 6), Lieque (LU 7) and Qiansanli (LI 10) groups (n=8). Eight rats received only thoracotomy (sham-operated group). The rats in the acupuncture groups received manual acupuncture at PC 6, LU 7 and LI 10 acupoints for 15 min, respectively. The microcirculation perfusion of pericardium meridian and heart was monitored by laser speckle perfusion imager (LSPI) before, during and after acupuncture manipulation for 15 min. Subsequently, the perfusion unit (PU) was calculated and analyzed by PSI System. RESULTS:After LAD, compared to pre-acupuncture stage, the heart microcirculation perfusion (HMP) in the AMI group decreased continuously at during-acupuncture (P>0.05) and post-acupuncture stages (P<0.05), and the pericardium meridian microcirculation perfusion (PMP) showed no significant differences at 3 stages (P>0.05). Compared to pre-acupuncture stage, the PMP and HMP in PC 6 group significantly increased during acupuncture manipulation (both P<0.05), and PMP decreased obviously after acupuncture (P<0.05). The PMP in the LU 7 and LI 10 groups were slightly elevated (both P>0.05); however, they were significantly reduced after acupuncture manipulation (both P<0.05). Additionally, HMP of LI 10 group was decreased significantly during acupuncture, especially compared to pre-acupuncture stage (P<0.05). CONCLUSIONS:Acupuncture at PC 6 obviously increased the PMP and HMP in AMI rats, and the effects were superior to at LU 7 and LI 10 acupoints. It was further confirmed that acupuncture promoted qi and blood circulation, indicating that acupoint specificity exists and features a meridian-propagated effect.

Background: Sympathetic and parasympathetic nerve remodeling play an important role in cardiac function after myocardial ischemia (MI) injury. Increasing evidence indicates that electroacupuncture (EA) can regulate cardiac function by modulating the autonomic nervous system (ANS), but little is known about its effectiveness on neural remodeling post-MI. Objectives: To investigate the role of EA in ANS remodeling post-MI. Methods: Adult male C57/BL6 mice were equally divided into the Control (Ctrl), MI and EA groups after generating the MI model by ligating the left anterior descending (LAD) coronary artery. Echocardiography and 2,3,5-triphenyltetrazolium (TTC) staining were employed to evaluate cardiac function and infarct size after EA treatment for five consecutive days. Serum norepinephrine (NE) levels were measured by ELISA to quantify sympathetic activation. Then, ANS remodeling was detected by immunohistochemistry (IHC), RT-qPCR, and Western blotting. Results: Our preliminary findings showed that EA increased ejection fraction and fractional shortening and reduced infarct area after MI injury. Serum NE levels in the EA group were significantly decreased compared with those in the MI group. IHC staining results demonstrated that the density of growth associated protein (GAP)43 and tyrosine hydroxylase (TH) positive nerve fibers in the EA group were decreased with increased choline acetyltransferase (CHAT) and vesicular acetylcholine transporter (VACHT). Meanwhile, the results verified that mRNA and protein expression of GAP43 and TH were significantly inhibited by EA treatment in the MI mice, accompanied by elevated CHAT and VACHT. Conclusions: EA treatment could improve cardiac function and reduce infarct size by modulating sympathetic and parasympathetic nerve remodeling post-MI, thus helping the cardiac ANS reach a new balance to try to protect the heart from further possible injury.

ABSTRACTBackgroundChemotherapeutic drugs creates severe adverse reactions for colorectal cancer. Moxibustion confers clinical benefits for postoperative patients undergoing chemotherapy, it will fill the blank period of western medicine treatment and provide useful help for tumor patients to prevent recurrence and metastasis, but the physiological mechanisms behind the antitumor effects are unclear. This study was aimed to determine the effect and characterize the differential cytokines and gene expression profiles in intrasplenic transplanted GFP-HCT-116 cells-induced tumors model by Pre-Mox, Post-Mox and Pre-Post-Mox intervention.MethodsHuman CRC cells with GFP fluorescence were implanted via intrasplenic injection into Balb/c nude mice spleens. Moxibustion stimulation was applied to the BL18 and ST36 acupoints. The model control (MC) group were given no treatment. Pre-Mox mice were received moxibustion for 2 weeks before HCT-116 cell injection. Post-Mox mice received moxibustion for 3 weeks after CRC cell injection. Pre-Post-Mox mice received moxibustion for 5 weeks (2 weeks before and 3 weeks after CRC cell injection). Peripheral bloods were collected, pooled and assayed using a RayBio® mouse inflammation antibody array. Multi-Analyte Suspension Array was opted for verification. RNA isolated from liver paracancerous tissues from the control group and the experimental groups was subjected to RNA-seq, and then screened out significant differences for in-depth verification.RESULTSThe results showed that moxibustion stimulation increased the survival rate and decreased CRC liver metastasis. With the help of Multi-Analyte Suspension Array and RNA-seq, we screened significant differential expression of cytokines and RNA, then further verified them. The metastasis rate decreased significantly from 100% (10/10, MC group) to 50% (6/12, Pre-Mox group), to 46% (6/13, Post-Mox group), and further to 25% (3/12, Pre-Post-Mox group). Cytokine chips were used significant differences were found in MIP-3α, MDC, IL-6, and IL-1a. Transcriptomic analysis suggested that the low-dose combination of Pre-Mox and Post-Mox modulated larger gene sets than the single treatment. We identified a small subset of genes, like APOA4, IGFBP5, IGFBP6, TIMP1, and MGP, as potential molecular targets involved in the preventive action of the combination of Pre-Mox and Post-Mox.ConclusionsTaken together, the current results provide the first evidence in support of the chemopreventive effect of a combination of Pre-Mox and Post-Mox in CRC. Moreover, the cytokines and transcriptional profile obtained in our study may provide a framework for identifying the mechanisms underlying the carcinogenesis process from colonic cancer to liver metastasis as well as the cancer inhibitory effects and potential molecular targets of Pre-Post-Mox.

目的 分析PubMed中迷走神经刺激疗法(VNS)的临床研究文献,总结其研究现状和临床特点,为其研究提供借鉴和参考.方法 在PubMed中检索1990年1月—2020年6月发表的所有VNS文献,采用CiteSpace软件进行作者、国家、机构、期刊、关键词共现分析,并绘制相关可视化图谱;通过信息提取并绘制表格,对VNS的疾病谱、治疗效果、刺激方式和参数等临床特点进行总结分析.结果 共纳入138篇文献.发文量最多的作者为朱兵;发文量前三位的国家为美国(75篇)、德国(26篇)、荷兰和英国(皆14篇);发文量最多的机构为中国中医科学院(7篇)、ElectroCore公司(7篇)和明尼苏达大学(7篇).论文分别发表于78本期刊,刊文前两位为Epilepsia(11篇)和Neurology(10篇).VNS治疗癫痫和抑郁症的相关研究是研究热点.研究共涉及27种疾病,癫痫、抑郁症、偏头痛最多;文献中选用的设备主要为植入式和经皮式刺激;刺激频率低频为主,参数随疾病和刺激方式而定.结论 VNS对神经精神系统疾病具有很好的疗效,尤其是癫痫和抑郁症;国内耳部VNS的研究水平处于相对领先地位;非植入式VNS将成为新的研究和发展方向.

Background: Lipids are known to accumulate abnormally in the alveoli and circulate during pulmonary alveolar proteinosis (PAP). However, the relationship between lipid ratios and PAP is not clear. In this study, we investigated the lipid ratios in PAP patients and explored the relationships between lipid ratios and the severity of PAP.Methods: A total of 122 PAP patients were diagnosed and divided the mild- moderate PAP group (n = 61) and the severe PAP group (n = 61) according to the value of disease severity score (DSS). One hundred thirty healthy volunteers were classified as the control group. Routine blood examination and pulmonary function tests were performed and lipid profile were measured.Results: Compared with the control group, patients with PAP had significantly higher TG, TC/HDL-C, TG/HDL-C, and non-HDL-C, while lower HDL-C (all P < 0.05). Patients with the severe PAP had higher TC, TG, LDL-C, TC/HDL-C, and non-HDL-C, while lower HDL-C than patients with the mild- moderate PAP (all P < 0.05). Binary logistic regression analysis indicated that TC/HDL-C (OR = 2.322, 95% CI 1.621–3.713, P = 0.024) and non-HDL-C (OR = 1.797, 95% CI 1.239–3.109, P = 0.036) were all significantly correlated with the severity of PAP after adjustment for other risk factors. The AUC value of TC/HDL-C for predicting the severity of PAP was larger than that of non-HDL-C. The AUROC for TC/HDL-C was 0.741 (0.654–0.828), and the optimal cut-off point for TC/HDL-C was 5.05 (sensitivity: 73.6%, specificity: 68.1%).Conclusions: Lipid ratios, including TC-HDL-C and non-HDL-C, were independent risk factors for the severity of PAP. TC/HDL-C is a promising biomarker for the severity of PAP.

目的 分析PubMed数据库中骶神经刺激疗法的临床研究文献,总结其研究现状和临床特点.方法 检索2019年12月31日以前PubMed数据库收录的所有关于骶神经刺激疗法的文献,采用HistCite软件对其发表年份、发表期刊、国家地区和研究机构进行统计分析;采用Pajek软件的主路径分析法,识别文献间热点主题的演进方向;文献涉及的疾病谱、治疗效果、刺激方式和刺激参数进行描述性分析.结果 共纳入96篇文献.自2000年发表数量大幅度增长,在2014年至2015年达到顶峰,其中2000年至2001年的文献影响力最大;共发表于32种期刊,刊文数排前两位的期刊是Urology(22篇)和Diseases of the Colon&Rectum(17篇);文献分别属于16个国家,发文数前三的是美国(17篇)、荷兰(13篇)、英国(13篇);涵盖211所研究机构,发文数最多的是丹麦的奥尔胡斯大学医院(12篇)和英国的圣马克斯医院(9篇);研究共涉及16种病症,以大便失禁、尿失禁、排尿障碍数量最多,且研究热点呈现出从泌尿系统疾病向消化系统疾病逐渐转变.最终研究结果为有效的文献占91.67％,刺激方式以植入式(77篇)和经皮式(10篇)为主.刺激参数随疾病和刺激方式而定,各不相同.结论 骶神经刺激疗法能有效改善盆底功能,将持续成为研究热点.非植入式骶神经刺激将成为新的研究方向.

目的:探讨中医古籍中针灸治疗踝关节扭伤的选穴规律.方法:以《中华医典》(第5版)为检索数据库,搜索针灸治疗踝关节扭伤的古代文献,进行频数分析、聚类分析和关联规则分析.结果:中医古籍中踝关节扭伤的针灸处方,以单穴为主,针法与灸法结合使用.使用频数高的经脉集中于足三阳经.使用频数高的腧穴集中于足外踝部的五腧穴(输穴、经穴和合穴)、原穴和八脉交会穴等.有效腧穴聚类为申脉-昆仑、丘墟-太冲和阳陵泉-三阴交-足三里-侠溪-悬钟-条口-承山-阴陵泉三大类.其中,阴陵泉、阳陵泉、三阴交、悬钟、太冲五穴之间的关联程度最高.结论:中医古籍中针灸治疗踝关节扭伤注重循经取穴和局部取穴相结合,旨在通络止痛消肿.