Abstract Objective To investigate the analgesic mechanism of Tuina (Chinese therapeutic massage) by observing the effect of the N-methyl-D-aspartate receptor subunit 2B (NR2B)/postsynaptic density-95 ( P SD-95) pathway on the dendritic structure of spinal cord dorsal horn in rats with lumbar disc herniation. Methods Fifty Sprague-Dawley rats were randomly divided into a blank group, a model group, a Tuina group, a blocker agent group, and a blocker agent + Tuina group. The sciatic nerve chronic constriction injury (CCI) model was prepared by the sciatic nerve ligation method. From the 4th day after modeling, rats in the Tuina group and the blocker agent + Tuina group were subject to daily Tuina intervention, and those in the blocker agent group and the blocker agent + Tuina group were daily intrathecally injected with NR2B blocker agent (MK-801). The spontaneous pain score was used to observe the pain behavior of all rats. The expression levels of NR2B and downstream PSD-95 were measured by immunohistochemistry, and the dendritic structure changes were observed by Golgi staining for rat spinal cord dorsal horn after 14 d of continuous intervention. Results Compared with the blank group, the degree of rat spontaneous pain after CCI was elevated in both the model and the Tuina groups ( P <0.01) and was reduced in the Tuina group after the Tuina intervention compared with the model group ( P <0.05). Compared with the model group, the rat spontaneous pain level after blocking NR2B was reduced in both the blocker agent group and the blocker agent + Tuina group ( P <0.05). The NR2B and PSD-95 protein levels were significantly higher in the model group compared with the blank group ( P <0.01); the total number of dendritic branches was increased ( P <0.01), and the total dendritic length became longer ( P <0.01) in the spinal cord dorsal horn. The rat NR2B and PSD-95 protein levels were significantly decreased in the Tuina group compared with the model group ( P <0.01); the total dendritic branch number was reduced ( P <0.01) and the total length was shortened ( P <0.01) in the spinal cord dorsal horn. After blocking NR2B, the expression levels of NR2B and downstream PSD-95 protein were significantly lower in both the blocker agent group and the blocker agent + Tuina group compared to the model group ( P <0.01). The total branch number was significantly reduced ( P <0.01), and the total length was significantly shortened ( P <0.01) of the dendrites in the spinal cord dorsal horn. Conclusion Tuina may exert an analgesic effect by remodeling the dendritic structure in the spinal cord dorsal horn in rats with lumbar disc herniation, and its mechanism may be related to the inhibition of NR2B/PSD-95 signaling pathway.
{"title":"基于NR2B/PSD-95通路探讨推拿对腰椎间盘突出症大鼠脊髓背角树突结构的影响","authors":"Huanzhen Zhang, Bingqian Wang, Shuijin Chen, Lechun Chen, Jingjing Jiang, Yu Jiang, Jincheng Chen, Hongye Huang, Jiayu Fang, Weiquan Zeng, Zhigang Lin","doi":"10.1007/s11726-023-1368-2","DOIUrl":"https://doi.org/10.1007/s11726-023-1368-2","url":null,"abstract":"Abstract Objective To investigate the analgesic mechanism of Tuina (Chinese therapeutic massage) by observing the effect of the N-methyl-D-aspartate receptor subunit 2B (NR2B)/postsynaptic density-95 ( P SD-95) pathway on the dendritic structure of spinal cord dorsal horn in rats with lumbar disc herniation. Methods Fifty Sprague-Dawley rats were randomly divided into a blank group, a model group, a Tuina group, a blocker agent group, and a blocker agent + Tuina group. The sciatic nerve chronic constriction injury (CCI) model was prepared by the sciatic nerve ligation method. From the 4th day after modeling, rats in the Tuina group and the blocker agent + Tuina group were subject to daily Tuina intervention, and those in the blocker agent group and the blocker agent + Tuina group were daily intrathecally injected with NR2B blocker agent (MK-801). The spontaneous pain score was used to observe the pain behavior of all rats. The expression levels of NR2B and downstream PSD-95 were measured by immunohistochemistry, and the dendritic structure changes were observed by Golgi staining for rat spinal cord dorsal horn after 14 d of continuous intervention. Results Compared with the blank group, the degree of rat spontaneous pain after CCI was elevated in both the model and the Tuina groups ( P <0.01) and was reduced in the Tuina group after the Tuina intervention compared with the model group ( P <0.05). Compared with the model group, the rat spontaneous pain level after blocking NR2B was reduced in both the blocker agent group and the blocker agent + Tuina group ( P <0.05). The NR2B and PSD-95 protein levels were significantly higher in the model group compared with the blank group ( P <0.01); the total number of dendritic branches was increased ( P <0.01), and the total dendritic length became longer ( P <0.01) in the spinal cord dorsal horn. The rat NR2B and PSD-95 protein levels were significantly decreased in the Tuina group compared with the model group ( P <0.01); the total dendritic branch number was reduced ( P <0.01) and the total length was shortened ( P <0.01) in the spinal cord dorsal horn. After blocking NR2B, the expression levels of NR2B and downstream PSD-95 protein were significantly lower in both the blocker agent group and the blocker agent + Tuina group compared to the model group ( P <0.01). The total branch number was significantly reduced ( P <0.01), and the total length was significantly shortened ( P <0.01) of the dendrites in the spinal cord dorsal horn. Conclusion Tuina may exert an analgesic effect by remodeling the dendritic structure in the spinal cord dorsal horn in rats with lumbar disc herniation, and its mechanism may be related to the inhibition of NR2B/PSD-95 signaling pathway.","PeriodicalId":14826,"journal":{"name":"Journal of Acupuncture and Tuina Science","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135518240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.1007/s11726-023-1366-4
Jiayi Chen, Xiaoji Zhu, Yang Peng, Huirong Liu, Huangan Wu, Cili Zhou
Abstract Objective To observe the effect of moxibustion on behaviors and related products of tryptophan (Trp) metabolism in the colon of mice with irritable bowel syndrome (IBS), and to explore the mechanism of moxibustion in the IBS treatment. Methods Twenty-four mice were randomly divided into a normal group, a model group, a moxibustion group, and a probiotic group, with 6 mice in each group. The visceral pain model of IBS was established by enema with 2,4,6-trinitrobenzene sulfonic acid (TNBS) solution. Mice in the moxibustion group were treated with mild moxibustion at bilateral Zusanli (ST36), and those in the probiotic group were treated with probiotics such as Bifidobacterium by gavage. Abdominal withdrawal reflex (AWR) test, elevated plus-maze (EPM) test, and forced swimming test (FST) were performed after treatment. The expression levels of 5-hydroxytryptamine (5-HT) and tryptophan hydroxylase 1 (TPH1) in the colon were detected by immunofluorescence, and the expression levels of Trp, kynurenine (Kyn), and indole-2,3-oxygenase (IDO) in the colon were detected by enzyme-linked immunosorbent assay. Results Compared with the normal group, the AWR scores were increased significantly in the model group under different pressure values ( P <0.01), the open-arm staying time and open-arm entries in the EPM test were decreased significantly ( P <0.01, P <0.05), the motionless time in the FST was increased significantly ( P <0.01), and the expression levels of colonic Trp, TPH1, IDO, 5-HT, and Kyn were increased significantly ( P <0.01) in the models. Compared with the model group, the AWR scores were differently decreased ( P <0.05 or P <0.01), the open-arm entries in the EPM test were increased ( P <0.05), the motionless times in the FST were decreased ( P <0.05), and the colonic expression levels of Trp, TPH1, IDO, and 5-HT were decreased ( P <0.01 or P <0.05) in the moxibustion and probiotic groups; the open-arm staying time was significantly increased in the moxibustion group ( P <0.01), and the colonic expression level of Kyn was significantly decreased in the probiotic group ( P <0.01). Conclusion Moxibustion at Zusanli (ST36) improves visceral pain and pain mood and down-regulates the expression levels of colonic TPH1, IDO, Trp, 5-HT, and Kyn in IBS mice.
{"title":"艾灸对肠易激综合征小鼠行为学及色氨酸代谢相关产物的影响","authors":"Jiayi Chen, Xiaoji Zhu, Yang Peng, Huirong Liu, Huangan Wu, Cili Zhou","doi":"10.1007/s11726-023-1366-4","DOIUrl":"https://doi.org/10.1007/s11726-023-1366-4","url":null,"abstract":"Abstract Objective To observe the effect of moxibustion on behaviors and related products of tryptophan (Trp) metabolism in the colon of mice with irritable bowel syndrome (IBS), and to explore the mechanism of moxibustion in the IBS treatment. Methods Twenty-four mice were randomly divided into a normal group, a model group, a moxibustion group, and a probiotic group, with 6 mice in each group. The visceral pain model of IBS was established by enema with 2,4,6-trinitrobenzene sulfonic acid (TNBS) solution. Mice in the moxibustion group were treated with mild moxibustion at bilateral Zusanli (ST36), and those in the probiotic group were treated with probiotics such as Bifidobacterium by gavage. Abdominal withdrawal reflex (AWR) test, elevated plus-maze (EPM) test, and forced swimming test (FST) were performed after treatment. The expression levels of 5-hydroxytryptamine (5-HT) and tryptophan hydroxylase 1 (TPH1) in the colon were detected by immunofluorescence, and the expression levels of Trp, kynurenine (Kyn), and indole-2,3-oxygenase (IDO) in the colon were detected by enzyme-linked immunosorbent assay. Results Compared with the normal group, the AWR scores were increased significantly in the model group under different pressure values ( P <0.01), the open-arm staying time and open-arm entries in the EPM test were decreased significantly ( P <0.01, P <0.05), the motionless time in the FST was increased significantly ( P <0.01), and the expression levels of colonic Trp, TPH1, IDO, 5-HT, and Kyn were increased significantly ( P <0.01) in the models. Compared with the model group, the AWR scores were differently decreased ( P <0.05 or P <0.01), the open-arm entries in the EPM test were increased ( P <0.05), the motionless times in the FST were decreased ( P <0.05), and the colonic expression levels of Trp, TPH1, IDO, and 5-HT were decreased ( P <0.01 or P <0.05) in the moxibustion and probiotic groups; the open-arm staying time was significantly increased in the moxibustion group ( P <0.01), and the colonic expression level of Kyn was significantly decreased in the probiotic group ( P <0.01). Conclusion Moxibustion at Zusanli (ST36) improves visceral pain and pain mood and down-regulates the expression levels of colonic TPH1, IDO, Trp, 5-HT, and Kyn in IBS mice.","PeriodicalId":14826,"journal":{"name":"Journal of Acupuncture and Tuina Science","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135518238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.5847/wjem.j.1920-8642.2023.062
Miao Gan, Liang Zong, Xuezhong Yu, Jun Xu
Background: Currently, prophylactic antibiotics are recommended only for cirrhotic patients with acute upper gastrointestinal bleeding (AUGIB); however, the benefit for other AUGIB patients remains undetermined. We aimed to compare the clinical outcomes between patients with AUGIB with and without prophylactic antibiotics to identify the population that requires this therapy.
Methods: Patients with AUGIB admitted between 1st January 2019 and 31st December 2021 in the Emergency Department of Peking Union Medical College Hospital were enrolled. Patients were divided into the antibiotic and non-antibiotic groups. The primary outcome was in-hospital mortality, and the secondary outcome was the onset of new infection. The risk factors for mortality and infection were analyzed, and stratification analysis of prophylactic antibiotics was performed. Continuous data were analyzed using the t-test or nonparametric rank sum test, and categorical data were analyzed using the Chi-square test or Fisher's exact test. Indicators with significant differences between the groups were included for logistic regression analysis. A P-value <0.05 was considered statistically significant.
Results: A total of 392 individuals were included, among them, 281 patients received prophylactic antibiotics, and 111 patients did not receive prophylactic antibiotics. The mortality rates were significantly lower in the antibiotic group than in the non-antibiotics group (6.41% vs. 17.12%, P=0.001). The risk factors for infection were varicose veins (P=0.045) and endotracheal intubation (P=0.005) in the prophylactic antibiotic group, and endoscopic treatment (P=0.010) in the non-prophylactic antibiotic group. Stratified analyses showed that patients with age ≥ 65 years, endotracheal intubation, endoscopic treatment, and AUGIB of variceal etiologies benefited from prophylactic antibiotics.
Conclusion: AUGIB patients may benefit from prophylactic antibiotics to decrease mortality, especially those aged ≥ 65 years and those with endotracheal intubation, endoscopic treatment, and variceal etiologies.
背景:目前，预防性抗生素仅推荐用于肝硬化急性上消化道出血(AUGIB)患者;然而，对其他AUGIB患者的益处仍不确定。我们的目的是比较使用和不使用预防性抗生素的AUGIB患者的临床结果，以确定需要这种治疗的人群。方法:选取2019年1月1日至2021年12月31日北京协和医院急诊科收治的AUGIB患者。患者分为抗生素组和非抗生素组。主要结局是住院死亡率，次要结局是新感染的发生。对死亡和感染的危险因素进行分析，并对预防性抗生素进行分层分析。连续资料分析采用t检验或非参数秩和检验，分类资料分析采用卡方检验或Fisher精确检验。纳入组间差异显著的指标进行logistic回归分析。结果:共纳入392例患者，其中使用预防性抗生素患者281例，未使用预防性抗生素患者111例。抗生素组的死亡率显著低于非抗生素组(6.41% vs. 17.12%， P=0.001)。感染危险因素预防性抗生素组为静脉曲张(P=0.045)和气管插管(P=0.005)，非预防性抗生素组为内镜治疗(P=0.010)。分层分析显示，年龄≥65岁、气管插管、内镜治疗和静脉曲张病因的AUGIB患者受益于预防性抗生素。结论:AUGIB患者可能受益于预防性抗生素以降低死亡率，特别是年龄≥65岁、气管插管、内镜治疗和静脉曲张病因的患者。
{"title":"The effect of prophylactic antibiotics in acute upper gastrointestinal bleeding patients in the emergency department.","authors":"Miao Gan, Liang Zong, Xuezhong Yu, Jun Xu","doi":"10.5847/wjem.j.1920-8642.2023.062","DOIUrl":"10.5847/wjem.j.1920-8642.2023.062","url":null,"abstract":"<p><strong>Background: </strong>Currently, prophylactic antibiotics are recommended only for cirrhotic patients with acute upper gastrointestinal bleeding (AUGIB); however, the benefit for other AUGIB patients remains undetermined. We aimed to compare the clinical outcomes between patients with AUGIB with and without prophylactic antibiotics to identify the population that requires this therapy.</p><p><strong>Methods: </strong>Patients with AUGIB admitted between 1<sup>st</sup> January 2019 and 31<sup>st</sup> December 2021 in the Emergency Department of Peking Union Medical College Hospital were enrolled. Patients were divided into the antibiotic and non-antibiotic groups. The primary outcome was in-hospital mortality, and the secondary outcome was the onset of new infection. The risk factors for mortality and infection were analyzed, and stratification analysis of prophylactic antibiotics was performed. Continuous data were analyzed using the <i>t</i>-test or nonparametric rank sum test, and categorical data were analyzed using the Chi-square test or Fisher's exact test. Indicators with significant differences between the groups were included for logistic regression analysis. A <i>P</i>-value <0.05 was considered statistically significant.</p><p><strong>Results: </strong>A total of 392 individuals were included, among them, 281 patients received prophylactic antibiotics, and 111 patients did not receive prophylactic antibiotics. The mortality rates were significantly lower in the antibiotic group than in the non-antibiotics group (6.41% vs. 17.12%, <i>P</i>=0.001). The risk factors for infection were varicose veins (<i>P</i>=0.045) and endotracheal intubation (<i>P</i>=0.005) in the prophylactic antibiotic group, and endoscopic treatment (<i>P</i>=0.010) in the non-prophylactic antibiotic group. Stratified analyses showed that patients with age ≥ 65 years, endotracheal intubation, endoscopic treatment, and AUGIB of variceal etiologies benefited from prophylactic antibiotics.</p><p><strong>Conclusion: </strong>AUGIB patients may benefit from prophylactic antibiotics to decrease mortality, especially those aged ≥ 65 years and those with endotracheal intubation, endoscopic treatment, and variceal etiologies.</p>","PeriodicalId":14826,"journal":{"name":"Journal of Acupuncture and Tuina Science","volume":"15 1","pages":"442-447"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10632749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70976334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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