加味滋肾通关方与五水头孢唑林钠联用治疗急性泌尿系感染疗效及对血清IL-6、IL-1β、TF水平的影响

目的探究加味滋肾通关方与五水头孢唑林钠联用治疗急性泌尿系感染疗效及对血清白细胞介素-6(Interleukin-6,IL-6)、白细胞介素-1β(Interleukin-1β,IL-1β)、组织因子(tissue factor,TF)水平的影响。方法选取2019年1月—2021年10月收治的急性泌尿系感染患者112例作为研究对象,按照随机数字表法分为观察组、对照组,各56例。给予基础干预的同时,对照组采取五水头孢唑林钠治疗,观察组采取加味滋肾通关方联合五水头孢唑林钠治疗。比较两组临床疗效、症状消失时间、治疗前、治疗7 d后中医证候积分、炎症状态(血清IL-6、IL-1β、TF水平)、免疫状态[血清免疫球蛋白A(immunoglobulin A,IgA)、免疫球蛋白M(Immunoglobulin M,IgM)、补体C3水平]及不良反应。结果(1)疗效、不良反应:观察组总有效率为92.86%(52/56),高于对照组76.79%(43/56)(P<0.05),两组不良反应发生率比较无显著差异(P>0.05);(2)症状改善情况:观察组体温复常、尿路刺激征消失、下腹疼痛消失、尿常规恢复正常时间短于对照组,治疗7 d后五心烦热、小便频数、腰酸乏力、尿黄灼痛、少腹拘急坠胀积分低于对照组(P<0.05);(3)炎症状态:治疗7 d后,观察组血清IL-6、IL-1β、TF水平均低于对照组(P<0.05);(4)免疫状态:治疗7 d后,两组血清IgA、IgM、补体C3水平均升高,观察组升高幅度较对照组高(P<0.05)。结论加味滋肾通关方与五水头孢唑林钠联用治疗急性泌尿系感染临床疗效显著,可加快患者症状减退,同时减轻机体炎症反应,调节免疫状态,且不影响治疗安全性。

针药结合治疗肩周炎106例

目的:观察中医内外合治肩周炎的临床疗效。方法:采取内服中药基本方(当归、黄芪、桂枝、鸡血藤等),配合针刺:主穴取肾关,辨证治疗肩周炎106例。结果:治愈67例,总有效率94.34。结论:针刺汤药联合治疗肩周炎有益气温经,散寒通络的功效。

Pharmacokinetics of mycophenolic acid in Chinese kidney transplant patients

To assess the influence of cyclosporin A (CsA) and tacrolimus (FK506) on mycophenolic acid (MPA) and correlation analysis of the pharmacokinetic parameters and patient characteristics, clinical outcome in Chinese kidney transplant recipients, the pharmacokinetics of 1000 mg mycophenolate mofetil (MMF) twice daily was measured by high-performance liquid chro- matography (HPLC). PKS (Pharmaceutical Kinetics Software) 1.0.2 software package was used for the calculation of pharma- cokinetic parameters. The mean Cmax, tmax, and AUC(0?12)were (21.88±10.52) μg/ml, (1.20±0.95) h, and (52.546±13.215) μg·h/ml, respectively. The level of AUC(0?12) in the FK506 group was significantly higher than that in the CsA group. MPA appeared not to be affected by renal function. MPA AUC(0?12) showed statistically significant difference according to the patient’s gender.

Clinical outcomes of isolated renal failure compared to other forms of organ failure in patients with severe acute pancreatitis

To assess differences in clinical outcomes of isolated renal failure (RF) compared to other forms of organ failure (OF) in patients with severe acute pancreatitis (SAP). METHODSUsing a prospectively maintained database of patients with acute pancreatitis admitted to a tertiary medical center between 2003 and 2016, those with evidence of persistent OF were classified to renal, respiratory, cardiovascular, or multi-organ (2 or more organs). Data regarding demographics, comorbidities, etiology of acute pancreatitis, and clinical outcomes were prospectively recorded. Differences in clinical outcomes after development of isolated RF in comparison to other forms of OF were determined using independent t and Mann-Whitney U tests for continues variables, and χ2 test for discrete variables. RESULTSAmong 500 patients with acute pancreatitis, 111 patients developed persistent OF: mean age was 54 years, and 75 (67.6%) were male. Forty-three patients had isolated OF: 17 (15.3%) renal, 25 (21.6%) respiratory, and 1 (0.9%) patient with cardiovascular failure. No differences in demographics, etiology of acute pancreatitis, systemic inflammatory response syndrome scores, or development of pancreatic necrosis were seen between patients with isolated RF vs isolated respiratory failure. Patients with isolated RF were less likely to require nutritional support (76.5% vs 96%, P = 0.001), ICU admission (58.8% vs 100%, P = 0.001), and had shorter mean ICU stay (2.4 d vs 15.7 d, P < 0.001), compared to isolated respiratory failure. None of the patients with isolated RF or isolated respiratory failure died. CONCLUSIONAmong patients with SAP per the Revised Atlanta Classification, approximately 15% develop isolated RF. This subgroup seems to have a less protracted clinical course compared to other forms of OF. Isolated RF might be weighed less than isolated respiratory failure in risk predictive modeling of acute pancreatitis.

RELATION OF HYPERTENSION TO DIABETIC NEPHROPATHY IN PATIENTS WITH NON-INSULIN-DEPENDENT DIABETES MELLITUS—A PAIR-MATCHED CASE-CONTROL STUDY

To assess the role of hypertension and family history of hypertensio n in the development of nephropathy in patients with non insulin dependent dia betes mellitus (NIDDM).Methods. A retrospective analysis was done on 2 groups of NIDDM patients, one g roup without proteinuria (urine protein< 300mg/24h, n=106) and the other group w ith proteinuria (urine protein≥500mg/24h, n=106). The 2 groups were matched by age(≤±3yrs), sex, ethnic and resident place. Some information of these subject s including demographic; history of disease, family history of diseases, lifesty le and behavior style variables was obtained by questionnaire; some variables w ere measured, including systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), quantity of protein in 24h urine. Then condi tional logistic regression analysis was performed.Results. Some factors, including history of hypertension, longer duration of hy pertension, higher levels of the past highest SBP and DBP, were independently as sociated with the occurrence risk of diabetic nephropathy (DN). Their correspond ing odd ratios (OR) with 95% confidence intervals (CI) were 2.00(1.17～3.43), 1 .25(1.08～1.46), 1.38(1.15～1.66), and 1.33(1.09～1.62) respectively, but family history of hypertension was not significantly associated with the development o f DN. When the above mentioned relations were respectively adjusted by some pos sible confounding factors, they still existed.Conclusions. History of hypertension, longer duration of hypertension, higher l evels of the past highest SBP and DBP are independent risk factors for DN in Chi nese NIDDM patients.

Detection and analysis of knee osteoarthritis in mice with gene expression profile

When gene expression profile is used for gene detection,the probe on the chip can emit fluorescence with different wavelengths.Under the action of confocal laser scanner,a clear gene change image can be obtained,by which the gene changes of the sample to be tested can be observed directly.First,the knee osteoarthritis(KOA)models of mice are established by the method of collateral ligament and meniscus resection(MLI-OA).Then,Bushen Huoxue formula is given by gavage,and ribonucleic acid(RNA)is routinely extracted and purified.Finally,the gene expression changes of KOA tissues of mice are detected by Agilent SurePrint G3 Mouse GE V2.0 gene expression profile.The results show that Bushen Huoxue formula has significant regulation effect on gene expression of KOA tissue.Among the genes with significant up-regulation effect of Bushen Huoxue formula,there are 56 genes of traditional Chinese medicine(TCM)groups up-regulated more than twice compared with model groups.Among the genes with significant down-regulation effect,there are 119 genes of TCM groups down-regulated more than twice compared with model groups.The experimental results indicate that Bushen Huoxue formula may promote the metabolism of arthritic factors and delay cartilage degeneration to treat KOA by regulating genes that are currently unknown in the pathological process of KOA.

Estrogen inhibits corticotropin-releasing hormone production in primary human placental cells

Objective: To study the inhibition effects of estrogen on the production of corticotropin-releasing hormone in human placental cells. Methods: Primary cultured placental cells were treated by ICI182, 780, a complete ER antagonist , and Tamoxifen, an ERa-mixed agonist/antagonist and ERβ antagonist for 24 h. The supernatant was havested for the radioimmunoassay of CRH. Results: 17β-estradiol inhibited the secretion of corticotropin-releasing hormone in human placental (P<0.05). ICI182, 780 stimulated the secretion of corticotropin-releasing hormone in human placental (P<0.05). Conclusion: Estrogen represses the synthesis and secretion of corticotropin-releasing hormone in human placental, which is possibly mediated by ERa.

Clinical observation of cerebral palsy treated with Chinese massage for promoting the Governor Vessel, benefiting the kidney and strengthening the spleen combined with music therapy

Objective To observe the effects on the range of motion （ROM） of ankle joint and muscular spasm of the lower limbs treated with Chinese massage for promoting the Governor Vessel, benefiting the kidney and strengthening the spleen combined with music therapy in infantile cerebral palsy （CP）. Methods In 286 cases of spasmodic CP, 7 kinds of Chinese massage were adopted, named massage on acupoints to promote circulation of the Governor Vessel, massage for strengthening the spleen and benefiting qi, spine-pinching therapy, segmental massage, foot massage, massage for promoting the recovery of muscle strength and massage for promoting ROM of joints. Chinese massage was applied in musical background. Buddha music and five-element music of Chinese medicine （music of the Heart, Liver and Kidney Meridians） were optioned. The treatment was given once or twice a day and 30 days made one course. The angles of femoral adductor and dorsal flexion of foot as well as the score of composite spasticity scale （CSS） were observed before and after treatment so that the therapeutic effect was assessed. Results In 30 days of treatment, 106 cases （37. 1%） were effective markedly, 172 cases （60. 1%） effective and 8 cases （2.8%） failed. The angle of dorsal flexion of foot was （105.64± 12.66）° and （76.58± 9.89）° before and after treatment respectively; the angle of femoral adductor was （119.89±25.47）° and （158.99± 18.66）° before and after treatment respectively; the score of CSS was （12.39±2.56） and （7. 069 ± 2.97） before and after treatment respectivel, there was significant difference before and after treatment （all P〈0.01）. Conclusion Chinese massage for promoting the Governor Vessel, benefiting the kidney and strengthening the spleen combined with music therapy brings the extremely active effect into play on the recovery of sitting, kneeling, standing and walking for children with CP.

Acupoints selection pattern in acupuncture-moxibustion treatment of perimenopausal syndrome from 2007 to 2016

Objective： To discuss the acupoints selection pattern in acupuncture-moxibustion treatment of perimenopausal syndrome（PMS） from 2007 to 2016. Methods： Clinical literatures related to PMS treated with acupuncture-moxibustion published from 2007 to 2016 were collected from Chinese Biomedical Literature Database（CBM）, Chongqing VIP Database（CQVIP）, China National Knowledge Infrastructure（CNKI）, and Wanfang Academic Journal Full-text Database（Wanfang）. The retrieved data underwent descriptive analysis, cluster analysis and association pattern analysis to determine the acupoints selection principle in acupuncture-moxibustion treatment of PMS. Results： The top five acupoints used in acupuncture-moxibustion treatment of PMS were Sanyinjiao（SP 6）, Shenshu（BL 23）, Guanyuan（CV 4）, Baihui（GV 20）, and Shenmen（HT 7）. The leading 4 meridians were Bladder Meridian, Conception Vessel, Spleen Meridian, and Governor Vessel. The clustering analysis showed that the 5 core acupoint groups were：（1） Sanyinjiao（SP 6）;（2） Shenshu（BL 23） and Guanyuan（CV 4）;（3） Baihui（GV 20）, Shenmen（HT 7）, Zusanli（ST 36）, Ganshu（BL 18） and Taichong（LR 3）;（4） Taixi（KI 3）, Pishu（BL 20）, Xinshu（BL 15）, Qihai（CV 6） and Neiguan（PC 6）;（5） Sishencong（EX-HN 1）, Zhongwan（CV 12）, Hegu（LI 4）, Yintang（GV 29）, Fengchi（GB 20）, Zhongji（CV 3） and Feishu（BL 13）. The three most significant acupoints were Sanyinjiao（SP 6）, Shenshu（BL 23） and Guanyuan（CV 4）. Acupoint groups based on syndrome differentiation included：（1） Hegu（LI 4）, Zhongwan（CV 12） and Sishencong（EX-HN 1）;（2） Feishu（BL 13）, Zhongji（CV 3）, Fengchi（GB 20） and Yintang（GV 29）;（3） Xinshu（BL 15）, Pishu（BL 20）, Qihai（CV 6）, Neiguan（PC 6） and Taixi（KI 3）;（4） Ganshu（BL 18）, Zusanli（ST 36）, Shenmen（HT 7）, Taichong（LR 3） and Baihui（GV 20）. The analysis of association pattern elaborated that Shenshu（BL 23） and Sanyinjiao（SP 6） won the highest support rate in the paired groups; Ganshu（BL 18）, Shenshu（BL 23） and Sanyinjiao（SP 6） had the highest support rate among the acupoint groups. Conclusion： The data mining results of acupuncture-moxibustion treatment of PMS substantially conform to the general principle in traditional acupuncture-moxibustion theories, able to reflect the acupoints selection and grouping pattern and provide references for acupuncture-moxibustion treatment of PMS.

Nephrogenic acute respiratory distress syndrome： A narrative review on pathophysiology and treatment

The kidneys have a close functional relationship with other organs especially the lungs. This connection makes the kidney and the lungs as the most organs involved in the multi-organ failure syndrome. The combination of acute lung injury （ALl） and renal failure results a great clinical significance of 80% mortality rate. Acute kidney injury （AKI） leads to an increase in circulating cytokines, chemokines, activated innate immune cells and diffuse of these agents to other organs such as the lungs. These factors initiate pathological cascade that ultimately leads to ALl and acute respiratory distress syndrome （ARDS）. We comprehensively searched the English medical literature focusing on AKI, ALl, organs cross talk, renal failure, multi organ failure and ARDS using the databases of PubMed, Embase, Scopus and directory of open access journals. In this narrative review, we summarized the pathophysiology and treatment of respiratory distress syndrome following AKI. This review promotes knowledge of the link between kidney and lung with mechanisms, diagnostic biomarkers, and treatment involved ARDS induced by AKI.

Therapeutic observation of 'warming-unblocking needling technique'for knee osteoarthritis due to deficiency of liver and kidney

Objective:To compare the clinical efficacy between'warming-unblocking needling technique7 and reinforcing method by twirling in treating knee osteoarthritis(KOA)due to deficiency of liver and kidney.Methods:A total of 72 patients with KOA were divided into a warming-unblocking group and a reinforcing group by complete randomized method,with 36 cases in each group.Xuehai(SP 10),Heding(EX-LE 2),Liangqiu(ST 34);Neixiyan(EX-LE 4),Xizhong(Extra),Dubi(ST 35),Yinlingquan(SP 9),Zusanli(ST 36)and Yanglingquan(GB 34)were the main points in both groups.Taichong(LR 3),Taixi(Kl 3)and Sanyinjiao(SP 6)were the combined points.'Warming-unblocking needling technique'was applied in the warming-unblocking group,and reinforcing method by twirling was applied in the reinforcing group.The treatments were performed once a day,10 times as a treatment course,at a 2-day interval between two courses,for 3 courses in total.The scores of Western Ontario and McMaster Universities osteoarthritis index(WOMAC)in the two groups were observed before and after the treatment,and the clinical efficacy was compared.Results:After treatment,the total effective rate was 94.3%in the warming-unblocking group and 87.9%in the reinforcing group,and the difference between the two groups was statistically significant(P<0.05).The component scores of pain,stiffness and daily activities in WOMAC and total WOMAC scores in both groups decreased after treatment(all P<0.01).The component and total WOMAC scores in the warming-unblocking group were lower than those in the reinforcing group(P<0.05 or P<0.01).Conclusion:'Warming-unblocking needling technique' has significant efficacy than reinforcing method by twirling in treating KOA due to deficiency of liver and kidney.It can significantly improve pain,stiffness and daily functional activities of patients.

Metachronous contralateral testicular and bilateral adrenal metastasis of chromophobe renal cell carcinoma:a case report and review of the literature

Chromophobe renal cell carcinoma(ChRCC) metastatic to the testis has not,to the best of our knowledge,been reported in the literature.Nor have there been reports of delayed bilateral adrenal metastasis of ChRCC.Here we report a case of metachronous contralateral testicular and bilateral adrenal metastasis of ChRCC in a 70-year-old man who underwent right radical nephrectomy for RCC six years ago.He was admitted to the hospital because of left intrascrotal enlargement of two-month duration.Ultrasonography revealed a mass in the upper pole of the left testis.Computed tomography(CT) showed irregular masses in the bilateral adrenal area.Left radical orchiectomy and laparoscopic bilateral adrenalectomy were performed.The pathologic examination showed metastatic ChRCC in the left testis and bilateral adrenal gland.Postoperative follow-up showed that the patient had survived for at least 56 months without recurrence.The case highlights the unique behavior of RCC with an unusual site of metastasis and favorable survival after multiple metastasectomy.

Effects of moxibustion on serum IL-6, IL-8 and TNF-α in rats with experimental rheumatoid arthritis

Objective:To observe the effects of moxibustion on serum levels of interleukin(IL)-6,IL-8 and tumor necrosis factor-α(TNF-α),and to explore the effects of moxibustion on inflammatory damaging factors in experimental rheumatoid arthritis(RA)model rats;the relationship between the therapeutic effect of moxibustion on RA and the change in the Toll-like receptor(TLR)signaling pathway was analyzed using Toll-like receptor 4(TLR4)antagonists and agonists.Methods:Fifty Sprague-Dawley(SD)rats were divided into a normal group,a model group,a moxibustion group,a moxibustion plus TLR4 agonist group(agonist group)and a moxibustion plus TLR4 antagonist group(antagonist group)according to the random number table,with 10 rats in each group.Except the normal group,rats in the other four groups were subjected to model preparation with the wind,cold and wet environmental factors plus Freund's complete adjuvant(FCA).Rats in the normal and model groups were not treated;rats in the moxibustion,agonist and antagonist groups started to be treated with the moxibustion(cigarette-type moxa)at bilateral Shenshu(BL 23)and Zusanli(ST 36)from the 4th day after the successful modeling,for 20 min each time with a total of 10 d.Rats in the agonist and the antagonist groups were injected with TLR4 agonist or antagonist[0.1 mg/(kg*bw)]via the tail vein 30 min before moxibustion.The concentrations of serum IL-6,IL-8 and TNF-αin each group were determined by enzyme-linked immunosorbent assay(ELISA).Results:Compared with the normal group,in the model group,the rat's right hind paw swelling was significantly obvious(P<0.01);there was a lot of inflammatory infiltration in the synovial tissues,the surface of the synovial membrane was unsmooth,the synovial membrane was hyperplasia and thicker,and the serum IL-6,IL-8 and TNF-αconcentrations increased significantly(P<0.05).Compared with the model group,the paw swelling degrees of the rats in the moxibustion,the agonist and the antagonist groups reduced significantly(all P<0.01);the swelling degree in the antagonist group was milder than that in the agonist group,but the between-group difference was not statistically significant(P>0.05);inflammatory infiltration and synovial membrane hyperplasia in the synovial tissues of the moxibustion group and the antagonist group were all relieved differently;the decrease of synovial layer number in the moxibustion group was more obvious,and there were no obvious improvements in inflammatory infiltration and synovial thickness in the agonist group;the concentrations of IL-6,IL-8 and TNF-αin the moxibustion group were decreased,and the differences in the IL-6 and TNF-αconcentrations were statistically significant(all P<0.01);there was no significant between-group difference in the IL-8 concentration(P>0.05);the concentrations of serum IL-8 and TNF-αin the agonist group increased significantly(both P<0.01),while the IL-6 concentration decreased without significant difference(P>0.05);the concentrations of IL-6 and IL-8 in the antagonist group decreased but the between-group differences were statistically insignificant(both P>0.05);and the TNF-αconcentration significantly increased(P<0.05).Compared with the moxibustion group,IL-6,IL-8 and TNF-αconcentrations increased in the agonist group,and the differences in the IL-8 and TNF-αconcentrations were statistically significant(both P<0.01);the concentrations of IL-6,IL-8 and TNF-αincreased in the antagonist group,and the differences in the IL-6 and TNF-αconcentrations were statistically significant(both P<0.01);there was no significant difference in the IL-8 concentration between the groups(P>0.05).The serum levels of IL-6,IL-8 and TNF-αin the antagonist group were lower than those in the agonist group(all P<0.05).Conclusion:Moxibustion at Shenshu(BL 23)and Zusanli(ST 36)can reduce the joint swelling degree and inflammation in synovial tissue of RA model rats,decrease the serum levels of IL-6,IL-8 and TNF-αin RA model rats;the decreases of IL-6 and TNF-αare more significant than the decrease of IL8;TLR4 agonist and antagonist can significantly attenuate the effect of moxibustion in inhibiting releases of IL-6,IL-8 and TNF-α,so that the change in TLR signaling pathway affects the effect of moxibustion in inhibiting the releases of IL-6,IL-8 and TNF-α.

Outcome ofJudet＇s quadricepsplasty for knee contractures and the effect of local infiltration of epinephrine on reducing blood loss

Objective： To evaluate the effectiveness ofJudet＇s quadricepsplasty for treatment of knee contractures and to identify the effect of local infiltration of epinephrine on blood loss associated with this procedure. Methods： A retrospective cohort study was conducted in which all cases of knee contractures managed with Judet＇s quadricepsplasty from 1st January 2009 to 31st December 2013 were included and were divided into two groups. The epinephrine group included patients who were infiltrated with diluted epinephrine （1：400,000） along with xylocaine, around the operative field 15 min prior to the incision time, while the control group did not receive any infiltration. Judet＇s outcome, blood loss, drop in he- moglobin and required blood transfusion were noted for all patients and compared between both groups. Results： Most common preceding pathology identified for the development of knee contractures was periarticular fracture while ilizarov application was the most common etiology. Both groups were found similar in all preoperative characteristics except preoperative flexion contracture （p = 0.02）. All func- tional outcome measures including Judet＇s outcome were similar in both groups. In contrast, duration of surgery （p = 0.01）, blood loss （p = 0.02）, drop in hemoglobin （p = 0.01） and number of transfusions （p = 0.03） were significantly reduced in epinephrine group. Conclusion： Judet＇s quadricepsplasty is a useful procedure to increase the range of motion of rigid knees and local infiltration of epinephrine is effective in decreasing the amount of subsequent blood loss and transfusion requirements.

Effect of Bushenhuoxue formula on interleukin-1 beta and discoidin domain receptor 2 levels in a rat model of osteoarthritis

OBJECTIVE:To determine the effects of Bushenhuoxue formula(BHF) on interleukin-1 beta(IL-1β),transforming growth factor beta 1(TGF-β1),discoidin domain receptor 2(DDR2) and matrix metalloproteinase-1(MMP-1) levels in a rat model of osteoarthritis(OA).METHODS:Sprague-Dawley rats were used to establish an OA model and subjected to various treatments over 6 weeks.Rats were treated with BHF,glucosamine sulfate(G5),or starch as a control.Serum levels of IL-1β and MMP-1 and joint fluid levels of IL-1 β were determined by means of ELISAs.We used immunohistochemistry to determine DDR2 levels in knee cartilage.Gene expression levels of MMP-1 in joint synovial tissue were assessed using reverse transcription polymerase chain reaction assays.RESULTS:Serum IL-1β levels were unchanged throughout the study.Levels of IL-1β in joint fluid and MMP-1 in sera from the BHF- and GS-treated groups were significantly reduced.DDR2 levels in knee cartilage were also significantly reduced in the BHF group.Expression of the MMP-1 gene was significantly reduced by BHF treatment.CONCLUSION:BHF might be beneficial in the inhibition and alleviation of local inflammatory responses and cartilage degeneration in OA.

Effect of moxibustion on N-methyl-D-aspartate receptor subtype 2B expression in hippocampus of rheumatoid arthritis model rats

Objective:To observe the effect of moxibustion on the expression of N-methyl-D-aspartic acid(NMDA)receptor subtype 2B(NR2B)in the hippocampus of rheumatoid arthritis(RA)rats,and to explore the analgesic mechanisms of moxibustion in RA treatment.Methods:Sixty male Sprague-Dawley rats were randomly divided into a normal group,a model group,a moxibustion group,a moxibustion+NMDA receptor antagonist(AP-5)group,and a moxibustion+NMDA receptor agonist(NMDA)group,with 12 rats in each group.Except for the normal group,rats in the other four groups were treated with complete Freund's adjuvant in a windy,cold,and damp environment to replicate RA models.Rats in the moxibustion group received suspended moxibustion with moxa sticks at Shenshu(BL23)and Zusanli(ST36),and the two points were used alternately.After intraperitoneal injection of AP-5 or NMDA,rats in the moxibustion+AP-5 group and the moxibustion+NMDA group received the same moxibustion intervention as in the moxibustion group,once a day for 15 d.The thermal withdrawal latency(TWL)of rats in each group was detected before and after modeling and after the 15-day intervention.After the 15-day intervention,hematoxylin-eosin staining was performed to observe the pathological changes in knee joints.The real-time fluorescence quantitative polymerase chain reaction method was used to detect the mRNA expression of NR2B in the hippocampus;Western blotting assay was used to detect the protein and the phosphorylated protein expression of hippocampal NR2B.Results:The synovial tissue was proliferated,the synovial lining was significantly thickened,the pannus was formed,and the cartilage and bone tissues were significantly damaged in the model group.After intervention,the pathological morphology of the knee joints in the moxibustion group,the moxibustion+AP-5 group,and the moxibustion+NMDA group was significantly improved,and the improvement in the moxibustion+AP-5 group was more notable than that in the moxibustion+NMDA group.Compared with the normal group,the TWL was significantly decreased(P<0.01),and the mRNA,protein,and phosphorylated protein expression levels of hippocampal NR2B were significantly increased in the model group(P<0.01).Compared with the model group,the TWL of each intervention group was significantly increased(P<0.01 or P<0.05),and the mRNA,protein,and phosphorylated protein expression levels of hippocampal NR2B were significantly decreased(P<0.01).Compared with the moxibustion group,the TWL was significantly increased(P<0.01),and the mRNA,protein,and phosphorylated protein expression levels of hippocampal NR2B were significantly decreased in the moxibustion+AP-5 group(P<0.01);the TWL was significantly decreased(P<0.01),and the mRNA,protein,and phosphorylated protein expression levels of hippocampal NR2B were significantly increased in the moxibustion+NMDA group(P<0.01).Conclusion:Moxibustion reduces hyperalgesia in RA inflammatory rats.The analgesic effect may be related to the decrease in the expression and phosphorylation levels of NR2B in the hippocampus.

Effect of Qilongtoutong granule on calcitonin gene-related peptide,beta-endorphin, serotonin, dopamine, and noradrenalin in migraine model rats and mice

OBJECTIVE： To study the effect of Qilongtoutong granule （QLTT） on plasma calcitonin gene-related peptide （CGRP）, beta-endorphin （I[3-EP）, 5-HT, dopa- mine （DA）, noradrenalin （NE）, and blood viscosity in migraine model rats and mice. METHODS： Both the acute blood stasis model group and nitroglycerin-induced migraine model group included 60 Sprague-Dawley rats. The reser- pine-reduced model group had 60 Kunming mice. Rats from each test were grouped into normal con- trol group, model group, Zhengtian pill （ZTP） group, and high, moderate, or low-dose QLTT groups. In the acute blood stasis model test, after gavage for 7 days, rats were given 0.8 mL/kg adren- aline hydrochloride subcutaneously twice, and kept in ice water for 5 min. After fasting for 12 h, rats were anesthetized and blood samples were collected for detection of blood viscosity. In the nitro- glycerin-induced migraine group, after gavage for 7 days, rats were intraperitoneally injected nitro- glycerin （10 mg/kg）, and 4 h later, blood samples were collected from postcava for measuring the plasma CGRP and 13-EP levels. In the reserpine-re- duced model test, except the normal control group, mice were administered reserpine （0.25 mg/ kg, i.h.） for 9 days. Mice received intragastric admin- istration from the third day to the ninth day. One hour after the last gavage, blood and brain tissue samples were obtained. Then, blood clotting time and the contents of neurotransmitters were deter- mined. RESULTS： QLTT- （3.6, 1.8, and 0.9 g/kg） and ZTP-treated rats had lower blood viscosity than that in model rats under different shear rates （P〈 0.01）. QLTT- （3.6, 1.8 g/kg） and ZTP-treated rats had significantly lower plasma CGRP levels and higher plasma 13-EP levels than those in model rats （P〈 0.01）. QLTT treatment at dose of 0.9 g/kg had lower plasma CGRP levels as well （P〈0.05）. QLTT- （5.2, 2.6 g/kg） and ZTP-treated mice had longer blood clotting time than that in model mice （P〈0.01）. QLTT- （2.6 g/kg） and ZTP-treated mice had higher plasma serotonin （5-HT） levels than those in model mice （P〈0.05）. CONCLUSION： QLTT-treated animals had lower plasma CGRP level, higher plasma 13-EP, 5-HT, high- er brain tissue 5-HT, NE, DA levels, and lower blood viscosity than those in the migraine model animals.