Trends in the Application of Dyadic Coping in Older Adults with Mild Cognitive Impairment and Their Spouses

Dyadic coping plays an important role in older adults with mild cognitive impairment and their spouses. Significant correlations were found between dyadic coping and self-efficacy, anxiety and depression, marital quality, and quality of life in elderly patients with mild cognitive impairment and their spouses, and there were gender differences, with a 36.1% [P = 0.028, OR = 0.639, 95% CI (0.429, 0.952)] and 54% [P = 0.004, OR = 0.460, 95% CI (0.269, 0.785)] reduction in the risk of MCI and dementia for older men aged 65 - 69 years with a spouse and for those aged 80 years and older with a spouse, respectively. In contrast, there was no significant difference in the association between having or not having a spouse and developing MCI and dementia in older women (all P > 0.05). Psychosocial interventions, skills interventions, and exercise from the perspective of dyadic relationships were effective in improving the physical and mental health of older adults with mild cognitive impairment and their spouses. However, there is a lack of specific intervention programs for dyadic relationships in the local cultural context as an entry point. Therefore, it is necessary to draw on internal and external relevant literature to treat both partners as a whole for intervention, provide personalized social, cognitive and motor therapy for patients and promote the integration and participation of caregivers, help patients and spouses to improve the sense of well-being and intimacy, reduce the burden of caregivers, and build a dyadic coping intervention program suitable for elderly patients with mild cognitive impairment in China. The current article aims to provide a conceptual review focusing on dyadic coping care to inform the development of a dyadic intervention program suitable for older adults with mild cognitive impairment in China. This review outlines the theoretical concepts, assessment tools, current state of research, and intervention methods for mild cognitive impairment and dyadic coping.

Endoscopic dacryocystorhinostomy in acute dacryocystitis:a multicenter study in China

AIM:To repor t the clinical profile,endoscopic dacryocystorhinostomy(En-DCR)management,and acute dacryocystitis(AD)outcomes in China.METHODS:Clinical data of 554 adult AD patients(554 eyes)who presented in 7 tertiary eye care centers for 10y from Jan 2010 to Mar 2020 were retrospectively analyzed.Clinical profile,En-DCR management,and outcomes of all cases were recorded.The anatomical and functional success were evaluated for 12mo post-operation.RESULTS:The analysis included 149 males and 368 females with a median age of 55.2y(range:18-84y).There were 459 eyes with a history of epiphora or purulent secretion.The time between a symptom of lacrimal duct obstruction and acute onset was 1 to 540(66.1±58.2)mo.Fifty-nine eyes had a history of the previous acute attack.Seventy-four eyes developed a cutaneous fistula,while 11 eyes had post septal cellulitis pre-operation.En-DCR with an anatomical success of 91.7%and functional success of 90.1%.The success rate of the patients with a history of acute episodes and the preoperative fistula was lower than the overall success rates.CONCLUSION:En-DCR can be performed during an acute episode in AD with a success rate of over 90%.

Acupuncture at the Taixi(KI3) acupoint activates cerebral neurons in elderly patients with mild cognitive impairment

Our previous ifndings have demonstrated that acupuncture at the Taixi （KI3） acupoint in healthy youths can activate neurons in cognitive-related cerebral cortex. Here, we investigated whether acupuncture at this acupoint in elderly patients with mild cognitive impairment can also activate neurons in these regions. Resting state and task-related functional magnetic resonance imaging showed that the pinprick senstation of acupuncture at the Taixi acupoint differed signiifcantly between elderly patients with mild cognitive impairment and healthy elderly controls. Results showed that 20 brain regions were activated in both groups of participants, including the bi-lateral anterior cingulate gyrus （Brodmann areas [BA] 32, 24）, left medial frontal cortex （BA 9, 10, 11）, left cuneus （BA 19）, left middle frontal gyrus （BA 11）, left lingual gyrus （BA 18）, right medial frontal gyrus （BA 11）, bilateral inferior frontal gyrus （BA 47）, left superior frontal gyrus （BA11）, right cuneus （BA 19, 18）, right superior temporal gyrus （BA 38）, left subcallosal gyrus （BA 47）, bilateral precuneus （BA 19）, right medial frontal gyrus （BA 10）, right superior frontal （BA 11）, left cingulate gyrus （BA 32）, left precentral gyrus （BA 6）, and right fusiform gyrus （BA 19）. These results suggest that acupuncture at the Taixi acupoint in elderly patients with mild cogni-tive impairment can also activate some brain regions.

Neuroimaging mechanisms of high-frequency repetitive transcranial magnetic stimulation for treatment of amnestic mild cognitive impairment:a double-blind randomized sham-controlled trial

Individuals with amnestic mild cognitive impairment(aMCI)have a high risk of developing Alzheimer’s disease.Although repetitive transcranial magnetic stimulation(rTMS)is considered a potentially effective treatment for cognitive impairment in patients with aMCI,the neuroimaging mechanisms are poorly understood.Therefore,we performed a double-blind randomized sham-controlled trial in which rTMS was applied to the left dorsolateral prefrontal cortex of aMCI patients recruited from a community near the Third Hospital Affiliated to Sun Yat-sen University,China.Twenty-four patients with aMCI were randomly assigned to receive true rTMS(treatment group,n=12,6 men and 6 women;age 65.08±4.89 years)or sham stimulation(sham group,n=12,5 men and 7 women;age 64.67±4.77 years).rTMS parameters included a stimulation frequency of 10 Hz,stimulation duration of 2 seconds,stimulation interval of 8 seconds,20 repetitions at 80%of the motor threshold,and 400 pulses per session.rTMS/sham stimulation was performed five times per week over a period of 4 consecutive weeks.Our results showed that compared with baseline,Montreal Cognitive Assessment scores were significantly increased and the value of the amplitude of low-frequency fluctuation(ALFF)was significantly increased at the end of treatment and 1 month after treatment.Compared with the sham group,the ALFF values in the right inferior frontal gyrus,triangular part of the inferior frontal gyrus,right precuneus,left angular gyrus,and right supramarginal gyrus were significantly increased,and the ALFF values in the right superior frontal gyrus were significantly decreased in the treatment group.These findings suggest that high-frequency rTMS can effectively improve cognitive function in aMCI patients and alter spontaneous brain activity in cognitive-related brain areas.This study was approved by the Ethics Committee of Shenzhen Baoan Hospital of Southern Medical University,China(approval No.BYL20190901)on September 3,2019 and registered in the Chinese Clinical Trials Registry(registration No.ChiCTR1900028180)on December 14,2019.

Special AT-rich sequence-binding protein 2 acts as a negative regulator of stemness in colorectal cancer cells

AIM To find the mechanisms by which special AT-rich sequence-binding protein 2(SATB2) influences colorectal cancer(CRC) metastasis.METHODS Cell growth assay, colony-forming assay, cell adhesion assay and cell migration assay were used to evaluate the biological characteristics of CRC cells with gain or loss of SATB2. Sphere formation assay was used to detect the self-renewal ability of CRC cells. The m RNA expression of stem cell markers in CRC cells with upregulated or downregulated SATB2 expression was detected by quantitative real-time polymerase chain reaction. Chromatin immunoprecipitation(Ch IP) was used to verify the binding loci of SATB2 on genomic sequences of stem cell markers. The Cancer Genome Atlas(TCGA) database and our clinical samples wereanalyzed to find the correlation between SATB2 and some key stem cell markers.RESULTS Downregulation of SATB2 led to an aggressive phenotype in SW480 and DLD-1 cells, which was characterized by increased migration and invasion abilities. Overexpression of SATB2 suppressed the migration and invasion abilities in SW480 and SW620 cells. Using sequential sphere formation assay to detect the selfrenewal abilities of CRC cells, we found more secondary sphere formation but not primary sphere formation in SW480 and DLD-1 cells after SATB2 expression was knocked down. Moreover, most markers for stem cells such as CD133, CD44, AXIN2, MEIS2 and NANOG were increased in cells with SATB2 knockdown and decreased in cells with SATB2 overexpression. Ch IP assay showed that SATB2 bound to regulatory elements of CD133, CD44, MEIS2 and AXIN2 genes. Using TCGA database and our clinical samples, we found that SATB2 was correlated with some key stem cell markers including CD44 and CD24 in clinical tissues of CRC patients.CONCLUSION SATB2 can directly bind to the regulatory elements in the genetic loci of several stem cell markers and consequently inhibit the progression of CRC by negatively regulating stemness of CRC cells.

Modulatory effects of acupuncture on brain networks in mild cognitive impairment patients

Functional magnetic resonance imaging has been widely used to investigate the effects of acupuncture on neural activity. However, most functional magnetic resonance imaging studies have focused on acute changes in brain activation induced by acupuncture. Thus, the time course of the therapeutic effects of acupuncture remains unclear. In this study, 32 patients with amnestic mild cognitive impairment were randomly divided into two groups, where they received either Tiaoshen Yizhi acupuncture or sham acupoint acupuncture. The needles were either twirled at Tiaoshen Yizhi acupoints, including Sishencong（EX-HN1）, Yintang（EX-HN3）, Neiguan（PC6）, Taixi（KI3）, Fenglong（ST40）, and Taichong（LR3）, or at related sham acupoints at a depth of approximately 15 mm, an angle of ± 60°, and a rate of approximately 120 times per minute. Acupuncture was conducted for 4 consecutive weeks, five times per week, on weekdays. Resting-state functional magnetic resonance imaging indicated that connections between cognition-related regions such as the insula, dorsolateral prefrontal cortex, hippocampus, thalamus, inferior parietal lobule, and anterior cingulate cortex increased after acupuncture at Tiaoshen Yizhi acupoints. The insula, dorsolateral prefrontal cortex, and hippocampus acted as central brain hubs. Patients in the Tiaoshen Yizhi group exhibited improved cognitive performance after acupuncture. In the sham acupoint acupuncture group, connections between brain regions were dispersed, and we found no differences in cognitive function following the treatment. These results indicate that acupuncture at Tiaoshen Yizhi acupoints can regulate brain networks by increasing connectivity between cognition-related regions, thereby improving cognitive function in patients with mild cognitive impairment.

Activation of various brain areas during acupuncture at Taixi (KI 3) and Qiuxu (GB 40) acupoints

A number of previous studies of acupuncture acupoint specificity have used sham acupoints, sham acupuncture or meridian acupoints at a great distance from each other as controls in functional MRI （fMRI） experiments. However, few studies have compared different meridian acupoints within the same segment, which are associated with similarly intense needle sensations. We performed fMRI on 12 healthy young volunteers and observed differences in brain activation elicited by acupuncture of the Taixi （KI 3） and Qiuxu （GB 40） acupoints. Acupuncture was applied at the Taixi and Qiuxu acupoints, using a multiple-block fMRI design with three blocks, involving three altemations of resting and task phases. After scanning, needle sensation was assessed. The behavioral results revealed that the subjective needle sensation was similar between the Taixiand Qiuxu acupoints. The fMRI results revealed that acupuncture at the right Taixi acupoint activated the right superior temporal gyrus （BA 22）, left middle frontal gyrus （BA 46） and inferior frontal gyrus （BA 45）, bilateral parietal lobe postcentral gyrus （BA 2）, right parietal lobe （BA 3）, and left parietal lobe （BA 40）. Acupuncture at the right Qiuxu acupoint activated the left superior temporal gyrus （BA 42）, right parietal lobe postcentral gyrus （BA 40, BA 43）, right inferior frontal gyrus （BA 47）, bilateral superior temporal gyrus （BA 22）, and right insula BA13. These results suggest that the right Taixiand Qiuxu acupoints activated different brain areas.

Anti-aging effects of moxa cone moxibustion As a free radical scavenger complement

Therapies that complement free radical scavenging are an important approach for treating aging in the brain. In the present study, two formulations of moxa cone moxibustion were applied at acupoints Zusanfi （ST 36） and Xuanzhong （GB 39）, and at acupoints Baihui （DU 20） and Guanyuan （RN 4）, in D-galactose-induced senile mice. The results revealed that moxa cone moxibustion improved total superoxide dismutase and Cu/Zn-superoxide dismutase activity in the homogenates of the cerebral tissue, as well as ameliorating deficits in neuronal morphology and neuronal density in the cerebral cortex and hippocampal CA3. Moxa cone moxibustion also enhanced learning and memory functions of senile mice. Moxa cone moxibustion at Zusanli, Xuanzhong, Baihuiand Guanyuan acupoints can thus be used to complement free radical scavengers, with efficacy that is equal to that of electroacupuncture at Zusanliand Xuanzhong, and superior to that of nimodipine treatment.

Collision tumor of squamous cell carcinoma and neuroendocrine carcinoma in the head and neck:A case report

BACKGROUND There are many disputes about the definition,diagnosis,therapy,and prognosis of collision tumors.CASE SUMMARY We describe a rare patient with a collision tumor consisting of neuroendocrine carcinoma(NEC)and squamous cell carcinoma(SCC)in the nasal cavity and paranasal sinus.She received operation,concurrent chemoradiotherapy,and then two cycles of palliative chemotherapy.Follow-up at 12 mo after diagnosis showed that this patient experienced a complete response with no signs of recurrence or metastasis.A literature review of previous 26 cases diagnosed with collision tumor of NEC and SCC in the head and neck was also undertaken.CONCLUSION It is challenging to manage collision tumors because there are two morphologically and etiologically distinct tumors.Well-designed multimodality therapy including surgery and chemoradiotherapy might lead to a long survival in these patients.

Propofol Target-Controlled Infusion Modeling in Rabbits:Pharmacokinetic and Pharmacodynamic Analysis

This study aimed to establish a new propofol target-controlled infusion（TCI） model in animals so as to study the general anesthetic mechanism at multi-levels in vivo. Twenty Japanese white rabbits were enrolled and propofol（10 mg/kg） was administrated intravenously. Artery blood samples were collected at various time points after injection, and plasma concentrations of propofol were measured. Pharmacokinetic modeling was performed using Win Nonlin software. Propofol TCI within the acquired parameters integrated was conducted to achieve different anesthetic depths in rabbits, monitored by narcotrend. The pharmacodynamics was analyzed using a sigmoidal inhibitory maximal effect model for narcotrend index（NI） versus effect-site concentration. The results showed the pharmacokinetics of propofol in Japanese white rabbits was best described by a two-compartment model. The target plasma concentrations of propofol required at light anesthetic depth was 9.77±0.23 μg/m L, while 12.52±0.69 μg/m L at deep anesthetic depth. NI was 76.17±4.25 at light anesthetic depth, while 27.41±5.77 at deep anesthetic depth. The effect-site elimination rate constant（ke0） was 0.263/min, and the propofol dose required to achieve a 50% decrease in the NI value from baseline was 11.19 μg/m L（95% CI, 10.25–13.67）. Our results established a new propofol TCI animal model and proved the model controlled the anesthetic depth accurately and stably in rabbits. The study provides a powerful method for exploring general anesthetic mechanisms at different anesthetic depths in vivo.

Effect of acupuncture on cerebral hematoma volume and HO-1 expression in rats with acute cerebral hemorrhage

Objective:To explore the effect of acupuncture on the expression of heme oxygenase-1 in rats with acute cerebral hemorrhage.Methods:108 Wistar male rats were randomly divided into sham operation group,model group,and acupuncture combined with model group(referred to as acupuncture group).Each group was divided into 3 subgroups according to 1d,3d and 7d,with 6 rats in each subgroup.The rat model of cerebral hemorrhage was established by autologous blood injection.Acupuncture was given at Baihui(GU20)and Qubin(GB7).Separately,at the 1st,3rd and 7th day,modified neurological severity score was used to evaluate the neurological function of rats,HE staining was used to measure the volume of cerebral hematoma and western blot was used to detect the expression of heme oxygenase-1 protein in cerebral hematoma tissue.Results:Compared with the model group,at each time point,the modified neurological severity score of the acupuncture group was significantly reduced(P<0.01);at the two time points of 3rd and 7th day,the cerebral hematoma volume of the acupuncture group was significantly reduced(P<0.05)and the expression of heme oxygenase-1 protein in brain tissue was significantly increased(P<0.05).Conclusion:Acupuncture may promote the expression of heme oxygenase-1 protein,reduce the volume of hematoma and the score of neurological deficit in rats with intracerebral hemorrhage,improve the performance of neurological deficit,and play a role in brain protection.

Dissecting the underlying pharmaceutical mechanism of Danggui Buxue decoction acting on idiopathic pulmonary fibrosis with network pharmacology

Backgroud:Danggui Buxue decoction(DBD),a classical prescription in traditional Chinese medicine,has been found to have protective effect on bleomycin-induced pulmonary fibrosis in rats by reducing alveolar inflammation and fibrosis.However,the biological activity of individual chemical components and mechanism of action of whole formula are not clear.Methods:Potential targets of active ingredients of DBD were collected through Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform and SymMap database.Target genes related to idiopathic pulmonary fibrosis were obtained from the Online Mendelian Inheritance in Man database,Therapeutic Targets Database and Gkb database.Then,the common targets were obtained by overlapping the potential targets of active ingredients in DBD and diseases related targets.The selected targets were subjected to Kyoto Encyclopedia of Genes and Genomes signaling pathway and Gene Ontology analysis,and the network map of active component-target-pathway was established using Cytoscape 3.7.1 software.The active components of DBD with most targets were selected for fibrosis-related marker verification.The mRNA and protein expression of fibrosis markers,α-smooth muscle actin,collagen 1 and fibronectin,were detected in TGF-β1-induced fibroblast cell line after treatment with the active components.Results:The 14 active ingredients,such as quercetin and kaempferol,were screened from DBD.It acts on 26 targets like estrogen receptor 2 and prostaglandin-endoperoxide synthase 2,and mainly involves 38 signaling pathways such as cell inflammation and autophagy.Kaempferol and quercetin are the two compounds with the highest network regulation,which can inhibit the transformation of fibroblasts into myofibroblasts and reduce the expression of fibrosis markersα-smooth muscle actin,collagen 1 and fibronectin.Conclusion:The integration mode of multi-component,multi-target,multi-channel and mechanism of DBD in the treatment of idiopathic pulmonary fibrosis are predicted by means of network pharmacology.Our study could indicate the direction of further anti-fibrotic mechanism research.

Protective effect of LIF-huM SCs on the retina of diabetic model rats

AIM:To investigate the protective effect of human umbilical cord mesenchymal stem cells(hUCMSCs)modified by the LIF gene on the retinal function of diabetic model rats and preliminarily explore the possible mechanism.METHODS:A stably transfected cell line of hUCMSCs overexpressing leukemia inhibitory factor(LIF)was constructed.Overexpression was verified by fluorescent quantitative polymerase chain reaction(qPCR).Forty-eight adult Sprague-Dawley rats were randomly divided into a normal control group(group A),streptozotocin-induced diabetic control group(group B),diabetic rats at 3mo injected with empty vector-transfected hUCMSCs(group C)or injected with LIF-hUCMSCs(group D).Four weeks after the intravitreal injection,analyses in all groups included retinal function using flash electroretinogram(F-ERG),retinal blood vessel examination of retinal flat mounts perfused with fluorescein isothiocyanate-dextran(FITCdextran),and retinal structure examination of sections using hematoxylin and eosin staining.Expression levels of adiponectin(APN),high-sensitivity C-reactive protein(hsCRP),and neurotrophin-4(NT-4)in each group was detected using immunohistochemistry,PCR,Western blotting,and ELISA,respectively.RESULTS:A stable transgenic cell line of LIF-hUCMSCs was constructed.F-ERG and FITC-dextran examinations revealed no abnormalities of retinal structure and function in group A,severe damage of the retinal blood vessels and function in group B,and improved retinal structure and function in group C and especially group D.qPCR,ELISA,and Western blot analyses revealed progressively higher APN and NT-4 expression levels in groups B,C,and D than in group A.hs-CRP expression was significantly higher in group B than in groups A,C,and D,and was significantly higher in group C than in group D(P<0.05).CONCLUSION:LIF-hUCMSCs protect the retina of diabetic rats by upregulating APN and NT-4 expression and downregulating hs-CRP expression in the retina.

manClinical Study on Infection of Chlamydia Trachomatis in Patients with Inflammation of Urogenital Tract

Object: To investigate the relationship between chlamydiatrachomatis (CT) and urogenital infection. Method Positive rate of CT in patients with inflammationof urogenital tract was significantly higher than those withoutinflammation(P<0.05). Result: There was statistical difference in the males nomatter they were patients with inflammation of urogenitaltract or not (P>H0.05), while there was no statistical differencein females (P>0.05). The incidence of the infection was highamong those aging from 21-50 years old. Conclusion: The clinical manifestations of CT infectionwere obscure, so we should examine CT in patients who haveno symptoms, especially in females and those of high-riskpopulation.

In situ immunomodulation of tumors with biosynthetic bacteria promote anti-tumor immunity

Immune checkpoint blockade(ICB)therapy potently revives T cell’s response to cancer.However,patients suffered with tumors that had inadequate infiltrated immune cells only receive limited therapeutic benefits from ICB therapy.Synthetic biology promotes the alternative strategy of harnessing tumor-targeting bacteria to synthesize therapeutics to modulate immunity in situ.Herein,we engineered attenuated Salmonella typhimurium VNP20009 with gene circuits to synthetize granulocyte-macrophage colony-stimulating factor(GM-CSF)and interleukin 7(IL-7)within tumors,which recruited dendritic cells(DCs)and enhanced T cell priming to elicit anti-tumor response.The bacteria-produced GM-CSF stimulated the maturation of bone marrow-derived dendritic cells(BMDCs),while IL-7 promoted the proliferation of spleen isolated T cells and inhibited cytotoxicity T cell apoptosis in vitro.Virtually,engineered VNP20009 prefer to colonize in tumors,and inhibited tumor growth by enhancing DCs and T cell infiltration.Moreover,the tumor-toxic GZMB^(+)CD8^(+)T cell and IFN-γ^(+)CD8^(+)T cell populations conspicuously increased with the treatment of engineered bacteria.The combination of GM-CSF-IL-7-VNP20009 with PD-1 antibody synergistically stunted the tumor progress and metastasis.

Cognitive impairment associated with individual and joint exposure to PM_(2.5)constituents in a Chinese national cohort

Nationwide longitudinal evidence linking cognitive decline with exposure to fine particulate matter(PM_(2.5))constituents remains scarce in China.By constructing a dynamic cohort based on the China Health and Retirement Longitudinal Study,we aimed to assess individual and joint associations of PM_(2.5)constituents with cognitive function among middle-aged and older adults in China.Linear mixed-effects models incorporated with quantile-based g-computation were applied to investigate individual and joint associations of long-term exposures to PM_(2.5)constituents with cognitive function.Among 13,507 respondents,we evaluated 38,950 follow-up records of cognitive function tests.Declines in global cognitive score associated with an interquartile range(IQR)increase in exposure were−1.477(95%CI:−1.722,−1.232)for nitrate,followed by−1.331(−1.529,−1.133)for ammonium,−1.033(−1.184,−0.883)for sulfate,−0.988(−1.144,−0.832)for organic matter and−0.822(−0.946,−0.699)for black carbon.An IQR-equivalent increase in joint exposure to these PM_(2.5)constituents was associated with a decline of−1.353(−1.659,−1.048)in global cognitive score.Female,younger,and well-educated individuals were at greater vulnerability to cognitive impairment related to individual and joint exposure to PM_(2.5)constituents.This study suggested that later-life exposures to PM_(2.5)constituents were associated with cognitive decline in middle-aged and older adults in China.

Chinese Medicine for Outcomes in Colorectal Cancer Patients： A Retrospective Clinical Study

Objective： To investigate the effect of Chinese medicine （CM） on survival of patients with stage Ⅱ and Ⅲ colorectal cancer （CRC）. Methods： A total of 295 patients who received chemotherapy were assigned to Group 1. The other 171 patients received the same chemotherapy treatment combined with the usage of CM Jianpi Jiedu Formula （健脾解毒方, JPJD） for more than 3 months （Group 2）. Patients＇ survival time, relapse and metastasis, and cause of death were observed. Cox proportional hazard regression models were established for the analysis of the effect of independent factors on the survival prognosis of patients with CRC. Results： The survival rate of patients in Group 2 was higher than that of Group 1 （P〈0.05）. Compared with Group 1, the mean survival time was prolonged by 5.594 months and the median survival time was prolonged by 6 months in Group 2 （P=0.004）. Cox regression analysis indicated that CM combined with chemotherapy provided significant protective effect, as observed with the improvements in the survival rates of CRC patients （P〈0.01）. Conclusion： CM can improve the survival rate in patients with stage Ⅱ and Ⅲ CRC.

Effect of Auricular Point Sticking on Pain Due to Lumbar Strain

Objective： To observe the effect of auricular point sticking on pain due to lumbar strain. Methods： Sixty patients with lumbar strain were randomized at ratio of 1：1 into two groups. The 30 cases in the observation group were given auricular point sticking plus externally applied medicinal plaster; the other 30 cases in a control group were only treated by the plaster. The Short-form of McGill Pain Questionnaire （SFMPQ） was adopted before treatment, after 3-day treatment, and at the end of 2-week treatment, for scoring and evaluation. Results： After 3-day treatment, the observation group gained significant improvement in Pain Rating Index （PRI）, Visual Analogue Scale （VAS）, and Present Pain Intensity （PPI） （P〈0.05）, while the improvements of PRI, VAS, and PPI in the control group were insignificant. After 2-week treatment, both groups gained significant progress in PRI, VAS, AND PPI compared with pre-treatment （P〈0.01）, and the inter-group comparison of PRI showed marked difference （P〈0.05）, but the differences in comparing VAS and PPI between the two groups were insignificant. There were merely any side effects happening in the two groups, except that some patients felt itchy, and the inter-group comparison did not show statistical significance. Conclusion： Auricular point sticking plus externally applied medicinal plaster has better effect than single plaster in treating lumbar strain induced pain, and it＇s safe and credible.

Co-infections of SARS-CoV-2 with multiple common respiratory pathogens in infected patients

Dear Editor,In late December 2019,an outbreak of severe pneumonia caused by an unknown etiological agent was initially reported in Wuhan,China,and then quickly spread throughout China and even abroad(Zhu et al.,2020).Swift control measures and etiological investigations were conducted by the Chinese government,physicians and researchers,and by using high throughput sequencing and virological testing,the mysterious pneumonia pathogen was shown to be a novel coronavirus(SARS-CoV-2)capable of person-to-person transmission(Zhu et al.,2020).Coronaviruses are a group of non-segmented,enveloped and positive-sense RNA viruses that belong to the subfamily of Coronavirinae in the family of Coronavirdiae and order of Nidovirales.

Functional organization of complex brain networks modulated by acupuncture at different acupoints belonging to the same anatomic segment

Background Noninvasive functional magnetic resonance imaging （fMRI） techniques have opened a ＂window＂ into the brain, allowing us to investigate the anatomical and physiological function involving acupuncture needling. Imaging its sustained effect rather than acute effect on the brain networks may further help elucidate the mechanisms by which acupuncture achieves its therapeutic effects. In this study, we aimed to investigate the functional brain networks during the post-resting state following acupuncture at KI3 in comparison with acupuncture at GB40. Methods Needling at acupoints GB40 and KI3 was performed in twelve subjects. Six minutes of scanning at rest were adopted before and after acupuncture at different acupoints. Then we divided the whole brain into 39 regions and constructed functional brain networks during the post-acupuncture resting states （PARS）. Results For direct comparisons, increased correlations during post-resting state following acupuncture at KI3 compared to resting state （RS） were primarily located between the dorsolateral prefrontal cortex （DLPFC） and post temporal cortex, ventromedial prefrontal cortex （vmPFC） and post temporal cortex. These brain regions were all cognitive-related functions. In contrast, the increased connections between the anterior insula and temporal cortex mainly emerged following acupuncture at GB40 compared with the RS. Conclusions The present study demonstrates that acupuncture at different acupoints belonging to the same anatomic segment can exert different modulatory effects on the reorganizations of post-acupuncture RS networks. The heterogeneous modulation patterns between twoconditions may relate to the functional specific modulatory effects of acupuncture.