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2023 Vol. 53, No. 5 Published: 2023-05-25   345 Recent status and prospect of researches on bio-feedback in the narrow sense and acupuncture and moxibustion rehabilitation feedback therapy in the broad sense LU Junyan, WU Qiaoyun, HE Rong,ZHOU Lihong, CAI Canhuang, JIANG Songhe DOI: 10.3969/j.issn.2095-9400.2023.05.001 Bio-feedback therapy is a physical therapy for self-function adjustment, which is extended from the concept of feedback in cybernetics to rehabilitation medicine. Virtual reality technology has been integrated into rehabilitation therapy and has been widely used, similar to the re expansion of bio-feedback therapy.Acupuncture & nmoxibustion therapy is a treatment of diseases by means of multiple feedback and non selfconscious functional regulation. This paper comprehensively analyzes the mechanism of three physical stimulation treatments in three aspects: neuro-modulation, humoral-regulation and organ tissue self-regulation. 2023 Vol. 53 (5): 345-352 [Abstract] ( 300 ) HTML (1 KB)  PDF (1460 KB)  ( 705 ) 353 The effect of electroacupuncture on mitochondrial autophagy in neuropathic pain rats: A study based on Keap1/Nrf2 signal pathway CHENG Bo, TU Wenzhan, LOU Xinfa, YANG Guanhu, JIANG Songhe,WU Qiaoyun DOI: 10.3969/j.issn.2095-9400.2023.05.002 Objective: To explore the mechanism of electroacupuncture at “Zusanli” and “Kunlun” points in regulating mitochondrial autophagy and alleviating neuropathic pain. Methods: Totally 39 healthy male SD rats were selected. The model group was treated with L5 spinal nerve ligation (SNL). The sham group and the model group had the same operation but no ligation. The electroacupuncture group was treated with electroacupuncture for 7 consecutive days. The mechanical threshold and thermal threshold were detected after operation. L4-6 spinal cord segments were taken and HE staining was used to detect the histopathological changes; Mitochondrial autophagy in dorsal horn of spinal cord was observed by transmission electron microscope; The expression levels of Kelch-like ECH-associated protein-1 (Keap1), nuclear factor erythroid-related factor 2 (Nrf2), BCL2 and adenovirus E1B19 kDa interacting protein 3-like (NIX), BCL2 and adenovirus E1B19 kDa interacting protein 3 (BNIP3) were detected by Western blot. Results: The rats showed obvious pain allergic reaction after operation.Compared with the model group, the electroacupuncture group had the increased pain threshold, with significant difference (P<0.05). HE staining results showed that the morphology and structure of spinal dorsal horn neurons in the sham group were normal; In the model group, the cell nucleus was obviously pyknotic and the cell structure was destroyed; The tissue structure was improved after electroacupuncture treatment. The results of transmission electron microscopy showed that the morphology of mitochondria in pseudo module was regular and the number was small; In the model group, mitochondria were obviously swollen, cells were necrotic and apoptotic, and autophagic lysosomes were found around them. Compared with the model group, the the electroacupuncture group had relatively regular mitochondria, with partial disappearance of the mitochondrial cristae, and there was autophagic lysosome structure in the cells, without obvious necrosis and apoptosis. Western blot results showed that Keap1, Nrf2, NIX and BNIP3 expressions increased in the model group compared with the sham group (P<0.05). Compared with the model group, the electroacupuncture group had decreased Keap1 expression (P<0.05), increased Nrf2, NIX and BNIP3 expression (P<0.05). Conclusion: Electroacupuncture can promote mitochondrial autophagy to relieve neuropathic pain via Keap1/Nrf2 signaling pathway. 2023 Vol. 53 (5): 353-358 [Abstract] ( 335 ) HTML (1 KB)  PDF (2155 KB)  ( 520 ) 359 The urodynamic effect of ultrasound-guided electroacupuncture on the bladder in patients with incomplete spinal cord injury LU Junyan, LIN Le, CHENG Bo. DOI: 10.3969/j.issn.2095-9400.2023.05.003 Objective: To investigate the effect of electroacupuncture at Guanyuan and other acupoints on neurogenic bladder (detrusor areflexia type) after spinal cord injury based on ultrasonic guidance technology.Methods: 32 patients with SCI who met the standard were randomly divided into ultrasonic electroacupuncture group (16 cases) and conventional electroacupuncture group (16 cases). The urodynamic tests were performed first, and then the bladder volume was maintained at about 400 mL. CV4, CV3 and bilateral ST29 points were selected for acupuncture with ultrasonic guidance and manual manipulation, respectively. The frequency of electroacupuncture was 40 Hz, the waveform was continuous wave, and the pulse width was 200 μs, and urodynamic parameters, micturition sensation, and contractions of the bladder were observed in real time.Results: Acupuncture guided by ultrasound can accurately and safely locate the needle tip to the bladder muscle layer. In the ultrasonic electroacupuncture group, there was a significant sense of urination during electroacupuncture, 11 patients had slight bladder contraction, and all patients had significant electrical stimulation signals around the anus. There was a significant difference compared with the conventional electroacupuncture group (P<0.05). Pdetmax and Qmax did not change significantly in the two groups before and after electroacupuncture, and there was no significant difference between the two groups (P>0.05). Conclusion:Ultrasound guided electroacupuncture can safely and effectively improve bladder micturition function of patients with detrusor areflexia bladder after incomplete SCI. 2023 Vol. 53 (5): 359-363,369 [Abstract] ( 252 ) HTML (1 KB)  PDF (1661 KB)  ( 520 ) 364 The effect of VR/AR rehabilitation training on upper limb motor function in patients with early cerebral infarction and its diffusion tensor imaging research WU Longqiang, HUANG Qianqian, JIN Yun,SU Tingting, CHEN Xiaoyong, JIANG Songhe DOI: 10.3969/j.issn.2095-9400.2023.05.004 Objective: To explore the effect of VR/AR rehabilitation training combined with conventional rehabilitation therapy on upper limb functional rehabilitation and daily living ability of patients with early cerebral infarction, to reconstruct corticospinal tract (CST) using diffusion tensor imaging (DTI) technology, and to study the correlation between the number of nerve fibers in CST and motor function recovery. Methods: Twenty patientswere randomly divided into two groups, given conventional drugs and rehabilitation treatment, with the experimental group given VR combined with AR rehabilitation training. The upper Brunnstrom staging scale, upper limb Fugl-Meyer assessment for upper extremity (FMA-UE) system and modified Barthel index (MBI) were used to evaluate the two groups before and after the treatment. Cranial DTI of the two groups were reconstructed and the number of nerve fibers in CST was calculated. The increase and decrease of nerve fiber number before and after treatment were compared and their correlation with FMA-UE score was discussed. Results: Before the treatment, there was no significant difference between the two groups (P>0.05) in scale scores and the number of nerve fibers in the affected CST; after 3 weeks of treatment, the above indexes of the two groups increased significantly (P<0.05) compared with those before. And the experimental group had higher FMA-UE and Brunnstrom staging score of the upper limbs and hands than the control group, with significant difference (P<0.05); There was no significant difference in MBI scores between the two groups (P>0.05). The difference in MBI and FMA-UE scores between the two groups was statistically significant after treatment (P<0.05), but there was no significant difference (P>0.05) in the number of CST side nerve fiber between the experimental group and the control group. The number of nerve fibers in the affected CST was positively correlated with the FMA-UE score of the upper limb before and after rehabilitation. Conclusion: VR/AR rehabilitation therapy combined with routine rehabilitation training can significantly improve the upper limb motor ability of hemiplegia patients with early cerebral infarction, and can promote cerebral nerve fiber recombination and improve CST compensation.DTI technology can be used to analyze the changes in motor ability of patients with early cerebral infarction. 2023 Vol. 53 (5): 364-369 [Abstract] ( 325 ) HTML (1 KB)  PDF (1488 KB)  ( 506 ) 370 Aerobic exercise inhibited cardiac Hmox-1/GPX4 mediating ferroptosis to alleviate cardiac remodeling in diabetic cardiomyopathy WANG Ting, ZOU Yan, LI Haiyan, WANG Yonghua DOI: 10.3969/j.issn.2095-9400.2023.05.005 Objective: To illuminate the protective effect of aerobic exercise inhibiting ferroptosis by heme oxygenase-1 (Hmox-1) and glutathione peroxidase 4 (GPX4) against diabetic myocardial remodeling. Methods:Male C57BL/6 mice (as control) and db/db mice were fed with ordinary diet, which were spontaneously induced with type 2 diabetes, and mice fed with high-fat diet (HFD) and streptozotocin (STZ)-induced type 2 diabetes mice were treated with 12 weeks treadmill training. Then, cardiac function was examined by echocardiography HE, Masson’s staining and Sirius staining were respectively used to measure cardiac fibrosis andmorphology. In addition, mRNA and protein of GPX4 and Hmox-1 levels were detected by real-time quantitative polymerase chain reaction or Western blot. And cardiac 4-HNE was detected by immunohistochemical method. Results:Compared with the controls, both the heart of db/db mice and HFD+STZ induced mice presented by increased cardiac Hmox-1 and 4-HNE expression, decreased cardiac GPX4 level, accompanied by a reduction of cardiac dysfunction and cardiac hypertrophy and fibrosis. However, these abnormal changes were reversed by aerobic exercise, reflected by improved cardiac function, downregulated Hmox-1 and 4-HNE level, markedly activated GPX4 (P<0.05). Conclusion: Aerobic exercise inhibited cardiac ferroptosis to reverse cardiac remodeling in diabetic mice. 2023 Vol. 53 (5): 370-378 [Abstract] ( 372 ) HTML (1 KB)  PDF (3297 KB)  ( 915 ) 379 Myocardial atrophy and cardiac function in stroke mice improved by exercise preconditioning through upregulating Aplein/APJ WANG Li, LU Junhong, LIN Qijun, GU Meilin, TU Wenzhan, LI Shengcun DOI: 10.3969/j.issn.2095-9400.2023.05.006 Objective: To explore the effect of exercise preconditioning on myocardial atrophy and cardiac function after stroke. Methods: The stroke mouse model was made by occlusion of middle cerebral artery, and the phenotype was observed. After 30 days of swimming exercise or resting, stroke mice models were created respectively. The expression of Atrogin-1, MuRF-1 and Apelin/APJ mRNA in myocardium was detected by qRTPCR.Small animal ultrasonic instrument was used to detect the cardiac function of mice, including an analysis of ejection fraction (EF), transient shortening rate (FS) and E/A ratio of diastolic function. The expression of APJ protein was detected by western blot. Results: Myocardial atrophy and decreased cardiac function occurred after stroke; The expression of Atrogin-1 and MuRF-1 in myocardium of stroke mice increased, while the expression of Apelin/APJ decreased (P<0.05). Exercise could reduce the expression of atrophy gene and myocardial atrophy but improve cardiac function after stroke. Exercise up-regulated the expression of Apelin/APJ in myocardium of stroke mice (P<0.05). Conclusion: Exercise preconditioning alleviated central muscle atrophy and decreased cardiac function in stroke. Exercise may prevent muscle atrophy in stroke center by up-regulating Apelin/APJ. 2023 Vol. 53 (5): 379-385 [Abstract] ( 290 ) HTML (1 KB)  PDF (2098 KB)  ( 354 ) 386 Effect of exercise inhibition HMGCS2 expression on alleviating mice cardiomyopathy induced by doxorubicin CHEN Haili, SHEN Kangmin, CHEN Yuewei, WANG Li, LU Junhong, LI Shengcun, TU Wenzhan DOI: 10.3969/j.issn.2095-9400.2023.05.007 Objective: To explore the effect of exercise on preventing myocardial atrophy and cardiac dysfunction after doxorubicin treatment. Methods: After swimming for 30 days and 40 minutes a day, the mice were divided into three groups, with 6 in each: the rest control group, and the exercise+doxorubicin group,with 6 mice in each group.The mouse model of doxorubicin was intraperitoneally injected with 20 mg/kg doxorubicin. Cardiac function of mice was detected with small animal ultrasound instrument VEVO2100 after 4 days, and then the myocardial tissue was taken for analysis. The cardiac function of the mice was detected with the small animal ultrasound instrument VEVO2100, and then the myocardial tissue was taken. The expression of atrophic markers Atrogin-1, MuRF-1 and HMGCS2 mRNA in myocardium was detected by qRT-PCR. The expression of HMGCS2 protein was detected by Western blot. Results: Doxorubicin induced myocardial atrophy and decreased cardiac function in mice (P<0.05); After doxorubicin injection, the expression of HMGCS protein and HMGCS2 mRNA in mouse myocardium increased (P<0.05); Exercise could prevent doxorubicin-induced cardiac dysfunction and myocardial atrophy (P<0.05). Exercise inhibited the expression of HMGCS2 in mice with doxorubicin cardiomyopathy (P<0.05). Inhibition of HMGCS2 in cultured myocardial cells could prevent doxorubicin-induced cardiomyocyte apoptosis (P<0.05). Conclusion:Exercise can protect cardiac function and myocardial atrophy in mice with doxorubicin cardiomyopathy by inhibiting HMGCS2. 2023 Vol. 53 (5): 386-391 [Abstract] ( 260 ) HTML (1 KB)  PDF (1992 KB)  ( 382 ) 392 Pathogenic bacteria distribution and antimicrobial susceptibility in children with bloodstream infections PAN Ya’nan, ZHOU Jinhui, ZHANG Manman, MAO Huining, LI Siyu, HAN Hao, YUAN Xiang, TU Huixi, LIN Li. DOI: 10.3969/j.issn.2095-9400.2023.05.008 Objective: To study the distribution of pathogenic bacteria and antimicrobial susceptibility with bloodstream infections in children. Methods: Clinical data, distribution of pathogenic bacteria and antimicrobial susceptibility test results of children with bloodstream infections admitted to the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University from January 2016 to December 2021 were analyzed retrospectively. Results: A total of 538 pathogenic strains were detected in 528 cases, Gram-positive bacteria (55.4%), Gram-negative bacteria (42.2%) and fungi (2.4%) were detected, and the top 3 pathogens were Escherichia coli, coagulase-negative Staphylococcus, and Streptococcus pneumoniae. The main pathogens of bloodstream infections in children aged < 1 years were Escherichia coli (30.6%), and Streptococcus pneumoniae (28.7%) was the main pathogen in ≥1 year old. Central line-associated bloodstream infection was reported in 36 cases, with Staphylococcus epidermidis (36.1%) as the main pathogen. The proportion of producing extended spectrum β-lactamases (ESBLs) of Escherichia coli and Klebsiella pneumoniae was 50.8% and 40.9%,respectively. The sensitivity of ESBLs-producing Escherichia coli to β-lactamase enzyme inhibitors was less than 70.0%. The proportion of methicillin-resistant Staphylococcus epidermidis (MRSE) and Staphylococcus aureus (MRSA) was 93.5% and 54.5%, respectively, and no strains resistant to vancomycin and linezolid were found. One strain of Enterococcus faecalis intermediate to linezolid and one strain of Streptococcus pneumoniae intermediate to vancomycin were detected. Conclusion: The distribution of BSI pathogenic bacteria varies among children at different ages. The proportion of ESBLs-producing Escherichia coli, Klebsiella pneumoniae,MRSE, MRSA is high. The distribution of pathogenic bacteria and antimicrobial susceptibility of bloodstream infections in children should be continuously monitored, and antimicrobial drugs should be used rationally. 2023 Vol. 53 (5): 392-398 [Abstract] ( 250 ) HTML (1 KB)  PDF (1487 KB)  ( 548 ) 399 Clinical characteristics and genotype analysis of a family with congenital dysfibrinogenemia due to a novel variant of FGG gene WANG Xiaoou, WANG Jinyuan, SHU Kuangyi, YOU Chang, HU Rong, WANG Jinle, LIN Suzhen, LI Shanshan, JIANG Minghua. DOI: 10.3969/j.issn.2095-9400.2023.05.009 Objective: To analyze the clinical features and genotype of a family with congenital dysfibrinogenemia. Methods: Coagulation tests of the proband and his pedigree members were detected. The three fibrinogen genes (FGA, FGB and FGG) were amplified, then sequenced to find the varint. Three bioinformatics software (PolyPhen-2, PROVEAN and Mutation Taster) and PyMol were used to forecast the possible impact of the variant on the function of the protein. Conservation of the amino acids were analyzed by Clustal X. The effect of single point variants on protein stability was analyzed by I-Mutant Suite. The coagulation function of proband and his predigree members with thrombelastography (TEG) was evaluated. Results: The antigen of fibrinogen (Fg:Ag) of the proband in plasma was normal (3.20 g/L), but the activity (Fg:C) was significantly decreased (0.91 g/L). Genetic analysis revealed a heterozygous c.1133G>A mutation in the exon 9 of FGG, which resulted in p.Gly378Asp substitution. Family studies revealed that the mother and brother bear the same variant. All bioinformatics software that were used showed the variant could affect the function of Fg. Clustal X software showed that Gly378 was highly conserved among homologous species. The results of TEG indicated that the fibrinogen function of three members carrying the c.1133G>A mutation decreased. Conclusion: The proband with dysfibrinogenemia was caused by the mutation of γ chain Gly378Asp. 2023 Vol. 53 (5): 399-404 [Abstract] ( 368 ) HTML (1 KB)  PDF (1827 KB)  ( 577 ) 405 Changes of gut microbiota in ovariectomized rats based on amplicon and macrogene technology DING Bingqian, XU Linlin, WANG Xueyuan, ZHAO Xin, WANG Yan, FU Jinying DOI: 10.3969/j.issn.2095-9400.2023.05.010 Objective: To investigate the changes of gut microbiota in ovariectomized rats before and after ovariectomy. Methods: Twelve 8-week-old SPF SD female experimental rats were fed adaptively for 3 days, and then the bilateral ovaries of 6 rats were randomly removed to replicate the clinical perimenopausal animal model.After that, 12 rats were divided as the control group (without any treatment) and the model group (with bilateral ovaries removed), which were fed in the same experimental environment for 3 weeks. Blood samples were collected from abdominal aorta and feces were taken. The changes of body weight and sex hormones in the two groups were observed, and the changes of gut microbiota were detected by 16S rDNA and macrogene technology. Results: Compared with the control group, the model group had significantly increased weight in experimental rats (P<0.05), significantly higher level of follicle-stimulating hormone and significantly lower level of estradiol (P<0.01), which confirmed the feasibility of perimenopausal animal model. The results of gut microbiota showed that the abundance of gut microbiota in the model group was significantly lower than that in the control group (P<0.05). Through KEGG functional annotation, the characteristic pathway of the model group was lipopolysaccharide biosynthesis pathway. Conclusion: A series of changes in perimenopausal syndrome are related to the decreased abundance of Limosilactobacillus reuteri, Lactobacillus acidophilus and uncultured Prevotella sp. and the signaling pathway of lipopolysaccharide biosynthesis. 2023 Vol. 53 (5): 405-411 [Abstract] ( 203 ) HTML (1 KB)  PDF (1859 KB)  ( 392 ) 412 The effect of continuous sewing suture, capsular hook fixation combined with capsular tension ring implantation phacoemulsification in the treatment of traumatic iridodialysis complicated by lens subluxation JING Lingyan, ZHANG Lingjie, DUAN Honghui, WU Haijian DOI: 10.3969/j.issn.2095-9400.2023.05.011 Objective: To study the curative effect of the continuous sewing suture, capsular hook fixation combined with capsular tension ring (CTR) implantation phacoemulsification in treatment of traumatic iridodialysis with lens subluxation. Methods: Altogether 19 patients (19 eyes) with traumatic iridodialysis and lens subluxated with traumatic cataract who underwent the continuous sewing suture to repair of iridodialysis combined phacoemulsification with temporary self- made capsular hook fixation as well as CTR and intraocular lens (IOL)implantation in Taizhou Eye Hospital from January 2016 to June 2020. Postoperative followed up for 6 months. Visual acuity, intraocular pressure (IOP), restoration of iridodialysis, pupillary shape and position of IOL were observed. Results: All eyes were operated successfully. No cases had iris damage or posterior capsular rupture. Complete postoperative restoration of iridodialysis was seen in all operated eyes. Among them 15 eyes were basically round pupils, with 2 eyes nearly round or oval pupil respectively. The IOLs in all operated eyes were at the central position. The best corrected visual acuity after surgery was significantly improved, compared with that before surgery, showing statistical difference (P<0.01). Postoperative intraocular pressure was normal,and there was no significant difference between preoperative and postoperative intraocular pressure (P>0.05).Conclusion: The continuous sewing suture, capsular hook fixation combined with CTR implantation phacoemulsification in the treatment of traumatic iridodialysis with lens subluxation can increase the safety of phacoemulsification with less surgical damage. Postoperative iridodialysis can be completely restored, IOL is centered and vision is ideally recovered. 2023 Vol. 53 (5): 412-415,419 [Abstract] ( 191 ) HTML (1 KB)  PDF (1632 KB)  ( 453 ) 422 Stress and mobile phone addiction among female freshmen: the mediating role of core self-evaluation and self-control LIU Xiaoyue, CHEN Li. DOI: 10.3969/j.issn.2095-9400.2023.05.014 Objective: To investigate the mediating role of core self-evaluation and self-control in the relationship between stress and mobile phone addiction among female freshmen. Methods: The sample included 3 373 female freshmen (Class of 2022) from Wenzhou (Wenzhou Medical University, Wenzhou University,Wenzhou Business College, Wenzhou University of Technology), majoring in medicine, psychology, mathematics,English, etc. They completed the stress scale, the core self-evaluations scale, the self-control scale, and the mobile phone addiction index. Results: Stress, core self-evaluation, self-control and mobile phone addiction were significantly correlated with each other (r=-0.64-0.64, P<0.01). Core self-evaluation and self-control both played the chain mediating role between stress and mobile phone addiction, with the chain mediating effect of 0.15,95%CI=0.13-0.16 and the effect size of 30.61%. Conclusion: The stress has direct negative influences on the mobile phone addiction of female freshman, and it also exerts its influences through the chain mediation of core self-evaluation and self-control. 2023 Vol. 53 (5): 422-426 [Abstract] ( 219 ) HTML (1 KB)  PDF (1426 KB)  ( 586 ) 427 The influence of phubbing on college students' interpersonal adaptability and its mechanism PENG Honglei, DING Ningning DOI: 10.3969/j.issn.2095-9400.2023.05.015 Objective: To explore the mediating effect of social anxiety on the relationship between phubbing and interpersonal adaptability of college students, and the moderation effect of interpersonal communication self-efficacy, a theoretical idea based on the internal mechanism was provided for the improvement of phubbing and interpersonal adaptability. Methods: Using cluster sampling method, 1 085 Wenzhou Medical University students were investigated by the college Phubbing Scale, Social Anxiety Scale, Adolescent Interpersonal Contact Selfefficacy Scale and Interpersonal Adaptability scale. Results: There was a significantly and negatively correlation between phubbing and interpersonal adaptability (r=-0.44, P<0.001); Social anxiety played a mediating role in the relationship between phubbing and interpersonal adaptability (β=-0.18, t=-7.95, P<0.001); Interpersonal communication self-efficacy played a moderating role in the relationship between phubbing and interpersonal adaptability (β=-0.04, t=-2.08, P<0.05), as well as phubbing and social anxiety (β=0.07, t=3.37, P<0.001).Conclusion: There is a close relationship between phubbing, social anxiety, interpersonal communication selfefficacy and interpersonal adaptability. Reducing phubbing, improving interpersonal communication self-efficacy and appropriately relieving social anxiety can improve college students’ interpersonal adaptability. 2023 Vol. 53 (5): 427-430,封三 [Abstract] ( 240 ) HTML (1 KB)  PDF (1475 KB)  ( 679 )

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