Objective Chronic stress can induce cognitive dysfunction,but the underlying mechanisms remain unknown.Studies have confirmed that the high mobility group box 1/Toll-like receptor 4(HMGB1/TLR4)pathway is closely assoc...Objective Chronic stress can induce cognitive dysfunction,but the underlying mechanisms remain unknown.Studies have confirmed that the high mobility group box 1/Toll-like receptor 4(HMGB1/TLR4)pathway is closely associated with cognitive impairment.Therefore,this research aimed to explore whether the HMGB1/TLR4 pathway involves in chronic stress-induced cognitive dysfunction.Methods The chronic unpredictable mild stress(CUMS)mouse model was established by randomly giving different types of stress every day for four consecutive weeks.Cognitive function was detected by novel object recognition test,Y-maze test,and Morris water maze test.The protein expressions of HMGB1,TLR4,B-cell lymphoma 2(BCL2),and BCL2 associated X(BAX)were determined by Western blot.The damage of neurons in the hippocampal CA1 region was observed by hematoxylin-eosin(HE)staining.Results The protein expressions of HMGB1 and TLR4 were significantly increased in the hippocampus of chronic stress mice.Furthermore,inhibition of the HMGB1/TLR4 pathway induced by ethyl pyruvate(EP,a specific inhibitor of HMGB1)and TAK242(a selective inhibitor of TLR4)treatment attenuated cognitive impairment in chronic stress mice,according to the novel object recognition test,Y-maze test,and Morris water maze test.In addition,administration of EP and TAK242 also mitigated the increase of apoptosis in the hippocampus of chronic stress mice.Conclusion These results indicate that the hippocampal HMGB1/TLR4 pathway contributes to chronic stress-induced apoptosis and cognitive dysfunction.展开更多
Neuromyelitis optica spectrum disorder(NMOSD)is an inflammatory disorder of the central nervous system predominantly targeting optic nerves and the spinal cord.The prevalence of the disease is much higher in Asia than...Neuromyelitis optica spectrum disorder(NMOSD)is an inflammatory disorder of the central nervous system predominantly targeting optic nerves and the spinal cord.The prevalence of the disease is much higher in Asia than in other parts of the world.Pain can be detected in more than 80%of NMOSD patients,with evoked pain mostly being caused by painful tonic muscle spasms and neuropathic pain as the most characteristic types.Depression is often comorbid with pain,and their comorbidity can severely influence quality of life.In recent years,studies have found considerable overlaps between the mechanisms of pain and depression;however,their association remains unclear.This article reviews the epidemiology,mechanism,evaluation and treatment of paindepression comorbidity in NMOSD patients.展开更多
Clinical Practice Guideline on Acupuncture and Moxibustion:Migraine(WFAS 007.9-2023)is a clinical practice guideline officially released by the World Federation of Acupuncture-Moxibustion Societies(WFAS)on October 9,2...Clinical Practice Guideline on Acupuncture and Moxibustion:Migraine(WFAS 007.9-2023)is a clinical practice guideline officially released by the World Federation of Acupuncture-Moxibustion Societies(WFAS)on October 9,2023,and is the first international guideline on the treatment of migraine with acupuncture.This international standard was developed under the guidance of rigorous evidence-based methodology,and it contains guideline purpose,scope,applicable population,applicable settings,overview of acupuncture for migraine,guideline development process and recommendations.For promoting the understanding and application of this guideline,this article summarizes a total of 18 recommendations in order to assist clinical decisions for migraine with acupuncture.展开更多
γ-Aminobutyric acid(GABA) neurotransmission alterations have been implicated to play a role in depression pathogenesis. While GABA_(A) receptor positive allosteric modulators are emerging as promising in clinical pra...γ-Aminobutyric acid(GABA) neurotransmission alterations have been implicated to play a role in depression pathogenesis. While GABA_(A) receptor positive allosteric modulators are emerging as promising in clinical practice, their precise antidepressant mechanism remains to be further elucidated. The aim of the present study was to investigate the effects of LY-02, a novel compound derived from the metabolite of timosaponin, on depression in animals and its mechanism. The results of behavioral tests showed that LY-02 exhibited better antidepressant effects in both male C57BL/6 mice and Sprague Dawley(SD) rats. The results of cellular voltage clamp experiments showed that LY-02 enhanced GABA-mediated currents in HEK293T cells expressing recombinant α6β3δ subunitcontaining GABA_(A) receptors. Electrophysiological recording from brain slices showed that LY-02 decreased the amplitude of spontaneous inhibitory postsynaptic current(sIPSC) and increased action potentials of pyramidal neurons in the medial prefrontal cortex(mPFC) of C57BL/6 mice. Western blot results showed that LY-02 dose-dependently up-regulated the protein expression levels of brain-derived neurotrophic factor(BDNF), tropomyosin related kinase B(TrkB) and postsynaptic density protein 95(PSD-95) in m PFC of mice. The above results suggest that LY-02, as a positive modulator of GABA_(A) receptors, reduces inhibitory neurotransmission in pyramidal neurons. It further activates the BDNF/TrkB signaling pathway, thus exerting antidepressant effects. It suggests that LY-02 is a potential novel therapeutic agent for depression treatment.展开更多
Objective:Inflammation in the central nervous system plays a crucial role in the occurrence and development of sepsis-associated encephalopathy.This study aims to explore the effects of maresin 1(MaR1),an anti-inflamm...Objective:Inflammation in the central nervous system plays a crucial role in the occurrence and development of sepsis-associated encephalopathy.This study aims to explore the effects of maresin 1(MaR1),an anti-inflammatory and pro-resolving lipid mediator,on sepsis-induced neuroinflammation and cognitive impairment.Methods:Mice were randomly assigned to 4 groups:A sham group(sham operation+vehicle),a cecal ligation and puncture(CLP)group(CLP operation+vehicle),a MaR1-LD group(CLP operation+1 ng MaR1),and a MaR1-HD group(CLP operation+10 ng MaR1).MaR1 or vehicle was intraperitoneally administered starting 1 h before CLP operation,then every other day for 7 days.Survival rates were monitored,and serum inflammatory cytokines[tumor necrosis factor alpha(TNF-α),interleukin(IL)-1β,and IL-6]were measured 24 h after operation using enzyme-linked immunosorbent assay(ELISA).Cognitive function was assessed 7 days after operation using the Morris water maze(MWM)test and novel object recognition(NOR)task.The mRNA expression of TNF-α,IL-1β,IL-6,inducible nitric oxide synthase(iNOS),IL-4,IL-10,and arginase 1(Arg1)in cortical and hippocampal tissues was determined by real-time reverse transcription PCR(RT-PCR).Western blotting was used to determine the protein expression of iNOS,Arg1,signal transducer and activator of transcription 6(STAT6),peroxisome proliferator-activated receptor gamma(PPARγ),and phosphorylated STAT6(p-STAT6)in hippocampal tissue.Microglia activation was visualized via immunofluorescence.Mice were also treated with the PPARγantagonist GW9662 to confirm the involvement of this pathway in MaR1’s effects.Results:CLP increased serum levels of TNF-α,IL-1β,and IL-6,and reduced body weight and survival rates(all P<0.05).Both 1 ng and 10 ng doses of MaR1 significantly reduced serum TNF-α,IL-1β,and IL-6 levels,improved body weight,and increased survival rates(all P<0.05).No significant difference in efficacy was observed between the 2 doses(all P>0.05).MWM test and NOR task indicated that CLP impaired spat展开更多
Pain is a signal of inflammation that can have both protective and pathogenic effects.Macrophages,significant components of the immune system,play crucial roles in the occurrence and development of pain,particularly i...Pain is a signal of inflammation that can have both protective and pathogenic effects.Macrophages,significant components of the immune system,play crucial roles in the occurrence and development of pain,particularly in neuroimmune communication.Macrophages exhibit plasticity and heterogeneity,adopting either pro-inflammatory M1 or anti-inflammatory M2 phenotypes depending on their functional orientation.Recent research highlights the contribution of macrophages to pain dynamics by undergoing changes in their functional polarity,leading to macrophage activation,tissue infiltration,and cytokine secretion.M1 macrophages release pro-inflammatory mediators that are not only essential in defending against infections,but also contributing to tissue damage and the elicitation of pain.However,this process can be counteracted by M2 macrophages,facilitating pain relief through producing anti-inflammatory cytokines and opioid peptides or enhancing efferocytosis.M1 and M2 macrophages play important roles in both the initiation and mitigation of pain.展开更多
Approximately 40% of pheochromocytoma and paraganglioma(PPGL) cases are familial, typically presenting earlier with more complex symptoms. This paper synthesizes literature and guidelines to inform on clinical charact...Approximately 40% of pheochromocytoma and paraganglioma(PPGL) cases are familial, typically presenting earlier with more complex symptoms. This paper synthesizes literature and guidelines to inform on clinical characteristics and perioperative care for PPGL. Pheochromocytoma in von Hippel-Lindau(VHL) disease exhibits heightened secretion activity without significant perioperative hemodynamic changes. Tumors in multiple endocrine neoplasia type 2(MEN2) have a stronger endocrine function, which may induce hemodynamic fluctuations during surgery. Therefore, pheochromocytoma screening is essential at all stages of MEN2. Neurofibromatosis type 1(NF1) often presents multisystem lesions and can result in difficult airway. Pheochromocytoma should be evaluated when NF1 patients present hypertension. Pheochromocytoma and paraganglioma type 5 may present multiple lesions of pheochromocytoma or paraganglioma. In summary, hereditary PPGLs may present with severe lesions in other systems, beyond tumor function. A multi-disciplinary team(MDT) approach is often invaluable in perioperative management.展开更多
Objective To explore the characteristics and clinical outcomes of patients with Heyde syndrome(HS)who undergo aortic valve replacement(AVR).Methods Electronic databases including Pub Med,Embase,Ovid,WANFANG,VIP and CN...Objective To explore the characteristics and clinical outcomes of patients with Heyde syndrome(HS)who undergo aortic valve replacement(AVR).Methods Electronic databases including Pub Med,Embase,Ovid,WANFANG,VIP and CNKI were searched to identify all case reports of HS patients undergoing AVR surgery,using different combinations of search terms"Heyde syndrome","gastrointestinal bleeding","aortic stenosis",and"surgery".Three authors independently extracted the clinical data including the patients’characteristics,aortic stenosis severity,gastrointestinal bleeding sites,surgical treatments and prognosis.Results Finally,46 case reports with 55 patients aging from 46 to 87 years,were determined eligible and included.Of them,1 patient had mild aortic stenosis,1 had moderate aortic stenosis,42 had severe aortic stenosis,and 11 were not mentioned.Gastrointestinal bleeding was detected in colon(n=8),jejunum(n=6),ileum(n=4),cecum(n=3),duodenal(n=3)and multiple sites(n=8).No specific bleeding site was identified in 23 patients.Preoperative hemoglobin level ranged from 43 to 117 g/L.All but one of 16 patients showed decreased level of high molecule weight von Willebrand factor.Of the 55 patients,43 underwent AVR,and 12 received transcatheter AVR.Aortic valves of 14 cases were replaced by mechanical valves,and 33 cases by biological valves.All patients recovered well during the follow-up,except 5 patients.One patient who had perivalvular leakage and gastrointestinal bleeding after AVR underwent the second AVR.Two patients had recurrent gastrointestinal bleeding.Two patients died of life-threatening acute subdural hematoma and multiple organ failure,respectively.Conclusions HS is a rare syndrome characterized by aortic stenosis and gastrointestinal bleeding.AVR is an effective treatment for HS.展开更多
Objective： To provide the clinical evidence to evaluate the feasibility and refine the protocol for acupotomy combined with fire needle and pudendal nerve block therapy in treatment of sacral nerve dysfunction syndr...Objective： To provide the clinical evidence to evaluate the feasibility and refine the protocol for acupotomy combined with fire needle and pudendal nerve block therapy in treatment of sacral nerve dysfunction syndrome（SNDS）. Methods： Seventy-five patients with SNDS were randomized into the treatment group（acupotomy and fire needle and pudendal nerve block therapy） and the control group（pudendal nerve block therapy）. After a course of treatment, Visual Analogue Scales（VAS） of anorectal pain, defecation disorders, anal incontinence, VAS of lumbar pain or soreness, VAS of abdominal distension and pain were compared before and after the treatment. Result： Scores of defecation disorders, including defecation interval time index, defecation time index, fecal property index and defecation difficulty index, of patients with SNDS in the two groups were statistically different before and after the treatment in the same group（all P〈0.05）, but the differences of those indexes between two groups were not statistically significant（all P〈0.05） after the treatment,. Scores of anal incontinence, VAS scores of lumbar pain or soreness, VAS scores of abdominal pain and distension in the two groups were statistically different before and after the treatment（all P〈0.05）. However, after treatment, the differences between two groups were not statistically significant（all P〈0.05）. VAS scores of anorectal pain in the two groups were statistically different before and after the treatment（both P〈0.05）, and that of the treatment group was statistically lower than control group after the treatment（1.61 ± 0.95 vs. 3.04 ± 1.81, P〈0.01）, the total effective rate of the treatment group was higher than that of the control group, and the difference was statistically significant（94.74% vs. 81.08%, P〈0.01）, there was no difference in self-evaluation between the two groups（P〈0.05）. Conclusion： In treating SNDS, acupotomy combined with fire needle and pudendal nerve block therap展开更多
文摘Objective Chronic stress can induce cognitive dysfunction,but the underlying mechanisms remain unknown.Studies have confirmed that the high mobility group box 1/Toll-like receptor 4(HMGB1/TLR4)pathway is closely associated with cognitive impairment.Therefore,this research aimed to explore whether the HMGB1/TLR4 pathway involves in chronic stress-induced cognitive dysfunction.Methods The chronic unpredictable mild stress(CUMS)mouse model was established by randomly giving different types of stress every day for four consecutive weeks.Cognitive function was detected by novel object recognition test,Y-maze test,and Morris water maze test.The protein expressions of HMGB1,TLR4,B-cell lymphoma 2(BCL2),and BCL2 associated X(BAX)were determined by Western blot.The damage of neurons in the hippocampal CA1 region was observed by hematoxylin-eosin(HE)staining.Results The protein expressions of HMGB1 and TLR4 were significantly increased in the hippocampus of chronic stress mice.Furthermore,inhibition of the HMGB1/TLR4 pathway induced by ethyl pyruvate(EP,a specific inhibitor of HMGB1)and TAK242(a selective inhibitor of TLR4)treatment attenuated cognitive impairment in chronic stress mice,according to the novel object recognition test,Y-maze test,and Morris water maze test.In addition,administration of EP and TAK242 also mitigated the increase of apoptosis in the hippocampus of chronic stress mice.Conclusion These results indicate that the hippocampal HMGB1/TLR4 pathway contributes to chronic stress-induced apoptosis and cognitive dysfunction.
基金Supported by the Fundamental Research Funds for the Central Universities(3332021015)。
文摘Neuromyelitis optica spectrum disorder(NMOSD)is an inflammatory disorder of the central nervous system predominantly targeting optic nerves and the spinal cord.The prevalence of the disease is much higher in Asia than in other parts of the world.Pain can be detected in more than 80%of NMOSD patients,with evoked pain mostly being caused by painful tonic muscle spasms and neuropathic pain as the most characteristic types.Depression is often comorbid with pain,and their comorbidity can severely influence quality of life.In recent years,studies have found considerable overlaps between the mechanisms of pain and depression;however,their association remains unclear.This article reviews the epidemiology,mechanism,evaluation and treatment of paindepression comorbidity in NMOSD patients.
基金Supported by National Key Research and Development Program of China:2019YFC1712200,2019YFC1712203Independent Project of the Institute of Acupuncture and moxibustion,China Academy of Chinese Medical Sciences:ZZ202219004Science and technology innovation project of China Academy of Chinese Medical Sciences:CI2020A03510。
文摘Clinical Practice Guideline on Acupuncture and Moxibustion:Migraine(WFAS 007.9-2023)is a clinical practice guideline officially released by the World Federation of Acupuncture-Moxibustion Societies(WFAS)on October 9,2023,and is the first international guideline on the treatment of migraine with acupuncture.This international standard was developed under the guidance of rigorous evidence-based methodology,and it contains guideline purpose,scope,applicable population,applicable settings,overview of acupuncture for migraine,guideline development process and recommendations.For promoting the understanding and application of this guideline,this article summarizes a total of 18 recommendations in order to assist clinical decisions for migraine with acupuncture.
文摘γ-Aminobutyric acid(GABA) neurotransmission alterations have been implicated to play a role in depression pathogenesis. While GABA_(A) receptor positive allosteric modulators are emerging as promising in clinical practice, their precise antidepressant mechanism remains to be further elucidated. The aim of the present study was to investigate the effects of LY-02, a novel compound derived from the metabolite of timosaponin, on depression in animals and its mechanism. The results of behavioral tests showed that LY-02 exhibited better antidepressant effects in both male C57BL/6 mice and Sprague Dawley(SD) rats. The results of cellular voltage clamp experiments showed that LY-02 enhanced GABA-mediated currents in HEK293T cells expressing recombinant α6β3δ subunitcontaining GABA_(A) receptors. Electrophysiological recording from brain slices showed that LY-02 decreased the amplitude of spontaneous inhibitory postsynaptic current(sIPSC) and increased action potentials of pyramidal neurons in the medial prefrontal cortex(mPFC) of C57BL/6 mice. Western blot results showed that LY-02 dose-dependently up-regulated the protein expression levels of brain-derived neurotrophic factor(BDNF), tropomyosin related kinase B(TrkB) and postsynaptic density protein 95(PSD-95) in m PFC of mice. The above results suggest that LY-02, as a positive modulator of GABA_(A) receptors, reduces inhibitory neurotransmission in pyramidal neurons. It further activates the BDNF/TrkB signaling pathway, thus exerting antidepressant effects. It suggests that LY-02 is a potential novel therapeutic agent for depression treatment.
基金supported by the National Natural Science Foundation (81601728,31500726)the Natural Science Foundation of Hunan Province (2021JJ41002),China。
文摘Objective:Inflammation in the central nervous system plays a crucial role in the occurrence and development of sepsis-associated encephalopathy.This study aims to explore the effects of maresin 1(MaR1),an anti-inflammatory and pro-resolving lipid mediator,on sepsis-induced neuroinflammation and cognitive impairment.Methods:Mice were randomly assigned to 4 groups:A sham group(sham operation+vehicle),a cecal ligation and puncture(CLP)group(CLP operation+vehicle),a MaR1-LD group(CLP operation+1 ng MaR1),and a MaR1-HD group(CLP operation+10 ng MaR1).MaR1 or vehicle was intraperitoneally administered starting 1 h before CLP operation,then every other day for 7 days.Survival rates were monitored,and serum inflammatory cytokines[tumor necrosis factor alpha(TNF-α),interleukin(IL)-1β,and IL-6]were measured 24 h after operation using enzyme-linked immunosorbent assay(ELISA).Cognitive function was assessed 7 days after operation using the Morris water maze(MWM)test and novel object recognition(NOR)task.The mRNA expression of TNF-α,IL-1β,IL-6,inducible nitric oxide synthase(iNOS),IL-4,IL-10,and arginase 1(Arg1)in cortical and hippocampal tissues was determined by real-time reverse transcription PCR(RT-PCR).Western blotting was used to determine the protein expression of iNOS,Arg1,signal transducer and activator of transcription 6(STAT6),peroxisome proliferator-activated receptor gamma(PPARγ),and phosphorylated STAT6(p-STAT6)in hippocampal tissue.Microglia activation was visualized via immunofluorescence.Mice were also treated with the PPARγantagonist GW9662 to confirm the involvement of this pathway in MaR1’s effects.Results:CLP increased serum levels of TNF-α,IL-1β,and IL-6,and reduced body weight and survival rates(all P<0.05).Both 1 ng and 10 ng doses of MaR1 significantly reduced serum TNF-α,IL-1β,and IL-6 levels,improved body weight,and increased survival rates(all P<0.05).No significant difference in efficacy was observed between the 2 doses(all P>0.05).MWM test and NOR task indicated that CLP impaired spat
基金supported by the Natural Science Foundation of Hunan Province(2021JJ41060,2022JJ30972)the Changsha Municipal Natural Science Foundation(kq2014280)+1 种基金the Research Program Project of Hunan Health Commission(B202304119634)China。
文摘Pain is a signal of inflammation that can have both protective and pathogenic effects.Macrophages,significant components of the immune system,play crucial roles in the occurrence and development of pain,particularly in neuroimmune communication.Macrophages exhibit plasticity and heterogeneity,adopting either pro-inflammatory M1 or anti-inflammatory M2 phenotypes depending on their functional orientation.Recent research highlights the contribution of macrophages to pain dynamics by undergoing changes in their functional polarity,leading to macrophage activation,tissue infiltration,and cytokine secretion.M1 macrophages release pro-inflammatory mediators that are not only essential in defending against infections,but also contributing to tissue damage and the elicitation of pain.However,this process can be counteracted by M2 macrophages,facilitating pain relief through producing anti-inflammatory cytokines and opioid peptides or enhancing efferocytosis.M1 and M2 macrophages play important roles in both the initiation and mitigation of pain.
文摘Approximately 40% of pheochromocytoma and paraganglioma(PPGL) cases are familial, typically presenting earlier with more complex symptoms. This paper synthesizes literature and guidelines to inform on clinical characteristics and perioperative care for PPGL. Pheochromocytoma in von Hippel-Lindau(VHL) disease exhibits heightened secretion activity without significant perioperative hemodynamic changes. Tumors in multiple endocrine neoplasia type 2(MEN2) have a stronger endocrine function, which may induce hemodynamic fluctuations during surgery. Therefore, pheochromocytoma screening is essential at all stages of MEN2. Neurofibromatosis type 1(NF1) often presents multisystem lesions and can result in difficult airway. Pheochromocytoma should be evaluated when NF1 patients present hypertension. Pheochromocytoma and paraganglioma type 5 may present multiple lesions of pheochromocytoma or paraganglioma. In summary, hereditary PPGLs may present with severe lesions in other systems, beyond tumor function. A multi-disciplinary team(MDT) approach is often invaluable in perioperative management.
文摘Objective To explore the characteristics and clinical outcomes of patients with Heyde syndrome(HS)who undergo aortic valve replacement(AVR).Methods Electronic databases including Pub Med,Embase,Ovid,WANFANG,VIP and CNKI were searched to identify all case reports of HS patients undergoing AVR surgery,using different combinations of search terms"Heyde syndrome","gastrointestinal bleeding","aortic stenosis",and"surgery".Three authors independently extracted the clinical data including the patients’characteristics,aortic stenosis severity,gastrointestinal bleeding sites,surgical treatments and prognosis.Results Finally,46 case reports with 55 patients aging from 46 to 87 years,were determined eligible and included.Of them,1 patient had mild aortic stenosis,1 had moderate aortic stenosis,42 had severe aortic stenosis,and 11 were not mentioned.Gastrointestinal bleeding was detected in colon(n=8),jejunum(n=6),ileum(n=4),cecum(n=3),duodenal(n=3)and multiple sites(n=8).No specific bleeding site was identified in 23 patients.Preoperative hemoglobin level ranged from 43 to 117 g/L.All but one of 16 patients showed decreased level of high molecule weight von Willebrand factor.Of the 55 patients,43 underwent AVR,and 12 received transcatheter AVR.Aortic valves of 14 cases were replaced by mechanical valves,and 33 cases by biological valves.All patients recovered well during the follow-up,except 5 patients.One patient who had perivalvular leakage and gastrointestinal bleeding after AVR underwent the second AVR.Two patients had recurrent gastrointestinal bleeding.Two patients died of life-threatening acute subdural hematoma and multiple organ failure,respectively.Conclusions HS is a rare syndrome characterized by aortic stenosis and gastrointestinal bleeding.AVR is an effective treatment for HS.
基金Youth Foundation Project of Jiangsu Natural Science Foundation of China,NO.BK20160135The twelfth batch of high-level talents training target of "Six Talent Peaks",NO.2015-WSW-070+1 种基金Third level of training target candidates of the fifth phase of the Jiangsu"333 Project":2016Ⅲ-0094Nanjing Medical Science and Technology Development Project,NO.YKK15127~~
文摘Objective： To provide the clinical evidence to evaluate the feasibility and refine the protocol for acupotomy combined with fire needle and pudendal nerve block therapy in treatment of sacral nerve dysfunction syndrome（SNDS）. Methods： Seventy-five patients with SNDS were randomized into the treatment group（acupotomy and fire needle and pudendal nerve block therapy） and the control group（pudendal nerve block therapy）. After a course of treatment, Visual Analogue Scales（VAS） of anorectal pain, defecation disorders, anal incontinence, VAS of lumbar pain or soreness, VAS of abdominal distension and pain were compared before and after the treatment. Result： Scores of defecation disorders, including defecation interval time index, defecation time index, fecal property index and defecation difficulty index, of patients with SNDS in the two groups were statistically different before and after the treatment in the same group（all P〈0.05）, but the differences of those indexes between two groups were not statistically significant（all P〈0.05） after the treatment,. Scores of anal incontinence, VAS scores of lumbar pain or soreness, VAS scores of abdominal pain and distension in the two groups were statistically different before and after the treatment（all P〈0.05）. However, after treatment, the differences between two groups were not statistically significant（all P〈0.05）. VAS scores of anorectal pain in the two groups were statistically different before and after the treatment（both P〈0.05）, and that of the treatment group was statistically lower than control group after the treatment（1.61 ± 0.95 vs. 3.04 ± 1.81, P〈0.01）, the total effective rate of the treatment group was higher than that of the control group, and the difference was statistically significant（94.74% vs. 81.08%, P〈0.01）, there was no difference in self-evaluation between the two groups（P〈0.05）. Conclusion： In treating SNDS, acupotomy combined with fire needle and pudendal nerve block therap
