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Introduction The chronic neuropathic pain associated with postherpetic neuralgia (PHN) can last for several months or even many years, seriously affecting the affected person’s work, sleep, mood, and daily life activities. In generaly, current treatments for PHN are at best limited and unsatisfactory, and adverse reactions are common, especially in elderly patients. Electroacupuncture (EA) is widely used clinically to manage painful diseases, but there remains a lack of evidence to support the effectiveness of EA on PHN. This study is designed to assess the efficacy and safety of EA on PHN, and to provide evidence-based medical evidence for EA treatment of PHN. Methods This multicenter, prospective, randomized controlled trial will recruit 448 patients with PHN at seven clinical centers. Multicenter stratified variable block randomization will be used, and the eligible patients will be randomly allocated in a ratio of 1:1 to the EA group or sham EA group. The EA group will receive 4 weeks of EA treatment, given as 30-min treatment sessions, once daily, 5 times per week, for a total of 20 treatments; the sham EA group will receive sham EA treatment under the same conditions. Planned Outcomes The primary outcome measure is the 11-point Numeric Rating Scale pain score at week 4. The secondary outcome measures, including mechanical pain threshold, pain area of PHN, average number of pain episodes, the short-form McGill Pain Questionnaire 2, Zoster Brief Pain Inventory, the Depression, Anxiety, and Positive Outlook Scale, Patient Global Impression of Change, safety of EA, and use of concomitant medications, among others. The primary analysis of the outcomes will be the mixed-effect model with repeated measurement between groups on an intent-to-treat population. Trial Registration Clinicaltrials.gov identifier: NCT04560361. Registered 23 September 2020 (https://clinicaltrials.gov/ct2/show/NCT04560361?term=NCT04560361&draw=2&rank=1). Supplementary Information The online version contains supplementary material available at 10.1007/s40122-021-00283-8.

Objective: Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting adverse effect of anticancer agents with virtually no effective treatment. Safe and effective therapies are needed urgently. Acupuncture shows therapeutic possibilities in this regard but needs to be further evaluated. Methods: A systematic search was conducted in seven databases from their inception to April 2020. Randomized controlled trials (RCTs) focused on acupuncture/electroacupuncture (EA) for the treatment of CIPN were included. Revman 5.3 software was used for meta-analysis if there was no significant heterogeneity. Otherwise, qualitative analysis was utilized. Results: Nine studies involving 582 patients were included in this review. Most of the studies exhibited unclear risk of bias because some details were not mentioned. As the clinical heterogeneity was significant, qualitative analysis was performed to describe nerve conduction velocity, effective rate for motor neuropathy, pain scores, quality of life and adverse events. Meta-analysis was performed on four studies to analyze the effective rate for sensory neuropathy due to inconspicuous heterogeneity. The results indicated that acupuncture may generate a better effect on sensory neuropathy than vitamin B (risk ratio = 1.60, 95% confidence interval = 1.31–1.95, I2 = 0%, p < 0.00001). The efficacy of EA plus glutathione (GSH) appeared to be better than that of GSH alone in alleviating sensory neurotoxicity and in improving nerve conduction velocity. Acupuncture plus methylcobalamin showed more favorable effects than methylcobalamin alone in relieving neuralgia, restoring nerve conduction velocity and improving quality of life. In terms of pain relief and improved CIPN-specific quality of life, acupuncture plus standard care was better than standard care alone. In terms of pain relief, EA was more effective than usual care. Conclusion: Acupuncture may be effective and safe in the treatment of CIPN according to the analyzed studies. However, more studies with higher methodological quality are warranted in order to be able to draw firmer conclusions. Future rigorous RCTs will be necessary to confirm the effectiveness and safety of acupuncture for CIPN.

Many articles have reported that Rab1A was overexpressed in a variety of human cancers and involved in tumor progression and metastasis. However, the biological function and molecular mechanism of Rab1A in nasopharyngeal carcinoma (NPC) remained unknown until now. Here we found that Rab1A overexpression is a common event and was positively associated with distant metastasis and poor prognosis of NPC patients. Functionally, Rab1A depletion inhibited the migration and EMT phenotype of NPC cells, whereas Rab1A overexpression led to the opposite effect. Furthermore, we reveal an important role for Rab1A protein in the induction of radioresistance via regulating homologous recombination (HR) signaling pathway. Mechanistically, Rab1A activated Wnt/β-catenin signaling by inhibiting the activity of GSK-3β via phosphorylation at Ser9. Then Wnt/β-catenin signaling induced NPC cells radioresistance and metastasis through nuclear translocation of β-catenin and transcription upregulation of HR pathway-related and EMT-related genes expression. In general, this study shows that Rab1A may serve as a potential biomarker for predicting prognosis in NPC patients. Targeting Rab1A and Wnt/β-catenin signaling may hold promise to overcome NPC radioresistance.

To compare the curative effect on diarrhea-predominant irritable bowel syndrome (IBS-D) between acupuncture for regulatingA total of 231 patients with IBS-D were randomized into an acupuncture group (154 cases) and a western medication group (77 cases) at the ratio of 2 to 1. In the acupuncture group, acupuncture was applied to acupoint regimen for regulatingAfter treatment and in follow-up, the total scores of IBS-SSS in the patients of the two groups were all reduced as compared with those before treatment (Acupuncture for regulating

To observe the clinical therapeutic effect ofA total of 20 patients with IBS-D and 20 healthy subjects were included. The patients with IBS-D were treated withAfter treatment, the abdominal pain severity score, the abdominal pain days score, the satisfaction in bowel movement score, the life interference score and the total IBS-SSS score were all lower than those before treatment in the patients with IBS-D (

Aims Acupuncture is frequently recommended as a complementary therapy for infertility. However, whether acupuncture can prevent early ovarian hyperstimulation syndrome has not been examined and its potential mechanisms are not well understood. Main methods Forty rats were randomized into four groups: Control, Ovarian Stimulation Model, Acupuncture, and Human Chorionic Gonadotropin (HCG). Serum estradiol, progesterone, testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) levels were measured by enzyme-linked immunosorbent assay. Pituitary ER mRNA and ERβ expression were detected by real-time PCR and western blotting respectively. The pathology of rat ovaries were observed by light microscopy. Key findings We observed significantly lower estradiol levels in the Acupuncture group than in the Model group and increased LH levels in the HCG group than in Model and Acupuncture groups. Testosterone and FSH levels were significantly lower in the Acupuncture group than in the HCG group. Western blotting showed significantly lower pituitary ERβ expression in the Model group than in the Control group and higher expression in the Acupuncture group than in the Model group. Real-time PCR showed lower pituitary ER mRNA expression in the Acupuncture group than in the Model group. Hematoxylin and eosin staining showed a lower proportion of atretic follicles in Acupuncture and HCG groups than in Model and Control groups. Instead, Acupuncture and HCG groups showed growing and mature follicles. Significance Our results demonstrate a relationship between acupuncture and the hypothalamic-pituitary-gonadal axis, and the potential mechanism underlying the preventative effects of acupuncture on the incidence of early ovarian hyperstimulation syndrome.

Professor

In many colour-related fields, such as textile colour measurement systems based on computer vision as well as dyestuff synthesis, colour constancy with illumination variation is a key problem to be solved. A new algorithm of illumination compensation for colour constancy for textured textiles is proposed in this paper, combining an improved least-squares support vector regression (LSSVR) and an improved GM(1,1) model of grey theory. The LSSVR algorithm was improved by determining the error limitation according to the distance between a standard sample and a test sample, while the improved GM(1,1) model used the average value of the sequence x11−x(1)n as the initial iteration value. The disadvantage of LSSVR, that it easily falls into global optimisation, can be compensated for by the local optimisation capacity of the GM(1,1) model. Experimental results show that the algorithm of this paper is very stable and provides good illumination compensation, whereby the time complexity of compensation is reduced by repeatedly processing fractional data with the LSSVR algorithm, and the prediction accuracy is improved by combining the improved GM(1,1) model and the LSSVR algorithm.

Objective: To analyze the value of autoantibody detection for illness assessment in systemic lupus erythematosus patients with refractory thrombocytopenia. Methods: A total of 60 cases of systemic lupus erythematosus (SLE) with refractory thrombocytopenia were the observation group A, 58 cases of patients with SLE alone were the observation group B, and 66 cases of healthy people who received physical examination were control group. Peripheral circulating blood was drawn from research subjects to detect the levels of autoantibody, illness-related factors, Th17, Th1 and Th2 cytokines, complements, and so on, and then the correlation between specific antibody positive rate and disease severity in SLE patients with refractory thrombocytopenia was further analyzed. Results: Anti-RNP antibody, anti-Sm antibody, antiScl-70 antibody, anti-AnuA antibody, anti-His antibody and anti-ds-DNA antibody positive rates of observation group A were higher than those of observation group B and control group (P

Background Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder characterized by abdominal pain and change of bowel habit without organic disease. A global perspective given by the World Gastroenterology Organization (WGO) points out that IBS can impact the quality of an individual’s daily life, cause socioeconomic problems and potentially impair the patient-physician relationship. It remains a problem to treat IBS due to the complicated pathophysiology. Acupuncture is an alternative therapy recommended for IBS. The aim of this study is to investigate the efficacy and safety of acupuncture therapy for patients with IBS. We also want to explore the correlation between IBS-gene subtypes and acupuncture effect. Methods/design A multicenter randomized controlled trial will be performed in seven hospitals. Six hundred participants will be stratified into two strata (IBS-C or IBS-D). Then, patients within each stratum will be divided into an experimental group and a control group randomly. The experimental group is treated with acupuncture while the control group is treated with Western medicine. All the patients will receive a 6-week treatment and a 3-month follow-up. The primary outcome is the IBS-Symptom Severity Score (IBS-SSS), the secondary outcome is the score of the IBS-Quality of Life (IBS-QoL).The correlation between IBS-gene subtypes and acupuncture effect will be detected based on polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Outcome measures (including primary and secondary outcome measures) are collected at baseline,1 week, 2 weeks, 4 weeks, and 6 weeks of the intervention, and 12 weeks after the intervention. Discussion This is a multicenter randomized controlled trial for IBS in China. It may clarify the efficacy of acupuncture as an alternative therapy for IBS. This is the first time ever that the potential mechanism of IBS based on genomics has been investigated. Trial registration Chinese Clinical Trials Register, ID: ChiCTR-IOR-15006259. First registered on 14 April 2015. Electronic supplementary material The online version of this article (10.1186/s13063-018-2922-y) contains supplementary material, which is available to authorized users.

To observe the effect of electroacupuncture (EA) at "Tianshu" (ST 25) on visceral pain and colonic mast cell (MCs) number and tryptase and SP expression in post-infectious irritable bowel syndrome (PI-IBS) rats, so as to reveal its mechanisms underlying improvement of PI-IBS.Forty-five female Wistar rats were randomly divided into control, model and EA groups (15 rats/ group, 3 rats/group used for H. E. staining, and 12 rats/group for immunohistochemistry). The PI-IBS model was established by intra-anal injection of mixed liquor of 50% ethyl alcohol and trinitro-benzene-sulfonic acid (TNBS). EA (2 Hz/15 Hz, 0.5-1.0 mA) was applied to bilateral "Tianshu" (ST 25) for 30 min, once every day for 14 days. The visceral pain was measured by abdominal withdrawal reflex (AWR), for which the rectal implanted air balloon was dilated by infusion of normal saline. The histopathological changes of the colon tissue were observed after H. E. staining, and the colonic MCs were displayed by Toluidine blue staining. The expression of tryptase and SP proteins in the colon specimens were detected by immunohistochemistry.The AWR threshold was significantly lowered in the model group relevant to the control group (EA of "Tianshu" (ST 25) can inhibit visceral pain in PI-IBS rats, which may be associated with its effects in activating MCs and down-regulating the expression of tryptase and SP proteins in the colonic tissues.

Supplemental Digital Content is available in the text, Background: Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder associated with visceral hypersensitivity. Increased expression of colonic TRPV1 and decreased expression of microRNA-199 are implicated in the pathogenesis of visceral hypersensitivity in IBS-D patients. Acupuncture is one of the frequently used complementary and alternative therapies for the treatment of IBS. The existing clinical studies mostly use IBS-SSS or other subjective scales, so there is a lack of objective biochemical evidence regarding the effect of acupuncture on IBS. Therefore, we designed this study to investigate whether acupuncture alleviate visceral hypersensitivity by influencing the expression of TRPV1 and microRNA-199. Method: This study is a randomized, sham-controlled trial involving 40 patients and 10 healthy volunteers. A total of 40 eligible patients with IBS-D will be randomly assigned to a traditional acupuncture group or sham acupuncture group in a 1:1 ratio. Patients will receive 3 acupuncture treatment sessions per week for 12 consecutive weeks, for a total of 36 sessions during the study. The primary outcome measure is the IBS-Symptom Severity Score (IBS-SSS). Secondary outcomes are Visceral Pain Scale and levels of TRPV1 and microRNA-199 in colonic tissues. Healthy volunteers will not receive any clinical intervention. The safety of interventions will be assessed at every visit. Discussion: The purpose of this trial is to evaluate the efficacy of acupuncture for IBS-D through IBS-SSS and Visceral Pain Scale. Furthermore, we want to explore the intervention mechanism of acupuncture in improving visceral hypersensitivity by analyzing the colonic TRPV1 and microRNA-199. Trial registration: This trial is registered with Chinese Clinical Trials Register, ChiCTR-IOR- 17010860(http://www.chictr.org.cn/showproj.aspx?proj=18445).

The humic acid-modified expanded perlite (HA/EP) was first reported and developed as a low-cost adsorbent for removal of cationic dye methylene blue (MB). Effects of pH, ionic strength, adsorption time, adsorption temperature, and the initial concentration of MB on removal efficiency were investigated. Under optimized conditions, the experimental maximum adsorption capacity of HA/EP could achieve 78.2 mg/g, which was significantly higher than that of EP (< 1 mg/g). Adsorption kinetics, equilibrium, and adsorption thermodynamics were also evaluated. Both experimental and theoretical results demonstrate that the HA/EP can be used as a promising adsorbent for removal of cationic dyes from aqueous solution.

Objective To assess the efficacy and safety of treating post-stroke depression with acupuncture compared to western medicine systematically. Methods Databases were retrieved such as Cochrane Library, PubMed, Web of Sicence, EMbase, CBM, CNKI and WanFang Data so as to look up randomized controlled trials (RCT) of treating post-stroke depression with acupuncture and western medicine, and the time limit for the retrieval spanned from the date of database established to September 2013. By extracting data and evaluating methodological quality of included studies according to inclusion and exclusion criteria, RevMan 5.2 software was applied for Meta-analysis and evidence quality was assessed by adopting the GRADE system. Results A total of 13 RCTs (845 patients with post-stroke depression) were included in this study. It was revealed by Meta-analysis that the differences of the two groups were statistically significant in terms of HAMD scale scores measured at the end of the treatment by comparing the treatment of acupuncture and western medicine [SMD=0.26, 95% CI (0.11, 0.40)], but via susceptibility analysis (excluding low quality studies), the differences were not statistically significant [SMD=-0.06, 95% CI (−0.37, 0.25)], and the reliability of the results was low; in terms of adverse events, the differences were statistically significant [RR= 0.32, 95% CI (0.19, 0.53)], and the risk of adverse events reduced by 68% in the acupuncture group. From the assessment on evidence quality grade based on GRADE system, it was revealed that HAMD scores and adverse events were evidences with fairly low quality. Conclusion Although this system assessment showed that treating post-stroke depression with acupuncture was more effective compared with western medicine, the result was less reliable and quality of evidences was poor. The above-mentioned results need more high-quality randomized controlled trials for further verification.

To systematically analyze the therapeutic efficacy and safety of acupuncture in treating functional constipation (FC). By searching the Cochrane Library, PubMed, Web of Science, Embase, CBM, CNKI, WanFang databases, the randomized controlled trials (RCTs) comparing acupuncture with Western medication in treating FC were retrieved, from the inception of the databases to September 2013. When the literatures were arranged according to the inclusion and exclusion criteria, and the methodological qualities were evaluated, RevMan 5.2 was adopted for meta-analysis. Ten RCTs were included, covering 1 041 cases of FC. The meta-analysis showed that there was no significant difference in comparing spontaneous bowel movements per week between shallow acupuncture at Tianshu (ST 25) and Western medication [MD=−0.47, 95% CI (−1.28, 0.34)]; there was a significant difference in comparing the spontaneous bowel movements per week between deep acupuncture at Tianshu (ST 25) and Western medication [MD = 0.53, 95% CI (0.13, 0.92)], but the difference was insignificant according to the sensitivity analysis [MD=0.38, 95% CI (−0.03, 0.80)], indicating the low reliability of the conclusion. Regarding the Cleveland clinic score (CCS), the difference between shallow acupuncture at Tianshu (ST 25) and Western medication was insignificant [MD = 0.39, 95% CI (− 1.13, 1.91)]; the difference between deep acupuncture at Tianshu (ST 25) and Western medication was significant [MD=2.64, 95% CI (1.32, 3.97)]. In the evaluation of security, the incidence rate of adverse events in acupuncture treatment (0.31%) was significantly lower than that in Western medication treatment (3.4%). Although the present systematic review showed that deep acupuncture at Tianshu (ST 25) should have better therapeutic efficacy than Western medication, the reliability and quality of the evidences were poor, and thus the above results require proving by more RCTs of higher quality.

To explore the effect of Soothing Gan (肝) and invigorating Pi (脾) (SGIP) acupuncture treatment on the clinical symptoms and quality of life (QOL) in patients with diarrhea-predominant irritable bowel syndrome (IBS-D). With a single-blinded randomized control study adopted, 63 patients who met the inclusion criteria were assigned by a random number table to two groups, 31 in the treatment group and 32 in the drug control group. The treatment group received SGIP acupuncture therapy; while the control group was treated orally with pinaverium bromide. The treatment duration of both groups was 28 days. The clinical efficacy was evaluated and compared by scoring patient’s symptom and QOL. A significant difference was found by variance analysis in efficacies between the two groups (P

Thermal deformation of welding structure is inevitable in welding process. The deformation will not only change the appearance, shape and geometry size of the welding structure, reduce assembly quality but also may reduce the bearing capacity. On this basis, a welding deformation measurement based on visual method was proposed for the problem of the thermal deformation measurement in welding process. Theoretical calculations were carried out and an image processing and measurement algorithm based on MATLAB was also put forward. Then welding deformation measurement experiment was carried out and the results show that the welding deformation obtained by actual measurement is consistent with the theoretical analysis, proving the feasibility of welding deformation measurement based on vision. The welding deformation measurement based on visual method lays a foundation for automatic measurement of welding deformation.

Objective: Optimization of combining electroencephalography (EEG), short latency somatosensory evoked potentials (SLSEP) and transcranial Doppler (TCD) techniques to diagnose brain death. Methods: One hundred and eleven patients (69 males, 42 females) from the major hospitals of Zhejiang Province were examined with portable EEG, SLSEP and TCD devices. Re-examinations occurred ≤12 h later. Results: The first examination revealed that the combination of SLSEP and EEG led to more sensitive diagnoses than the combination of SLSEP and TCD. Re-examination confirmed this and also revealed that the combination of TCD and EEG was the most sensitive. Conclusion: The results show that using multiple techniques to diagnose brain death is superior to using single method, and that the combination of SLSEP and EEG is better than other combinations.

BACKGROUND An apnea test is essential in the clinical determination of brain death. This study was conducted to analyse complications associated with the apnea test in the determination of the brain death. METHODS On 93 adult patients in coma in Zhejiang Province of China from January 2003 to December 2006, 179 apnea tests were performed as a part of the determination of brain death. Potential risk conditions and complications were analysed during apnea tests. RESULTS During apnea, serious cardiac arrhythmia did not occur in all patients. Complications occurred in 37 of 179 (21%) apnea tests. Hypotension occurred in 30 patients (17%) and it was observed in 8/94 (9%) tests with baseline value of systolic arterial blood pressure not less than 120 mmHg, and 22/85 (26%) less than 120 mmHg (P < 0.05). Severe hypoxaemia occurred in 10 patients (6%) of which 3/138 (2%) tests with baseline value of arterial oxygen pressure not less than 200 mmHg, and 7/41 (17%) less than 200 mmHg (P < 0.05). CONCLUSIONS This study demonstrated that complications occurred mostly in patients with inadequate baseline systolic arterial blood pressure and preoxygenation. Adequate precautions during the apnea tests may reduce the risk of cardiovascular and oxygenation complication.

Background To examine whether electro-acupuncture (EA) could decrease 5-hydroxytryptamine (5-HT) and calcitonin gene-related peptide (CGRP), and increase neuro-peptide Y (NPY) in the brain-gut axis (BGA) in D-IBS using rat models. Methods Rats were randomly exposed to unpredictable chronic stress for 3 weeks followed by 1-hour acute restraint stress (CAS) after 7 days of rest, or daily gavage of Senna decoction (6 g/kg) plus chronic restraint stress (for a duration of 2 h, starting from 1 h prior to the gavage) for 2 weeks (ISC). The content of 5-HT, CGRP and NPY in the distal colon, spinal cord, hypothalamus was examined at the end of the treatment. Results 1. The two rat models exhibited similar characteristics, e.g., increased number of fecal pellets expelled in 1 h, decreased sacchar-intake, decreased CRD, elevated 5-HT, CGRP content and decreased NPY in the distal colon, spinal cord, hypothalamus (P

To observe the effect of acupuncture combined physical training and relearning on stroke patients.A multi-center, randomized controlled trial design was adopted. A total of 364 stroke patients were recruited and randomly assigned to the experimental group (184 cases) and the control group (180 cases). Patients in the experimental group received acupuncture combined with physical training and relearning, while those in the control group only received physical training and relearning. All received four weeks of treatment. Effects on Fugl-Meyer motor function, neurological impairment, activities of daily living difference were compared before treatment, after treatment, 2 and 5 months after follow-ups between the two groups.Totally 353 patients completed this trial, 179 in the experimental group and 174 in the control group. (1) compared with before treatment, brief Fugl-Meyer motor functions scores and FIM scored obviously increased, and scores for neurological impairment obviously decreased in the two group. Besides, the increment of brief Fugl-Meyer motor functions scores and FIM scores was obviously higher in the experimental group than in the control group at month 2 and 5 of follow-ups; scores for neurological impairment was obviously lower in the experimental group than in the control group. The increment of FIM scores was obviously higher in the experimental group than in the control group at month 5 of follow-ups (P0.05, P0.01). (2) There was statistical difference in inter-group comparison of total Fugl-Meyer motor functions scores and FIM scores, or scores for neurological impairment (P0.01). The improvement of Fugl-Meyer motor functions grading and neurological impairment grading was obviously superior in the experimental group at month 2 and 5 of follow-ups. The distribution of FIM grading was also better in the experimental group at month 5 of follow-ups (P0.05, P0. 01).Both acupuncture combined exercise training and relearning and physical training and relearning could effectively promote the rehabilitation of stroke patients, reduce their neurological impairment degrees, improve motor functions and independent capacities. Better long-term efficacy could be obtained by acupuncture combined exercise training and relearning.

To understand the prevalence and risk factors of Enterobius vermicularis among preschool children in kindergartens in Luohu District, Shenzhen City.A total of 489 children in 6 kindergartens were selected by the stratified sampling method and investigated for E. vermicularis infection by the cellophane anal swab technique. The information of sanitary condition of the kindergartens, personal hygiene, and family hygiene were investigated by questionnaire.The infection rate of E. vermicularis was 10.2% (50/489). The single factor analysis indicated that the following factors might related to the infection: the different classes of kindergartens, grades, ground of bed ioom, private toilet, types of taps and beds, bed management, education levels of parents, frequency of shower and washing anus, and washing hands before meal and after WC. The multivariate Logistic analysis indicated that the bed management, education level of mothers, frequency of washing anus, and private toilet were independent risk factors for E. vermicularis infection.To control the infection of E. vermicularis, the circumstance and management of kindergartens, parents' knowledge of E. vernicularis infection, and children's healthy habit need improve.

// Jia-hong Wang 1, * , Wei Wei 1, * , Jing Xu 2 , Zhi-xing Guo 3 , Cheng-zuo Xiao 1 , Yong-fa Zhang 1 , Pei-en Jian 1 , Xiao-liang Wu 2 , Ming Shi 1 , Rong-ping Guo 1 1 Department of Hepatobilliary Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China 2 State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China 3 Department of Ultrasonics, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China * These authors have contributed equally to this work Correspondence to: Rong-Ping Guo, e-mail: guorp@sysucc.org.cn Keywords: hepatocellular carcinoma, Cripto-1, MMP-9, aggressiveness, prognosis Received: April 20, 2015 Accepted: August 24, 2015 Published: September 05, 2015 ABSTRACT Cripto-1 could promote tumorigenesis in a wide range of carcinomas, yet little is known in hepatocellular carcinoma (HCC). The expression of Cripto-1 and MMP-9 were assessed by immunohistochemistry in 205 HCC specimens. The correlation between Cripto-1 and MMP-9, clinicopathological/prognostic value in HCC was examined. Cripto-1 overexpression was correlated with larger tumor, TNM stage, BCLC stage and tumor recurrence. In multivariate analyses, Cripto-1 was an independent predictor for overall survival (OS) and time to recurrence (TTR). Cripto-1 expression was increased in TNM and BCLC stage-dependent manner. Cripto-1 overexpression was associated with poor prognosis in patients subgroups stratified by tumor size, tumor differentiation, TNM and BCLC stage. In addition, Cripto-1 was positively correlated with MMP-9 among 205 HCC samples. Patients with Cripto-1 upregulation had poor OS and shorter TTR in low and high aggressiveness groups. Furthermore, Cripto-1 had predictive validity for early and late recurrence in HCC patients. Combination of Cripto-1 and serum AFP was correlated with OS and TTR. In conclusion, Cripto-1 overexpression contributes to aggressiveness and poor prognosis of HCC. Cripto-1/AFP expression could be a potential prognostic biomarker for survival in HCC patients.

We have previously reported that Cezanne could be a prognostic biomarker for survival in hepatocellular carcinoma (HCC) patients. However, the role of Cezanne genes in HCC cells and its response to postoperative adjuvant transcatheter arterial chemoembolization (TACE) in HCC patients remains unknown. In this study, Cezanne expression was detected in human HCC using real-time PCR, western blot and immunohistochemistry. The function of Cezanne in HCC cells was determined by Transwell invasion assays and nude mice metastasis assay. The response of Cezanne in patients who received adjuvant TACE after hepatectomy was evaluated. Functional study demonstrated that interference of Cezanne expression promoted the migration and invasion of HCC cells in vitro and boosted metastasized HCC formation in mice. Upregulation of Cezanne diminished the adhesion and migration of hepatoma cells. Further study indicated that Cezanne might inhibit invasion of HCC cells by inducing epithelial–mesenchymal transition (EMT). In addition, patients with low Cezanne expression had significant improvement in prognosis after receiving adjuvant TACE. In contrast, patients with high Cezanne expression had a poorer response to adjuvant TACE. Moreover, Cezanne status was associated with response to adjuvant TACE in patients subgroup stratified by vascular invasion, tumor size and tumor number. In conclusion, Cezanne may be a novel antioncogene that has a pivotal role in the invasion of HCC and contribute to the selection of patients who may benefit from adjuvant TACE to prevent recurrence.

Along with the application of genetic polymorphism techniques to individualized treatment of clinical disorders, the screening of polymorphisms markers of serotonin (5-HT) transporter (SERT) is a hot-spot of researches on irritable bowel syndrome (IBS). In the present paper, the authors introduce 1) optimized schemes of diagnosis and treatment of IBS on the basis of syndrome-differentiation for acupuncture in combination with Chinese herbal medicines, and application of 5-HT transporter polymorphism, 2) application of genetic polymorphism to researches on IBS, and 3) feasibility of genetic polymorphism techniques for guiding individualized treatment of IBS. Up to now, serotonin transporter length polymorphic region (5-HTTLPR), serotonin transporter intron 2 variable number of tandem repeat (Stin 2 VNTR) and single nucleotide polymorphism rs 25531 in the long allele of the 5-HTTLPR have been identified. On the basis of the treatment of IBS, we need establishing a set of guide lines for the individualized acupuncture treatment. The genotyping methods for genetic polymorphism should be widely used in this research field. 5-HT TLPR/ Stin 2 VNTR/rs 25531 polymorphisms would have a bright future in the field of IBS research and treatment.

The clinical experiences and proven cases of distinguished doctor of TCM, professor WU Xu, on acupuncture for acute upper abdominal pain is introduced. Professor WU's manipulation characteristics of acupuncture for acute upper abdominal pain, including acute cholecystitis, kidney stone, acute stomach pain, are one-hand shape but both hands in nature, moving like Tai Chi, force on the tip of needle, movement of qi mainly. The main technique posture is one-hand holding needle with middle finger for pressing, the needle is hold by thumb and index finger, and is assisted by middle finger. The special acupuncture experience of emergency is treatment according to syndrome differentiation, combination of acupuncture and moxibustion, selecting acupoint based on experience, blood-letting acupuncture therapy and so on.

To evaluate the clinical efficacy of acupuncture for treatment of diarrhea-predominant irritable bowel syndrome and discuss its action mechanism.Fifty-seven cases were randomly divided into two groups. The acupuncture group (29 cases) was treated with acupuncture at Taichong (LR 3), Zusanli (ST 36) and Sanyinjiao (SP 6) etc., once a day and 5 times per week. The medication group (28 cases) was treated with oral administration of pinaverium (50 mg each time, 3 times a day) and live combined bifidobacterium and lactobacillus tablet (4 tablets each time, 3 times a day). Four weeks were taken as a treatment course in both groups. Before and after treatment ELISA method was applied to measure the level of serum 5-HT of the patients in two groups. The scores of clinical symptoms were observed before treatment, after one and four weeks of treatment and 3 months after treatment, respectively.The level of serum 5-HT was significantly reduced in the acupuncture group and medication group (P0.01, P0.05), which had no statistical difference between two groups (P0.05). Compared with the medication group, the scores of clinical symptoms were obviously improved in the acupuncture group after one and four weeks of treatment and 3 months after treatment (P0.01, P0.05). The total effective rate was 89.66% (26/29) in the acupuncture group, which was superior to 67.85% (19/28) in the medication group (P0.05).The efficacy of acupuncture is superior to that of medicine in the treatment of diarrhea-predominant irritable bowel syndrome. The acupuncture treatment could reduce the visceral sensitivity, improve the intestinal motility and regulate the imbalance of brain-intestine interactive function.

To observe clinical therapeutic effects of acupuncture for pattern of liver-stagnation and spleen-deficiency in diarrhea-predominant irritable bowel syndrome (D-IBS) and its impact on cell factors.Forty cases were selected and divided into an acupuncture group (21 cases) in which acupuncture was applied and a medicine group (19 cases) in which oral administration of dicetel and bifidobacterium lactobacillus triple viable capsules were applied. The symptom scores, level of Th1-type cytokine (IFN-gamma, IL-2) and Th2-type cytokine (IL-4, IL-10) and ratio of IFN-gamma to IL-4 were compared in two groups before and after treatment to analyze acupuncture effect.The clinical symptoms were improved after one-week treatment in the acupuncture group (P0.05), which had faster onset than the medicine group (P0.05). The total effective rate was 90.48% (19/21) in the acupuncture group, which was superior to 78.95% (15/19) in the medicine group (P0.05). Compared with medicine treatment, imbalanced condition of Th1/Th2 was turning towards the direction of Th2 after acupuncture, indicating a tendency to recover the balance.The clinical efficacy of acupuncture for D-IBS has close relationship with effectively improving balance of Th1/Th2 in patients with liver-stagnation and spleen-deficiency.

Intensity inhomogeneity often causes considerable difficulties in image segmentation. In order to tackle this problem, we propose a novel region-based active contour model in a variational level set formulation. We first define a data fitting energy with a local Gaussian distribution fitting (LGDF) term, which induces a local force to attract the contour and stops it at object boundaries, and a local signed difference (LSD) term based on local entropy, which possesses both local separability and global consistency. This energy is then incorporated into a level set formulation with a level set regularization term that is necessary for accurate computation in the corresponding level set method. Experimental results show that the proposed model can not only segment images with intensity inhomogeneities and weak boundaries but also be robust to the noise, initial contours.

To evaluate the clinical efficacy and safety of acupuncture-moxibustion in treatment of irritable bowel syndrome systematically.Clinical randomized controlled trials on treatment of irritable bowel syndrome with acupuncture-moxibustion were collected. Through retrieval of CNKI (1979 - December of 2011) and VIP (1979- December of 2011), randomized and quasi-randomized controlled clinical trials on treatment of irritable bowel syndrome with control study between acupuncture and sham acupuncture or western medication were included. The test bias risk and quality assessment of each experiment were carried out by two researchers in accordance with the Cochrane Handbook 5.1.0 standard. And RevMan 5.1.6 software was adopted for the Meta analysis.Eleven researches were included with totally 969 patients. Meta analysis shows that the effective rate of the combined methods of acupuncture and moxibustion [RR = 1. 27, 95% CI ( 1.09, 1.49)] is superior to conventional western medication treatment.Acupuncture-moxibustion for irritable bowel syndrome is better than the conventional western medication treatment.

To observe the effect of electroacupuncture (EA) of "Tianshu" (ST 25) on colonic smooth muscle structure and interstitial cells of Cajal (ICC) in slow transit constipation (STC) rats, so as to investigate its mechanism underlying improving STC.Wistar rats (n = 56) were randomly allocated to control (n = 20), model and EA groups (n = 18/ group). STC model was established by feeding the rats with forage containing compound Diphenoxylate. EA (0.8 - 1.3 mA, 2 Hz/15 Hz) was applied to bilateral "Tianshu" (ST 25) for 15 min, once daily for 14 days. The treatment was given beginning from the next day on after the rat's first black stool excretion was found. The colonic smooth muscle structure was observed under microscope after sectioning and HE staining. The immunoactivity (average optical density, OD) of intestinal immuno-reaction (IR) po-sitive ICC product was detected by immunohistochemistry.(1) Microscopic observation displayed that after modeling, the rat's intestinal mucosa gland showed atrophy with reduction in the acinar number, being sparse in distribution; and the smooth muscle thickness was obviously thinner compared with the normal control group (P0.05). Whereas this situation of the colonic smooth muscle in the EA group was close to that of the normal control group. Compared with the model group, the thickness of the intestinal smooth muscle in the EA group was significantly bigger (P0.05). (2) Immunohistochemical results showed that the average OD values and number of IR-positive colonic ICC in the model group were obviously decreased in comparison with the normal control group (P0.05). Compared with the model group, the average OD values and the number of IR-positive coIonic ICC in the EA group were upregulated considerably (P0.05).EA of bilateral "Tianshu"(ST 25) is able to improve STC-induced structural changes of the colonic smooth muscle, and upregulate expression of colonic ICC in STC rats, which may be responsible for its efficacy in improving STC.

Sai-Ping Jiang,1 Zheng-Yi Zhu,2 Xiao-Liang Wu,3 Xiao-Yang Lu,1 Xing-Guo Zhang,1 Bao-Hua Wu1 1Department of Pharmacy, the First Affiliated Hospital, 2Department of Pharmacy, Children’s Hospital, College of Medicine, Zhejiang University, Hangzhou, 3Intensive Care Unit, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China Background: The impact of continuous renal replacement therapy (CRRT) on drug removal is complicated; pharmacist dosing adjustment for these patients may be advantageous. This study aims to describe the development and implementation of pharmacist dosing adjustment for critically ill patients receiving CRRT and to examine the effectiveness of pharmacist interventions. Methods: A comparative study was conducted in an intensive care unit (ICU) of a university-affiliated hospital. Patients receiving CRRT in the intervention group received specialized pharmacy dosing service from pharmacists, whereas patients in the no-intervention group received routine medical care without pharmacist involvement. The two phases were compared to evaluate the outcome of pharmacist dosing adjustment. Results: The pharmacist carried out 233 dosing adjustment recommendations for patients receiving CRRT, and 212 (90.98%) of the recommendations were well accepted by the physicians. Changes in CRRT-related variables (n=144, 61.81%) were the most common risk factors for dosing errors, whereas antibiotics (n=168, 72.10%) were the medications most commonly associated with dosing errors. Pharmacist dosing adjustment resulted in a US$2,345.98 ICU cost savings per critically ill patient receiving CRRT. Suspected adverse drug events in the intervention group were significantly lower than those in the preintervention group (35 in 27 patients versus [vs] 18 in eleven patients, P