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Cryoablation (CRA) and microwave ablation (MWA) are two main local treatments for hepatocellular carcinoma (HCC). However, which one is more curative and suitable for combining with immunotherapy is still controversial. Herein, CRA induced higher tumoral PD-L1 expression and more T cells infiltration, but less PD-L1highCD11b+ myeloid cells infiltration than MWA in HCC. Furthermore, CRA had better curative effect than MWA for anti-PD-L1 combination therapy in mouse models. Mechanistically, anti-PD-L1 antibody facilitated infiltration of CD8+ T cells by enhancing the secretion of CXCL9 from cDC1 cells after CRA therapy. On the other hand, anti-PD-L1 antibody promoted the infiltration of NK cells to eliminate PD-L1highCD11b+ myeloid cells by antibody-dependent cell-mediated cytotoxicity (ADCC) effect after CRA therapy. Both aspects relieved the immunosuppressive microenvironment after CRA therapy. Notably, the wild-type PD-L1 Avelumab (Bavencio), compared to the mutant PD-L1 atezolizumab (Tecentriq), was better at inducing the ADCC effect to target PD-L1highCD11b+ myeloid cells. Collectively, our study uncovered the novel insights that CRA showed superior curative effect than MWA in combining with anti-PD-L1 antibody by strengthening CTL/NK cell immune responses, which provided a strong rationale for combining CRA and PD-L1 blockade in the clinical treatment for HCC.
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Continuous drug monitoring is a promising alternative to current therapeutic drug monitoring strategies and has a strong potential to reshape our understanding of pharmacokinetic variability and to improve individualised therapy.This review highlights recent advances in biosensing technologies that support continuous drug monitoring in real time.We focus primarily on aptamer-based biosensors,wearable and implantable devices.Emphasis is given to the approaches employed in constructing biosensors.We pay attention to sensors'biocompatibility,calibration performance,long-term characteristics stability and measurement quality.Last,we discuss the current challenges and issues to be addressed in continuous drug monitoring to make it a promising,future tool for individualised therapy.The ongoing efforts are expected to result in fully integrated implantable drug biosensing technology.Thus,we may anticipate an era of advanced healthcare in which wearable and implantable biochips will automatically adjust drug dosing in response to patient health conditions,thus enabling the management of diseases and enhancing individualised therapy.
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<p><b>OBJECTIVE</b>To observe the effect difference between reinforcing-reducing manipulation and "" manipulation for amblyopia in children.</p><p><b>METHODS</b>A total of 68 children patients with amblyopia were assigned into an observation group and a control group by random number table, 34 cases (68 eyes) in each one. In the observation group, reinforcing-reducing manipulation was used at Yuyao (EX-HN 4), Taiyang (EX-HN 5), Tongziliao (GB 1), Jingming (BL 1), Cuanzhu (BL 2), and Chengqi (ST 1); twirling-reinforcing method was applied at Ganshu (BL 18), Shenshu (BL 23), and Guangming (GB 37);""manipulation was applied at bilateral Fengchi (GB 20). The acupoints and manipulations in the control group were the same as those in the observation group, except Fengchi (GB 20) with reinforcing-reducing method. All the treatment was given for 4 courses, 5 times as a course and once a day. The vision improvement was observed half a year after treatment.</p><p><b>RESULTS</b>The effective rates for ametropic amblyopia in the observation and control groups were respectively 92.0% (23/25) and 70.4% (19/27); anisometropic amblyopia, 85.7% (18/21) and 55.0% (11/20); strabismic amblyopia, 66.7% (12/18) and 29.4% (5/17). The effect of each type in the observation group was better than that in the control group (all<0.05).</p><p><b>CONCLUSION</b>""manipulation for amblyopia is superior to reinforcing-reducing method and can obviously improve the vision.</p>
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<p><b>OBJECTIVE</b>To compare the difference in the clinical efficacy on post-stroke upper limb spasmodic hemiplegia between the combined therapy ofneedling technique and Bobath technology and simple Bobath technology.</p><p><b>METHODS</b>Sixty patients were randomized into an observation group and a control group, 30 cases in each one. The usual medication of neurological internal medicine was used in the two groups. In the control group, Bobath facilitation technology was applied to the rehabilitation training. In the observation group, on the basis of the treatment as the control group,needling technique was used to stimulate Zhongfu (LU 1), Tianfu (LU 3), Chize (LU 5), Quchi (LI 11), Jianshi (PC 5) and Daling (PC 7). The treatment was given once a day; 5 treatments made one session and totally 4-week treatment was required in the two groups. The modified Ashworth scale, the modified Fugle-Meyer assessment (FMA) and the Barthel index (BI) were adopted to evaluate the muscular tension, the upper limb motor function and the activities of daily living (ADL) before and after treatment in the two groups. The clinical efficacy was compared between the two groups.</p><p><b>RESULTS</b>Compared with those before treatment, the modified Ashworth scale, Fugl-Meyer score and BI score were all improved after treatment in the two groups (all<0.01). The results in the observation group were better than those in the control group (all<0.01). The total clinical effective rate was 93.3% (28/30) in the observation group and was 80.0% (24/30) in the control group. The efficacy in the observation group was better than that in the control group (<0.05).</p><p><b>CONCLUSIONS</b>Theneedling technique combined with Bobath therapy achieve the superior efficacy on post-stroke upper limb spasmodic hemiplegia as compared with the simple application Bobath therapy. This combined treatment effectively relieve spasmodic state and improve the upper limb motor function and the activities of daily living.</p>
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Objective To observe clinical efficacy of warm-promotion needling for the treatment of cold coagulation and blood stasis of primary dysmenorrhea.Methods Totally 120 patients with cold coagulation and blood stasis of primary dysmenorrhea were randomly divided into warm-promotion needling group (60 cases) and control group (60 cases). Warm-promotion needling group was treated with warm-promotion needling at Guanyuan (RN4), Sanyinjiao (SP6), Shiqizhui (EX-B8), and Diji (SP8), and cooperated with Ciliao (BL32), Hegu (LI4), and Taichong (LR3). Control group took same acupoints and applied uniform reforcing-reducing method. The two groups began treatment 5-7 d before menstruation, 1 times a day, for 7 times. The treatment was given 3 menstrual cycles. The visual analogue scale (VAS) and COX menstrual symptom scale (CMSS) were used to observe the pain degree at the end of 1, 2, 3 menstrual cycles. The clinical efficacy was evaluated 3 months after treatment.Results The scores of VAS and CMSS was obviously reduced in the two groups after the treatment compared with those before treatment (P<0.01). The synperiodic scores of VAS and CMSS in warm-promotion needling group was obviously lower than those in the control group (P<0.05). The total effective rate of warm-promotion needling group was 96.67% (58/60), and the control group was 73.33% (44/60), the difference was significant (P<0.05).Conclusion Warm- promotion needling can obviously relieve dysmenorrhea symptoms and shorten the time of pain of patients with cold coagulation and blood stasis of primary dysmenorrhea, which has affirmative clinical efficacy.
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<p><b>OBJECTIVE</b>To compare the clinical efficacy differences between Zheng's gold hook, fishing acupuncture and electroacupuncture (EA) for lumbar disc herniation (LDH).</p><p><b>METHODS</b>Sixty patients of LDH were randomly allocated to a gold hook fishing acupuncture group and an EA group, 30 cases in each one. Lumbar Jiaji (EX-1 B 2), Yaoyangguan (GV 3), Shenshu (BL 23), Dachangshu (BL 25), Guanyuanshu (BL 26) and ashi points were selected in the gold hook fishing acupuncture group; after the needles were inserted, the manipulation of gold hook fishing acupuncture was applied at tendon junction points and ashi points. The identical acupoints were selected in the EA group and patients were treated with EA. The treatment was both given once a day; ten days of treatment were taken as one session, and totally 3 sessions were given. The clinical effective rate, visual analogue scale (VAS), low back pain score and Oswestry disability index (ODI) were used for efficacy evaluation.</p><p><b>RESULTS</b>The effective rate was 93.3% (28/30) in the gold hook fishing acupuncture group, which was superior to 86.7% (26/30) in the EA group (P < 0.05). The VAS, low back pain score and ODI were both significantly improved after treatment (all P < 0.05), which were more significant in the gold hook fishing acupuncture group (all P < 0.05).</p><p><b>CONCLUSION</b>ZHENG's gold hook fishing acupuncture could effectively improve the symptoms and sings of LDH, reduce the disability index and improve the quality of life, which is superior to EA.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Acupuncture Points , Acupuncture Therapy , Electroacupuncture , Intervertebral Disc Displacement , Therapeutics , Low Back Pain , Therapeutics , Quality of LifeABSTRACT
<p><b>OBJECTIVE</b>To compare the clinical efficacy differences betweenmethod and twirling-reinforcing needling method for ankylosing spondylitis (AS) at early stage.</p><p><b>METHODS</b>Sixty-eight patients were randomly assigned to an observation group and a control group, 34 cases in each one. The acupoint selection in the two groups was identical, taking Dazhui (GV 14) and Mingmen (GV 4) as the main acupoints. Patients in the observation group were treated withmethod, while patients in the control group were treated with twirling-reinforcing needling method. The treatment was given once a day, and seven treatments were considered as one course of treatment. The TCM symptom grading quantitative standard score, Barthel ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis ankylosing spondylitis function index (BASFI) were compared in the two groups before and after 3 treatment courses; also the efficacy was evaluated.</p><p><b>RESULTS</b>The total efficacy rate was 91.2% (31/34) in the observation group, which was superior to 79.4% (27/34) in the control group (<0.05); after treatment, the TCM symptom grading quantitative standard score, BASDAI and BASFI were significantly improved in the two groups (all<0.05), which were more significant in the observation group (all<0.05).</p><p><b>CONCLUSIONS</b>Themethod at Dazhui (GV 14) and Mingmen (GV 4) could effectively improve the symptoms of AS patients at early stage, which was superior to twirling-reinforcing needling method.</p>
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Objective To systematically assess the effectiveness and safety of acupuncture and moxibustion for treatment of rheumatoid arthritis. Methods Articles were searched from databases, i.e., CNKI, VIP, WanFang Data, CBM, Embase, and PubMed. Articles about RCT on acupuncture and moxibustion for rheumatoid arthritis and traditional medicine therapy were under meta-analysis. Results Totally 24 articles involving 2006 patients were included. The results of meta-analysis indicated that the overall effective rate of treatment in the group receiving acupuncture and moxibustion was higher than that in the drug group, with statistical significance [OR=2.73, 95%CI (2.18, 3.41), Z=8.78, P<0.000 01]. Sub-group analysis showed that:acupuncture and moxibustion showed statistical significance in decreasing serum RF levels compared with drug therapy [MD=-2.92, 95%CI (-5.60, -0.25), P<0.05]. Acupuncture and moxibustion showed statistical significance in decreasing serum ESR levels compared with drug therapy [MD=-2.99, 95%CI (-4.78, -1.21), P<0.05]. Acupuncture and moxibustion showed statistical significance in decreasing serum CPR levels compared with drug therapy [MD=-1.44, 95%CI (-2.44, -0.44), P <0.05]. Conclusion The overall effective rates of acupuncture and moxibustion for rheumatoid arthritis and the decreasing levels of RF, ESR, CRP are superior to drug therapy, but it still needs larger samples, multi-center, and high quality RCT to verify.