Comparison of simultaneous integrated boost and late course boost intensity-modulated radiation therapy in the treatment of esophageal carcinoma / 中华放射医学与防护杂志

Objective To analyze and compare the outcomes of esophageal carcinoma treated with simultaneous integrated boost intensity-modulated radiation therapy (SIB-IMRT) and late course boost intensity-modulated radiation therapy (LCB-IMRT).Methods We retrospectively analyzed 128 patients with esophageal squamous cell carcinoma who were treated with SIB-IMRT or LCB-IMRT at the fifth department of radiation oncology in our hospital,from January 2009 to August 2015.Propensity score matching analysis was used to balance the variables differences in the two groups.Survival,failure patterns and toxicities were observed and compared between the two groups.Results one hundred and eleven patients were finally included after propensity scores matching.The 1-,3-and 5-year local control rates and survival rates were 83.6％ vs.81.7％,70.8％ vs.46.3％ and 66.0％ vs.38.2％ in the whole group,respectively.The 1-,3-and 5-year local control rates of SIB-IMRT and LCB-IMRT group were 81.6％ vs.88.0％,72.3％ vs.67.6％ and68.5％ vs.60.8％,respectively (P＞0.05).The 1-,3-and 5-year survival rates of SIB-IMRT and LCB-IMRT group were 81.3％ vs.82.4％,51.7％ vs.36.7％ and 45.8％ vs.26.7％,respectively (P ＞ 0.05).There was no statistical difference between the two group in ≥ grade 3 toxicities (P ＞ 0.05).There were 40 (36.0％) patients result in treatment failure in all.The treatment failure rates in SIB-IMRT and LCB-IMRT group were 33.8％ (26/77) vs.41.2％ (14/34),respectively (P ＞ 0.05).The local failure accounted for 65.0％ (26/40) of all treatment-related failures.Conclusions The toxicities of esophageal squamous cell carcinoma treated with SIB-IMRT and LCB-IMRT have no significant differences and were well tolerated.There were no significant differences in local control rates and survival rates between the two groups.However,SIB-IMRT had better trend than LCB-IMRT.Given SIB-IMRT's convenient manipulation,it could be a better choice in the treatment of advanced esophageal carcinoma.

Analysis of Short-and Long-Term Therapeutic Efficacies of Acupuncture for Metabolic Syndrome / 上海针灸杂志

Objective To observe the short- and long-term efficacies of acupuncture in treating metabolic syndrome (MS). Method A hundred MS patients were randomized into an acupuncture group and a Western medication group. In addition to basic treatment, acupuncture was used in the acupuncture group, while Western medication was adopted in the Western medication group. The fasting plasma glucose (FPG), high-density lipoprotein (HDL), insulin (INS), triglyceride (TG), blood pressure (BP), weight circumference (WC), body mass index (BMI), and MS score were evaluated before and after treatment, and a month and 3 months after the treatment. Result There was no significant difference in comparing the short-term therapeutic efficacy between the two groups after treatment, while the long-term therapeutic efficacy of the acupuncture group was superior to that of the Western medication group (P<0.01); the FPG, INS, TG, HDL, BP, and MS score were significantly improved after treatment and a month after the treatment in both groups (P<0.01); the acupuncture group had significant improvements in WC and BMI after treatment and a month after the treatment (P<0.01), significantly superior to the Western medication group (P<0.01); the acupuncture group showed marked improvement in INS, HDL, WC, and BMI 3 months after the treatment (P<0.01), significantly superior to the Western medication group (P<0.01,P<0.05). Conclusion Acupuncture can produce a similar short-term but a better long-term therapeutic efficacy compared to Western medication. Hence, acupuncture can be taken as an assistant intervention for MS.

YANG's pricking-cupping therapy for knee osteoarthritis: a multi-center randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy of YANG's pricking-cupping therapy for knee osteoar thritis (KOA). Methods This was a multi-center randomized parallel controlled trial. One hundred and seventy one patients with KOA were randomly allocated to a pricking-cupping group (89 cases) and a conventional acu puncture group (82 cases). Neixiyan (EX-LE 4), Dubi (ST 35) and ashi points were selected in the two groups. Patients in the pricking-cupping group were treated with YANG's pricking-cupping therapy; the seven-star needles were used to perform pricking at acupoints, then cupping was used until slight bleeding was observed. Patients in the conventional acupuncture group were treated with semi-standardized filiform needle therapy. The treatment was given for 4 weeks (from a minimum of 5 times to a maximum of 10 times). The follow-up visit was 4 weeks. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the visual analogue scale (VAS) were adopted for the efficacy assessments.</p><p><b>RESULTS</b>The pain score, stiffness score, physical function score and total score of WOMAC were all reduced after 4-week treatment and during follow-up visit in the two groups (all P<0. 0001). Except that the difference of stiffness score between the two groups was not significant after 4-week treatment (P>0. 05), each score and total score of WOMAC in the pricking-cupping group were lower than those in the conventional acupuncture group after 4-week treatment and during follow-up visit (P<0. 0001, P<0. 01). After 2-week treatment, 4-week treatment and during follow-up visit, the VAS was all reduced compared with that before treatment (all P<0. 0001) ; with the increase of the treatment, the reducing trend of VAS was more significant (P<0. 0001). The scores of VAS in the pricking-cupping group were lower than those in the conventional acupuncture group after 4-week treatment and during follow-up visit (P < 0. 01, P <0. 0001). CONCLUSION The YANG's pricking-cupping and conventional acupuncture therapy can both significantly improve knee joint pain and function in patients with KOA, which are relatively safe. The pricking cupping therapy is superior to conventional acupuncture with the identical selection of acupoints.</p>

A clinical study of salvage radiotherapy for supraclavicular lymph node metastasis in patients with esophageal cancer / 中华放射肿瘤学杂志

Objective To evaluate the efficacy of salvage radiotherapy for supraclavicular lymph node metastasis ( SLNM) after initial treatment in patients with esophageal cancer. Methods A total of 117 patients with SLNM after radical resection for esophageal cancer were enrolled as subjects from 2006 to 2012. All patients received three?dimensional radiotherapy with 1. 8?2. 0 Gy per cycle, 5 cycles a week. The survival rates were calculated using the Kaplan?Meier method and analyzed using the log?rank test. The Cox model was used for multivariate analysis. Results The follow?up rate was 100%. In all the patients, the 1?and 3?year overall survival (OS) rates were 38. 5% and 14. 1%, respectively. The 1?and 3?year OS rates were significantly higher in patients treated with salvage radiotherapy or radiochemotherapy ( n=100) than in patients without any salvage treatment (n=17)(42% vs. 18%,P=0. 008;17% vs. 0%, P=0. 008). The patients treated with radiochemotherapy ( n=32) had significantly higher 1?and 3?year OS rates than those treated with radiotherapy alone (n=68)(59% vs. 34%, 36% vs. 11%, P=0. 002) or without any salvage treatment (n=17)(59% vs. 18%, 36% vs. 0%, P=0. 002). Patients without visceral metastasis (n=80) had significantly higher 1?and 3?year OS rates than those with visceral metastasis ( n=37) ( 44% vs. 27%, P=0. 002;22% vs. 0%,P=0. 002) . Patients with supraclavicular doses of ≥60 Gy in salvage radiotherapy ( n=75) had significantly higher 1?and 3?year OS rates than those with supraclavicular doses of<60 Gy in salvage radiotherapy ( n=25) ( 75% vs. 25%,P=0. 000;24% vs. 8%,P=0. 000) . The multivariate analysis using the Cox model showed that supraclavicular doses of ≥60 Gy, mediastinal metastasis, visceral metastasis, and salvage treatment method were independent factors for survival ( P=0. 001,0. 015,0. 009, 0. 025) . Conclusions Salvage radiotherapy can improve the survival of patients with SLNM in esophageal cancer. Salvage radiotherapy or radiochemotherapy is highly recommended for patients with SLNM alone. A radiation dose of ≥60 Gy in salvage radiotherapy improves survival in patients.

Moxibustion：its outlook in the intestinal flora and mucosal immunity for regulation of irritable bowel syndrome / 中国组织工程研究

BACKGROUND:The interaction and mutual influence of intestinal flora in the host intestine with mucosal immune barrier play an important role in the homeostasis regulation within the intestine. OBJECTIVE:To explore the role of intestinal flora in the pathogenesis of irritable bowel syndrome and the mechanism of moxibustion in the treatment of irritable bowel syndrome from the aspects of intestinal flora imbalance and mucosal immune activation. METHODS:With the key words of “irritable bowel syndrome, intestinal flora, intestinal immune, moxibustion” in Chinese and in English, respectively, a computer-based search was performed for articles published in CNKI, VIP and PubMed databases from October 2001 to October 2014. After the initial screening, the reserved articles were further detailed, summarized and concluded. RESULTS AND CONCLUSION:Totaly 37 articles were colected, including 15 in Chinese and 22 in English. The analysis results showed that, the imbalance of intestinal flora and mucosal immune can play an important role in the pathogenesis of irritable bowel syndrome, and the former one can affect the body’s feeling of rectal distension threshold and visceral sensitivity. Moxibustion excels at improvement of the symptoms of irritable bowel syndrome, particularly abdominal pain with high visceral sensitivity, by regulating the body’s physiological balance from multi-link and multi-target aspects.

Epigenetic modification and the regulatory mechanism of moxibustion in inflammatory bowel disease / 中国组织工程研究

METHODS:A computer-based online research of PubMed, CNKI and VIP databases was performed with the key words of “epigenetic; inflammatory bowel disease; Crohn’s disease; ulcerative colitis; DNA methylation; histone modification; miRNA; moxibustion” in Chinese and English. RESULTS AND CONCLUSION:The correlation of epigenetic modification with inflammatory bowel disease occurrence and development is elaborated. The mechanisms in inflammatory bowel disease have been related from DNA methylation, histone modifications and miRNA targets. The mechanism of moxibustion on inflammatory bowel disease is primarily associated with immune regulation, and its anti-inflammatory mechanism may be affected by epigenetic regulation of inflammatory cytokines.

Clinical application and progression of warm acup-moxibustion as an analgesic therapy / 中国组织工程研究

BACKGROUND:Warm acup-moxibustion is an effective treatment in Chinese traditional medicine, which combines acupuncture with moxibustion. With an immediate analgesia or/and long-term effect, warm acup-moxibustion has been used clinicaly for acute and chronic pain. OBJECTIVE:To analyze the progress in the studies about clinical application of warm acup-moxibustion as analgesic therapy for acute and chronic pain and to discuss the influential factors. METHODS: CNKI, VIP and Wanfang databases were searched for relevant articles published between January 1995 and July 2015 using the keywords of “warm needling; warm acup-moxibustion; pain; analgesic” in Chinese. According to the exclusion and inclusion criteria, 51 articles were included in result analysis. RESULTS AND CONCLUSION: Compared with ordinary acupuncture, medicine and other treatment methods, warm acup-moxibustion can play an analgesic role in multiple systems, which is better than ordinary acupuncture and Western medicine. Warm acup-moxibustion combined with drugs and acupuncture techniques can increase the analgesic effect and improve joint function activity. Warm acup-moxibustion with the overal regulatory role plays an effective analgesic pain role in the multiple systems and shortens the duration of treatment, which is an effective method for treating pain and worthy of further promotion and application.

Observations on the Therapeutic Effect of Du meridian Moxibustion on Polycystic Ovarian Syndrome of Spleen-kidney Yang Deficiency Type / 上海针灸杂志

Objective To investigate the clinical efficacy of Du meridian moxibustion in treating polycystic ovarian syndrome of spleen-kidney yang deficiency type. Methods Seventy patients with polycystic ovarian syndrome of spleen-kidney yang deficiency type were randomly allocated to treatment and control groups, 35 cases each. The treatment group received Du meridian moxibustion plus medication and stomach and the control group, medication alone. Sex hormones [follicle-stimulating hormone (FSH), luteinizing hormone (IH) and testosterone (T)], fasting insulin (INS), fasting blood glucose (GLU), body mass index (BMI) and changes in menstrual cycle were observed in the two groups before and after three weeks of treatment. The clinical therapeutic effects were compared between the two groups. Results The total efficacy rate was 94.3%in the treatment group and 77.1%in the control group;there was a statistically significant difference between the two groups (P＜0.05). There were statistically significant pre-/post-treatment differences in LH, LH/FSH and T in the two groups (P＜0.01, P＜0.05). There were no statistically significant post-treatment differences in sex hormones between the two groups (P>0.05). There were statistically significant pre-/post-treatment differences in INS, BMI and menstrual cycle in the treatment group (P＜0.01, P＜0.05). There was a statistically significant pre-/post-treatment difference in menstrual cycle in the control group (P＜0.05). There were no statistically significant post-treatment differences in INS, GLU, BMI and menstrual cycle between the two groups (P>0.05). Conclusion Du meridian moxibustion is an effective way to treat polycystic ovarian syndrome of spleen-kidney yang deficiency type. It can improve insulin resistance and insulin sensitivity.

Moxibustion therapy for chronic abdominal pain due to irritable bowel syndrome / 中国组织工程研究

BACKGROUND:Chronic visceral pain is one of major complaints of irritable bowel syndrome which seriously affects patient’s quality of life. Recent researches have shown that moxibustion therapy has positive effects on aleviating chronic visceral pain in irritable bowel syndrome patients. OBJECTIVE: To study the clinical utility of moxibustion in coping with chronic visceral pain of irritable bowel syndrome patients, and shed light on the theoretical basis of moxibustion analgesia, thereby to give insights into the further research and application on moxibustion. METHODS: With the key words of “moxibustion, irritable bowel syndrome, visceral pain, abdominal pain” in Chinese and in English, respectively, a computer-based search was performed in CNKI, VIP, Wanfang and PubMed databases for articles published from January 1990 to October 2014. After the initial screening, the remained articles went through further selection and categorization. RESULTS AND CONCLUSION:The result shows promising results of moxibustion on relieving chronic visceral pain for both two subtypes of irritable bowel syndrome patients, diarrhea type and constipation type. Moxibustion may exert an analgesic effect on chronic visceral pain in irritable bowel syndrome patients through regulation of visceral hypersensitivity, gastrointestinal motility disorders, brain-gut axis and neuroendocrine system disorders, immune dysfunction and low-grade inflammation in the gut, psychological abnormalities, and alteration of intestinal flora. However, to fuly understand the analgesia effect of moxibustion and elucidate its mechanism, more standardized randomized controled trials employing advanced scientific techniques and equipments wil stil be needed in the future.

Research for Optimizing the Acupuncture-moxibustion Treatment Protocol for Diabetic Gastroparesis / 上海针灸杂志

ObjectiveTo explore the optimal acupuncture-moxibustion treatment protocol in treating diabetic gastroparesis. MethodA hundred patients were randomized into a body-acupuncture group, an electroacupuncture group, a hydroacupuncture group, and an acupuncture-moxibustion group, allto receive 3 treatment courses. The clinical symptoms and sign scores were observed before and after the intervention in the four groups.ResultThe markedly-effective rate of the acupuncture-moxibustion group was significantly higher than that of the other three groups (P<0.05). Regarding the symptom score for bloating, poor appetite, belching, upper abdominal pain, and nausea, the improvements in the acupuncture-moxibustion group were more significant than that in the other three groups (P<0.05,P<0.01).ConclusionCombination of acupuncture and moxibustion is the optimal treatment protocol for diabetic gastroparesis.

Clinical Observation of Moxibustion in Treatment of Knee Osteoarthritis / 上海针灸杂志

ObjectiveTo observe the effects of moxibustion in treating knee osteoarthritis (KOA).MethodTotally105 patients with KOA were randomly divided intoamoxibustion group (n=39), anelectroacupuncture group(n=44) andaCelebrex group (n=22).The three groups were treatedsuccessively for 4 weeks.The visual analogue scale (VAS) score of knee-joint pain and knee-joint function score were observed.ResultSeven days,fourteen days and twenty-eight daysrespectivelyafterthe treatment,theVAS scores of knee-joint pain and knee-joint function scoresweresignificantlydecreased in the three groups (P<0.001). Fourteen days and twenty-eight days afterthe intervention,the knee-joint function scores ofthemoxibustion group and electroacupuncture group weresignificantlyhigherthan those oftheCelebrex group (P<0.05).ConclusionMoxibustion therapy can improve the clinical symptoms and the knee-joint function in patients with KOA,similar to the electroacupuncture group and Celebrex group, and the moxibustion group has better effect in improving theknee-joint functioncompared to the Celebrex group.