Acupuncture combined with auricular point sticking therapy for post stroke depression:a randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To observe the clinical effects of acupuncture combined with auricular point sticking based on the western medication for post stroke depression (PSD).</p><p><b>METHODS</b>Sixty patients with PSD were randomly assigned into an acupuncture plus auricular application group (a combination group) and a medication group, 30 cases in each one. 20 mg paroxetine hydrochloride was prescribed orally in the medication group, once a day for continuous 8 weeks. Based on the above treatment, 30-minute acupuncture was used in the combination group for 8 weeks at Baihui (GV 20), Sishencong (EX-HN 1), Shenting (GV 24), Yintang (GV 29), Shenmen (HT 7), Neiguan (PC 6), Taichong (LR 3), Hegu (LI 4), Zusanli (ST 36), Sanyinjiao (SP 6) and Fenglong (ST 40), once the other day and three times a week. Auricular point sticking therapy for 8 weeks was applied at shenmen (TF), pizhixia (AT), xin (CO), and gan (CO), with pressing 3 times a day and once 3-5 days. The total score and each factor scores of Hamilton's depression scale (HAMD) were observed in the two groups before and after treatment, and Asberg's antidepressant side-effect rating scale (SERS) and clinical effect were evaluated.</p><p><b>RESULTS</b>After treatment, the total HAMD scores of the two groups decreased compared with those before treatment (both<0.05), with better effect in the combination group (<0.05). The scores of the combination group after treatment were lower than those in the medication group, including the anxiety/somatization factor, sleep disturbance factor, hopelessness factor (all<0.05). The total effective rate of the combination group was 86.7% (26/30), which was better than 66.7% (20/30) of the medication group (<0.05). The SERS score of the combination group was lower than that of the medication group (<0.05).</p><p><b>CONCLUSIONS</b>Acupuncture combined with auricular point sticking can improve the clinical symptoms and are effective and safe for PSD.</p>

MicroRNA 145 may play an important role in uveal melanoma cell growth by potentially targeting insulin receptor substrate-1 / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>MicroRNAs (miRNAs) contribute to tumorigenesis by acting as either oncogenes or tumor suppressor genes. In this study, we investigated the role of miR-145 in the pathogenesis of uveal melanoma.</p><p><b>METHODS</b>Expression profiles of miRNAs in uveal melanoma were performed using Agilent miRNA array. Quantitative real-time polymerase chain reaction was used to screen the expression levels of miR-145 in normal uveal tissue, uveal melanoma tissue, and uveal melanoma cell lines. Lenti-virus expression system was used to construct MUM-2B and OCM-1 cell lines with stable overexpression of miR-145. Cell proliferation, cell cycle, and cell apoptosis of these miR-145 overexpression cell lines were examined by MTT assay and flow cytometry respectively. The target genes of miR-145 were predicted by bioinformatics and confirmed using a luciferase reporter assay. The expression of insulin-like growth factor-1 receptor (IGF-1R), insulin receptor substrate-1 (IRS-1) proteins was determined by Western blotting analysis. IRS-1 was knocked down in OCM-1 cells. TUNEL, BrdU, and flow cytometry assay were performed in IRS-1 knocked down OCM-1 cell lines to analyze its function.</p><p><b>RESULTS</b>Forty-seven miRNAs were up regulated in uveal melanoma and 61 were down regulated. miR-145 expression was significantly lower in uveal melanoma sample and the cell lines were compared with normal uveal sample. Overexpression of miR-145 suppressed cell proliferation by blocking the G1 phase entering S phase in uveal melanoma cells, and promoted uveal melanoma cell apoptosis. IRS-1 was identified as a potential target of miR-145 by dual luciferase reporter assay. Knocking down of IRS-1 had similar effect as overexpression of miR-145.</p><p><b>CONCLUSION</b>miR-145 might act as a tumor suppressor in uveal melanoma, and downregulation of the target IRS-1 might be a potential mechanism.</p>

Observation and management of retinal changes related to diving in professional divers / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>It is very common for professional divers to have damage on the retinas. Severe retinal lesions can profoundly affect athletes' training efficacy and their daily lives. At present, it is not clear if there is effective preventive action. Thus, in our study, we continuously tracked the ocular changes in athletes and closely monitored the risk factors associated with retinal detachment. Also, we analyzed possible interventions, their associated factors, and efficacies for timely preventions to protect the retina from damage in professional divers.</p><p><b>METHODS</b>Between 2009 and 2012, a total of 39 professional divers enrolled in follow-up management. The conducted examinations included ocular examination, record screening on retinal lesion, monitoring best-corrected visual acuity, and checking intraocular pressure (IOP) and the scope of retinal lesion. The management included optimizing training methods, taking customized follow-up based on different retinal lesions, laser treatments for definite cases of retinal tear, retinal degeneration caused by retinal layer thinning or vitreous traction, and observing the changes in the scope of retinopathy.</p><p><b>RESULTS</b>Every year, the percentage of divers who have various degrees of retinal lesions is between 43.3% and 56.2%. During the 4 years, there were no statistically significant differences in divers' best-corrected visual acuity and retinal lesions. There were also no statistically significant differences between male and female athletes. However, there were statistically significant differences in IOP during these years. Moreover there were statistically significant differences in IOP and the scope of retinal lesions between platform divers and springboard divers.</p><p><b>CONCLUSIONS</b>Our management of retinal lesions could be effective to prevent severe retinopathy in professional divers. At the same time, platform divers are more likely to have retinal lesions than springboard divers.</p>

Intravitreal ranibizumab therapy versus photodynamic therapy for idiopathic choroidal neovascularization: a comparative study on visual acuity, retinal and choroidal thickness / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Photodynamic therapy (PDT) has been recommended as a main treatment for idiopathic choroidal neovascularization (I-CNV). But the visual results of PDT were inconsistent and variable, and PDT may bring severe damage to the retinal pigment epithelium and choriocapillaries. In recent years, intravitreal ranibizumab therapy, showing favorable visual outcomes, has developed as an advanced treatment for choroidal neovascularization (CNV). Although both methods have been reported to be effective in treating I-CNV, there is no detailed comparative report between the two methods. This study aimed to compare visual outcomes, retinal and choroidal thickness between intravitreal ranibizumab therapy and PDT in the treatment of I-CNV, and investigate the correlation of visual outcomes with retinal and choroidal thickness in each of the two groups.</p><p><b>METHODS</b>Thirty-seven eyes of 37 patients with I-CNV were involved in this study; 19 eyes were treated with intravitreal ranibizumab therapy and 18 eyes were treated with PDT. The best corrected visual acuity (BCVA) was recorded before and at each follow-up visit after treatments (logMAR). Enhanced-depth imaging optical coherence tomography (EDI-OCT) was used to evaluate the retinal structural changes, and to measure central retinal thickness (CRT) and central choroidal thickness (CCT).</p><p><b>RESULTS</b>Mean BCVA was 0.64 ± 0.27 in PDT group and 0.69 ± 0.22 in ranibizumab group at baseline (P = 0.55). When compared with the baseline, mean BCVA in PDT group was improved significantly at 3-month after PDT (0.41 ± 0.16, P = 0.002), then changed little (0.42±0.25 at 12-month, P = 0.88). Whereas mean BCVA in Ranibizumab group was improved significantly at each follow-up visit. It improved much more obviously in the first month and then remained stable. The mean BCVA in the ranibizumab group was significantly better at each follow-up visit than that in PDT (P < 0.05). When compared with the baseline, mean CRT in PDT group decreased significantly since 3-month visit, whereas mean CRT in ranibizumab group decreased significantly from 1-month visit. Mean CRT at 1-month and 3-month decreased much more in ranibizumab group than that in PDT group, almost in the same period as BCVA improving. When compared with the baseline, mean CCT did not change significantly at each follow-up visit in each group (P > 0.05). The CCT difference was not statistically significant between the two groups at each same time visit (P > 0.05). Mean BCVA was correlated with CRT, but was not correlated with CCT.</p><p><b>CONCLUSIONS</b>Both intravitreal ranibizumab therapy and PDT are effective for the treatment of I-CNV. It is obvious that ranibizumab therapy is significantly superior to PDT in improving BCVA and decreasing CRT. CRT decreases much more rapidly in ranibizumab group than in PDT group, simultaneously with visual improvement. CRT reduction has significant correlation with the visual outcomes in the recovery of I-CNV, whereas BCVA prognosis may have no correlation with CCT. CCT is not changed significantly after each of the treatments. Both PDT and ranibizumab therapy may have no significant effect on choroid.</p>

Clinical research on the influence of moxibustion on body sub-health fatigue degree / 国际中医中药杂志

Objective To observe the clinical effect of moxibustion on body sub-health fatigue state.Methods 120 cases of body sub-health patients were randomly divided into A,B,C three groups,with 40 cases in each group.Group A was treated with moxibustion,group B was treated with acupuncture therapy,and group C (control group) did not receive any measure of treatments.Fatigue scale (FS) was adopted to the three groups respectively for measuring physical fatigue score,mental fatigue score and total fatigue score before and after the treatment.Treatment efficacy was evaluated and analyzed after three weeks of continuous treatment.Results The total score of fatigue scale was 6.10 ± 2.47、6.82± 2.36、and 10.10±2.66 respectively in group A,group B and group C.Compared with group C,the difference in group A and group B was statistically significant (P＜0.01).Compared with group B,the difference in group A was not statistically significant (P＞0.05) ; The Physical fatigue points of group A,B,C was 2.46± 2.06、3.60 ± 2.24 and 5.03 ± 2.66 respectively.Compared with C group,the difference in group A and group B was statistically significant (P＜0.01).Compared with group B,the difference in group A was statistically significant (P＜0.05).Conclusions Moxibustion and acupuncture can effectively improve patients total body sub-health state of fatigue.Moxibustion treatment showed better effects in alleviating physical fatigue,

Late course accelerated hyper-fractionated radiotherapy of upper and middle thoracic esophageal T2N0M0 carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To analyse the result of late course accelerated hyper-fractionated radiotherapy (LCAHFR) of upper and middle thoracic segment esophageal T2N0M0 carcinoma.</p><p><b>METHODS</b>Fifty-three patients with squamous cell esophageal T2N0M0 carcinoma in the upper and middle segment were treated by LCAHFR from August 1994 to January 2000. The design of the radiation fields were based on CT and barium examination. All patients were treated with the conventional fractionated radiotherapy during the first two-thirds of the treatment to a dose about 41.4 Gy/23 F/4 to 5 weeks. This was followed by accelerated hyper-fractionated irradiation using reduced fields, twice daily at 1.5 Gy per fraction to a dose about 27 Gy/18 d. Thus, the total dose was 67-70 Gy/40-43 F/40-49 d.</p><p><b>RESULTS</b>The 1-, 2- and 5-year actuarial survival rates were 89.9%, 66.8% and 51.2%, respectively. The 1-, 2- and 5-year local control rates were 92.1%, 87.1% and 87.1%. Of the 17 patients who died, 5 died of local failure (29.4%), 9 (52.9%) of distant metastasis, 5 (29.4%) of lymph metastasis and 1 (5.9%) of bleeding from the esophagus. The Cox multivariate model showed that the site of lesion was the only prognostic factor, with upper better than the middle segment.</p><p><b>CONCLUSION</b>Late course accelerated hyper fractionated radiotherapy is one of the best radiation treatment regimen for early esophageal carcinoma in the upper and middle thoracic segment.</p>

Intracavitary hyperthermia combined with radiochemotherapy for esophageal carcinoma / 中国癌症杂志

Hyperthermia can enhance the sensitivity of tumors to radiotherapy and chemotherapy, In order to understand the impact of intracavitary hyperthermia on radiochemotherapy in esophageal carcinoma, the biological basis,advances,efficacy and active factors of intracavitary hyperthermia combined with radiochemotherapy in esophageal carcinoma is reviewed and evaluated.

Advances on esophageal carcinoma radiotherapy in China / 中国癌症杂志

Carcinoma of the esophagus is one of the most common cancer in China. Because the early diagnosis is delayed, 80% patients have the locally extensive or distant metastasis at the time of diagnosis, and radiotherapy is one of the most important modalities in esophageal carcinoma management. In this paper , a brief introduction about the advances on esophageal carcinoma radiotherapy in China will be done ,such as radiotherapy alone, radiotherapy combined with surgery,chemotheropy or intraluminal hyperthermia.

Advances in biological markers on prognosis of esophageal cancer / 中国癌症杂志

With the development of molecular biology,the study of biological markers will probably help to predict the prognosis and to improve the method of treatment and the survival. Advances in biological markers of esophageal cancer prognosis were reviewed. [

Do the patients with esophageal cancer benefit from higher radiation dose?——Dose escalation of 3-D conformal radiation therapy in the patients with esophageal cancer / 中国癌症杂志

Background and purpose:It may improve local control to increase radiation dose for esophageal cancer.The purpose of the study is to obtain the maximum tolerance dose(MTD)and assess toxicity of 3-D conformal radiation therapy(3-DCRT)for esophageal cancer.Methods:The scheduled dose escalation ranged from 70 Gy to 76 Gy.All patients received conventional fractionation irradiation to a dose of 46 Gy/23 Fx/4.5 weeks,followed by accelerated hyperfractionation irradiation using reduced fields,1.5 Gy twice a day,to a dose of 24 Gy/16 Fx.The criteria for stopping dose escalation was grade ≥3 radiation-induced toxicity in ≥15% patients.Results:From July,2000 to July,2001,18 patients were enrolled.Five patients completed a total dose of 70 Gy and an additional 5 patients received 73 Gy.Eight patients completed a total dose of 76 Gy.No patient occurred grade ≥3 radiation-induced toxicity at the level of 70 Gy.Four patients(80%)experienced grade ≥3 radiation-induced late toxicity(2 patients died of late radiation-induced pneumonitis)at the level of 73 Gy.Five patients(62.5%)experienced grade ≥3 radiation-induced acute toxicity and 6 patients(75%)had grade≥3 late toxicity(1 patients died of late radiation-induced esophagitis,and 2 patients died of late radiation-induced pneumonitis)at the level of 76 Gy.Conclusions:Based on the clinical trial,there were more severe radiation-induced toxicities when the patients with esophageal cancer received more than 70 Gy.

THE TREATMENT OF TESTICLE EMBRYONAL RHABDOMYOSARCOMA / 中国癌症杂志

PURPOSE 10 cases of testicle embryonal rhabdomyosarcoma (RMS) were treated in the Cancer Hospital of Shanghai Medical University from 1971 to 1988. All cases were treated by orchiectomy followed by retroperitoneal node dissection and three of them did not have lymph node metastases. Methods 2 cases were given postoperative irradiation, 7 cases received adjuvant chemotherapy. Results The 2-. 5-year overall survival were 50% and 30% respectively. Conclusion This report analyzes the prognosis of adult testicle embryonal rhabdomyosarcoma. The treatment is a combination of surgery、 chemotherapy and radiotherapy. Intensive chemotherapy should be administered. The prognosis of RMS in adult seems to be worse than in childhood. Patients with negative lymph nodes has better outcome than those with node metastases. Retroperitoneal lymph node dissection after radical inguinal orchiectomy is unnecessary in patients without CT evidence of nodal involvement.

Late course accelerated hyperfractionation radiotherapy for elderly patients with esophageal carcinoma / 中华放射肿瘤学杂志

Objective To study the clinical results and prognostic factors of late course accelerated hyperfractionation radiotherapy (LCAHR) in the treatment of esophageal carcinoma in the elderly. Methods 105 over 60 year-old patients with esophageal carcinoma who received radical LCAHR, were retrospectively analysed. Radical tumoricidal dose of 67.9～72.0?Gy was delivered in 39～43 fractions over 42～53 days. Results The 5-year local control rate was 63.7%. The 5-year disease-free survival and overall survival rate were 22.6% and 34.4%. Acute esophagitis and bronchitis were the most common but acceptable radioreactions Grade 1～2. No significant differences were found either in the clinical response or complication, between the 60～69 year and 70～80 year groups. By multivariate analysis, T stage and KPS score were two independent prognostic factors. Of 67 death cases, 31 died of local relapse, 23 of distant metastases, 8 of both and 5 of other causes. Conclusions LCAHR toxicity ,being tolerable for the older esophageal carcinoma patients,may improve their survival and quality of life.

Expression and signification of transforming growth factor-?1 and its typeⅠ receptor in experimental choroidal neovascularization of BN rat / 眼科

Objective To investigate the expression and signification of Transforming growth factor-?1 and its typeⅠReceptor in choroidal neovascularization(CNV) induced with krypton laser on Brown Norway rat. Design Experimental study. Participants Five groups of 30 BN rats. Methods The rats were photocoagulated with krypton laser in single eye to induce CNV. 3 days, 1 week, 2 weeks, 3 weeks and 4 weeks after photocoagulation, the retina was processed respectively for immunohistochemistry of FⅧR:Ag, TGF-?1 and T?RⅠ, in situ hybridization of TGF-?1mRNA. Main Outcome Measures FⅧR:Ag, TGF-?1, TGF-?1mRNA and T?RⅠ. Results FⅧR:Ag positive staining cells formed vessels in the lesion 1 week after photocoagulation. TGF-?1mRNA expressed in the ganglion cells, RPE in normal BN retina, TGF-?1 and T?RⅠexpressed in the ganglion cells, inner nuclear layer, RPE in normal BN retina, and they all expressed in the lesions after photocoagulation. From 3 days to 4 weeks, the expression density of FⅧR:Ag in the lesions increased (P

Analysis of outcome and failure reasons of late course accelerated hyperfrationation radiotherapy for esophageal carcinoma / 中华放射肿瘤学杂志

Objective To define the prognostic factors and local failure in late course accelerated hyperfractionation radiotherapy(LCAHR) for esophageal carcinoma.Methods A retrospective study was conducted in 201 esophageal squamous cell carcinoma patients treated by LCAHR during the period between August 1994 to January 2000.The radiotherapeutic portals were set and based on CT scan and esophagograms. All patients received a mean dose of 41.4 Gy /23 F/4～5 WK. With conventional fractionation regimen during the first two thirds of the course,and followed by LCAHR with reduced fields, at dose of 27 Gy/18 d,1.5 Gy per fraction,twice daily. The total dose varied up to 67～70 Gy/40～43 F/40～49 d. Results The 1 ,3 and 5 year actuarial survivals were 72.5% ,35.6% and 31.1%. The 1 ,3 and 5 year local control rates were 82.2%, 71.3% and 71.3%,respectively. Of the 95 patients who died, 34(35.8%) did so from local failure , 32(33.7%) from distant metastasis(33.7 %), 13(3.7%) from lymphatic metastasis, 4(4.2%) frome both local and distant metastasis and 12(12.7%) from complications.Conclusions It is showed that significant improvement in local control and survival are observed after LCAHR for esophageal carcinoma in comparison to conventional fractionated regimen. The prevention and management of distant metastasis and lymphatic spread have become the major problems in the future.

Late course accelerated hyperfractionated irradiation combined with intraluminal hyperthermia for esophageal carcinoma / 中华放射肿瘤学杂志

Objective To evaluate the effect of late course accelerated hyperfractionated irradiation combined with intraluminal hyperthermia for esophageal carcinoma. Methods From March 2000 to October 2002, totally 91 such eligible patients were entered into the prospective randomized control trial of late course accelerated hyperfractionated irradiation (LCAH-, 44 patients) versus LCAH combined with intraluminal hyperthermia ( LCAH-HT-, 47 patients). Radiotherapy regimen consisted of conventional fractionation radiotherapy (1.8 ?Gy/f, 5f/w, totally 41.4 ?Gy/23fx) during the first two-thirds of the radiotherapy course, followed by accelerated hyperfractionation radiotherapy (1.5?Gy/f, 2f/d, with 6 h interval), using the cone-down fields, to a total dose of 68.4?Gy/41fx . Hyperthermia was given weekly during conventional fractionation irradiation, totally 4 times. Results The CR and PR rates were 47.7% and 72.3%, 52.3%and 27.8% in the LCAH arm and LCAH-HT group,respectively(P=0.016). The median survivals were 30.3 and 30.6 months,the 1-,2-,3-year survival rates were 77.3%,57.4% ,37.3% and 80.5%,68.6%, 46.3%(P= 0.526 ), the 1-,2-,3-year local control rates were 86.3%,70.5%,56.5% and 92.4%,72.5%,65.5% (P= 0.686 )in the LCAH group and LCAH-HT group,respectively. Grade III and severer of esophagitis were 18.2% and 27.6% in LCAH and LCAH-HT (P= 0.498 ), Grade III and severer tracheitis were 11.4% and 19.2% respectively (P=0.191). Conclusions The immediate effect of LCAH combined with hyperthermia is better than that of LCAH alone. Additional hyperthermia to LCAH does not increase the likelihood of radiation injury.