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Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related death, and most patients with HCC are diagnosed at an advanced stage. Before 2017, tyrosine kinase inhibitors were the main drugs for the treatment of advanced hepatocellular carcinoma. With the emergence of immune checkpoint inhibitors (ICIs), immunotherapy has gradually brought new hope to such patients. At present, the combination of ICIs and other systemic or local treatments has become a potential strategy for the treatment of advanced hepatocellular carcinoma, and some of these combinations have been included in large-scale clinical trials. The main challenges of immunotherapy for advanced hepatocellular carcinoma include the exploration of predictive biomarkers, management of immune-related adverse events, and exploration of effective combination regimens. This article provides the latest research progress on the single or combined use of ICIs and other immunotherapy for hepatocellular carcinoma and discusses the limitations of current research and clinical application and the future development direction.
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Thyroid-associated ophthalmopathy(TAO)is an organ-specific autoimmune disease, which will cause a series of symptoms to significantly reduce the health level and life quality of patients. The pathogenesis of TAO has not been fully clarified. At present, there is a lack of unified and mature treatment scheme of it. Indeed, T-helper 17 lymphocyte(Th17)cells, regulatory T(Treg)cells and their imbalance are closely related to the immunological pathogenesis of TAO. It is currently believed that the cytokines secreted by Th17 cells can not only promote the inflammatory response of TAO and the fibrosis of orbital connective tissue, but also inhibit the adipogenic differentiation of TAO orbital connective tissue. In addition, Treg cells mainly exert immunosuppressive effect on TAO and delay the disease progression. At the same time, there is a dynamic balance relationship between Th17 and Treg cells, the imbalance of Th17/Treg cells can trigger the occurrence and development of TAO. This paper mainly expounds the influence mechanism of Th17, Treg cells and their balance on TAO, and analyzes the reasons for the differences between different research results, so as to provide some reference for the study of the pathogenesis and clinical treatment of TAO.
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Objective:To evaluate the safety and effectiveness of Tiandan Tongluo capsule in the treatment of cerebral infarction （CI） in convalescence （stoke involving meridians and collaterals due to wind-phlegm-static blood obstructing vessels）， with Naoshuantong capsule as a control. Method:A total of 352 convalescent patients with CI differentiated into stoke involving meridians and collaterals due to wind-phlegm-static blood obstructing vessels in traditional Chinese medicine （TCM） were included in this multi-center， randomized， double-blind， single-simulated， Naoshuantong capsule-controlled clinical trial， which lasted from 28 December， 2016 to 12 April， 2019. After being randomized into an experimental group and a control group at a ratio of 3∶1， patients in the experimental group were provided with oral Tiandan Tongluo capsule， five capsules per time， three times per day， whereas those in the control group received both Naoshuantong capsule simulator， two capsules per time， three times per day， and Naoshuantong capsule， three capsules per time， three times per day， for 12 successive weeks. The patients were followed up until 180 days after onset. The Barthel activities of daily living （ADL） index （BI） score was used as the primary outcome， and the secondary outcomes included neurological deficit score ［assessed with National Institutes of Health Stroke Scale （NIHSS）］， modified Rankin scale （mRS）， TCM syndrome score， and proportion of patients with new vascular events. The changes in laboratory indexes and the incidence of adverse reactions during treatment were observed. Result:Among the 389 cases enrolled， 30 dropped out， with the drop-out rate being 7.71%. There were 374 cases included in the full analysis set and 377 in the safety set. The comparison with the control group revealed that the total BI score and the percentage of BI score ≥ 75 in the experimental group were increased， but the difference was not statistically significant. The percentage of mRS score ≤ 2 within 180 days after onset in the experimental group obviously elevated in contrast to that of the control group （<italic>P</italic><0.05）. As demonstrated by TCM syndrome score analysis， the markedly effective rate in the experimental group was significantly higher than that in the control group （<italic>P</italic><0.05）. During the trial， the incidence rates of new vascular events in the experimental group and the control group were 0.00% and 1.09% （one case）， respectively， exhibiting no statistically significant difference between the two groups. Conclusion:Tiandan Tongluo capsule and Naoshuantong capsule both produce definite therapeutic effects in the treatment of CI in convalescence （stoke involving meridians and collaterals due to wind-phlegm-static blood obstructing vessels）. Compared with Naoshuantong capsule， Tiandan Tongluo capsule better alleviates neurological deficit， promotes neural functional recovery， and improves TCM syndrome score， without inducing severe adverse reactions.
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Aim To investigate the effect of adenosine on the autophagy and proliferation of hepatocellular carcinoma cells, and improve the curative effect of a-denosine on hepatocellular carcinoma. Methods HepG2 cells were incubated with adenosine, CCK-8 method was used to study the changes of cell prolifera-tion,Western blot was used to study the expression of LC3-Ⅱ and LC3-Ⅰ, and MDC staining was used to observe the number of autophagosomes. Results HepG2 cells were incubated with adenosine(1.0~4.0 mmol·L-1) for 48 h,the proliferation of HepG2 cells were detected at the different time points (12,24,48 h),and the result showed the proliferation was signifi-cantly inhibited by adenosine (P < 0.01). HepG2 cells were incubated with adenosine (0.2,0.5,1.0, 2.0,4.0 mmol·L-1) for 24 h,the ratio of LC3-Ⅱ/LC3-Ⅰ decreased significantly in low concentration of adenosine group (0.2, 0.5 mmol·L-1, P <0.05;1.0 mmol·L-1,P<0.01),and the ratio of LC3-Ⅱ/LC3-Ⅰ increased significantly in higher concentration of adenosine group (4.0 mmol·L-1, P <0.05). HepG2 cells were incubated with adenosine(1.0 mmol·L-1) for 24 h, the ratio of LC3-Ⅱ/LC3-Ⅰ de-creased significantly at 6,12 and 24 h detecting point, the number of autophagosomes were reduced, the low-est ratio of LC3-Ⅱ/LC3-Ⅰ and autophagosomes were observed at 12 h detecting point(P<0.01). Conclu-sions Adenosine inhibits the proliferation of hepato-cellular carcinoma cells,the low concentration of aden-osine inhibits the autophagy,while the high concentra-tion of adenosine increases the autophagy, which is of great significance to reduce multi-drug resistance and improve the therapeutic effect of anti-hepatoma drugs.
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Objective To observe the clinical efficacy of acupuncture at the three nasal acupoints plus bloodletting at Suliao (GV 25) in treating rosacea.Method Sixty rosacea patients were randomized into a treatment group and a control group, 30 cases each. The treatment group was intervened by acupuncture at the three nasal acupoints plus bloodletting at Suliao (GV 25), while the control group was intervened by ordinary medication. The skin lesion scores of the two groups were observed before and after 4-week treatment, and the clinical efficacies were also compared. Result The skin lesion scores were significantly changed after respectively 2, 3 and 4 weeks of treatment in both groups (P<0.05). The skin lesion scores in the treatment group were significantly different from those in the control group respectively after 2, 3 and 4 weeks of treatment (P<0.05). The total effective rate was 93.3％ in the treatment group versus 73.3％ in the control group, and the between-group difference was statistically significant (P<0.05). Conclusion Acupuncture at the three nasal acupoints plus bloodletting at Suliao (GV 25) is an effective approach in treating rosacea.
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Objective:To observe the clinical efficacy of fire-needle therapy in treating deglutition disorders due to pseudobulbar palsy in the remission stage of stroke.Methods:Sixty-two eligible subjects were divided into a fire-needle group and a rehabilitation group by a simple randomization method at a ratio of 1:1.The two groups received same basic intervention;in addition,the fire-needle group received fire-needle treatment,while the rehabilitation group received rehabilitation training.The two groups of subjects all received a 3-week treatment and were evaluated by the dysphagia severity rating scale (DSRS),modified Mann assessment of swallow ability (MMASA) and Kubota Toshio swallow test (KTST) before and after the intervention.The complications and adverse events occurred during the trial were recorded.The data were statistically analyzed.Results:At the third week,the DSRS,MMASA and KTST scores changed significantly compared with the baseline in both groups (P＜0.05),and the changes in the fire-needle group were more significant than those in the rehabilitation group (P＜0.05).The between-group comparison at the third week showed that the therapeutic efficacy in the fire-needle group was superior to that in the rehabilitation group (P＜0.05).Conclusion:Fire-needle therapy can obviously change the DSRS,MMASA and KTST scores in pseudobulbar palsy in the remission stage of stroke,and significantly enhance the therapeutic efficacy of the treatment of deglutition disorders in this stage.
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Objective To observe the clinical efficacy of acupoint thread embedding plus Western medication in treating major epilepsy.Method Sixty epilepsy patients were randomized into a thread embedding group and a Western medication group, 30 cases each. The Western medication group was intervened by Western medication; the thread embedding group was given acupoint thread embedding based on the same Western medication treatment. Seizure frequency, seizure score, general efficacy and the improvement of adverse reactions due to Western medications were analyzed.Result Compared to the Western medication group, the thread embedding group was more effective in controlling seizure frequency (P<0.01), and reducing seizure score (P<0.05) and adverse reactions of Western medications (P<0.05); the general efficacy of the thread embedding group was superior to that of the Western medication group in treating epilepsy (P<0.05).Conclusion Acupoint thread embedding plus Western medication is effective in treating epilepsy, and is superior to the use of Western medication alone.
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Objective To observe the clinical efficacy of acupoint thread embedding plus Western medication in treating major epilepsy.Method Sixty epilepsy patients were randomized into a thread embedding group and a Western medication group, 30 cases each. The Western medication group was intervened by Western medication; the thread embedding group was given acupoint thread embedding based on the same Western medication treatment. Seizure frequency, seizure score, general efficacy and the improvement of adverse reactions due to Western medications were analyzed.Result Compared to the Western medication group, the thread embedding group was more effective in controlling seizure frequency (P<0.01), and reducing seizure score (P<0.05) and adverse reactions of Western medications (P<0.05); the general efficacy of the thread embedding group was superior to that of the Western medication group in treating epilepsy (P<0.05).Conclusion Acupoint thread embedding plus Western medication is effective in treating epilepsy, and is superior to the use of Western medication alone.
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ObjectiveTo observe the therapeutic efficacy of ginger-partitioned moxibustion plus Ba Zhen decoction in treating chronic fatigue syndrome (CFS).MethodSixty patients with CFS were randomized into two groups, 30 in each group. The treatment group was intervened by ginger-partitioned moxibustion plus Ba Zhen decoction, while the control group was by electroacupuncture.ResultAfter 3 treatment courses, the total effective rate was 93.3% in the treatment group versus 83.3% in the control group, and the difference was statistically significant (P<0.05).ConclusionGinger-partitioned moxibustion plus Ba Zhen decoction can produce a higher total effective rate than electroacupuncture in treating CFS.
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ObjectiveTo observe the clinical efficacy of electroacupuncture at bilateral Auditory Fainting Region plus body acupuncture in treating tinnitus.MethodForty patients were randomized into a treatment group and a control group, 20 cases in each group. The treatment group was intervened by electroacupuncture at bilateral Auditory Fainting Region in addition to the routine acupuncture, once each day, 7 times as a course, with 1-day interval between two courses; the control group was by routine acupuncture by selecting Ermen (TE21), Tinggong (SI19), Tinghui (GB2), Yifeng (TE17), Zhongzhu (TE3), and Xiaxi (GB43) on the affected side, once a day, 7 times as a course, with 1-day interval between two courses. The therapeutic efficacies were observed and compared after 4 treatment courses.ResultThe total effective rate was 85% in the treatment group, versus 60% in the control group, and the difference was statistically significant (P<0.05).ConclusionElectroacupuncture at bilateral Auditory Fainting Region plus body acupuncture can produce a more significant therapeutic efficacy.
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<p><b>OBJECTIVE</b>To compare the differences in the therapeutic effect on diabetic peripheral neuropathy between the combined therapy of electroacupuncture and acupoint injection and the simple acupoint injection.</p><p><b>METHODS</b>Under the satisfactory control of blood glucose, 60 cases of diabetic peripheral neuropathy were divided randomly into two groups, 30 cases in each one. In electroacupuncture plus acupoint injection group (group A), electroacupuncture and acupoint injection with Methylcobalamin were administered. Penetrating acupuncture was applied from Gongsun (SP 4) to Quanzhong (Extra) and from Yongquan (KI 1) to Taichong (LR 3) mainly. Acupoint injection was administered on Sanyinjiao (SP 6). In acupoint injection group (group B), only acupoint injection with Methylcobalamin was provided on Sanyinjiao (SP 6). After 2 sessions of treatment, the conduction velocity of ulnar nerve and tibial nerve was measured. The scores of Chinese medicine syndrome and diabetic peripheral neuropathy were recorded before and after treatment in two groups.</p><p><b>RESULTS</b>The effective rates were 90.0% (27/30) and 63.3% (19/30) in group A and group B respectively, presenting significant statistical difference (P < 0.05). After treatment, the motor nerve conduction velocity (MCV) and sensory nerve conduction velocity (SCV) of ulnar nerve and tibial nerve in group A were higher than those in group B (P < 0.05, P < 0.01). After treatment, the score of Chinese medicine syndrome in group A was lower than that in group B (14.36 +/- 1.88 vs 26.58 +/- 3.52, P < 0.01), the score of diabetic peripheral neuropathy in group A was lower than that in group B (12.86 +/- 4.28 vs 17.89 +/- 4.35, P < 0.01).</p><p><b>CONCLUSION</b>Electroacupuncture and acupoint injection with Methylcobalamin achieve a significant clinical efficacy on diabetic neuropathy and its efficacy is superior to that of simple acupoint injection with Methylcobalamin. This therapy can effectively increase nerve conduction velocity, control and relieve the symptoms of diabetic peripheral neuropathy.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Acupuncture Points , Combined Modality Therapy , Diabetic Neuropathies , Drug Therapy , Therapeutics , Electroacupuncture , Injections , Tibial Nerve , Vitamin B 12ABSTRACT
<p><b>OBJECTIVE</b>To compare the accuracy of 64-slice computed tomography and coronary angiography in the diagnosis of coronary atherosclerosis.</p><p><b>METHODS</b>The imaging data of both 64-slice computed tomography and coronary angiography in 65 patients were analyzed retrospectively.</p><p><b>RESULTS</b>Among the 455 coronary arteries evaluated, the sensitivity, specificity and accuracy of 64-slice computed tomography were 54.6%, 95.1%, and 85.5%, respectively.</p><p><b>CONCLUSION</b>64-slice computed tomography has a good potential in the diagnosis of coronary atherosclerosis with excellent sensitivity and specificity.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Coronary Angiography , Coronary Artery Disease , Diagnosis , Retrospective Studies , Sensitivity and Specificity , Tomography, Spiral Computed , MethodsABSTRACT
Objective: To observe the clinical efficacy of puncturing Renying (ST 9) in the treatment of poststroke dysphagia. Methods: Sixty cases of poststroke dysphagia were randomized into two groups, a control group in which 30 cases were given rehabilitation training, and a treatment group in which 30 cases were treated by puncturing Renying (ST 9) and rehabilitation training, with a course of four weeks. Results: The total effective rate for dysphagia was higher in the treatment group than in the control group (P<0.05). Conclusion: Puncturing Renying (ST 9) is quite effective for poststroke dysphagia.
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<p><b>OBJECTIVE</b>To study the in vivo stability of normal and anterior cruciate ligament (ACL)-injured knee joint before and after epidural anesthesia under 134 N pre-loading and evaluate the influence of muscular tension on the knee stability.</p><p><b>METHODS</b>Eight volunteers with unilateral ACL rupture and normal contralateral knee were enrolled in this study. CT (3D) images and 2 orthogonal images of the knee were captured at 0°, 30°, 60°, and 90° under 134 N pre-loading. The orthogonal images were used to recreate the in vivo knee positions at each of the targeted flexion angles by 2D/3D registration to analyze the tibial translation data.</p><p><b>RESULTS</b>The anterior tibia translation of both the intact and ACL-injured knees after anesthesia was significantly different from that before anesthesia at all the angles (P<0.05). The anterior tibial translation of the intact knee after anesthesia increased by 1.7 mm at 0°, 2.7 mm at 30°, 2.6 mm at 60°, and 2.3 mm at 90°, as compare to the increase of ACL-injured knee by 4.2 mm, 2.6 mm, 1.2 mm, and 1.6 mm, respectively.</p><p><b>CONCLUSION</b>The muscular tension has evident influence on the knee stability in static loading.</p>
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Adult , Female , Humans , Male , Young Adult , Joint Instability , Knee Joint , Physiology , Muscle StrengthABSTRACT
BACKGROUND: Acupuncture has been confirmed to be effective in treating Parkinson disease both clinically and experimentally, but there is still lack of systematical and complete therapeutic principle and law to be followed in clinic.OBJECTIVE: To observe the influence on glutathione (GSH), glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), malondialdehyde(MDA)and nitric oxide synthase (NOS) in corpus striatum of the damaged side in rat models of Parkinson disease by acupuncture at subthalamus.DESIGN: A randomized controlled animal experiment.SETTING: The Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine.MATERIALS: The experiment was performed in the Experimental Animal Center of Heilongjiang University of Traditional Chinese Medicine from January to June in 2003. Eighteen healthy adult Wistar rats of pure breed were randomly divided into 3 groups with 6 rats in each:electroacupuncture group, model group and normal saline group.METHODS: ① Model group: The rats were made into models of Parkinson disease with damaged corpus striatum by injecting 6-hydroxydopamine (6-OHDA, 12 μg), which was dissolved in 5 μL normal saline containing 2 g/L ascorbic acid, slowly into caudal putamen. without intervention. ②Normal saline group: 6-OHDA was replaced by normal saline of the same dosage, and other treatments were the same as those in the model group. ③ Electroacupuncture group: The model preperation was the same as that in the model group. The needles were embedded in subthalamus at 6 weeks postoperatively, and then electroacupuncture (in frequency of 100 Hz, and the intensity about 1 mA) was given one week later for 2 weeks, once a day,15 minutes for each time.MAIN OUTCOME MEASURES: All the rats were killed by cutting heads to remove brain under anesthesia at 2 weeks after electroacupuncture, and the activities of GSH, GSH-Px, SOD and NOS and the concentration of MDA were detected with chromatometry.RESULTS: All the 18 rats were involved in the analysis of results. ① MDA concentration was higher in the model group and electroacupuncture group than in the normal saline group [(5.53±0.71),(4.10±0.27), (5.53±0.71) μmol/L, P ＜ 0.01], but lower in the electroacupuncture group than in the model group (P ＜ 0.05). ② The activities of GSH and GSH-Px were both lower model group and electroacupuncture group than in the normal saline group (P ＜ 0.01), but lower in the electroacupuncture group than in the model group (P ＜ 0.05).③ The activity of SOD was higher in the model group and electroacupuncture group than in the normal saline group [(113.36±2.17),(73.85±5.17), (42.34±1.83) μkat/g, P ＜ 0.01], but lower in the electroacupuncture group than in the model group (P ＜ 0.01).CONCLUSION: The anti-oxidation capability of the rat models of Parkinson disease has been recovered and the nerve injury has been reduced after acupuncture, indicating that it is available and effective to treat Parkinson disease by acupuncture at subthalamus.
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Objective: To observe the clinical effect on treatment of Tourette's syndrome with combination of acupuncture and Chinese herbs. Method: Sixty cases were randomly divided into acupuncture-Chinese group and western drug group, which have been treated with acupuncture plus modified Tranquilizing Liver-wind Decoction and orally taken holoperidol respectively.Result: Therapeutic effect comparison between the two groups showed a significant difference (P＜0.05).Conclusion: Combination of scalp acupuncture and Chinese herbs has good effect in treating Tourette's syndrome, with better result than western drug.
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BACKGROUND AND OBJECTIVES: The proportion of mitral regurgitation caused by chordae rupture has recently been seen to be increasing, as has the role of mitral valve repair in the treatment of chordae rupture. This study evaluated the clinical characteristics and trends of surgical treatment of chordae rupture. Additionally, we attempted to discern the usefulness of transthoracic echocardiography (TTE) in the preoperative diagnosis of chordae rupture. SUBJECTS AND METHODS: Forty patients (20 men, mean age:49+/-14) presenting with chordae rupture confirmed during surgery between January 1994 and April 2001 were included in this study. Clinical, TTE and surgical data were analyzed retrospectively. RESULTS: The cause of chordae rupture was idiopathic degeneration in 28 cases, rheumatic heart disease in 5, infective endocarditis in 6, and trauma in 1 case. The sites of rupture were the anterior leaflet (14), posterior leaflet (23), and anterior and posterior leaflets (3). Mitral valve repair was performed in 20 cases and mitral valve replacement was performed in 20 cases. Most mitral valve repairs were performed beginning in 1998 (17/20). Chordae rupture diagnosed by TTE numbered 14 cases (35%). CONCLUSION: Regurgitation caused by chordae rupture was primarily associated with idiopathic degenerative change. Posterior leaflet rupture was more frequent than anterior leaflet rupture. The use of mitral valve repair has been increasing since 1998.