Acupuncture in Women with Human Polycystic Ovary/Ovarian Syndrome: Protocol for a Randomized Controlled Trial.

(1) Background: Human polycystic ovary/ovarian syndrome (PCOS) is linked to endocrine, metabolic, and psychological complications. We propose a randomized controlled pilot study for an acupuncture protocol regarding the management of PCOS symptoms based on TCM diagnosis; (2) Methods: We will randomly allocate 120 women diagnosed with PCOS into two groups. The study group will be treated with acupuncture for points known to act upon the autonomous regulation of the hormonal, metabolic and emotional components. (3) Results and Conclusions: We expect to provide evidence of high methodological quality related to the effects and safety of an acupuncture protocol based on the perspective of a TCM diagnostic.

Upper esophageal sphincter abnormalities on high-resolution esophageal manometry and treatment response of type II achalasia.

BACKGROUND: Little is known about the clinical significance of upper esophageal sphincter (UES) motility disorders and their association with the treatment response of type II achalasia. None of the three versions of the Chicago Classification of Esophageal Motility Disorders has defined UES abnormality metrics or their function. UES abnormalities exist in some patients and indicate a clinically significant problem in patients with achalasia. AIM: To demonstrate the manometric differentiation on high-resolution esophageal manometry between subjects with abnormal UES and normal UES, and the association between UES type and the treatment response of type II achalasia. METHODS: In total, 498 consecutive patients referred for high-resolution esophageal manometry were analyzed retrospectively. The patients were divided into two groups, those with normal and abnormal UES function. UES parameters were analyzed after determining lower esophageal sphincter (LES) function. Patients with type II achalasia underwent pneumatic dilation for treatment. Using mixed model analyses, correlations between abnormal UES and treatment response were calculated among subjects with type II achalasia. RESULTS: Of the 498 consecutive patients, 246 (49.40%) were found to have UES abnormalities. Impaired relaxation alone was the most common UES abnormality (52.85%, n = 130). The incidence rate of type II achalasia was significantly higher in subjects with abnormal UES than those with normal UES (9.77% vs 2.58%, P = 0.01). After pneumatic dilation, LES resting pressure, LES integrated relaxation pressure, and UES residual pressure were significantly decreased (41.91 ± 9.20 vs 26.18 ± 13.08, 38.94 ± 10.28 vs 16.71 ± 5.65, and 11.18 ± 7.93 vs 5.35 ± 4.77, respectively, P < 0.05). According to the Eckardt score, subjects with type II achalasia and abnormal UES presented a significantly poorer treatment response than those with normal UES (83.33% vs 0.00%, P < 0.05). CONCLUSION: Impaired relaxation alone is the most common UES abnormality. The incidence of type II achalasia is associated with abnormal UES. Type II achalasia with abnormal UES has a poorer treatment response, which is a potentially prognostic indicator of treatment for this disease.

Identification of Potential Diagnostic and Prognostic Biomarkers for Colorectal Cancer Based on GEO and TCGA Databases.

Colorectal cancer (CRC) is one of the most common neoplastic diseases worldwide. With a high recurrence rate among all cancers, treatment of CRC only improved a little over the last two decades. The mortality and morbidity rates can be significantly lessened by earlier diagnosis and prompt treatment. Available biomarkers are not sensitive enough for the diagnosis of CRC, whereas the standard diagnostic method, endoscopy, is an invasive test and expensive. Hence, seeking the diagnostic and prognostic biomarkers of CRC is urgent and challenging. With that order, we screened the overlapped differentially expressed genes (DEGs) of GEO (GSE110223, GSE110224, GSE113513) and TCGA datasets. Subsequent protein-protein interaction network analysis recognized the hub genes among these DEGs. Further functional analyses including Gene Ontology and KEGG pathway analysis and gene set enrichment analysis were processed to investigate the role of these genes and potential underlying mechanisms in CRC. Kaplan-Meier analysis and Cox hazard ratio analysis were carried out to clarify the diagnostic and prognostic role of these genes. In conclusion, our present study demonstrated that CCNA2, MAD2L1, DLGAP5, AURKA, and RRM2 are all potential diagnostic biomarkers for CRC and may also be potential treatment targets for clinical implication in the future.

Identification of CD200+ colorectal cancer stem cells and their gene expression profile.

CD200 is a cell surface glycoprotein that has been implicated in a variety of human cancer cells. It has been proposed as a cancer stem cell (CSC) marker in colon cancer and is closely related to tumor immunosuppression. However, there is little functional data supporting its role as a true CSC marker, and the mechanism by which CD200 contributes to colorectal cancer has not been elucidated. In the present study, CD200+ and CD200- COLO 205 colorectal cancer cells were sorted out by flow cytometry, and colonosphere formation and Transwell migration assays were performed. Affymetrix Human U133 Plus2.0 arrays were used to screen the gene expression profiles of CD200+ and CD200- colorectal cancer cells. The results suggest that there are differentially expressed genes between the two subpopulations, including several important genes that function in cell proliferation, metastasis, apoptosis and the immune response. Pathway analysis revealed that the Wnt, MAPK and calcium signaling pathways were differentially expressed between CD200+ and CD200- cells. Moreover, several key genes upregulated in CD200+ cells were also highly overexpressed in CD44+CD133+ colorectal stem cells compared to the CD44-CD133- fraction of the same cell line. In the present study, we showed for the first time a correlation between CD200 expression and the Wnt signaling pathway in colon cancer cells.

[Risk factors and clinical characteristics of gastroesophageal reflux disease: analysis based on a prospective database of functional gastrointestinal disease].

OBJECTIVE: To explore the risk factors and clinical characteristics of non-erosive reflux disease (NERD) based on a prospective single disease database of functional gastrointestinal disease. METHODS: Using a customized case report form, we collected the personal and clinical data of all study participants in an online database for further analysis. High-resolution manometry and multichannel intraluminal impedance-pH monitoring were performed in some cases. RESULTS: A total of 504 NERD cases and 152 control cases were included in our database. The NERD patients consisted of 266 (52.8%) female patients and 238 (47.2%) male patients; 32.7% of the patients were from rural areas and 67.3% from urban areas; 23.1% of the patients worked in the line of business, 19.6% were civil servants, 19.2% were unemployed, and 17.1% were workers; the mean disease duration of the patients was 27.88∓16.33 month. Our analysis showed that adverse events in life (P=0.045, OR=1.954), frequent drinking (P=0.040, OR=3.957), snoring (P=0.002, OR=2.334), late meals (P=0.002, OR=2.752), and anxiety or depression (P=0.003, OR=2.723) were all independent risk factors for NERD. Of these patients, 60.81% had varying degrees of ineffective contraction of the esophageal body. The total liquid reflux events differed significantly between NERD patients with hiatal hernia and those without (P<0.05). CONCLUSION: Unhealthy eating habits and lifestyle, history of adverse events, anxiety and depression, snoring, poor esophageal motor function and hiatal hernia are significant factors contributing to NERD, which is related with occupation and living areas and occurs most commonly at 30-50 years of age.

[Construction of a online database for functional dyspepsia].

OBJECTIVE: To establish a clinical database of functional dyspepsia for epidemiological researches and standardizing clinical diagnosis and treatment. METHODS: The functional dyspepsia database was designed to incorporate the data from in-patients and out-patients with functional dyspepsia treated since July, 2013 and was constructed using Visual Studio. The patient data were collected using a customized case report form designed according to the Roman criteria III and the etiology, symptoms, and treatments of the patients. All the cases deemed ineligible were excluded. The database was displayed on a website and allowed online data entry, case searches and statistical analysis of the clinical parameters. RESULTS AND CONCLUSION: The established online database for functional dyspepsia contained data of the general information, clinical symptoms, psychological status, living habits, dietary habits, medical history, examination results, clinical diagnosis, treatment methods and courses, outcomes and data statistics. The database was fully functional and provided complete and standardized data of functional dyspepsia for clinical studies.

[Application of genome-wide genechip for screening and identifying genes related to CD133(+)CD200(+) colorectal cancer stem cells].

OBJECTIVE: To screen and identity genes related to CD133(+)CD200(+) colorectal cancer stem cells. METHODS: The two subpopulations of colorectal cancer cells, namely CD133(+)CD200(+) and CD133(-)CD200(-) cells, were sorted and verified by flow cytometry. The gene expression profiles of CD133(+)CD200(+)and CD133(-)CD200(-) colorectal cancer cells were examined using Affymetrix Human U133 Plus2.0 genome-wide genechip. The differentially expressed genes between the two cell subpopulations were analyzed to identify the genes responsible for the main effect in association with colorectal cancer stem cells. Real-time quantitative PCR was performed to confirm some of the differentially expressed genes identified by genechip. RESULTS: The genechip result showed that 655 genes were differentially expressed in CD133(+)CD200(+) colorectal cancer stem cells by at least 3 folds, including 290 up-regulated and 365 down-regulated ones. Bioinformatics analysis and gene co-expression network building identified 3 genes (MDM2, PRKACG, and CACNA1G) with specific expression in CD133(+)CD200(+) colorectal cancer stem cells, and this result was confirmed by real-time quantitative PCR analysis. CONCLUSION: A specific gene expression profile of colorectal cancer stem cells has been established through screening and identifying genes related to CD133(+)CD200(+)colorectal cancer stem cells by gene genechip technique, which provides a basis for further study of gene targeting therapy of colorectal cancer.

[Clinical analysis of 39 cases of multiple primary colorectal carcinoma].

OBJECTIVE: To investigate the clinical features and prognosis of multiple primary colorectal carcinoma (MPCC). METHODS: Among the 1462 patients with colorectal cancer admitted in our department from January 2000 to December 2007, 39 patients with MPCC were identified based on the Warran and Gates MPC diagnosis criteria. The age of onset, 5-year survival rate, lesion location and therapies were analyzed retrospectively. RESULTS: The incidence of MPCC was 2.67% (39/1462). Eighteen of the patients had synchronous carcinomas and 21 were diagnosed to have metachronous carcinomas. Most of the tumors were located in the left colon and rectum. The average age of onset was (61.02∓13.94) in these patients who had an overall 5-year survival rate of 61.76%. The patients with metachronous carcinomas had a better prognosis than those with synchronous carcinomas. The 5-year survival rate of 3 early-stage cases (TNM stage I) was 100% after radical surgery. Thirty advanced cases underwent radical surgery combined with adjuvant chemotherapy, and their 1-, 3- and 5-year survival rates were 93.33%, 83.33%, and 73.33%, respectively. The 1- and 3-year survival rates of 3 advanced cases undergoing palliative surgery and adjuvant chemotherapy were 66.67% and 0, respectively. The 1- and 3-year survival rates of another 3 advanced cases with palliative chemotherapy were 66.67% and 0, respectively. CONCLUSION: Early diagnosis and effective treatment can help prolong the survival of MPC patients. Surgical intervention and chemotherapy can improve the survival and prognosis of patients with advanced MPCC.