Phosphorylated p38, a negative prognostic biomarker, complements TNM staging prognostication in colorectal cancer.

Phosphorylated p38 (p-p38) played a pivotal role in the regulation of disease progression and correlated with tumor prognosis. Here, we characterized the prognostic effect of p-p38 in colorectal cancer (CRC). Three hundred and sixteen CRC patients in stages I-III were recruited in this study. P-p38 expression was semi-quantitatively evaluated using tissue microarrays and immunohistochemistry staining. Overall survival (OS), disease-free survival (DFS), local failure-free survival (LFFS), and distant metastasis-free survival (DMFS) of patient subgroups, segregated by p-p38 expression level and clinical stage, were compared using Kaplan-Meier analysis. We found that p-p38 was overexpressed in 48.1 % (152/316) CRC tissues, whereas low or deficiently expressed in normal adjacent epithelia. Overexpression of p-p38 predicted poor OS (P < 0.001), DFS (P = 0.002), LFFS (P = 0.016), and DMFS (P = 0.025) in CRC. Importantly, patient subgroups in the early stage (stages I + II) and with low p-p38 had similar OS, PFS, LFFS, and DMFS probabilities to that of stage I, whereas those with high p-p38 were similar to stage III disease. In addition, for stage III disease, the subgroup with low p-p38 had a similar survival probability to that of stage I, whereas the subgroup with high p-p38 had the worst survival. Multivariate Cox analysis confirmed that p-p38 was indeed a significantly independent factor for death, recurrence, and distant metastases in CRC. Our results demonstrated that p-p38 was a negative independent prognostic factor for CRC. Complementing TNM staging with p-p38 might refine the risk definition more accurately for a subset of patients.

Effects of electroacupuncture on depression and the production of glial cell line-derived neurotrophic factor compared with fluoxetine: a randomized controlled pilot study.

BACKGROUND AND OBJECTIVE: Postmortem studies indicate that the number and density of glial cells are reduced in different brain regions of patients with depression. Glial cell line-derived neurotrophic factor (GDNF) plays an important role in the pathogenesis of depressive disorder (DD) and might be a biomarker for damage to nerve cells. In this study, we compared the therapeutic effects of electroacupuncture (EA) and fluoxetine, a serotonin reuptake inhibitor, on DD patients, focusing on the serum level of GDNF. DESIGN: This was a prospective, randomized clinical trial. SETTING: Seventy-five patients with DD from the Department of Acupuncture, Beijing Hospital of Traditional Chinese Medicine, were recruited. INTERVENTION: Twenty patients were treated with acupuncture for 6 weeks on the acupoints of Baihui (DU20) and Zusanli (ST36). Sixteen patients were treated with acupuncture for 6 weeks on the acupoints of Taichong (LR3), Sanyinjiao (SP6), Neiguan (PC6), and Shenmen (HT7), and constituted the electroacupuncture control group. The patients received acupuncture treatment five times per week. Twenty-five patients were treated with oral fluoxetine (20 mg/day) for 6 weeks. OUTCOME MEASURES: All subjects were evaluated by the Hamilton Depression Rating Scale at four time points (0 [baseline], 2, 4, and 6 weeks after treatment). Serum GDNF was quantified in duplicate by enzyme-linked immunosorbent assay (ELISA). RESULTS: EA and fluoxetine had similar curative effects on DD patients. EA had a faster onset of action, better response rate, and better improvement rate than fluoxetine. Both fluoxetine and EA treatment restored the normal concentration of GDNF in the serum of DD patients. CONCLUSION: EA treatment for depression is as effective as a recommended dose of fluoxetine. However, EA demonstrates an advantage in the regulation of the production of GDNF compared with fluoxetine.

[Efficacy observation on knee osteoarthritis treated with electroacupuncture and its influence on articular cartilage with T2 mapping].

OBJECTIVE: To observe therapeutic efficacy of osteoarthritis treated by electroacupuncture, and explore its function of promoting cartilage restoration. METHODS: According to random digital table, sixty cases of knee osteoarthritis (60 knees) were randomly divided into an electroacupuncture group and a physiotherapy group, 15 cases (30 knees) in each one. The electroacupuncture was applied at Neixiyan (EX-LE 4), Dubi (ST 35), Heding (EX-LE 2) and Xuehai (SP 10) in the electroacupuncture group, once every other day. The physiotherapy group was treated by medium-frequency therapeutic apparatus every day. For both groups, 4 weeks of treatment were required. The Lysholm knee scoring scale (LKSS) was used to evaluate and compare the knee joints function before and after treatment. At the same time, the GE Signa EXCITE Twin Speed HD 1.5T was used to take MRI examination of knee joints, and measure the T2 values in 10 sub-regions of the cartilage of tibiofemoral joints. RESULTS: Compared before treatment, the LKSS score of both groups were improved with significant differences except item demands for support (P < 0.01, P < 0.05). Between the two groups after treatment, there were significant differences on total score, item instability and swelling (all P < 0.05), the electroacupuncture group was better than the physiotherapy group, but no significant difference on the other items (all P > 0.05). In the electroacupuncture group after treatment, T2 value in anterior lateral tibial sub-region (LTa) was significantly lowered (P < 0.05), but no significant difference in the other nine sub-regions (all P > 0.05). In the physiotherapy group, T2 value in any sub-region was not significantly different before and after treatment (all P > 0.05). CONCLUSION: Electroacupuncture could effectively improve the symptom, sign and knee joint's function of patients with knee osteoarthritis. Compared with physiotherapy, it has more superior effect and considered as a better non-operative treatment for osteoarthritis. Electroacupuncture also has positive influence on T2 value in cartilage, indicating that electroacupuncture may have the function of promoting cartilage restoration.

[Influence of acupuncture on IL-1beta and TNF-alpha expression in the cartilage of rats with knee osteoarthritis].

OBJECTIVE: To explore the influence of acupuncture treatment on proinflammatory cytokines of osteoarthritic (OA) cartilage. METHODS: Forty female SD rats were randomly and averagely divided into four groups: the normal, model, acupuncture and control group. The method of heel tendon resection for unilateral hind limb was used to establish OA animal models-that was to cut off the rat's heel tendon of left hind limb. The acupuncture group and control group were respectively treated by electro-acupuncture and Diclofenac on right hind limb of each animal for 2 weeks. Immunohistochemical staining was used to observe the expression characteristic of IL-1beta and TNF-alpha in cartilage of each group,and the differences were compared among the groups. RESULTS: Both IL-1beta and TNF-alpha expression in model group were significantly up-regulated than those in the normal group (P<0.01). Their expression in model, acupuncture and control group were significantly different (P< 0.01). IL-1beta and TNF-alpha expression were significantly down-regulated in acupuncture and control group than that in model group (P<0.01), while the difference between the two former groups was not significant (P>0.05). CONCLUSION: Acupuncture can down-regulate the expression of IL-1beta and TNF-alpha in osteoarthritic chondrocytes, and the regulating effect is the same as Diclofenac. This shows that acupuncture has a certain protective effect on osteoarthritic cartilage.

[Effect of acupuncture on expression of matrix metalloproteinase and tissue inhibitor in cartilage of rats with knee osteoarthritis].

OBJECTIVE: To explore the curative mechanism of acupuncture treatment on osteoarthritis (OA). METHODS: Forty cases of female SD rats were randomly divided into a normal group, a model group, an acupuncture group and a medication group, 10 cases in each group. OA animal model was established by using the method of heel tendon resection for unilateral hind limb. The acupuncture group was treated with electroacupuncture at "Xiqian"(ST 35) and "Housanli"(ST 36), and the medication group with inunction of Diclofenac cream, and the normal group and the model group without any treatment. The expression of matrix metalloproteinase-1, 3 (MMP-1, MMP-3) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in the cartilage were observed by immunohistochemistry. RESULTS: There were significant differences among four groups. The expressions of MMP-1, MMP-3 and TIMP-1 in the model, acupuncture and medication groups were all significantly stronger than those in the normal group (all P < 0.01). The expressions of MMP-1 and MMP-3 in the acupuncture and medication groups were down regulated and TIMP-1 expression up-regulated with significant differences as compared with the model group (all P < 0.01), and the expressions of MMP-1 and MMP-3 in acupuncture group were significantly lower, while TIMP-1 expression significantly higher than that in the medication group (all P < 0.01). CONCLUSION: Acupuncture can down-regulate the expression of MMP-1 and MMP-3 and up-regulate the expression of TIMP1, which is superior to that of Diclofenac cream, showing that acupuncture has a certain protective effect on cartilage from OA.

[Effect of acupuncture at Baihui (GV 20) and Zusanli (ST 36) on the level of serum inflammatory cytokines in patients with depression].

OBJECTIVE: To investigate the immunologic mechanism of acupuncture at Baihui (GV 20) and Zusanli (ST 36) for treatment of depression. METHODS: Eighty-four cases of depression patients were randomly divided into an electroacupuncture observation group (group A), an electroacupuncture control group (group B) and a medication control group (group C), 28 cases in each group. Baihui (GV 20) and Zusanli (ST 36) were used in the group A; Taichong (LR 3), Sanyinjiao (SP 6), Neiguan (PC 6) and Shenmen (HT 7) were used in the group B; and the group C was treated with oral administration of Fluoxetine. The scores of Hamilton Depression Scale (HAMD) were tested and the level of serum interleukin 1 (IL-1 beta), interleukin 6 (IL-6), and tumor necrosis factor alpha (TNF-alpha) were measured by Enzyme Linked Immunosorbent Assay (ELISA) before and after treatment. RESULTS: Their scores of HAMD were obviously decreased after treatment in three groups (all P<0.01). In the group A, 2 cases were cured, 19 cases were markedly effective, 5 cases were effective and 2 cases were ineffective. In the group B, 16 cases were markedly effective, 12 cases were effective. While in the group C, 1 case was cured, 17 cases were markedly effective, 7 cases were effective and 3 cases were ineffective. The grade distribution of clinical effect showed that the effect of group A was better (P<0.05). The levels of serum IL-1 beta and IL-6 in the three groups were obviously decreased after treatment (P<0.05, P<0.01), while there was no significant difference between the level of serum TNF-alpha before and after treatment. CONCLUSION: The effect of electroacupuncture observation group is superior to those of electroacupuncture control group and medication control group. All of these three methods can clear the inflammatory cytokines such as IL-1 beta and IL-6 away and improve the symptoms of depression.

[Thinking on teaching experiences of acupuncture manipulation and moxibustion method in western medicine college].

For the problems existed in the teaching of acupuncture manipulation and moxibustion method in western medicine college, for instance, the lack of credit hours and divorce from theory and practice, in addition to visualization teaching, this paper introduced case study and problem-centered teaching approaches. Besides clinical teaching, this paper emphasized anatomical knowledge which strengthen memory. In this way, the quality of teaching and teaching effects will be improved in the education of acupuncture manipulation and moxibustion method in western medicine college.

[Comparison of therapeutic effects between body acupuncture and scalp acupuncture combined with body acupuncture on atherosclerotic cerebral infarction at acute stage].

OBJECTIVE: To compare therapeutic effects between body acupuncture and scalp acupuncture combined with body acupuncture on atherosclerotic cerebral infarction at acute stage. METHODS: Forty-two cases of atherosclerotic cerebral infarction at acute stage were divided into 2 groups. They were treated respectively by scalp acupuncture combined with body acupuncture and simple body acupuncture. The comprehensive scores of mind, speech, limb motor function, etc. of the patients before and after treatment were recorded and compared. RESULTS: After treatment, the cumulative scores in the two groups reduced significantly (P < 0.01); the difference of scores before and after treatment in the scalp-body acupuncture group was significantly higher than that in the body acupuncture group (P < 0.05); there was no significant difference between the two groups in clinically effective rate (P > 0.05), but there was a very significantly difference between the two groups in the markedly effective rate (P < 0.01), the scalp-body acupuncture group being significantly higher than that in the body acupuncture group. CONCLUSION: Acupuncture can improve mind, speech and limb motor function of the patient with atherosclerotic cerebral infarction at acute stage, and the therapeutic effect of scalp combined with body acupuncture is better than that of simple body acupuncture.

[Clinical observation on different acupuncture and moxibustion therapies for treatment of postsurgical gastroparesis syndrome].

OBJECTIVE: To optimize therapy of acupuncture and moxibustion for postsurgical gastroparesis syndrome (PGS). METHODS: Forty-one cases of PGS were randomly divided into 3 groups in order of visiting. Group A (n = 17) were treated by warming needle moxibustion, group B (n = 12) by acupuncture plus auricular point sticking, and group C (n = 12) by routine acupuncture. Changes of gastric drainage volume, therapeutic times and cured rate were investigated in the 3 groups. RESULTS: All the 3 therapeutic methods could significantly decrease gastric drainage volume. The cured rate was 100.0% and the therapeutic times was (7.24 +/- 3.87) in the group A, 66.7%, (9.83 +/- 4.60) times in the group B and 75.0%, (15.25 +/- 3.81) times in the group C, with significant differences in the cured rate and the therapeutic times among the 3 groups (P < 0.05, P < 0.01). CONCLUSION: The warming needle moxibustion is the best method for PGS, with less therapeutic times, high cured rate and rapid effect.

[Observation on clinical therapeutic effect of scalp acupuncture combined with body acupuncture on apoplectic hemiplegia].

OBJECTIVE: To search for the best method for increasing clinical therapeutic effect on apoplectic hemiplegia. METHODS: One hundred and twenty cases of apoplectic hemiplegia were randomly divided into three groups in order of visiting. Group A (n = 33) were treated by scalp acupuncture combined with consciousness-restoring resuscitation method, group B (n = 60) by scalp acupuncture combined with traditional acupuncture, and group C (n = 27) by traditional acupuncture. The clinical therapeutic effects were evaluated according to the scores of manner, speech, motor function of limbs, and so on. RESULTS: Three cases were basically cured, 20 were markedly effective, 7 were effective, with a total effective rate of 90.9% in the group A; and the corresponding figures were 7, 28, 21 cases and 93.3%, respectively in group B with no significant difference between the group A and B (P > 0.05); and 7 cases were markedly effective, 11 effective with a total effective rate of 66. 7% in the group C with a significant difference as compared with the group A and B (P < 0.05, P < 0.001). CONCLUSION: Scalp acupuncture combined with consciousness-restoring resuscitation method and scalp acupuncture combined with traditional acupuncture have a similar therapeutic effect on apoplectic hemiplegia, which is superior to that of traditional acupuncture.