[Dong's extraordinary point needling technique combined with medication for postoperative complications of anal fistula: a randomized controlled trial].

OBJECTIVE: To observe the effect of Dong's extraordinary point needling technique on postoperative complications of anal fistula. METHODS: A total of 241 patients undergoing anal fistula surgery were randomly divided into an observation group (121 cases, 3 cases dropped off) and a control group (120 cases, 2 cases dropped off). The patients in the control group were treated with intramuscular injection of compound diclofenac sodium injection and oral administration of tamsulosin hydrochloride sustained release capsules. In addition to the treatment in the control group, the patients in the observation group were treated with Daoma needling technique at the "Sanqi points" (Qimen point, Qijiao point, and Qizheng point) combined with Dongqi needling technique at "Sanhuang points" (sub-Tianhuang point, Dihuang point, Renhuang point), with each session lasting 30 min. The treatment in the two groups both started on the first day after surgery, and was given once daily for 14 consecutive days. Visual analog scale (VAS) score was compared between the two groups on postoperative day 1, 7, and 14; bladder residual urine volume, spontaneous voiding volume, and urinary catheterization frequency were assessed after treatment on postoperative day 1; and anorectal dynamic indexes (anal canal resting pressure, rectal resting pressure, maximum squeeze pressure of the anal canal, and minimum rectal sensory threshold) were evaluated before surgery and on postoperative day 4. Clinical efficacy was assessed in both groups one month after surgery. RESULTS: On postoperative day 7 and 14, the VAS scores of both groups were lower than those on postoperative day 1 (P<0.05), and the VAS scores in the observation group were lower than those in the control group (P<0.05). The bladder residual urine volume and urinary catheterization frequency in the observation group were lower than those in the control group (P<0.05), while the spontaneous voiding volume was higher than that in the control group (P<0.05). On postoperative day 4, the anal canal resting pressure, maximum squeeze pressure of the anal canal, and the minimum rectal sensory threshold were lower than preoperative values (P<0.05), while the rectal resting pressure was higher than preoperative value (P<0.05) in both groups. The anal canal resting pressure, maximum squeeze pressure of the anal canal, and minimum rectal sensory threshold were lower than those in the control group, and the rectal resting pressure was higher than that in the control group (P<0.05). The effective rate was 93.2% (110/118) in the observation group, which was higher than 84.7% (100/118) in the control group (P<0.05). CONCLUSION: Dong's extraordinary point needling technique could reduce postoperative pain, alleviate urinary retention, and improve defecation in patients undergoing anal fistula surgery.

Revitalizing quality of life: a case report on the beneficial impact of comprehensive rehabilitation therapy in treating upper-limb lymphedema following breast cancer surgery.

Objective: To underscore the paramount significance of incorporating comprehensive rehabilitation therapy as a crucial aspect of managing lymphedema caused by breast cancer surgery, and to illuminate our first-hand experience and insights gained in utilizing this approach. Methods: We present a case report of a breast cancer survivor who had been suffering from persistent left upper-limb edema for over 15 years, who was effectively treated with a combination of conventional rehabilitation (seven-step decongestion therapy) and a comprehensive rehabilitation program (seven-step decongestion therapy, along with core and respiratory function training, as well as functional brace wearing). The efficacy of the rehabilitation therapy was evaluated through a comprehensive assessment. Results: Although the patient underwent the conventional rehabilitation program for one month, only limited improvement was observed. However, after an additional month of comprehensive rehabilitation treatment, the patient exhibited significant improvement in both lymphedema and the overall function of the left upper limb. The patient's progress was quantified by measuring the reduction in arm circumference, which demonstrated a notable decrease. Furthermore, improvements in joint range of motion were observed, with forward flexion of the shoulder enhancing by 10°, forward flexion improving by 15°, and elbow flexion increasing by 10°. In addition, manual muscular strength tests revealed an increase in strength from Grade 4 to Grade 5. The patient's quality of life was also significantly improved, as evidenced by the increase in the Activities of Daily Living score from 95 to 100 points, the increase in the the Functional Assessment of Cancer Therapy: Breast score from 53 to 79 points, and the decrease in the Kessler Psychological Distress Scale score from 24 to 17 points. Conclusion: While seven-step decongestion therapy has been shown to be effective in reducing upper-limb lymphedema caused by breast cancer surgery, it has limitations in treating more chronic cases of the condition. However, when combined with core and respiratory function training and functional brace wearing, seven-step decongestion therapy has been shown to be even more effective in reducing lymphedema and improving limb function, ultimately leading to significant improvements in quality of life.

Which evaluation criteria of the short-term efficacy can better reflect the long-term outcomes for patients with nasopharyngeal carcinoma?

PURPOSE: To compare the consistency of one-dimensional Response Evaluation Criteria in Solid Tumors (1D-RECIST), two-dimensional WHO criteria (2D-WHO), and three-dimensional (3D) measurement for therapeutic response assessment of nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS: Retrospective data of 288 newly diagnosed NPC patients were reviewed. Tumor size was assessed on magnetic resonance imaging (MRI) according to the 1D-RECIST, 2D-WHO, and 3D measurement criteria. Agreement between tumor responses was assessed using unweighted k statistics. The receiver operating characteristic (ROC) curve was used to determine the optimal cut-off point of the PTV. The Kaplan-Meier method and Cox regression were used for the survival analysis. RESULTS: The optimal cut-off point of the PTV for progression-free survival (PFS) was 29.6%. Agreement with PTV measurement was better for 1D measurement than for 2D and 3D measurements (kappa values of 0.646, 0.537, and 0.577 for 1D, 2D, and 3D measurements, respectively; P < 0.05). The area under the curve of the 1D measurement (AUC=0.596) was similar to that of the PTV measurement (AUC=0.621). Compared with 2D and 3D measurements, 1D measurement is superior for predicting prognosis in NPC (C-index of 0.672, 0.663, and 0.646 were for 1D, 2D, and 3D measurements, respectively; P < 0.005). Survival analysis showed that patients with non-responders had worse prognosis (P < 0.05). CONCLUSIONS: The 1D measurement more closely agreed with the PTV measurement than the 2D and 3D measurements for predicting therapeutic responses in NPC. Therefore, we recommend using the less time-consuming 1D-RECIST criteria in routine clinical practice.

Circ-0001313/miRNA-510-5p/AKT2 axis promotes the development and progression of colon cancer.

Circular RNAs (circRNAs) have recently emerged as novel and potentially promising therapeutic targets in a serious of cancers. However, the expression pattern and biological function of circRNAs in colon cancer remain largely elusive. This study firstly analyzed circRNA microarray of colon cancer and selected circ-0001313 as the study object. We aim to comprehensively investigate the expression pattern and biological function of circ-0001313 in the progression of colon cancer. Relative levels of circ-0001313 and miRNA-510-5p in colon cancer tissues and cell lines were determined with qRT-PCR. The binding relationship between miRNA-510-5p to circ-0001313 and AKT2 was predicted by bioinformatics analyses and further confirmed by dual-luciferase reporter gene assay. Regulatory effects of circ-0001313/miRNA-510-5p/AKT2 axis on colon cancer cells were evaluated by EdU assay and flow cytometry. Consistent with the microarray analysis, circ-0001313 was highly expressed in colon cancer tissues and cell lines. Knockdown of circ-0001313 attenuated proliferative ability, but induced apoptosis of colon cancer cells. Furthermore, we confirmed that circ-0001313 competitively bound to miRNA-510-5p, thus upregulating its target gene AKT2. Moreover, western blot analyses revealed that circ-0001313 also affects the expression of Bcl-2 family proteins and the activation of PI3K/Akt signaling pathway. In conclusion, our study revealed that circ-0001313 regulates the pathogenesis of colon cancer by sponging miRNA-510-5p to upregulate AKT2 expression.

MicroRNA-204 targets signal transducer and activator of transcription 5 expression and inhibits proliferation of B-cell lymphoma cells.

The function of microRNAs (miRNAs) in tumorigenesis has been extensively investigated. In the present study, the aim was to investigate the expression and role of miR­204 in B­cell lymphoma. The present study demonstrated that miR­204 is downregulated in B­cell lymphoma. Using in vitro studies, overexpression of miR­204 was shown to inhibit growth in Daudi and Raji B­cell lymphoma cell lines. Furthermore, miR­204 could bind the 3'­untranslated region of signal transducer activator of transcription 5 (STAT5), a transcription factor that promotes B­cell lymphoma oncogenesis. Re­introduction of STAT5 reversed the antiproliferative roles of miR­204, confirming the specific importance of STAT5 for miR­204 action in cell proliferation. The present study suggests a novel mechanism for dysregulated miRNAs in the progression of B­cell lymphoma.

Effects of acupuncture knife on inflammatory factors and pain in third lumbar vertebrae transverse process syndrome model rats.

The aim of this paper was to explore the long-term effects and pain relief mechanism of acupuncture knife on third lumbar vertebrae (L3) transverse process syndrome. Forty SD rats were randomized into control, model, electroacupuncture (EA), and acupuncture knife (AK) group. Except control rats, other rats were subjected to an operation to emulate L3 transverse process syndrome. Fourteen days after the operation, EA and AK rats were given electroacupuncture and acupuncture knife treatments, respectively. Fifty-six days after the operation, enzyme-linked immunosorbent assay was used to measure substance P (SP), 5-hydroxytryptamine (5-HT), interleukin-1ß (IL-1ß), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α), and transforming growth factor-ß (TGF-ß) in peripheral blood. The tail flick test was used to observe pain threshold. We found that rats with the simulation operation had significantly higher levels of SP, 5-HT, IL-1, IL-10, TNF-α, and TGF-ß, while the AK rats had lower levels. In addition, the pain threshold of AK rats was similar to that of control rats. AK pretreatment could alleviate pain through modulating inflammatory response.

PCSK6 regulated by LH inhibits the apoptosis of human granulosa cells via activin A and TGFß2.

Mammalian proprotein convertases (PCs) play an important role in folliculogenesis, as they proteolytically activate a variety of substrates such as the transforming growth factor beta (TGFß) superfamily. PC subtilism/kexin 6 (PCSK6) is a member of the PC family and is ubiquitously expressed and implicated in many physiological and pathological processes. However, in human granulosa cells, the expression of the PC family members, their hormonal regulation, and the function of PCs are not clear. In this study, we found that PCSK6 is the most highly expressed PC family member in granulosa cells. LH increased PCSK6 mRNA level and PCSK6 played an anti-apoptosis function in KGN cells. Knockdown of PCSK6 not only increased the secretion of activin A and TGFß2 but also decreased the secretion of follistatin, estrogen, and the mRNA levels of FSH receptor (FSHR) and P450AROM (CYP19A1). We also found that, in the KGN human granulosa cell line, TGFß2 and activin A could promote the apoptosis of KGN cells and LH could regulate the follistatin level. These data indicate that PCSK6, which is regulated by LH, is highly expressed in human primary granulosa cells of pre-ovulatory follicles and plays important roles in regulating a series of downstream molecules and apoptosis of KGN cells.

Decidual stromal cells recruit Th17 cells into decidua to promote proliferation and invasion of human trophoblast cells by secreting IL-17.

T helper 17 (Th17) cells have both regulatory and protective roles in physiological conditions. The Th17 subset and the cytokine interleukin-17A (IL-17A) have been implicated in the pathogenesis of certain autoimmune diseases, several types of cancer and allograft rejection. However, the role of Th17 cells at the maternal/fetal interface remains unknown. Here, we demonstrate that Th17 cells are present in decidua and are increased in the peripheral blood of 10 clinically normal pregnancies based on intracellular cytokine analysis. Our results suggest a potential role of Th17 cells in sustaining pregnancy in humans. Furthermore, we demonstrate that decidual stromal cells (DSCs) but not trophoblast cells recruit peripheral Th17 cells into the decidua by secreting CCL2. The recruited Th17 cells promote proliferation and invasion and inhibit the apoptosis of human trophoblast cells by secreting IL-17 during the first trimester of pregnancy. These findings indicate a novel role for Th17 cells in controlling the maternal-fetal relationship and placenta development.

[Expression of MMR in endometrial adenocarcinoma in women under 50 years old].

OBJECTIVE: To investigate the expression of DNA mismatch repair (MMR) genes (MLH1, MSH2, MSH6 and PMS2) in endometrial adenocarcinoma (EC) of patients under 50 years and to explore the relationship between MMR expression and clinicopathological features including body mass index (BMI), histological grade and pathological stage of EC. METHODS: MMR gene expression was investigated by immunohistochemical S-P method in endometrial adenocarcinomas of patients under age of 50. The control groups included complexity atypical hyperplasia endometrium (CAHE), simple hyperplasia endometrium (SHE), normal endometrium (NE) of patients under age of 50 and EC of patients older than 65 years. RESULTS: Twenty seven of 40 EC (67.5%) lost at least one MMR protein expression. Loss of at least one MMR protein expression was seen in 5/15 cases of CAHE, 1/13 SHE and 1/11 NE, respectively (P < 0.01). The rates of loss of expression of MLH1, MSH2, MSH and PMS2 proteins in EC were 52.5%, 12.5%, 35.0%, and 30.0%, respectively. The difference between MLH1 and MSH6 expression among the four groups were significant (P < 0.05), but the expression of MSH2 showed no significant difference among the groups (P = 0.295). The expression of MMR protein had no relationship with histological grade and pathological stage, although loss of MSH6 was more frequently seen in patients of higher BMI. CONCLUSIONS: Abnormal expression of MMR proteins is correlated with the development of EC from complex atypical hyperplasia. With the exception of the correlation of MSH6 expression with higher BMI, the expression of MMR proteins in EC has no significant relationship with histological grade and pathological stage.

[Effect of electroacupuncture on learning-memory ability, and Abeta and LRP1 immunoactivity in hippocampal sulcus microvessels in APP transgenic mice].

OBJECTIVE: To investigate the effect of electroacupuncture (EA) of "Baihui" (GV 20) and "Yongquan" (KI 1) on the expression of amyloid beta protein (Abeta) and low density lipoprotein (LDL) receptor-related protein 1 (LRP 1) in the hippocampal sulcus microvessels in amyloid precursor protein (APP) 695 V717 I transgenic mice, so as to study its mechanism underlying relief of Alzheimer Disease (AD). METHODS: Twelve APP 695 V717 I transgenic mice were randomly divided into model group and EA group. Six C 57 BL/6 mice were used as the control group. EA (2 Hz/100 Hz, 3-5 mA) was applied to "Baihui" (GV 20) and "Yongquan" (KI 1) for 15 min, once every other day for three months. The learning-memory ability of mice was detected by using Lashley III water maze system. The expression level of Abeta(1-42), and LRP 1 in the hippocampal sulcus microvessels were measured by immunohistochemistry. RESULTS: Water maze test showed that the swimming duration from the start to the goal box (terminal) in the Lashley III water maze was significantly longer in the model group than in the control group (P < 0.05), suggesting a markedly lower learning-memory capacity of APP 695 V717 I transgenic mice. Compared with the model group, the swimming duration in the EA group was decreased considerably (P < 0.05). The integrated optical density (IOD) value of hippocampal Abeta(1-42) immunoreaction (IR) positive products in the model group was significantly higher than that in the control group (P < 0.01) and the IOD value of hippocampal LRP 1 IR-positive products in the model group was apparently lower than that in the control group (P < 0.01). In comparison with the model group, the IOD value of Abeta(1-42) IR-positive products in the EA group was obviously lower than that in the model group (P < 0.05), while that of LRP 1 IR-positive products in the EA group was significantly higher than that in the model group (P < 0.05), suggesting down-regulation of hippocampal Abeta(1-42) expression and up-regulation of LRP 1 expression after EA, and reduction of deposition of Abeta in the cerebral microvessels after EA. CONCLUSION: EA can improve the learning-memory capacity of APP transgenic mice, which is closely related to its effects in up-regulating hippocampal LRP 1 expression and down-regulating hippocampal Abeta(1-42) expression.

Functional regulation of thymic stromal lymphopoietin on proliferation and invasion of trophoblasts in human first-trimester pregnancy.

BACKGROUND: Thymic stromal lymphopoietin (TSLP) is a novel cytokine that triggers the dendritic cell-mediated T(H)2 response and regulatory T cell expansion. The aim of this study is to evaluate whether TSLP and TSLP receptor (TSLPR) are expressed in primary human extravillous trophoblast (EVT), how proimflammatory cytokines (tumor necrosis factor (TNF)-alpha, IL-1beta), T(H)2 and T(H)3 cytokines (IL-4, TGF-beta) and pregnancy-associated hormones regulate TSLP production by EVT and whether the SLP-TSLPR interaction affects the biological behavior of trophoblsts. METHODS: We assessed TSLP mRNA and protein expression by real-time RT-PCR, ELISA and immunochemistry, respectively. We further investigated effects of TSLP on the proliferation and invasion of trophoblast cells in vitro. RESULTS: The primary EVTs constitutively expressed TSLP and TSLPR. IL-4 and TNF-alpha or pregnancy-associated hormones result in a significant increase in TSLP mRNA expression and protein release from EVT, and TSLP promotes primary EVT proliferation and invasion in vitro. CONCLUSIONS: This study has demonstrated that the first-trimester human trophoblast cells express TSLP and TSLPR, that cytokine milieu which mimics the maternal-fetal interface modulates expression of TSLP in trophoblast and that TSLP stimulates trophoblast proliferation and invasion. This suggests that TSLP plays an important role in human EVT invasion and placentation in human early pregnancy.