Effect of soothing-liver and nourishing-heart acupuncture on early selective serotonin reuptake inhibitor treatment onset for depressive disorder and related indicators of neuroimmunology: a randomized controlled clinical trial.

OBJECTIVE: To observe the effect of soothing-liver and nourishing-heart acupuncture on selective serotonin reuptake inhibitor (SSRIs) treatment effect onset in patients with depressive disorder and related indicators of neuroimmunology. METHODS: Overall, 126 patients with depressive disorder were randomly divided into a medicine and acupuncture-medicine group using a random number table. Patients were treated for 6 consecutive weeks. The two groups were evaluated by the Montgomery-Asberg Depression Rating Scale (MADRS) and Side Effects Rating Scale (SERS) to assess the effect of the soothing-liver and nourishing-heart acupuncture method on early onset of SSRI treatment effect. Changes in serum 5-hydroxytryptamine (5-HT) and inflammatory cytokines before and after treatment were recorded and compared between the medicine group and the acupuncture-medicine group. RESULTS: The acupuncture-medicine group had significantly lower MADRS scores at weeks 1, 2, 4, and 6 after treatment compared with the medicine group (P < 0.01). The acupuncture group had significantly lower SERS scores at weeks 1, 2, 4, and 6 after treatment compared with the medicine group (P < 0.01). At 6 weeks after treatment, serum 5-HT in the acupuncture-medicine group was significantly higher compared with the medicine group (P < 0.01). Interleukin-6 (IL-6) in the acupuncture-medicine group was significantly lower than that in the medicine group (P < 0.01), whereas there was no significant difference in IL-1ß between the groups (P > 0.05). Anti-inflammatory cytokines IL-4 and IL-10 were significantly higher in the acupuncture-medicine group compared with the medicine group (P < 0.01, P < 0.05, respectively). CONCLUSION: The soothing-liver and nourishing-heart acupuncture method can effectively accelerate the onset of SSRI effects when treating depressive disorder and can significantly reduce the adverse reactions of SSRIs. Moreover, acupuncture can enhance serum 5-HT and regulate the balance of pro-inflammatory cytokines and anti-inflammatory cytokines.

[Effect of acupuncture on early onset of SSRIs treating depressive disorder and related indicators of neuroimmunology].

OBJECTIVE: To observe the intervention effect of acupuncture on early onset of selec- tive serotonin reuptake inhibitors (SSRIs) in treating depressive disorder, and to study its effect on ser- um 5-HT and unbalanced inflammatory cytokines secreted by TH1/TH2. METHODS: Totally 90 patients with depressive disorder were randomly assigned to the drug control group (as the control group, 45 cases) and the acupuncture combined drug treatment group (as the treatment group, 45 cases). All patients were treated for 4 consecutive weeks. Another 45 healthy subjects were recruited as a healthy control group. The effect of acupuncture on early onset of SSRls in treating acute phase depressive disorder pa- tients was evaluated by HAMD score in the control group and the treatment group before treatment,and at weekends of the 1st, 2nd, and 4th week after treatment. Besides, their serum levels of 5-HT, IL-1ß and IL-6 (secreted by TH1), and IL-4 and IL-10 (secreted by TH2) were detected before treatment and after treatment at the weekend of the 4th week. RESULTS: Compared with the healthy control group,serum lev- els of 5-HT, IL-4, and IL-10 decreased in the two drug-treated groups before treatment (P < 0.01); serum levels of IL-1ß and IL-6 increased (P <0.01). Compared with before treatment in the same group, HAMD score decreased in the control group at weekends of the 2nd and the 4th week after treatment (P < 0.01); HAMD scores decreased in the treatment group at weekends of the 1st, 2nd, 3rd,and 4th week after treatment (P < 0.01); serum levels of 5-HT, IL-4, and IL-10 increased,serum levels of IL-1ß and IL- 6 decreased in the two drug-treated groups after treatment (all P < 0.01). Compared with the control group at the same time point,HAMD scores decreased in the treatment group at weekends of the 1st, 2nd,3rd,and 4th week after treatment (P < 0.01),serum levels of 5-HT, IL-4, and IL-10 increased (P < 0.05, P < 0.01), serum levels of IL-6 decreased (P < 0. 01). CONCLUSION: Acupuncture could accelerate early onset of SSRIs in treating acute phase depressive disorder, and effectively regulate serum 5-HT levels and inflammatory cytokines secreted by TH1/TH2.

Prognostic values of CEA, CA19-9, and CA72-4 in patients with stages I-III colorectal cancer.

OBJECTIVE: The purpose of this study was to explore the relationship between the levels of three tumor markers (TMs), carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9, and CA72-4, and the prognoses of colorectal cancer patients. METHODS: From January 2012 to December 2015, 101 patients with stages I-III colorectal cancer treated in the general surgery department of Nanfang Hospital, Southern Medical University were included in this retrospective study. The patients' blood was collected at different time points to determine their biochemical index values. The CA19-9 and CEA levels were measured using a chemiluminescence analyzer, and the CA72-4 level was determined using a semi-automatic enzyme-free analyzer. The relationship between the tumor marker expressions and the prognoses of patients with colorectal cancer was analyzed. RESULTS: The sensitivity of the combined quantification of the three TMs was higher than quantifying just one of them, but the specificity was decreased. Those three TM levels were stable at two years after the operations, and they were significantly lower than they were before the operations (P < 0.05). A Kaplan Meier survival curve analysis showed that, compared with the patients with normal levels, the patients with increased levels of the three TMs had significantly shorter overall survival times and higher recurrence rates (P < 0.05). CONCLUSION: The combined quantification of CEA, CA19-9, and CA72-4 is of great significance in determining the prognoses of colorectal cancer patients. It is helpful to predict the outcomes of patients with stages I-III colorectal cancer two years after their operations.

Efficacy of serotonin receptor agonists in the treatment of functional dyspepsia: a meta-analysis.

INTRODUCTION: Functional dyspepsia (FD) is typically treated with serotonin receptor (5-HT) agonists such as cisapride, mosapride, tegaserod and tandospirone citrate. However, there are conflicting efficacy data, possibly due to significant heterogeneity between studies. In this meta-analysis, we analyzed the efficacy and safety data from studies evaluating the efficacy of serotonin receptor agonists in patients with FD. MATERIAL AND METHODS: Relevant studies were selected from the Medline, Cochrane, EMBASE, and Google Scholar databases. The meta-analysis included 10 RCTs which evaluated the efficacy of serotonin receptor agonists in patients with FD (final total of 892 patients in the serotonin receptor agonist group, and 640 participants in the placebo group). The primary outcomes were the response rates and abdominal symptoms score. The Cochrane Collaboration's tool was used to assess risk. Sensitivity analysis was carried out using the leave-one-out approach. RESULTS: Patients treated with serotonin receptor agonists had a significantly higher response rate compared to placebo-treated patients (pooled OR = 2.99; 95% CI: 1.15-7.77; p = 0.025). Patients treated with serotonin receptor agonists had a significant improvement in symptom scores compared to the placebo group (pooled standardized mean difference = -0.43; 95% CI: -0.83 to -0.04; p = 0.031). Sensitivity analysis indicated that the pooled estimates for abdominal symptom score might be affected by the Yeoh et al. (1997) study. CONCLUSIONS: Serotonin receptor agonists had a significantly higher efficacy compared to placebo in the treatment of FD.

[Regulation action and nerve electrophysiology mechanism of acupuncture on arousal state in patients of primary insomnia].

OBJECTIVE: To compare the difference between acupuncture and estazolam on arousal state in patients of primary insomnia, and to explore its nerve electrophysiology mechanism. METHODS: Sixty-four patients of primary insomnia were randomized into an acupuncture group (32 cases) and a medication group (32 cases). After 3 patients were excluded, 31 cases in the acupuncture group and 30 cases in the medication group were included. Patients in the acupuncture group were treated with acupuncture at Sishencong (EX-HN 1), Anmian (Extra), Shenmen (HT 7), Sanyinjiao (SP 6), Zhaohai (KI 6), Shenmai (BL 62) as main acupoints, combined with supporting acupoints, once a day, five times per week, continuously for 4 weeks. Patients in the medication group were treated with oral administration of estazolam, once a day, continuously for 4 weeks. The Pittsburgh sleep quality index (PSQI) and mean sleep latency (MSL) of multiple sleep latency test (MSLT) were compared before and after treatment in the two groups; the polysomnography (PSG) was applied to monitor the indices regarding sleep structure. RESULTS: Compared before treatment, PSQI score was reduced after treatment in the two groups (both P<0.01), which was more significant in the acupuncture group (P<0.05). Compared before treatment, sleep onset latency (SOL), number of awakenings (NWAK) and wake after sleep onset (WASO) were reduced, while total sleep time (TST) and sleep efficiency (SE) were significantly increased in the two groups after treatment (all P<0.01). Compared before treatment, the percentage of non-rapid eye movement period 1/2/3 (N1, N2, N3) and the percentage of rapid eye movement period (REM) to TST were not significantly changed after treatment in the medication group (all P>0.05). Compared before treatment, the percentage of N1, N2 to TST was reduced, while the percentage of N3 and REM to TST was increased after treatment in the acupuncture group (P<0.01). The SOL, NWAK, WASO, TST, SE were not statistically changed after treatment in each group (all P>0.05). Compared with the medication group, the percentage of N1 and N2 was reduced while that of N3 and REM was increased after treatment in the acupuncture group (all P<0.01). After treatment, MSL of MSLT were obviously decreased in the two groups (both P<0.01), which were more significant in the acupuncture group (P<0.05). CONCLUSIONS: Acupuncture can more effectively improve sleep quality of primary insomnia than estazolam, and is more beneficial for regulation of hyperarousal state.

[Impact on serum 5-HT and TH1/TH2 in patients of depressive disorder at acute stage treated with acupuncture and western medication].

OBJECTIVE: To compare the difference in depression relief in the treatment of depressive disorder at the acute stage between the combined therapy of acupuncture and 5-HT (5-hydroxytryptamine) selective serotonini reuptake inhibitors (SSRIs) and the single application of SSRIs and explore the impact on the imbalance of 5-HT and TH1/TH2. METHODS: Ninety cases of depressive disorder at the acute stage were randomized into a combined therapy group and a medication group, 45 cases in each one. In the medication group, SSRIs were prescribed forl oral administration, once or twice a day, continuously for 4 weeks. In the combined therapy group, on the basis of treatment as the medication group, acupuncture was combined. The main acupoints were Baihui (GV 20), Yintang (GV 29), Shenting (GV 24), Fengchi (GB 20), Dazhui (GV 14) and Sishencong (EX-HN 1), once every two. days, continuously for 4 weeks. Before treatment, and after the 1st, 2nd and 4th weeks of treatment, the Hamilton depression scale (HAMD) was used to evaluate the depression severity. Separately, before and after the 4 weeks of treatment, the levels of serum 5-HT, interleukin-1 beta (IL-1ß), interleukin-6 (IL-6), interleukin-4 (IL-4) and interleukin-10 (IL-10) were determined and compared with those in 45 cases of the healthy group. RESULTS: HAMD score was reduced in the 1st, 2nd and 4th weeks of treatment as compared with that before treatment in the combined therapy group (all P<0 01). HAMD score was reduced in the 2nd and 4th weeks of treatment as compared with that before treatment in the medication group (all P<0. 01). HAMD scores in the combined therapy group were lower than those in the medication group in the 1st, 2nd and 4th weeks of treatment (all P< 0. 01). Before treatment, in the combined therapy group and the medication group, the levels of serum 5-HT, IL-4 and IL-10 were all lower than those in the healthy group (all P<0. 01); the levels of IL-1ß and IL-6 were higher than those in the healthy group (all P<0. 01). In the combined therapy group and the medication group, the levels of 5-HT, IL-4 and IL-10 in 4 weeks of treatment were all increased as compared with those before treatment (all P<0. 01), and the levels of IL-1ß and IL-6 were lower than those before treatment (all P<0. 01). In the combined therapy group, the levels of IL-1ß and IL-6 in 4 weeks of treatment were lower than those in the medication group, and the levels of 5-HT, IL-4 and IL-10 were higher than those in the medication group (P<0. 01, P< 0. 05). CONCLUSION: The combined therapy of acupuncture and SSRIs achieves much quicker and more effective re-' sult for relieving depression in the patients of depressive disorder as compared with simple oral administration of' SSRIs, and much more contributes to adjust the imbalance of serum 5-HT and TH1/TH2.