Predictors of efficacy of corticosteroid switching from abiraterone plus prednisone to dexamethasone in patients with metastatic castration-resistant prostate cancer / 亚洲男科学杂志(英文版)

Corticosteroid switching can reverse abiraterone resistance in some patients with metastatic castration-resistant prostate cancer (mCRPC). Here, we investigated the potential biomarkers for predicting the efficacy of corticosteroid switching during treatment with abiraterone acetate (AA). We retrospectively analyzed 101 mCRPC patients receiving corticosteroid switching from West China Hospital and Sun Yat-Sen University Cancer Center between January 2016 and December 2018. All cases received AA plus prednisone as first-line therapy during mCRPC. Primary end points were biochemical progression-free survival (bPFS) and overall survival (OS). The risk groups were defined based on multivariate analysis. A total of 42 (41.6%) and 25 (24.8%) patients achieved 30% and 50% decline in prostate-specific antigen (PSA), respectively, after corticosteroid switching. The median bPFS and median OS on AA plus dexamethasone were 4.9 (95% confidence interval [CI]: 3.7-6.0) months and 18.8 (95% CI: 16.2-30.2) months, respectively. Aldo-keto reductase family 1 member C3 (AKR1C3) expression (hazard ratio [HR]: 2.15, 95% Cl: 1.22-3.80, P = 0.008) and baseline serum alkaline phosphatase (ALP; HR: 4.95, 95% Cl: 2.40-10.19, P < 0.001) were independent predictors of efficacy before corticosteroid switching in the multivariate analysis of bPFS. Only baseline serum ALP >160 IU l-1 (HR: 3.41, 95% Cl: 1.57-7.38, P = 0.002) together with PSA level at switch ≥50 ng ml-1 (HR: 2.59, 95% Cl: 1.22-5.47, P = 0.013) independently predicted poorer OS. Based on the predictive factors in multivariate analysis, we developed two risk stratification tools to select candidates for corticosteroid switching. Detection of serum ALP level, PSA level, and tissue AKR1C3 expression in mCRPC patients could help make clinical decisions for corticosteroid switching.

Acupoint selection rules of acupuncture for pseudobulbar palsy dysphagia / 中国针灸

OBJECTIVE@#To analyze the acupoint selection rules of acupuncture for pseudobulbar palsy dysphagia using data mining technology.@*METHODS@#The literature of acupuncture for pseudobulbar palsy dysphagia published from January 1, 1990 to May 1, 2021 was retrieved from CNKI, SinoMed, Wanfang, VIP, and PubMed databases. Acupuncture prescription database was established. The frequency of acupoint selection was analyzed by Microsoft Excel 2016; Apriori algorithm was used to analyze the association rules and draw the high-frequency acupoint co-occurrence network diagram; SPSS21.0 was used to perform clustering analysis.@*RESULTS@#A total of 87 literature was included, involving 89 acupuncture prescriptions and 71 acupoints. Fengchi (GB 20) was the most frequently-used acupoint; the commonly-selected meridians were gallbladder meridian, conception vessel, governor vessel and stomach meridian; the acupoints located at the neck were the most frequently-used acupoints; the crossing points were commonly selected among the special acupoints. The most commonly-used acupoint combination was Jinjin (EX-HN 12) plus Yuye (EX-HN 13).@*CONCLUSION@#The modern acupuncture for pseudobulbar palsy dysphagia usually selects local acupoints, especially the neck acupoints such as Fengchi (GB 20) and Lianquan (CV 23). The acupoints in the front and back are concurrently selected with needles towards the disease location.

Effect of acupuncture on blood pressure variability in elderly patients with cerebral infarction complicated with essential hypertension / 中国针灸

OBJECTIVE@#To observe the therapeutic effect of acupuncture on blood pressure variability (BPV) in elderly patients with cerebral infarction complicated with essential hypertension.@*METHODS@#Seventy-six elderly patients with cerebral infraction complicated with essential hypertension were randomized into an observation group and a control group, 38 cases in each group. acupuncture and nifedipin were given in the control group. On the basis treatment in the control group, the and acupuncture was applied at Renying (ST 9), Hegu (LI 4), Quchi (LI 11), Zusanli (ST 36) and Taichong (LR 3) in the observation group for 30 min. The treatment was given once a day, 5 times a week for 8 weeks. The 24-hour ambulatory blood pressure was monitored in the two groups. The changes of blood pressure and blood pressure variability were observed before and after 8 weeks of treatment, and the occurrence of adverse reactions during the treatment were recorded.@*RESULTS@#The mean systolic blood pressure (SBP), diastolic blood pressure (DBP), daytime SBP, DBP, nighttime SBP and DBP were reduced in the two groups after 8 weeks of treatment (0.05).@*CONCLUSION@# and acupuncture method can effectively control the blood pressure and blood pressure variability in the elderly patients with cerebral infraction complicated with essential hypertension.

Multi-central controlled study on acupuncture for treatment of cerebral infarction in restoration stage / 中国针灸

<p><b>OBJECTIVE</b>To probe into long-term therapeutic effect and safety of Xingnao Kaiqiao acupuncture for treatment of cerebral infarction in restoration stage.</p><p><b>METHODS</b>Two hundred and thirty-four cases of cerebral infarction in restoration stage were randomly assigned to a Xingnao group and a routine group. The Xingnao group (n=116) were treated by Xingnao Kaiqiao acupuncture (once each day, for 4 weeks) and routine treatment of western medicine, and the routine group (n=118) were treated with routine acupuncture and the routine treatment of western medicine. They were followed-up for 6 months. The main indexes living, treatment and recurrence at the end of the following survey and the secondary indexes assessment of nervous functions at the end of the following survey, and the incidence rate of bad events in acupuncture were observed.</p><p><b>RESULTS</b>The death rate was 0.86% and the continuing treatment rate was 36.21% in the Xingnao group, and 1.69% and 36.44% in the routine group, with no significant difference between the two groups (both P>0.05) at the following-up of 6 months; the Xingnao group in decreasing recurrent rate and improving nervous function was better than the routine group (P<0.01); no severe adverse response was found in the 2 groups.</p><p><b>CONCLUSION</b>Xingnao Kaiqiao acupuncture is safe and it is superior to routine acupuncture in long-term therapeutic effect, decreasing recurrence rate, improving nervous function.</p>

Effects of acupuncture on mood and glucose metabolism in the patient of type 2 diabetes / 中国针灸

<p><b>OBJECTIVE</b>To observe effects of acupuncture on depression and anxiety, and glucose metabolism in the patient of type 2 diabetes.</p><p><b>METHODS</b>One hundred cases of type 2 diabetes mellitus patients were randomly divided into the control group treated with oral administration of Diaformin and the observation group treated with oral administration of Diaformin combined with acupuncture at Baihui (GV 20), Fengfu (GV 16), 50 cases in each group. Before and after treatment, depression scale (HAMD, SDS) and anxiety scale (HAMA, SAS) scores, and fasting blood glucose (FPG), blood glucose 2 h after meal (PG 2 h), glycosylated hemoglobin (GHb) levels were detected.</p><p><b>RESULTS</b>After treatment, the mood disorder improved and FPG, PG 2 h, GHb levels decreased in the two groups, with the observation group being better than the control group (P < 0.05).</p><p><b>CONCLUSION</b>Acupuncture can improve negative mental state, glucose metabolism and blood glucose in type 2 diabetes patients.</p>

Study on clinical therapeutic effect of activating brain and regaining consciousness needling method on poststroke depression and the mechanism / 中国针灸

<p><b>OBJECTIVE</b>To probe into an effective method for treatment of poststroke depression.</p><p><b>METHODS</b>Two hundred and fifty-six cases of poststroke depression were randomly divided into a control group (n = 76) treated by oral administration of amitilin and an acupuncture group (n = 180) treated by activating brain and regaining consciousness needling method. Their clinical therapeutic effects and changes of relative factors of poststroke depression and plasma contents of monoamine neurotransmitters were observed.</p><p><b>RESULTS</b>In the acupuncture group, the clinical symptoms and the relative indexes in the depression scales improved and plasma contents of the monoamine neurotransmitters increased significanty as compared with the control group (P < 0.05).</p><p><b>CONCLUSION</b>The needling method for activating brain and regaining consciousness can improve relative factors to cure poststroke depression.</p>

Treatment of renal calculi with percutaneous nephrolithotomy / 中华泌尿外科杂志

Objective To evaluate the feasibility and efficacy of percutaneous nephrolithotomy (PCNL)in treating renal calculi.Methods The data of 118 patients with renal calculi who had underg- one PCNL from July 2002 to August 2004 were retrospectively analyzed.There were 86 men and 32 women. The mean age was 39 years(range,7-68 years).Of the 118 cases,11 had pelvic calculi,16 had calyx cal- culi,35 had pelvocalyceal calculi,54 had staghorn calculi,and 2 had bilateral renal calculi.The mean stone size was 2.5 cm?1.5cm(ranged from 2.0 cm?1.0 cm to 4.5cm?4.0cm).Results Of the 118 ca- ses,112 underwent one-stage PCNL,and 6,two-stage PCNL.The procedure was performed by single tract in 114 cases,and by two tracts in 4 cases.Lithotomy was done by one session in 60 cases,by 2 sessions in 42 cases,and by 3 sessions in 16 cases.The total stone clearance rate was 81.4%.The mean operative time was 120 min,and mean hospital stay was 15 d.No blood transfusion was needed during operation,and only one patient experienced bleeding(about 500 ml)after 4 d postoperatively,and was cured by conservative treat- ment such as blood transfusion and anti-inflammation.No major complications were observed in other pa- tients.Conclusions PCNL has advantages of minimal trauma,less blood loss,fewer complications,and is safe and effective in treating renal calculi,especially for patients who will have the second procedure.