Abdominopelvic Lymphatic Drainage Area Irradiation for Consolidative Radiotherapy of Advanced Ovarian Carcinoma: Analysis of Clinical Application Efficacy and Dosimetric Verification.

Background: The aim of the study was to evaluate the efficacy of abdominopelvic lymphatic drainage area irradiation (APLN), instead of whole abdominal radiotherapy (WART), in the consolidative radiotherapy of advanced ovarian carcinoma patients. Methods: We conducted a retrospective analysis collecting 99 patients with locally advanced ovarian cancer treated by APLN with 45 - 50 Gy/25- 28 fractions/5-7#, instead of WART. We evaluated the clinical outcome of APLN. Five patients were selected for dosimetric verifications verses WART (30 Gy/20 fractions). The normal tissue complication probability (NTCP) was calculated for the two treatment methods. Results: The mean follow-up time was 64.10 months (5.5 - 113.2 months), after APLN consolidative radiotherapy, 1-, 3-, and 5-year overall survival (OS) was 87.9%, 81.3%, and 61.5%, median disease-free survival (DFS) was 40.8 months, 5-year local recurrence free survival (LRFS) was 75.9%, and 5-year distant metastasis free survival (DMFS) was 49.2%. One patient died due to intestinal perforation. Local recurrence in the area between WART and APLN was rare (3/99 patients). The number of surgical procedures < 2 was an independent risk factor for LRFS (P = 0.023). Dosimetric comparison showed that comparing with WART, APLN significantly reduced the organ at risk (OAR) dose: 25.37 ± 3.63 Gy (25%) for liver, 8.77 ± 5.03 Gy (25%) for kidney, 8.14 ± 1.51 Gy (25%) for small intestine, etc. NTCP was reduced by 0.04-1.04% for liver, kidney, and small intestine. Conclusion: For consolidative radiotherapy in locally advanced ovarian cancer, APLN (intensity-modulated radiotherapy 45 - 50 Gy/25 - 28 fractions) could be an alternative to WART, resulting in excellent LRFS and DFS, with acceptable toxicities, comparing with previous literature reports. Dosimetric analysis also showed the benefits of APLN in NTCP.

Modulation effect of acupuncture treatment on chronic neck and shoulder pain in female patients: Evidence from periaqueductal gray-based functional connectivity.

AIMS: Chronic neck and shoulder pain (CNSP) is a common neurological disorder, which females are more likely to suffer from. The periaqueductal gray (PAG) plays a key role in the descending modulation of pain. This study aimed to investigate altered PAG-based functional connectivity (FC) in female patients with CNSP related to healthy controls (HCs) and the effect of acupuncture for female patients with CNSP using PAG-based FC biomarkers. METHODS: PAG-based FC value was calculated based on resting-state functional images and then compared between patients with CNSP at pre-acupuncture, post-acupuncture, and HCs. Then, correlational analyses were performed to examine the relationships between increased PAG-based FC strength and improved clinical parameters in patients after acupuncture treatment. RESULTS: Before acupuncture treatment, compared to HCs, patients with CSNP showed altered PAG-based FC with widely distributed brain regions, including the left medial superior frontal gyrus, bilateral posterior insula (pIns), and cingulate gyrus. After treatment, patients with CNSP exhibited specially improved PAG-pIns FC compared to that before treatment, and no significant difference was observed in the increased PAG-pIns FC strength between HCs and patients with CNSP after treatment. Furthermore, pain catastrophizing reduction was significantly correlated with the increased PAG-pIns FC strength in patients after treatment. CONCLUSION: The effect of acupuncture treatment may relate to the increased PAG-pIns FC, which significantly correlated with pain catastrophizing reduction after treatment. These findings shed important mechanistic information on the role of therapeutic approaches in treating chronic neck and shoulder pain.

Effect of sling exercise therapy combined with Tuina on nerve conduction of upper extremities after radicular cervical spondylosis / 中国康复理论与实践

@#Objective To observe the effect sling exercise therapy (SET) and Tuina on radicular cervical spondylosis. Methods From August, 2015 to December, 2016, 72 patients with radicular cervical spondylosis were randomly divided into control group (n = 36) and trial group (n = 36), who accepted traction and SET+Tuina, respectively, for four weeks. They were measured F-wave conduction velocity with electromyogram from median nerve and ulnar nerve, somatosensory evoked potential (SEP), and current perception threshold (CPT) before and after treatment. The clinical ratio of improvement was calculated. Results The ratio of improvement was 83.33% in the trial group more than 58.33% in the control group (Z = 2.093, P < 0.05). F-wave conduction velocity increased in both groups after treatment (t > 12.059, P < 0.001), and increased more in the trial group than in the control group (t > 3.266, P < 0.01); while the latency of SEP decreased in N9 and N13 in both groups (t > 7.061, P < 0.001), and decreased more in the trial group than in the control group (t > 8.033, P < 0.001); the grade of CPT decreased in both groups (t > 8.895, P < 0.001), and decreased more in the trial group than in the control group (t = 8.913, P < 0.001). Conclusion The combination of SET and Tuina can promote the repair of nerve conduction of cervical spondylotic radiculopathy.

Neuroimaging in the Understanding of Acupuncture Analgesia: A Review of Acupuncture Neuroimaging Study Based on Experimental Pain Models.

With the development of real-time and visualized neuroimaging techniques, the studies on the central mechanism of acupuncture analgesia gain increasing attention. The experimental pain models have been widely used in acupuncture-analgesia neuroimaging studies with quantitative and controlled advantages. This review aimed to analyze the study design and main findings of acupuncture neuroimaging studies to provide reference for future study. The original studies were collected and screened in English databases (PubMed, EMBASE, and Cochrane Library) and Chinese databases (Chinese Nation Knowledge Infrastructure, Chinese Biomedical Literature Database, the Chongqing VIP Database, and Wanfang Database). As a result, a total of 27 articles were included. Heat stimulation and electroacupuncture were the mostly used pain modeling method and acupuncture modality, respectively. The neuroimaging scanning process can be divided into two models and five subtypes. The anterior cingulate cortex and insula were the most commonly reported brain regions involved in acupuncture analgesia with experimental pain models.

Progress and prospect of machine learning in research of acupuncture and moxibustion / 中国针灸

The application progress of machine learning in research of acupuncture and moxibustion was reviewed from three aspects: mining of acupuncture and moxibustion prescription and indications, acupuncture efficacy prediction and its influencing factors, acupoint specificity and acupuncture manipulation research, and the existing problems in current research and future research trends were discussed. It is believed that the appropriate machine learning algorithm should be selected to build the model according to the research purpose and data characteristics in the future research; attention should be paid to feature design, feature selection and feature cleaning; sample data collection should be a priority, and data sharing platform and standardized data collection should be developed to improve the data quality.

Radiotherapy for thyroid cancer / 中国实用外科杂志

With the obvious improvement of the diagnosis and treatment level of thyroid cancer,the treatment methods of thyroid cancer have also been improved.The treatment of thyroid cancer is dominated by surgery,TSH inhibition therapy and radioactive iodine therapy. With the development of computer, imaging and radiotherapy equipment,radiotherapy has gradually become an important auxiliary treatment for thyroid cancer. For parts of the cases which operation could not thoroughly remove lesions or lost 131I treatment of thyroid cancer,external beam radiotherapy is increasingly being used for adjuvant therapy.Although external beam radiotherapy has gradually played a significant role,currently EBRT is not widely used in the clinic,and the therapeutic effect has been controversial yet in the treatment of thyroid cancer.

Integrated medicine concepts in pathological PBL teaching reform / 基础医学与临床

Problem-based leaning(PBL) teaching method has been widely carried out in pathology teaching,but it still have limitations in the implementation, and integrated medicine concepts could improve the effect of PBL teaching to a great extent.In this paper,by analyzing the necessity of integrated medicine concepts in the pathologi-cal PBL teaching,some principles are put forward to optimizing PBL teaching,including the principle of integration and the networking, unpack and topology, and optimizing the"typical case selection and the shortage of PBL mechanism". Finally,the paper indicates that deep understanding of complementary relationship between integrated medicine and PBL could help to establish medical scenario,which is easier to understand,operate and grasp,thus to promote the pathological teaching reform.

Integrated medicine concepts in pathological PBL teaching reform / 基础医学与临床

Problem-based leaning(PBL) teaching method has been widely carried out in pathology teaching,but it still have limitations in the implementation, and integrated medicine concepts could improve the effect of PBL teaching to a great extent.In this paper,by analyzing the necessity of integrated medicine concepts in the pathologi-cal PBL teaching,some principles are put forward to optimizing PBL teaching,including the principle of integration and the networking, unpack and topology, and optimizing the"typical case selection and the shortage of PBL mechanism". Finally,the paper indicates that deep understanding of complementary relationship between integrated medicine and PBL could help to establish medical scenario,which is easier to understand,operate and grasp,thus to promote the pathological teaching reform.

Deep needling and shallow needling at three acupoints around ear for subjective tinnitus: a randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To compare the effective differences between deep needling and shallow needling at three acupoints around ear for subjective tinnitus.</p><p><b>METHODS</b>Fifty patients with subjective tinnitus were randomized divided into a deep needling group and a shallow needling group, 25 cases in each group. Twenty-two patients in the deep needling group and 20 patients in the shallow needling group were brought into statistic in the end. In the two groups, the three acupoints around ear and distal acupoints were both selected. The acupoints of the affected side such as Yifeng (TE 17), Tinghui (GB 2), Ermen (TE 21), Zhigou (TE 6), Zhongzhu (TE 3) and Hegu (LI 4) were adopted. Yifeng (TE 17), Tinghui (GB 2) and Ermen (TE 21) were acupunctured 30-38 mm in the deep needling group and 15-20 mm in the shallow needling group. The other acupoints were conventionally acupunctured in the two groups. The needles were retained for 30 min,once a day and five times a week for all patients. The treatment was continuously for 4 weeks in the two groups. Tinnitus handicap inventory (THI) scores, tinnitus grades and visual analogue scale (VAS) for tinnitus sound levels were observed before and after treatment, and the effects of the two groups were compared.</p><p><b>RESULTS</b>The total effective rate in the deep needling group was 59.1% (13/22), and it was better than 20.0% (4/20) in the shallow needling group (P < 0.05). In the deep needling, group, the THI score, tinnitus grade and the VAS score were improved than those before treatment (all P < 0.05). In the shallow needling group, the three above indices before and after treatment were not different in statistical significance (all P > 0.05). After treatment, all the three indices in the deep needling group were superior to those in the shallow needling group (all P < 0.05).</p><p><b>CONCLUSION</b>Acupuncture at the three acupoints around ear deeply could apparently improve tinnitus, and reduce tinnitus sound levels for subjective tinnitus. The effect is better than that by shallow needling at the three acupoints.</p>

Acupuncture Induces Time-Dependent Remodelling Brain Network on the Stable Somatosensory First-Ever Stroke Patients: Combining Diffusion Tensor and Functional MR Imaging.

Different treatment interventions induce distinct remodelling of network architecture of entire motor system. Acupuncture has been proved to be of a promising efficacy in motor recovery. However, it is still unclear whether the reorganization of motor-related brain network underlying acupuncture is related with time since stroke and severity of deficit at baseline. The aim of study was to characterize the relation between motor-related brain organization following acupuncture and white matter microstructural changes at an interval of two weeks. We demonstrated that acupuncture induced differential reorganization of motor-related network for stroke patients as time-lapse since stroke. At the baseline, acupuncture can induce the increased functional connectivity between the left primary motor cortex (M1) and the right M1, premotor cortex, supplementary motor area (SMA), thalamus, and cerebellum. After two-week recovery, the increased functional connectivity of the left M1 was more widely distributed and primarily located in the insula, cerebellum, basal ganglia, and SMA. Furthermore, a significant negative relation existed between the FA value in the left M1 at the baseline scanning and node centrality of this region following acupuncture for both baseline and two-week recovery. Our findings may shed a new insight on understanding the reorganization of motor-related theory underlying motor impairments after brain lesions in stroke patients.

Herbs for calming liver and suppressing yang in treatment of hyperthyroidism with hyperactive liver yang: herbal effects on lymphocyte protein expression / 中国中药杂志

<p><b>OBJECTIVE</b>To observe the herbal effects on hyperthyroidism patients with syndrome of hyperactivity of liver-Yang by method for calming the liver and suppressing Yang and investigate its effects on the lymphocyte protein expression. This approach may lay a foundation for the further investigation of the curative mechanisms of calming the liver and suppressing Yang treatment.</p><p><b>METHOD</b>A total of 48 hyperthyroidism patients with syndrome of hyperactivity of liver-Yang were randomly divided into treatment group and control group. The treatment group was treated by method for calming the liver and suppressing Yang in accordance with traditional Chinese medicine (TCM) and the control group with thiamazole tablets for three periods of treatment The therapeutic effects, the score of TCM symptom, electrocardiogram (P wave), thyroid hormones and ultrasound were observed in both groups before and after the treatment. The side effects in the treatment course were observed in both groups. The level of differential protein expression was analyzed by two-dimensional electrphoresis and matrix assisted laser desorption/ionizaton time-of-flight mass spectrometry.</p><p><b>RESULT</b>The treatment group has the effect on stepping down the heart rate, cutting down the P wave amplitude changes, regulating the level of thyroid hormones and decreasing the volume of thyromegaly. There are not statistically significant between the treatment group and control group. However, the treatment group has obviously better effect on regulating TCM symptom and decreasing the side reaction than the control group (P<0.05). There are not statistically significant on the total effective between the treatment group and control group. The average spots in lymphocyte for normal people, before and after treating hyperthyroidism patients with syndrome of hyperactivity of liver-Yang were (429 +/- 31), (452 +/- 28) and (437 +/- 36) spots respectively. Eight down-regulated protein expressions and 11 up-regulated protein expressions were obtained in the hyperthyroidism patients with syndrome of hyperactivity of liver-Yang and normal people. Five strengthened expressions of protein were also obtained in 8 down-regulated expressions of protein and 8 lower expressions of protein in 11 up-regulated expressions of protein before and after treating the migraine patients with syndrome of hyperactivity of liver-Yang. Ten of the total 8 differential protein spots were successfully identified by MALDI-TOF-MS. The functions of these proteins were involved in metabolism associated, transportation, antioxidation, sigal transduction and immume associated protein, etc. according to information provided by NCBI and MSDB database.</p><p><b>CONCLUSION</b>In this study, the TCM complex prescription with herbs for calming the liver and suppressing Yang can regulate the thyroid hormones, improves TCM symptoms, and decrease the adverse reaction. It can possibly regulate lymphocyte protein expression.</p>

Effective treatment of advanced cholangiocarcinoma by hepatic arterial infusion chemotherapy combination with sorafenib: one case report from China.

BACKGROUND/AIMS: Cholangiocarcinoma, especially intrahepatic type, is difficult to be found early and diagnosed at early stages. Although it was reported as rare to happen, it is a well-known devastating malignancy with little treatment effects. As a result, most of the patients suffer from poor prognosis. On the other hand, the incidence of intrahepatic cholangiocarcinoma arises worldwide. Radical surgical resection was regarded as the most effective treatment, in spite of recurrence. Unfortunately, only 30 percent of patients qualify for this at the time of diagnosis. Hence, for advanced cholangiocarcinoma, chemotherapy is the only modality left to be chosen. Recently LaRocca and Kudoh reported about effective chemotherapy for cholangiocarcinoma. Even so, because of no randomized study, no standard chemotherapy for cholangiocarcinoma has been accepted, and most of the projects were based on 5-Fu. Sorafenib, a multikinase inhibitor, which can competitively inhibit RAF/MEK/ERK pathway, human vascular endothelial growth factor receptors (VEGFR2, VEGFR3) platelet-derived growth factor receptor beta (PDGFR), Flt3, and C-kit receptors, has been successfully applied for solid tumors such as renal cancer and hepatocellular carcinoma. Sorafenib used alone or in combinations, can induce growth-inhibition and apoptosis in vitro experiments. Application of sorafenib alone for cholangiocarcinoma has also been published. The role of combination with other chemotherapy drugs in advanced cholangiocarcinoma still needs to be defined. METHODOLOGY: A patient admitted for exploratory operation was demonstrated to be suffering from unresectable, biopsy-proven intrahepatic cholangiocarcinoma. A pump was placed inside hepatic artery, for the purpose of infusion chemotherapy. Program of chemotherapy was scheduled and hepatic arterial infusion of 5-Fu/LV +oxaliplatin +hydroxycamptothecine was performed. Three months later, no effect was discovered, so sorafenib was suggested to combine with infusion chemotherapy. For the first time we applied sorafenib combination to hepatic arterial infusion chemotherapy RESULT: After lower dosage of sorafenib was used as a combination with hepatic arterial infusion chemotherapy, size of hepatic lesions and level CA19-9 of peripheral blood count were decreased, without any damage to the hepatic function, except for temporary skin hyperkeratosis as well as vomit. Efficacy of treatment was demonstrated by computed tomography (CT) scan. CONCLUSION: So far as in our patient, the application of sorafenib combination with other agents through hepatic arterial infusion chemotherapy may be an effective way for cholangiocarcinoma, but the definite mechanism has to be confirmed by methods of molecular biology.

[Comparative study on leaf ultrastructure in varieties of Chrysanthemum morifolium].

OBJECTIVE: To study leaf ultrastructure in varieties of Chrysanthemum morifolium. METHOD: The ultrastructure of leaves was observed through the transmission electron microscope. RESULT AND CONCLUSION: Chloroplast, mitochondria, starch grains and peroxide were observed in the ultrastructure of leaves, but the organelle, ultrastructure and their quantity showed differences in various cultivars. The results may explain, why hangju'has a better resistance to the adversity and is planted in large scale.

[Effects of climate factors on quality of Chrysanthemum morifolium originated from Wenxian county].

OBJECTIVE: To study the effects of climate factors on the Chrysanthemum morifolium originated from Wenxian county (i. e "huaiju") for assuring the quality of medicinal C. morifolium. METHOD: The content of water-soluble extracts, protein, sugar, flavonoid and chlorogenic acid of "huaiju" collected from Henanwenxian, Jiangsunanjing and Zhejiangtongxiang were selected as the indicator and determined, climate data of the corresponding places were collected for studying the effects on "huaiju" quality through path analysis and correlation analysis. RESULT AND CONCLUSION: There existed no obviously differences among the detected indicators except the soluble sugar content. Sunlight, temperature and precipitation showed more effects on quality of "huaiju", the sunlight had the most direct effect on flavonoid, the 10 cm ground temperature had the most direct effect on chlorogenic acid.

Effects of climate factors on quality of Chrysanthemum morifolium originated from Wenxian county / 中国中药杂志

<p><b>OBJECTIVE</b>To study the effects of climate factors on the Chrysanthemum morifolium originated from Wenxian county (i. e "huaiju") for assuring the quality of medicinal C. morifolium.</p><p><b>METHOD</b>The content of water-soluble extracts, protein, sugar, flavonoid and chlorogenic acid of "huaiju" collected from Henanwenxian, Jiangsunanjing and Zhejiangtongxiang were selected as the indicator and determined, climate data of the corresponding places were collected for studying the effects on "huaiju" quality through path analysis and correlation analysis.</p><p><b>RESULT AND CONCLUSION</b>There existed no obviously differences among the detected indicators except the soluble sugar content. Sunlight, temperature and precipitation showed more effects on quality of "huaiju", the sunlight had the most direct effect on flavonoid, the 10 cm ground temperature had the most direct effect on chlorogenic acid.</p>

The design for curing circuit used in Chinese acupuncture & moxibustion instrument / 中国医疗器械杂志

In this paper, we introduce a multiple electro-stimulative pulse generator based on IC555, which can produce continuous, discontinuous, frequency modulated and amplitude modulated modes, and thus multiple-output, independent adjustment & control are realized. The principle block diagram and a reference circuit are presented too. This design adds acusetor curing function to BME-500 series Chinese Acupuncture & Moxibustion Instrument, making it a multifunctional therapy device of electro-acupuncture, massage and drug permeation Moxibustion Instrument.