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 Jiannao Anshen acupuncture on insomnia: a functional magnetic resonance imaging study].

OBJECTIVE: To observe the efficacy of Jiannao Anshen acupuncture (acupuncture for brain-invigorating and mind-calming) on insomnia, and the dynamic changes of functional magnetic resonance imaging (fMRI) before and after acupuncture, to provide neuroimaging basis of acupuncture for insomnia. METHODS: A total of 58 participants were included. Of them, 29 patients with insomnia were included into an observation group, and 29 healthy participants were included into a control group. The patients in the observation group were treated with Jiannao Anshen acupuncture at Baihui (GV 20), bilateral Sishencong (EX-HN 1), Fengfu (GV 16), Fengchi (GB 20), Qiangjian (GV 18), occipital sideline, Anmian (Extra), Yiming (EX-HN 14) and Dazhui (GV 14); treatment was given once a day, 10 days as a course of treatment, and a total of 2 courses of treatment was given. The resting-state fMRI data was collected in the observation group before and after treatment. The participants in the control group received no treatment, and the resting-state fMRI data was collected only once. The resting-state fMRI data in the observation group before treatment and in the control group, also the observation group before and after treatment were compared. The Pittsburgh sleep quality index (PSQI), insomnia severity index (ISI), daytime insomnia symptom scale (DISS), hyperarousal scale (HAS), Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD), digit symbol test, mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA) and the A, B speed of trail making test (NCT) were observed in the observation group before and after treatment. The clinical efficacy of the observation group was evaluated. RESULTS: The total effective rate was 89.7% (26/29) in the observation group. In the observation group, the scores of PSQI, ISI and DISS, the A, B speed of NCT were all decreased after treatment (P<0.01, P<0.05). Before treatment, compared with the control group, functional connectivity in ventral dorsal prefrontal cortex, dorsal anterior cingulate cortex, inferior parietal lobe, dorsal lateral prefrontal cortex, dorsal anterior cingulate cortex, left ventral anterior cingulate gyrus and right ventral anterior cingulate gyrus was reduced in the observation group; compared before treatment, the functional connectivity in lingual gyrus, cerebellar area 6, frontal lobe, insular lobe and anterior cingulate gyrus, premotor gyrus and posterior cingulate gyrus was increased after treatment in the observation group. After treatment, the functional connection intensity of left ventral caudate nucleus and insular lobe was negatively correlated with HAMD score in the observation group (r =-0.55, P<0.05), and the functional connection intensity of left ventral caudate nucleus and anterior cingulate gyrus was negatively correlated with HAMA score in the observation group (r =-0.47, P<0.05). CONCLUSION: The Jiannao Anshen acupuncture could effectively improve the sleep quality in patients with insomnia, and acupuncture could enhance the connection of left dorsal, right ventral and left ventral caudate nucleus with brain area.

Conjugation of DM1 to anti-CD30 antibody has potential antitumor activity in CD30-positive hematological malignancies with lower systemic toxicity.

An anti-CD30 antibody-drug conjugate incorporating the antimitotic agent DM1 and a stable SMCC linker, anti-CD30-MCC-DM1, was generated as a new antitumor drug candidate for CD30-positive hematological malignancies. Here, the in vitro and in vivo pharmacologic activities of anti-CD30-MCC-DM1 (also known as F0002-ADC) were evaluated and compared with ADCETRIS (brentuximab vedotin). Pharmacokinetics (PK) and the safety profiles in cynomolgus monkeys were assessed. Anti-CD30-MCC-DM1 was effective in in vitro cell death assays using CD30-positive lymphoma cell lines. We studied the properties of anti-CD30-MCC-DM1, including binding, internalization, drug release and actions. Unlike ADCETRIS, anti-CD30-MCC-DM1 did not cause a bystander effect in this study. In vivo, anti-CD30-MCC-DM1 was found to be capable of inducing tumor regression in subcutaneous inoculation of Karpas 299 (anaplastic large cell lymphoma), HH (cutaneous T-cell lymphoma) and L428 (Hodgkin's disease) cell models. The half-lives of 4 mg/kg and 12 mg/kg anti-CD30-MCC-DM1 were about 5 days in cynomolgus monkeys, and the tolerated dose was 30 mg/kg in non-human primates, supporting the tolerance of anti-CD30-MCC-DM1 in humans. These results suggest that anti-CD30-MCC-DM1 presents efficacy, safety and PK profiles that support its use as a valuable treatment for CD30-positive hematological malignancies.

Gambogic acid improves non-small cell lung cancer progression by inhibition of mTOR signaling pathway.

Gambogic acid (GA) has been shown to inhibit cancer cell proliferation, induce apoptosis, and enhance reactive oxygen species accumulation. However, whether GA could improve multidrug resistance through modulating autophagy has never been explored. We demonstrated that the combination of GA and cisplatin (CDDP) resulted in a stronger growth inhibition effect on A549 and NCI-H460 cells using the MTT assay. Furthermore, treatment with GA significantly increased autophagy in these cells. More importantly, GA-induced cell death could be largely abolished by 3-methyladenine (3-MA) or chloroquine (CQ) treatment, suggesting that GA-induced cell death was dependent on autophagy. Western blot analysis showed that GA treatment suppressed the activation of Akt, mTOR, and S6. In addition, using a GA and rapamycin combination induced more cell death compared to either GA or rapamycin alone. In summary, GA may have utility as an adjunct therapy for non-small cell lung cancer (NSCLC) patients through autophagy-dependent cell death, even when cancer cells have developed resistance to apoptosis.

A Distinct Pathway for Polar Exocytosis in Plant Cell Wall Formation.

Post-Golgi protein sorting and trafficking to the plasma membrane (PM) is generally believed to occur via the trans-Golgi network (TGN). In this study using Nicotiana tabacum pectin methylesterase (NtPPME1) as a marker, we have identified a TGN-independent polar exocytosis pathway that mediates cell wall formation during cell expansion and cytokinesis. Confocal immunofluorescence and immunogold electron microscopy studies demonstrated that Golgi-derived secretory vesicles (GDSVs) labeled by NtPPME1-GFP are distinct from those organelles belonging to the conventional post-Golgi exocytosis pathway. In addition, pharmaceutical treatments, superresolution imaging, and dynamic studies suggest that NtPPME1 follows a polar exocytic process from Golgi-GDSV-PM/cell plate (CP), which is distinct from the conventional Golgi-TGN-PM/CP secretion pathway. Further studies show that ROP1 regulates this specific polar exocytic pathway. Taken together, we have demonstrated an alternative TGN-independent Golgi-to-PM polar exocytic route, which mediates secretion of NtPPME1 for cell wall formation during cell expansion and cytokinesis and is ROP1-dependent.

Preablative Stimulated Thyroglobulin Correlates to New Therapy Response System in Differentiated Thyroid Cancer.

CONTEXT: Studies suggested a potential value of preablative stimulated thyroglobulin (ps-Tg) on predicting the recurrent and persistent diseases of differentiated thyroid cancer, whereas its correlations with therapeutic response remain uncertain. OBJECTIVE: To establish the correlation between ps-Tg and therapeutic response proposed in 2015 American Thyroid Association guidelines, and calculate a cutoff ps-Tg threshold for predicting a poor response. DESIGN/SETTING: Patients who underwent total thyroidectomy and radioactive iodine therapy in a university hospital participated in this retrospective study. PATIENTS: Totally, 452 patients with differentiated thyroid cancer were followed for a median of 38 months and were divided into three groups in terms of ps-Tg level: group 1, less than 1 ng/ml (n = 82); group 2, 1-10 ng/ml (n = 173); and group 3, at least 10 ng/ml (n = 197). MAIN OUTCOME MEASURE: Clinical outcomes were assessed based on response to therapy restaging system, dividing responses into excellent, indeterminate, biomedical incomplete, and structural incomplete (SIR). RESULTS: Therapeutic responses could be obviously distinguished by different ps-Tg strata. SIR was identified in none of group 1, 1.73% of group 2, and 42.74% of group 3, respectively (χ(2) = 123.037, P < .001). A cutoff value of ps-Tg at 26.75 ng/ml was obtained by receiver operating characteristic curve for differentiating SIR from either excellent, indeterminate, or biomedical incomplete responses. The area under curve was 0.947 and negative predictive value was 96.99%. Ps-Tg was an independent predictive variable of SIR (odds ratio, 42.312; P < .001). CONCLUSIONS: Ps-Tg has a great performance in predicting therapeutic response and providing incremental value for decision making of radioactive iodine therapy, especially for patients with high ps-Tg level.

Pinellia ternata lectin exerts a pro-inflammatory effect on macrophages by inducing the release of pro-inflammatory cytokines, the activation of the nuclear factor-κB signaling pathway and the overproduction of reactive oxygen species.

Pinellia ternata (PT) is a widely used traditional Chinese medicine. The raw material has a throat-irritating toxicity that is associated with the PT lectin (PTL). PTL is a monocot lectin isolated from the tubers of PT, which exhibits mouse peritoneal acute inflammatory effects in vivo. The present study aimed to investigate the pro-inflammatory effect of PTL on macrophages. PTL (50 µg/ml)­stimulated macrophages enhanced the chemotactic activity of neutrophils. PTL (50, 100, 200 and 400 µg/ml) significantly elevated the production of cytokines [tumor necrosis factor­α (TNF-α) , interleukin (IL)­1ß and IL­6]. PTL (25, 50 and 100 µg/ml) induced intracellular reactive oxygen species (ROS) overproduction. PTL also caused transfer of p65 from the macrophage cytoplasm to the nucleus and activated the nuclear factor­κB (NF­κB) signaling pathway. Scanning electron microscope images revealed severe cell swelling and membrane integrity defection of macrophages following PTL (100 µg/ml) stimulation, which was also associated with inflammation. PTL had pro­inflammatory activity, involving induced neutrophil migration, cytokine release, ROS overproduction and the activation of the NF-κB signaling pathway, which was associated with the activation of macrophages.

[Antagonistic effect of gingerols against TNF-α release, ROS overproduction and RIP3 expression increase induced by lectin from Pinellia ternata].

To explore the antagonistic effect of gingerols against the inflammation induced by lectin from Pinellia ternata. In this study, ELISA method was used to determine the effect of different extracts from gingerols on the release of inflammatory factor TNF-α from macrophages induced by lectin from P. ternata. The fluorescence probe was used to determine the effect of gingerols on the changes in ROS of macrophages induced by lectin from P. ternata. The western-blot method was applied to study the effect of gingerols on the increase in expression of cell receptor interacting protein RIP3 in macrophages induced by lectin from P. ternata. The scanning electron microscope (SEM) was used to study the effect of gingerols on morphological changes in macrophages induced by lectin from P. ternata. According to the results, gingerols can significantly inhibit the release of inflammatory factor from macrophages induced by lectin from P. ternata, ROS overproduction and increase in RIP3 expression. SEM results showed that gingerols can inhibit the cytomorphosis and necrocytosis induced by lectin from P. ternata. Fresh ginger's detoxication may be related to gingerols' effects in inhibiing release of inflammatory factor, ROS overproduction and increase in RIP3 expression caused by macrophages induced by lectin from P. ternata, which are mainly inflammatory development.

[Comparative study on toxicity of extracts from Phytolaccae Radix before and after being processed with vinegar].

OBJECTIVE: To extract and separate toxic components from Phytolaccae Radix, and to comare the changes in toxicity of Phytolaccae Radix before and after being processed with vinegar. METHOD: The mucous membrane irritation response, mouse peritoneal inflammation model and in vitro macrophages release NO model were applied to compared the changes in inflammatory toxicity of toxic components from Phytolaccae Radix before and after being processed with vinegar. RESULT: Toxic components of Phytolacca Radix had significant inflammatory toxicity, which could cause conjunctival edema in rabbits, and increase of PGE2 and macrophages release NO content in peritoneal exudate in mice. After being processed with vinegar, they showed reduced irritation, which resulted in decrease of PGE2 and macrophages release NO content in peritoneal exudate in mice. CONCLUSION: After being processed with vinegar, the toxicity of toxic components from Phytolacca Radix decreased obviously.

[Study on inflammatory effect of toxic raphides from Pinellia ternate and its correlation with macrophages].

OBJECTIVE: To study the toxic mechanism of toxic raphides from Pinellia ternata. METHOD: Mouse peritoneal macrophage in vitro culture model was adopted to study dose-dependent and time-dependent curves of toxic raphides, with TNF-alpha, IL-1beta and IL-6 in supernatant as indexes. Scanning electron microscopy was used to observe the changes in surface morphology of raphides-treated macrophages. Macrophages-neutrophils co-cultured the transport model to study the effect of toxic raphides' stimulation of macrophages on neutrophils migration. RESULT: Toxic raphides' stimulation of macrophages could cause the increase in the levels of TNF-alpha, IL-1beta and IL-6 released, and showed dose dependence and time dependence. Scanning electron microscopy showed that toxic raphides were swallowed by macrophages, with notable cell membrane creases, increase in the number of pseudopods and decrease in integrity of cell membranes, and could significantly induce migration of neutrophils. CONCLUSION: The inflammatory process induced by toxic raphides is mainly mediated by macrophages. The toxic mechanism of toxic raphides from P. ternata is that toxic raphides penetrate into tissues to activate resident macrophages, release phagocytic and inflammatory cytokines, and cause migration of neutrophils, which finally results in acute inflammatory response.

[Comparative study on pro-inflammatory toxicity of Pinellia pedatiecta before and after being processed with alum].

OBJECTIVE: To explore the pro-inflammatory toxicity of Pinellia pedatiecta, as well as the alum processing method on its pro-inflammatory effect. METHOD: Raphide and agglutinin (PPA) proteins were isolated from fresh P. pedatiecta. The overall animal and cellular level models were applied to investigate the pro-inflammatory effect of raphide and PPA in P. pedatiecta, as well as the impact of the alum processing method on the pro-inflammatory effect, with inflammatory mediators as the index. RESULT: Intraperitoneal injection with P. pedatiecta raphide suspension could significantly increase the content of inflammatory mediators PGE2 and NO. After the alum processing method was adopted, fresh P. pedatiecta and raphide-induced PGE2 and NO release significantly reduced. The stimulation of mice macrophages with P. pedatiecta agglutinin protein could cause the content of dose-dependent inflammatory mediators TNF-alpha and IL-6. After the alum processing method was adopted, PGE2 content in P. pedatiecta agglutinin protein-induced mice peritoneal exudate notably decreased. CONCLUSION: The irritation and toxicity of P. pedatiecta were inflammatory responses in organisms. Its raphide and agglutinin proteins were toxic components, both could cause significant the release of inflammatory medium. The alum processing method could help significantly reduce the pro-inflammatory toxicity of P. pedatiecta.