Effects of acupuncture in treating insomnia due to spleen-stomach disharmony syndrome and its influence on intestinal microbiome: Study protocol for a randomized controlled trial / 中西医结合学报

BACKGROUND@#Insomnia is a common complaint that is closely related to gastrointestinal symptoms, which is consistent with the traditional Chinese medicine classical theory of "stomach disharmony leading to restless sleep." Acupuncture is an effective complementary and alternative medicine therapy to improve gastrointestinal function and restore the normal sleep-wake cycle. However, studies on the effectiveness of acupuncture for insomnia due to spleen-stomach disharmony syndrome are limited to case reports and few randomized controlled trials; deeper research on its mechanism is still lacking. This randomized controlled trial aims to assess the treatment efficacy of "harmonizing stomach to tranquilize mind" acupuncture for insomnia and its influence on the intestinal microbiome.@*METHODS/DESIGN@#This is a randomized, single-blind, parallel-group study. Sixty eligible patients with insomnia due to spleen-stomach disharmony syndrome will be randomly divided into two groups (1:1 allocation ratio). The intervention group will use "harmonizing stomach to tranquilize mind" acupuncture, and the control group will receive sham acupuncture. Participants will receive 5 acupuncture treatment sessions per week for 4 consecutive weeks. The Pittsburgh Sleep Quality Index will be used to evaluate the clinical efficacy of acupuncture treatment by making assessments at baseline, the end of treatment and the end of the follow-up. High-throughput 16S ribosomal ribonucleic acid gene sequencing will be performed to detect changes in the intestinal microbial composition before and after treatment.@*DISCUSSION@#The results of this trial are expected to confirm that "harmonizing stomach to tranquilize mind" acupuncture can effectively relieve insomnia and alter the intestinal microbiome.@*TRIAL REGISTRATION@#Chinese Clinical Trials Registry: ChiCTR1800017092.

Two new ent-atisane diterpenoids from the whole plants of Euphorbia wallichii.

Two new ent-atisanediterpenoids, ent-atisane-16ß, 17-isopropylidenedioxy-19-ol-3-one (1) and ent-atisane-16ß, 17-isopropylidenedioxy-11ß, 18-dihydroxyl-3-one (2) were isolated from the whole plants of Euphorbia wallichii. Their structures were elucidated on the basis of extensive spectroscopic analyses.

Photo-thermal effect enhances the efficiency of radiotherapy using Arg-Gly-Asp peptides-conjugated gold nanorods that target αvß3 in melanoma cancer cells.

BACKGROUND: Thermotherapy has been known to be one of the most effective adjuvants to radiotherapy (RT) in cancer treatment, but it is not widely implemented clinically due to some limitations, such as, inadequate temperature concentrations to the tumor tissue, nonspecific and non-uniform distribution of heat. So we constructed arginine-glycine-aspartate peptides-conjugated gold nanorods (RGD-GNRs) that target the alpha(v) beta(3) Integrin (αvß3) and investigate whether the photo-thermal effect of RGD-GNRs by near infrared radiation (NIR) could enhance the efficiency of RT in melanoma cancer cells. RESULTS: RGD-GNRs could be seen both on the surface of the cell membranes and cytoplasm of A375 cells with high expression of αvß3. After exposed to 808 nm NIR, RGD-GNRs with various concentrations could be rapidly heated up. Compared to other treatments, flow cytometric analysis indicated that RT + NIR + RGD-GNRs increased apoptosis (p < 0.001) and decreased the proportion of cells in the more radioresistant S phase (p = 0.014). Treated with NIR + RGD-GNRs, the radiosensitivity was also significantly enhanced (DMFSF2: 1.41). CONCLUSION: Results of the current study showed the feasibility of using RGD-GNRs for synergetic RT with photo-thermal therapy. And it would greatly benefit the therapeutic effects of refractory or recurrent malignant cancers.

Adjuvant chemoradiation plus intraoperative radiotherapy versus adjuvant chemoradiation alone in patients with locally advanced rectal cancer.

OBJECTIVES: To document the efficacy of intraoperative radiotherapy (IORT) followed by adjuvant chemoradiation in the management of locally advanced rectal cancer. MATERIALS AND METHODS: A total of 148 patients with pT4N0/T1-4N+ rectal adenocarcinoma were enrolled. Seventy-seven patients received total mesorectal excision surgery followed by adjuvant chemoradiation alone, 71 patients received total mesorectal excision surgery followed by IORT (range, 10 to 20 Gy) and adjuvant chemoradiation. RESULTS: The 5-year local control (LC) and disease-free survival were 79.2% versus 89.7% (P=0.032), 58.5% versus 69.0% (P=0.049) for external-beam radiation (EBRT) and IORT+EBRT groups, respectively. Multivariate analysis revealed that adjuvant IORT has a trend toward improvement of LC (P=0.079); 5 (3%) patients (EBRT n=2; IORT n=3) experienced incomplete intestinal obstruction and 3 patients had chronic diarrhea. There was no clinically relevant neuropathy or sacral osteoradionecrosis. Hydronephrosis occurred in 13 patients (EBRT n=8; IORT+EBRT n=5), 8 of whom had documented concomitant disease recurrence. CONCLUSIONS: For patients with locally advanced rectal cancer, higher radiation dose may contribute to the improvement of both LC and disease-free survival, without significantly increasing the incidence of acute and long-term complications compared with adjuvant chemoradiotherapy alone.

[Effect of electroacupuncture stimulation of "Ganshu" (BL 18) on locomotor, gastric mucosal and hypothalamic SP immunoactivity and hippocampal 5-HT content in rats with depression and gastric ulcer].

OBJECTIVE: To observe the effect of electroacupuncture (EA) stimulation of "Ganshu" (BL18) on expression of substance P (SP) in the gastric mucosa and hypothalamus tissues and hippocampal 5-hydroxytryptamine (5-HT) content in rats with depression + gastric ulcer, so as to explore its mechanism underlying improvement of depressive gastric ulcer. METHODS: A total of 60 SD rats were equally randomized into normal, model, EA-BL18 and non-acupoint groups. The depression + gastric ulcer model was established by chronic unpredictable mild stress (CUMS) paradigm for 21 days in accordance with Willner and colleagues' methods (1987), and injection of 90% glacial acetic acid (0.01 mL) into the sub-serous layer near the gastric antrum under anesthesia on day 10 after starting CUMS. Following modeling, EA (4 Hz/15 Hz, 2 V) was applied to bilateral "Ganshu" (BL 18) for 20 min, once daily for 2 weeks, with one day's interval between two weeks. The non-acupoint was located about 2.5 cm lateral to the umbilicus and stimulated by EA similar to EA-BL18. The rats' locomotor ability was assessed by open field tests (crossing and rearing numbers). The gastric ulcer index was calculated according to Guth's method, and hypothalamic and gastric antrum SP immunoactivity was determined by immunohistochemistry and hippocampal 5-HT content was detected by ELISA. RESULTS: After modeling, compared to the normal group, both crossing number and rearing number of open field tests on day 21 and 34 were significantly decreased in the model group (P < 0.01), while compared to the model group, both crossing and rearing numbers on day 34 were considerably increased in the EA-BL18 group (P < 0.01) rather than in the non-acupoint group (P > 0.05). Following modeling, the gastric ulcer index, SP expression levels in the gastric antrum and hypothalamus tissue were obviously increased in the model group (P < 0.01), and notably decreased in the EA-BL18 group (P < 0.01) but not in the non-acupoint group (P > 0.05). The hippocampal 5-HT content was remarkably lower in the model group than in the normal group, but obviously higher in the EA-BL18 group than in the model group (P < 0.01). No significant difference was found between the model and non-acupoint groups in the hippocampal 5-HT content (P > 0.05). CONCLUSION: EA of "Ganshu" (BL18) can promote locomotor and reduce gastric ulcer index in depression + gastric ulcer rats, which may be related to its effects in lowering gastric and hypothalamic SP immunoactivity and in raising hippocampal 5-HT content.

Temperature feedback based heating strategy for ultrasound thermal surgery.

Phased array transducer has the ability to generate multiple-focus pattern by adjusting the driving signal of individual element of the array. For the treatment of large target volume, several multiple-focus pattern could be used by using temporal switching technique among these power patterns. Typically, to obtain a uniform thermal dose, properly adjust the power level within the target volume is important. In this study, we proposed a temperature feedback based heating strategy without the need of power level adjustment. Several parameters, such as the setting temperature, sonication time, power level and blood perfusion, may affect the final thermal dose. Simulation results show that setting temperature is the key parameter to determine the final thermal dose while the effects of blood perfusion could be neglected and the sonication time should be as short as possible. Small power level is not suggested because the resulting thermal dose would extended owing to the thermal conduction.

Adjuvant chemoradiotherapy with or without intraoperative radiotherapy for the treatment of resectable locally advanced gastric adenocarcinoma.

PURPOSE: To document the long-term efficacy of intraoperative electron radiotherapy (IOERT) followed by concurrent chemotherapy and external-beam radiotherapy (EBRT) in the management of locally advanced gastric cancer. MATERIALS AND METHODS: A total of 97 consecutive patients with T3/4 or N+ gastric adenocarcinoma were enrolled. Fifty-one patients received adjuvant chemoradiotherapy (EBRT group) and 46 received IOERT (dose range, 12-15 Gy) followed by chemoradiotherapy (EBRT+IOERT group). RESULTS: The 5-year locoregional control rates were 50% and 35% in the two groups with or without IOERT, respectively (p=0.04). Two patients had recurrence within the IOERT field in the EBRT+IOERT group and 14 patients recurred in the same area in the EBRT group (p=0.02). Multivariate analyses revealed that adjuvant IOERT was an independent prognosticator for both local-regional control (p=0.02) and disease-free survival (p=0.05). G3/4 late toxicity was observed in 5 patients in the EBRT+IOERT group, but none in the EBRT group (p=0.02). CONCLUSIONS: Higher radiation dose may contribute to the improvement of local control, especially in the field encompassed by IOERT. The addition of IOERT to surgery and adjuvant chemoradiation deserves further investigation in a randomized trial.

A survey of the geographic distribution of Ophiocordyceps sinensis.

Ophiocordyceps sinensis is one of the best known fungi in Traditional Chinese Medicine. Many efforts have been devoted to locating the production areas of this species resulting in various reports; however, its geographic distribution remains incompletely understood. Distribution of O. sinensis at the county level is clarified in this work based on both a literature search and fieldwork. More than 3600 publications related to O. sinensis were investigated, including scientific papers, books, and online information. Herbarium specimens of O. sinensis and field collections made by this research group during the years 2000-2010 were examined to verify the distribution sites. A total of 203 localities for O. sinensis have been found, of which 106 are considered as confirmed distribution sites, 65 as possible distribution sites, 29 as excluded distribution sites and three as suspicious distribution sites. The results show that O. sinensis is confined to the Tibetan Plateau and its surrounding regions, including Tibet, Gansu, Qinghai, Sichuan, and Yunnan provinces in China and in certain areas of the southern flank of the Himalayas, in the countries of Bhutan, India and Nepal, with 3,000 m as the lowest altitude for the distribution. The fungus is distributed from the southernmost site in Yulong Naxi Autonomous County in northwestern Yunnan Province to the northernmost site in the Qilian Mountains in Qilian County, Qinghai Province, and from the east edge of the Tibetan Plateau in Wudu County, Gansu Province to the westernmost site in Uttarakhand, India. The clarification of the geographic distribution of O. sinensis will lay the foundation for conservation and sustainable use of the species.

Folic acid-conjugated silica-modified gold nanorods for X-ray/CT imaging-guided dual-mode radiation and photo-thermal therapy.

Multifunctional nanoprobes are designed to own various functions such as tumor targeting, imaging and selective therapy, which offer great promise for the future of cancer prevention, diagnosis, imaging and treatment. Herein, silica was applied to replace cetyltrimethylammonium bromide (CTAB) molecules on the surface of gold nanorods (GNRs) by the classic Stöber method, thus eliminating their cytotoxicity and improving their biocompatibility. Folic acid molecule was covalently anchored on the surface of GNRs with silane coupling agent. The resultant folic acid-conjugated silica-modified GNRs show highly selective targeting, enhanced radiation therapy (RT) and photo-thermal therapy (PTT) effects on MGC803 gastric cancer cells, and also exhibited strong X-ray attenuation for in vivo X-ray and computed tomography (CT) imaging. In conclusion, the as-prepared nanoprobe is a good candidate with excellent imaging and targeting ability for X-ray/CT imaging-guided targeting dual-mode enhanced RT and PTT.

Waste ashes for use in agricultural production: I. Liming effect, contents of plant nutrients and chemical characteristics of some metals.

The chemical characteristics of 89 municipal waste ashes, including food scrap ash (FSA), animal waste ash (AWA), horticulture waste ash (HWA), sewage sludge ash (SSA) and incinerator bottom ash (IBA), from various locations in Japan were examined with the aim of evaluating their suitability for use in agriculture. Although the waste ashes came from different sources and consisted of various materials, the gross elemental composition was similar. Acid neutralization capacity (liming effect) for the waste ashes was equivalent to 10-30% of CaO and followed the sequence SSA > IBA > AWA > FSA > HWA. Average P concentrations for the five types of waste ashes ranged from 10 to 29 g kg(-1) and average K concentrations ranged from 14 to 63 g kg(-1), respectively. Metal contents in the waste ashes were compared with levels in Japanese agricultural soils. K in the waste ashes was 1.3-6 times higher and Ca was 3-12 times higher; contents of the other metals in FSA, AWA and HWA were generally less than five times higher, but Ni, Cu, Zn, Cd, Sn, Pb in SSA or IBA were approximately 10-200 times higher than those in soils. Moreover, the ceiling amounts of waste ashes that may be applied to main Japanese agricultural soils were calculated by using soil contamination standards for Cu. Water solubility of P and metals in the waste ashes were also examined.