Effects of Nei-Guan (P6) Acupressure Wristband: On Nausea, Vomiting, and Retching in Women After Thyroidectomy.

BACKGROUND: Postoperative nausea and vomiting (PONV) after thyroidectomy is a common health problem in the recovery room. OBJECTIVE: The aim of this study is to examine the effect of the Nei-Guan (P6) acupressure wristband for PONV among patients undergoing thyroidectomy. METHODS: Sixty Korean female participants were assigned to 1 of 3 groups (n = 20 each). The control group received usual care without the wristband. The placebo group received usual nursing care plus a wristband at the non-P6 site. The treatment group received usual care plus a wristband at the P6 acupoint 30 minutes before anesthesia; the wristband was removed before leaving the recovery room. Data were collected at 3 periods: in the recovery room and at 6 and 24 hours after surgery. RESULTS: The nausea scores of the treatment group were significantly lower than the scores of the placebo or control groups in the recovery room (F = 6.229, P = .044). There were no significant differences in vomiting or retching among the groups. CONCLUSIONS: The P6 stimulation with wristband suppressed nausea right after thyroidectomy in the recovery room but did not suppress subsequent vomiting or retching. IMPLICATION FOR PRACTICE: The findings indicate that P6 acupressure has the short-term effect of relieving nausea but not vomiting and retching. Use of P6 wristband holds promise and suggests the need for further testing in a larger randomized clinical trial. Identifying other acupoints is recommended to achieve successful management of PONV.

Actionable gene expression-based patient stratification for molecular targeted therapy in hepatocellular carcinoma.

BACKGROUND: The effectiveness of molecular targeted agents is modest in hepatocellular carcinoma (HCC). Efficacy of molecular targeted therapies has been better in cancer patients with high expression of actionable molecules defined as cognate target molecules. However, patient stratification based on the actionable molecules dictating the effectiveness of targeted drugs has remained understudied in HCC. EXPERIMENTAL DESIGN & RESULTS: Paired tumor and non-tumoral tissues derived from a total of 130 HCC patients were studied. Real-time RT-PCR was used to analyze the mRNA expression of actionable molecules in the tissues. mRNA levels of EGFR, VEGFR2, PDGFRß, FGFR1, and mTOR were up-regulated in tumors compared to non-tumors in 35.4, 42.3, 61.5, 24.6, and 50.0% of patients, respectively. Up-regulation of EGFR was observed at early stage and tended to gradually decrease toward late stages (BCLC stage A: 41.9%; B: 30.8%; C: 17.6%). Frequency of VEGFR2 expression in tumors at stage C was lower than that in the other stages (BCLC stage A: 45.9%; B: 41.0%; C: 29.4%). PDGFRß and mTOR were observed to be up-regulated in more than 50% of tumors in all the stages whereas FGFR1 was up-regulated in only about 20% of HCC irrespective of stages. A cluster analysis of actionable gene expression revealed that HCC can be categorized into different subtypes that predict the effectiveness of molecular targeted agents and combination therapies in clinical trials. Analysis of in vitro sensitivity to sorafenib demonstrated that HCC cells with up-regulation of PDGFRß and c-Raf mRNA are more susceptible to sorafenib treatment in a dose and time-dependent manner than cells with low expression of the genes. CONCLUSIONS: mRNA expression analysis of actionable molecules could provide the rationale for new companion diagnostics-based therapeutic strategies in the treatment of HCC.