Mobilizing endogenous neuroprotection: the mechanism of the protective effect of acupuncture on the brain after stroke.

Given its high morbidity, disability, and mortality rates, ischemic stroke (IS) is a severe disease posing a substantial public health threat. Although early thrombolytic therapy is effective in IS treatment, the limited time frame for its administration presents a formidable challenge. Upon occurrence, IS triggers an ischemic cascade response, inducing the brain to generate endogenous protective mechanisms against excitotoxicity and inflammation, among other pathological processes. Stroke patients often experience limited recovery stages. As a result, activating their innate self-protective capacity [endogenous brain protection (EBP)] is essential for neurological function recovery. Acupuncture has exhibited clinical efficacy in cerebral ischemic stroke (CIS) treatment by promoting the human body's self-preservation and "Zheng Qi" (a term in traditional Chinese medicine (TCM) describing positive capabilities such as self-immunity, self-recovery, and disease prevention). According to research, acupuncture can modulate astrocyte activity, decrease oxidative stress (OS), and protect neurons by inhibiting excitotoxicity, inflammation, and apoptosis via activating endogenous protective mechanisms within the brain. Furthermore, acupuncture was found to modulate microglia transformation, thereby reducing inflammation and autoimmune responses, as well as promoting blood flow restoration by regulating the vasculature or the blood-brain barrier (BBB). However, the precise mechanism underlying these processes remains unclear. Consequently, this review aims to shed light on the potential acupuncture-induced endogenous neuroprotective mechanisms by critically examining experimental evidence on the preventive and therapeutic effects exerted by acupuncture on CIS. This review offers a theoretical foundation for acupuncture-based stroke treatment.

Combination of preoperative CA19-9 levels, cell differentiation, and age predicts survival for patients with gastric cancer before surgery.

ABSTRACT: Gastric cancer (GC) is very common in China, posing a threat to public health, with high morbidity and mortality ranks. Tumor-node-metastasis (TNM) staging system is routinely used to predict prognosis for patients with GC but only available after surgery. Therefore, searching for markers that can predict prognosis of GC patients before surgery is desirable to assist management decisions preoperatively. Among 322 GC patients followed-up for 128 months, the tumor markers alpha fetoprotein, carcinoembryonic antigen, carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 15-3 and carbohydrate antigen 72-4 of 168 patients were detected before surgery, and their impact on survival was analyzed. Four major findings were revealed: (1) Preoperative examined CA19-9 levels and cell differentiation using endoscopic biopsies were positively correlated with lymphatic metastases and TNM stages obtained after surgery. (2) Kaplan-Meier analyses demonstrated that poor survival of patients with GC was associated with higher CA19-9 levels, poor cell differentiation, and older age. (3) Cox multi-factorial regression analyses indicated that, in terms of predicting overall survival for GC patients, preoperative CA19-9 level, cell differentiation and age were independent factors, respectively, comparable to postoperative TNM staging system. (4) Using receiver operating characteristic curve analysis, we first revealed that preoperative CA19-9 levels and cell differentiation had the impact weights (IW) on survival comparable to postoperative TNM components. These findings suggest that preoperative CA19-9 levels, cell differentiation and age are useful prognostic related markers for GC patients, superior to postoperative TNM system in terms of timing for management. We propose that, assisted by clinical imaging, a comprehensive utilization of these preoperative survival-predictors may help formulate individualized medical management for GC patients such as surgical strategy, optimal chemotherapy and radiotherapy, and appropriate follow-up intervals after surgery.

[Expression of MiR-429 in Patients with Acute Lymphoblastic Leukemia and Its Prognostic Value].

OBJECTIVE: To analyze the expression level of miR-429 in patients with acute lymphoblastic leukemia(ALL) and its clinical prognostic value. METHODS: One hundred and Twenty-six patients with ALL treated in our hospital from April 2016 to February 2018 were selected, and 100 healthy persons in the same period were selected as control group. Bone marrow mononuclear cells were collected. The expression level of miR-429 in bone marrow mononuclear cells was detected by RT-PCR, and the correlation of miR-429 expression with clinical characteristics and therapeutic efficacy was analyzed. Kaplan-Meier method and multi-factorial Cox regression model were used to analyze the correlation between the level of microRNA-429 and the prognosis of ALL patients. RESULTS: The relative level of miR-429 in ALL patients was 2.47±0.07, which was signifi-cantly higher than that in control group (P<0.05). The level of miR-429 significantly correlated with the leucocyte level（r=0.994）, LDH（r=0.992）, the ratio of bone marrow primordial cells（r=0.995） and risk grade of ALL patients（r=0.991). The level of miR-429 not correlate with the age, sex, Hb level, Plt level and immunophenotype of ALL patients (P>0.05). The level of miR-429 was not significantly different between CR patients and control group (P>0.05); the level of miR-429 in PR patients was higher than that in control group and CR patients (P<0.05). The level of miR-429 in NR patients was higher than that in other groups (P<0.05). Kaplan-Meier survival analysis showed that the overall survival rate of ALL patients with low expression of miR-429 was better than that of ALL patients with high expression of miR-429 (P<0.05). Univariate Cox regression analysis showed that leukocyte level, ratio of bone marrow primordial cells, Hb and LDH level, risk grading and miR-429 were the factors influencing overall survival rate in ALL patients (P<0.05). Multivariate Cox regression analysis showed that leukocyte level, ratio of bone marrow primordial cells, risk grading, and miR-429 were the factors influencing overall survival rate (P<0.05). CONCLUSION: The expression of miR-429 is high in ALL patients, which closely relates to the curative effect and pro-gnosis of ALL patients, and can be used as a reference index for evaluation of clinical prognosis of ALL patients.

[Expression of Aurora Family Genes in Acute Leukemia and Its Clinical Significance].

OBJECTIVE: To explore the mRNA expression of Aurora-A,B,C(AUR-A,B,C) in acute leukemia(AL) and their correlations with the clinical indications. METHODS: The mRNA expression levels of AUR-A,B,C in 73 cases of newly diagnosed AL (untreated group), 20 cases of AL with remission (remission group) and 14 healthy volunteers as control (healthy group) were detected by QRT-PCR, and the difference of expression levels in difference groups, their correlations with clinical indicators and the correlation between the AUR-A,B,C mRNA expression levels themselves were analyzed. RESULTS: The mRNA expression levels of AUR-A,B,C in untreated group were all higher than those in healthy group and remission group(P<0.01), but there was not significant difference between healthy group and remission group(P>0.05); the mRNA expressions of AUR-A,B,C in acute lymphoblastic leukemia(ALL) group were all significantly higher than that in AML group(P<0.01). The mRNA expression of AUR-A,B,C in high risk group was higher than that in low risk group(P<0.05), but there was no difference in mRNA expression of AUR-A,B,C between high risk group and middle risk group as well as between middle risk group and low risk group(P>0.05). The mRNA expression of AUR-A, B, C in CD34, CD71 and CD56 negative group was not statistically different from that in CD34,CD71 and CD56 positive group(P>0.05). In 73 cases of newly diagnosed AL, the mRNA expression levels of AUR-A, B significantly were positively correlated with lactate dehydrogenase(LDH) level and risk stratification (r=0.279, P=0.017; r=0.314, P=0.007 and r=0.277, P=0.018; r=0.349, P=0.002), while the mRNA expression levels of AUR-A, B were not significantly correlated with age, WBC count, blast ratio in bone marrow at initial diagnosis and remission or no-remission after 1 cours of chemotherapy; the mRNA expression level of AUR-C was significantly positively correlated with WBC count (r=0.263, P=0.025), and LDH level (r=0.348, P=0.003) at initial diagnosis and risk stratificantion(r=0.376, P=0.001), and negatively correlated with age (r=-0.241, P=0.040), and was not significantly correlated with blast ratio in bone marrow at initial diagnosis and remission or noremission after 1 course of chemotherapy. There were significant positive correlations in the mRNA expression between AUR-A and B (r=0.444, P=0.000), AUR-B and C (r=0.763, P=0.000) as well as AUR-A and C (r=0.616, P=0.000). CONCLUSION: Aur-A, B, C mRNA were highly expressed in patients with newly diagnosed AL, moreover the mRNA expression levels of Aur-A,B,C were positively correlated with each other, the high expression of Aur-A, B, C are associated with leukemia types, risk stratification, WBC count and LDH level at initial diagnosis, so they all maybe used as the prognostic markers and potential therapeutic targets.

Preoperative Body Mass Index, Blood Albumin and Triglycerides Predict Survival for Patients with Gastric Cancer.

BACKGROUND: Gastric cancer (GC) is common and its prognosis is often poor due to difficulties in early diagnosis and optimal treatment strategies. TNM staging system is useful in predicting prognosis but only possible after surgery. Therefore, it is desirable to investigate prognostic factors/markers that may predict prognosis before surgery by which helps appropriate management decisions preoperatively. METHODS: A total of 320 GC patients were consecutively recruited from 2004 to 2013 and followed up for 127 months (10.6 years) after surgery. These patients' were examined for body mass index (BMI) and blood levels of albumin, triglyceride, total cholesterol, low density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol (HDL-C). Kaplan-Meier method and log rank test were used to analyze long-term survival using the above potential risk markers. We first employed medians of these variables to reveal maximal potentials of the above prognostic predictors. RESULTS: Three major findings were obtained: (1) Preoperative BMI was positively correlated with albumin (r = 0.144, P<0.05) and triglyceride (r = 0.365, P<0.01), but negatively correlated with TNM staging (r = -0.265, P<0.05). Preoperative albumin levels were positively correlated with triglyceride (r = 0.173, P<0.05) but again, negatively correlated with TNM staging (r = -0.137, P<0.05); (2) Poor survival was observed in GC patients with lower levels of BMI (P = 0.028), albumin (P = 0.004), and triglyceride (P = 0.043), respectively. Receiver operating characteristic (ROC) curve analyses suggested BMI, albumin and triglyceride to have survival-predictor powers similar to TNM system; and (3) Cox multi-factorial analyses demonstrated that age (P = 0.049), BMI (P = 0.016), cell differentiation (P = 0.001), and TNM staging (P = 0.011) were independent overall survival-predictors for GC patients. CONCLUSIONS: Preoperative BMI, albumin, and triglyceride levels are capable of predicting survival for GC patients superior to postoperative TNM system in terms of timing for management. As potential survival-predictors, preoperative tests of BMI, albumin and triglyceride, combined with clinical imaging, may help personalized management for GC patients including planning surgical strategy, optimal radio-chemotherapy and appropriate follow-up intervals after surgery.