The toxicity response of the electrochemical signal of the cell to the drug metabolized by the S9 system.

The electrochemical detection method of cytotoxicity using intracellular purines as biomarkers has shown great potential for in vitro drug toxicity evaluation. However, no electrochemical detection system based on an in vitro drug metabolism mechanism has been devised. In this paper, electrochemical voltammetry was used to investigate the effect of the S9 system on the electrochemical behavior of HepG2 cells, and benzo[a]pyrene, fluoranthene, and pyrene were employed to investigate the sensitivity of electrochemical signals of cells to the cytotoxicity of drugs metabolized by the S9 system. The results showed that, within 8 h of exposure to the S9 system, the electrochemical signal of HepG2 cells at 0.7 V did not alter noticeably. The levels of xanthine, guanine, hypoxanthine, and adenine in the cells were not significantly altered. Compared with the absence of S9 system metabolism, benzo[a]pyrene and fluoranthene processed by the S9 system decreased the electrochemical signal of the cells in a dose-dependent manner, while pyrene did not change it appreciably. HPLC also revealed that benzo[a]pyrene and fluoranthene metabolized by the S9 system decreased the intracellular purine levels, whereas pyrene had no effect on them before and after S9 system metabolism. The cytotoxicity results of the three drugs examined by electrochemical voltammetry and MTT assay showed a strong correlation and good agreement. The S9 system had no effect on the intracellular purine levels or the electrochemical signal of cells. When the drug was metabolized by the S9 system, variations in cytotoxicity could be precisely detected by electrochemical voltammetry.

Perioperative Electroacupuncture Can Accelerate the Recovery of Gastrointestinal Function in Cancer Patients Undergoing Pancreatectomy or Gastrectomy: A Randomized Controlled Trial.

The effect of perioperative acupuncture on accelerating gastrointestinal function recovery has been reported in colorectal surgery and distal gastrectomy (Billroth-II). However, the evidence in pancreatectomy and other gastrectomy is still limited. A prospective, randomized controlled trial was conducted between May 2018 and August 2019. Consecutive patients undergoing pancreatectomy or gastrectomy in our hospital were randomly assigned to the electroacupuncture (EA) group and the control group. The patients in the EA group received transcutaneous EA on Bai-hui (GV20), Nei-guan (PC6), Tian-shu (ST25), and Zu-san-li (ST36) once a day in the afternoon, and the control group received sham EA. Primary outcomes were the time to first flatus and time to first defecation. In total, 461 patients were randomly assigned to the groups, and 385 were analyzed finally (EA group, n = 201; control group, n = 184). Time to first flatus (3.0 ± 0.7 vs 4.2 ± 1.0, P < 0.001) and first defecation (4.2 ± 0.9 vs 5.4 ± 1.2, P < 0.001) in the EA group were significantly shorter than those in the control group. Of patients undergoing pancreatectomy, those undergoing pancreaticoduodenectomy and intraoperative radiation therapy (IORT) surgery benefitted from EA in time to first flatus (P < 0.001) and first defecation (P < 0.001), while those undergoing distal pancreatectomy did not (P flatus=0.157, P defecation=0.007) completely. Of patients undergoing gastrectomy, those undergoing total gastrectomy and distal gastrectomy (Billroth-II) benefitted from EA (P < 0.001), as did those undergoing proximal gastrectomy (P=0.015). Patients undergoing distal gastrectomy (Billroth-I) benefitted from EA in time to first defecation (P=0.012) but not flatus (P=0.051). The time of parenteral nutrition, hospital stay, and time to first independent walk in the EA group were shorter than those in the control group. No severe EA complications were reported. EA was safe and effective in accelerating postoperative gastrointestinal function recovery. Patients undergoing pancreaticoduodenectomy, IORT surgery, total gastrectomy, proximal gastrectomy, or distal gastrectomy (Billroth-II) could benefit from EA. This trial is registered with NCT03291574.

[Analysing the defect of control design of acupuncture: taking RCTs of treating simple obesity with acupuncture for example].

OBJECTIVE: By analysing the defect of control design in randomized controlled trials (RCTs) of simple obesity treated with acupuncture and using acupuncture as the contrast, presenting the essential factors which should be taken into account as designing the control of clinical trial to further improve the clinical research. METHODS: Setting RCTs of acupuncture treating simple obesity as a example, we searched RCTs of acupuncture treating simple obesity with acupuncture control. According to the characteristics of acupuncture therapy, this research sorted and analysed the control approach of intervention from aspects of acupoint selection, the penetration of needle, the depth of insertion, etc, then calculated the amount of difference factor between the two groups and analyzed the rationality. RESULTS: In 15 RCTs meeting the inclusion criterias, 7 published in English, 8 in Chinese, the amount of difference factors between two groups greater than 1 was 6 (40%), 4 published in English abroad, 2 in Chinese, while only 1 was 9 (60%), 3 published in English, 6 in Chinese. CONCLUSION: Control design of acupuncture in some clinical RCTs is unreasonable for not considering the amount of difference factors between the two groups.

[Analyzation of expressive elements for clinical RCT of acupuncture and moxibustion:taking peptic ulcer as an example].

To explore the expressive elements for the clinical randomized controlled trials of acupuncture and moxibustion so as to provide reference for them, taking peptic ulcer as an example. Sixty-six papers from 1996 to 2015 were collected in domestic and overseas databases, including China National Knowledge Infrastructure (CNKI), WANFANG, VIP, China Biology Medicine (CBM), PubMed, Web of Science, Sciencedirect, Springer, Wiley. The expression qualities were evaluated according to the Consolidated Standards of Reporting Trials (CONSORT) and the Standards for Reporting Interventions in Clinical Trials of Acupuncture(STRICTA). We consider that the reports are not sound, especially their preface, trial design and intervention.

[Study of acupoints selection rule on peptic ulcer treated with acupuncture and moxibustion].

OBJECTIVE: To explore the acupoints selection rules on peptic ulcer treated with acupuncture and moxibustion,so as to provide references for acupoints clinical selecting. METHODS: Literature on clinical report and clinical study for peptic ulcer treated with acupuncture and moxibustion was retrieved in CNKI, WANFANG, VIP, CBM, PubMed, Web of Science and other databases from January 1, 2003 to August 31, 2014,and acupoints selecting rules were summarized according to syndromes and symptoms. RESULTS: One hundred and ten articles were acquired, and acupoints the first to the fifth used were Zhongwan (CV 12), Zusanli (ST 36), Weishu (BL 21), Pishu (BL 20) and Neiguan (PC 6). The main acupoints were Zhongwan (CV 12) and Zusanli (ST 36). As to acupoints mainly selected in accordance with different syndromes: (1)Weishu (BL 21), Pishu (BL 20), Neiguan (PC 6) were matched for the syndrome of deficiency cold in the spleen and the stomach. (2) Weishu (BL 21), Pishu (BL 20), Neiguan (PC 6), Geshu (BL 17) were combined for the syndrome of qi stagnation and blood stasis. (3) Weishu (BL, 21), Pishu (BL 20), Qimen (LR 14) for the syndrome of qi stagnation induced by liver depression. (4) Neiguan (PC 6) and Taichong (LR 3) for the syndrome of liver qi invading the stomach. (5) Weishu (BL 21) and Pishu (BL 20) for the syndrome of weakness of the spleen and the stomach. (6) Weishu (BL 21), Pishu (BL 20), Neiguan (PC 6), Gongsun (SP 4) for the syndrome of cold in the stomach. (7) Weishu (BL 21), Pishu (BL 20), Neiguan (PC 6), San yinjiao (SP 6) for the syndrome of yin deficiency in the stomach. (8) Weishu (BL 21), Pishu (BL 20), Neiguan (PC 6), Yinlingquan (SP 9), Ganshu (BL 18) for the syndrome of phlegm and dampness stagnation. As for acupoints majorly selected according to different symptoms, (1) Weishu (BL 21), Pishu (BL 20), Neiguan (PC 6), Taichong (LR 3) were combined for acid regurgitation. (2) Weishu (BL 21), Neiguan (PC 6), Tianshu (ST 25), Gongsun (SP 4) were selected for abdominal distension. (3) Weishu (BL 21), Neiguan (PC 6), Liangqiu (ST 34), Gongsun (SP 4) for unbearable stomach pain. (4) Weishu (BL 21), Pishu (BL 20), Neiguan (PC 6), Qihai (CV 6), Gongsun (SP 4) for lacking in strength. CONCLUSION: We treating peptic ulcer with acupuncture and moxibustion mainly choose Zhongwan (CV 12) and Zusanli (ST 36), and attach importance to acupoints selection based on syndrome and symptom differentiation.