The Effects of Electroacupuncture as an Adjunct Therapy on Poststroke Aphasia: A Systematic Review and Meta-Analysis.

Background: To systematically collate, appraise, and synthesize evidence of electroacupuncture (EA) as an adjunct therapy for poststroke aphasia (PSA) from randomized controlled trials (RCTs) through a systematic review and meta-analysis. Methods: An electronic search was conducted in eight databases to identify RCTs evaluating EA adjuvant therapy versus speech and language therapy (SLT). Methodological quality of the included trails was assessed by the Cochrane risk of bias. The software Review Manager 5.4 was used for data analysis. Results: Nineteen RCTs enrolling a total of 1263 subjects were identified. The use of EA combined with speech and language therapy (SLT) showed significant improvements in effective rate (RR 1.31, 95% CI [1.21, 1.41]), oral expression score (SMD 1.34, 95% CI [1.13, 1.56]), comprehension score (SMD 1.95, 95% CI [0.88, 3.03]), repetition score (SMD 1.84, 95% CI [0.75, 2.93]), naming score (SMD 1.97, 95% CI [0.81, 3.13]), and reading score (SMD 1.55, 95% CI [1.07, 2.04]) compared to the use of SLT alone. Conclusions: The pooled data indicate that EA combined with SLT for the treatment of PSA may improve clinical effectiveness, compared with SLT alone. Future high quality RCTs with large samples are still needed to confirm and expand our findings.

Ginsenoside Rh2 inhibits thyroid cancer cell migration and proliferation via activation of miR-524-5p.

INTRODUCTION: Thyroid cancer is an important disease that threatens the health of humans. Ginsenoside Rh2 is known as an anticancer molecule; however, its function in thyroid cancer cells has not been reported. In the present study, we identified that Rh2 treatment of the thyroid cancer cell line K1 inhibited cell migration and proliferation. MATERIAL AND METHODS: We determined the Rh2 function in thyroid cancer cell lines. By RT-PCR, expression of miR-524-5p and related genes were determined. The cell phenotype including cell migration and proliferation were detected after serials treatment. The relevant protein level were checked by Western blot. RESULTS: Interestingly, we observed that miR-524-5p, a type of miRNA, had lower expression in the thyroid cancer cell lines TPC-1, K1, and NPA than in the normal thyroid cell line Nthyri3-1. Additionally, Rh2 treatment induced miR-524-5p expression. Further examination using overexpression of miR-524-5p identified that the miR-524-5p mimic inhibited cell migration and proliferation of the K1 line. Similar to Rh2-treated cells, the miR-524-5p mimic-expressing cells had increased E-cadherin and reduced vimentin levels compared to the control cells. Next, we examined the relationship between Rh2 and miR-524-5p with respect to thyroid cell migration and proliferation. Treatment with Rh2 and miR-524-5p inhibitor suppressed Rh2 action on K1 thyroid cell migration and proliferation, and the rates were similar to those in control cells, suggesting that Rh2 might induce miR-524-5p expression to inhibit thyroid cancer cell migration and proliferation. CONCLUSIONS: Our analyses identified Rh2 and miR-524-5p action on thyroid cancer cell migration and proliferation as well as the linkage between Rh2 and miR-524-5p in thyroid cancer cell development.

Impact of the Result of Continued Thrombolysis After Stenting Following Pharmacomechanical Thrombectomy for Iliofemoral Deep Vein Thrombosis-A Retrospective Study.

OBJECTIVE: The aim of this study is to compare the procedure and treatment outcomes of using either direct stenting alone following pharmacomechanical thrombectomy or continued catheter-directed thrombolysis after stenting for treatment of acute left iliofemoral deep vein thrombosis while clot removal degree achieved grade III. METHODS: From March 2018 to May 2019, 82 patients who underwent iliac venous stenting for treatment of acute left iliofemoral deep vein thrombosis with iliac vein stenosis after pharmacomechanical thrombectomy therapy using the AngioJet system while Clot removal degree achieved grade III were divided into two groups: Direct stenting alone group (n = 39) and continued catheter-directed thrombolysis after stenting group (n = 43). Comparisons were made regarding the treatment outcomes, stent patency rate, and Villalta scale between these two groups. RESULTS: No serious perioperative complications occurred. The mean urokinase dose and hospitalization time in the stenting alone group and continued catheter-directed thrombolysis after the stenting group were 0.30 million U versus 1.76 ± 0.54 million U and 4.85 ± 0.93 days versus 6.33 ± 1.02 days, (P < .001). In the first 30 days after the operation, there were 3 recurrent episodes of deep vein thrombosis in the stenting alone group (P = 0.064). Each patient has completed at least one year of follow-up, the mean follow-up was 15.95 ± 3.44 months. Overall cumulative stent patency rates were 87.2% in stenting alone group and 97.7% in continued catheter-directed thrombolysis after stenting group at 12months (P = 0.037). The Villalta scores at 12 months had a significant difference between the two groups. The mean Villalta scores in the stenting alone group and continued catheter-directed thrombolysis after the stenting group were 4.44 ± 1.63 and 1.63 ± 1.29, respectively (P < 0.001). CONCLUSION: When the clot removal degree of pharmacomechanical thrombectomy thrombectomy reaches grade III, both stenting alone and continued catheter-directed thrombolysis after stenting are effective treatment modalities. For young patients with low bleeding risk, continued catheter-directed thrombolysis after stenting has a better patency rate and a lower 1-year post-thrombotic syndrome risk and does not increase major bleeding events. However, it may increase the time and costs of hospitalization accordingly.

Clinical Outcomes of Stenting Extending Below the Inguinal Ligament for Treatment of Chronic Iliofemoral Venous Obstruction.

BACKGROUND: Patients with chronic iliofemoral venous obstructive lesions that often require stenting extending below the inguinal ligament. However, the issue of stents crossing the inguinal ligament is currently controversial. Some guidelines suggest that it should be avoided, and some guidelines suggest that in order to ensure adequate flow, the inguinal ligament can be crossed if necessary. The aim of this study was to evaluate the technical aspects and examine patency rates of stent placement across the inguinal ligament for managing iliofemoral venous obstruction. METHODS: A retrospective analysis of 127 patients with chronic iliofemoral venous obstruction were treated with interventional surgery in a single institution from January 2012 to January 2018 was conducted. All patients underwent balloon dilatation and placement of at least 2 stents extending below inguinal ligament. Inflow condition, technical success, operation duration, stent patency rates, anticoagulant selection and duration, and complications were recorded after the interventions. RESULTS: The technical success rate was 100%. No major perioperative complications occurred. The mean number of stents was 2.14 ± 0.37. Follow up periods ranged from 12 to 60 months (28.79 ± 10.90 months). Overall cumulative primary, assisted primary, and secondary stent patency rates were 81.9%, 90.5%, and 92.9% at 12 months and 70.4%, 80.9%, and 86.0% at 24 months, and 64.2%, 72.3%, and 74.3% at 36months, respectively. Cumulative patency rates at 12 months, 24 months and 36 months were significantly greater in the patients with "good" inflow as compared to "fair" inflow. The symptoms of all patients improved. None of the stents were compressed, fractured or migrated. CONCLUSIONS: Stenting across the inguinal ligament for treatment of the patients with chronic iliofemoral venous obstruction was a feasible and safe treatment with good patency and clinical results in short and midterm follow up, and stents with good inflow have better patency.

Endovascular treatment for long segment iliac artery occlusion involving the iliac artery opening.

OBJECTIVE: This retrospective nonrandomized study investigated the outcomes of endovascular therapy for long-segment iliac artery occlusion involving the iliac artery opening. METHODS: During a 5-year period (from Mar 2012 to Mar 2017), 32 patients (two women and 30 men; mean age, 69.0 years; range, 51-90 years) received endovascular therapy, with or without catheter-directed thrombolysis (CDT), for long-segment iliac artery occlusion (mean lesion length, 129.8 mm; range, 74.7-189.3 mm). RESULTS: The technical success rate was 90.6% (29 of 32). The major complication rate was 3.5%, but no in-hospital mortality was recorded. The access site complication rate was 10.3%. The clinical symptoms of 29 patients were significantly improved. All 29 patients were followed up for 6-40 months, with an average of 16.7 ± 10.9 months. The primary patency rates were 96.6 ± 3.4% at 6 months, 86.6 ± 7.3% at 12 months, 79.4 ± 9.6% at 24 months, and 66.2 ± 14.5% at 36 months. CONCLUSIONS: Depending on the characteristics of the disease, endovascular treatment with an individualized, rational choice of approach and with fine-tuning of the operation is a safe and effective treatment for long-term iliac artery occlusion involving the opening of the iliac arteries. Customization of the treatment is also the key to a successful operation and to ensuring good postoperative efficacy.

MicroRNA-524-5p suppresses the progression of papillary thyroid carcinoma cells via targeting on FOXE1 and ITGA3 in cell autophagy and cycling pathways.

MicroRNAs are beneficial for cancer therapy as they can simultaneously downregulate multiple targets involved in diverse biological pathways related to tumor development. In papillary thyroid cancer, many microRNAs were identified as differentially expressed factors in tumor tissues. In another way, recent studies revealed cell proliferation, cell cycling, apoptosis, and autophagy are critical pathways controlling papillary thyroid cancer development and progression. As miR-524-5p was approved as a cancer suppressor targeting multiple genes in several types of cancer cells, this study aims to characterize the role of miR-524-5p in the thyroid cancer cell. The expression of miR-524-5p was decreased in the papillary thyroid cancer tissues and cell lines, while forkhead box E1 (FOXE1) and ITGA3 were increased. In the clinical case, expression of miR-524-5p, FOXE1, and ITGA3 were significantly correlated with papillary thyroid cancer development and progression. FOXE1 and ITGA3 were approved as direct targets of miR-524-5p. miR-524-5p could inhibit papillary thyroid cancer cell viability, migration, invasion, and apoptosis through targeting FOXE1 and ITGA3. Cell cycling and autophagy pathways were disturbed by downregulation of FOXE1 and ITGA3, respectively. Collectively, miR-524-5p targeting on FOXE1 and ITGA3 prevents thyroid cancer progression through different pathways including cell cycling and autophagy.

Endovascular Repair of a Large Abdominal Aortic Aneurysm in a Patient Presenting with Lower Extremity Edema as a Result of Inferior Vena Cava Thrombosis.

PURPOSE: Abdominal aortic aneurysm (AAA) can present with symptoms because of aneurysmal compression of adjacent organ systems. This condition has always been treated by open surgical repair. Here, we report a case of an AAA complicated by inferior vena cava (IVC) thrombosis and deep venous thrombosis (DVT) due to IVC compression by aneurysm successfully treated by endovascular aneurysm repair (EVAR). CASE REPORT: A 50-year-old man was presented with 3-day right lower extremity edema. He was diagnosed with acute DVT and IVC thrombosis initially. Anticoagulation therapy and catheter-directed thrombolysis under the protection of IVC filter were performed. Subsequent imaging revealed a 9.5-cm infrarenal AAA compressing the IVC. The patient was transferred to our hospital and underwent EVAR successfully. CONCLUSIONS: EVAR is a viable treatment option for patients with an AAA complicated by IVC thrombosis and DVT due to IVC compression by aneurysm.

Depletion of G9a gene induces cell apoptosis in human gastric carcinoma.

G9a is a mammalian histone methyltransferase that contributes to the epigenetic silencing of tumor suppressor genes. Evidence suggests that G9a is required to maintain the malignant phenotype, but little documentation show the role of G9a function in mediating tumor growth. We retrospectively analyzed the protein of G9a and monomethylated histone H3 lysine 9 (H3K9 me1), and dimethylated histone H3 lysine 9 (H3K9 me2) in 175 cases of gastric carcinoma by immunohistochemistry. RNAi-based inhibition of G9a in MGC803 cancer cell line was studied. G9a depletion was done by transient transfection using Lipofectamine 2000. Depletion efficiency of G9a was tested using real-time PCR and western blot analysis. Cell apoptosis and proliferation were detected by TUNEL assay and MTT, respectively. The proteins of H3K9 me1, me2, trimethylation of H3K9 (H3K9 me3), monomethylated histone H3 lysine 27 (H3K27 me1), dimethylated histone H3 lysine 27 (H3K27 me2) and histone acetylated H3, apoptotic proteins were studied by western blot analysis. G9a and H3K9 me2 expression was higher in gastric cancer cells compared to the control (p<0.05). Both G9a and H3K9 me2 were positively correlated with the degree of differentiation, depth of infiltration, lymphatic invasions and tumor-node-metastasis stage in gastric carcinoma, (p<0.05). RNAi-mediated knockdown of G9a induced cell apoptosis and inhibited cell proliferation. Depletion of G9a reduced the levels of H3K9 me1 and me2, H3K27 me1 and me2. Nonetheless, it did not activate acetylation of H3 and H3K9 me3. These data suggest that G9a is required in tumorigenesis, and correlated with prognosis. Furthermore, G9a plays a critical role in regulating epigenetics. Depletion of G9a inhibits cell growth and induces cells apoptosis in gastric cancer. It might be of therapeutic benefit in gastric cancers.

[Effects of electroacupuncture on learning-memory ability and expression of hippocampal vascular endothelial growth factor (VEGF), VEGF receptor 1 and 2 genes in vascular cognitive impairment rats].

OBJECTIVE: To observe the effect of electroacupuncture (EA) of "Dazhui" (GV 14), "Baihui" (GV 20), etc. on learning-memory ability and expression of vascular endothelial growth factor (VEGF) mRNA, VEGF receptor 1 (VEGFR-1/Flt-1) mRNA, and VEGFR-2 (Flk-1) mRNA in the hippocampus in vascular cognitive impairment (VCI) rats so as to reveal its mechanism underlying improvement of VCI. METHODS: A total of 60 Wistar rats were randomly divided into sham operation, VCI model, EA and medication groups (n=12 in each group). The VCI model was established by occlusion of the bilateral vertebral arteries and bilateral cervical arteries. EA (2 Hz/20 Hz) was applied to "Baihui" (GV 20), "Dazhui" (GV 14), "Shuigou" (GV 26) and "Shenting" (GV 24) for 20 min, once daily for 20 days. Rats of the medication group were treated by intragastric perfusion of Aniracetam capsules (0.0625 g/kg),once daily for 20 days. The rats' learning-memory ability was detected by step-down test. The expression levels of VEGF mRNA, Flt-1 mRNA and Flk-1 mRNA in the hippocampus were detected by RT-PCR, and the neurological deficit scores were assessed by Zea Longa (0-4 scaling) method. RESULTS: Compared with the sham operation group, rats of the model group showed a significant increase in reaction time and error number and decrease of escape latency (reduction of learning-memory ability), and increase in neurological deficit score, and in expression levels of hippocampal VEGF mRNA, Flt-1 mRNA and Flk-1 mRNA (all P<0.01). After EA treatment, in comparison with the model group, the learning-memory ability and hippocampal VEGF mRNA, Flt-1 mRNA and Flk-1 mRNA were apparently increased, neurological deficit score were markedly decreased in the EA group (all P<0.01). The effects of EA treatment was obviously superior to those of medication in raising learning-memory ability and up-regulating hippocampal VEGF mRNA and Flt-1 mRNA expression levels, and in reducing neurological deficit score (all P<0.05). CONCLUSION: EA intervention can apparently up-regulate hippocampal VEGF mRNA, Flt-1 mRNA and Flk-1 mRNA expression in VCI rats, which may contribute to its effect in improving learning-memory ability, possibly by promoting neovasculization.

Aberrant histone methylation and the effect of Suv39H1 siRNA on gastric carcinoma.

The present study aimed to investigate the involvement of the Suv39H1 histone methyltransferase in the epigenetic changes in the euchromatic promoter in gastric carcinoma. We retrospectively analyzed the protein of Suv39H1 and tri-methylated histone H3 lysine 9 (H3K9) and histone H3 lysine 4 (H3K4) in 175 cases of gastric carcinoma by immunohistochemistry. Suv39H1 was depleted by siRNA, and cell apoptosis and cell proliferation were assessed by TUNEL and MTT assays, respectively. Histone methylated H3K9 and histone acetylated H3 and H4 were evaluated by western blotting. We found that the expression of Suv39H1 and tri-methylated H3K9 in gastric carcinoma was higher than that in benign gastric diseases (p<0.05). Tri-methylated H3K4 was similar in both tissue types (p>0.05). Both Suv39H1 and tri-methylated H3K9 were positively correlated with the degree of differentiation, depth of infiltration and lymphatic invasion (p<0.05) in gastric carcinoma. In addition, tri-methylated H3K9 was positively correlated with tumor stage, and node and metastatic statuses (p<0.05). Activation of Suv39H1 and overexpression of H3K9 tri-methylation may play an important role in tumorigenesis. They may be useful as a predictor for poor prognosis in gastric carcinoma. Silencing of the Suv39H1 gene decreased tri-methylated H3K9 and increased histone H3 acetylation, which caused activation of gene transcription, while there was no change in histone H4 acetylation. Depletion of Suv39H1 induced apoptosis and inhibited cell proliferation in the gastric cancer MGC803 cell line, while decreasing BCL-2, pro-caspase-9, pro-caspase-3 and C-myc. Suv39H1 may be a potential gene target for anti-gastric carcinoma therapy.

[Impact of hemocoagulase on coagulatory function and deep venous thrombosis after abdominal surgery].

OBJECTIVE: To investigate the impact of hemocoagulase on coagulatory function and deep venous thrombosis after abdominal surgery. METHODS: From June 2008 to January 2009, 60 cases (gastric cancer 20 cases, colonic cancer 40 cases) undergoing gastrointestinal surgery at the Union Hospital of Fujian Medical University were randomized to the hemocoagulase group and the control group(n=30 in each group). Intravenous hemocoagulase at a daily dose of 2U was used on the same day and the next day postoperatively in the hemocoagulase group. D-dimer(D-D), tissue plasminogen activator(t-PA), plasminogen activator inhibitor-1(PAI-1), PT, APTT, TT, platelet count were measured before and after operation. Doppler ultrasound examination was carried out to exclude deep venous thrombosis on the 5th to 7th days after operation. RESULTS: Significant increased D-D, t-PA, PAI-1, prolonged PT, APTT, shortened TT and lower platelet count after surgery were noticed as compared to the baseline in both groups(P<0.05, P<0.01). PT, APTT, D-D, t-PA, and PAI-1 significantly increased, and TT significantly shortened in the hemocoagulase group as compared to the control group after surgery(P<0.05, P<0.01). Deep venous thrombosis in the left lower limbs was noticed in 7 patients(23.3%) in the hemocoagulase group and 3 cases(10.0%) in the control group, however the difference was not statistically significant(P>0.05). CONCLUSIONS: Hypercoagulable state usually appears after abdominal surgery and use of hemocoagulase may aggravate hypercoagulability and increase the incidence of deep venous thrombosis in lower limbs after abdominal surgery. Preventative use of hemocoagulase must be administered with caution.

[Simple analysis on professor ZHANG Dao-Zong's academic thought of dredging the Governor Vessel and regulating mentality].

Introduce Professor Zhang Dao-zong's studies on the Governor Vessel and its academic thought of dredging the Governor Vessel and regulating mentality, and clinical experiences of dredging the Governor Vessel and regulating mentality therapy for apoplexy, epilepsy, vertigo, ankynosing spondylitis, traumatic paraplegia, child Tourette's disease, etc....