Clinical Observation on the Post-stroke Shoulder Pain and Blood Viscosity Treated by Acupuncture-moxibustion Therapy

Objective： To reveal the therapeutic effect of acupuncmre-moxibustion therapy for the treatment of post-stroke shoulder pain. Methods： Ninety patients with post-stroke shoulder pain were randomized into three groups at ratio of 1：1：1, to receive acupuncture-moxibustion therapy （AM）, acupuncture-moxibustion plus Chinese herbal decoction （AMCH）, and Chinese herbal decoction （CH） respectively. Results： In the comparison of the therapeutic effects and blood viscosity, there was significant difference between the AM and CH group, as well as between the AMCH and CH group （P〈0.01）; the difference was not significant between the AM and AMCH group. Conclusion： Acupuncture-moxibustion is an effective therapy in the treatment of the post-stroke shoulder pain, and it can also reduce the blood viscosity in short-term.

Treatment of 35 Cases with Type 2 Diabetes Mellitus by Acupuncture-moxibustion Therapy

Diabetes mellitus （DM） is a metabolic syndrome, characterized by long-standing hyperglycemia. The incidence of type 2 diabetes is higher than 90%. Treatment of diabetes by acupuncture existed in ancient times, and as early as in Zhen Jiu Jia Yi Jing （A-B Canon of Acupuncture and Moxibustion）, it documented the points selection therapy in treating diabetes. In recent years, according to traditional Chinese medicine （TCM） theory, I treated 35 patients of type 2 diabetes by acupuncture therapy, and now it is reported as follows.

Clinical Observation on Acupuncture-moxibustion Therapy in Treating Ankylosing Spondylitis

Objective： To compare the clinical effects of different acupuncture methods in treating ankylosing spondylitis （AS）. Methods： Sixty patients in accordance with the diagnostic criteria for AS were randomly divided into an observation group （30 cases） and a control group （30 cases）. Patients in the observation group were given warm needling therapy, while that in the control group were treated by electroacupuncture. The effects of the two groups were compared after treatment. Results： The curative rate of the observation group was 40.0%, and the total effective rate was 96.7%; the curative rate of the control group was 10.0%, and the total effective rate was 76.7%. The difference was statistically significant （P〈0.05） Conclusion： As to acupuncture treatment for AS, warming needling moxibustion was significantly more effective than electroacuouncture.

Acupuncture-moxibustion Therapy for Infertility due to Sperm Abnormality

Objective： To observe the clinical efficacy of acupuncture-moxibustion therapy for infertility due to sperm abnormality （SAI）. Methods： We treated a series of 35 cases of SAI with electroacupuncture combined with herb cake-partitioned moxibustion, observing the variation before and after treatment in symptom integral, sperm status, sex hormone and prostate function. Results： After treatment, the patients were remarkably improved in symptom integral, sperm status, sex hormone and prostate function as compared with those prior to treatment. Conclusion： Acupuncture-moxibustion is an effective therapy for SAI.

Case Report of Three Patients with Wei-flaccidity Syndrome Cured by Acupuncture-moxibustion Therapy

Acupuncture-moxibustion therapy has an advantage in treating Wei-flaccidity syndrome resulted from peripheral nerve injuries. We have adopted acupuncture and moxibustion to treat 3 patients with Wei-flaccidity syndrome in clinical practice and now reports as follows.

Effect of Acupuncture-moxibustion Therapy on Sperm Quality in Infertility Patients with Sperm Abnormality

Objective： Working on seminal plasma acid phosphatase, to explore the mechanism by which acupuncture improves sperm quality （concentration, viability and motility） in infertility patients. Methods： A total of 118 patients received acupuncture-moxibustion treatment. Before and 3, and 6 months after the treatment were detected their seminal plasma acid phosphatase, sperm concentration, sperm viability and sperm motility were measured. Results： The differences between before and after treatments in sperm motility and seminal plasma acid phosphatase levels were statistically significant （P〈0.01）. Conclusion： Acupuncture-moxibustion can improve seminal plasma acid phosphatase levels in infertility patients.

Effects of fuzhengbutu acupuncture-moxibustion therapy on walking function in the patients with post-stroke hemiplegia

Objective: To observe the effects of fuzhengbutu(strengthening antipathogenic qi and tonifying the earth)acupuncture-moxibustion therapy on walking function in the patients with post-stroke hemiplegia.Methods: A total of 57 patients with hemiplegia after ischemic stroke treated in our hospital from January2018 through to October 2018 were collected as the study objects. According to random number table,they were divided into a treatment group(29 cases) and a control group(28 cases). In the treatment group, the fuzhengbutu acupuncture-moxibustion therapy combined with rehabilitation treatment was adopted. In the control group, the rehabilitation treatment was given. The persistent walking time and pause time in PIERENSTEP gait measurable training and test system as well as the score of Berg balance scale(BBS) were compared between the two groups.Results: In the treatment group, the persistent walking time after treatment 1.47 ±0.28) s was shorter obviously versus before treatment(2.12 ± 0.38)s, indicating the significant difference(P<0.05). The pause time after treatment was not different obviously versus before treatment(P> 0.05). In the control group,the persistent walking time after treatment(1.88 ± 0.22) s was shorter obviously versus before treatment(2.18 ± 0.30)s, indicating the significant difference(P<0.05). The pause time after treatment was not different obviously versus before treatment(P> 0.05). Before treatment, the differences were not significant in the persistent walking time and pause duration in the patients of either group(P>0.05). After treatment, the persistent walking time in the treatment group was shorter obviously than the control group(P<0.05) and the difference in pause time was not significant between the two groups(P>0.05). Before treatment, there was no difference in BBS score between the two groups(P>0.05). In the treatment group, BBS score(42.79 ±2.78) after treatment was higher than(35.86 ±2.64) before treatment, indicating the significant difference(P<0.05). In the control group, BBS score(39.07 ±2.67) after treatment was higher than(35.86 ±2.64) before treatment, indicating the significant difference(P<0.05). In comparison of BBS score after treatment between the two groups, the score in the treatment group was higher than the control group, indicating the significant difference(P<0.05).Conclusion: Based on rehabilitation treatment, Fuzhengbutu acupuncture-moxibustion therapy effectively improves the walking function of the patients with hemiplegia after ischemic stroke.

Acupuncture-moxibustion therapy of "banking up original qi and consolidating the foundation" for prevention and treatment of seasonal allergic rhinitis:A randomized controlled trial

Objective： To observe the clinical efficacy of acupuncture-moxibustion therapy of ＂banking up original qi and consolidating the foundation＂ for prevention and treatment of seasonal allergic rhinitis.Methods： Sixty included patients were divided into two groups according to the random number table method with 30 patients in each group. In acupuncture group, warming-needle moxibustion was carried out at Zúsānlǐ（足三里ST 36）, and cone moxibustion on Fùzǐ（附子Radix Aconiti Lateralis Praeparata） cake was conducted at Guānyuán（关元CV 4）, Qìhǎi（气海CV 6） and Dàzhuī（大椎GV 14）. The treatment was conducted in May or June（2 months before the onset of rhinitis in this area）. The treatment was carried out for once every other day and three times per week. Treatment for 24 times was considered as 1 course of treatment. No intervention treatment was conducted in control group. The score of rhinitis symptom, the visual analogue scale（VAS） score changes of total nasal symptom score（TNSS） and total non-nasal symptom score（TNNSS） of patients in 2015 and in 2016 were observed, and the clinical efficacy of the two groups was compared.Results：（1） The score of rhinitis symptom, the VAS score changes of TNSS and TNNSS in acupuncture group in 2016 declined when compared with the results in 2015, which were 4.57 ±0.82 vs 9.40 ± 1.89,13.37 ± 4.01 vs 30.80 ±4.77 and 15.93 ±6.30 vs 46.13 ± 9.79（P〈 0.001）, the results in acupuncture group after treatment were lower than that in control group at same time, which were 4.57 ±0.82 vs 7.53 ±2.06,13.37±4.01 vs 27.17±6.84,15.93±6.30 vs 35.53±11.69（all P〈0.001）. According to comparison, there was no obvious difference in the results in control group at the two time points, which were 8.60 ±2.39 vs7.53 ± 2.06, 29.63 ± 6.30 vs 27.17 ± 6.84 and 40.90 ±12.31 vs 35.53± 11.69（all P〉 0.05）.（2） The total effective rate was 96.7%（29/30） in acupuncture group and 10%（3/30） in control group, and the difference was statistically significant（P〈 0.001）.Conclusion： Acupuncture-moxibustion therapy of ＂banking up original qi and consolidating the foundation＂ was effective on prevention and treatment of seasonal allergic rhinitis.

Treatment of spinal cord injury with biomaterials and stem cell therapy in non-human primates and humans

Spinal cord injury results in the loss of sensory,motor,and autonomic functions,which almost always produces permanent physical disability.Thus,in the search for more effective treatments than those already applied for years,which are not entirely efficient,researches have been able to demonstrate the potential of biological strategies using biomaterials to tissue manufacturing through bioengineering and stem cell therapy as a neuroregenerative approach,seeking to promote neuronal recovery after spinal cord injury.Each of these strategies has been developed and meticulously evaluated in several animal models with the aim of analyzing the potential of interventions for neuronal repair and,consequently,boosting functional recovery.Although the majority of experimental research has been conducted in rodents,there is increasing recognition of the importance,and need,of evaluating the safety and efficacy of these interventions in non-human primates before moving to clinical trials involving therapies potentially promising in humans.This article is a literature review from databases(PubMed,Science Direct,Elsevier,Scielo,Redalyc,Cochrane,and NCBI)from 10 years ago to date,using keywords(spinal cord injury,cell therapy,non-human primates,humans,and bioengineering in spinal cord injury).From 110 retrieved articles,after two selection rounds based on inclusion and exclusion criteria,21 articles were analyzed.Thus,this review arises from the need to recognize the experimental therapeutic advances applied in non-human primates and even humans,aimed at deepening these strategies and identifying the advantages and influence of the results on extrapolation for clinical applicability in humans.

Optimizing care for gastric cancer with overt bleeding:Is systemic therapy a valid option?

Gastric cancer(GC)and gastroesophageal junction cancer(GEJC)represent a significant burden globally,with complications such as overt bleeding(OB)further exacerbating patient outcomes.A recent study by Yao et al evaluated the effectiveness and safety of systematic treatment in GC/GEJC patients presenting with OB.Using propensity score matching,the study balanced the comparison groups to investigate overall survival and treatment-related adverse events.The study's findings emphasize that systematic therapy can be safe and effective and contribute to the ongoing debate about the management of advanced GC/GEJC with OB,highlighting the complexities of treatment decisions in these high-risk patients.

Human induced pluripotent stem cell-derived therapies for regeneration after central nervous system injury

In recent years,the progression of stem cell therapies has shown great promise in advancing the nascent field of regenerative medicine.Considering the non-regenerative nature of the mature central nervous system,the concept that“blank”cells could be reprogrammed and functionally integrated into host neural networks remained intriguing.Previous work has also demonstrated the ability of such cells to stimulate intrinsic growth programs in post-mitotic cells,such as neurons.While embryonic stem cells demonstrated great potential in treating central nervous system pathologies,ethical and technical concerns remained.These barriers,along with the clear necessity for this type of treatment,ultimately prompted the advent of induced pluripotent stem cells.The advantage of pluripotent cells in central nervous system regeneration is multifaceted,permitting differentiation into neural stem cells,neural progenitor cells,glia,and various neuronal subpopulations.The precise spatiotemporal application of extrinsic growth factors in vitro,in addition to microenvironmental signaling in vivo,influences the efficiency of this directed differentiation.While the pluri-or multipotency of these cells is appealing,it also poses the risk of unregulated differentiation and teratoma formation.Cells of the neuroectodermal lineage,such as neuronal subpopulations and glia,have been explored with varying degrees of success.Although the risk of cancer or teratoma formation is greatly reduced,each subpopulation varies in effectiveness and is influenced by a myriad of factors,such as the timing of the transplant,pathology type,and the ratio of accompanying progenitor cells.Furthermore,successful transplantation requires innovative approaches to develop delivery vectors that can mitigate cell death and support integration.Lastly,host immune responses to allogeneic grafts must be thoroughly characterized and further developed to reduce the need for immunosuppression.Translation to a clinical setting will involve careful consideration when assessing both physiologic and functional outcomes.This review will highlight both successes and challenges faced when using human induced pluripotent stem cell-derived cell transplantation therapies to promote endogenous regeneration.

Acupuncture-moxibustion in treating irritable bowel syndrome: How does it work?

Irritable bowel syndrome (IBS) is a functional intestinal disease characterized by abdominal pain or discomfort and altered bowel habits. It has drawn great attention because of its high prevalence, reoccurring symptoms, and severe influence on patients&#x02019; lives. Many clinical studies have demonstrated the efficacy of acupuncture-moxibustion in treating IBS. Increasing attention has been paid to research regarding the action mechanisms of acupuncture-moxibustion for IBS, and the adoption of modern techniques has achieved some progress. This article reviews the latest advances among action mechanism studies from the perspectives of gastrointestinal motility, visceral hypersensitivity, the brain-gut axis, the neuroendocrine system, and the immune system. It is shown that acupuncture-moxibustion can effectively regulate the above items, and thus, this treatment should have a high efficacy in the treatment of IBS. This article also identifies existing problems in current mechanism research and raises several ideas for future studies. Further revelations regarding these action mechanisms will promote the application of acupuncture-moxibustion in treating IBS.

Neoadjuvant therapy for pancreas cancer: Past lessons and future therapies

Pancreatic adenocarcinoma remains a most deadly malignancy, with an overall 5-year survival of 5%. A subset of patients will be diagnosed with potentially resectable disease, and while complete surgical resection provides the only chance at cure, data from trials of postoperative chemoradiation and/or chemotherapy demonstrate a modest survival advantage over those patients who undergo resection alone. As such, most practitioners believe that completion of multimodality therapy is the optimal treatment. However, the sequence of surgery, chemotherapy and radiation therapy is frequently debated, as patients may benefit from a neoadjuvant approach by initiating chemotherapy and/or chemoradiation prior to resection. Here we review the rationale for neoadjuvant therapy, which includes a higher rate of completion of multimodality therapy, minimizing the risk of unnecessary surgical resection for patients who develop early metastatic disease, improved surgical outcomes and the potential for longer overall survival. However, there are no prospective, randomized studies of the neoadjuvant approach compared to a surgeryfirst strategy; the established and ongoing investigations of neoadjuvant therapy for pancreatic cancer are discussed in detail. Lastly, as the future of therapeutic regimens is likely to entail patient-specific genetic and molecular analyses, and the treatment that is best applied based on those data, a review of clinically relevant biomarkers in pancreatic cancer is also presented.

When combination therapy isn't working: Emerging therapies for the management of inflammatory bowel disease

Although antagonists of tumor necrosis factor have resulted in major therapeutic benefits in inflammatory bowel disease, the magnitude and durability of response are variable. Similar to previously available drugs such as 5-aminosalicylates and immunomodulators, the therapeutic effect is not universal leaving many people searching for options. The development of newer agents has benefited from advances in the understanding of the pathophysiology of the disease. Uncontrolled activation of the acquired immune system has an important role, and lymphocytes, cytokines, and adhesion molecules are broadly targeted for therapeutic intervention. There is increasing evidence of an important role of the innate immune system and the intestinal epithelium, and the therapeutic paradigm is also shifting from immunosuppression to the reinforcement of the intestinal barrier, and modification of the disease process. In this review, we explore the limitation of current therapy as well as mechanisms of actions of new drugs and the efficacy and adverse events from data from clinical trials.

Loco-regional therapies for patients with hepatocellular carcinoma awaiting liver transplantation: Selecting an optimal therapy

Hepatocellular carcinoma(HCC) is a common, increasingly prevalent malignancy. For all but the smallest lesions, surgical removal of cancer via resection or liver transplantation(LT) is considered the most feasible pathway to cure. Resection- even with favorable survival- is associated with a fairly high rate of recurrence, perhaps since most HCCs occur in the setting of cirrhosis. LT offers the advantage of removing not only the cancer but the diseased liver from which the cancer has arisen, and LT outperforms resection for survival with selected patients. Since time waiting for LT is time during which HCC can progress, locoregional therapy(LRT) is widely employed by transplant centers. The purpose of LRT is either to bridge patients to LT by preventing progression and waitlist dropout, or to downstage patients who slightly exceed standard eligibility criteria initially but can fall within it after treatment. Transarterial chemoembolization and radiofrequency ablation have been the most widely utilized LRTs to date, with favorable efficacy and safety as a bridge to LT(and for the former, as a downstaging modality). The list of potentially effective LRTs has expanded in recent years, and includes transarterial chemoembolization with drug-eluting beads, radioembolization and novel forms of extracorporal therapy. Herein we appraise the various LRT modalities for HCC, and their potential roles in specific clinical scenarios in patients awaiting LT.

Advances in radiotherapy and targeted therapies for rectal cancer

The last decade witnessed a significant progress in understanding the biology and immunology of colorectal cancer alongside with the technical innovations in radiotherapy.The stepwise implementation of intensitymodulated and image-guided radiation therapy by means of megavolt computed tomography and helical tomotherapy enabled us to anatomically sculpt dose delivery,reducing treatment related toxicity.In addition,the administration of a simultaneous integrated boost offers excellent local control rates.The novel challenge is the development of treatment strategies for medically inoperable patient and organ preserving approaches.However,distant control remains unsatisfactory and indicates an urgent need for biomarkers that predict the risk of tumor spread.The expected benefit of target?ed therapies that exploit the tumor genome alone is so far hindered by high cost techniques and pharmaceuticals,hence hardly justifying rather modest improvements in patient outcomes.On the other hand,the immune landscape of colorectal cancer is now better clarified with regard to the immunosuppressive network that promotes immune escape.Both N2 neutrophils and myeloid-derived suppressor cells(MDSC)emerge as useful clinical biomarkers of poor prognosis,while the growing list of anti-MDSC agents shows promising ability to boost antitumor T-cell immunity in preclinical settings.Therefore,integration of genetic and immune biomarkers is the next logical step towards effective targeted therapies in the context of personalized cancer treatment.

Combining chemotherapy and targeted therapies in metastatic colorectal cancer

Colorectal cancer remains one of the major causes of cancer death worldwide. During the past years, the development of new effective treatment options has led to a considerable improvement in the outcome of this disease. The advent of agents such as capecitabine, irinotecan, oxaliplatin, cetuximab and bevacizumab has translated into median survival times in the range of 2 years. Intense efforts have focused on identifying novel agents targeting specific growth factor receptors, critical signal transduction pathways or mediators of angiogenesis. In addition, several clinical trials have suggested that some of these molecularly targeted drugs can be safely and effectively used in combination with conventional chemotherapy. In this article we review various treatment options combining cytotoxic and targeted therapies currently available for patients with metastatic colorectal cancer.

Revolutionizing gastric cancer treatment:The potential of immunotherapy

Gastric cancer,a prevalent malignancy worldwide,ranks sixth in terms of frequency and third in fatality,causing over a million new cases and 769000 annual deaths.Predominant in Eastern Europe and Eastern Asia,risk factors include family medical history,dietary habits,tobacco use,Helicobacter pylori,and Epstein-Barr virus infections.Unfortunately,gastric cancer is often diagnosed at an advanced stage,leading to a grim prognosis,with a 5-year overall survival rate below 5%.Surgical intervention,particularly with D2 Lymphadenectomy,is the mainstay for early-stage cases but offers limited success.For advanced cases,the National Comprehensive Cancer Network recommends chemotherapy,radiation,and targeted therapy.Emerging immunotherapy presents promise,especially for unresectable or metastatic cases,with strategies like immune checkpoint inhibitors,tumor vaccines,adoptive immunotherapy,and nonspecific immunomodulators.In this Editorial,with regards to the article“Advances and key focus areas in gastric cancer immunotherapy:A comprehensive scientometric and clinical trial review”,we address the advances in the field of immunotherapy in gastric cancer and its future prospects.

Pathologically successful conversion hepatectomy for advanced giant hepatocellular carcinoma after multidisciplinary therapy:A case report and review of literature

BACKGROUND Hepatocellular carcinoma(HCC)is one of the leading causes of death due to its complexity,heterogeneity,rapid metastasis and easy recurrence after surgical resection.We demonstrated that combination therapy with transcatheter arterial chemoembolization(TACE),hepatic arterial infusion chemotherapy(HAIC),Epclusa,Lenvatinib and Sintilimab is useful for patients with advanced HCC.CASE SUMMARY A 69-year-old man who was infected with hepatitis C virus(HCV)30 years previously was admitted to the hospital with abdominal pain.Enhanced computed tomography(CT)revealed a low-density mass in the right lobe of the liver,with a volume of 12.9 cm×9.4 cm×15 cm,and the mass exhibited a“fast-in/fast-out”pattern,with extensive filling defect areas in the right branch of the portal vein and an alpha-fetoprotein level as high as 657 ng/mL.Therefore,he was judged to have advanced HCC.During treatment,the patient received three months of Epclusa,three TACE treatments,two HAIC treatments,three courses of sintilimab,and twenty-one months of lenvatinib.In the third month of treatment,the patient developed severe side effects and had to stop immunotherapy,and the Lenvatinib dose had to be halved.Postoperative pathological diagnosis indicated a complete response.The patient recovered well after the operation,and no tumor recurrence was found.CONCLUSION Multidisciplinary conversion therapy for advanced enormous HCC caused by HCV infection has a significant effect.Individualized drug adjustments should be made during any treatment according to the patient's tolerance to treatment.

Immunotherapy for esophageal cancer:Where are we now and where can we go

Immune checkpoint inhibitor therapy has dramatically improved patient prognosis,and thereby transformed the treatment in various cancer types including esophageal squamous cell carcinoma(ESCC)in the past decade.Monoclonal antibodies that selectively inhibit programmed cell death-1(PD-1)activity has now become standard of care in the treatment of ESCC in metastatic settings,and has a high expectation to provide clinical benefit during perioperative period.Further,anti-cytotoxic T-lymphocyte–associated protein 4(CTLA-4)monoclonal antibody has also been approved in the treatment of recurrent/metastatic ESCC in combination with anti-PD-1 antibody.Well understanding of the existing evidence of immune-based treatments for ESCC,as well as recent clinical trials on various combinations with chemotherapy for different clinical settings including neoadjuvant,adjuvant,and metastatic diseases,may provide future prospects of ESCC treatment for better patient outcomes.