EGFR gene copy number as a predictive biomarker for resistance to anti-EGFR monoclonal antibodies in metastatic colorectal cancer treatment:a meta-analysis

Objective：The epidermal growth factor receptor （EGFR） inhibitors monoclonal antibodies （MoAbs） have already shown the therapeutic effectiveness in patients with metastatic colorectal cancer （mCRC）.But many patients resist to the treatment.The aim of this meta-analysis was to assess EGFR gene copy number （GCN） as a candidate predictive biomarker for resistance to anti-EGFR MoAbs in mCRC treatment.Methods：Systematic computerized searches of the PubMed,EMBase and Cochrane Library were performed.The primary endpoint was objective response rate （ORR）.The second endpoints included progression-free survival （PFS）,and overall survival （OS）.The pooled odd ratio （OR） and pooled sensitivity,specificity,and summary receiver operator characteristic （SROC） for ORR were estimated.The pooled hazard ratios （HR） for PFS and OS were also calculated.Results：Fourteen studies with 1,021 patients were included.Increased EGFR GCN was associated with increased ORR （OR=6.905; 95％ CI：4.489-10.620）.It was also found in wild-type KRAS mCRC patients,with the pooled OR of 8.133 （95 ％ CI：4.316-15.326）.GCN has medium value for predicting ORR,with the pooled sensitivity of 0.79 （95％ CI：0.73-0.84）,the pooled specificity of 0.59 （95％ CI：0.55-0.62）.In wildtype KRAS mCRC patients,the sensitivity and the specificity were 0.80 （95％ CI：0.70-0.87） and 0.60 （95％CI：0.53-0.66）,respectively.Increased EGFR GCN was associated with increased PFS （HR=0.557; 95％ CI：0.382-0.732） and OS （HR=0.579; 95％ CI：0.422-0.737）.Conclusions：This meta-analysis suggests that EGFR GCN represents a predictive biomarker for tumor response in mCRC patients treated with MoAbs regardless of KRAS mutation.mCRC patients with increased EGFR GCN are more likely to have a better response,PFS,and OS when treated with cetuximab or panitumumab.

XRCC1 Polymorphisms and Pancreatic Cancer:A Meta-Analysis

Objective：To assess the association between X-ray repair cross-complementating group 1 （XRCC1） polymorphisms and pancreatic cancer.Methods：We searched MEDLINE,Web of Science and HuGE Navigator at June 2010,and then quantitatively summarized associations of the XRCC1 polymorphisms with pancreatic cancer risk using meta-analysis.Results：Four studies with 1343 cases and 2302 controls were included.Our analysis found：at codon 194,the Trp allele did not decrease pancreatic cancer risk （Arg/Arg versus Trp/Trp：OR=0.97;95% CI：0.48-1.96;P=0.97;Arg/Arg versus Arg/Trp：OR=0.89;95% CI：0.70-1.13;P=0.55;Arg/Trp versus Trp/Trp：OR=1.06;95% CI：0.52-2.16;P=0.90）;at codon 280,only a study showed a nonsignificant association between single nucleotide polymorphism with pancreatic cancer risk;at codon 399,the Gln allele also showed no signi？cant effect on pancreatic cancer compared to Arg allele （Arg/Arg versus Gln/Gln：OR=0.94;95% CI：0.74-1.18;Arg/Arg versus Arg/Gln：OR=0.97;95% CI：0.83-1.13;Arg/Gln versus Gln/Gln：OR=0.97;95% CI：0.77-1.22）.The shape of the funnel plot and the Egger＇s test did not detect any publication bias.Conclusion：There is no evidence that XRCC1 polymorphisms （Arg194Trp,Arg280His,and Arg399Gln） are associated with pancreatic cancer risk.

Transcutaneous acupoint electrical stimulation(TAES)for pre-operative anxiety:a prospective observational pilot investigation

Objective:Transcutaneous acupoint electrical stimulation(TAES)treatment is effective for post-operative anxiety.The investigation was designed to study the feasibility and effectiveness of TAES treatment for pre-operative anxiety.Methods:62 volunteered surgical patients were included in the pilot investigation.They all received TAES treatment for 30 minutes in the evening of the day before operation.Hegu(LI4)and Neiguan(PC6)of both sides were selected as the treatment acupoints.The anxiety degrees were measured by State-Trait Anxiety Inventory.Heart rate and blood pressure were also recorded.Results:After TAES,pre-operative anxiety measured by State-Trait Anxiety Inventory dropped by almost 12%,and both heart rate and systolic blood pressure decreased significantly.Conclusion:The pilot investigation of TAES for pre-operative anxiety can successfully test the feasibility of outcome measurements and provide necessary data for calculating the sample size of a subsequent randomized controlled trial.

Hazards of insomnia and the effects of acupuncture treatment on insomnia

Insomnia is a common disease in modern society; it is made worse by increasingly fierce competition in the workplace and elsewhere, along with rapid economic and social development. Sleep disorders can result in changes in serum biomarkers and decreased immunity, and may cause maladies such as depression and cardiac diseases, as well as many other somatic symptoms. Western medications for treating insomnia can easily lead to addiction and other adverse effects. Fortunately, acupuncture can ease the symptoms of insomnia. This review summarizes the hazards associated with insomnia and the use of acupuncture in its treatment. Furthermore, the authors introduce an effective and lowcost method of treating insomnia with acupuncture. This review indicates that insomnia poses a major threat to mental health through its effects on serum components, heart function and the immune system of patients, which may lead to other physiological disorders. Anxiety and depression are the two main negative emotions affected by insomnia. Acupuncture, which has showed effectiveness against insomnia and its complications, may be an effective and complementary method for the treatment of insomnia and associated maladies.

Can acupuncture therapy reduce preoperative anxiety?A systematic review and meta-analysis

Background:Acupuncture therapy has shown promise for effectively relieving preoperative anxiety.Nevertheless,previous findings from randomized controlled trials(RCTs)are inconsistent and must be examined in detail.Objective:This study systematically evaluates the efficacy and safety of acupuncture therapy for preoperative anxiety as well as the quality of evidence supporting this application.Search strategy:The China National Knowledge Infrastructure Database,Wanfang Data Journal Database,Chinese Biomedical Literature Database,Chongqing VIP,Embase,Pub Med and Cochrane Library Databases were queried from their inception to 19,February 2020,using keywords such as“acupuncture therapy,”“preoperative”and“anxioty.”Manual searches expanded the search breadth and included conference abstracts and other reference lists.Inclusion criteria:RCTs were included in the current study if they contained a comparison between a group of anxiety patients that received acupuncture therapy and a control group that received sham acupuncture.Data extraction and analysis:Literature was reviewed,and various articles were selected using the Note Express 3.2.0 software.Two researchers independently screened and extracted data and evaluated the risk of bias in the included studies.The Rev Man 5.3 software was used for data aggregation and the Grades of Recommendation,Assessment,Development and Evaluation(GRADE)assessment was used to evaluate the quality of the study outcomes.Results:Twelve studies were included in the review,containing a total of 916 patients.Meta-analysis showed that,compared with the control group,patients who received acupuncture therapy had reduced State-Trait Anxiety Inventory Scale(STAI-S)score(mean difference[MD]=–9.07,95%confidence interval[CI][–13.19 to–4.96],P<0.0001)and Visual Analogue Scale(VAS)score(MD=–1.37,95%CI[–2.29 to–0.45],P=0.003).However,for the Hamilton Anxiety Scale(HAMA)score,there was no difference between the two groups(MD=–3.98,95%CI[–12.89 to 4.92],P=0.38).Further,the GRADE assessment demonstrated that the STAI-S was of moderate quality,the VAS of low quality and the HAMA of very low quality.Conclusion:Acupuncture therapy may be able to decrease anxiety in preoperative patients,but the results need to be further verified due to the small sample sizes and the low quality of evidence to date.

Research progress on acupuncture-moxibustion in treatment of refractory infertility

Refractory infertility is a relatively intractable issue regarding its treatment at present.In recent years,acupuncture-moxibustion therapy participate increasingly in treatment of refractory infertility and has achieved a certain therapeutic effect.It is discovered that acupuncture-moxibustion effectively improves ovarian function,promotes ovulation and improves ovum quality and endomentrial receptivity.Hence,this therapy has been widely applied to the treatment of infertility induced by primary ovarian insufficiency(POI),polycystic ovarian syndrome(PCOS),endometriosis(EM),intrauterine adhesion(IUA),etc..In the paper,the research status of this disease treated with acupuncture-moxibustion is reviewed.It is anticipated to determine the direction and lay the foundation for further research.