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.

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.

PRaG 3.0 therapy for human epidermal growth factor receptor 2-positive metastatic pancreatic ductal adenocarcinoma:A case report

BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is a highly fatal disease with limited effective treatment especially after first-line chemotherapy.The human epidermal growth factor receptor 2(HER-2)immunohistochemistry(IHC)positive is associated with more aggressive clinical behavior and shorter overall survival in PDAC.CASE SUMMARY We present a case of multiple metastatic PDAC with IHC mismatch repair proficient but HER-2 IHC weakly positive at diagnosis that didn’t have tumor regression after first-line nab-paclitaxel plus gemcitabine and PD-1 inhibitor treatment.A novel combination therapy PRaG 3.0 of RC48(HER2-antibody-drug conjugate),radio-therapy,PD-1 inhibitor,granulocyte-macrophage colony-stimulating factor and interleukin-2 was then applied as second-line therapy and the patient had confirmed good partial response with progress-free-survival of 6.5 months and overall survival of 14.2 month.She had not developed any grade 2 or above treatment-related adverse events at any point.Percentage of peripheral CD8^(+) Temra and CD4^(+) Temra were increased during first two activation cycles of PRaG 3.0 treatment containing radiotherapy but deceased to the baseline during the maintenance cycles containing no radiotherapy.CONCLUSION PRaG 3.0 might be a novel strategy for HER2-positive metastatic PDAC patients who failed from previous first-line approach and even PD-1 immunotherapy but needs more data in prospective trials.

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.

Back to the drawing board:Overview of the next generation of combination therapy for inflammatory bowel disease

Inflammatory bowel disease(IBD)is entering a potentially new era of combined therapeutics.Triantafillidis et al provide an insightful review of the current state of combination therapy,with a focus on the use of a combined biologic and immunomodulator,as well as emerging data on the future potential of dual-biologic therapy(DBT).While current evidence for DBT is limited,encouraging safety profiles and ongoing trials suggest a brighter future for this approach.The importance of controlled trials should be stressed in establishing new treatment paradigms.Ongoing prospective randomized trials of DBT and perhaps future combinations of biologics and small molecule therapies will hopefully guide the next generation of IBD care.

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.

Vonoprazan-amoxicillin dual regimen with Saccharomyces boulardii as a rescue therapy for Helicobacter pylori:Current perspectives and implications

Yu et al’s study in the World Journal of Gastroenterology(2023)introduced a novel regimen of Vonoprazan-amoxicillin dual therapy combined with Saccharomyces boulardii(S.boulardii)for the rescue therapy against Helicobacter pylori(H.pylori),a pathogen responsible for peptic ulcers and gastric cancer.Vonoprazan is a potassium-competitive acid blocker renowned for its rapid and long-lasting acid suppression,which is minimally affected by mealtime.Compared to proton pump inhibitors,which bind irreversibly to cysteine residues in the H+/K+-ATPase pump,Vonoprazan competes with the K+ions,prevents the ions from binding to the pump and blocks acid secretion.Concerns with increasing antibiotic resistance,effects on the gut microbiota,patient compliance,and side effects have led to the advent of a dual regimen for H.pylori.Previous studies suggested that S.boulardii plays a role in stabilizing the gut barrier which improves H.pylori eradication rate.With an acceptable safety profile,the dual-adjunct regimen was effective regardless of prior treatment failure and antibiotic resistance profile,thereby strengthening the applicability in clinical settings.Nonetheless,S.boulardii comes in various formulations and dosages,warranting further exploration into the optimal dosage for supplementation in rescue therapy.Additionally,larger,randomized,double-blinded controlled trials are warranted to confirm these promising results.

Early antiplatelet therapy used for acute ischemic stroke and intracranial hemorrhage

In this editorial we comment on the article published by Zhang et al in the recent issue of World Journal of Clinical Cases.We evaluate their claims on the benefit of use of Aspirin in the early management of patients with ischemic stroke.We also comment on their contention of using aspirin in the early management of patients with intracranial hemorrhage,a practice not seen in modern medicine.Large clinical trials such as the International Stroke Trial and the Chinese Acute Stroke Trial have shown the benefit of Aspirin use within 48 h of patients with Acute Ischemic Stroke.The findings were corroborated in the open-label trial performed by Zhang et al in a smaller sample group of 25 patients where they showed improvement in functional scores at 90 days without an increase in adverse events.As such,this intervention is also recommended by the American Heart Association stroke guidelines from 2021.With regard to Intracranial hemorrhage,traditional practice has been to discontinue or avoid antiplatelet therapy in these patient groups.However,no studies have been done to evaluate this management strategy that is more borne out of the mechanism behind Aspirin’s effect on the coagulation pathway.Zhang et al evaluate the benefits of Aspirin on patients with low-volume intracranial hemorrhage,i.e.,less than 30 mL on computed tomo-graphy imaging,and show no increase in mortality.The caveat of this finding is that all outcomes were pooled into one group for results,and the number of patients was low.While more studies with larger patient groups are required,the data from Zhang et al suggests that patients with small-volume intracranial hemorrhages may benefit from Aspirin administration in the acute phase of management.

Present and future of new systemic therapies for early and intermediate stages of hepatocellular carcinoma

Hepatocellular carcinoma(HCC)is a high mortality neoplasm which usually appears on a cirrhotic liver.The therapeutic arsenal and subsequent prognostic outlook are intrinsically linked to the HCC stage at diagnosis.Notwithstanding the current deployment of treatments with curative intent(liver resection/local ablation and liver transplantation)in early and intermediate stages,a high rate of HCC recurrence persists,underscoring a pivotal clinical challenge.Emergent systemic therapies(ST),particularly immunotherapy,have demonstrate promising outcomes in terms of increase overall survival,but they are currently bound to the advanced stage of HCC.This review provides a comprehensive analysis of the literature,encompassing studies up to March 10,2024,evaluating the impact of novel ST in the early and intermediate HCC stages,specially focusing on the findings of neoadjuvant and adjuvant regimens,aimed at increasing significantly overall survival and recurrence-free survival after a treatment with curative intent.We also investigate the potential role of ST in enhancing the downstaging rate for the intermediate-stage HCC initially deemed ineligible for treatment with curative intent.Finally,we critically discuss about the current relevance of the results of these studies and the encouraging future implications of ST in the treatment schedules of early and intermediate HCC stages.

Diabetes mellitus in patients with type 1 autoimmune pancreatitis at diagnosis and after corticosteroid therapy

Background:A high prevalence of diabetes mellitus(DM)coexisting with autoimmune pancreatitis(AIP)is observed.However,evidence on the circumstances under which corticosteroid therapy(CST)for AIP improves or worsens DM is scarce.This study aimed to demonstrate and identify predictors of DM control under the influence of CST.Methods:Patients diagnosed with type 1 AIP were enrolled from a prospectively maintained cohort and were classified into three groups according to the chronology in which AIP and DM were diagnosed:pre-existing DM(pDM),concurrent DM(cDM),and non-DM(nDM).The responses of DM to CST were assessed when corticosteroid was ceased or tapered to a maintenance dose and classified as‘improvement’and‘non-improvement’(including‘no change’and‘exacerbation’).Results:Among 101 patients with type 1 AIP,52(51.5%)patients were complicated with DM at the time of AIP diagnosis,with 36 patients in the cDM group and 16 patients in the pDM group.The incidences of diffuse pancreatic swelling(72.2%)and pancreatic body/tail involvement(91.7%)were significantly higher in the cDM group than in both the pDM and nDM groups.Of the 52 patients with DM,CST was administered in 48 cases.Multivariate logistic analysis identified that elevated serum gamma-glutamyl transferase(GGT)level at AIP diagnosis[odds ratio(OR)=0.032,95%confidence interval(CI):0.003-0.412,P=0.008]and pancreatic atrophy after CST(OR=0.027,95%CI:0.003-0.295,P=0.003)were negatively associated with DM control improvement.Conclusions:Patients with diffuse pancreatic swelling and pancreatic body/tail involvement in pancreatitis tended to be complicated with cDM at AIP diagnosis.CST exerted a beneficial effect on the clinical course of DM in nearly half of the AIP patients complicated with DM at diagnosis,particularly in those without elevated serum GGT levels at diagnosis and who did not experience pancreatic atrophy after CST.

Paradoxical herniation associated with hyperbaric oxygen therapy after decompressive craniectomy: A case report

BACKGROUND Whether hyperbaric oxygen therapy(HBOT)can cause paradoxical herniation is still unclear.CASE SUMMARY A 65-year-old patient who was comatose due to brain trauma underwent decompressive craniotomy and gradually regained consciousness after surgery.HBOT was administered 22 d after surgery due to speech impairment.Paradoxical herniation appeared on the second day after treatment,and the patient’s condition worsened after receiving mannitol treatment at the rehabilitation hospital.After timely skull repair,the paradoxical herniation was resolved,and the patient regained consciousness and had a good recovery as observed at the follow-up visit.CONCLUSION Paradoxical herniation is rare and may be caused by HBOT.However,the underlying mechanism is unknown,and the understanding of this phenomenon is insufficient.The use of mannitol may worsen this condition.Timely skull repair can treat paradoxical herniation and prevent serious complications.

Cell reprogramming therapy for Parkinson’s disease

Parkinson’s disease is typically characterized by the progressive loss of dopaminergic neurons in the substantia nigra pars compacta.Many studies have been performed based on the supplementation of lost dopaminergic neurons to treat Parkinson’s disease.The initial strategy for cell replacement therapy used human fetal ventral midbrain and human embryonic stem cells to treat Parkinson’s disease,which could substantially alleviate the symptoms of Parkinson’s disease in clinical practice.However,ethical issues and tumor formation were limitations of its clinical application.Induced pluripotent stem cells can be acquired without sacrificing human embryos,which eliminates the huge ethical barriers of human stem cell therapy.Another widely considered neuronal regeneration strategy is to directly reprogram fibroblasts and astrocytes into neurons,without the need for intermediate proliferation states,thus avoiding issues of immune rejection and tumor formation.Both induced pluripotent stem cells and direct reprogramming of lineage cells have shown promising results in the treatment of Parkinson’s disease.However,there are also ethical concerns and the risk of tumor formation that need to be addressed.This review highlights the current application status of cell reprogramming in the treatment of Parkinson’s disease,focusing on the use of induced pluripotent stem cells in cell replacement therapy,including preclinical animal models and progress in clinical research.The review also discusses the advancements in direct reprogramming of lineage cells in the treatment of Parkinson’s disease,as well as the controversy surrounding in vivo reprogramming.These findings suggest that cell reprogramming may hold great promise as a potential strategy for treating Parkinson’s disease.

A review of the literature on the use of CRISPR/Cas9 gene therapy to treat hepatocellular carcinoma

Noncoding RNAs instruct the Cas9 nuclease to site speifillyl cleave DNA in the CRISPR/Cas9 system.Despite the high incidence of hepatocellular carcinoma(HCC),the patient's outcome is poor.As a result of the emergence of therapeutic resistance in HCC patients,dlinicians have faced difficulties in treating such tumor.In addition,CRISPR/Cas9 screens were used to identify genes that improve the dlinical response of HCC patients.It is the objective of this article to summarize the current understanding of the use of the CRISPR/Cas9 system for the treatment of cancer,with a particular emphasis on HCC as part of the current state of knowledge.Thus,in order to locate recent developments in oncology research,we examined both the Scopus database and the PubMed database.The ability to selectively interfere with gene expression in combinatorial CRISPR/Cas9 screening can lead to the discovery of new effective HCC treatment regimens by combining clinically approved drugs.Drug resistance can be overcome with the help of the CRISPR/Cas9 system.HCC signature genes and resistance to treatment have been uncovered by genome-scale CRISPR activation screening although this method is not without limitations.It has been extensively examined whether CRISPR can be used as a tool for disease research and gene therapy.CRISPR and its applications to tumor research,particularly in HCC,are examined in this study through a review of the literature.

Effects of hormone replacement therapy on mood and sleep quality in menopausal women

BACKGROUND Hormone replacement therapy is an effective treatment strategy for the management of symptoms in naturally menopausal women.However,some patients report experiencing adverse effects.AIM To analyze the effects of hormone replacement therapy in menopausal female patients.METHODS A total of 152 menopausal female patients admitted to the Gynecology Department of the Ganzhou Maternal and Child Health Hospital between January 2021 and December 2023 were divided into the observation group(n=76,conventional treatment+hormone replacement therapy)and the control group(n=76,conventional treatment only)via random casting.The improvement observed in the following items were compared between the groups:Kupperman menopausal index(KMI),emotional state[The Positive and Negative Affect Scale(PANAS)],sleep quality[Self-Rating Scale of Sleep(SRSS)],treatment effectiveness,and treatment safety.RESULTS The modified KMI and SRSS scores of the observation group were lower than those of the control group after three rounds of treatment.The improvement in the PANAS score observed in the observation group was greater than that observed in the control group(P<0.05).The total treatment effectivity rate in the observation group was higher than that in the control group(86.84%vs 96.05%,χ2=4.121,P=0.042).The incidence rate of adverse reactions in the two groups was comparable(6.58%vs 9.21%,χ2=0.361,P=0.547).CONCLUSION Hormone replacement therapy effectively improved the clinical symptoms,actively channeled negative emotions,and improved the quality of sleep in menopausal patients,indicating its effectiveness and safety.