BACKGROUND Diabetic peripheral neuropathy(DPN)is a common complication of diabetes mellitus and can lead to serious complications.Therapeutic strategies for pain control are available but there are few approaches that...BACKGROUND Diabetic peripheral neuropathy(DPN)is a common complication of diabetes mellitus and can lead to serious complications.Therapeutic strategies for pain control are available but there are few approaches that influence neurological deficits such as numbness.AIM To investigate the effectiveness of acupuncture on improving neurological deficits in patients suffering from type 2 DPN.METHODS The acupuncture in DPN(ACUDPN)study was a two-armed,randomized,controlled,parallel group,open,multicenter clinical trial.Patients were randomized in a 1:1 ratio into two groups:The acupuncture group received 12 acupuncture treatments over 8 wk,and the control group was on a waiting list during the first 16 wk,before it received the same treatment as the other group.Both groups received routine care.Outcome parameters were evaluated after 8,16 and 24 wk and included neurological scores,such as an 11-point numeric rating scale(NRS)11 for hypesthesia,neuropathic pain symptom inventory(NPSI),neuropathy deficit score(NDS),neuropathy symptom score(NSS);nerve conduction studies(NCS)were assessed with a handheld point-of-care device.RESULTSSixty-two participants were included.The NRS for numbness showed a difference of 2.3(P<0.001)in favor of theacupuncture group,the effect persisted until week 16 with a difference of 2.2(P<0.001)between groups and 1.8points at week 24 compared to baseline.The NPSI was improved in the acupuncture group by 12.6 points(P<0.001)at week 8,the NSS score at week 8 with a difference of 1.3(P<0.001);the NDS and the TNSc score improvedfor the acupuncture group in week 8,with a difference of 2.0 points(P<0.001)compared to the control group.Effects were persistent in week 16 with a difference of 1.8 points(P<0.05).The NCS showed no meaningfulchanges.In both groups only minor side effects were reported.CONCLUSION Study results suggest that acupuncture may be beneficial in type 2 diabetic DPN and seems to lead to a reductionin neurological deficits.No serious adverse events were recorded and the adherence to treatment was high.Confirmatory randomized sham-controlled clinical studies with adequate patient numbers are needed to confirmthe results.展开更多
文摘目的 探讨飞燕草素调节Numb/Notch信号通路诱导卵巢癌细胞A2780凋亡的作用机制。方法 使用顺铂(500μmoL/mL)和低剂量(500μmoL/mL)、高剂量(1000μmoL/mL)飞燕草素处理卵巢癌细胞A2780,同时设立卵巢癌细胞A2780对照组,各组设6个平行样,培养72 h后。实验结束后,采用CCK-8试剂盒测定各组细胞增殖水平,流式细胞术检测细胞凋亡率,Transwell法测定细胞侵袭水平,划痕实验检测细胞迁移水平,实时荧光定量(RT-qPCR)及蛋白印记法(West-blot)检测细胞Numb、Notch1 m RNA和蛋白表达水平。结果 与A2780细胞组比较,顺铂组、飞燕草素低、高剂量组A值、存活率、穿膜数、迁移距离、Notch1 m RNA和蛋白表达降低(P<0.05);与顺铂组比较,飞燕草素低剂量组A值、存活率、穿膜数、迁移距离、Notch1 m RNA和蛋白表达升高(P<0.05),高剂量组A值、存活率、穿膜数、迁移距离、Notch1 m RNA和蛋白表达无明显变化(P>0.05);与飞燕草素低剂量组比较,飞燕草素高剂量组A值、存活率、穿膜数、迁移距离、Notch1 mRNA和蛋白表达降低(P<0.05)。与A2780细胞组比较,顺铂组、飞燕草素低、高剂量组凋亡率、Numb mRNA和蛋白表达升高(P<0.05);与顺铂组比较,飞燕草素低剂量组凋亡率、Numb mRNA和蛋白表达降低(P<0.05),高剂量组凋亡率、Numb mRNA和蛋白表达无明显变化(P>0.05);与飞燕草素低剂量组比较,飞燕草素高剂量组凋亡率、Numb mRNA和蛋白表达升高(P<0.05)。结论 飞燕草素可以通过激活Numb进而抑制Notch1通路来抑制卵巢癌细胞的增殖、迁移、侵袭,促进其凋亡。
文摘BACKGROUND Diabetic peripheral neuropathy(DPN)is a common complication of diabetes mellitus and can lead to serious complications.Therapeutic strategies for pain control are available but there are few approaches that influence neurological deficits such as numbness.AIM To investigate the effectiveness of acupuncture on improving neurological deficits in patients suffering from type 2 DPN.METHODS The acupuncture in DPN(ACUDPN)study was a two-armed,randomized,controlled,parallel group,open,multicenter clinical trial.Patients were randomized in a 1:1 ratio into two groups:The acupuncture group received 12 acupuncture treatments over 8 wk,and the control group was on a waiting list during the first 16 wk,before it received the same treatment as the other group.Both groups received routine care.Outcome parameters were evaluated after 8,16 and 24 wk and included neurological scores,such as an 11-point numeric rating scale(NRS)11 for hypesthesia,neuropathic pain symptom inventory(NPSI),neuropathy deficit score(NDS),neuropathy symptom score(NSS);nerve conduction studies(NCS)were assessed with a handheld point-of-care device.RESULTSSixty-two participants were included.The NRS for numbness showed a difference of 2.3(P<0.001)in favor of theacupuncture group,the effect persisted until week 16 with a difference of 2.2(P<0.001)between groups and 1.8points at week 24 compared to baseline.The NPSI was improved in the acupuncture group by 12.6 points(P<0.001)at week 8,the NSS score at week 8 with a difference of 1.3(P<0.001);the NDS and the TNSc score improvedfor the acupuncture group in week 8,with a difference of 2.0 points(P<0.001)compared to the control group.Effects were persistent in week 16 with a difference of 1.8 points(P<0.05).The NCS showed no meaningfulchanges.In both groups only minor side effects were reported.CONCLUSION Study results suggest that acupuncture may be beneficial in type 2 diabetic DPN and seems to lead to a reductionin neurological deficits.No serious adverse events were recorded and the adherence to treatment was high.Confirmatory randomized sham-controlled clinical studies with adequate patient numbers are needed to confirmthe results.
