Treatment of Prostatalgia by Acupuncture: A Randomized Controlled Trial

Objective： To observe the clinical efficacy of acupuncture therapy for prostatalgia. Methods： Sixty subjects were randomized into two groups： an acupuncture group in which 30 cases were treated by acupuncture and a medication group in which the other 30 cases were treated with herbal decoction. The clinical efficacy in these two groups were observed and compared. Results： In the acupuncture group, 5 cases were cured, 12 cases were significantly improved, 11 cases improved and 2 cases failed, and the overall effective rate was 93.3%. In the medication group, 2 cases were cured, 8 cases were significantly improved, 13 cases improved and 7 cases failed, and the overall effective rate was 76.6%; the overall effective rate was higher in the acupuncture group than in the medication group （P0.05）. Moreover, the total score of National Institutes of Health-Chronic Prostatitis Symptom Index （NIH-CPSI）, and the scores for pain severity, urinary symptoms and quality of life were reduced more significantly in the acupuncture group than in the medication group. Conclusion： Acupuncture is an effective therapy for prostatalgia.

Development and Validation of a Clinical Risk Score to Predict Immune-mediated Liver Injury Caused by Sintilimab:Assessed for Causality Using Updated RUCAM

Background and Aims:Immune-mediated liver injury is a fatal side effect of sintilimab.This study aimed to shed light on the associated risk factors and characteristics of this adverse event.Methods:The clinical records of 772 patients treated with sintilimab were retrospectively reviewed to investigate risk factors associated with sintilimab immune-related hepatotoxicity,as well as its incidence and outcome.The Roussel Uclaf Causality Assessment Method was used o identify cases of sintilimab-induced hepatotoxicity.Furthermore,logistic regressions were performed to compare the clinical and bloodwork characteristics of patients with and without immune-mediated liver injury caused by checkpoint inhibitors.Resu/ts:Of the 585 patients included in the study,71(12.1%)developed liver injury during sintili-mab use.The median RUCAM score with interquartile range was 7(6,8).Hypoproteinemia,dyslipidemia,and the pres-ence of thyroid peroxidase antibodies were risk factors for sintilimab-related hepatotoxicity.A nomogram model was constructed for sintilimab-induced immune-mediated liver injury based on these risk factors,which had a C-index value of 0.713 and a good calibration curve.When applied o patients with grade≥3 and≥4 sintilimab-induced immune-mediated liver injury,it achieved C-index values of 0.752 and 0.811,respectively.The nomogram model also showed a good prediction potential in patients≥65 years and males.Six of the patients with sintilimab-related hepatotoxicity showed improved liver function upon treatment with steroids.Conclusions:This study demonstrated that hypoproteinemia,dyslipidemia,and the presence of thyroid peroxidase antibodies were clinically feasible prognostic biomarkers to predict liver injury in patients treated with sintilimab.