[Exploration of the thinking and methods in treatment of cancer pain with acupuncture and moxibustion on the base of the fascia theory]

There is a commonality between jingjin (muscle region of meridian) and the fascial network for coordinating the balance in the body. The occurrence and the progression of tumor may disrupt the overall coordination between the fascial network and jingjin directly or indirectly, thereby, the impairment of this coordination may result in cancer pain. Rooted on the theory of overall balance of the fascial network, and combined with understanding of pain in jingjin theory, professor HUANG Jin-chang emphasizes the importance of "relaxing the knot" in treatment of cancer pain. It is recommended to select the fascia reaction point as the target point, in accordance with the principle of balance adjustment and apply various acupuncture and moxibustion therapies, such as Fu's subcutaneous needling, small-needle scalpel therapy, fire needling, and moxibustion.

Uncommon Culprit Vessel of de Winter Electrocardiogram Pattern

This case report describes a patient in their 50s who presented to the emergency department with perspiration, persistent and squeezing chest pain, and chest distress that had persisted for 90 minutes without relief.

[Clinicopathological features of patients with RET fusion-positive non-small cell lung cancer]

Objective: To investigate the clinicopathological features, treatment and prognosis of patients with RET fusion positive non-small cell lung cancer (NSCLC). Methods: A total of 1 089 NSCLCs were retrieved at Affiliated Hospital of Jiangnan University from August 2018 to April 2020. In all cases, multiple gene fusion detection kits (fluorescent PCR method) were used to detect the gene status of RET, EGFR, ALK, ROS1, KRAS, BRAF and HER2; and immunohistochemical method was used to detect the expression of PD-L1 and mismatch repair related proteins. The correlation between RET-fusion and patients' age, gender, smoking history, tumor stage, grade, pathologic type, and PD-L1, mismatch repair related protein expression was analyzed. Results: There were 22 cases (2.02%) detected with RET fusion-positive in 1 089 NSCLC patients, in which 11 males and 11 females; and the median age was 63.5 years. There were 20 adenocarcinomas, including 11 acinar predominant adenocarcinoma (APA), five solid predominant adenocarcinoma (SPA) and four lepidic predominant adenocarcinoma (LPA); There were one case each of squamous cell carcinoma (non-keratinizing type) and sarcomatoid carcinoma (pleomorphic carcinoma). There were 6 and 16 patients with RET fusion-positive who were in stage Ⅰ-Ⅱ and Ⅲ-Ⅳ respectively, and 16 cases with lymph node metastasis, 11 cases with distant metastasis. Among RET fusion-positive cases, one was detected with HER2 co-mutation. The tumor proportion score of PD-L1≥1% in patients with RET fusion positive lung cancer was 54.5% (12/22). Defects in mismatch repair protein expression were not found in patients with RET fusion positive NSCLC. Four patients with RET fusions positive (two cases of APA and two cases of SPA) received pratinib-targeted therapy, and two showed benefits from this targeted therapy. Conclusions: The histological subtypes of RET fusions positive NSCLC are more likely to be APA or SPA. RET fusion-positive NSCLC patients are associated with advanced clinical stage, lymph node metastases, and they may benefit from targeted therapy with RET-specific inhibitors.

Yeast mediates the interspecific interaction between introduced Bactrocera dorsalis and indigenous Bactrocera minax

BACKGROUND

Host plant-microbe associations mediate interspecific interactions amongst herbivorous insects. However, this theory has rarely been ecologically verified in tephritid fruit flies. Research on this subject can not only help predict tephritid species invasion and occurrence patterns, but also develop potential novel lures for the control of the tephritid fruit fly pests. Recently, we observed mixed infestation of Bactrocera minax and Bactrocera dorsalis larvae in citrus orchards, which prompted us to explore the underlying mechanism.

RESULTS

Following oviposition by B. minax, the yeast Pichia kluyveri translocated to and proliferated inside the citrus fruit. The level of d-limonene released from citrus fruits containing P. kluyveri was 27 times higher than that released from healthy fruits. Mature B. dorsalis females were attracted to d-limonene and oviposited into fruits previously infested by B. minax. Furthermore, the interspecific interaction between B. dorsalis and B. minax within the same fruit significantly decreased the number of surviving larvae and pupal weight in B. dorsalis, but its effect on B. minax was weaker.

CONCLUSION

In the studied interspecific interaction, B. minax occupies the dominant position, implying ecological significance for this species in terms of consolidating its own niche and inhibiting the invasion of exotic species. To our best knowledge, this is the first report from both ecological and physiological perspectives on a symbiotic yeast mediating the interaction between B. minax and B. dorsalis through altering fruit volatiles. © 2022 Society of Chemical Industry.

[Study on efficacy, recurrence rate and related risk factors between ablation index and contact force guided radiofrequency ablation of paroxysmal atrial fibrillation in elderly patients]

Objective: To compare the efficacy, safety and recurrence rate between ablation index (AI) and contact force (CF) guided radiofrequency ablation of paroxysmal atrial fibrillation in elderly patients. Methods: Elderly patients (age ≥60 years) with paroxysmal atrial fibrillation who received radiofrequency ablation for the first time at Department of Cardiology, Beijing Friendship Hospital from April 2018 to April 2019 were enrolled. Patients were divided into 2 groups: AI-group (n=40) and CF group (n=37) depending on their ablation methods. Follow-up was performed until 1 year post the procedure, and efficacy related indexes like first-pass pulmonary vein isolation (PVI) rate, ablation duration, operation duration and major complications were compared between 2 groups. The recurrence rates between 2 groups and related risk factors after radiofrequency ablation were analyzed. Results: A total of 77 patients [mean age (68.5±6.4) years, 40 were male] were enrolled at last. In AI guided patients, frequency of first-pass PVI rate was higher [52.5%(21 cases) vs 29.7%(3 cases), P=0.011] with a shorter ablation duration [(24.5±1.7) min vs (33.7±2.2) min, P<0.001] and operation duration [(136.6±6.1) min vs (139.7±7.4) min, P=0.048] compared with CF guided group. At 1 year follow-up, AI group showed an amendatory recurrence rate in Kaplan-Meier analysis (22.5% vs 40.5%,log-rank P=0.048). Multivariate Cox regression analysis showed that CF guided ablation (HR=3.272,95%CI:1.319-8.114,P=0.011), enlarged anteroposterior diameter of the left atrium (HR=4.233,95%CI:1.511-11.862,P=0.006) and complicated with coronary heart disease (HR=4.829,95%CI:1.399-16.666,P=0.013) were independent risk factors for recurrence of atrial fibrillation in elderly patients. Conclusions: Compared with CF guided ablation, radiofrequency ablation of paroxysmal atrial fibrillation in elderly patients guided by AI showed a higher first-pass PVI rate, shorter procedure duration of both ablation time and total operation time, meanwhile a lower recurrence rate. Further analysis revealed that different ablation alternation (AI or CF), enlarged anteroposterior diameter of left atrium, and complicated with coronary heart disease are independent risk factors for recurrence after radiofrequency ablation of atrial fibrillation in elderly patients.

[Discussion on registry study of acupuncture-moxibustion for malignant pleural effusion]

Malignant pleural effusion (MPE) is one of the common complications of tumor. Acupuncture-moxibustion therapy has several advantages for treatment of MPE. Acupuncture is regarded as a complex individualized intervention, and its characteristics of TCM is difficult to be reflected by strict randomized controlled trials. The registry study provides more possibilities for the data collection of individualized diagnosis and treatment under the guidance of the overall concept and syndrome differentiation, and is more suitable for data management and collection of large samples and multi-center trials in the real-world study. It has become an opportunity to carry out real-world study of acupuncture for MPE. There are many challenges in the registry study of acupuncture for MPE. However, it is of great significance to collect real-world data of acupuncture for MPE to improve the clinical effect of MPE and provide a new clinical research method for acupuncture in tumors and related complications.

[Effect of Electroacupuncture Intervention at Different Time-points on Locomotor Function and Apoptosis in Rats with Acute Spinal Cord Injury]

OBJECTIVE

To observe the effect of electroacupuncture (EA) intervention at different treatment time-points on locomotor function and neuronal apoptosis in rats with acute spinal cord injury (ASCI), so as to explore its mechanism under-lying improvement of ASCI.

METHODS

Seventy-two female Wistar rats were randomly divided into sham operation, ASCI model and EA groups which were further divided into 4 time-points:1, 3, 7 and 14 d (n=6 at each). The ASCI model was established by weight-drop striking the exposed spinal cord (T₁₀) using a NYU impactor device. EA (0.4-0.6 mA, 100 Hz) was applied to bilateral "Jiaji" (EX-B 2) for 30 min, once a day for 1, 3, 7 and 14 days, respectively in the EA group. The Basso-Beattie-Bresnahan (BBB) grading score was used to assess the animals' locomotor function, and H.E. staining was used to display the pathological changes of spinal cord injury at different time points. The TUNEL staining was used to detect the nerve cell apoptosis of spinal cord tissue.

RESULTS

After ASCI, the BBB scores were significantly decreased and the numbers of the apoptotic nerve cells considerably increased on day 1, 3, 7 and 14 in the model group compared with the sham operation group (P<0.05). In addition, H.E. staining showed severe damage of the spinal cord tissue, infiltration of inflammatory cells, increase of dead nerve neurons and glia cells in the number from day 3 to 7, and additional increase of vacuoles on day 14. Following EA intervention, the decrease of BBB scores and the increase of apoptotic nerve cell numbers were markedly suppressed on day 3, 7 and 14 (P<0.05). The TUNEL staining showed a decrease of the apoptotic nerve cells from day 3 on and an improvement of the injured tissue structure from day 7 to 14 in the EA group.

CONCLUSIONS

EA stimulation of EX-B 2 can significantly improve locomotor function, and lighten the spinal cord injury in ASCI rats, presenting a time-dependant tendency, which may be associated with its effect in reducing neuronal apoptosis in the spinal cord.

Studies on expression of p14ARF and MDM2 in human thyroid neoplasms

AIM

We sought to evaluate the expression and clinical significance of p14ARF and MDM2 proteins in thyroid neoplasm.

METHODS

Immunohistochemical streptavidin-peroxidase (S-P) method was used to detect the expression of p14ARF and MDM2 proteins in 78 cases of papillary thyroid carcinoma (PTC), 34 cases of papillary thyroid microcarcinoma (PTMC) and 45 cases of thyroid adenoma.

RESULTS

The expression of p14ARF and MDM2 protein differed significantly (P<0.01) among three group. The positivity rate of p14ARF protein in PTC was significantly lower than that in thyroid adenoma (P=0.002) and PTMC (P=0.008). While the positivity rate of MDM2 protein in PTC was significantly higher than that in thyroid adenoma (P=0.000) and PTMC (P=0.009). There was a significant correlation found between the expressions of p14ARF and MDM2 proteins in PTC (P=0.013) and PTMC (P=0.012). Also, a significant correlation was found between p14ARF protein expression and lymph node metastasis in PTC (P=0.011).

CONCLUSION

It was concluded that p14ARF and MDM2 proteins might be involved in the induction and development of PTC and PTMC whereas p14ARF also had diagnostic value in determining the biological behavior of PTC.

Repair of articular cartilage defects by tissue-engineered cartilage constructed with adipose-derived stem cells and acellular cartilaginous matrix in rabbits

After injury, inflammation, or degeneration, articular cartilage has limited self-repair ability. We aimed to explore the feasibility of repair of articular cartilage defects with tissue-engineered cartilage constructed by acellular cartilage matrices (ACMs) seeded with adipose-derived stem cells (ADSCs). The ADSCs were isolated from 3-month-old New Zealand albino rabbit by using collagenase and cultured and amplified in vitro. Fresh cartilage isolated from adult New Zealand albino rabbit were freeze-dried for 12 h and treated with Triton X-100, DNase, and RNase to obtain ACMs. ADSCs were seeded in the acellular cartilaginous matrix at 2x10(7)/mL, and cultured in chondrogenic differentiation medium for 2 weeks to construct tissue-engineered cartilage. Twenty-four New Zealand white rabbits were randomly divided into A, B, and C groups. Engineered cartilage was transplanted into cartilage defect position of rabbits in group A, group B obtained ACMs, and group C did not receive any transplants. The rabbits were sacrificed in week 12. The restored tissue was evaluated using macroscopy, histology, immunohistochemistry, and transmission electron microscopy (TEM). In the tissue-engineered cartilage group (group A), articular cartilage defects of the rabbits were filled with chondrocyte-like tissue with smooth surface. Immunohistochemistry showed type II-collagen expression and Alcian blue staining was positive. TEM showed chondrocytes in the recesses, with plenty of secretary matrix particles. In the scaffold group (group B), the defect was filled with fibrous tissue. No repaired tissue was found in the blank group (group C). Tissue-engineered cartilage using ACM seeded with ADSCs can help repair articular cartilage defects in rabbits.