[Effect of acupoint catgut embedding therapy on joint attention and social communication in children with autism spectrum disorder: a randomized controlled trial]

OBJECTIVE

To compare the clinical effect on the joint attention and social communication in children with autism spectrum disorder (ASD) between the combined treatment of acupoint catgut embedding therapy with rehabilitation training and the simple application of rehabilitation training.

METHODS

A total of 60 children with ASD were randomized into an observation group and a control group, 30 cases in each one. In the control group, the routine ASD rehabilitation training was adopted, including conductive education, speech training and music therapy, once a day. In the observation group, on the base of the treatment as the control group, the catgut embedding therapy was applied to Shenting (GV 24), Baihui (GV 20), Shenmen (HT 7) and the optic area (the point of scalp acupuncture), once a week. In the two groups, the treatment for 4 weeks was as one course, at the interval of 1 week between the courses. A total of 3 courses of treatment were required. The social domain of the autism treatment evaluation checklist (ATEC) and the autism behavior checklist (ABC) were adopted to assess the therapeutic effect of the two groups.

RESULTS

After treatment, the scores of each item of the social domain in ATEC and the scores of ABC (feeling, communication, physical movement, language and healthy behavior) were all lower than those before treatment in the two groups (P<0.01). The scores of each item in the observation group were lower than those in the control group after treatment (P<0.05).

CONCLUSION

The combined treatment of acupoint catgut embedding therapy with the rehabilitation training effectively improves in the joint attention and social communication. The therapeutic effect of this combined treatment is better than the simple application of rehabilitation training.

Circulating B7-H4 in serum predicts prognosis in patients with hepatocellular carcinoma

B7-H4 is member of the B7 family that negatively regulates the immune response, which are important for fine-tuning of the tumor microenvironment. Dysregulation of B7-H4 expression has been associated with tumor progression. However, expression level of B7-H4 in hepatocellular carcinoma (HCC) tissues is still a controversial topic. In addition, whether serum B7-H4 expression of HCC patients has any clinical value is unknown. We compared serum levels of B7-H4 in patients with HCC and healthy controls by using the ELISA method. Association between serum B7-H4 expression level and clinical parameters of HCC was further investigated. Log-rank test and Kaplan-Meier method were employed to evaluate the overall survival rate of HCC patients. Univariate and multivariate analysis of prognostic factors were performed with the Cox regression model. Our results showed that HCC patients had significantly higher serum B7-H4 level as compared with healthy controls (P < 0.001). In addition, serum B7-H4 expression was correlated with HCC clinical parameters including serum AFP expression and TNM stage. HCC patients in the higher serum B7-H4 expression group had a poorer 5-year overall survival rate (P = 0.028). Moreover, serum B7-H4 expression was shown to be an independent prognostic factor for HCC (P = 0.034). The findings from this study suggest that serum B7-H4 is an independent prognostic indicator for HCC and may be a promising biomarker for early diagnosis as well as disease prognosis of HCC.

Apoptosis induced by 5-flucytosine in human pancreatic cancer cells genetically modified to express cytosine deaminase

AIM

To elucidate the pattern of 5-flucytosine (5-FC)-induced apoptosis and its role in gene therapy of human pancreatic cancer.

METHODS

The human pancreatic cancer SW1990 cells (CEA-producing) were infected with recombinant adenoviruses (Adex1CEA-prCD or Adex1CEA-prZ). Expression of CD gene protein was examined by western blot. Apoptosis induced by 5-FC in human pancreatic cancer SW1990 cells genetically modified to express cytosine deaminase was observed by means of electron microscopy, DNA electrophoresis, and flow cytometry analysis techniques.

RESULTS

The SW1990 cells infected with Adex1CEA-prCD were treated with 5-FC at 100 mumol.L-1 for 48 h, and cell apoptosis was observed. Typical apoptosis morphological feature appeared and DNA ladder could be demonstrated on DNA electrophoresis. Apoptosis peak was also showed by flow cytometry. Apoptotic cells accounted for 34.6% of the cell population. Cells in G1, S, and G2/M phase of cell cycle were 64%, 11%, and 7%, respectively.

CONCLUSION

The apoptosis induced by 5-FC may be a primary mechanism in CD gene therapy of pancreatic cancer.

[Microwave treatment of 20 patients with oral cancers]

Twenty patients with oral cancers were treated by microwave alone from October 1989 to December 1990. There were: 7 cancer of floor of mouth and 13 cancer of the tongue. After treatment, pathology all turned negative. The patients were followed up for 9 to 24 months with all the primary lesions controlled. The functions and cosmetic results were perfect. Complications included edema of local tissue and bleeding. To prevent bleeding after microwave treatment, ligation of the ipsilateral external carotid artery should be done. To prevent dyspnea, tracheostomy should be done in patients with cancer of the root of tongue. Effect of microwave coagulation is best achieved by the interstitial technique. For lymph node metastasis, radical neck dissection should be done after the edema of the primary lesion subsides.

[Surgical treatment of papillary thyroid carcinoma--report of 437 cases]

Four hundred and thirty-seven patients with papillary thyroid carcinoma were treated from April 1963 to December 1989. The main treatment was surgery which was divided into 4 types: lobectomy combined with neck dissection (RND or MND); total thyroidectomy; isthmusectomy plus lobectomy; lobectomy combined with RND and then followed by contralateral MND. The 10-year survival rates of these four groups were 88.6%, 89.5%, 80% and 80%, respectively. The over-all 5-, 10- and 15-year survival rates were 92.7%, 87.9% and 79.4%. Lymph node metastasis was present in 80%. The authors believe that functional neck dissection is indicated if the number of lymph node is limited and the size is small.

[Clinical analysis of 202 cases of malignant tumor of the major salivary glands]

From March 1963 to July 1982, 202 patients with malignant tumor of the major salivary glands were admitted to our hospital. 198 cases were treated by surgery alone or combined with postoperative radiotherapy. The overall 3, 5, 10, 15-year survival rates were 73.2%, 59.6%, 41.5% and 29.9% respectively. The 5-year survival rates of parotid tumor, submandibular gland tumor and sublingual gland tumor were 65.2%, 44.2% and 60% respectively. The prognosis of the patients with a poor-differentiated pathology, especially the 10-year survival rates, were poor. In this study 50 cases were treated with postoperative radiotherapy. 118 cases without radiotherapy. The 5-year survival rates of the both were 62.5%, 57.0% respectively. After operation, 44 cases had positive evidence of microscopic metastasis. Of them, there were 21 cases had postoperative radiotherapy, 23 cases had not. The 5-year survival rates of the both were 38.1% and 30.4% respectively.

[Surgical treatment of carcinoma of the gingiva]

78 patients with squamous cell carcinoma of the gum were treated in our hospital from 1964 to 1982. 54 were male and 24 female, the sex ratio was 2.3:1. The peak age ranged from 50 to 59 years. 19 (24%) patients had lesions of stages I-II and 56 (71.7%) of stage III. All the patients were treated with surgery only or radiotherapy plus surgery. In 72 treated by surgery only, the lesions of the upper and lower gingival carcinoma without regional lymph node metastasis gave 5 year survival rates of 50% and 83.3%, while those with regional lymph node metastasis gave 5 year survivals of 20% and 58.5%, respectively. The rest 6 patients receiving radiotherapy plus surgery gave a 5 year survival rate of 50%. The results indicate that the prognosis is better for the carcinoma of the lower gum without regional lymph node metastasis.

[Malignant melanoma of the head and neck--a clinical analysis of 46 patients]

46 patients with malignant melanoma of the head and neck as treated in our hospital from March 1964 to December 1981 are reported. 29 were male and 17 were female. The sex ratio ws 1.7:1. 56.5% of patients were 40-60 years old. The tumor occurred most frequently in the nasal cavity, next in the oral cavity. Lesions originating from the eye and skin in the head and neck region comprised 15.2% of cases. Melanoma of the nasal cavity and eye rarely metastasized into the cervical lymph nodes but melanoma arising from the skin of head and neck had a metastatic rate of 57.1%. 50% of melanoma of the gingiva metastasized to the neck glands. In this series, 29 patients were treated by operation. The overall 3 and 5 year survival rates of these 46 patients are 38% and 15.7%. The 3 and 5 year survival rates of those without regional lymph node metastasis are 51% and 28%. The 3 and 5 year survivals of those with regional lymph node metastasis are 13% and 0%. Other methods, such as surgery plus chemotherapy, chemotherapy alone and radiotherapy plus surgery or chemotherapy were used only in a few cases which could not be evaluated.