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Background: Optimal management for endometrial cancer in patients with clinically negative lymph nodes is still under debate. Several prediction models for lymphatic dissemination of early-stage endometrial cancer have been developed. However, external validation is rare, and decision curve analysis has hardly been applied for these models. Objective: To develop and validate a nomogram to predict lymph node metastasis of presumed stage I and II endometrial cancer. Study Design: The prediction nomogram was developed by using multivariable logistic regression with data for 700 EC patients who underwent initial surgery from 2006 to 2017 at Peking University People's Hospital (training dataset), Beijing. External validation was performed in 727 eligible patients from Fudan University Shanghai Cancer Center (validation dataset), Shanghai. Results: For the 700 women in the training dataset, the lymph node metastasis rate was 8.0% (56/700). Lymphovascular space invasion, histological grade, cervical stromal invasion, and myometrial invasion were independent prognostic factors in the training dataset. We generated a nomogram based on these pathological factors. To determine the clinical usefulness of our nomogram, we compared it with the Mayo criteria. For our nomogram, the area under the receiver operating characteristic curve (AUC) was 0.85 as compared with 0.63 for the Mayo criteria. In the validation dataset, the AUC was 0.78 as compared with 0.57 for the Mayo criteria. The nomogram was well-calibrated in both the training and validation datasets. At a 10% probability threshold, our nomogram decreased almost 29 unnecessary lymphadenectomies per 100 patients than the Mayo criteria without missing more metastatic disease. Conclusion: We developed a nomogram to predict lymph node metastasis in patients with early-stage endometrial cancer in China. This prediction model may help clinicians in decision-making for patients with early-stage endometrial cancer, especially for the patient with incomplete surgery, reducing overtreatment, and medical costs.

The perioculomotor (pIII) region of the midbrain was postulated as a sleep-regulating center in the 1890s but largely neglected in subsequent studies. Using activity-dependent labeling and gene expression profiling, we identified pIII neurons that promote non-rapid eye movement (NREM) sleep. Optrode recording showed that pIII glutamatergic neurons expressing calcitonin gene-related peptide alpha (CALCA) are NREM-sleep active; optogenetic and chemogenetic activation/inactivation showed that they strongly promote NREM sleep. Within the pIII region, CALCA neurons form reciprocal connections with another population of glutamatergic neurons that express the peptide cholecystokinin (CCK). Activation of CCK neurons also promoted NREM sleep. Both CALCA and CCK neurons project rostrally to the preoptic hypothalamus, whereas CALCA neurons also project caudally to the posterior ventromedial medulla. Activation of each projection increased NREM sleep. Together, these findings point to the pIII region as an excitatory sleep center where different subsets of glutamatergic neurons promote NREM sleep through both local reciprocal connections and long-range projections.

// Jie Liu 1 , Feixiang Yuan 1 , Jian Gao 2 , Boer Shan 3 , Yulan Ren 3 , Huaying Wang 3 and Ying Gao 1 1 Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China 2 Nutrition Department, Affiliated Zhongshan Hospital of Fudan University, Shanghai, China 3 Department of Female Tumor, Fudan University Shanghai Cancer Center, Shanghai, China Correspondence to: Ying Gao, email: // Keywords : isoflavone supplementation, endometrial thickness, meta-analysis, randomized controlled trials, Gerotarget Received : January 25, 2016 Accepted : February 23, 2016 Published : March 07, 2016 Abstract Background: Isoflavone from soy and other plants modulate hormonal effects in women, and the hormone disorder might result in different caners including endometrial cancer. However, it’s effect on the risk of endometrial cancer is still inconclusive. We aimed to assess the effects of isoflavone on endometrial thickness, a risk factor of endometrial cancer in peri- and post-menopausal women. Methods: A meta-analysis of randomized controlled trials was conducted to evaluate the effect of oral isoflavone supplementation on endometrial thickness in peri- and post-menopausal women. Electronic searches were performed on the PubMed, Embase, the Cochrane Library, web of science, CINAHL, and WHO ICTRP to August 1 st , 2015. Reviews and reference lists of relevant articles were also searched to identify more studies. Summary estimates of standard mean differences (SMD’s) and 95%CIs were obtained with random-effects models. Heterogeneity was evaluated with meta-regression and stratified analyses. Results: A total of 23 trials were included in the current analysis. The overall results did not show significant change of endometrial thickness after oral isoflavone supplementation (23 studies, 2167subjects; SMD:-0.05; 95%CI:-0.23, 0.13; P =0.60). Stratified analysis suggested that a daily dose of more than 54mg could decrease the endometrial thickness for 0.26mm (10 trials, 984subjects; SMD:-0.26; 95%CI:-0.45, -0.07; P =0.007). Furthermore, isoflavone supplementation significantly decrease the endometrial thickness for 0.23mm in North American studies (7 trials, 726 subjects; SMD:-0.23; 95%CI:-0.44, -0.01; P =0.04), but it suggested an increase for 0.23mm in Asian studies (3 trials, 224 subjects; SMD: 0.23; 95%CI:-0.04, 0.50; P =0.10). Conclusion: Oral isoflavone supplementation might have different effects in different populations and at different daily doses. Multiple-centre, larger, and long-term trials are deserved to further evaluate its effect.

Objective The adjuvant treatment of high-risk endometrial cancer (HREC) remains controversial. This prospective phase-II clinical trial was conducted to evaluate the adjuvant concurrent chemoradiotherapy followed by chemotherapy in patients with HREC. Methods Altogether 122 patients were enrolled between January 2007 and January 2013, in which 112 were analyzable. The inclusion criteria included endometrioid endometrial cancer of histological grade 3 and with greater than 50% myometrial invasion, cervical stromal invasion, pelvic and/or para-aortic lymph node metastases; non-endometrioid endometrial cancer; no residual disease and distant metastases. Pelvic radiation was administered with cisplatin on days 1 and 28. Para-aortic radiation was administered with confirmed para-aortic lymph node metastases, and vaginal afterloading brachytherapy with cervical stromal invasion after total hysterectomy. Four courses of paclitaxel and carboplatin (PC) or cisplatin, cyclophosphamide and epirubicin (CEP) were administered at three-week interval after radiation. Results Ninety-six patients (85.7%) completed the planned treatment. Treatment discontinuation was the result of toxicity (5/112, 4.5%), disease progression (8/112, 7.1%), and patients refusal (3/112, 2.7%). There was no life-threatening toxicity. Twenty-five (22.3%) patients recurred, in which 4 cases recurred in the field of radiation, and 13 (11.6%) patients died of endometrial cancer during follow-up. The estimated five-year progression-free survival and overall survival were 73% and 84%, respectively. Adverse effects were less common in patients who received PC than CEP ( p =0.001). Conclusions This regimen demonstrated acceptable toxicity and good survival outcomes despite a preponderance (62.5%) of late stage disease. PC showed less adverse effects than CEP. A well designed randomized trial is under development. Clinical trial ID https://clinicaltrials.gov/: 070148-7.

IntroductionOpioid use disorder (OUD) is a worldwide health problem. Clinical trials indicated that acupuncture combined with medication is effective in OUD, however, there are different conclusions presented by previous trials. This study is designed to evaluate the efficacy and safety of acupuncture combined with medication in OUD.Methods and analysisPubMed, CENTRAL, Embase, Web of Science, CINAHL, PsycINFO, ProQuest Dissertation and Theses, AMED, OpenGrey, Clinicaltrials.gov and who.int/trialsearch will be searched in September 2019 without a language restriction. Randomised controlled trials (RCTs) and quasi-RCTs which included participants with OUD receiving acupuncture therapy combined with medication versus control group will be included in this study. Two reviewers will independently screen studies, extract data, assess risk of bias by the Cochrane risk of bias assessment tool and assess quality of evidence by Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Any disagreements will be arbitrated by the third reviewer. Data synthesis and analysis will be conducted by using RevMan V.5.3. Subgroup analyses, sensitivity analysis, meta-regression and reporting bias assessment will be conducted if necessary and appropriate.Ethics and disseminationOn account of the nature of this systematic review and meta-analysis, ethical approval is not required. The results will be published in a peer-reviewed journal.PROSPERO registration numberCRD42019123436.

Background Elevated blood pressure (hypertension) affects about one billion people worldwide. It is important as it is a major risk factor for stroke and myocardial infarction. However, it remains a challenge for the medical profession as many people with hypertension have blood pressure (BP) that is not well controlled. According to Traditional Chinese Medicine theory, acupuncture has the potential to lower BP. Objectives To assess the effectiveness and safety of acupuncture for lowering blood pressure in adults with primary hypertension. Search methods We searched the Hypertension Group Specialised Register (February 2017); the Cochrane Central Register of Controlled Trials (CENTRAL) 2017, Issue 2; MEDLINE (February 2017); Embase (February 2017), China National Knowledge Infrastructure (CNKI) (January 2015), VIP Database (January 2015), the World Health Organisation Clinical Trials Registry Platform (February 2017)and ClinicalTrials.gov (February 2017). There were no language restrictions. Selection criteria We included all randomized controlled trials (RCTs) that compared the clinical effects of an acupuncture intervention (acupuncture used alone or add-on) with no treatment, a sham acupuncture or an antihypertensive drug in adults with primary hypertension. Data collection and analysis Two review authors independently selected studies according to inclusion and exclusion criteria. They extracted data and assessed the risk of bias of each trial, and telephoned or emailed the authors of the studies to ask for missing information. A third review author resolved disagreements. Outcomes included change in systolic blood pressure (SBP), change in diastolic blood pressure (DBP), withdrawal due to adverse effects, and any adverse events. We calculated pooled mean differences (MD) with 95% confidence intervals (CI) for continuous outcomes using a fixed-effect or random-effects model where appropriate. Main results Twenty-two RCTs (1744 people) met our inclusion criteria. The RCTs were of variable methodological quality (most at high risk of bias because of lack of blinding). There was no evidence for a sustained BP lowering effect of acupuncture; only one trial investigated a sustained effect and found no BP lowering effect at three and six months after acupuncture. Four sham acupuncture controlled trials provided very low quality evidence that acupuncture had a short-term (one to 24 hours) effect on SBP (change) -3.4 mmHg (-6.0 to -0.9) and DBP -1.9 mmHg (95% CI -3.6 to -0.3). Pooled analysis of eight trials comparing acupuncture with angiotensin-converting enzyme inhibitors and seven trials comparing acupuncture to calcium antagonists suggested that acupuncture lowered short-term BP better than the antihypertensive drugs. However, because of the very high risk of bias in these trials, we think that this is most likely a reflection of bias and not a true effect. As a result, we did not report these results in the 'Summary of findings' table. Safety of acupuncture could not be assessed as only eight trials reported adverse events. Authors' conclusions At present, there is no evidence for the sustained BP lowering effect of acupuncture that is required for the management of chronically elevated BP. The short-term effects of acupuncture are uncertain due to the very low quality of evidence. The larger effect shown in non-sham acupuncture controlled trials most likely reflects bias and is not a true effect. Future RCTs must use sham acupuncture controls and assess whether there is a BP lowering effect of acupuncture that lasts at least seven days.

To explore the acupoint electrosensitivity and regularity for assisting the clinical diagnosis and treatment so as to improve the clinical therapeutic effects.By means of the computer retrieval (CBMdisc, CNKI, VIP, WanFang, PubMed and EMBASE) and manual retrieval, the relevant literature on acupoint electrosensitivity was reviewed and the modern literature database of acupoint electrosensitivity was established. Using bibliometric, the relations were analyzed among the detected indexes, acupoints, meridians and disorders in the conditions of acupoint electrosensitivity, and the potential regularity was explored.The general detection indexes of acupoint electrosensitivity were resistance, inertia area, volt-ampere area, electric conduction quantity, electric potential, electric current and capacitance. The electrosensitive points included meridian points, auricular points and extraordinary points. Among those points, the electrosensitivity easily occurred at the special points.The acupoint electrosensitivity is mainly reflected on the electrical impedance and volt-ampere characteristics. The relative specificity exists between acupoint electrosensitivity and

Objective An improved nerve-sparing radical hysterectomy (NSRH), which is based on the paravesico-vaginal space, has been recently introduced in a phase II, prospective clinical trial by our team. This study aims to report the surgical and oncological outcomes of this improved NSRH. Methods One hundred seventy-seven consecutive patients were enrolled in our study and underwent the improved NSRH. The proportion of successful catheter removal and postvoid residual urine volume (PVR) of 50 mL or less at postoperative day 7 or day 4 was used to assess surgical outcomes. The local control rate (LCR), disease free survival (DFS), and overall survival (OS) were used to assess oncological outcomes. Results Postoperative 30-day complications occurred in 27/177 (15.3%) patients. The rate of successful catheter removal and PVR of 50 mL or less were 85.2% (23/27) and 66.7% (18/27) at postoperative day 7, and 73.3% (110/150) and 35.3% (53/150) at postoperative day 4. A total of 13 (7.9%) patients showed recurrence after a median follow-up time of 39.2 months (range 3.2–68.1 months). The estimated 2-year and 5-year DFS rates were 92.2% and 91.1%, respectively. Seven (4.2%) patients presented local recurrence, and five (3.0%) patients were dead at the end of the follow-up period. The estimated 5-year LCR and OS were 95.1% and 96.2%, respectively. In univariate analysis, International Federation of Gynecology and Obstetrics (FIGO) stage, lymphovascular space invasion (LVSI), and lymph node metastasis were found to be the prognostic risk factors of DFS. Patients with LVSI were associated with a worse DFS according to the multivariate analysis. Conclusions The improved NSRH in our study may provide better surgical outcomes without compromising the survival in patients with early cervical cancer.

To explore the protective effect of acupuncture along meridians on rats with myocardial ischemia and its effect and action mechanism on cardiomyocyte energy metabolism.A total of 104 healthy 12-week-old SD rats were fed adaptively for 1 week and included into study with no disease symptoms observed. Of them, 24 SD rats were selected regardless of gender, and were randomly divided into a blank group and a sham operation group, 12 rats in each one. The remaining 80 SD rats were treated with ligation of left anterior descending coronary artery to establish the model of myocardial ischemia. The successful rate of model establishment was 60%, and 48 rats survived. They were randomly divided into a model group, an acupuncture along meridian group, an acupuncture along another-meridian group and a non-acupoint group, 12 rats in each one. The blank group was not treated with operation, but only bundle fixation. The sham operation group was treated with sham operation (coronary artery was not ligatured). The model group bundle fixation. The acupuncture along meridian group were treated with electroacupuncture (EA) at "Neiguan" (PC 6), the acupuncture along another-meridian group were treated with EA at "Hegu" (LI 4), and the non-acupoints group were treated at a non-acupoint which located in the hollow of the 3rd and 4th metatarsal bones of the dorsal foot of fore rate limb. Each bundle fixation or EA was given for 30 min, once a day for consecutive 5 days. The electrocardiogram was tested in all groups; the apoptosis rate of cardiomyocytes was detected by Tunel; the contents of ATP, ADP and AMP in myocardium were detected by high performance liquid chromatography.The ST segment voltage after model establishment was higher than that before modeling (allAcupuncture along meridians can effectively relieve the damage of cardiac muscle tissue; the possible mechanism is to increase ATP and reduce ADP, AMP of cardiomyocytes, so EC level is elevated and myocardial cell apoptosis is inhibited, leading to protective effect on cardiac muscle tissue and cells.

Objectives. To assess the efficacy of acupuncture in treating opioid use disorder (OUD). Design. Systematic review and meta-analysis. Methods. PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, ProQuest Dissertation and Theses, Allied and Complementary Medicine Database (AMED), Clinicaltrials.gov, and who.int/trialsearch were searched from inception to 23 December 2017. The methodological quality of selected studies and the quality of evidence for outcomes were assessed, respectively, by the Cochrane risk of bias assessment tool and the GRADE approach. Statistical analyses were conducted by RevMan 5.3. Results. A total of nine studies involving 1063 participants fulfilled the inclusion criteria. The results showed that acupuncture could be more beneficial than no treatment/sham acupuncture in terms of changes in craving for opioid (MD -2.18, 95% CI -3.10 to -1.26), insomnia (MD 2.31, 95% CI 1.97 to 2.65), and depression (SMD -1.50, 95% CI -1.85 to -1.15). In addition, these findings showed that, compared to sham electroacupuncture (EA), EA had differences in alleviating symptoms of craving (SMD -0.50, 95% CI -0.94 to -0.05) and depression (SMD -1.07, 95% CI -1.88 to -0.25) and compared to sham transcutaneous acupoint electrical stimulation (TEAS), TEAS had differences in alleviating symptoms of insomnia (MD 2.31, 95% CI 1.97 to 2.65) and anxiety (MD -1.26, 95% CI -1.60 to -0.92) compared to no treatment/sham TEAS. Conclusions. Acupuncture could be effective in treating OUD. Moreover, EA could effectively alleviate symptoms of craving for opioid and depression, and TEAS could be beneficial in improving symptoms of insomnia and anxiety. Nevertheless, the conclusions were limited due to the low-quality and small number of included studies. PROSPERO registration number is CRD42018085063.

The prevalence of vascular dementia (VaD) is high among the elderly. Acupuncture, a popular therapeutic method in China, can improve memory, orientation, calculation, and self-managing ability in VaD patients. However, in clinical acupuncture and acupuncture research, the selection of acupoints to treat VaD remains challenging. This study aimed to discover acupoints and acupoint combinations with potential for VaD based on data mining. After database searching and screening for articles on clinical trials evaluating the effects of acupuncture on VaD, 238 acupuncture prescriptions were included for further analysis. Baihui (GV 20), Sishencong (EX-HN 1), Fengchi (GB 20), Shuigou (GV 26), and Shenting (GV 24) appeared most frequently in the modern literature and are potential acupoints for VaD. Combinations between Baihui (GV 20), Sishencong (EX-HN 1), Fengchi (GB 20), Shenting (GV 24), Shuigou (GV 26), and Zusanli (ST 36) were most frequent and represent potential combinations for VaD treatment. These results provide a reference for the selection and combination of acupoints to treat VaD in clinical acupuncture and acupuncture research.

To perform a bibliometrics analysis on patent literature regarding diagnosis and treatment devices of acupuncture in China, aiming to provide references for the development of diagnosis and treatment devices of acupuncture.Based on SooPAT, a patent database, the patent literature regarding diagnosis and treatment devices of acupuncture in China was collected. With bibliometrics methods, the annual distribution of type, quantity, classification and content of diagnosis and treatment devices of acupuncture were analyzed.The number of acupuncture diagnosis and treatment devices reached its peak in 2012 and 2013 in China. The A61N in patent and utility model patent were the most, which were mainly related to electrotherapy, magnetic therapy, radioactive therapy and ultrasound therapy, etc. The main content was acupuncture treatment devices and meridian treatment devices. The 24-01 in design patent was the most, involving fixation devices used by doctors, hospitals and laboratories, etc.Currently the majority of diagnosis and treatment devices of acupuncture is therapeutic apparatus, while the acupuncture diagnosis devices are needed.

Coronary heart disease (CHD) is believed to be one of the major diseases with myocardial ischemia (MI) as basic pathological change. The clinical trials and experimental researches in the last 15 years were analyzed in this paper, and it was found that purinergic signaling could transduce the selective expression of molecular adenosine receptors A

Modern literature on the physical property of the

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effectiveness and gather evidence on safety from randomised controlled trials (RCTs) of acupuncture for unilateral amblyopia in children.

Background. Chronic stable angina pectoris (CSAP) is a major syndrome of ischemic heart disease (IHD). CSAP manifests as chest pain or discomfort and affects patients’ quality of life. Acupoint application (AP) has been reported to be effective for managing the symptoms of CSAP, but the evidence is not convincing. Therefore, we designed a randomized, double-blind, placebo-controlled clinical trial to evaluate the efficacy of AP in the treatment of CSAP.Methods and Analysis. Two hundred participants with CSAP will be randomly assigned in a 1 : 1 : 1 : 1 ratio into 4 groups. All participants will receive 12 sessions of treatment in 4 weeks and the same basic treatment procedure. The participants will be visited and assessed for 12 weeks, including a 4-week screening, a 4-week treatment phase, and a 4-week follow-up phase. The primary outcome is the change in the total frequency of self-reported angina attack at 4th week compared with the baseline. The secondary outcomes include the intensity of angina pain, consumption of nitroglycerin orSuxiao Jiuxinpills, CCS angina classification, SAQ, SAS and SDS score.Ethics. The study protocol has been reviewed and approved by the Sichuan Regional Ethics Review Committee on TCM (number 2013kl-001). This trial is registered with clinicaltrials.govNCT02029118.

A facile hydrothermal route has been developed to prepare graphene–Co3O4 nanocomposites. The graphene–Co3O4 nanocomposite catalyst demonstrates an excellent catalytic activity toward oxygen-reduction reaction including a considerably more positive half-wave potential (−0.23 V) than that of pristine graphene (−0.39 V), as well as higher cathodic currents. More importantly, this catalyst shows better long-term durability than the commercial Pt/C catalyst in an alkaline solution. The preliminary results indicate that the graphene–Co3O4 nanocomposite is an efficient and stable bifunctional catalyst for Li–air batteries and may be an alternative to the high-cost commercial Pt/C catalyst for the ORR/OER in alkaline solutions.

We developed a seed-assisted method to grow ultra-thin γ-Fe2O3 nanosheets with a paramagnetic behaviour on the surfaces of graphene sheets. Scanning electron microscopy and the transmission electron microscopy measurements showed that the length, height and thickness of the nanosheets were about 140, 120 and 5 nm, respectively. The measured electromagnetic parameters indicated that the three-dimensional (3D) graphene/γ-Fe2O3 nanosheet arrays exhibited a significantly enhanced electromagnetic wave absorption property compared to that of the graphene sheets and some magnetic nanomaterials. The minimal reflection loss was less than −15.2 dB for 3D graphene/γ-Fe2O3 nanosheet arrays with thicknesses of 2 mm, and it was up to −64.1 dB when the thickness was 4.92 mm. Good electromagnetic wave absorption properties of the 3D graphene/γ-Fe2O3 nanosheet arrays indicate that they are very promising for applications in the electromagnetic wave absorbing field.

We used facile one step solvothermal method to fabricate Bi2O3/BiOBr microspheres with porous flower-like structure which has good photocatalytic degradation ability to Rhodamine B. Meanwhile, the active species during photocatalytic reaction were explored. The results showed that the catalytic activity of Bi2O3/BiOBr was higher than that of BiOBr. After 140 min’ irradiation with 7 W LED lamp, the degradation efficiency of the Bi2O3/BiOBr photocatalyst reached 91.4%. The larger specific surface area and higher visible light utilization both improved the photocatalytic activity. O2− and h+ played a major role in the reaction process.

Reason for withdrawal from publication Protocol withdrawn from Issue 2, 2016 as the authors could not complete the review.

This paper presents for the first time a successful synthesis of quaternary nanocomposites consisting of graphene, Fe(3)O(4)@Fe core/shell nanopariticles, and ZnO nanoparticles. Transmission electron microscopy measurements show that the diameter of the Fe(3)O(4)@Fe core/shell nanoparitcles is about 18 nm, the Fe(3)O(4) shell's thickness is about 5 nm, and the diameter of ZnO nanoparticles is in range of 2-10 nm. The measured electromagnetic parameters show that the absorption bandwidth with reflection loss less than -20 dB is up to 7.3 GHz, and in the band range more than 99% of electromagnetic wave energy is attenuated. Moreover, the addition amount of the nanocomposites in the matrix is only 20 wt %. Therefore, the excellent electromagnetic absorption properties with lightweight and wide absorption frequency band are realized by the nanocomposites.

5512Background: Defects in DNA damage repair (DDR) system may lead to genomic instability and manifest as increased tumor mutation burden (TMB) in multiple types of cancers. But the prognostic valu...

By using data mining technology, the characteristics of acupoints selection of modern moxibustion for primary dysmenorrhea (PD) were analyzed. The modern literature regarding moxibustion for PDl was coll6cted~ from a comprehensive retrieval in Chinese Biomedical Medicine (CBM), China National Knowledge Infrastructure (CNKI), VIP and PubMed. The prescription database of moxihustion was established, and the association rule4 method of data mining technology was adopted to analyze characteristics and rules of acupoints selection of modern moxibustion for PD. As a result, a total of 35 acupoints were involved with a total frequency of 399. The acupoints, with higher selected frequency included Guanyuan (CV 4, 90 times), Sanyinjiao (SP 6, 47 times), Shenque (CV 8, 43 times), Zhongji (CV 3, 3 times) and Qihai (CV 6, 28 tirmes); the ratio of yin-meridian acupoints to1 yang-meridian acupoints was approximately 341; the utilization of the specific acupoints accountedfor68. 6% (24/35); the crossing acupoints were used mostly (203 "times), featured with high acupoints selected, especially Guanyuan (CV 4), Sanyinjiao CSP 6) and Zhongji (CV 3); the front-mu points (130 times), he-sa points (19 times) and lower he-sea points (18 times) were frequently used. The results reveal thiat acupoints selection of moxibustion of PD focuses on the local acupoints and comnbination with the distal acupoints. The yin-meridian acupoints are preferred and the specific acupoints are the main part of the prescription. This conclusion can also be used to optimize the choosing of acupoints in clinic.

Background While peripheral neuropathy is a common side effect of platinum-based chemotherapy, central nervous system (CNS) toxicity, such as encephalopathy or seizures, appears to be rare. This manuscript describes the only reported case of nonconvulsive status epilepticus associated with cisplatin in a cervical cancer patient who does not have other underlying medical conditions. Case presentation The patient is a 54-year-old Chinese female with recurrent stage IIIB moderately differentiated squamous cell carcinoma of the cervix who was being treated with cisplatin and topotecan. During the sixth cycle of this regimen, the patient presented with mental status changes. While imaging and laboratory values were within normal limits, the patient’s EEG revealed nonconvulsive status epilepticus. After appropriate intervention, she made a complete recovery with no further seizures. The patient currently remains on antiepileptic therapy, but is no longer receiving cisplatin. Conclusion Patients who present with new onset seizures should primarily be evaluated for underlying medical conditions. Among patients who are suspected to have CNS side effects associated with platinum use, we recommend avoidance of platinum agents in future chemotherapeutic regimens. Although rare, providers should be aware of the potential for CNS toxicity associated with this drug class.

Objective The aim of this study was to determine the impact of neoadjuvant chemotherapy (NACT) on survival in patients with bulky stage IIIC and IV epithelial ovarian cancer. Methods Between January 2009 and December 2012, 408 patients with ovarian cancer with extensive upper abdominal disease were reviewed. On the basis of the cycle number of NACT, patients were divided into 2 groups, namely, primary debulking surgery (PDS) group, which included the patients who received no more than 1 cycle of NACT; and neoadjuvant chemotherapy followed by interval debulking surgery (NACT-IDS) group, which included the patients who received more than 1 cycle of NACT. All patients underwent cytoreductive surgery with the goal of optimal outcome (⩽1 cm). Progression-free survival and overall survival were evaluated. Results There was no difference in surgical outcomes between PDS and NACT-IDS group, which was evaluated with either complete cytoreduction (41/376, 10.9% vs 6/32, 18.8%) or optimal cytoreduction (201/376, 53.5% vs 18/32, 56.2%). The median survival was 43.0 and 27.3 months in the PDS group and NACT-IDS group, with an estimated 5-year survival of 36% and 31%, respectively (P = 0.032; hazard ratio, 0.59; 95% confidence interval, 0.36–0.95). Complete cytoreduction, without bowel mesenteric carcinomatosis, and no more than 1 cycle of NACT were associated with lengthened survival by the multivariate analysis (P = 0.012, 0.025, and 0.036, respectively). Conclusions Neoadjuvant chemotherapy was associated with poor survival of patients with bulky stage IIIC and IV ovarian cancer. A well-designed randomized trial with a better quality control of surgical procedures is needed to confirm the results.

Acupoint catgut embedding (ACE) was applied widely to antiweight in China. The aim of this review is to estimate the effectiveness and safety of ACE on obesity. A literature search was conducted in PubMed, Cochrane Library, EBASE, CNKI, and so forth, using combination subject terms of obesity (or overweight, weight loss, etc.) and acupoint catgut embedding (or catgut implantation, catgut embedding). Improvement rate, reduction of body weight and body mass index (BMI), and so forth were analyzed. 43 studies were included for systematic review and meta-analysis. Although with poor methodological quality, ACE was superior to manual acupuncture (MA), sham, and cupping in improvement rate and presented a better tendency (OR>1) compared with drugs and electroacupuncture (EA). Mean values of weight loss by ACE were 1.14 kg, 1.26 kg, 1.79 kg, and 3.01 kg comparing with MA, drugs, EA, and sham, respectively. Mean of BMI reduced to 0.56 kg/m2, 0.83 kg/m2, 0.79 kg/m2, and 1.63 kg/m2comparing with MA, drugs, EA, and sham. Less adverse effects were reported. Pooled outcomes presented a tendency of equal or superior effects to other interventions and fewer side effects. Future high quality trials with rigorous design and positive FDA approved drug as control are urgent to assess the effect of ACE for obesity. PROSPERO registration number is as follows:CRD42015016006.

The purpose of this study was to detect micrometastases in sentinel lymph nodes (SLNs) by reverse transcriptase-polymerase chain reaction (RT-PCR) and immunohistochemistry (IHC) analyses for cytokeratin 19 (CK19) expression in early-stage cervical cancer. One hundred twenty-five SLNs were collected from 46 patients with early-stage cervical cancer. Conventional histopathologic techniques revealed 14 metastatic SLNs from 11 out of 46 patients. CK19 expression was detected by RT-PCR and IHC in all the 125 SLNs. Cervical cancer tissues from nine patients and five pelvic lymph nodes from the patients without tumor were utilized as positive and negative controls, respectively. All the metastastic SLNs on conventional histopathologic techniques were positive by either RT-PCR or IHC analyses, while all the positive controls were positive and all the negative controls were negative as expected. Of 35 patients without metastatic SLNs on conventional histopathologic techniques, the detection rate of micrometastases was 42.85% by RT-PCR and 20% by IHC analyses. RT-PCR and IHC were more sensitive to identify micrometastases in SLNs of patients with early-stage cervical cancer than routine pathology. These findings demonstrated that micrometastasis could be identified by molecular technique such as RT-PCR and IHC analyses for CK19 expression. RT-PCR was more sensitive to detect micrometastases in SLNs than IHC in patients with early-stage cervical cancer. Therefore, molecular assessment of the SLNs may be a valuable tool to complement routine histologic examination of cervical cancer. The importance of micrometastases in SLNs is under close clinical observation to determine whether it can be used as a predicting factor to help us make decision whether to proceed with whole-pelvic lymph node dissection or as a prognostic factor for clinical outcome.

A rare tetra-yttrium-supported Krebs-type tungstoantimonate was prepared in an acidic solution at pH 2.2 and characterized by elemental analysis and IR spectroscopy. Single-crystal X-ray analysis was carried out on Na2[{Y(H2O)7}4Sb2W22O76]·14H2O (1), which comprises a Krebs-type [Sb2W22O76]14– unit supported by four yttrium ions.

Background: The aim of this study was to evaluate the survival benefit of radical surgery with additional extensive upper abdominal procedures (EUAS) for the treatment of stage IIIC and IV ovarian cancer with bulky upper abdominal disease (UAD). Methods: An observational study was conducted between 2009 and 2012 involving two different surgical teams. Team A was composed of the “believers” in EUAS and Team B the “non-believers” in EUAS. Patients were divided into a radical surgery group (EUAS group) or a standard surgery group (non-EUAS group) according to whether or not they had received EUAS. All patients underwent primary cytoreductive surgery with the goal of optimal debulking (≤1 cm); this was reviewed in the pelvis, middle abdomen, and upper abdomen. The baseline for the two groups was optimal cytoreduction in both the pelvis and middle abdomen. Progression-free survival (PFS) was evaluated. Results: Radical surgery was performed in 70.7 % (82/116) and 12.7 % (30/237) of the patients by Teams A and B, respectively. The study groups had similar clinicopathologic characteristics. The median PFS and OS were significantly improved in the radical surgery group, compared with standard surgery groups (PFS: 19.5 vs. 13.3 months, HR: 0.61; 95 % CI: 0.46–0.80, P< 0.001; OS: not reached vs. 39.3 months, HR: 0.47; 95 % CI: 0.30–0.72, P

Background.Dysmenorrhea is a common problem for which acupuncture provides effective analgesia. Although acupoint selection affects the effectiveness of acupuncture, the basic rules of acupoint selection are little understood. This study aims to investigate the principles of acupoint selection and characteristics of acupoints used for primary dysmenorrhea.Methods.PubMed, China National Knowledge Infrastructure, and Chinese Biomedical Database were searched for clinical trials published in English or Chinese from January 1978 to April 2014 evaluating the effect of acupuncture on primary dysmenorrhea, with or without methods of randomization and/or control. Three authors extracted information and two reviewers inputted information on titles, journals, interventions, main acupoints, and outcomes using the self-established Data Excavation Platform of Acupoint Specificity for data mining.Results. Sanyinjiao(SP06),Guanyuan(CV04), andQihai(CV06) were used most frequently. The most frequently used meridians were Conception Vessel, Spleen Meridian of FootTaiyin, and Bladder Meridian of FootTaiyang. 67.24% of acupoints used were specific acupoints. Acupoints on lower limbs were most frequently used.Conclusion.Data mining is a feasible approach to identify the characteristics of acupoint selection. Our study indicated that modern acupuncture treatment for primary dysmenorrhea is based on selection of specific acupoints according to traditional acupuncture theory.

Deqirefers to the special sensation and reaction sensed mainly by both acupuncturist and patient when a needle was inserted into the acupoints and is considered to be vital to achieve acupuncture effect. For acupuncturist, it is important to judge and controlDeqiin clinical practice. However, enough attention is paid to patients’ feelings rather than acupuncturists’ nowadays. We thus conducted this survey to determine acupuncturists’ perspectives aboutDeqiand to further find the proper way to induceDeqi. A total of 250 questionnaires were sent out to acupuncturists and 202 (80.8%) were returned. According to the results, most acupuncturists believe thatDeqiis vital to obtain preferable clinical effects. The reliability of acupuncturists’Deqisensation ranks as sinking> tightening> astringent. The reliability of patients’Deqisensations ranks as sourness> numbness> distention> heaviness> pain. The reliability of influential factors ranks as manipulation> specificity of acupoint> TCM constitution> disease status> patient’s psychological condition> acupuncturists’ psychological guidance> clinical environment. This study is believed to provide additional evidence to the qualitative and quantitative research ofDeqiin the future.

Background Salvage cytoreductive surgery (SCR) has been shown to improve the survival of cancer patients. This study aimed to determine the survival benefits of SCR for recurrent endometrial cancer in Chinese population. Methods Between January 1995 and May 2012, 75 Chinese patients with recurrent endometrial cancer undergoing SCR were retrospectively analyzed. Results 43 patients (57.3%) had R0 (no visible disease), 15 patients (20.0%) had R1 (residual disease ≤1 cm), and 17 (22.7%) had R2 (residual disease >1 cm) Resection. 35 patients (46.7%) had single, and 40 (53.3%) had multiple sites of recurrence. The median survival time was 18 months, and 5-year overall survival (OS) rate were 42.0%. Multivariate analysis showed that residual disease ≤1 cm and high histology grade were significantly associated with a better OS. The size of the largest recurrent tumors (≤6 cm), solitary recurrent tumor, and age at recurrence (≤56 years old) were associated with optimal SCR. Conclusion Optimal SCR and high histology grade are associated with prolonged overall survival for patients with recurrent endometrial cancer. Patients with young age, tumor size

ObjectiveTo assess the effectiveness and safety of acupuncture therapy for angina pectoris.MethodsRandomized controlled trials (RCTs) concerned with acupuncture treatment of angina pectoris were identified by searching Academic Source Premier, MEDLINE, Science Citation Index Expanded, and three Chinese databases (China biology medicine database, China national knowledge infrastructure, and VIP database for Chinese technical periodicals). The valid data were extracted in accordance with our inclusion and exclusion criteria. The main outcomes of the included studies were synthesized using Revman 5.1.ResultsTwenty-one articles on 16 individual studies were included and evaluated as having high or moderate risk of bias according to the standards of the Cochrane Collaboration. Meta-analysis indicated that acupuncture combined with conventional drugs (ACCD) was superior to conventional drugs alone in reducing the incidence of acute myocardial infarction (AMI) [OR=0.18, 95% CI (0.04, 0.84), P=0.03]. Moreover, ACCD was superior to conventional drugs in the relief of angina symptoms [OR=4.23, 95% CI (2.73, 6.56), P

To investigate the feasibility and efficacy of curettage with hysteroscopy followed by megestrol acetate (MA) for well-differentiated endometrioid carcinoma (EC) confined to the endometrium and for atypical hyperplasia (AH) in young women. Fourteen patients with EC and 12 patients with AH were prospectively enrolled in this study. All of the patients received at least 12 weeks of oral MA (160 mg/day) following thorough curettage with hysteroscopy. The response was assessed histologically every 12 weeks. The primary endpoint was the complete response rate. Adverse events, pregnancy rates and recurrence rates were secondary end points. Twenty-one (80.8 %) patients responded to treatment. The median time to response was 12 weeks. After a median follow-up of 32 months, 6 patients had recurrences. Significantly, more patients with infertility or PCOS experienced recurrence (P = 0.040, P = 0.015). Eight patients attempted to conceive after complete response; two spontaneous conceptions and one normal delivery were achieved. No disease-related or treatment-related deaths were observed. Fertility-sparing treatment with MA following entirely hysteroscopic curettage is effective, demonstrating the least toxicity for rigorously selected young women with well-differentiated EC confined to the endometrium or with AH; however, close follow-up is required for the potential consequences of improper patient selection and a substantial rate of recurrence.

As an ancient empirical medicine, acupuncture has profound theory basis and extensive clinical application. With the popularity of evidence-based medicine (EBM), rigorous challenges have been brought to acupuncture: (1) How to translate the tremendous source of evidence into an optimal treatment schema in clinical practice? (2) How to integrate the theory and methodology of the empirical medicine with that of EBM into a theory and methodology which will benefit the development of acupuncture? The aim of this chapter is to encourage reflection on the combination of the theory and methodology of EBM with the features of acupuncture so as to guide acupuncture clinical practice, health policy, and scientific research.

The index dynamic operation includes three operations such as search operation insert operation and delete operation. In the inserting operation it possibly results node overflow. So it needs to use the node splitting algorithm to realize the inserting new node operation. R–tree search performance depends on the cover and overlap two parameters. Overlapping minimize is more critical than forehead minimization. This algorithm put forward in R - tree node apart, according to make the principle of least overlapping. It will divided nodes into two parts. Then it adjusts the position of already insert node and inserts the new node in the new position. The R-tree improved algorithm performances well in the search operation.

Na2 [{Y(H2O) 7}4Sb2W22O76] ·14H2O is synthesized from an aqueous HNO3 solution of Y2O3 and Na9[SbW9O33], (pH 2.2 adjusted with 4 M HCl, 95 °C, 2 h, 50% yield).

Objective. To analyze clinico-pathological features of Chinese patients with UPSC, and investigate roles of Her-2/neu protein expression and gene amplification in UPSC prognosis. Methods. Thirty-six patients with UPSC treated in Cancer Hospital of Fudan University from 1996 to 2006 were analysed retrospectively. Chromogenic in situ hybridization (CISH) and immunohistochemistry (IHC) were performed to evaluate Her-2/neu gene amplification and protein expression respectively. Results. The median age was 63 years, and 61% (22/36) were late stages (stage III/IV). The 1-year, 3-year, and 5-year overall survival (OS) was 73.1%, 51.9% and 43.9%, respectively. Advanced stages ( 𝑃 = . 0 0 0 6 ) and deep myometrial invasion ( 𝑃 = . 0 1 3 8 ) were significantly associtated with a shorter OS. In 36 cases, 27.8% (10/36) showed 2 + staining and 8.3% (3/36) showed 3 + by IHC. Amplification of the Her-2/neu gene was observed in 11.1% (4/36) cases. The 5-year overall survival rate in Her-2/neu IHC 2 + ∼ 3 + and 0 ∼ 1 + cases was 12.9% and 68.6% respectively. Her-2/neu protein expression 2 + ∼ 3 + was significantly associated with advanced surgical stage and worse overall survival ( 𝑃 = . 0 3 and 𝑃 = . 0 0 2 3 , resp.). Conclusion. Chinese patients with UPSC showed characteristics of deep myometrial invasion, advanced stages and poor overall survival. Her-2/neu protein overexpression is associated with advanced stage and poor survival outcome.

We developed a new strategy, i.e., a seed-assisted method, to fabricate a three-dimensional (3D) SiO2@Fe3O4 core/shell nanorod array/graphene architecture. The fabrication processes involved deposition of β-FeOOH seeds on the graphene surfaces in the ferric nitrate aqueous solution, subsequent growth of β-FeOOH nanorod arrays on the graphene surfaces in the ferric chloride aqueous solution under hydrothermal conditions, deposition of SiO2 coating on the surfaces of β-FeOOH nanorods, and final formation of the 3D architecture by a thermal treatment process. Scanning electron microscopy and transmission electron microscopy measurements showed that the SiO2@Fe3O4 core/shell nanorods with a length and diameter of about 60 and 25 nm, respectively, were almost grown perpendicularly on both side surfaces of graphene sheets. The measured electromagnetic parameters showed that the 3D architecture exhibited excellent electromagnetic wave absorption properties, i.e., more than 99% of electromagnetic wave energy could be attenuated by the 3D architecture with an addition amount of only 20 wt% in the paraffin matrix. In addition, the growth mechanism of the 3D architecture was proposed, and thus, the strategy presented here could be used as a typical method to synthesize other 3D magnetic graphene nanostructures for extending their application areas.