BACKGROUND: At present, researches have been proved that nerve growth factor (NGF) plays an important role in repairing neural regeneration after spinal cord injuries. Poor ability of neural regeneration is related to lack of microenvironment for neuronal growth at local injured site. Whether electro-acupuncture can protect nerve after spinal cord injuries through increasing NGF level in injured spinal cord or not is lack of experimental data on the view of molecule.OBJECTIVE: To observe the effect of electro-acupuncture on motor function, morphology of spinal cord and mRNA expression of NGF in rats with experimental spinal cord injuries through morphology and hybridization in situ.DESIGN: Randomized controlled animal study.SETTING: Department of Acupuncture and Moxibustion, the Tenth People's Hospital Affiliated to Tongji University; Shanghai Institute of Acupuncture and Meridian.MATERIALS: The experiment was completed in the Shanghai Institute of Acupuncture and Meridian from January 1999 to February 2002. A total of 15 male SD rats weighing (260±9.52) g were randomly divided into sham operation group, injured control group and acupuncture group with 5 in each group.METHODS: Models of spinal cord injuries were established in injured control group and electro-acupuncture group, and rats in sham operation group were just treated with resection of lamina of vertebra. Two hours after operation, rats in electro-acupuncture group were treated with electroacupuncture at Daczhui (GV14) and Mingmen (GV4), L2 Jiaji (Ex-B2-L2)and Huantiao (GB30), alternatively. Then, G6805 electro-acupuncture apparatus was used with distant wave, 0.8 Hz, 0.3-0.6 mA, and slight shake on muscle was regarded as proper response. The electro-acupuncture was performed every 30 minutes a day for 30 days. Rats in injured control group and sham operation group were not treated with any way, and motor functions 2 hours and 30 days after operation were observed with modified Tarlov scale and Rivlin method. ① Modified Tarlov scale: Pamplegia and irresponsivity of lower limbs during electro-acupuncture were scored from 0 to 6 points. ② Modified Rivlin method: Tiltboard was consisted of two rectangular alloy boards which was connected to one end through hinge.Board turned around axis at the beginning of horizontal position (0°) and the angle of ram could be measured. Rats faced towards front were put vertically as longitudinal axis of body to longitudinal axis of tiltboard.Angle was increased gradually when rats were not able to keep the primary position for 5 seconds, and the critical angle was recorded. Hybridization in situ assay: Amount of positive NGF cells was recorded under light microscope and photographs were completed at the same time.MAIN OUTCOME MEASURES: Scale of motor function (modified Tarlov score), critical angle of ram test (modified Rivlin method) and changes of amount of positive NGF mRNA cells in rats with spinal cord injuries.RESULTS: A total of 15 experimental rats were involved in the final analysis. ① Two hours after spinal cord injuries of rats in injured control group and electro-acupuncture group, score of motor function and critical angle of ram which was measured with modified Rivlin method were decreased remarkably; 30 days later, score of motor function measured with modified Tarlov scale and critical angle of ram were increased at various degrees, especially those in electro-acupuncture group were increased remarkably, and there was significant difference from those in injured control group [35.40±6.62, 27.80±1.10; (35.40±6.62)°, (27.80±1.10)°, P ＜ 0.05]. ② Thirty days after injury, pathological lesion of rats in electroacupuncture group was milder than that in injured control group, and morphological injury of spinal cord and amount of positive NGF mRNA cells were obvious as compared with those in injured control group (28.13±1.64,12.63±1.41, P ＜ 0.01).CONCLUSION: Electro-acupuncture can improve mRNA expression of NGF in spinal cord, relieve morphological injury of spinal cord, accelerate recovery of motor function of rats with spinal cord injuries, and protect nerve through mRNA expression of NGF.

Objective To determine the influence of abiraterone acetate (AA) on neuroendocrine differentiation (NED) in metastatic castration-resistant prostate cancer (mCRPC) and the prognostic predicting value of the serum NED markers in mCRPC patients treated with AA.Methods We conducted an analysis in 115 chemotherapy-naive mCRPC patients who were treated with chemotherapy in Renji hospital from 2013 to 2017.The median age was 70,ranged from 65 to 76 years old.The median CgA,NSE and PSA levels were 101.1 ng/ml (78.5-150.0 ng/ml),13.4 ng/ml (10.5-17.6 ng/ml) and 38.8 ng/ml (11.2-123.2 ng/ml),respectively.Among them,48 cases were classified as the group without AA treatment.The other 67 cases were classified as group after AA failure.In group without AA treatment,the median CgA,NSE and PSA levels were 109.1 ng/ml(80-151.5 ng/ml);13.8 ng/ml(10.8-18.2 ng/ml) and 39.2 ng/ml (8.6-200 ng/ml),respectively.In group after AA failure,the median CgA,NSE and PSA levels were 105.4 ng/ml(78.8-175.5 ng/ml),13.8 ng/ml(10.8-17.6 ng/ml) and 39.0 ng/ml(8.4-219.8 ng/ml),respectively.In the group with serial evaluation of NED markers during AA treatment,the median serum CgA,NSE levels at baseline were 115.9 ng/ml(90.1-201.5 ng/ml),13.3 ng/ml (10.4-18.1 ng/ml),respectively.The endpoints were PSA PFS(progression-free survival) and radiographic PFS (rPFS).Results In 34 patients with serial evaluation,serum NED markers level in 19 patients increased after the failure of AA treatment.Median serum CgA and NSE levels were 115.9 ng/ml(90.1-201.5 ng/ml)and 13.25 ng/ml (10.37-18.14 ng/ml) at baseline.Median serum CgA and NSE levels were 129.6ng/ml (75.5-230.5 ng/ml) and 14.7 ng/ml (11.8-19.1 ng/ml) after 6 months treatment,respectively.The median serum CgA and NSE levels were 130.4 ng/ml (95.7-205.7 ng/ml) and 15.2 ng/ml(12.4-18.7 ng/ml) at the time of failure of AA treatment,respectively.There was no significant difference of NED markers between baseline and failure of AA treatment (P =0.243).In logistic univariate analysis,AA treatment and its duration were not independent factors influencing NED(P =0.30;P =0.52).Compared with the NED markers elevation group in the first 6 months of AA treatment and baseline supranormal NED markers group,the NED markers decline group(PSA PFS(17.1 vs.10.4 months,P ＜ 0.001) and rPFS (17.0 vs.10.4 months,P =0.003)) and baseline normal NED markers group(PSA PFS(14.1 vs.9.5 months,P =0.001) and rPFS(16.4 vs.10.5 months,P ＜ 0.001)) has a longer median PSA PFS and rPFS respectively.In multivariate Cox analysis,baseline NED markers level and NED markers variation during the first 6 months of AA treatment remained significant predictors of rPFS(P ＜ 0.05),and PSA-PFS (P ＜ 0.05).Conclusions We found there was heterogeneity in changes of NED markers in different mCRPC patients during AA treatment,and AA might not significantly lead to progression of NED of mCRPC in general.Serial CgA and NSE evaluation might help clinicians guide clinical treatment of mCRPC patients.Serum NED markers elevation during the first 6 months of AA treatment and elevated baseline NED markers levels indicated poor prognosis in mCRPC treated with AA.