Objective:To observe the characteristics of brain functional activity in patients with chronic non-specific low back pain(CNLBP)and to explore the potential mechanism of brain functional remodeling in acupuncture treatment based on resting-state fMRI.Method:The 22 patients with CNLBP were included as the CNLBP group,and 22 healthy subjects(HCs)were included as the HCs group.The visual analogue scale(VAS)for pain,Oswestry disability index(ODI),Japanese Orthopedic Association(JOA)score for lumbar spine were collected before and after acu-puncture treatment in the CNLBP group.Resting-state fMRI data were acquired for all participants.The frac-tional amplitude of low frequency fluctuation(fALFF)values of the different brain regions in CNLBP patients before treatment compared with the HCs group were extracted and correlated with the differences in VAS,ODI,and JOA scores.Result:Acupuncture treatment significantly improved the VAS,ODI,and JOA scores in the CNLBP group(P＜0.001);Before treatment,the CNLBP group showed higher fALFF values in the right orbital middle frontal gy-rus,right anterior cingulate gyrus,left anterior cingulate gyrus and left precuneus compared to the HCs group,while lower fALFF values were observed in the right precentral gyrus/right postcentral gyrus,left precentral gy-rus/left postcentral gyrus,right thalamus,right postcentral gyrus/precentral gyrus,and left thalamus.After treat-ment,the CNLBP group exhibited increased fALFF values in the right precentral gyrus/postcentral gyrus,left precentral gyrus/postcentral gyrus,and left middle temporal gyrus,and decreased fALFF values in the left me-dial superior frontal gyrus,right precuneus/left precuneus compared to pre-treatment.Additionally,pre-treatment fALFF value in the right orbital part of the middle frontal gyrus,right anterior cingulate gyrus and left anteri-or cingulate gyrus in the CNLBP group was negatively correlated with the changes in VAS scores(r=-0.699,P=0.000).Conclusion:Acupuncture treatment can significantly improve pain intensity and lumbar spinal dysfunction in CNLBP.CNLBP has multiple abnormalities in brain functional activities related to pain regulation pathways and the default mode network(DMN),and acupuncture treatment can restore most of these abnormal brain ac-tivities;the characteristic of brain functional activity in the right orbital part of the middle frontal gyrus,right anterior cingulate gyrus and left anterior cingulate gyrus before CNLBP treatment is related to the difference in VAS score,providing a potential imaging biomarker for predicting treatment efficacy.

Objective:To observe the characteristics of brain functional activity in patients with chronic non-specific low back pain(CNLBP)and to explore the potential mechanism of brain functional remodeling in acupuncture treatment based on resting-state fMRI.Method:The 22 patients with CNLBP were included as the CNLBP group,and 22 healthy subjects(HCs)were included as the HCs group.The visual analogue scale(VAS)for pain,Oswestry disability index(ODI),Japanese Orthopedic Association(JOA)score for lumbar spine were collected before and after acu-puncture treatment in the CNLBP group.Resting-state fMRI data were acquired for all participants.The frac-tional amplitude of low frequency fluctuation(fALFF)values of the different brain regions in CNLBP patients before treatment compared with the HCs group were extracted and correlated with the differences in VAS,ODI,and JOA scores.Result:Acupuncture treatment significantly improved the VAS,ODI,and JOA scores in the CNLBP group(P＜0.001);Before treatment,the CNLBP group showed higher fALFF values in the right orbital middle frontal gy-rus,right anterior cingulate gyrus,left anterior cingulate gyrus and left precuneus compared to the HCs group,while lower fALFF values were observed in the right precentral gyrus/right postcentral gyrus,left precentral gy-rus/left postcentral gyrus,right thalamus,right postcentral gyrus/precentral gyrus,and left thalamus.After treat-ment,the CNLBP group exhibited increased fALFF values in the right precentral gyrus/postcentral gyrus,left precentral gyrus/postcentral gyrus,and left middle temporal gyrus,and decreased fALFF values in the left me-dial superior frontal gyrus,right precuneus/left precuneus compared to pre-treatment.Additionally,pre-treatment fALFF value in the right orbital part of the middle frontal gyrus,right anterior cingulate gyrus and left anteri-or cingulate gyrus in the CNLBP group was negatively correlated with the changes in VAS scores(r=-0.699,P=0.000).Conclusion:Acupuncture treatment can significantly improve pain intensity and lumbar spinal dysfunction in CNLBP.CNLBP has multiple abnormalities in brain functional activities related to pain regulation pathways and the default mode network(DMN),and acupuncture treatment can restore most of these abnormal brain ac-tivities;the characteristic of brain functional activity in the right orbital part of the middle frontal gyrus,right anterior cingulate gyrus and left anterior cingulate gyrus before CNLBP treatment is related to the difference in VAS score,providing a potential imaging biomarker for predicting treatment efficacy.

Objective CD4 +IL-17 +cells are a group of newly discovered effector CD4 +T cells, which may play a key role in the pathogenesis of cancer.This study aims to investigate the expres-sion of CD4 +IL-17 +cells in pancreatic cancer and its correlation with the clinicopathological characteristics and prognosis of the dis-ease as well as the clinical significance of the cells in the microenvironment of pancreatic cancer. Methods We collected tumor tis-sue and tumor-adjacent normal tissue samples from 51 pancreatic cancer patients.We determined the expressions of CD34 and vascular endothelial growth factor ( VEGF) and measured the proportion of IL-17 +cells in the cancer tissue using immunohistochemistry and the fluorescence activated cell sorter, respectively, followed by analysis of their correlation with tumor angiogenesis, clinicopathological pa-rameters, and survival time of the patients. Results The percentage of CD4 +IL-17 +cells in tumor tissue was positively correlated with microvessel density (r =0.534, P<0.05) and the expression of VEGF in the tumor tissue (r=0.356, P<0.05).IL-17 +cells were expressed more highly in the tumorous than in the tumor-adjacent normal tissue (P<0.05), and the expression level was correla-ted with the stage of tumor, node, and metastasis (TNM) and lymph node metastasis (P<0.05), but not with the patients′gender or age, tumor size, tumor location, histological grade, or local invasion (P>0.05).Fifty (98.0%) of the patients were successfully followed up for 2-67 months, which revealed a median survival time of 16.6 ±4.8 months, significantly longer in those with a higher expression of intratumoral IL-17 +cells (P<0.05).Univariate analysis showed an association of the survival rate with the tumor size, TNM stage, lymph node metastasis, and level of intratumoral IL-17 +cells, while multivariate analysis showed the TNM stage to be an independent prognostic factor for the survival of the pancreatic cancer patients. Conclusion The expression of CD4 +IL-17 +cells in the tumor tissue is positively correlated with tumor angiogenesis, while that of IL-17 +cells with the clinicopathological parameters and survival time of the patients and therefore may serve as an important immune indicator for the prognosis of pancreatic cancer.

BACKGROUND:CT-guided percutaneous intervention and rehabilitation techniques are both classic programs for diagnosis and treatment of lumbar disc herniation. Is the combination of CT-guided percutaneous intervention and rehabilitation techniques preferential y used for treatment of lumbar disc herniation?
OBJECTIVE:To evaluate the curative effect of CT-guided interventional injection combined with rehabilitation integration treatment for lumbar disc herniation and to analyze prognostic factors.
METHODS:Eighty-eight patients with lumbar disc herniation were subjected to CT-guided interventional injection combined with rehabilitation integration treatment from May 2010 to May 2013. Injection medicine consisted of betamethasone, tanshinone Ⅱ A sulfonate, neurotropin, normal saline and iohexol. Rehabilitation integration treatment included traction, manipulation, acupuncture, transcutaneous electrical nerve stimulation and thermal magnon. Macnab criteria and Chinese version of Oswestry low back pain disability questionnaire were used to assess the curative effects in comparison with the 112 patients receiving only CT-guided interventional injection that were reported previously. The prognostic factors, such as age, disease course time and herniation type of target segment were testified by correlation analysis.
RESULTS AND CONCLUSION:Total y 77 patients were completely fol owed up for 1 year. There were excellent outcomes in 64 cases, while favorable outcomes in 7 cases, fair outcomes in 5 case, poor outcome in 1 case, with a better outcome rate of 92%.There was a significantly decreased trend in Oswestry disability Index scores at 1, 6, 12 months during the fol ow-ups (P<0.01). No severe complications occurred in al the included patients. The curative effects were improved in term of better outcomes rate compared with the 112 patients receiving only CT-guided interventional injection, but there was no significant difference (P>0.05). The young group (≤ 45 years) had better outcomes than the older group (>45 years;P<0.01). In addition, disease course time and herniation type of target segment were not statistical y significant risk factors predicting clinical results (P>0.05). These findings indicate that CT-guided interventional injection combined with rehabilitation integration treatment could relieve lower back pain and radical leg pain effectively and decrease life disability level.

To study the changes in median frequency (MF) from a surface electromyogram of skeletal muscles and functional assessment of chronic illness therapy (FACIT) figure scale scores for patients with chronic fatigue syndrome (CFS) before and after Tuina treatment.

Objective:To study the tuina effect on sleep disorder and emotional problems of chronic fatigue syndrome (CFS) cases.Method:Thirty CFS cases were treated in the treatment group,by applying one-thumb pushing,rolling and pressing-kneading manipulations along the Governor Vessel,Bladder and Yangming Meridians.The intended major points include Fengfu (GV 16),Yaoyangguan (GV 3),Xinshu (BL 15),Pishu (BL 20),Ganshu (BL 18),Hegu (LI 4) and Taixi (KI 3).The treatment was done once every other day;10 times constitute a course of treatment.Another 30 healthy cases were selected in the control group,without any intervention.The sleep quality and mental state in the two groups were evaluated by PSQI,HAMA and HAMD.In addition,the pre-treatment and post-treatment score changes were observed.Results:Before treatment,the total score of PSQI,sleep quality,time of falling asleep,sleep efficiency,sleep disorder,daytime functional impairment,and scores of HAMD and HAMA in treatment group were all substantially higher than the control group (P＜0.01).After 10 tuina treatments,the total score of PSQI,time of falling asleep,sleep disorder and daytime functional impairment as well as scores of HAMD and HAMA in treatment group were significantly changed,compared with before treatment,P＜0.05.Conclusion:Those with CFS may present with sleep disorder and mental or psychological abnormality,tuina can improve their sleep quality and adjust their mental conditions.