OBJECTIVE: To investigate the distribution of peripheral blood lymphocytes and natural killer (NK) cells, and its influence on the prognosis of patients with myelodysplastic syndromes (MDS). METHODS: The lymphocytes proportion, absolute lymphocyte counts (ALC), NK cell proportion and absolute NK cell counts (ANKC) as well as the related data of 95 MDS patients diagnosed between 2013 and 2017 analyzed retrospectively. The correlation of ALC and ANKC with prognosis was also analyzed. RESULTS: As compared with low ALC patients, MDS patients with ALC≥0.885×10/L had a higher overall response rate (66.7% vs 35.8%) (P＜0.01). The ALC of effective patients after treatment significatitly increased in compaison of ALC at diagnosis. Multivariate analysis indicated that patients with ALC≥0.885×10/L had long overall survival (OS) time in comparison with patients with low level (16.4 vs 12.4 months) (P＜0.05). The OS time of patients with ANKC≥0.110×10/L was shorter in comparison with patients with low level (10.9 vs 16.3 months) (P＜0.01). Otherwise, blast, cytogenetic risks and treatment response were also independent risk factors of MDS (P＜0.05). Revised International Prognostic Scoring System (IPSS-R) combined with ANKC could improve predictive accuracy of IPSS-R alone (AUC 0.718 vs 0.674) (P＜0.05). CONCLUSION Lymphocytes and NK cells are important for the prognosis evaluation of MDS patients.

The value of the "touching-bone" acupuncture technique in clinical application was explained through the investigation on the origin of the theory of the "touching-bone" acupuncture technique, the analysis on the characteristics of acupoint selection, the introduction of clinical characteristics and the discussion on the mechanism of acupuncture in treatment. The "touching-bone" acupuncture technique refers to deep needling method, originated from the short needling and needling of the ancient needling methodslisted in the . The target points are the reaction sites on meridian near to bone and the attachments of soft tissues on bone. During the needle insertion, the needle tip is thrust deeply to the bone or the needle body is closely attached to the bone so as to stimulate periosteum specifically. This needling technique contributes to the satisfactory effect on spasmodic, deep-located and intractable pain disorder, motor system diseases, mental diseases and cerebral diseases, etc. Hence, this acupuncture technique deserves to be promoted in clinical application and explored in research.
Acupuncture Therapy ; Meridians ; Needles

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.

Objective: To explore susceptibility genes for autism spectrum disorders (ASD). Methods: Whole-exome sequencing was carried out for 60 family trios affected with sporadic ASD. Genetic variants discovered in over 10% of the patients were selected for genotype-phenotype correlation and pathway enrichment analysis using Phenolyzer software and metascape database. Combining gene-phenotypic scores, pathway-related genes associated with neural and neurite triggering were screened for the candidates. Results: A total of 170 common variants were found to be associated with the ASD phenotype. Among these, there was only one high-confidence gene [SHANK2 (0.8146)] and four medium-confidence genes [ERBB2 (0.1322), LAMC3 (0.1117), PPFIA4 (0.1059), DISC1 (0.1002)]. Twenty-pathways and four biological processes were found to be statistically significant by pathway enrichment analysis, which included neuron projection morphogenesis (GO: 0048812), regulation of neuroblast proliferation (GO: 1902692), modulation of excitatory postsynaptic potential (GO: 0098815), and dendrite morphogenesis (GO: 0048813). Twenty-one genes were found to be closely associated with neurological and neurite triggering, among which only SHANK2, ERBB2, and DISC1 had above-medium confidence correlation scores with the ASD phenotypes. Conclusion Abnormal neuron projection morphogenesis (GO: 0048812) may be closely related to the occurrence of ASD. SHANK2, ERBB2, and DISC1 are susceptibility genes for ASD.

Objective: To observe the effects of Chinese herbalprescription Tizhi-Pingtiao Powder (TP) based on Five-Yun Six-Qi theory to treat hyperlipidemia (HLP). Methods: This study included 641 HLP patients from Constitution medicine clinic in Dongzhimen hospital from January 2015 to November 2017. The embryonic period’s (ten months) Five-Yun Six-Qi endowments of the enrolled patients were analyzed and TP were prescribedaccordingly, in the absent of lipid-lowering drugs. The curative effect was observed after three months’ TP treatment and reviewed ofeach 3 months, and long-term effects will be observed for 1 year,either take the priscription or not. Curative effect is based on blood lipids maintain normal as well as constitution improved while stopped lipid-lowering drugs. Results: Among the 641 patients who met the inclusion criteria, 379 patients take on complete, and 300 patients (79.2%) were clinically cured (with blood lipid decreased to normal, overall constitution and complication condition improved), 375 patients (99.0%) were completely cured. Among 262 patients without dietary restriction, 143 patients (54.6%) were clinically cured, 240 patients (91.6%) were completely cured. Long-term effects showed that 210 patients stopped the TP after 3 months' treatment, the recurrence rate at the end of the 3rd month, 6th month and 12th month in the patients who were on complete dietary restriction were 4.1%, 48.8% and 76.9%, while the recurrence rate in the patients who had not implemented dietary restriction were 37.1%, 70.8%, 89.9%. A total of 115 patients continued the TP for the other 12 months, the recurrence rate at the end of 3rd month, 6th month and 12th month in the patients who were on complete dietary restriction were 2.5%, 4.8% and 6.0%, while the recurrence rate in the patients who had not implemented dietary restriction were 6.5%, 16.1%, 29.0%. The difference between the four groups was significant. All recrudescent patients could gain recovery in a month after re-taking the herbs. Conclusions Chinese herbal priscription TP combined with dietary modification showed long term effect for HLP and improve the constitution comprehensively.

Objective To explore the expression and clinical pathological significance of long non-coding transcription factor 7 (lncTCF7) in gastric cancer tissues and to investigate the role of lncTCF7 in the invasion and metastasis of gastric cancer by in vitro experimental study.Methods From January to June 2011,one hundred patients with gastric cancer who underwent radical gastrectomy were selected from Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine.The expression of lncTCF7 at mRNA level was detected by quantitative real-time polymerase chain reaction (qRT-PCR).The patients were divided into high expression group (50 cases) and low expression group (50 cases) according to the lncTCF7 mRNA expression level.The stable interferenced lncTCF7 cell line (stable interference group) and blank control lncTCF7 cell line (blank control group) were established.Then the relationship between lncTCF7 expression level and clinical pathological characteristics and prognosis was analyzed.The interferenced lncTCF7 cell line was constructed and utilized,and the role of lncTCF7 in the invasion and metastasis of gastric cancer was detected by wound healing,Transwell and Western blotting method.The Chi square test and t test were performed for statistical analysis.The Kaplan-Meier curve was used for survival analysis.Univariate and multivariate analyses were used for screening the independent factors affecting prognosis.Results The results of qRT-PCR showed that the expression levels of lncTCF7 mRNA in high expression group and low expression group were 0.019 ± 0.003 and 0.002 ± 0.001,respectively.The survival rate of high expression group was lower than that of low expression group (46％,23/50 vs.72％,36/50),and the difference was statistically significant (P =0.002 5).The expression level of lncTCF7 was correlated with intravascular tumor thrombus formation,nerve invasion,depth of invasion and lymph node metastasis (x2 =7.862,7.162,11.903 and 8.280,all P ＜ 0.05).The results of univariate and multivariate analyses showed that the expression level of lncTCF7 was significantly correlated with the depth of invasion (hazard ratio (HR) =4.205,P =0.002;HR =3.125,P =0.018).The results of wound healing assay indicated that lncTCF7 interference could significantly inhibit wound healing ((92.90 ± 1.51) ％ vs.(12.33 ± 0.67) ％,t =48.72,P ＜ 0.01).The results of Transwell assay demonstrated that after 24 hours of culture the number of cells passed through the membrane of the chamber of blank control group was higher than that of stable interference group (83.6 ± 12.5 vs.26.6 ± 4.3),and the difference was statistically significant (t =9.65,P ＜ 0.01).The results of Western blotting showed that the expression of E-cadherin,a marker of epithelial origin,of stable interference group was significantly increased compared with that of blank control group (0.32 ±0.01 vs.0.76 ± 0.01),however the expression levels of vimentin and N-cadherin,markers of mesenchymal origin,were significantly decreased (0.56 ±0.01 vs.0.39 ± 0.01 and 0.67 ± 0.01 vs.0.33 + 0.01),and the differences were all statistically significant (t =26.68,10.09 and 24.14,all P ＜ 0.05).Conclusions The prognosis of gastric cancer patients with high expression of lncTCF7 is poor.lncTCF7 may promote the invasion and metastasis of gastric cancer by influencing eoithelial-mesenchymal transition in gastric cancer cells.

AIM:To investigate the effect of interleukin-6 (IL-6) on epithelial-mesenchymal transition (EMT) , migration and invasion of papillary thyroid carcinoma TPC-1 cells by inducing the expression of long noncoding RNA lnc TCF7.METHODS:The effects of IL-6 on the expression of lnc TCF7 in the TPC-1 cells were detected by RT-q PCR after the TPC-1 cells were treated with IL-6 at 0, 5, 10, 20 and 50μg/L for 24 h or with IL-6 at 50μg/L for 0, 6, 12 and 24 h.After the TPC-1 cells were treated with IL-6 at 50μg/L for 24 h, the effect of IL-6 on the protein expression of E-cadherin and vimentin in the TPC-1 cells was detected by Western blot.The TPC-1 cell line with lnc TCF7 over-expression was established, and the effects of lnc TCF7 over-expression on EMT, migration and invasion of the TPC-1 cells were measured by Western blot and Transwell assay.After knockdown of lnc TCF7 expression and exposure to IL-6 at 50μg/L, the effects of lnc TCF7 on EMT, migration and invasion of TPC-1 cells treated with IL-6 were observed.RESULTS:The expression of lnc TCF7 in the TPC-1 cells was induced by IL-6 in a dose-and time-dependent manner.The expression of E-cadherin was down-regulated, the expression of vimentin was up-regulated, and the migration and invasion abilities of the TPC-1 cells were enhanced by lnc TCF7 over-expression (P<0.05).The expression of E-cadherin was decreased, the expression of vimentin, Snail and Slug was increased, and the migration and invasion abilities of the TPC-1 cells and intercellular space were enhanced by IL-6.The above changes induced by IL-6 were significantly inhibited by knockdown of lnc TCF7expression.CONCLUSION:IL-6 promotes the EMT, migration and invasion of papillary thyroid carcinoma TPC-1 cells by inducing the expression of lnc TCF7.

Objective To evaluate in vitro antimicrobial effect of fosfomycin sodium single use and combination with other antimicrobial agents on clinically isolated Staphylococcus aureus (S.aureus), Klebsiella pneumoniae (K.pneumoniae) and Pseudomonas aeruginosa (P.aeruginosa) in China.Methods Combined antimicrobial susceptibility testing was performed with checkerboard method, minimal inhibitory concentrations (MICs) were detected by two-fold agar dilution method, susceptibility of S.aureus (n=113 strains), K.pneumoniae (n=108 strains), and P.aeruginosa (n=110 strains) isolated from 18 hospitals in China in recent three years was determined by single and combined antimicrobial susceptibility testing.Results MIC50 value of fosfomycin sodium single use were all≤32 mg/L against all tested strains, regardless of whether strains were resistant to other antimicrobial agents or not.The synergistic rate of fosfomycin sodium with levofloxacin, minocycline, oxacillin, and clindamycin against methicillin-resistant S.aureus (MRSA) was＞43％.Synergistic rate of fosfomycin sodium with levofloxacin and imipenem against imipenem-nonsusceptible P.aeruginosa was＞35％, synergistic rates of fosfomycin sodium with tested antimicrobial agents against imipenem-susceptible P.aeruginosa were all＞35％.Conclusion Fosfomycin sodium still has good antimicrobial activity against common clinical drug-resistant bacteria, such as MRSA, extended-spectrumβ-lactamase-producing K.pneumoniae and so on, it has synergistic effect with many other kinds of antimicrobial agents, suggesting that in the limited treatment of infection caused by drug-resistant bacteria, fosfomycin in combination with other antimicrobial agents may be a useful choice.

Objective To explore the effects of electroacupuncture at Baihui (DU20) and Shenting (GV24) on Alzheimer's disease, and possible mechanism for it.Methods A total of 24 eight-month-old APP/PS1 male mice were randomly divided into model group (n = 8), electroacupuncture group (n = 8) and non-acupoint group (n = 8), and other eight wild-type mice were as wild-type group.The electroacupuncture group accepted electroacupuncture at Baihui and Shenting, while the non-acupoint group accepted electroacupuncture at bilateral subcostal non-acupoint area, and the wild-type group and the model group accepted the same grasping and fixing, for 28 days. Then they assessed with Morris water maze test. The levels of β-amyloid protein (Aβ) and β-site amyloid precursor protein cleaving enzyme 1 (BACE1) in cerebral cortex were detected with immunohistochemistry and immunofluorescence respectively, and the level of BACE1 m RNA with RT-PCR.Results Compared with the model group, the escape latency decreased in the electroacupuncture group (P ＜ 0.001), and the times crossing platforms increased (P ＜ 0.001), while the expression of BACE1 and Aβ decreased (P ＜ 0.001).Conclusion Electroacupuncture may improve the learning-memory ability by inhibiting the expression of BACE1 in the cerebral cortex of APP/PS1 mice to decreasing the level of Aβ.

Castleman disease (CD) is a rare lymphoproliferative disease that is clinically classified into unicentric Castleman disease (UCD) and multicentric Castleman disease (MCD). According to the status of human herpes virus-8 (HHV-8) infection, MCD is further classified into HHV-8-positive MCD, and HHV-8-negative MCD, which is also called idiopathic multicentric Castleman disease (iMCD). There are standard treatment options for both UCD and HHV-8-positive MCD, but there has been no uniform standard of diagnosis and treatment for iMCD, which mainly relied on the experience of clinicians. In recent years, Castleman Disease Collaborative Network (CDCN) has newly defined the concept and diagnostic criteria of iMCD, and a comprehensive guidance on the treatment of iMCD was established in November 2018. In this paper, we try to review the current treatment options and advances of iMCD, which might help Chinese clinicians to diagnose and treat this rare disease.