OBJECTIVE: To observe the clinical efficacy of Qihuang needle therapy for autism spectrum disorder (ASD) children with sleep disorder. METHODS: A total of 60 ASD children with sleep disorder were randomly divided into an observation group and a control group, 30 cases in each group. Both groups were treated with structured education intervention, 60 min each time, once a day, 6 times a week. Qihuang needle therapy was applied at Yintang (GV24⁺), Baihui (GV20) and bilateral Jueyinshu (BL14), Xinshu (BL15) in the observation group, multi-direction needling was delivered and without needle retaining. The treatment was given 2 times a week, each treatment was delivered at interval of 2 days at least. Behavioral intervention was adopted in the control group. Treatment for consecutive 12 weeks was required in both groups. Before and after treatment, the scores of children's sleep habits questionnaire (CSHQ), the autism behavior checklist (ABC), the childhood autism rating scale (CARS), and the childhood autism behavior scale (CABS) were observed in the two groups. RESULTS: After treatment, the scores of CSHQ, ABC, CARS and CABS were decreased compared with those before treatment (P<0.01), and the above scores in the observation group were lower than those in the control group (P<0.05). CONCLUSION Qihuang needle therapy can effectively treat ASD with sleep disorder, improve the core symptoms of ASD and the sleep quality.
Humans ; Autism Spectrum Disorder/physiopathology* ; Male ; Female ; Child ; Sleep Wake Disorders/physiopathology* ; Child, Preschool ; Acupuncture Therapy ; Acupuncture Points ; Treatment Outcome ; Sleep ; Needles

Breast cancer is one of the most common and fatal malignancies among women worldwide, and its treatment efficacy is often limited by drug resistance and the presence of undruggable targets. Traditional small-molecule drugs have difficulty effectively modulating certain critical targets such as transcription factors and non-coding RNAs, necessitating new therapeutic strategies. Proteolysis-targeting chimeras (PROTACs) function by recruiting pathogenic proteins to the cellular ubiquitin-proteasome system, thereby inducing their specific degradation. In contrast, ribonuclease-targeting chimeras (RIBOTACs) utilize small-molecule ligands but bind to RNA and direct endogenous RNases to selectively degrade pathogenic RNA molecules. By employing a "degradation rather than inhibition" mechanism, targeting chimera technology broadens the druggable landscape and offers a novel precision therapeutic strategy for breast cancer, particularly for refractory and drug-resistant cases. This approach not only overcomes the limitations of traditional drugs, such as the absence of suitable binding sites or poor selectivity, but also reduces required dosages and potential adverse effects. Recent studies have preliminarily demonstrated the therapeutic potential of PROTACs and RIBOTACs in breast cancer, encompassing target design, mechanistic investigation, and preclinical as well as early clinical applications. Research into these technologies reveals their ability to tackle previously undruggable targets, thereby providing theoretical support for the development of safer and more effective precision therapies for breast cancer. In the future, with advances in drug delivery systems and clinical trials, PROTACs and RIBOTACs are expected to be used synergistically with immunotherapy and chemotherapy, offering breast cancer patients more promising comprehensive treatment options and potentially driving oncology toward broader intervention of undruggable targets.
Humans ; Breast Neoplasms/drug therapy* ; Female ; Proteolysis ; Ribonucleases/metabolism* ; Molecular Targeted Therapy/methods* ; Antineoplastic Agents/therapeutic use*

OBJECTIVES: To explore the efficacy of DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy for management of cancer pain and provide reference for its standardized clinical application. Methods and. RESULTS: Recommendations were formulated based on literature review and expert group discussion, and consensus was reached following expert consultation. The consensus recommendations are comprehensive, covering the entire treatment procedures from preoperative assessment and preparation, surgical operation process, postoperative management and traditional Chinese medicine treatment to individualized treatment planning. The study results showed that the treatment plans combining traditional Chinese with Western medicine effectively alleviated cancer pain, reduced the use of opioid drugs, and significantly improved the quality of life and enhanced immune function of the patients. Postoperative follow-up suggested good treatment tolerance among the patients without serious complications. CONCLUSIONS The formulated consensus is comprehensive and can provide reference for clinicians to use DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy. The combined treatment has a high clinical value with a good safety profile for management of cancer pain.
Humans ; Medicine, Chinese Traditional ; Cancer Pain/therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Drug Delivery Systems ; Pain Management/methods* ; China

【Objective】 To explore the effectiveness and safety of polyglycolic acid (PGA) and hydroxypropyl methylcellulose (HPMC) composite materials in distal pancreatectomy postoperative suturing. 【Methods】 We selected 36 healthy adult beagles and divided them randomly into observation group and control group, with 18 distal pancreatectomy surgeries in each group. The observation group used PGA+HPMC composite materials for incision reinforcement while the control group used NEOVEIL for incision reinforcement. 3 days before surgery, 3 days after surgery, and before dissection, blood routine tests were performed on each group of experimental dogs. Observation periods of 2-week, 4-week and 8-week were set, and six animals at each observation point were evaluated for histological examination of heart, liver, spleen, lung, and kidney tissues, hard tissue slice pathological diagnosis, and safety evaluation. 【Results】 There was no significant difference between the observation group and the control group in the preoperative blood routine test. Repeated measures ANOVA results showed differences in the mean values of white blood cell count (WBC) ( F=14.875, P=0.001), mean corpuscular hemoglobin concentration (MCHC) (F=5.049,P=0.009), neutrophil percentage (Neu%) (F=4.794, P=0.011), red blood cell count (RBC) (F=6.591, P=0.002), hemoglobin (HGB) (F=8.154, P=0.001), hematocrit (HCT) (F=5.281, P=0.007), platelet count (PLT) (F=6.560, P=0.014), red blood cell distribution width coefficient of variation (RDW-CV) (F=33.950, P=0.039), or lymphocyte percentage (Lym%) (F=3.299, P=0.043) at different time points. However, the observation group and the control group did not differ, and the interaction between time and group had no significant effect on the above indicators, suggesting that both groups of dogs had inflammatory response or surgical stress. For the 8-week postoperative hard tissue pathological section score, there was no significant difference between the observation group and the control group in the inflammation and necrosis related score, fibrosis, repair or other related scores and total score (P>0.05). In the dissection at 8 weeks after surgery, no obvious damage to the heart, liver, spleen, lung, kidney, or other organs was found in both groups, nor was there any residual suture material, pancreatic fistula, or pancreatitis, indicating that the suture materials in both groups had been completely absorbed and metabolized, and the incision healed well without causing adverse effects on the visceral organs. 【Conclusion】 PGA and HPMC are effective and safe postoperative suture materials, with good biodegradability, biocompatibility, suture strength, and wound healing quality. They can be comparable to traditional absorbable reinforcement materials in distal pancreatectomy postoperative suturing, thus providing scientific basis for their clinical application.

Objective:To explore the prospects of ovarian tissue oocyte- in vitro maturation (OTO-IVM) in fertility preservation for patients with malignancy. Methods:OTO-IVM outcomes from 27 malignant tumor patients who underwent fertility preservation in Reproductive Medicine Research Center of the Sixth Affiliated Hospital of Sun Yat-Sen University from March 2017 to August 2022 were analyzed, including the number of mature oocytes (M II oocytes), maturation rate, and maturation time. The fertilization rate, the cleavage rate, and the embryonic development potential of IVM-derived M II were also analyzed. Further, the short-term use of gonadotropin (Gn) in OTO-IVM before ovarian tissue acquisition was initially explored. Results:After OTO-IVM, 81.48% (22/27) of patients had at least one M II oocyte, with a mean number of M II oocytes of 3.00 (1.50, 7.00) and a maturation rate of 38.81%. About 4.85% (13/268) of oocytes matured within 24 h; 14.93% (40/268) matured between 24 h and 36 h; 16.79% (45/268) matured between 36 h and 48 h, and only 2.24% (6/268) matured after 48 h. A total of 41 M II oocytes from 4 patients were fertilized by intracytoplasmic sperm injection (ICSI), with a fertilization rate of 85.37% (35/41), cleavage rate of 94.29% (33/35), variable embryo rate of 54.29% (19/35), and high-quality embryo rate of 34.29% (12/35). The IVM rate was significantly higher in patients who used Gn than in those who did not [63.16% (48/76) vs. 29.17% (56/192), P<0.001]. Conclusion:OTO-IVM can be used as a complementary method for fertility preservation in oncology patients and obtain a certain number of oocytes and embryos. Short-term use of Gn before ovarian tissue acquisition can improve oocyte maturation rate, but further studies are needed to verify the value of Gn in OTO-IVM.

Objective:To explore the prospects of ovarian tissue oocyte- in vitro maturation (OTO-IVM) in fertility preservation for patients with malignancy. Methods:OTO-IVM outcomes from 27 malignant tumor patients who underwent fertility preservation in Reproductive Medicine Research Center of the Sixth Affiliated Hospital of Sun Yat-Sen University from March 2017 to August 2022 were analyzed, including the number of mature oocytes (M II oocytes), maturation rate, and maturation time. The fertilization rate, the cleavage rate, and the embryonic development potential of IVM-derived M II were also analyzed. Further, the short-term use of gonadotropin (Gn) in OTO-IVM before ovarian tissue acquisition was initially explored. Results:After OTO-IVM, 81.48% (22/27) of patients had at least one M II oocyte, with a mean number of M II oocytes of 3.00 (1.50, 7.00) and a maturation rate of 38.81%. About 4.85% (13/268) of oocytes matured within 24 h; 14.93% (40/268) matured between 24 h and 36 h; 16.79% (45/268) matured between 36 h and 48 h, and only 2.24% (6/268) matured after 48 h. A total of 41 M II oocytes from 4 patients were fertilized by intracytoplasmic sperm injection (ICSI), with a fertilization rate of 85.37% (35/41), cleavage rate of 94.29% (33/35), variable embryo rate of 54.29% (19/35), and high-quality embryo rate of 34.29% (12/35). The IVM rate was significantly higher in patients who used Gn than in those who did not [63.16% (48/76) vs. 29.17% (56/192), P<0.001]. Conclusion:OTO-IVM can be used as a complementary method for fertility preservation in oncology patients and obtain a certain number of oocytes and embryos. Short-term use of Gn before ovarian tissue acquisition can improve oocyte maturation rate, but further studies are needed to verify the value of Gn in OTO-IVM.

ObjectivesTo evaluate the learning curve for percutaneous endoscopic transforaminal discectomy（PETD）at L4/5 level and L5/S1 level respectively， and to evaluate the differences of learning curve for PETD between the two levels. MethodsTwo batches of the first 51 cases who were each treated with PETD for L4/5 or for L5/S1 disc herniation respectively in the department between December 2019 and November 2020 were reviewed. The operation time， radiation exposure time， VAS score， preoperative ODI score， and the postoperative follow-up were reviewed. Each level was divided into three groups： for the earliest stage， Patients #1~17 were assigned to Group A； for the middle stage， Patients #18~34 were assigned to Group B； and for the latest stage， Patients #35~51 were assigned to Group C. ResultsAll patients were observed postoperatively for 8.4 months ［range： 6 months-12 months， M （P₂₅~P₇₅） = 8.0（7.0~9.3）months］. Significant differences were observed in the mean operation time for L4/5 level both between Group A and Group B （P=0.006） and between Group A and Group C （P=0.000）， while for the average operation time for L5/S1 level there was significant difference between Group A and Group C （P=0.000）， but not between Group A and Group B （P=0.344）. Compared with the operation time at L4/5 level， the operation time at L5/S1 was significantly longer for each stage （Group A： P=0.080， Group B： P=0.000， Group C： P=0.016， Total： P=0.000）. The average X-ray exposure period at each Group A L4/5 level was shortened successively， and there were significant differences between Group A and Group B （P=0.000）， also between Group A and Group C （P=0.000）. However， the mean radiation time of the three stages in L5/S1 level improved less rapidly than that in L4/5 level， in which significant difference was not observed between Group A and Group B （P=0.995）， but was between Group A and Group C （P=0.000）. The radiation exposure time at L5/S1 was significantly longer than L4/5 level for each stage （Group A： P=0.000， Group B： P=0.000， Group C： P=0.000， Total： P=0.000）. In the improvement of VAS score among 3 stages for L4/5 level， no significant differences were observed neither between Group A and Group B （P=0.967） nor between Group A and Group C （P=0.927）. Higher improvement in the ODI score was observed in L4/5 level both between Group A and Group B （P=0.036） and between Group A and Group C （P=0.011）. There was no significant difference in the improvement of VAS score for L5/S1 level neither between Group A and Group B （P=0.397） nor between Group A and Group C （P=0.960）； neither was there any significant difference in the improvement of ODI score both between Group A and Group B （P=0.207） and between Group A and Group C （P=0.109）. ConclusionsThe learning curve in the L4/5 level is steeper than that in the L5/S1 level. Suitable patient selection is of much importance for shortening the learning curve for PETD.

Background and Objectives: Stroke is the most common cause of human death and functional disability, resulting in more than 5 million deaths worldwide each year. Bone marrow mesenchymal stem cells (BMSCs) are a kind of stem cell that are able to self-renew and differentiate into many types of tissues. Therefore, BMSCs have the potential to replace damaged neurons and promote the reconstruction of nerve conduction pathways and connective tissue. However, it remains unknown whether transplanted BMSCs promote angiogenesis or improve the tissue microenvironment directly or indirectly through paracrine interactions. This study aimed to determine the therapeutic effect of BMSCs on ischemic stroke with hypertension in a rodent model and to explore the possible mechanisms underlying any benefits. Methods: and Results: Middle cerebral artery occlusion was used to establish the experimental stroke model. The area of cerebral infarction, expression of vascular endothelial growth factor (VEGF) and glial cell line-derived neurotrophic factor (GDNF), and increment of astrocyte were measured by TTC staining, western blot, real-time quantitative polymerase chain reaction (RT-qPCR) and immunocytochemistry. The results showed a smaller area of cerebral infarction and improved neurological function scores in animals treated with BMSCs compared to controls. The results of RT-qPCR and western blot assays showed higher expression of VEGF and GDNF in BMSC-treated animals compared with controls. Our study also showed that one round of BMSCs transplantation significantly promoted the proliferation of subventricular zone and cortical cells, especially astrocytes, on the ischemic side following cerebral ischemia. Conclusions Above findings support that BMSCs have therapeutic effects for ischemic stroke complicated with hypertension, which may occur via up-regulated expression of VEGF and GDNF and reduction of neuronal apoptosis, thereby promoting the recovery of nerve function.

Objective:To explore the feasibility of autologous transplantation of frozen-thawed ovarian tissue to induce pubertal development in adolescent females.Methods:Before hematopoietic stem cell transplantation in patient with severe β-thalassemia, 11 pieces of ovarian tissue were frozen in the Center of Reproductive Medicine, the Sixth Affiliated Hospital of Sun Yat-sen University in 2019. The patient was diagnosed as premature ovarian failure after hematopoietic stem cell transplantation. There were no signs of puberty development and menarche. Orthotopic ovarian tissue transplantation was performed for the patient through laparoscopy, and a total of 5 pieces of ovarian tissue were transplanted on January 20, 2022. Postoperatively, we followed up the sex hormone levels, growth and development of the patients and menarche.Results:The patient developed menarche 5 months after ovarian transplantation. The levels of sex hormones showed that follicle-stimulating hormone and luteinizing hormone were significantly decreased, and estradiol levels were significantly increased, indicating that ovarian tissue transplantation was successful, and follicles had begun to recruit and develop. The patient's ultrasonography revealed a markedly enlarged uterus and a thickened endometrium. Antral follicles were detected in the left implantation site of pelvic cavity.Conclusion:Cryopreservation of ovarian tissue is recommended for fertility preservation in prepubertal children. Autologous frozen-thawed ovarian tissue transplantation can induce natural puberty development and restore the reproductive endocrine function in children with ovarian failure, delayed puberty development or even stagnation.

Objective:To explore the feasibility of autologous transplantation of frozen-thawed ovarian tissue to induce pubertal development in adolescent females.Methods:Before hematopoietic stem cell transplantation in patient with severe β-thalassemia, 11 pieces of ovarian tissue were frozen in the Center of Reproductive Medicine, the Sixth Affiliated Hospital of Sun Yat-sen University in 2019. The patient was diagnosed as premature ovarian failure after hematopoietic stem cell transplantation. There were no signs of puberty development and menarche. Orthotopic ovarian tissue transplantation was performed for the patient through laparoscopy, and a total of 5 pieces of ovarian tissue were transplanted on January 20, 2022. Postoperatively, we followed up the sex hormone levels, growth and development of the patients and menarche.Results:The patient developed menarche 5 months after ovarian transplantation. The levels of sex hormones showed that follicle-stimulating hormone and luteinizing hormone were significantly decreased, and estradiol levels were significantly increased, indicating that ovarian tissue transplantation was successful, and follicles had begun to recruit and develop. The patient's ultrasonography revealed a markedly enlarged uterus and a thickened endometrium. Antral follicles were detected in the left implantation site of pelvic cavity.Conclusion:Cryopreservation of ovarian tissue is recommended for fertility preservation in prepubertal children. Autologous frozen-thawed ovarian tissue transplantation can induce natural puberty development and restore the reproductive endocrine function in children with ovarian failure, delayed puberty development or even stagnation.