Guangzhou University Of Chinese Medicine Research Articles

Patient-based real-time quality control for quantitative hepatitis B virus DNA test using moving rate of positive and negative patient results.

Patient-based real-time quality control (PBRTQC) has gained increasing attention in the field of laboratory quality management in recent years. However, PBRTQC has not been reported for use in molecular diagnostics. This study introduces PBRTQC to quantitative hepatitis B virus (HBV) DNA test using moving rate (MR) of positive and negative patient results. In contrast to the MR protocols described in other literature, MR protocol for HBV-DNA test has an additional logarithmic transformation and binary conversion steps before using a common statistical process control algorithm, such as the MR. We used all patient test results of HBV-DNA assay from August 2018 to August 2021 at the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, for parameters setting, optimization, and performance validation. The false rejection rate, error detection curves and validation charts were used to assess the MR protocols. The false rejection rates of two MR protocols were both <0.7%. The optimal block sizes for positive and negative errors in each cut-off value were not the same, so we first proposed a combined protocol that used different block size to detect negative and positive errors. It turned out that the combined protocols outperformed the simple protocols for each cut-off value, especially detecting positive errors. The performances of MR protocols using positive or negative patient results to detect constant errors of HBV-DNA test could meet laboratory requirements. Therefore, we have provided an effective alternative toolfor internal quality control in the field of molecular diagnostics.

Publication Trends in Rehabilitative Effects of Acupuncture: A Visual Analysis of the Literature.

Objectives To conduct a comprehensive analysis of scientific outputs in 2011–2021 regarding the rehabilitative effects of acupuncture on diseases. Methods The study was conducted in the form of knowledge graph and data visualization, with data being drawn from the Web of Science Core Collection database. Results Articles and reviews were the dominant types; China, Guangzhou University of Chinese Medicine and Medicine ranked was the active country, institution, and journal, respectively, in terms of issued articles. Systematic reviews and the meta-analyses of stroke and pain were extensively carried out in the past decade, whose principal interventions were manual acupuncture, electroacupuncture, scalp acupuncture, and dry needling correspondingly at Baihui (DU20) and Zusanli (ST36). And most frequently utilized rehabilitation assessment criteria were the Fugl-Meyer Assessment Scale and the Barthel Index. More recently, motor function and chronic obstructive pulmonary disease have captured researchers' attention, which might be the futuristic frontier. Conclusions This article provided a relatively panoramic picture of the scientific outputs in acupuncture for disease rehabilitation, which may help readers embrace the heated topic and grasp the recent research focus on this field.

Exploration of the Value of Combined UA, IL-6, and fPSA/tPSA in the Diagnosis of Prostate Cancer.

Objective To investigate the differences in uric acid (UA), interleukin-6 (IL-6), and free prostatic-specific antigen (fPSA)/total prostatic-specific antigen (tPSA) (F/T) between patients with and without prostate cancer (PCa) in order to discover the value of the three indicators in improving PCa diagnostic accuracy. Methods Patients with pathologically diagnosed PCa (PCa group, n = 25), patients with other benign prostate diseases (benign group, n = 25), and men who underwent normal physical examination (control group, n = 25) at the First Affiliated Hospital of Guangzhou University of Chinese Medicine between October 2020 and January 2021 were included. The serum UA, IL-6, and F/T levels of participants in the three groups were measured, and the measured data were statistically analyzed. Results There were statistically significant differences in IL-6 and F/T among the three groups (all P < 0.05), but there were no statistically significant differences in UA (P > 0.05). The area under the receiver operating characteristic (ROC) curve (AUC) for the three indicators was, respectively, as follows: PCa group-benign group 0.5416, 0.6776, and 0.6832; PCa group-control group 0.5432, 0.9536, and 0.9887; and benign group-control group 0.5000, 0.8784, and 0.9456. Logistic regression analysis indicated that IL-6 and F/T were independent predictors of PCa, with AUCs of 0.6776 and 0.6832, respectively, and a combined accuracy of 72.0%. Conclusion These results suggest that IL-6 and F/T have a good detection effect for PCa screening. Compared with the detection of F/T alone, the combined detection of IL-6 and F/T can improve the diagnosis rate of PCa to a certain extent, providing effective guidance for the clinical diagnosis and treatment of patients. The value of UA needs to be further studied, and its feasibility in the diagnosis of PCa needs to be further explored.

Effects of pericapsular nerve group (PENG) block on postoperative recovery in elderly patients with hip fracture: study protocol for a randomised, parallel controlled, double-blind trial

IntroductionHip fracture is a common and serious emergency in the elderly, and it is associated with severe pain, significant morbidity and mortality. The use of peripheral nerve block can relieve...

Effects of Home-Based Baduanjin Exercise on Left Ventricular Remodeling in Patients With Acute Anterior ST-Segment Elevation Myocardial Infarction: Study Protocol for a Randomized Controlled Trial.

BackgroundLeft ventricular (LV) remodeling after ST-segment elevation myocardial infarction (STEMI) is a major pathological basis associated with heart failure and increased mortality. Exercise-based cardiac rehabilitation has been verified to significantly improve prognosis and quality of life. As a traditional Chinese Qigong, Baduanjin exercise has effectively alleviated adverse LV remodeling in STEMI patients. Despite this, participation in exercise rehabilitation remains low, and home-based exercise rehabilitation may be an alternative approach. Besides, anterior STEMI is reported to have higher risk of adverse LV remodeling. However, the efficiency regarding home-based Baduanjin exercise on LV remodeling in anterior STEMI patients remains uncertain currently.Methods/DesignA single-blind, randomized controlled clinical trial was conducted to explore the efficacy and safety of home-based Baduanjin exercise in anterior STEMI patients compared with moderate intensity aerobic walking. A total of 114 participants were assigned randomly to the Baduanjin group or walking control group at a 1:1 ratio. Eligible participants practiced Baduanjin or walking exercise (5 times a week) for 12 weeks, and then followed up for another 12 weeks. The primary outcome is a relative change in the LV end-diastolic volume. The secondary outcomes include the plasma levels of hypersensitive C-reactive protein and interleukin 6, health-related quality of life measured by EQ-5D-5L, LV ejection fraction, patient health questionnaire-9, generalized anxiety disorder screener-7, short physical performance battery score, and clinical endpoint events. The proportion of circulating regulatory T-cells were also assessed. Adverse events were recorded throughout the trial for safety evaluation. Data were be analyzed by researchers blinded to the treatment allocation.DiscussionThis study provided powerful evidence for the use of home-based Baduanjin exercise in anterior STEMI patients in alleviating LV remodeling and improving clinical outcomes.Trial RegistrationThe Research Ethics Committee of the First Affiliated Hospital of Guangzhou University of Chinese Medicine has approved this study (ZYYECK[2020]045). Written informed consent of patients were required. This trial is registered in the Chinese Clinical Trial Registry (ChiCTR2100047298).DisseminationOur results will be published in peer-reviewed journals and disseminated through academic conferences and the Internet.

Analysis of the factors contributing to endometriosis in China and UK

To explore the differences in the factors associated with endometriosis between Chinese and British patients. This case-control study was conducted in 387 patients with endometriosis and 199 non-endometriosis patients admitted to John Radcliffe Hospital (Oxford, UK) and in 101 patients with endometriosis and 50 non-endometriosis patients admitted in the First Affiliated Hospital of Guangzhou University of Chinese Medicine. The clinical data including height, weight, body mass index, marital status, employment, menstruation, fertility, and operation reasons were collected via a standardized WERF EPHect questionnaire. Multivariate logistic regression analysis indicated that body mass index, surgery for dysmenorrhea, history of pregnancy, counts of previous surgeries for endometriosis and status of employment were all significantly associated with endometriosis in the UK (P < 0.05), while a history of dysmenorrhea was significantly correlated with endometriosis in Chinese patients (P < 0.05). Dysmenorrhea may be the most important common factor associated with endometriosis in China and the UK, but the other factors contributing to endometriosis may differ between these two countries.

Development and External Validation of a Nomogram to Predict Cancer-Specific Survival in Patients with Primary Intestinal Non-Hodgkin Lymphomas.

PurposePrimary intestinal non-Hodgkin lymphoma (PINHL) is a biologically and clinically heterogeneous disease. Few individual prediction models are available to establish prognoses for PINHL patients. Herein, a novel nomogram was developed and verified to predict long-term cancer-specific survival (CSS) rates in PINHL patients, and a convenient online risk calculator was created using the nomogram.Materials and MethodsData on PINHL patients from January 1, 2004, to December 31, 2015, obtained from the Surveillance, Epidemiology, and End Results (SEER) database (n = 2372; training cohort), were analyzed by Cox regression to identify independent prognostic parameters for CSS. The nomogram was internally and externally validated in a SEER cohort (n = 1014) and a First Affiliated Hospital of Guangzhou University of Chinese Medicine (FAHGUCM) cohort (n = 37), respectively. Area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis (DCA) were used to evaluate nomogram performance.ResultsFive independent predictors were identified, namely, age, marital status, Ann Arbor Stage, B symptoms, and histologic type. The nomogram showed good performance in discrimination and calibration, with C-indices of 0.772 (95% CI: 0.754–0.790), 0.763 (95% CI: 0.734–0.792), and 0.851 (95% CI: 0.755–0.947) in the training, internal validation, and external validation cohorts, respectively. The calibration curve indicated that the nomogram was accurate, and DCA showed that the nomogram had a high clinical application value. AUC values indicated that the prediction accuracy of the nomogram was higher than that of Ann Arbor Stage (training cohort: 0.804 vs 0.630; internal validation cohort: 0.800 vs 0.637; external validation cohort: 0.811 vs 0.598), and Kaplan–Meier curves indicated the same.ConclusionA nomogram was developed to assist clinicians in predicting the survival of PINHL patients and in making optimal treatment decisions. An online calculator based on the nomogram was made available at https://cuifenzhang.shinyapps.io/DynNomapp/.

Efficacy of manual acupuncture versus placebo acupuncture for generalized anxiety disorder (GAD) in perimenopause women: study protocol for a randomized controlled trial

BackgroundGeneralized anxiety disorder (GAD) is common among perimenopausal women. Acupuncture may be an effective treatment for GAD, but evidence is limited. The pathogenesis of GAD is not yet clear, but it is related to the hypothalamic-pituitary-adrenal axis and its excretion, cortisol (CORT), and adrenocorticotropic hormone (ACTH). The object of this study is to evaluate the efficacy of manual acupuncture (MA) versus placebo acupuncture (PA) for perimenopausal women with GAD.MethodsThis study is a single-center, randomized, single-blind clinical trial that will be conducted in the First Affiliated Hospital of Guangzhou University of Chinese Medicine. A total of 112 eligible GAD patients will be randomly assigned (1:1) to receive MA (n=56) or PA (n=56) three times per week for 4 weeks. The primary outcome measure will be the HAMA score. The secondary outcome measures will be the GAD-7 and PSQI scores and the levels of CORT and ACTH. The evaluation will be executed at baseline, 2 weeks, the end of the treatment, and a follow-up 3-month period. All main analyses will be carried out based on the intention-to-treat (ITT) principle.DiscussionThis study intends to compare the efficacy between MA and PA in the treatment of perimenopausal women with GAD and to further study the mechanisms underlying the effect.Trial registrationChinese Clinical Trial Registry ChiCTR2100046604. Registered on 22 May 2021.

Contralateral S1 function is involved in electroacupuncture treatment-mediated recovery after focal unilateral M1 infarction.

Acupuncture at acupoints Baihui (GV20) and Dazhui (GV14) has been shown to promote functional recovery after stroke. However, the contribution of the contralateral primary sensory cortex (S1) to recovery remains unclear. In this study, unilateral local ischemic infarction of the primary motor cortex (M1) was induced by photothrombosis in a mouse model. Electroacupuncture (EA) was subsequently performed at acupoints GV20 and GV14 and neuronal activity and functional connectivity of contralateral S1 and M1 were detected using in vivo and in vitro electrophysiological recording techniques. Our results showed that blood perfusion and neuronal interaction between contralateral M1 and S1 is impaired after unilateral M1 infarction. Intrinsic neuronal excitability and activity were also disturbed, which was rescued by EA. Furthermore, the effectiveness of EA treatment was inhibited after virus-mediated neuronal ablation of the contralateral S1. We conclude that neuronal activity of the contralateral S1 is important for EA-mediated recovery after focal M1 infarction. Our study provides insight into how the S1-M1 circuit might be involved in the mechanism of EA treatment of unilateral cerebral infarction. The animal experiments were approved by the Committee for Care and Use of Research Animals of Guangzhou University of Chinese Medicine (approval No. 20200407009) April 7, 2020.

A Percutaneous Nephrolithotripsy Performed in the Oblique Supine Lithotomy Position: A Better Choice.

Objective. To investigate the efficacy and safety of the oblique supine lithotomy during percutaneous nephrolithotomy (PCNL) to treat upper urinary calculi. Methods. Clinical data were retrospectively analyzed for 371 patients with upper urinary calculi who underwent PCNL at The First Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2017 to October 2020. Based on different positions, patients were divided into the observation group (oblique supine lithotomy position, 155 cases, Group 1) or control group (prone position, 216 cases, Group 2). Groups were compared for effectiveness, complications, bleeding, surgical time, clinical indicators, and hospitalization time. Results. There were no significant differences in the clinical baseline data between the two groups (p > .05). However, the stone-free rate for patients was significantly higher in the observation than in the control group (p < .05). Both operation time and hospital stay time were significantly lower in the observation versus the control groups (p < .05). No significant differences were observed for complications or amount of blood loss (p > .05). Conclusion. In patients with upper urinary calculi, percutaneous nephrolithotomy in the oblique supine lithotomy position has a higher stone-free rate than the prone position. This approach can shorten the operation and provide better comfort and quicker recovery to the patients. A further advantage is that there is no difference in safety and blood loss between the prone position and the oblique lithotomy position.

Histone Demethylase KDM5C Deficiency Inhibits Bone Formation and Fracture Healing in Aged Mice by Epigenetically Activating Erdr1

Background: Fractures are one of the most common clinical injuries, especially for elders with osteoporosis. KDM5C specifically demethylate di- and tri-methylated lysine 4 on histone. It is frequently mutated in X-linked intellectual disability patients exhibiting physical and behavioral abnormalities. However, it is unclear whether KDM5C plays a role in bone formation and fracture repair. Methods: We used KDM5C conventional knockout mice model to investigate its role on bone formation. Western blotting, immunofluorescence staining, RNAseq, and ChIP assay were applied to demonstrate the molecular mechanism. Open femur fracture model was used to investigate the effects of KDM5C and Erdr1 on fracture healing. Findings: We found that the expression level of KDM5C was constantly increased during the osteogenesis of MSCs. Silencing endogenous KDM5C inhibited osteogenic differentiation of MSCs in vitro and KDM5C knockout mice displayed decreased bone mass and abnormal bone development. Further, RNA-seq analysis showed that PI3K-Akt signaling pathway and Erdr1 were most significantly influenced by KDM5C. KDM5C deficiency resulted in increased Erdr1 expression by histone modification. While knockdown of Erdr1 could promote osteogenesis and angiogenesis. Finally, using an experimental mouse femur fracture model, we found that KDM5C deficiency would impair fracture healing, which could be rescued by silencing Erdr1. More importantly, we found that KDM5C was decreased in bone samples of osteoporotic fracture. Interpretation: Taken together, these results showed that KDM5C was a novel regulator of osteogenesis and angiogenesis. KDM5C or Erdr1 might be potential therapeutic targets for the treatment of fracture and other bone diseases. Funding: The work was supported by grants from the National Natural Science Foundation of China (NSFC No. 81871778). Declaration of Interest: The authors declare that they have no conflict of interest. Ethical Approval: All surgical interventions, treatments and postoperative animal care procedures were strictly performed in accordance with the guidelines for Animal Welfare and Ethics Committee of Guangzhou University of Chinese medicine. Human bone tissues were obtained in the Second Affiliated Hospital of Guangzhou Medical University. All animal experiments were performed in accordance with protocols that were approved and authorized by the Animal Welfare and Ethics Committee of Guangzhou University of Chinese medicine.

An Online Teaching Design of Oral English against COVID-19: An “Ideological-and-Political-Theories-Education-in-All-Courses” Perspective

Under the outbreak of the Coronavirus Disease 2019 (COVID-19) and the philosophy of &amp;ldquo;Ideological and Political Theories Education in all Courses (IPTEC)&amp;rdquo; by China&amp;rsquo;s Ministry of Education, college curriculum reform has become a pressing issue in both form and content. Oral English course is characterized with flexible organization and a wide selection of teaching materials, thus closely related to the shaping of college students&amp;rsquo; values. An online teaching mode of oral English featuring &amp;ldquo;DingTalk + WeChat Group + FiF&amp;rdquo; is proposed after a mining of &amp;ldquo;ideological and political elements&amp;rdquo;, with the sophomore oral English course of School of Foreign Studies, Guangzhou University of Chinese Medicine as a case. The highlights of this mode are as follows. First, all links of the teaching design are permeated with ideological and political elements, which realizes the blending of explicit and implicit educations. Second, it supports teacher-to-student and student-to-student voice interactions in a multi-party manner at any time. Third, a complex is created where one online classroom is systematically nested in another among the various platforms. Fourth, group and single games enrich the organization of the classroom. Fifth, it provides private and convenient classroom and homework management.

Corrigendum: Book Review: The Big Five in SLA

[This corrects the article DOI: 10.3389/fpsyg.2021.710042.].

Exploration of the mechanism by which icariin modulates hippocampal neurogenesis in a rat model of depression

Icariin (ICA) has a significant capacity to protect against depression and hippocampal injury, but it cannot effectively cross the blood-brain barrier and accumulate in the brain. Therefore, the mechanism by which ICA protects against hippocampal injury in depression remains unclear. In this study, we performed proteomics analysis of cerebrospinal fluid to investigate the mechanism by which ICA prevents dysfunctional hippocampal neurogenesis in depression. A rat model of depression was established through exposure to chronic unpredictable mild stress for 6 weeks, after which 120 mg/kg ICA was administered subcutaneously every day. The results showed that ICA alleviated depressive symptoms, learning and memory dysfunction, dysfunctional neurogenesis, and neuronal loss in the dentate gyrus of rats with depression. Neural stem cells from rat embryonic hippocampi were cultured in media containing 20% cerebrospinal fluid from each group of rats and then treated with 100 μM corticosterone. The addition of cerebrospinal fluid from rats treated with ICA largely prevented the corticosterone-mediated inhibition of neuronal proliferation and differentiation. Fifty-two differentially expressed proteins regulated by chronic unpredictable mild stress and ICA were identified through proteomics analysis of cerebrospinal fluid. These proteins were mainly involved in the ribosome, PI3K-Akt signaling, and interleukin-17 signaling pathways. Parallel reaction monitoring mass spectrometry showed that Rps4x, Rps12, Rps14, Rps19, Hsp90b1, and Hsp90aa1 were up-regulated by chronic unpredictable mild stress and down-regulated by ICA. In contrast, HtrA1 was down-regulated by chronic unpredictable mild stress and up-regulated by ICA. These findings suggest that ICA can prevent depression and dysfunctional hippocampal neurogenesis through regulating the expression of certain proteins found in the cerebrospinal fluid. The study was approved by the Experimental Animal Ethics Committee of Guangzhou University of Chinese Medicine of China in March 2017.

Development and Validation of a Risk Prediction Model for Breast Cancer Prognosis Based on Depression-Related Genes

Background: Depression plays a significant role in mediating breast cancer recurrence and metastasis. However, a precise risk model is lacking to evaluate the potential effects of depression on breast cancer prognosis. In this study, we established a depression-related gene (DRG) signature that can predict overall survival (OS) and elucidated its correlation with pathological parameters and sensitivity to therapy in breast cancer. Methods: The model training and validation assays were based on the analyses of 1096 patients from The Cancer Genome Atlas (TCGA) database and 2969 patients from GSE96058. A risk signature was established through univariate and multivariate Cox regression analyses. Findings: Ten DRGs were determined to construct the risk signature. Multivariate analysis revealed that the signature was an independent prognostic factor for OS. Receiver operating characteristic (ROC) curves indicated good performance of the model in predicting 1-, 3-, and 5-year OS, particularly for patients with triple-negative breast cancer (TNBC). In the high-risk group, the proportion of immunosuppressive cells, including M0 macrophages, M2 macrophages, and neutrophils, was higher than that in the low-risk group. Furthermore, low-risk patients responded better to chemotherapy and endocrine therapy. Finally, a nomogram consisting of risk score, age, tumor-node-metastasis (TNM) stage, and molecular subtypes was established, and it showed good agreement between the predicted and observed OS. Interpretation: The 10-gene risk model not only highlights the significance of depression in breast cancer prognosis, but also provides a novel gene-testing tool to better prevent the potential adverse impact of depression on breast cancer prognosis. Funding Statement: This work was supported by the National Natural Science Foundation of China [82074165, 81873306, 81973526, 82004132, 82004373]; Science and Technology Planning Project of Guangdong Province [2021A0505030059, 2017B030314166, 2016A030306025]; Department of Education of Guangdong Province [2018KZDXM022, A1-2606-19-111-009, 2019KQNCX019]; The 2020 Guangdong Provincial Science and Technology Innovation Strategy Special Fund (Guangdong- Hong Kong-Macau Joint Lab) [2020B1212030006]; Guangdong traditional Chinese medicine bureau project [20201132, 20211114]; the Ph.D. Start-up Fund of Natural Science Foundation of Guangdong Province [2018A030310506]; Guangzhou science and technology project [202102010316，201904010407]; The Specific Research Fund for TCM Science and Technology of Guangdong provincial Hospital of Chinese Medicine [YN2018MJ07, YN2018QJ08]，and the Foundation for Young Scholars of Guangzhou University of Chinese Medicine [QNYC20190101]. Declaration of Interests: The authors have declared that no competing interest exists. Ethics Approval Statement: . Ethical approval was waived by institutional ethics committee because data are obtained from public databases and all the patients are de-identified.

Long-term efficacy and safety of bone cement-augmented pedicle screw fixation for stage III K\xfcmmell disease

This study aimed to evaluate the efficacy and safety of bone cement-augmented pedicle screw fixation for stage III Kümmell disease. Twenty-five patients with stage III Kümmell disease who received bone cement-augmented pedicle screw fixation at the First Affiliated Hospital of Guangzhou University of Chinese Medicine between June 2009 and December 2015 were enrolled. All patients were females with a history of osteoporosis. The vertebral Cobb angle (V-Cobb angle), the fixed segment Cobb Angle (S-Cobb angle), pelvic parameters, visual Analogue Scale (VAS) score, and Oswestry Disability Index (ODI) were assessed preoperatively, postoperatively and at the final follow-up. Complications, loosening rate, operation time, and intraoperative bleeding were recorded. The average lumbar vertebral density T-value was − 3.68 ± 0.71 SD, and the average age was 71.84 ± 5.39. The V-Cobb angle, S-Cobb angle, and Sagittal Vertical Axis (SVA) were significantly smaller postoperatively compared to the preoperative values. The VAS and ODI at 1 month after surgery were 3.60 ± 1.00 and 36.04 ± 6.12%, respectively, which were both significantly lower than before surgery (VAS: 8.56 ± 1.04, ODI: 77.80 ± 6.57%). Bone cement-augmented pedicle screw fixation is a safe and effective treatment for stage III Kümmell disease. It can effectively correct kyphosis, restore and maintain sagittal balance, and maintain spinal stability.

Effect of acupotomy in knee osteoarthritis patients: study protocol for a randomized controlled trial

BackgroundSymptomatic knee osteoarthritis (KOA) is common in China. Pharmacological therapy is not the first recommendation because of its safety issues. Nonpharmacological therapy, such as lifestyle adjustments, weight loss, muscle strengthening, and aerobic exercise programs, is strongly recommended for KOA. However, these approaches may fail due to poor patient compliance. There is a lack of high-quality randomized controlled trials of acupotomy, an effective treatment for KOA. This study was designed to investigate the efficacy of acupotomy in patients with KOA.MethodsA total of 136 patients will be enrolled at the First Affiliated Hospital of Guangzhou University of Chinese Medicine and assigned to the acupotomy group or sham acupotomy group according to the block randomization scheme. Patients in the acupotomy group will receive 2 sessions of acupotomy for 2 weeks (once a week). Patients in the sham group will receive 2 sessions of sham stimulation for 2 weeks (once a week). All patients will use indomethacin cream externally. The primary outcome will be the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the secondary outcomes will be the visual analog scale (VAS) score, plantar pressure distribution test result, X-ray examination findings, musculoskeletal ultrasound findings, maximum knee circumference, joint mobility, and quality of life. Measurements will be taken at baseline, 1 week after the end of treatment, and at the 3- and 6-month follow-ups.DiscussionTo the best of our knowledge, this will be the first single-blind, sham-controlled study of acupotomy. The outcome assessors will also be blinded. The aim of this work is to demonstrate the efficacy of acupotomy in treating KOA.Trial registrationChinese Clinical Trial Registry ChiCTR2000033047. Registered on 18 May 2020.

Evaluation of the Clinical Efficacy and Prognosis of Long-Term Maintenance Lenalidomide Therapy in Patients with Multiple Myeloma

To investigate the clinical efficacy and prognosis of patients with multiple myeloma (MM) treated by long-term maintenance lenalidomide treatment. A total of 97 patients diagnosed as MM in the Department of Hematology of First Affiliated Hospital of Guangzhou University of Chinese Medicine from 2012 to 2019 were selected, and the basic clinical characteristics and laboratory indicators of the patients were tested and evaluated. After long-term maintenance lenalidomide treatment for patients with MM, the short-term and long-term clinical efficacy and the incidence of adverse reactions were evaluated, and factors affecting the prognosis of the patients were analyzed. Before maintenance treatment, 47.42% of the patients (46/97) did not achieve complete remission (CR), among 52.58% (51/97) of CR patients, there were 20.62% of the patients showed minimal residual leukemia (MRD) negative. After lenalidomide maintenance treatment, the patients who did not achieve CR were reduced to 24.74% (24/97), among 75.26% (73/97) of the patients with CR, there were 47.42% of the patients showed MRD negative, the difference showed statistically significant (P<0.001). After maintenance treatment, the median pro-gression-free survival of the patients was 58 months, and the 5-year survival rate was 89.69%. The incidence of adverse reactions was 40.21% (39/97), including neutropenia (31/39, 79.49%), fatigue (21/39, 53.85%), thrombocytopenia (17/39, 43.59%) and gastrointestinal reaction (15/39, 38.46%) were the most common. The discontinuation rate was 24.74% (24/97), and the median time for discontinuation was 21 months. The main reasons for discontinuation were neutropenia (12/24, 50.00%) , thrombocytopenia (8/24, 33.33%) and gastrointestinal reactions accounted for 8.33% (2/24). Old age and positive MRD were the risk factors affecting the prognosis of the patients. The adjusted OR was 1.43 (95% CI 1.03-1.76, P=0.034) and 3.78 (95% CI 2.56-9.56, P=0.037), respectively. The long-term maintenance lenalidomide treatment shows a good clinical effect on patients with MM, and MRD detection can assist the cilinical judge the prognosis of the patients. During maintenance treatment, the clinical symptoms, especially blood system damage of the patients should be take care, so as to avoid serious adverse reactions.

Mechanosensitive Piezo1 Mediates Bone Fracture Repair by Promoting Angiogenesis Through Notch Signaling

Piezo1, a calcium-permeable non-selective cationic channel that senses mechanical stimulation in multicellular organisms, mediates various biological processes, including angiogenesis. The supply of nutrients and oxygen through newly formed blood vessels at the fractured lesion is critical for bone fracture repair. The elucidation of the underlying mechanisms involved in angiogenesis and bone repair can aid in improving fracture healing. Here, mice with endothelial cell-specific deletion of Piezo1 channels were used to examine the role of Piezo1 in the initiation of fracture healing. The expression and distribution of Piezo1 was explored in the vasculature of the bone. The deletion of endothelial Piezo1 resulted in impaired bone fracture repair, downregulation of calcium-activated proteolytic calpain activity during vascularization, inhibition of osteoblast maturation and ossification, downregulation of phosphorylated PI3K-AKT, and impaired Notch signaling during bone fracture union. These findings indicated that Piezo1 protein is a potential target for enhancing bone regeneration and treating delayed or nonunion bone fractures. Funding Information: The study was supported by the National Natural Science Foundation of China (NSFC 81770453, 81774339, 81603641). Declaration of Interests: The authors have declared that no conflict of interest exists. Ethics Approval Statement: All animal studies were approved by the Animal Care and Use Committee of Guangzhou University of Chinese Medicine (Approval number: 2017030543).

The upper eyelid levator weakening procedure for the correction of severe cicatricial entropion caused by trachoma.

Trachoma-induced upper eyelid cicatricial entropion (UCE) is a common and challenging eyelid disease. Surgeons have developed various surgical techniques to address UCE in the world. However, there are few reports about surgery for Chinese patients. Our study aims to evaluate the esthetic and functional outcomes of correction of trachoma-induced UCE using upper eyelid levator weakening combined with tarsotomy and an anterior lamella recession procedure in China. A retrospective non-comparative study was performed in the Ophthalmology Department of Second Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2017 to December 2019. Thirty-six patients (56 eyelids) with severe UCE caused by trachoma, defined as shortening and retraction of the posterior lamella, were collected. Upper eyelid levator weakening combined with tarsotomy and an anterior lamella recession procedure was done on all patients. The mean follow-up time was 11.6±2.71 months (range, 6-24 months). Among the patients, 48 eyelids (85.7%) achieved complete success. Recurrence was observed in 4 eyelids (7.1%). No other severe complications occurred. This case series showed that upper eyelid levator weakening combined with tarsotomy and an anterior lamella recession procedure is a safe and effective treatment for severe trachoma-induced UCE in Chinese patients.