BACKGROUNDFatigue is the most common symptom negatively affecting the quality of life of patients with cancer. The objective of the current study was to evaluate the preliminary efficacy and safety of 10.6‐μm infrared laser moxibustion for cancer‐related fatigue (CRF).METHODSThe authors conducted a randomized, placebo‐controlled trial among 78 patients with cancer who were diagnosed with CRF. The group treated with infrared laser moxibustion received 10.6 μm of infrared laser moxibustion on the ST36 (bilateral), CV4, and CV6 acupoints. Each participant received a 20‐minute treatment session 3 times per week for 4 weeks. The sham group received the same treatment duration on the same acupoints, but without infrared laser output. The outcome was change in fatigue as measured by the Chinese version of the Brief Fatigue Inventory between groups at week 4 with additional evaluation at week 8 for durability of treatment effects. A mixed effects model was used to evaluate the difference in treatment effect over time.RESULTSAmong those randomized, 61 patients (78%) completed the entire study. At the end of the intervention, the individuals in the group treated with the laser were found to have significantly less fatigue than those in the sham group (3.01 vs 4.40; P = .002). The improvement in fatigue persisted to week 8, favoring the group treated with laser moxibustion (3.03 vs 4.26; P = .006). Laser moxibustion was safe, with 3 cases of mild local erythema that resolved without medical intervention reported.CONCLUSIONSInfrared laser moxibustion appeared to be safe and efficacious for improving CRF in a Chinese patient population. Larger studies in more racial/ethnically diverse populations are needed to confirm the benefit of this technique for fatigue in patients with cancer. Cancer 2016;122:3667‐72. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Moderate to severe fatigue complaints exceed 50% among AI users. Fatigue is highly related to younger age, higher education level, higher BMI, pain severity and insomnia.

Glucocorticoids (GCs) are commonly used in the treatment of nephrotic syndrome. However, high doses and long periods of GC therapy can result in severe side effects. The present study aimed to selectively deliver albumin-methylprednisolone (MP) nanoparticles towards glomerular podocytes, which highly express the specific neonatal Fc receptor (FcRn) of albumin. Bovine serum albumin (BSA) was labeled with a fluorescent dye and linked with modified MP via an amide bond. The outcome nanoparticle named BSA633-MP showed a uniform size with a diameter of approximately 10 nm and contained 12 drug molecules on average. The nanoconjugates were found to be stable at pH 7.4 and acid-sensitive at pH 4.0, with approximately 72% release of the MP drug after 48 h of incubation. The nanoparticle demonstrated a 36-fold uptake in receptor-specific cellular delivery in the FcRn-expressing human podocytes compared to the uptake in the non-FcRn-expressing control cells. Co-localization further confirmed that uptake of the nanoconjugates involved receptor-mediated endocytosis followed by lysosome associated transportation. In vitro cellular experiments indicated that the BSA633-MP ameliorated puromycin aminonucleoside-induced podocyte apoptosis. Moreover, in vivo fluorescence molecular imaging showed that BSA633-MP was mainly accumulated in the liver and kidney after intravenous dosing for 24 h. Collectively, this study may provide an approach for the effective and safe therapy of nephrotic syndrome.

Objective. Coronary slow/no reflow is not rare after successfully undergoing primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI), and shock index (SI) is an important factor for adverse cardiovascular prognosis. In this study, we are to explore whether SI is associated with coronary slow/no reflow in patients with AMI following primary PCI. Methods. A total of 153 consecutive AMI patients undergoing primary PCI within 24 hours of symptom onset were included in this study. The participants were divided into normal flow group (n=124) and slow/no reflow group (n=29) according to cineangiograms recorded during the period of PCI. Cardiovascular risk factors, hematologic parameters, preoperative management of antithrombotic therapy, and baseline angiography were collected. Results. SI, plasma glucose, white blood cells (WBC) and neutrophil count, neutrophil to lymphocyte ratio (PLR), high sensitivity C-reactive protein (hs-CRP), probrain natriuretic peptide (pro-BNP), and Killip classification on admission and thrombus burden on initial angiography were significantly different between patients with and without slow/no reflow. Multivariate analysis revealed that SI≥0.66, thrombus burden, and plasma glucose on admission were independent predictors for coronary slow/no reflow. Preoperative management of tirofiban therapy improves initial thrombolysis in myocardial infarction (TIMI). However, it has no effect on prognosis of slow/no reflow. Conclusion. Our findings demonstrated that slow/no reflow in patients with AMI following primary PCI was more likely associated with SI≥0.66, thrombus burden, and plasma glucose on admission. SI as a predictor for coronary slow/no reflow should be further confirmed in the following more large-scale and prospective studies. The clinical registration number is ChiCTR1900024447.

Electroacupuncture (EA) is a promising clinical approach to treating posttraumatic stress disorder (PTSD), yet the mechanisms whereby EA can alleviate anxiety and other PTSD symptoms have yet to be clarified. In the present report, rats underwent EA for 14 consecutive days following modified single prolonged stress (MSPS) exposure. These animals were then evaluated in open field and elevated plus maze tests (OFT and EPM), while Fos immunohistochemical staining was performed to assess ventromedial prefrontal cortex (vmPFC) functional activation. In addition, an extracellular recording and stimulation system was used to analyze vmPFC inputs into the ventral tegmental area (VTA) in these rats. Temporary vmPFC inactivation was further performed to assess whether this was sufficient to reverse the anxiolytic effects of EA. Overall, rats that underwent EA treatment spent more time in the central region (OFT) and the open arm (EPM) relative to MSPS model animals (P < 0.05). These MSPS model animals also exhibited significantly fewer activated Fos-positive nuclei in the vmPFC following behavioral testing, while EA was associated with a significant relative increase in c-Fos expression in this region. The transient inactivation of the vmPFC was sufficient to reverse the effects of EA treatment on anxiety-like behaviors in MSPS model rats. MSPS and SEA rats exhibiting no differences in bursting activity between baseline and vmPFC stimulation, whereas bursting activity rose relative to baseline upon ventral mPFC stimulation in EA treated and control rats. Together, these findings indicate that the vmPFC and its inputs into the VTA are functionally linked to the anxiolytic activity of EA, implicating this pathway in the EA-mediated treatment of PTSD.

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Objective: Students have had to adapt to a “new normal” of online education at home during the COVID-19 pandemic. This poses a considerable challenge to the conduct of online acupuncture courses. Here, we provide our experience and guidance for conducting an online experimental acupuncture course during the COVID-19 pandemic. We aimed to compare the different perceptions of undergraduates to the educational environment between online and face-to-face learning approaches. Methods: This study included senior undergraduates majoring in acupuncture during the academic years 2015 (face-to-face) and 2020 (online only) for the Experimental Acupuncture course. A survey was conducted at the end of this course. The Dundee Ready Educational Environment Measure (DREEM) questionnaire was used to assess students’ perceptions. The results of students’ responses to online learning were compared with those assessed for face-to-face learning. Results: In total, 56/70 (80%) students in 2015 and 49/54 (91%) students in 2020 completed the questionnaire, respectively. Total DREEM scores were higher in the online learning group than in the face-to-face learning group (160.3 ± 21.9 vs 147.6 ± 17.9, p = 0.007), with improved students’ perceptions on four out of five dimensions (social self-perception, learning, atmosphere and academic self-perception). The positive aspects of their online learning experience included the acquisition of new knowledge and skills. The significant limitations of this course included the lack of practical classes. Conclusion: Students’ perceptions regarding the Experimental Acupuncture program were satisfactory for both online and face-to-face learning approaches, but even better with online learning. Online learning may be encouraged in traditional Chinese medicine (TCM) education. However, a combination of face-to-face and online methods is likely to be required to maximize the benefits. We hope that our online Experimental Acupuncture program practices may assist in the development of online curricula for acupuncture during the COVID-19 pandemic.

A highly sensitive volt-ampere characteristics detecting system was applied to measure the volt-ampere curves of nine acupuncture points, LU9, HT7, LI4, PC6, ST36, SP6, KI3, LR3, and SP3, and corresponding nonacupuncture points bilaterally from 42 healthy volunteers. Electric currents intensity was increased from 0 μA to 20 μA and then returned to 0 μA again. The results showed that the volt-ampere curves of acupuncture points had nonlinear property and magnetic hysteresis-like feature. On all acupuncture point spots, the volt-ampere areas of the increasing phase were significantly larger than that of the decreasing phase (P < 0.01). The volt-ampere areas of ten acupuncture point spots were significantly smaller than those of the corresponding nonacupuncture point spots when intensity was increase (P < 0.05 ~ P < 0.001). And when intensity was decrease, eleven acupuncture point spots showed the same property as above (P < 0.05 ~ P < 0.001), while two acupuncture point spots showed opposite phenomenon in which the areas of two acupuncture point spots were larger than those of the corresponding nonacupuncture point spots (P < 0.05 ~ P < 0.01). These results show that the phenomenon of low skin resistance does not exist to all acupuncture points.