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Glioblastoma (GBM) is a prevalent and highly lethal form of glioma, with rapid tumor progression and frequent recurrence. Excessive outgrowth of pericytes in GBM governs the ecology of the perivascular niche, but their function in mediating chemoresistance has not been fully explored. Herein, we uncovered that pericytes potentiate DNA damage repair (DDR) in GBM cells residing in the perivascular niche, which induces temozolomide (TMZ) chemoresistance. We found that increased pericyte proportion correlates with accelerated tumor recurrence and worse prognosis. Genetic depletion of pericytes in GBM xenografts enhances TMZ-induced cytotoxicity and prolongs survival of tumor-bearing mice. Mechanistically, C-C motif chemokine ligand 5 (CCL5) secreted by pericytes activates C-C motif chemokine receptor 5 (CCR5) on GBM cells to enable DNA-dependent protein kinase catalytic subunit (DNA-PKcs)-mediated DDR upon TMZ treatment. Disrupting CCL5-CCR5 paracrine signaling through the brain-penetrable CCR5 antagonist maraviroc (MVC) potently inhibits pericyte-promoted DDR and effectively improves the chemotherapeutic efficacy of TMZ. GBM patient-derived xenografts with high CCL5 expression benefit from combined treatment with TMZ and MVC. Our study reveals the role of pericytes as an extrinsic stimulator potentiating DDR signaling in GBM cells and suggests that targeting CCL5-CCR5 signaling could be an effective therapeutic strategy to improve chemotherapeutic efficacy against GBM.

Hematology patients often have severe thrombocytopenia and coagulation dysfunction. Despite the risk of bleeding, PICC insertion is still needed to reduce chemotherapy-related adverse reactions. Currently, there are no definitive indicators for predicting whether PICC placement increases bleeding risk in these patients. Additionally, large-scale studies on the safety of PICC insertion in hematology–oncology patients with platelet counts ≤ 50 × 10⁹/L and/or coagulation abnormalities are lacking. To evaluate the safety of PICC insertion in hematological oncology patients with a platelet concentration ≤ 50 × 10⁹/L and/or coagulation dysfunction through a large-sample retrospective study and to identify risk factors for bleeding after PICC placement. We retrospectively analyzed 1511 hematological patients with a platelet count ≤ 50 × 10⁹/L who underwent PICC insertion from February 2017 to January 2020, focusing on risk factors for bleeding within 24 h post-insertion. Multivariate analysis identified independent risk factors for bleeding within 24 h after PICC insertion as PT ≥ 13 s, platelet count ≤ 25 × 10⁹/L, and ADL score ≤ 95 points. Based on these three risk factors, patients were divided into low-risk (0–1 risk factors, 1% bleeding rate) and high-risk (≥ 2 risk factors, 7% bleeding rate) groups. When 0–1 risk factors are present, PICC insertion is safe even for patients with low platelet counts. If ≥ 2 risk factors exist, the decision to insert a PICC should consider the patient’s clinical symptoms and needs. Blood product intervention does not affect the bleeding rate.

Objectives. This systematic review aims to critically evaluate the efficacy of manual acupuncture for optic atrophy. Eight English and Chinese databases, including Cochrane Library, EMbase, PubMed, Chinese National Knowledge Infrastructure (CNKI), Wanfang Database, China Science and Technology Journal Database (VIP), and Chinese Biomedical Literature Database (CBM), as well as ongoing trials registered with the WHO International Clinical Trials Registry Platform, were searched to identify eligible randomized controlled trials (RCTs) studying manual acupuncture for optic atrophy compared to medication alone. The quality of evidence was assessed using Cochrane Collaboration’s risk of bias tool. Meta-analysis was performed using Review Manager version 5.3. Nine studies were identified and included for meta-analysis. The meta-analysis showed significant differences in favor of manual acupuncture or manual acupuncture plus medication compared with medication alone in the following outcome measures: visual acuity (MD = 0.18, 95% CI [0.17, 0.20], P < 0.00001), mean sensitivity of visual field (MD = 2.11, 95% CI [1.90, 2.32], P < 0.00001), the latent period of P-VEP100 (MD = -6.80, 95% CI [-8.94, -4.66], P < 0.00001), the total effectiveness (264 eyes) (OR = 3.22, 95% CI [1.88, 5.51], P<0.0001), and the total effectiveness (344 participants) (OR = 4.29, 95% CI [2.56, 7.19], P < 0.00001). Despite statistical advantages of manual acupuncture in the literature, due to serious methodological flaws in study design, it cannot be concluded that manual acupuncture is more effective than medicine alone. It is essential that a properly controlled clinical trial is designed and controls are established to exclude placebo effects.

Objective By observing the effects of electroacupuncture (EA) on the apoptosis of conjunctival cells of rabbits with dry eye syndrome (DES) and the expressions of apoptosis-related proteins Caspase-3, Fas and Bcl-2, to discuss the mechanism of EA in the treatment of DES from the perspective of cell apoptosis. Methods Male New Zealand rabbits were randomly divided into a normal group (NG), a model group (MG), an EA group (EAG) and a sham EA group (SEAG). DES rabbit model was developed by eye drop of 0.1% benzalkonium chloride. The rabbit tear secretion and tear film break-up time (BUT) were measured; terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay was used to detect the apoptosis of conjunctival cells; the expressions of Caspase-3, Fas and Bcl-2 proteins in conjunctival cells were detected by immunohistochemistry. Results Compared with the NG, the rabbit tear secretion decreased and the BUT was shortened in the MG (both P <0.01); compared with the MG and the SEAG, the rabbit tear secretion increased and the BUT was prolonged in the EAG (all P <0.05). Compared with the NG, the apoptosis of rabbit conjunctival cells increased ( P <0.01), the expressions of Caspase-3 and Fas proteins increased (both P <0.05), and the expression of Bcl-2 protein decreased ( P <0.01) in the MG; compared with the MG and the SEAG, the apoptosis of rabbit conjunctival cells decreased (both P <0.01), the expressions of Caspase-3 and Fas proteins decreased (all P <0.05), and the expression of Bcl-2 protein increased (both P <0.01) in the EAG. Conclusion EA can inhibit the apoptosis of rabbit conjunctival cells, down-regulate the expressions of apoptosis-related proteins Caspase-3 and Fas, and up-regulate the expression of Bcl-2 protein, which may be one of the mechanisms of EA in treatment of DES.

Objective To observe whether the effect of electroacupuncture (EA) on improving sex hormone disorders and follicle development is by decreasing the expression of anti-Mullerian hormone (AMH) in rats with experimental polycystic ovarian syndrome (PCOS). Methods Forty rats were randomly divided into four groups, a normal group (NG), a model group (MG), an EA at acupoints group (EAAG), and an EA at non-acupoints group (EANAG), with 10 rats in each group. The rats in the EAAG and EANAG were intervened by EA treatment for consecutive 14 d. Zhongji (CV 3) and Guanyuan (CV 4) were selected as the acupoints in the EAAG, and the tip of the tail and 1 cm up from the tail tip were selected as the non-acupoints in the EANAG. After treatment, the histomorphological changes of the ovary, the levels of aromatase P450 (P450arom), testosterone and estradiol in the ovarian tissues, and the expressions of follicle stimulating hormone (FSH) and AMH were observed. Results After treatment, compared with the MG and EANAG, the expression of AMH decreased ( P <0.05), the levels of P450arom and estradiol increased significantly, and the level of testosterone decreased significantly (all P <0.01) in the EAAG. Additionally, several normal follicles were present and the number of cystically dilated follicles decreased in the EAAG. Compared with the MG and EANAG, the EAAG obviously had more follicular granulosa cells. Conclusion EA can down-regulate the abnormally increased expression of AMH to improve sex hormone disorders and follicle development in PCOS rats.

Objective To observe the effect of Zhen’ai needling method in Nei Jing ( Classic of Internal Medicine ) on quality of life in patients with allergic rhinitis (AR). Methods A total of 99 patients with AR who met the inclusion criteria were randomized into a conventional needling group (51 cases) and a Zhen’ai needling group (48 cases). The conventional needling group was treated with acupuncture at Zusanli (ST 36), Hegu (LI 4), Juliao (ST 3), Yingxiang (LI 20), Yintang (GV 29), Shangxing (GV 23) and Baihui (GV 20). The Zhen’ai needling group added acupoints of Zhen’ai needling method {Lieque (LU 7), Shanglianquan [Extra, located at 1 cun above Lianquan (CV 23)] and Tianrong (SI 17)} in addition to points in the conventional needling group. The needles were retained for 30 min. The treatment was performed twice a week. All patients were assessed by total nasal symptom score (TNSS), total ocular symptom score (TOSS) and sino-nasal outcome test-20 (SNOT-20) before and after 15 treatments to evaluate the quality of life. The clinical efficacy was evaluated after 15 treatments. Results During the treatment, 8 cases dropped out in the conventional needling group and 7 cases in the Zhen’ai needling group. There were no significant differences in TNSS, TOSS and SNOT-20 scores between the two groups before treatment (all P >0.05). After treatment, the total effective rate of the Zhen’ai needling group was 92.7%, versus 88.4% in the conventional needling group. There was no significant difference between the two groups ( P >0.05). After treatment, there were no significant differences between the two groups in TNSS and TOSS scores (both P >0.05). The SNOT-20 score of the Zhen’ai needling group was lower than that of the conventional needling group, and the difference was statistically significant ( P <0.05). There were statistical differences between the two groups in the scores of cough and nasal reflux (to the throat) of the NOT-20 scale (both P <0.05). Conclusion Both Zhen’ai needling method and conventional acupuncture are effective in the treatment of AR. Zhen’ai needling method has a better effect than conventional acupuncture in improving cough and nasal reflux (to the throat) in AR patients.

To observe the effects of moxibustion on the hematopoietic function in mice with aplastic anemia (AA) induced by bone marrow (BM) suppression, and to investigate the intervention effects of moxibustion on AA from the perspective of intestinal bacteria. A total of 24 C57BL/6 J male mice were randomly and evenly divided into control, model and moxibustion groups. The myelosuppression-induced AA model was established by cyclophosphamide (CTX) and cyclosporine (Cs) intraperitoneal injection. Mice in the moxibustion group were intervened in mild moxibustion at unilateral “Zusanli(ST36)” acupoint for 15 min per day, and the sides were switched the next day. The intervention of mild moxibustion lasted 60 days consecutively. The red blood cell (RBC), white blood cell (WBC), platelet (PLT) counts and haemoglobin (Hb) concentration levels of mice in each group were detected by peripheral blood cells count staining, and the BM hematopoietic cells and hematopoietic structures were observed by BM smear Wright-Giemsa staining and HE staining. 16SrDNA sequencing was used to analyze the gut bacterial species abundance and diversity in mice from each group. After all the intervention, compared to the control group, the model group had lower levels of RBC, WBC, PLT counts and Hb concentration in peripheral blood (P < 0.05) and fewer hematopoietic cells and hematopoietic structures; compared to the model group, moxibustion group had higher levels of RBC, WBC, PLT counts and Hb concentration in peripheral blood (P < 0.05), and more BM hematopoietic cells and hematopoietic structures. Gut flora showed that moxibustion increased the species richness and diversity of intestinal bacteria in mice; compared with the control group, the relative abundance of Faecalibaculum and Anaeroplasmataceae in the model group was higher (P < 0.05); whereas, the relative abundance of Faecalibaculum and Anaeroplasmataceae in the moxibustion group was lower (P < 0.05) when compared with the model group. In addition, Faecalibaculum was significantly correlated with RBC, WBC, PLT count and Hb concentration (P < 0.05). Moxibustion can improved BM histology, restored hematopoietic cells function, and increased peripheral blood cells count and Hb concentration in AA mice. The mechanism may be related to the fact that moxibustion regulates the abundance of specific intestinal bacteria to maintain the stability of the flora structure.

Dry eye syndrome （DES） is a commonly encountered ophthalmological disease, with a relatively high incidence, and expects an effective treatment method. Acupunctureoxibustion therapy promotes tear production of lacrimal gland without causing a trauma, and thus has a great advantage in treating DES. Through literature analysis, this article summarized the research progress in both clinical practice and mechanism of acupuncture- moxibustion in treating DES during the recent 10 years, for providing valuable references for the application of acupuncture-moxibustion for DES.

Objective To observe the clinical efficacy of Zhen’ai needling method in Nei Jing ( Classic of Internal Medicine ) for children with allergic rhinitis (AR) accompanied by adenoid hypertrophy (AH). Methods A total of 74 children who met the screening criteria were divided into a Zhen’ai group and a control group by the random number table method, with 37 cases in each group. The control group was treated with acupuncture at Zusanli (ST 36), Hegu (LI 4), Yingxiang (LI 20), Juliao (ST 3), Yintang (GV 29), Shangxing (GV 23) and Baihui (GV 20). The Zhen’ai group added points of Zhen’ai needling method {Shanglianquan [Extra, located at 1 cun above Lianquan (CV 23)], Tianrong (SI 17) and Lieque (LU 7)} in addition to the points in the control group. The needles were retained for 30 min. The treatment was performed twice a week. The total nasal symptom score (TNSS), sino-nasal outcome test-20 (SNOT-20) and symptom scale for AH (SSAH) were assessed before and after 10 treatments. The clinical efficacy of the two groups was compared after treatment. Results During the treatment, 5 cases dropped out in the control group and 2 cases in the Zhen’ai group. After treatment, the total effective rate of the Zhen’ai group was 94.3%, versus 93.8% in the control group. There was no significant difference between the two groups ( P >0.05). The markedly effective rate of the Zhen’ai group was 42.9%, versus 12.5% in the control group, and the difference was statistically significant ( P <0.05). After treatment, there were significant intra-group differences in the scores of TNSS, SNOT-20 and SSAH in both groups (all P <0.05); the scores of SNOT-20 and SSAH in the Zhen’ai group were lower than those in the control group, and the differences between the groups were statistically significant (both P <0.05). Conclusion Both conventional acupuncture and conventional acupuncture plus Zhen’ai needling method can improve clinical symptoms of children with AR accompanied by AH; and conventional acupuncture plus Zhen’ai needling method has a better effect than conventional acupuncture in improving AH symptoms.

Objective To analyze and review the clinical efficacy of acupuncture (including electroacupuncture) alone for allergic rhinitis (AR) and to compare its efficacy with antihistamines and Chinese patent medicine Bi Yan Kang Tablet. Methods The search strategy, inclusion and exclusion criteria were made according to the principle of evidence-based medicine. We performed a systematic search on China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang), Chongqing VIP Database (CQVIP), Chinese Biomedical Literature Database (CBM), PubMed, Excerpta Medica Database (EMBASE), Web of Science, Cochrane Library, and Cochrane Central Register of Controlled Trials (CENTRAL) for randomized controlled trials (RCTs) of acupuncture for allergic rhinitis between January 1990 and December 2015. The quality was evaluated by Cochrane Handbook for Systematic Reviews of Interventions Version 5.1, and the meta-analysis was conducted by RevMan 5.3 version. Results Twenty eligible RCTs were included into the meta-analysis after selection. Compared with antihistamines, the meta-analysis showed RR=1.24>1, 95%CI[1.15, 1.33], P <0.00001, indicating that acupuncture achieved a better total effective rate for AR than antihistamines; MD = –0.93<0, 95%CI[–1.22,–0.63], P <0.00001, indicating that acupuncture is better than antihistamines in decreasing the total nasal symptom score (TNSS) in AR patients; and MD = 1.46>0, 95%CI[–10.84, 13.75], P = 0.82, indicating that there was no statistical difference between acupuncture and antihistamines in regulating immunoglobulin E (IgE) in AR patients. Compared with Bi Yan Kang Tablet, the meta-analysis has shown RR = 1.50>1, 95%CI[1.30, 1.73], P <0.00001, indicating that acupuncture achieved a better total effective rate for AR than Chinese patent medicine Bi Yan Kang Tablet. Conclusion Acupuncture alone can achieve a better total effective rate for AR than antihistamines and Bi Yan Kang Tablet. It is also better than antihistamines in improving clinical symptom scores; however, whether acupuncture is better than Bi Yan Kang Tablet needs further proof. As far as current data are concerned, there was no statistical difference between acupuncture and antihistamines in improving serum IgE; further study is needed in this regard. The risk of bias due to absent randomization methods or blinding implementation decreased the evidence level of the overall conclusion.