Letter regarding article named 'Is acupuncture effective in the treatment of COVID-19 related symptoms? Based on bioinformatics/network topology strategy'.

I noticed a recently published paper named 'Is acupuncture effective in the treatment of COVID-19 related symptoms? Based on bioinformatics/network topology strategy' with great interest. I am inspired and also have some doubts, which are mainly about the active compounds of acupuncture treating COVID-19. The authors choose only two active compounds, which remains to be elucidated clearly with some criteria description. The 11 300 disease targets of COVID-19 were screened using the terms like the related symptoms, which might be other diseases' manifestations. So the better legends of Figures and Tables should be the terms like COVID-19-related symptoms, instead of COVID-19.

Bioinformatics/network topology analysis of acupuncture in the treatment of COVID-19: response to methodological issues.

Coronavirus disease 2019 (COVID-19) is a global pandemic and there is an urgent need to discover the therapy for COVID-19. In our original article, we first obtained the target proteins of acupuncture and related target genes of COVID-19 by searching English and Chinese databases, then Gene Ontology biological processes and enrichment analysis were performed on the overlapping targets of acupuncture with COVID-19. Moreover, the compound-target and compound-disease-target network was constructed. This is an innovative attempt to predict the potential benefits of acupuncture treatment for COVID-19. In this letter, we answered reader Zheng's comments.

Acupuncture in cancer care: recommendations for safe practice (peer-reviewed expert opinion).

BACKGROUND: Up-to-date recommendations for the safe practice of acupuncture in integrative oncology are overdue with new cancer treatments and an increase in survivors with late effects of disease; 17 years have elapsed since Filshie and Hester's 2006 guidelines. During 2022/2023 an expert panel assembled to produce updated recommendations aiming to facilitate safe and appropriate care by acupuncturists working with people with cancer. METHODS: A core development team comprising three integrative oncology professionals comprehensively updated pre-existing unpublished recommendations. Twelve invited international experts (senior acupuncturists with and without experience of working in oncology settings, oncologists, physicians and nurses trained in integrative oncology, researchers, academics, and professional body representatives) reviewed the recommendations. In multiple iterations, the core team harmonised comments for final ratification. To aid dissemination and uptake the panel represents national and international integrative oncology associations and major cancer treatment centres in Europe, USA, Australia, and the Middle East. RESULTS: These recommendations facilitate safe care by articulating contra-indications, cautions, and risks for patients both on and off treatment (surgery, SACT, radiotherapy). Situations where acupuncture may be contra-indicated or practices need adapting are identified. "Red and Amber Flags" highlight where urgent referral is essential. CONCLUSION: These are the first international, multidisciplinary peer-reviewed recommendations for safe acupuncture practice in integrative oncology. Concerns about safety remain a significant barrier to appropriate referral from oncology teams, to use by acupuncturists and to uptake by patients. Disseminating trustworthy, widely accessible guidance should facilitate informed, confident practice of acupuncture in and outside of oncology healthcare settings.

Barriers and future improvements of workplace-based learning in Korean medicine clinical clerkship: perspectives of graduates.

BACKGROUND: Workplace-based learning (WPBL) has emerged as an essential practice in healthcare education. However, WPBL is rarely implemented in Korean medicine (KM) due to the passive attitude of teachers and possible violation of medical laws that limit the participation of trainees in medical treatment. In this study, we implemented WPBL in the clinical clerkship of Acupuncture and Moxibustion Medicine at a single College of KM and explored the barriers and future improvements of WPBL. METHODS: The WPBL was implemented from January to July 2019. During the clerkship, each senior student was assigned an inpatient at the university hospital. WPBL was conducted as follows: patient presentation by the supervisor, interaction with the patient at the bedside, preparation of medical records, oral case presentation, and discussion with feedback. The student performed a physical examination and review of systems as a clinical task. In addition, six doctors of KM who are currently practicing after three years of WPBL were interviewed in September 2022 to investigate the real-world effects and unmet needs of WPBL in their workplaces. RESULTS: Two major themes identified from the interview were: "the experience of novice doctors of KM with KM practice" and "Current state of KM clinical education." The five subcategories were: "Clinical competency priorities vary according to the KM workplace," "Difficulties faced by doctors of KM immediately after graduation," "WPBL experience of the interviewees," "Necessary but difficult to implement real patient learning," and "Unmet needs for clinical clerkship in KM." CONCLUSION: It is essential to consider the unique characteristics of KM practice and the duties required in various workplaces for successful WPBL. We anticipate our study to be a starting point for improving the WPBL and addressing the unmet needs in KM clinical education.

Is acupuncture effective in the treatment of COVID-19 related symptoms? Based on bioinformatics/network topology strategy.

Acupuncture is an important part of Chinese medicine that has been widely used in the treatment of inflammatory diseases. During the coronavirus disease 2019 (COVID-19) epidemic, acupuncture has been used as a complementary treatment for COVID-19 in China. However, the underlying mechanism of acupuncture treatment of COVID-19 remains unclear. Based on bioinformatics/topology, this paper systematically revealed the multi-target mechanisms of acupuncture therapy for COVID-19 through text mining, bioinformatics, network topology, etc. Two active compounds produced after acupuncture and 180 protein targets were identified. A total of 522 Gene Ontology terms related to acupuncture for COVID-19 were identified, and 61 pathways were screened based on the Kyoto Encyclopedia of Genes and Genomes. Our findings suggested that acupuncture treatment of COVID-19 was associated with suppression of inflammatory stress, improving immunity and regulating nervous system function, including activation of neuroactive ligand-receptor interaction, calcium signaling pathway, cancer pathway, viral carcinogenesis, Staphylococcus aureus infection, etc. The study also found that acupuncture may have additional benefits for COVID-19 patients with cancer, cardiovascular disease and obesity. Our study revealed for the first time the multiple synergistic mechanisms of acupuncture on COVID-19. Acupuncture may play an active role in the treatment of COVID-19 and deserves further promotion and application. These results may help to solve this pressing problem currently facing the world.

An economic evaluation of pharmacopuncture versus usual care for chronic neck pain: a pragmatic randomized controlled trial.

BACKGROUND: This study aimed to evaluate the cost utility of pharmacopuncture in comparison with usual care for patients with chronic neck pain. METHODS: A 12-week, multicenter, pragmatic randomized controlled trial was conducted, and 101 patients suffering from chronic neck pain for more than six months were randomly placed into the pharmacopuncture and usual care groups to receive four weeks of treatment and 12 weeks of follow-up observations. The quality-adjusted life year (QALY) was calculated using EQ-5D and SF-6D. Concerning costs in 2019, a primary analysis was performed on societal perspective cost, and an additional analysis was performed on healthcare perspective cost. RESULTS: Compared to usual care, pharmacopuncture was superior as it showed a slightly higher QALY and a lower incremental cost of $1,157 from a societal perspective. The probability that pharmacopuncture would be more cost-effective at a willingness-to-pay (WTP) of $26,374 was 100%. Pharmacopuncture was also superior from a healthcare perspective, with a lower incremental cost of $26. The probability that pharmacopuncture would be more cost-effective at a WTP of $26,374 was 83.7%. CONCLUSIONS: Overall, pharmacopuncture for chronic neck pain was found to be more cost-effective compared to usual care, implying that clinicians and policy makers should consider new treatment options for neck pain. TRIAL REGISTRATION: Number NCT04035018 (29/07/2019) Clinicaltrials.gov; Number KCT0004243 (26/08/2019) Clinical Research Information Service.

The characteristics of registered acupuncture clinical trials enrolling cancer patients.

PURPOSE: This study sought to explore and summarize the global state of acupuncture clinical trials enrolling cancer patients included in international registries to date. METHODS: All relevant trials evaluating acupuncture-related interventions for the treatment of cancer that were registered in 16 trial registries from January 1, 2001, through December 31, 2020, were identified. Subsequent publications related to these trials were additionally retrieved from the PubMed, Cochrane Library, Embase, CNKI (China National Knowledge Infrastructure), VIP (China Science and Technology Journal Database), and Wanfang databases. We compared information included in these registries regarding completed trials with any associated publications, with a focus on study design, sample size, and selective reporting, based on the registered protocol. RESULTS: In total, 222 eligible trials across 19 countries were identified. These trials included 17 specific cancer types and 32 symptoms. The five most common cancer types were breast cancer, head and neck cancer, colorectal cancer, lung cancer, and gastric cancer, accounting for almost half of all registered trials (48.2%). The top five symptoms included in these trials were chemotherapy-induced peripheral neuropathy (CIPN), cancer-related pain, cancer-related fatigue, chemotherapy-induced nausea and vomiting (CINV), and gastrointestinal dysfunction. The overall rate of article publication was low, with publications being associated with just 33.3% of these registered trials. CONCLUSIONS: This review is the first snapshot of the landscape of acupuncture clinical trials registered in international trial registries, providing a methodological basis for the management of common treatment- and disease-related side effects among cancer patients undergoing acupuncture and offering useful information that will guide future acupuncture-focused research.

PROSPECT guideline for tonsillectomy: systematic review and procedure-specific postoperative pain management recommendations.

Tonsillectomy is one of the most frequently performed surgical procedures; however, pain management remains challenging. Procedure-specific efficacy as well as specific risks of treatment options should guide selection of pain management protocols based on evidence and should optimise analgesia without harm. The aims of this systematic review were to evaluate the available literature and develop recommendations for optimal pain management after tonsillectomy. A systematic review utilising preferred reporting items for systematic reviews and meta-analysis guidelines with procedure-specific postoperative pain management (PROSPECT) methodology was undertaken. Randomised controlled trials published in the English language up to November 2019 assessing postoperative pain using analgesic, anaesthetic or surgical interventions were identified. Out of the 719 potentially eligible studies identified, 226 randomised controlled trials met the inclusion criteria, excluding the studies examining surgical techniques. Pre-operative and intra-operative interventions that improved postoperative pain were paracetamol; non-steroidal anti-inflammatory drugs; intravenous dexamethasone; ketamine (only assessed in children); gabapentinoids; dexmedetomidine; honey; and acupuncture. Inconsistent evidence was found for local anaesthetic infiltration; antibiotics; and magnesium sulphate. Limited evidence was found for clonidine. The analgesic regimen for tonsillectomy should include paracetamol; non-steroidal anti-inflammatory drugs; and intravenous dexamethasone, with opioids as rescue analgesics. Analgesic adjuncts such as intra-operative and postoperative acupuncture as well as postoperative honey are also recommended. Ketamine (only for children); dexmedetomidine; or gabapentinoids may be considered when some of the first-line analgesics are contra-indicated. Further randomised controlled trials are required to define risk and combination of drugs most effective for postoperative pain relief after tonsillectomy.

Role of Lateral Hypothalamus in Acupuncture Inhibition of Cocaine Psychomotor Activity.

Acupuncture modulates the mesolimbic dopamine (DA) system; an area implicated in drug abuse. However, the mechanism by which peripheral sensory afferents, during acupuncture stimulation, modulate this system needs further investigation. The lateral hypothalamus (LH) has been implicated in reward processing and addictive behaviors. To investigate the role of the LH in mediating acupuncture effects, we evaluated the role of LH and spinohypothalamic neurons on cocaine-induced psychomotor activity and NAc DA release. Systemic injection of cocaine increased locomotor activity and 50 kHz ultrasonic vocalizations (USVs), which were attenuated by mechanical stimulation of needles inserted into HT7 but neither ST36 nor LI5. The acupuncture effects were blocked by chemical lesions of the LH or mimicked by activation of LH neurons. Single-unit extracellular recordings showed excitation of LH and spinohypothalamic neurons following acupuncture. Our results suggest that acupuncture recruits the LH to suppress the mesolimbic DA system and psychomotor responses following cocaine injection.

The analgesic and sedative effects of GV20 pharmacopuncture with low-dose hydromorphone in healthy dogs undergoing ovariohysterectomy.

This study evaluates the analgesic efficacy of low-dose hydromorphone administered via pharmacopuncture at Governing Vessel 20 (GV20) for postoperative pain management following canine ovariohysterectomy. Fifty clinically healthy female dogs undergoing ovariohysterectomy were allocated to receive hydromorphone [0.1 mg/kg body weight (BW)] intramuscularly (IM, n = 25) or hydromorphone (0.01 mg/kg BW) pharmacopuncture at GV20 (GV, n = 25) following extubation. This was a prospective, blinded, randomized clinical trial. Pain and sedation scores were evaluated using the Glasgow Composite Measure Pain Scale Short Form (CMPS-SF) at 1, 2, 3, 4, and 12 hours following study treatment. Time of treatment failure (CMPS-SF ≥ 6/24) was recorded and analyzed using Kaplan-Meier survival analysis. Patient demographics and duration of surgery and anesthesia were analyzed using the appropriate unpaired Student's t-test. The Glasgow CMPS-SF and sedation score were analyzed using a repeated measures 2-way analysis of variance (ANOVA) followed by Bonferroni post-test where appropriate. Significance was set a P < 0.05. There were no significant differences in patient demographics, anesthesia and surgery duration, and study treatment failure. The Glasgow CMPS-SF scores were significantly higher for IM compared with GV [2 (0 to 8) versus 1 (0 to 6), respectively; P = 0.044] at 4 hours. Sedation scores were significantly higher for IM compared with GV at 2 [2 (1 to 3) and 1 (1 to 3), respectively; P = 0.0004] and 4 [1 (1 to 3) and 1 (1 to 2), respectively; P = 0.03] hours. Pharmacopuncture with low-dose hydromorphone provided adequate postoperative analgesia in dogs undergoing ovariohysterectomy with reduced sedative effects. Pharmacopuncture is a good alternative in dogs when reduced dosing of opioids is recommended.

Les effets analgésiques et sédatifs de la pharmacopuncture du GV20 avec de l'hydromorphone à faible dose chez des chiens sains subissant une ovariohystérectomie. Cette étude visait à évaluer l'efficacité analgésique de l'hydromorphone à faible dose administrée par pharmacopuncture au Vaisseau Gouverneur 20 (GV20) pour la gestion de la douleur postopératoire après une ovariohystérectomie canine. Cinquante chiennes cliniquement saines subissant une ovariohystérectomie ont été assignées à une pharmacopuncture d'hydromorphone [0,1 mg/kg de poids corporel (PC)] par voie intramusculaire (IM, n = 25) ou d'hydromorphone (0,01 mg/kg de poids corporel) à GV20 (GV, n = 25) après extubation. Il s'agissait d'un essai clinique prospectif, en aveugle et randomisé. Les scores de douleur et de sédation ont été évalués à l'aide de la Glasgow Composite Measure Pain Scale Short Form (CMPS-SF) à 1, 2, 3, 4 et 12 heures après le traitement de l'étude. Le temps d'échec du traitement (CMPS-SF ≥ 6/24) a été enregistré et analysé à l'aide de l'analyse de survie de Kaplan-Meier. Les données démographiques des patients et la durée de la chirurgie et de l'anesthésie ont été analysées à l'aide du test t de Student non apparié approprié. Le Glasgow CMPS-SF et le score de sédation ont été analysés à l'aide d'une analyse de variance à deux voies (ANOVA) à mesures répétées suivie d'un post-test de Bonferroni, le cas échéant. La signification a été fixée à un P < 0,05. Il n'y avait pas de différences significatives dans les caractéristiques démographiques des patients, la durée de l'anesthésie et de la chirurgie et l'échec du traitement de l'étude. Les scores Glasgow CMPS-SF étaient significativement plus élevés pour IM par rapport à GV [2 (0 à 8) versus 1 (0 à 6), respectivement; P = 0,044] à 4 heures. Les scores de sédation étaient significativement plus élevés pour IM par rapport à la GV à 2 [2 (1 à 3) et 1 (1 à 3), respectivement; P = 0,0004] et 4 [1 (1 à 3) et 1 (1 à 2), respectivement; P = 0,03] heures. La pharmacopuncture avec de l'hydromorphone à faible dose a fourni une analgésie postopératoire adéquate chez les chiens subissant une ovariohystérectomie avec des effets sédatifs réduits. La pharmacopuncture est une bonne alternative chez le chien lorsqu'un dosage réduit des opioïdes est recommandé.(Traduit par Dr Serge Messier).

Acupuncture induces adenosine in fibroblasts through energy metabolism and promotes proliferation by activating MAPK signaling pathway via adenosine3 receptor.

Acupuncture has many advantages in the treatment of certain diseases as opposed to drug therapy. Besides, adenosine has been revealed to affect cellular progression including proliferation. Therefore, this study aimed at exploring the mechanism involving acupuncture stress and adenosine in fibroblast proliferation. The fibroblasts from fascia tissues of the acupoint area (Zusanli) were stimulated by different levels of stress, different concentrations of adenosine, and agonist or antagonist of A3 receptor (A3 R) to investigate the effect of stress stimulation, adenosine, and adenosine-A3 R inhibition on fibroblasts. Then, the fibroblasts were treated with stress stimulation of 200 kPa or/and mitogen-activated protein kinase (MAPK) blocker. We revealed that stress stimulation and the binding of adenosine and A3 R promoted fibroblast proliferation in the fascial tissue, increased the expression of immune-related factors, adenosine and A3 R, and activated the MAPK signaling pathway. MAPK signaling pathway also directly affected the expression of adenosine, A3 R, and immune-related factors. Stress stimulation and adenosine treatment upregulated A3 R expression, and then activated the MAPK signaling pathway, which could in turn upregulate expression of adenosine, A3 R and immune-related factors, and promote cell proliferation. Adenosine is shown to form a positive feedback loop with the MAPK signaling pathway. Collectively, stress stimulation in vitro induces the increase of adenosine in fibroblasts through the energy metabolism and activation of the MAPK signaling pathway through A3 R, ultimately promoting fibroblast proliferation.

The importance of regulating the education and training of Traditional Chinese Medicine practitioners and a potential role for ISO/TC 249.

As Traditional Chinese Medicine (TCM) transcends its cultural boundaries and becomes widely used in many countries around the world, one of the major risks to the growing use of TCM internationally is the damage caused to its reputation and to community safety when TCM practitioners are not adequately trained. Ensuring the quality and competency of TCM practitioners is a fundamental requirement. This paper covers (1) the current level of regulation of education and training of TCM practitioners particularly in countries with well developed health systems; (2) the progress of self regulatory standards for education and training developed by international organizations and (3) the potential role of ISO/TC 249 in assisting these initiatives.

Efficacy, acceptability, and tolerability of all available treatments for insomnia in the elderly: a systematic review and network meta-analysis.

OBJECTIVES: Symptoms of insomnia are highly prevalent in the elderly. A significant number of pharmacological and non-pharmacological interventions exist, but, up-to-date, their comparative efficacy and safety has not been sufficiently assessed. METHODS: We integrated the randomized evidence from every available treatment for insomnia in the elderly (>65 years) by performing a network meta-analysis. Several electronic databases were searched up to May 25, 2019. The two primary outcomes were total sleep time and sleep quality. Data for other 6 efficacy and 8 safety outcomes were also analyzed. RESULTS: Fifty-three RCTs with 6832 participants (75 years old on average) were included, 43 of which examined the efficacy of one or more drugs. Ten RCTs examined the efficacy of non-pharmacological interventions and were evaluated only with pairwise meta-analyses because they were disconnected from the network. The overall confidence in the evidence was very low primarily due to the small amount of data per comparison and their sparse connectedness. Several benzodiazepines, antidepressants, and z-drugs performed better in both primary outcomes, but few comparisons had data from more than one trial. The limited evidence on non-pharmacological interventions suggested that acupressure, auricular acupuncture, mindfulness-based stress reduction program, and tart cherry juice were better than their control interventions. Regarding safety, no clear differences were detected among interventions due to large uncertainty. CONCLUSIONS: Insufficient evidence exists on which intervention is more efficacious for elderly patients with insomnia. More RCTs, with longer duration, making more direct interventions among active treatments and presenting more outcomes are urgently needed.

[Acupuncture and chronic pain†: practical considerations for primary care physicians]. / Acupuncture et douleur chronique†: guide pratique à l'usage des médecins généralistes.

Different international clinical guidelines from expert committees recommend acupuncture on equal terms with conventional pharmacological or interventional techniques for the management of chronic pain. Thus, this traditional Chinese medicine technique has won its place in a primary care chronic pain management plan. It should not be reserved as a last resort, when all other techniques have failed. Inspired by the concept of integrative medicine, this article proposes an overview of currently validated indications, and offers some tools for the primary care physician who wishes to orient a patient towards an acupuncture treatment.

Des récentes recommandations cliniques internationales de différents comités d'experts incluent l'acupuncture au même titre que les traitements médicamenteux ou interventionnels pour le traitement de douleurs chroniques. Dès lors, cette technique de médecine traditionnelle chinoise trouve sa place dans un plan de traitement antalgique en médecine générale, et ne devrait pas être réservée au dernier recours suite à l'échec de toutes les autres modalités. Dans l'esprit d'une antalgie intégrative, cet article propose un aperçu d'indications actuellement validées, ainsi que quelques clefs pour le médecin de premier recours qui souhaite orienter son patient vers un traitement d'acupuncture.

[Prospects for the use of antioxidant pharmacopuncture in metabolic syndrome]. / Perspektivy primeneniya farmakopunktury antioksidantnymi sredstvami pri metabolicheskom sindrome.

OBJECTIVE: The purpose of the study was to further reveal the mechanisms and therapeutic capabilities of the pharmacopuncture method (the introduction of drugs into the area of reflexotherapy points) in metabolic syndrome. In previously published materials on the problem, we pointed out the efficacy of the pharmacopuncture antioxidant Ubiquinone Composite (as a pilot study), similar in effect to the drug Coenzyme Composite (Heel, Germany). The present work develops this topic by further comparing the characteristics of pharmacopuncture with the presented drugs. MATERIAL AND METHODS: The study included 160 patients (103 women and 57 men) with metabolic syndrome. In addition to clinical parameters, lipid and carbohydrate metabolism, atherogenic index, catalase and superoxide dismutase activity, the level of prooxidant processes, and the presence of insulin resistance were evaluated. In the clinical phase, the patients were divided into four groups. In group 1, treatment was limited to standard medication, in other groups, pharmacopuncture was additionally performed. In the 2nd group, physiological solution (placebo) was used as an agent, in the 3rd and 4th groups - the drugs Ubiquinone compositum and Coenzyme compositum, which differ mainly in antioxidant effect. RESULTS AND DISCUSSION: It was found that pharmacopuncture with both drugs leads, in general, to comparable positive results, significantly superior to the effectiveness of other methods. However, certain differences were noted within these groups: in the case of using the drug Ubiquinone compositum, a predominant decrease in blood pressure and dyslipidemia is observed, and when using the drug Coenzyme compositum, a shift in insulin resistance against the background of regression of disbalance in the peroxidation system. On the one part, the presented data show about the therapeutic breadth of the effects of pharmacopuncture, and on the other part, they demonstrate the possibility of a differentiated influence.

Functionalized acupuncture needle as a SERS-active platform for rapid and sensitive determination of adenosine triphosphate.

The development of sensitive and rapid methods for analysis and detection of small molecules is highly desirable for medical diagnostics and therapeutics. We report an acupuncture needle functionalized with gold nanoparticles (Au NPs) and a macrocyclic amine (MA) Raman tag as the platform to realize the sensitive detection of adenosine triphosphate (ATP) by surface-enhanced Raman spectroscopy (SERS). The assembled Au NPs with abundant hot spots on the surface of the needle avoids the aggregation of Au NPs and results in a good signal response. Moreover, there is strong combination between ATP and MA through electrostatic adsorption, hydrogen-bonding interactions, and π-π stacking, and as a consequence, this functionalized needle can be used as a SERS platform for detection of ATP (25 nM) through a decrease of the Raman signal of MA resulting from the high chemical affinity of ATP for MA. Specially, the Au NP/MA-functionalized needle is conveniently used to monitor ATP (100 nM) added to serum, and demonstrates great promise in the study and detection of ATP in a complex sample, laying the foundation for SERS applications in complex acupuncture specimens with fast response and simple operation. Graphical abstract.

Advancing supportive oncology care via collaboration between psycho-oncology and integrative medicine.

PURPOSE: As survival after cancer diagnosis increases, patients are increasingly turning toward integrative therapies (e.g., yoga, acupuncture, massage) to manage acute and chronic concerns related to cancer treatment and survivorship. As such, integrative medicine programs devoted to combining conventional Western cancer care with complementary treatments such as yoga, acupuncture, botanicals, and homeopathy are increasingly common in cancer communities around the world. However, few integrative medicine programs have included psycho-oncology providers in order to systematically evaluate and treat psychological and behavioral health factors affecting adjustment to cancer. METHODS: A pilot program was initiated at a large academic medical center to explore benefits of a collaborative clinic visit conducted with psycho-oncology and integrative medicine within an existing supportive oncology clinic. Collaborative medical and psychological interventions were provided to enhance patient quality of life and reduce symptom burden. RESULTS: Forty-nine patients were seen via the dyadic consultation model. Sixty-eight percent of patients rated their emotional distress at or above clinical cutoffs, indicating unmet supportive care needs. The majority of patients seen were White, non-Hispanic, and female. CONCLUSIONS: Many cancer patients and survivors report persistent emotional distress and chronic physical problems associated with their diagnosis and treatment. The types of patients seen in this pilot program raise concern about ongoing inequalities in access to integrative medicine and psycho-oncology services, which may contribute to downstream health disparities and poorer clinical outcomes. Future directions will explore billing practices, financial sustainability, and methods to increase access to this type of program for demographically diverse individuals across cancer populations.

Acupuncture Augmentation of Lidocaine for Provoked, Localized Vulvodynia: A Feasibility and Acceptability Study.

OBJECTIVE: The aim of the study was to assess the feasibility and acceptability of acupuncture's augmentation of lidocaine therapy in the treatment of provoked localized vulvodynia (PLV). MATERIALS AND METHODS: For 12 weeks, women with moderate to severe PLV were randomized to either 18 sessions of traditional acupuncture (TA) or non-TA (NTA). All participants applied lidocaine 5% cream 4 times daily to the vestibule. Feasibility was assessed by recruitment, enrollment, assessment completion, and blinding. Acceptability was assessed by study visit attendance and satisfaction. The primary outcome was change in tampon test scores from baseline to week 12 and follow-up at week 24. RESULTS: Nineteen women enrolled and 14 completed the study. Five withdrew because of lidocaine reaction (n = 2), inability to insert tampon (n = 1), starting a new medication (n = 1), or change in vulvar diagnosis (n = 1). Participants in both groups reported pain reduction for 12 weeks. There was no statistically significant difference between groups. Women in the TA group (n = 7) experienced less pain from baseline to 12 weeks (mean difference [MD] = 42.4 ± 19.4 and MD = 35.7 ± 17.8 at week 24). In the non-TA group (n = 7), women experienced a within-group MD of 28.7 ± 28.5 at 12 weeks and an MD of 36.7 ± 17.7. CONCLUSIONS: In this early-phase research, acupuncture augmentation of lidocaine was acceptable. The study procedures, with modifications, may be feasible for future investigation. Both acupuncture techniques showed a favorable effect; however, the contribution to pain relief is undetermined.

Nurses and Holistic Modalities: The History of Chinese Medicine and Acupuncture.

Holistic nursing practices holism and holistic modalities to create a healing space and optimize the healing process. Holistic nurses employ a complementary and integrative focus in their work and help patients access their greatest healing potential. This article supports that nursing professionals embrace acupuncture and alternative therapy as a great gift that inspire them to extend their already extraordinary healing power. An overview of the history of Traditional Chinese Medicine and the development and milestones of acupuncture and moxibustion in past dynasties is presented. In particular, the development of Traditional Chinese Medicine and acupuncture in the last 20 years, as well as how social and economic conditions have impacted their expansion, is discussed.

TRPV1 is a Responding Channel for Acupuncture Manipulation in Mice Peripheral and Central Nerve System.

BACKGROUND/AIMS: Acupuncture involves inserting a fine needle into a specific point, often called an acupoint, thereby initiating a therapeutic effect accompanied by phenomena such as soreness, heaviness, fullness, and numbness. Acupoints are characterized as points located in deep tissues with abundant sensory nerve terminals, which suggests that there is a strong relationship between acupoints and peripheral sensory afferents. In this study, we determined whether manual acupuncture (MA) or different frequencies of electroacupuncture (EA) share similar mechanisms for activating excitatory neurotransmission. METHODS: We performed MA or EA at acupoint ST36 and we also used western blot and immunostaining techniques to determine neural changes at the peripheral dorsal root ganglion (DRG), spinal cord (SC), and somatosensory cortex (SSC) levels. RESULTS: Our results show that either MA or EA at the ST36 acupoint significantly increased components of the TRPV1-related signaling pathway, such as pPKA, pPI3K, pPKC-pERK, and pAKT (but not pp38 or pJNK) at the peripheral DRG and central SC-SSC levels. Furthermore, excitatory phosphorylated N-methyl-D-aspartate receptor (pNMDA) and pCaMKIIα (but not pNR2B, pCaMKIIδ, or pCaMKIIγ) also increased. These molecules could not increase in the DRG and SC-SSC of TRPV1-/-mice. CONCLUSION: Our data demonstrates that both MA and EA can activate excitatory signals in either peripheral or central levels. We also define that TRPV1 is crucial for an acupuncture effect and then initiate excitatory pNR1-pCaMKII pathway, at peripheral DRG and central SC-SSC level. We suggest that the TRPV1 signaling pathway is highly correlated to Acupuncture effect that implies the real clinical significance.