Moxibustion for medical personnel with negative emotion and insomnia during COVID-19 pandemic: A randomized, controlled trial.

Background: We conducted this randomized controlled trial (RCT) to evaluate the effectiveness and safety of moxibustion at Sanyinjiao (SP6) acupoint for treatment of negative mood and sleep quality in healthcare workers during the 2019 coronavirus disease (COVID-19). Methods: A total of 180 participants were divided in a 1:1 ratio into two groups, the treatment group (for moxibustion) and the control group (for no treatment). The treatment group had a 30-minute moxibustion therapy once a day for two weeks, followed by a two-week follow-up. The Hamilton Anxiety Scale (HAMA) was used to assess the degree of the participants' anxiety, and the Patient Health Questionnaire-9 (PHQ-9) was utilized to examine their depressed condition. The Maslach Burnout Inventory-General Survey (MBI-GS) was used to measure the level of burnout among healthcare workers. To determine the severity of insomnia, the Sleep Dysfunction Rating Scale (SDRS) was utilized. At baseline, week 2, and week 4, all scales were evaluated. Results: Compared to the control group, The treatment group improved more significantly in the HAMA at week 2 (MD = -19.01, 95% CI: -21.89 to -16.14; P<0.001) and at week 4 follow-up visits (MD = -8.96, 95% CI: -11.19 to -6.73; P<0.001). A subgroup study of HAMA scores revealed that position and education had significant impact on treatment effectiveness. During the 2-week intervention period, the treatment group showed more significant improvements in depressive symptoms measured by PHQ-9 (13.00±2.41 vs. 15.60±3.65; P<0.001), work burnout symptoms measured by MBI-GS (MD = -11.88, 95% CI, -15.73 to -8.03; P<0.001), and insomnia symptoms measured by SDRS (MD = -2.45, 95% CI, -4.24 to -0.66; P<0.01). There were no significant adverse effects reported. Conclusion: Moxibustion at SP6 may be an effective treatment to improve anxiety, depression, sleep quality, and quality of life for healthcare workers during COVID-19. Trial registration: Chinese Clinical Trial Registry (ChiCTR): ChiCTR-2200059327.

New smokeless moxibustion for knee osteoarthritis: A study protocol for a multicenter, single-blind, randomized controlled trial.

INTRODUCTION: Knee osteoarthritis (KOA) is a chronic inflammatory disease with high morbidity and disability. As the aging and obese population increase, so will the medical services for this disease. The purpose of this study is to compare the clinical efficacy of herbal activated carbon smokeless moxibustion and traditional moxibustion in the treatment of KOA and to determine the clinical efficacy of herbal activated carbon smokeless moxibustion in the treatment of KOA. METHODS/DESIGN: This is a multicenter, two parallel-group, single-blind, randomized controlled trial. Eighty-eight subjects with KOA (Kellgren Lawrence grade II or III) will be recruited and randomly treated with smokeless moxibustion or traditional moxibustion in the ratio of 1:1. The smokeless moxibustion group will use plant herbal activated carbon smokeless moxa cone. The traditional moxibustion group will be treated with pure moxa cone. Subjects in both groups will receive treatment at the affected knee(s) at the acupuncture point ST35, EX-LE2, and EX-LE4. Subjects in both groups will receive 3 sessions per week of moxibustion for 4 weeks. The primary outcome are changes in the Western Ontario and McMaster Universities Osteoarthritis Index pain scores from baseline to week 24. Secondary outcomes include visual analog scale, 50 yards fast walking time, short-form heath survey 36, overall clinical efficacy evaluation, self-assessment of safety, treatment credibility and expectancy, and cytokines related to osteoarthritis in serum. DISCUSSION: This randomized single-blind controlled trial takes traditional moxibustion as the control group to provide strict evidence for the clinical efficacy and safety of herbal activated carbon smokeless moxibustion in the treatment of KOA.

An Ex Vivo Study on Release, Uptake, and miRNA Profile of Exosomes in Rat Lens.

Purpose: To identify the ability of releasing and uptaking exosomes in rat lens and characterize the exosomal microRNA profile of lens-derived exosomes. Methods: The rat lenses were cultured ex vivo and the medium was collected. The exosomes were isolated from medium and measured in size and concentration by nanoflow cytometry (nFCM) and transmission electron microscopy (TEM) and verified with CD63 and TSG101 by Western blot. The miRNAs in exosomes released from lens epithelial cells (LECs) were sequenced. The plasma exosomes labeled by PKH26 were used to verify the exosomes uptake LECs, and their colocalized fluorescence was imaged by confocal microscopy. Results: LECs released numerous exosomes into the medium through the capsule, which contained abundant miRNAs. The most abundant miRNAs included miR-184, let-7c-5p, let-7a-5p, let-7b-5p, let-7f-5p, miR-125a-5p, miR-204-5p, miR-125b-5p, miR-1b, and miR-23a-3p. The LECs but not the lens fibre cells showed exosome uptake. The LECs uptake more PKH26-labeled exosomes at day 7 than day 3 and day 14. Conclusions: Our results suggested that LECs can release and uptake exosomes through the capsule. Exosomes may be an important way for the lens to communicate among LECs, aqueous humour, vitreous body, and other ocular tissues.

Huang Qi Tong Bi Decoction Attenuates Myocardial Ischemia-Reperfusion Injury via HMGB1/TLR/NF-κB Pathway.

The aim of this study was to study the protective effect of Huang Qi Tong Bi Decoction (HQTBT) on the heart of rats. Ischemia-reperfusion injury was established by coronary artery ligation. Proinflammatory cytokines were decreased by XFZY in coronary artery ligated rats. ST segment was also restored with the treatment of HQTBT. Triphenyltetrazole chloride (TTC) staining and pathological analysis showed that HQTBT reduced myocardial injury. Besides, the expressions of HMGB1/TLR/NF-κB pathway in rats were significantly decreased by HQTBT. This study shows that HQTBT inhibited inflammatory reaction on myocardial injury in rats.

Ameliorative Effect of Dangguibuxue Decoction against Cyclophosphamide-Induced Heart Injury in Mice.

Dangguibuxue decoction (DBD), a kind of Chinese herbal medicine, has been widely used to treat blood deficiency disease in China. In this experiment, we studied the effects of the Dangguibuxue decoction (DBD) on the myocardial injury induced by cyclophosphamide in mice. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase (CK), and lactic dehydrogenase (LDH) in serum were detected by commercial kits. Total white blood cell (WBCs), platelets, and cytokines pathological changes of heart tissue were also examined. In addition, the protein levels of the NF-кB pathway were detected to reveal its mechanism. The results showed that DBD significantly decreased the levels of ALT, AST, CK, and LDH and increased WBCs in CTX-induced mice. In addition, DBD significantly alleviated pathological changes of heart tissue. DBD significantly reduced the protein expressions of NF-кB signaling pathway. In summary, DBD can be considered an effective drug to alleviate CTX-induced heart damage in mice.

[Origin and thought on the philosophical ideas of acupuncture in Chinese medicine].

Acupuncture in Chinese medicine has been a treasure in Chinese traditional medicine for thousands of years. It is opposite to many basic theories in modern medicine in dynasties. Different from the cross compatibility and interactions among medical medicines, acupuncture in Chinese medicine has its own consolidation and inherent philosophical ideas. In view of this, how to discuss the philosophical ideas and its development of acupuncture in Chinese medicine becomes of great importance. It is crucial to clearly answer the three theoretical propositions in the development of acupuncture in Chinese medicine. Firstly, the differences in acupuncture should be identified between the ancient time and the modern time. The issues focus on the origin of Huangdi Neijing (Yellow Emperor's Internal Medicine) and its philosophical divergence. Secondly, the origin of acupuncture should be identified, whether it is from China or India. Thirdly, the differences in acupuncture should be identified between China and the west, focusing on the explanation and rectification of the interrelationship between the acupuncture in Chinese medicine and the western acupuncture. Hence, the basic features are discussed on the reality of acupuncture in Chinese medicine as well as its diversity. Finally, the proposition is extended on how to holistically grasp the philosophical foundation of acupuncture in Chinese medicine and its future trend.

APOC3 induces endothelial dysfunction through TNF-α and JAM-1.

BACKGROUND: The fatality rate for cardiovascular disease (CVD) has increased in recent years and higher levels of triglyceride have been shown to be an independent risk factor for atherosclerotic CVD. Dysfunction of endothelial cells (ECs) is also a key factor of CVD. APOC3 is an important molecule in lipid metabolism that is closely associated with hyperlipidemia and an increased risk of developing CVD. But the direct effects of APOC3 on ECs were still unknown. This study was aimed at determining the effects of APOC3 on inflammation, chemotaxis and exudation in ECs. METHODS: ELISA, qRT-PCR, immunofluorescence, flow cytometry and transwell assays were used to investigate the effects of APOC3 on human umbilical vein endothelial cells (HUVECs). SiRNA-induced TNF-α and JAM-1 silencing were used to observe how APOC3 influenced the inflammatory process in the ECs. RESULTS: Our results showed that APOC3 was closely associated with the inflammatory process in ECs, and that this process was characterized by the increased expression of TNF-α. Inflammatory processes further disrupted the tight junctions (TJs) between HUVECs by causing increased expression of JAM-1. JAM-1 was involved in maintaining the integrity of TJs, and it promoted the assembly of platelets and the exudation of leukocytes. Changes in its expression promoted chemotaxis and the exudation of ECs, which contributed to atherosclerosis. While the integrity of the TJs was disrupted, the adhesion of THP-1 cells to HUVECs was also increased by APOC3. CONCLUSIONS: In this study, we describe the mechanism by which APOC3 causes inflammation, chemotaxis and the exudation of ECs, and we suggest that controlling the inflammatory reactions that are caused by APOC3 may be a new method to treat CVD.

Effectiveness of moxibustion treatment in quality of life in patients with knee osteoarthritis: a randomized, double-blinded, placebo-controlled trial.

Objective. To observe the effects of traditional Chinese moxibustion, compared with sham moxibustion, on the quality of life (QOL) in patients with chronic knee osteoarthritis (KOA). Methods. This is a randomized double-blinded, placebo-controlled trial. 150 patients with KOA were randomly allocated to either a true moxibustion treatment (n = 77) or a sham moxibustion treatment (n = 73) three times a week for six weeks. The QOL of patients was evaluated with SF-36 at baseline and 3, 6, and 12 weeks after baseline. Results. 136 patients were available for analysis. Participants in the true moxibustion group experienced statistically significantly greater improvement in GH (general health) scores than the sham group at week 6 (P = 0.015) and week 12 (P = 0.029). Participants in the true moxibustion group experienced statistically significantly greater improvement in VT (vitality) scores than the sham group at week 12 (P = 0.042). No significant adverse effects were found during the trial. Conclusion. A 6-week moxibustion treatment seems to improve general health and vitality, which are associated with physical and mental quality of life, in patients with KOA up to 12 weeks, relative to credible sham moxibustion. This trial is registered with Clinicaltrials.gov ISRCTN68475405.

[Knee osteoarthritis treated with moxibustion: a randomized controlled trial].

OBJECTIVE: To observe the efficacy of moxibustion on the improvement in pain, stiffness and motor disturbance for the patients with knee osteoarthritis (OA) and evaluate the effectiveness and safety of moxibustion therapy. METHODS: Fifty-nine cases of knee OA were randomly divided into a moxibustion group (31 cases) and a placebo moxibustion group (28 cases), in which moxa cone and placebo moxa sticker were applied to Neixiyan (EX-LE 4), Dubi (ST 35) and Ashi points separately, 3 cones on each point in each treatment. The treatment was given once every two days, 3 times per week, continuously for 6 weeks. The follow-up visit was performed in 6 weeks after the end of treatment. The Western Ontario and Mcmaster Universities Osteoarthritis Index (WOMAC) and the time of 46-meter walking at the fastest speed were adopted to evaluate the recovery of joint function. UT-325 digital thermal detector was used to record the temperature change at the most apparent pain points of knee joint before and after moxibustion treatment. RESULTS: In moxibustion group, the scores in WOMAC were reduced apparently in 3 and 6 weeks treatment and during follow-up visit, separately (P < 0.05, P < 0.01, P < 0.001). In placebo moxibustion group, during follow-up visit, the score of stiffness was lower as compared with that before treatment (P < 0.05). In 6 weeks of treatment and during follow-up visit, the scores of pain, stiffness and motor disturbance in moxibustion group were reduced much more remarkably as compared with placebo moxibustion group (P < 0.01, P < 0.05). In moxibustion group, after treatment for 6 weeks,the time of 46-meter walking at the fastest speed was shorter apparently as compared with that before treatment (P < 0.01), but there was no apparent improvement after treatment in placebo moxibustion group (P > 0.05). The difference was not significant statistically in group comparison (P > 0.05). After moxibustion, the temperature at treatment point was (49.81 +/- 3.10) degrees C in moxibustion group and was (40.98 +/- 1.67) degrees C in placebo moxibustion group. The local skin temperature increased apparently as compared with that before treatment in either group (P < 0.001, P < 0.01), but the temperature increasing in moxibustion group was much more remarkable (P < 0.001). CONCLUSION: Moxibustion can obviously improve in the clinical symptoms for the patients with knee osteoarthritis, such as pain, stiffness and motor disturbance. It is a safe and effective therapy.

[Clinical observation on acupoint irradiation with combined laser or red light on patients with knee osteoarthritis of yang deficiency and cold coagulation type].

OBJECTIVE: To explore the effects of combined laser on patients with knee osteoarthritis (OA) of yang deficiency and cold coagulation type. METHODS: Forty-one cases with knee OA of yang deficiency and cold coagulation type were randomly divided into a combined laser group (n = 22) and a red light group (n = 19), with combined laser and red light irradiation on Dubi (ST 35) and Neixiyan (EX-LE 4), respectively. They were treated for 6 weeks. The scores of Western Ontario and McMaster Universities' Osteoarthritis Index (WOMAC VA3. 1) were used for assessment of therapeutic effects. RESULTS: After treatment for 2 weeks and 6 weeks, the WOMAC scores significantly decreased in the two groups as compared with those before treatment (P < 0.05, P < 0.01 and P < 0.001). The mean improvement rate of WOMAC scores in the combined laser group was better than those in the red light group. CONCLUSION: Combined laser irradiation can improve the pain, stiffness and functional limitation of patients with knee OA of yang deficiency and cold coagulation type.