Traditional Chinese acupuncture and postpartum depression: A systematic review and meta-analysis.

BACKGROUND: Acupuncture, a key component of traditional Chinese medicine, is a form of alternative medicine in which thin needles are inserted into the body commonly for pain relief. To date, the role of traditional Chinese acupuncture in mood disorders in the postpartum period is unclear. Thus, this study aimed to review the effectiveness of acupuncture in patients with postpartum depression (PPD). METHODS: We searched databases such as PUBMED, EMBASE, and Cochrane Controlled Trials Register until September 2018. Meta-analysis was performed using Comprehensive Meta-Analysis 2.0 software. The mean difference (MD) and risk ratio (RR) with 95% confidence intervals (CI) were calculated to evaluate the results of each comparison. RESULTS: A total of 887 PPD patients from 12 randomised controlled trials were included in the quantitative meta-analysis, with 443 patients in the treatment group and 444 patients in the control group. Patients in the acupuncture group had significantly better performances assessed by the Hamilton Depression Scale than those in the control group, and the pooled MD was -1.27 (95% CI: -2.55 to 0.01; p = 0.05, I = 83%) in the random-effect model. In addition, significantly better performance in the effective rate was observed in the acupuncture group than in the control group, and the pooled RR was 1.20 (95% CI: 1.09 to 1.33; p < 0.0001, I = 46%). However, in subgroup analysis for the acupuncture therapy alone, only effective rate showed a significantly better performance. CONCLUSION: Traditional Chinese acupuncture seems to be effective in improving some symptoms of PPD, although the evidence is uncertain. Therefore, further studies following standardized guidelines with a low risk of bias are needed to confirm the effectiveness of acupuncture in the treatment of PPD.

Modifying the details of aspiration operation may contribute to the improvement of prognosis of patients with ICH.

AIM: The aim of the retrospective study was to compare the clinical efficacy of the traditional way of aspiration and the modified way of aspiration. MATERIAL and METHODS: Clinical data of total 159 patients with spontaneous intracerebral hemorrhage treated by traditional (group A, n=66) or modified (group B, n=93) way of aspiration (both combined with thrombolysis) were retrospectively analyzed. Reduction of clot volume in the first operation, rate of mortality and re-bleeding, complications, and long-term clinical outcomes of the two groups were compared. RESULTS: Twenty-five out of 159 patients (15.7%) died during in-hospital stay. The mortality and post-operation re-bleeding rate in group B (10.8% and 1.1%) were significantly lower than that in group A (22.7% and 9.1%), (P < 0.05). The BI scores of patients in group B (79.5±23.2) were significantly higher than that in group A (69.2±23.9), (P < 0.05). CONCLUSION: Our data suggested that modifying details of aspiration operation may contribute to the improved prognosis of ICH patients.

[Clinical efficacy of clot aspiration in the treatment of intracerebral hemorrhage by reviewing papers].

OBJECTIVE: To investigate the clinical efficacy of clot aspiration in the treatment of intracerebral hemorrhage (ICH) by reviewing literatures. METHODS: All studies assigned into two groups of hard or soft tunnel aspiration of clots (HTAC or STAC) on the basis of surgical approaches were obtained by searching four major Chinese medical databases. And the surgical outcomes were descriptively analyzed. RESULTS: A total of 1205 reports (72,855 patients) met the eligibility criteria. The trials (34.0%) with 80% - 89% of clot removal ratio were the most in all HTAC papers and those (37.7%) with 50% - 69% of clot removal ratio were the most in all STAC papers. The mortality and re-bleeding rate in HTAC and STAC group were 14.0% vs 14.5% and 7.2% vs 7.6% respectively (P > 0.05). As compared with the conventional medical group, the mortalities in HTAC and STAC groups were 13.4% vs 36.0% and 14.3% vs 36.1% (P < 0.001) and the re-bleeding rates 9.3% vs 10.6% and 12.2% vs 16.1% (P > 0.05) respectively. As compared with the craniotomy group, the mortalities in HTAC and STAC groups were 14.4% vs 24.1% and 16.7% vs 24.8% (P < 0.01) and the re-bleeding rates 9.1% vs 13.9% (P > 0.05) and 7.1% vs 14.7% (P < 0.01) respectively. CONCLUSION: Aspiration of clots can effectively remove hematoma and reduce the mortality. But it does not increase the risk of re-bleeding. The outcome of HTAC is similar to that of STAC. HTAC has the advantage of clot removal over STAC.

In vitro evaluation of the compatibility of a novel collagen-heparan sulfate biological scaffold with olfactory ensheathing cells.

BACKGROUND: Stroke and traumatic injury to the nerve system may trigger axonal destruction and the formation of scar tissue, cystic cavitations and physical gaps. Olfactory ensheathing cells (OECs) can secrete neurotrophic factors to promote neurite growth and thus act as a prime candidate for autologous transplantation. Biological scaffolds can provide a robust delivery vehicle to injured nerve tissue for neural cell transplantation strategies, owing to the porous three-dimensional structures (3D). So transplantation of the purposeful cells seeded scaffolds may be a promising method for nerve tissue repair. This study aimed to evaluate the compatibility of a novel collagen-heparan sulfate biological scaffold with olfactory ensheathing cells in vitro. METHODS: Collagen-heparan sulfate (CHS) biological scaffolds were made, and then the scaffolds and OECs were co-cultured in vitro. The viability of OECs was tested by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium (MTT) assay at days 1, 3, 5 and 7. Statistical analysis was evaluated by student's t test. Significance was accepted at P < 0.05. OECs were labeled with carboxyfluorescein diacetate succinimidyl ester (CFSE), and the CFSE-labeled OECs were seeded into CHS scaffolds. The attachment and growth of OECs in CHS scaffolds were observed and traced directly by fluorescent microscopy and environmental scanning electron microscope (ESEM). RESULTS: CHS biological scaffolds had steady porous 3D structures and no cytotoxicity to OECs (F = 0.14, P = 0.9330). CHS biological scaffolds were good bridging materials for OECs attachment and proliferation, and they promoted the axonal growth. CONCLUSION: The compatibility of CHS biological scaffolds with OECs is pretty good and CHS biological scaffold is a promising cell carrier for the implantation of OECs in nerve tissue bioengineering.

Combined transplantation of neural stem cells and olfactory ensheathing cells improves the motor function of rats with intracerebral hemorrhage.

OBJECTIVE: To investigate the effects of combined transplantation of neural stem cells (NSC) and olfactory ensheathing cells (OEC) on the motor function of rats with intracerebral hemorrhage. METHODS: In three days after a rat model of caudate nucleus hemorrhage was established, NSCs and OEC, NSC, OEC (from embryos of Wistar rats) or normal saline were injected into hematomas of rats in combined transplantation group, NSC group, OEC group, and control group, respectively. Damage of neural function was scored before and in 3, 7, 14, 30 days after operation. Tissue after transplantation was observed by immunocytochemistry staining. RESULTS: The scores for the NSC, OEC and co-transplantation groups were significantly lower in 14 and 30 days after operation than in 3 days after operation (P < 0.05). The scores for the NSC and OEC groups were significantly lower than those for the control group only in 30 days after operation (P < 0.05), while the difference for the NSC-OEC group was significant in 14 days after operation (P < 0.05). Immunocytochemistry staining revealed that the transplanted OEC and NSC could survive, migrate and differentiate into neurons, astrocytes, and oligodendrocytes. The number of neural precursor cells was greater in the NSC and combined transplantation groups than in the control group. The number of neurons differentiated from NSC was significantly greater in the co-transplantation group than in the NSC group. CONCLUSION: Co-transplantation of NSC and OEC can promote the repair of injured tissue and improve the motor function of rats with intracerebral hemorrhage.