Acupuncture treatment of dorsal wrist ganglion: Case report.

Ganglion cysts are benign soft tissue tumors most commonly encountered in the hand. The most widely used approaches are watchful waiting, non-operative aspiration, steroid injection and surgical removal, but these are often associated with high recurrence rates and complications. We report the case of a 38-year-old female graphic designer who presented to the acupuncture outpatient department with chief complaint of an enlarging, painless lump on the left wrist for 5 months. Ultrasound analysis demonstrated a 1.8 * 1.07 cm mass lesion on the dorsum of the left wrist. Her wrist range of motion was approximately 40° active flexion and 30° active extension. Discomfort was the maximum during wrist extension. For each acupuncture treatment, three needles (0.30 mm in diameter, 40 mm in length) were inserted transversely at an angle of 15° and to a depth of 15-20 mm. When the needles were removed after the first treatment, ultrasound analysis showed that the mass lesion decreased in size from 1.8 cm to 1.72 cm, and further to 1.55 cm the following day. The patient underwent treatment every other day for a total of six treatments over a three-week period. By the end of the sixth visit, the cyst had become insignificant in size. The treatment outcome suggests that acupuncture may have effects in perforating the cyst wall and promoting the absorption of the gelatinous fluid within the cyst. Acupuncture may be a viable treatment option with reduced complications and potential faster recovery time for dorsal wrist ganglions.

Study of Thermal Behavior of Moxa Floss Using Thermogravimetric and Pyrolysis-GC/MS Analyses.

Moxa floss is a type of biomass used as the main combustion material in moxibustion, a therapy that applies heat from moxa floss combustion to points or body areas for treatment. Safety concerns regarding moxa smoke have been raised in recent years. Since moxa floss is the source material in moxibustion, its thermal behavior and pyrolysis products would be related to the products formed in moxa smoke. This work aims to understand the thermal behavior of moxa floss and investigate the pyrolysis products generated from moxa floss combustion. Six commercial moxa floss samples of 3 storage years and 10 storage years, and of low, medium, and high ratios, were selected. The kinetic data from moxa floss combustion was carried out by a thermogravimetric analyzer. Pyrolysis-gas chromatography and mass spectroscopy using a gas chromatograph and mass spectrometer equipped with a pyroprobe were used to examine the pyrolysis products. Thermogravimetric profiles for all the samples were overall similar and showed a monotonic weight decrease. The range of intensive reaction temperature occurred between 150°C and 450°C, which was characterized by a major weight loss and accompanied by an exothermal degradation of the main components. The average ignition temperature for the samples of 3 and 10 storage years was 218.3°C and 222.6°C, respectively, which was lower than most herbaceous plants. The identified pyrolysis products include monocyclic aromatic hydrocarbons, polycyclic aromatic hydrocarbons, ketones, acids, and alkanes. All were of relatively low intensities of below 5% in relative abundance. No volatiles were detected in the samples of 10 storage years. The relatively low values of ignition temperature suggested that moxa floss is more combustible and can be ignited more easily than other herbaceous plants. This may explain why moxa floss has remained as the preferred material used for moxibustion over the years.

Quality grade classification of China commercial moxa floss using electronic nose: A supervised learning approach.

Moxa floss is the primary material used in moxibustion, an important traditional Chinese medicine therapy that uses ignited moxa floss to apply heat to the body for disease treatment. Till date, there is no available data regarding quality control of different grades of moxa floss. The objectives of this study were to explore the probative value of the electronic nose (e-nose) in differentiating different quality grades of commercial moxa floss sold in China, and to investigate if data mining techniques could be used to optimize the sensor array while retaining classification accuracy of the samples. The e-nose with 12 metal oxide semiconductor type sensors was used to analyze the odor profiles of 15 commercial moxa floss samples of different quality grades. Feature selection algorithms using principal component analysis (PCA) and BestFirst (BC) coupled with correlation-based feature subset selection (CfsSubsetEval) method were used to obtain the most efficient feature subsets. Results for the BC feature selection method identified 3 optimized sensors (S2, S6, and S11), suggesting that aromatic compounds relate more to the identification of the samples. Radial basis function (RBF), multilayer perceptron (MLP), and random forests (RF) performed well in discriminating the samples, retaining prediction accuracies above 85%, which achieved cost-effectiveness and operational simplicity, while retaining prediction accuracy. The e-nose could be a rapid and nondestructive method for objective preliminary classification of quality grades of moxa floss and may be used for future studies related to moxa products safety and quality.

Influence of storage duration and processing on chromatic attributes and flavonoid content of moxa floss.

OBJECTIVE: Moxibustion is an important traditional Chinese medicine therapy using heat from ignited moxa floss for disease treatment. The purpose of the present study is to establish a reproducible method to assess the color of moxa floss, discriminate the samples based on chromatic coordinates and explore the relationship between chromatic coordinates and total flavonoid content (TFC). METHODS: Moxa floss samples of different storage years and production ratios were obtained from a moxa production factory in Henan Province, China. Chromatic coordinates (L*, a* and b*) were analyzed with an ultraviolet-visible spectrophotometer and the chroma (C*) and hue angle (h°) values were calculated. TFC was determined by a colorimetric method. Data were analyzed with correlation, principal component analysis (PCA). RESULTS: Significant differences in the chromatic values and TFC were observed among samples of different storage years and production ratios. Samples of higher production ratio displayed higher chromatic characteristics and lower TFC. Samples of longer storage years contained higher TFC. Preliminary separation of moxa floss production ratio was obtained by means of color feature maps developed using L*-a* or L*-b* as coordinates. PCA allowed the separation of the samples from their storage years and production ratios based on their chromatic characteristics and TFC. CONCLUSION: The use of a colorimetric technique and CIELAB coordinates coupled with chemometrics can be practical and objective for discriminating moxa floss of different storage years and production ratios. The development of color feature maps could be used as a model for classifying the color grading of moxa floss.

PM2.5 and ash residue from combustion of moxa floss.

BACKGROUND: Moxibustion, a Traditional Chinese Medicine technique, involves burning moxa floss to apply heat to certain points or areas of the body surface to treat disease. Moxibustion releases a considerable amount of smoke into the environment. There remains controversy over the safety of moxa smoke and its potential effects on human health. METHODS: We measured the PM2.5 (particulate matter with aerodynamic diameter <2.5 µm) mass concentration in moxa smoke and the oxidative capacity of PM2.5 and moxa ash (using a plasmid scission assay in whole and water-soluble fractions) in the by-products of moxibustion produced from burning moxa floss of different ratios (3:1 or 15:1) and duration of storage (3 or 10 years) in three simulated moxibustion clinics. RESULTS: PM2.5 mass concentration was 224.28, 226.39  and 210.56 µg/m(3) for samples A (3 years and 3:1 ratio), B (3 years and 15:1 ratio), and C (10 years and 3:1 ratio), respectively. Average D500 oxidative damage of PM2.5 was 29.42%, 29.16% and 27.01% and that of moxa ash was 22.78%, 20.60% and 21.42% for samples A, B and C, respectively. PM2.5 demonstrated a significantly greater oxidative capacity than moxa ash (p<0.05). CONCLUSIONS: The oxidative DNA damage induced by individual PM2.5 following moxibustion was lower than that reported in other environments. However, PM2.5 mass concentration after moxibustion is still relatively high. We would recommend ensuring adequate ventilation during moxibustion to reduce any possible risks. Further studies are needed to better define the potential impact of particles in moxibustion by-products on human health.

Contrasts in spatial and temporal variability of oxidative capacity and elemental composition in moxibustion, indoor and outdoor environments in Beijing.

Moxibustion is a traditional Chinese medicine therapy that burns moxa floss which produces a substantial amount of PM10 into the environment, thus spawning safety concerns about health impacts of the smoke. We compared the oxidative capacity and elemental composition of moxibustion-derived and ambient PM10 in summer and winter to provide a source-, spatial- and temporal-comparison of PM10 biological responses. The PM10 oxidative capacity was 2.04 and 1.45 fold lower, and dose-dependent slope gradient was 2.36 and 1.76 fold lower in moxibustion environment than indoor or outdoor. Oxidative damage was highly correlated with iron, cesium, aluminum and cobalt in indoor, but moxibustion environment displayed low associations. The total elemental concentration was also lower in moxibustion environment than indoor (2.28 fold) or outdoor (2.79 fold). The source-to-dose modeling and slope gradient analysis in this study can be used as a model for future source-, spatial- and temporal-related moxibustion safety evaluation studies.

Current status of acupuncture and moxibustion in China.

Acupuncture and moxibustion are more integrated in the Chinese healthcare system than in the national healthcare systems of other countries. Development of acupuncture and moxibustion in China is making progress in this field. For overseas researchers, this commentary offers perspectives on the current status of acupuncture and moxibustion in China and examines relevant opportunities and challenges in healthcare reforms. There has been a steady increase in the number of undergraduates and postgraduates studying acupuncture and moxibustion in Chinese Medicine (CM) universities in China over the past decade. The legislation of CM physicians that was established in 1999 and the launch of continuing medical education in CM in 2002 have ensured the basic competency of practitioners. The Chinese Government has also shown support for CM development by increasing investment in related fields of research and administration. New challenges have emerged as the healthcare landscape in China has evolved over the past decade. It is important to harness the potential of acupuncture and moxibustion to create a value-driven healthcare system that meets the health needs of a rapidly aging society.

Standardisation of moxibustion: challenges and future development.

International organisations such as WHO and the International Organization for Standardization are increasingly committed to the development of traditional Chinese medicine (TCM). Moxibustion is an integral modality of acupuncture that has been in use for thousands of years. It stands out as a health choice due to its potential effects in disease prevention, health promotion and maintenance, as well as affordability and accessibility. As the use of moxibustion increases, concerns are being raised regarding its safety and quality. The need to establish standards to protect patient safety is paramount in all medical fields. As a form of medical practice, it is essential to develop moxibustion standards in the areas of terminology, moxibustion products, treatment rooms and practice to ensure its harmonisation and safe usage. The evidence base guiding policy and decision making has to be based on evidence from basic and clinical research. Promoting strategic basic and clinical research on the safety and effectiveness of moxibustion will answer some of the fundamental questions surrounding moxibustion, create a climate of awareness and acceptance and, in turn, drive its standardisation.

Prevalence and Correlates of Discomfort and Acceptability of Acupuncture among Outpatients in Chinese Acupuncture and Moxibustion Departments: A Cross-Sectional Study.

Objective. This study aims to give a profile of discomfort and acceptability of acupuncture, including the prevalence and association with demographic and acupuncture-related factors. Methods. A cross-sectional study was conducted in Beijing, China. Outpatients of acupuncture and moxibustion departments were recruited using purposive sampling. 925 subjects were interviewed with an anonymous questionnaire. Multinomial and binary logistic regression were used to analyze factors affecting discomfort and acceptability of acupuncture. Results. The average VAS value of 925 subjects' acupuncture discomfort was 2.66 ± 2.02, within the range of mild discomfort. Acupuncture was easily accepted by 81.1% of the subjects. Results of logistic regression were as follows: (1) subjects with a better knowledge of acupuncture, or a greater fear of pain or needles, experienced more "moderate to severe discomfort" and showed a decreased acupuncture acceptance (P < 0.001 or P < 0.01); (2) Acupuncture with less discomfort or implemented by a more qualified doctor was easy to be accepted (P < 0.001); (3) subjects aged 20-29 preferred to report "moderate to severe discomfort" while those aged 40-59 preferred to report "slight discomfort" (P < 0.001). Conclusion. Acupuncture is an acceptable therapy with less discomfort, which can be greatly affected by fear of pain or needles, age, knowledge of acupuncture, and professional title of acupuncturist.

Effects of Moxa Smoke on Monoamine Neurotransmitters in SAMP8 Mice.

Objectives. To investigate the anti-aging effects of moxa smoke on SAMP8 mice. Methods. Using 2 × 3 factorial design, exposure length (15 or 30 minutes daily), and concentration (low, 5-15 mg/m(3); middle, 25-35 mg/m(3); high, 85-95 mg/m(3)), 70 SAMP8 mice were randomly assigned, n = 10/group, to a model group or one of six moxa smoke groups: L1, L2, M1, M2, H1, or H2. Ten SAMR1 mice were used as normal control. Mice in moxa smoke groups were exposed to moxa smoke at respective concentrations and exposure lengths; the model and normal control mice were not exposed. Cerebral 5-HT, DA, and NE levels were determined using ELISA. Results. Compared to normal control, the model group showed a significant decrease in 5-HT, DA, and NE. Compared to model group, 5-HT and NE were significantly higher in groups L2, M1, and M2 and DA was significantly so in L2 and M1. 5-HT, DA, and NE levels were the highest in group M1 among moxa smoke groups. A marked exposure length × concentration interaction was observed for 5-HT, DA, and NE. Conclusion. Moxa smoke increases monoamine neurotransmitter levels, which varies according to concentration and exposure length. Our finding suggests that the middle concentration of moxa smoke for 15 minutes seems the most beneficial.