The Transformation of Acupuncture Practice Using Ultrasonography: Expert Opinions.

Importance: The rapidly growing use of ultrasound in South Korea has revolutionized the real-world application of acupuncture, making it a safer, more accurate treatment. However, little is known about the challenges Korean medicine doctors (KMDs) encounter, as well as the procedures and resources necessary for hygienic, safe ultrasound-guided acupuncture. Objective: This study aimed to investigate the purpose, indications, and procedure for ultrasound-guided acupuncture in Korean medicine (KM) practice and the challenges KMDs encounter in using ultrasonography. Methods: Eleven KMDs with expertise in practicing or teaching ultrasonography were consulted in detail. The purpose of ultrasonography in real-world practice, the overall process, resources utilized in ultrasound-guided procedures, and the unaddressed needs of KMDs were investigated. Results: Ultrasound guidance, employed for various diseases in KM practice, is crucial for pharmacopuncture and acupotomy to increase accuracy and safety. Ultrasoundguided acupuncture involves covering the probe, putting on sterile gloves, and scanning with disinfectants, though the exact steps vary among experts. They also suggested that a lack of insurance coverage was a common obstacle for KMDs utilizing ultrasonography. Conclusions and Relevance: Acupuncture with ultrasound guidance has become a prevalent procedure in South Korea. Standard procedure guidelines and insurance coverage for ultrasonography used for acupuncture procedures are essential to ensure safe, accurate procedures.

Research trends on acupuncture for neuropathic pain: A bibliometric analysis from 1979 to 2023.

BACKGROUND: Acupuncture has drawn increasing attention as a complementary and alternative therapy for neuropathic pain (NP). The present study aimed to summarize the current status and research trends on acupuncture for NP over the past several decades. METHODS: The publications on acupuncture for NP in the database of Web of Science Core Collection from 1979 to 2023 were searched. VOSviewer (1.6.15) and CiteSpace software (5.5.R2) were applied to identify active authors, journals, countries and institutions, co-cited references and hot keywords. RESULTS: A total of 642 publications were finally included, and the quantitative trend of annual publications on acupuncture for NP have shown overall upward from 1979 to 2023. Peoples R China was the most productive and influential country, while Kyung Hee University from South Korea was both the first in publications and citations. Fang JQ ranked the first productive author and Han JS was the first 1 among the co-cited authors. The first productive journal was Evidence-based Complementary and Alternative Medicine, while the first co-cited journal was Pain. The high-frequency keywords were divided into 9 clusters, and the frontier topic focused on "Chronic pain". CONCLUSION: This present study visually showed the research status and trends of acupuncture for NP from 1979 to 2023 on the basis of bibliometric analysis, which may in some way help researcher discovery and explore some new research directions and ideas in the future.

Development and current application status of acupuncture manipulation measuring instrument and operating instrument. / é’ˆåˆºæ‰‹æ³•æµ‹å®šä»ªå’Œæ“ä½œä»ªçš„ç ”åˆ¶åŠåº”ç”¨çŽ°çŠ¶.

Acupuncture manipulation, a crucial component of acupuncture procedures, significantly influences the therapeutic outcomes. Acupuncture manipulation measuring instrument and operating instrument have been developed based on modern technology to objectively characterize manipulation parameters, and achieve standardized and normalized output of acupuncture manipulation. This paper systematically reviews the development and current application status of in vivo acupuncture manipulation measuring instrument, ex vivo acupuncture manipulation measuring instrument, and acupuncture manipulation operating instrument worldwide, and explores key issues that acupuncture manipulation operating instruments need to address for clinical applications, and provides insights into the future prospect of acupuncture robots.

Efectividad del tratamiento con acupuntura en la urgencia hipertensiva / Effectiveness of acupuncture treatment in hypertensive emergency

Introducción: La hipertensión arterial constituye un problema de salud, tanto a nivel mundial como en Cuba, por las complicaciones e implicaciones que tiene en la morbilidad de la población mayor de 15 años. Una mayor y mejor asistencia sanitaria no consiste tan solo en la práctica de costosos tratamientos, sino ante todo en educar, sanitariamente, a la población en la utilización de los recursos de la naturaleza, así como en el empleo de técnicas y la búsqueda de terapias menos invasivas y sin efectos secundarios. Objetivo: Evaluar la efectividad del tratamiento acupuntural en la urgencia hipertensiva. Métodos: Se realizó un estudio cuasi-experimental en el Policlínico Fray Benito, municipio Rafael Freyre, en el período comprendido enero de 2019 y mayo de 2020. El universo lo conformaron todos los pacientes que acudieron al cuerpo de guardia de dicho policlínico, remitidos del consultorio médico de familia con diagnóstico de urgencia hipertensiva. La muestra de estudio se escogió de forma aleatoria y quedó constituida por aquellos pacientes con diagnóstico de urgencia hipertensiva, que cumplieron con los criterios de inclusión y los criterios de exclusión. Las principales variables utilizadas fueron edad, sexo, resultados del tratamiento, presencia de reacciones adversas o no. Conclusiones: Se demostró la efectividad del tratamiento acupuntural en la urgencia hipertensiva en el Policlínico Fray Benito(AU)

Introduction: Hypertension constitutes a health problem, both worldwide and in Cuba, due to the complications and implications it has on the morbidity of the population over 15 years of age. More and better health care does not consist only in the practice of expensive treatments, but above all in educating the population in health, in the use of natural resources, as well as in the use of techniques and the search for less invasive therapies and without side effects. Objectives: To evaluate the effectiveness of acupuncture treatment in hypertensive emergency. Methods: A quasi-experimental study was carried out at Fray Benito Community Clinic, Rafael Freyre municipality, from January 2019 to May 2020. The universe was made up of all the patients who attended the emergency room of said polyclinic, referred from their family doctor's office with emergency hypertensive diagnosis. The study sample was chosen randomly with those patients with a hypertensive emergency diagnosis, who met the inclusion and exclusion criteria. The main variables used were age, sex, treatment results, presence of adverse reactions or not. Conclusions: The effectiveness of acupuncture treatment in hypertensive emergencies was demonstrated at Fray Benito Community Clinic(AU)

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.

Review of economic analysis of available interventions on idiopathic short stature: A protocol for systematic review and meta-analysis.

BACKGROUND: Idiopathic short stature (ISS) causes a high economic burden worldwide. As part of a research project that synthesizes economic evidence for Korean medicine treatment of ISS, we describe the methods that will be used for the comprehensive review of articles that analyze health-related economic evaluation for available interventions for ISS using a systematic review methodology. METHODS: Eight electronic English, Korean, and Chinese databases will be searched from their inception until December 2020 to identify studies on the economic evaluation of available interventions on ISS, without language, study design, or publication status restrictions. From the included studies, the effectiveness, utility, and cost data will be collected as the outcome measures by two researchers independently. Descriptive analysis of individual studies will be conducted. If it is judged that the interventions and outcomes of the included studies are sufficiently homogeneous, we will attempt a quantitative synthesis through meta-analysis using Review Manager version 5.4 software (Cochrane, London, UK). RESULTS: This study will summarize the evidence regarding the economic evaluation of available interventions for ISS. CONCLUSIONS: The findings of this review will help clinicians and patients in evidence-based decision-making in clinical settings and help policy makers develop effective policies and distribute resources based on the available evidence.

Anti-Inflammatory Effects of Acupuncture at ST36 Point: A Literature Review in Animal Studies.

So far, a number of acupuncture studies have shown anti-inflammatory effects of acupuncture treatment, mostly known at specific point ST36. However, there is no literature that oversaw the inflammation-regulatory effects of acupuncture in each tissue. Therefore, we investigated how acupuncture at specific acupoint ST36 regulates inflammation and its underlying mechanisms. We searched literatures on PubMed until July 2021 using the keywords "animal, acupuncture, ST36, inflammation, immune," and 292 literatures were searched. We ultimately selected 69 studies to determine the anti-inflammatory actions of acupuncture at ST36 and classified the changes of inflammatory mediators according to target regions. Forty-three studies were included in body fluids, 27 studies in the digestive system, 17 studies in the nervous system, and 30 studies in other tissues or organs. In this review, we found that acupuncture at ST36 has clinical benefits in relieving inflammation through several mechanisms such as vagus nerve activation, toll-like receptor 4 (TLR4)/NF-κB signaling, macrophage polarization, mitogen-activated protein kinase (MAPK) signaling pathway, and cholinergic anti-inflammatory pathway. We expect that these data will inform further studies related to ST36 acupuncture on inflammation.

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.

A importância da implantação de Práticas Integrativas e Complementares (PICS) em contextos hospitalares: uma revisão de literatura voltada a acupuntura / The importance of implementing Integrative and Complementary Practices (PICS) in hospital contexts: a literature review focused on acupuncture

As Práticas Integrativas e Complementares (PICs) é um conjunto de ações terapêuticas que não estão presentes na biomedicina e vêm ganhando papel de destaque nos serviços de saúde, pois reduzem sintomas de doenças, prevenção de agravos, e com vantagem de ser uma prática não medicamentosa, promovendo uma assistência humanizada, segura, eficaz, universal e suporte para medicina convencional. A acupuntura é um conjunto de procedimentos que estimula locais através da inserção de agulhas filiformes metálicas para promoção, manutenção, recuperação da saúde e prevenção de doenças. A maior parte das experiências com PICs ocorre na Atenção Básica a Saúde e apenas 4% em Alta Complexidade, onde fica importante a ampliação do acesso e oferta a essas práticas em hospitais para que ocorra o auxílio na qualidade de vida, afim de harmonizar diferentes modos de viver, nos níveis: físico, mental, social, cultural, ambiental e espiritual(AU).

Integrative and Complementary Practices (PICs) is a set of therapeutic actions that are not present in biomedicine and have been gaining a prominent role in health services, as they reduce disease symptoms, prevent diseases, and with the advantage of being a non-drug practice., promoting humanized, safe, effective, universal care and support for conventional medicine. Acupuncture is a set of procedures that stimulates places through the insertion of metallic filiform needles for promotion, maintenance, health recovery and disease prevention. Most experiences with PICs occur in Primary Health Care and only 4% in High Complexity, where it is important to expand access and offer to these practices in hospitals so that quality of life help occurs, in order to harmonize different ways to live on the levels: physical, mental, social, cultural, environmental and spiritual

Locating Specific Acupoints Large Intestine 4 (LI4) and Large Intestine 6 (LI6) in Cadavers Using Anthropometric and Cun Measurement Systems.

BACKGROUND: Anthropometric and anatomical Chinese inch measurement (CUN) systems are useful in understanding the location of acupoints; however, locating acupoints is challenging. OBJECTIVES: The study aimed to locate LI4 and LI6, to measure differences and similarities in body dimensions based on sex using anthropometric and CUN systems, and to observe the relationship between f-cun and b-cun. METHODS: 25 forearms and hands from 16 embalmed cadavers had body dimensions measured using anthropometric and CUN systems. LI4 and LI6 were located using a combination of both systems. Data were compiled and calculated to observe any variation in means and ranges. Statistical analysis was performed using a paired t-test. RESULTS: LI4 was found on the skin at the lateral border of the midpoint of the second metacarpal bone. LI6 was found 3 cun or 74 ± 8 mm from LI5. Differences were observed between male and female cadavers and a large difference between f-cun and b-cun measurements of 1.5 to 3 cun. There were positive correlations between several body dimensions observed. CONCLUSIONS: LI4 was located on the dorsum of the hand, radial to the midpoint of the second metacarpal bone. LI6 was located 3 cun from LI5 with an error of 1 to ½ cun variation. The differences in f-cun and b-cun in isolating LI6 seem to account for this error. Future studies using cadavers may need to take this error into consideration for variation and measuring differences.

Acupuntura y terapia neural para el tratamiento de la Parálisis de Bell / Acupuncture and Neural Therapy for Treating Bell's Palsy

Introducción: La efectividad de las terapias alternativas para el tratamiento de la parálisis de Bell es aún controvertida. Objetivo: Reportar la experiencia en el tratamiento de la PB mediante la administración conjunta de acupuntura y terapia neural. Métodos: Se recopiló información de 30 pacientes con parálisis de Bell, quienes recibieron una sesión semanal de acupuntura y terapia neural de manera conjunta y fueron evaluados mediante la escala House-Brackmann durante 12 semanas. Resultados: El 80 por ciento (24) de los pacientes continuaron el tratamiento hasta la semana 12 y al término de la misma ninguno alcanzó función motora normal. Apenas 6 (25 por ciento) pacientes mostraron signos de recuperación entre las semanas 6 y 12. Así, el porcentaje de pacientes con grado IV se redujo de 6 (20 por ciento) durante la evaluación inicial a 3 (12 por ciento) durante la semana 9 (p = 0,001) y el de pacientes con grado III de 12 (50 por ciento) durante la semana 9 a 9 (38 por ciento) durante la semana 12 (p = 0,663). Se evidenciaron efectos adversos en 9 (32 por ciento) pacientes, lo que incluyó hematoma en el sito de puntura y síncope, que se resolvieron sin complicaciones. Conclusiones: La administración conjunta de acupuntura y terapia neural durante al menos 6 semanas tuvo efectos modestos sobre la recuperación de pacientes con parálisis de Bell sin producir efectos adversos mayores(AU)

Introduction: The effectiveness of alternative therapies for treating Bell's palsy is still controversial. Objective: To report the experience in the treatment of Bell's palsy through joint administration of acupuncture and neural therapy. Methods: Information was collected from 30 patients with Bell's palsy, who received a weekly session of acupuncture and neural therapy jointly and were assessed using the House-Brackmann scale for 12 weeks. Results: 80 percent (24) of the patients continued treatment until week 12 and, at the end of the week, none reached normal motor function. Only 6 patients (25 percent) showed signs of recovery between weeks 6 and 12. Thus, the percentage of patients with grade IV decreased from 6 (20 percent), during the initial evaluation, to 3 (12 percent), during week 9 (p<0.001); while the percentage of patients with grade III decreased from 12 (50 percent), during week 9, to 9 (38 percent), during week 12 (p=0.663). Adverse effects were evidenced in 9 (32 percent) patients, including hematoma at the puncture site and syncope, which was solved without complications. Conclusions: Joint administration of acupuncture and neural therapy for at least six weeks had modest effects on the recovery of patients with Bell's palsy, without producing major adverse effects(AU)

Efectividad del tratamiento acupuntural en las urgencias hipertensivas durante el preoperatorio de cirugías menores / Effectiveness of Acupuncture against Hypertensive Emergencies during the Preoperative of Minor Surgeries

Introducción: Las urgencias hipertensivas constituyen una de las complicaciones agudas más frecuentes de la hipertensión arterial y es causa de muerte prematura entre adultos. Muchas publicaciones abogan por el uso de la Medicina Tradicional y Natural como método terapéutico eficaz e inocuo en su manejo. Objetivo: Evaluar la efectividad del tratamiento acupuntural en las urgencias hipertensivas durante el preoperatorio en los pacientes que serán sometidos a intervenciones quirúrgicas ambulatorias menores en el Hospital Clínico Quirúrgico Dr. Juan Bruno Zayas Alfonso, de enero a octubre de 2019. Métodos: Se efectuó un estudio de intervención terapéutica. El universo estuvo constituido por 150 pacientes hipertensos que fueron asignados aleatoriamente a un grupo estudio que recibió tratamiento con acupuntura y un grupo control que recibió tratamiento medicamentoso. A todos se les realizó diagnóstico occidental y oriental. Ambos grupos estuvieron conformados por 75 pacientes. Resultados: Predominó el grupo de edades de 45 a 54 años en ambos grupos, un mayor número de mujeres enfermas. El síntoma que más afectó al total de los pacientes fue la cefalea y hubo superioridad del diagnóstico síndrome hiperactividad de fuego de hígado. El 74 por ciento de los pacientes a los que se les aplicó acupuntura mejoraron y un 66 por ciento lo lograron en el grupo control. Conclusiones: El tratamiento acupuntural resultó ser efectivo en los pacientes con urgencias hipertensivas durante el preoperatorio para las intervenciones quirúrgicas ambulatorios menores(AU)

Introduction: Hypertensive emergencies are one of the most frequent acute complications of arterial hypertension and the cause of premature death among adults. Many publications advocate the use of traditional and natural medicine as an effective and safe therapeutic method for its management. Objective: To assess the effectiveness of acupuncture against hypertensive emergencies during the preoperative period in patients who will undergo minor outpatient surgical interventions at Dr. Juan Bruno Zayas Alfonso Clinical-Surgical Hospital, from January to October 2019. Methods: A therapeutic intervention study was carried out. The population consisted of 150 hypertensive patients who were randomly assigned to either a study group that received acupuncture or a control group that received drug treatment, all of whom underwent Western and Eastern diagnoses. Both groups consisted of 75 patients. Results: The age set 45-54 years predominated in both groups, together with a greater number of sick women. The symptom that most affected all the patients was headache and there was superiority of the diagnosis of Liver-fire hyperactivity syndrome. 74 percent of the patients who received acupuncture improved, while 66 percent achieved it as part of the control group. Conclusions: Acupuncture turned out to be effective in patients with hypertensive emergencies during the preoperative period for minor outpatient surgeries(AU)

[Revelation and reflection of overseas acupuncture to acupuncture in China].

The development and innovation of overseas acupuncture was expounded from four aspects: meridian diagnosis and physical examination, activity of acupoint, acupuncture and moxibustion method and acupuncture level, enrichment and improvement of TCM theory and technology, and it was summarized what can be learned of principles, methods, prescriptions, acupoints and technology. On the basis of inheriting the experience of ancient acupuncture and moxibustion, the advanced experience and theory at home and abroad should be accommodated , which is helpful to better perfect and reconstruct the theoretical system of acupuncture and moxibustion, and realize the sustainable development of acupuncture and moxibustion.

[Strategies for identifying biological rationality of meridian theory based on biological heterogeneity].

Some of the "new viewpoints" in the meridians study of foreign countries were the reappearance of the old mode and connotation of the former meridian research. The meridian theory is an early understanding of the living life and the surface regulation law of the living life. Combined with the relevant viewpoints of biological heterogeneity research, it may not be enough to analyze the biological rationality of the meridian theory with the current biological knowledge. The biological rationality researches of the meridian theory should be based on a clear effect of acupuncture and moxibustion, integrating the knowledge of acupuncture and moxibustion since the Miraculous Pivot: Meridian, absorbing the ideas and techniques of cutting-edge concepts, and conducting researches on the relations between acupoints-symptoms, acupoints-efficacy, and dose-effect.

[Collection methods, stylistic layout and value of extraordinary points in Doutaishi Zhenjing (Master Dou's Canon of Acupuncture)].

The literature source, collection methods and stylistic layout, value and influence of 32 extraordinary points in Doutaishi Zhenjing (Master Dou's Canon of Acupuncture) were collected. The sources of the literature are extensive. The collection methods include 5 aspects, named inheritance, integration and repair; name rectification, identification and differentiation; new point explication on the base of extraordinary points; well arrangement of points and mutual use of three methods for stylistic layout; as well as integrative illustration with text and picture, and determined location. In reference to the holistic layout of name, location, techniques of acupuncture and moxibustion and indications of extraordinary points in Doutaishi Zhenjing (Master Dou's Canon of Acupuncture), it is the first time to make a standardized and unified collection of extraordinary points, which is valuable in the historical literature, the theoretic research and clinical practice of extraordinary points. It brings a great impact on the special articles or books after the Yuan dynasty and even the establishment of national standards at present.

Acupuntura e farmacopuntura no tratamento da asma em adultos e idosos: qual é a eficácia e a segurança da acupuntura, da auriculoterapia e da farmacopuntura para o tratamento da asma em adultos e/ou idosos? / Acupuncture and pharmacopuncture in the treatment of asthma in adults and the elderly: what is the effectiveness and safety of acupuncture, auriculotherapy and pharmacopuncture for the treatment of asthma in adults and/or the elderly?

A acupuntura se caracteriza pela estimulação de pontos cutâneos específicos por meio do uso de agulhas. A auriculoterapia consiste na estimulação mecânica de pontos específicos do pavilhão auricular com esferas de aço, ouro, prata, plástico, agulhas ou sementes de mostarda. A acupuntura é recomendada para promoção, manutenção e recuperação da saúde, bem como prevenção de agravos e doenças. Além disso, parece propiciar a liberação de neurotransmissores e outras substâncias responsáveis pela promoção da analgesia. A auriculoterapia promove a regulação psíquico orgânica do indivíduo. Ambas as prá ticas foram incorporadas no SUS mediante Portaria nº 971, de 03 de maio de 2006. Qual é a eficácia e a segurança da acupuntura e da auriculoterapia para o tratamento de asma em adultos e/ou idosos? As buscas foram realizadas em sete bases de dados sem restrição de ano de publicação. Os critérios de inclusão foram: revisões sistemáticas em inglês, português e espanhol que avaliaram os efeitos da acupuntura e auriculoterapia no tratamento de asma na população adulta e idosa. A avaliação da qualidade metodológica foi realizada por meio da ferramenta AMSTAR 2, feita por uma pesquisadora e revisada por outra. Nesta revisão rápida, produzida em cinco dias, foram utilizados atalhos metodológicos, de maneira que apenas o processo de seleção foi realizado em duplicidade e de forma independente. De 142 relatos recuperados nas bases de dados, foram incluídas cinco revisões sistemáticas que atenderam aos critérios de elegibilidade. A pergunta de pesquisa incluiu acupuntura e auriculoterapia, o que orientou as buscas de evidências. No entanto, não foram identificados estudos sobre auriculoterapia e a maioria das revisões analisou um tipo específico de acupuntura, denominada farmacopuntura, uma técnica que combina acupuntura com injeção de ervas medicinais. De maneira geral, a farmacopuntura combinada ou não a outros tratamentos, mostrou melhores resultados, em relação a seus comparadores, nos seguin tes desfechos: taxa de resposta e melhora dos sintomas de adultos com asma, melhora da Capacidade Vital Forçada (CVF), do Volume Expiratório Forçado em 1 segundo (VEF1), da relação VEF1/CVF e no Pico de Fluxo Expiratório (PFE). Os resultados sobre acupuntura foram melhores com relação a taxa de melhora dos sintomas de asma e do VEF1. Duas revisões avaliaram a segurança das intervenções, com relatos sobre ocorrência de eventos adversosleves com o uso da farmacopuntura. Esta revisão identificou alguns benefícios da acupuntura e farmacopuntura como tratamento adjuvante em pessoas com asma. No entanto, é necessário interpretar estes resultados com cautela, devido à diversidade de terapias utilizadas nos estudos primários e à qualidade metodológica das revisões sistemáticas, avaliadas como de confiança baixa ou criticamente baixa.

Acupuncture for patients with glucagon-like peptide-1 receptor agonists-induced nausea and vomiting: A systematic review protocol.

INTRODUCTION: The glucagon-like peptide-1 receptor agonists (GLP-1 RAs) class agent has grown rapidly in the last decade due to its effects on lowering HbA1c and weight and the low possibility of hypoglycemia. However, GLP-1 RAs are not devoid of adverse effects among which nausea and vomiting rank first, which reduce adherence to treatment. Accumulated evidences proved that acupuncture can properly treat nausea and vomiting caused by various reasons. The study aims at assessing the safety and effectiveness exhibited by acupuncture treatment for patients with nausea and vomiting induced by GLP-1 RAs. METHODS AND ANALYSIS: Articles that have been identified via electronically searching databases of MEDLINE, Nature, PubMed, the Cochrane Library, WorldSciNet, EMbase, Science Online, AMED, China National Knowledge Infrastructure, the Wanfang Databse and China Biology Medicine Disc and the Chongqing VIP Chinese Science and Technology Periodical Database from their inception of to December 31, 2019 will be incorporated into the systematic review. The review only adopts Chinese and English. It will also pay attention to searching resources of qualified studies, relevant conference proceedings, potential reference list, as well as related system reviews. Two researchers will take charge of completing the selection of research, the extraction of data as well as the assessment of research quality independently. A random- or fixed-effects model will be employed to synthesize data combining the heterogeneity test. The primary outcomes will be nausea and vomiting, seen from the objective and self-reported assessment. Data analysis will be performed via the RevMan 5 software, and GRADE will help to assess the evidence level. The heterogeneity level will determine whether the random-effects model or the fixed-effects model will be used. The 2 categories will adopt risk ratio (RR) or odds ratio (OR) and 95% confidence interval (CI). Continuous variables will adopt the weighted mean difference or standardized mean difference and 95% CI. Meta-analysis will not be conducted if no assessment, like subgroup analysis, is able to explain existing meaningful heterogeneity. The subgroup analysis shall carefully consider each subgroup in certain case. ETHICS AND DISSEMINATION: The systematic review does not involve the evaluation of patients' individual information or patients' right; thus, there is no need to gain the approval from ethical institution. The article will be published in journals reviewed by peers and present at related conference.Registration: Open Science Framework (OSF) Preregistration. 2020, April 8. osf.io/3fgu8.

[Discussion on the issues of time recorded in Lingshu: Weiqixing].

Lingshu: Weiqixing (the Chapter 76 of Miraculous Pivot) states the running course and time of the defensive qi circulation, as well as the needling techniques of acupuncture for waiting for qi arrival. However, because of the conflicts on the time system of acupuncture in the record, it is hard to be adopted in clinical practice in the later generations. In comparison of the 28-lunar-mansion time system with the clepsydra time system, it is known that the 28-lunar-mansion time system is much more rational because the clepsydra system is the tool for counting rather than timing. Hence, in compliance with the original meaning recorded in Lingshu: Weiqixing, the method for estimating the circulation of defensive qi is re-collected so as to provide a new approach to the study on the needling techniques of acupuncture for waiting for qi arrival.

Outcome measures for assessing the effectiveness of non-pharmacological interventions in frequent episodic or chronic migraine: a Delphi study.

OBJECTIVES: The aim of this Delphi survey was to establish an international consensus on the most useful outcome measures for research on the effectiveness of non-pharmacological interventions for migraine. This is important, since guidelines for pharmacological trials recommend measuring the frequency of headaches with 50% reduction considered a clinically meaningful effect. It is unclear whether the same recommendations apply to complementary (or adjunct) non-pharmacological approaches, whether the same cut-off levels need to be considered for effectiveness when used as an adjunct or stand-alone intervention, and what is meaningful to patients. SETTING: University-initiated international survey. PARTICIPANTS: The expert panel was chosen based on publications on non-pharmacological interventions in migraine populations and from personal contacts. 35 eligible researchers were contacted, 12 agreed to participate and 10 completed all 3 rounds of the survey. To further explore how migraine patients viewed potential outcome measures, four migraine patients were interviewed and presented with the same measurement tools as the researchers. PROCEDURES: The initial Delphi round was based on a systematic search of the literature for outcome measures used in non-pharmacological interventions for headache. Suggested outcome measures were rated by each expert, blinded towards the other members of the panel, for its usefulness on a 5-point Likert scale ranging from definitely not useful to extremely useful. Results were combined using median values and IQRs. Tools rated overall as definitely or probably not useful were excluded from subsequent rounds. Experts further suggested additional outcome measures that were presented to the panel in subsequent rounds. Additionally, experts were asked to rank the most useful tools and provide information on feasible cut-off levels for effectiveness for the three highest ranked tools. RESULTS: Results suggest the use of the Migraine Disability Assessment (MIDAS), Headache Impact Test (HIT-6) and headache frequency as primary outcome measures. Patient experts suggested the inclusion of a measure of quality of life and evaluation of associated symptoms and fear of attacks. CONCLUSIONS: Recommendations are for the use of the MIDAS, the HIT-6 and headache frequency, in combination with an outcome measure for quality of life. Associated symptoms and fear of attacks should also be considered as secondary outcomes, if relevant for the individual target population. The cut-off level for effectiveness should be lower for non-pharmacological interventions, especially when used as an adjunct to medication. TRIAL REGISTRATION NUMBER: German Register of Clinical Trials (DRKS00011777).

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.