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BACKGROUND: Along with increasing research on acupuncture for chronic pain, the validity of sham acupuncture (SA) has also been argued. METHODS: Nine databases were searched for randomized controlled trials (RCTs) from the inception dates of the databases to July 5, 2022. With Markov Chain Monte Carlo methods, a Bayesian multiple-treatment network meta-analysis (NMA) with random-effects model was conducted. RESULTS: A total of 62 RCTs with 6,806 patients and four kinds of treatments (real acupuncture [RA], non-acupuncture [NA], penetrative SA [PSA], and non-penetrative SA [NPSA]) were included. The results indicated that both NPSA and PSA were not superior to NA in improving chronic pain (NPSA: mean difference [MD]= -4.77, 95% confidence interval [CI] -11.09 to 1.52; PSA: MD= -4.96, 95% CI -10.38 to 0.48). After NPSA and PSA were combined into the SA group, the weak trend of pain relief from SA was still not statistically significant (MD= -4.91, 95% CI -9.93 to 0.05). NPSA and PSA had similar effects (MD= 0.18, 95% CI -5.45 to 5.81). RA was significantly associated with pain relief, compared with NPSA and PSA (NPSA: MD= -12.03, 95% CI -16.62 to -7.41; PSA: MD= -11.85, 95% CI -15.48 to -8.23). The results were generally consistent regardless of pain phenotype, frequency, duration, acupuncture methods, analgesic intake, or detection bias. CONCLUSION: These results suggested that acupuncture was significantly associated with reduced chronic pain. The two kinds of placebo acupuncture, NPSA and PSA, have similar effects. Both NPSA and PSA, with a weak but not significant effect, are appropriate to be inert placebo controls in RCTs for chronic pain.
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OBJECTIVE: To observe the efficacy of acupuncture on symptom burden in patients with gastric cancer during adjuvant chemotherapy after gastrectomy. METHODS: A total of 58 patients were randomized into a high-dose acupuncture group (19 cases, 5 cases dropped off), a low-dose acupuncture group (20 cases, 6 cases dropped off) and a control group (19 cases, 2 cases dropped off). Conventional chemotherapy and antiemetic treatment were adopted in the control group. On the basis of the treatment in the control group, acupuncture was applied 7 times each chemotherapy cycle for totally 21 times in the high-dose acupuncture group, and 3 times each chemotherapy cycle for totally 9 times in the low-dose acupuncture group. Baihui (GV 20), Zusanli (ST 36), Neiguan (PC 6), etc. were selected in the two acupuncture groups, as well as back-shu points selected by the meridian heat sensing technique. Electroacupuncture was connected to ipsilateral Zusanli (ST 36) and Neiguan (PC 6), with continuous wave, 2 Hz in frequency for 20 min. The Edmonton symptom assessment system (ESAS) score was observed on day 1-7, 14, and 21 of each cycle of chemotherapy respectively in the 3 groups. RESULTS: The symptom burden was worst within 7 days of each cycle of chemotherapy in the 3 groups. After the 3rd chemotherapy cycle, the total score of ESAS in the low-dose acupuncture group was lower than the control group (P<0.05), the total score and the scores of feeling of non-well being, pain and shortness of breath of ESAS in the acupuncture group (the high-dose acupuncture group combined with the low-dose acupuncture group) were lower than the control group (P<0.05). CONCLUSION: Acupuncture shows promising effect in controlling symptom burden during adjuvant chemotherapy in gastric cancer patients after gastrectomy.
Subject(s)
Acupuncture Therapy , Stomach Neoplasms , Humans , Acupuncture Points , Stomach Neoplasms/drug therapy , Stomach Neoplasms/surgery , Gastrectomy/adverse effects , Chemotherapy, AdjuvantABSTRACT
[This corrects the article DOI: 10.1155/2021/9911935.].
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Patients with EGFR gene mutation often obtain de novo resistance to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) or develop secondary resistance to EGFR-TKIs after taking EGFR-TKI therapy. Traditional Chinese medicine (TCM) with different treatment principles, in combination with EGFR-TKIs, plays an important role in the treatment of cancers including resistant non-small cell lung cancer (NSCLC). However, inappropriate use of TCM herbs may induce resistance to gefitinib. Therefore, it is of a great value to evaluate which TCM treatment principle should be combined with EGFR-TKIs, and which one should be avoided, and find out the potential mechanisms. The lentiviral transfection assay was used for overexpression of PIK3CA mutation gene in PC-9 cells to construct PC-9-PIK3CA-mutation (PC-9-PIK3CA-M) cells. Cell proliferation, apoptosis, and the expression of EGFR/PI3K/AKT and EGFR/RAS/RAF/ERK in PC-9-PIK3CA-M and H1975 cells treated by the typical cooling-heat drug, Qing-kai-ling (QKL) and Tan-re-qing (TRQ), or the typical warming-yang drug, Shen-fu (SF) and gefitinib treatment, were detected by MTT, Annexin V/PI double labeling, and Western blot assays, respectively. Tumor xenograft and immunohistochemistry experiments were carried out to confirm the in vitro findings. PC-9-PIK3CA-M cells were less sensitive to gefitinib, when compared with PC-9 cells. QKL injection and TRQ injection, not SF injection, combined with gefitinib induced significantly increased cell growth inhibition and apoptosis in PC-9-PIK3CA-M and H1975 cells. SF injection antagonized the effect of gefitinib in promoting cancer cell apoptosis. QKL injection and TRQ injection increased the sensitivity of gefitinib by inhibiting the phosphorylation of AKT or ERK in H1975 and PC-9-PIK3CA-M cells. Similar findings were observed in vivo in H1975 xenograft mouse model. QKL and TRQ, with cooling-heat TCM treatment principle, should be combined with gefitinib in the treatment of NSCLC. Furthermore, warming-yang drug SF should be avoided to be used together with EGFR-TKIs.
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Traditional Chinese Medicine (TCM) therapies should be tailored according to the different syndrome types. In order to identify the relationship between the TCM Yin-cold (YC) or Yang-heat (YH) syndrome types and the EGFR gene status, we prospectively studied 310 NSCLC patients. TCM YH or YC was diagnosed by three TCM experts. TCM symptoms and signs were entered into a binary cluster analysis. The relationships between the EGFR gene status, YH or YC syndrome types, and classification by cluster analysis were analyzed using the chi-square test and multivariate logistic regression. In the 299 patients who had their EGFR gene tested, 45.24% YC (76/168) and 25.95% YH (34/131) patients had EGFR mutations (p = 0.001). Among the 292 patients entered into the cluster analysis, 132 were classified into group A, with signs and symptoms similar to YC, whereas 160 group B patients were similar to YH. In the 281 patients with EGFR tested, 45.67% group A (58/127) and 28.57% group B patients (44/154) had EGFR mutations (p = 0.003). The EGFR status was independently correlated with TCM syndrome type and classification by cluster analysis on multivariate logistic regression. NSCLC patients with YC were more likely to have EGFR gene mutations.
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OBJECTIVE: To improve an extraction and determination method for gastrodin in Gastrodia elata. METHODS: On the basis of single factor experiment, used the method of hot water reflux extraction and applied the response surface methodology to determine the best conditions for extracting gastrodin and using HPLC test. RESULTS: Under the boiling water condition, pure water as solvent, the solid-liquid ratio was 1:37,extraction 2 times and extraction time 126 min per times,the content of gastrodin was 0.377%. Comparison with the 2010 edition of the China pharmacopoeia of gastrodin extracted in Gastrodia elata, the result showed the gastrodin content was increased by 2. 12 times. CONCLUSION: This extraction method of gastrodin dissolution rate is high and can reflect the real content of gastrodin of Gastrodia elata.
Subject(s)
Benzyl Alcohols/isolation & purification , Gastrodia/chemistry , Glucosides/isolation & purification , Plants, Medicinal/chemistry , Technology, Pharmaceutical/methods , Benzyl Alcohols/analysis , Chromatography, High Pressure Liquid/methods , Drugs, Chinese Herbal/analysis , Drugs, Chinese Herbal/chemistry , Drugs, Chinese Herbal/isolation & purification , Glucosides/analysis , Liquid-Liquid Extraction/methods , Plant Roots/chemistry , Solvents/chemistry , Temperature , Time Factors , Water/chemistryABSTRACT
OBJECTIVE: To evaluate strength of bi-layer alumina/Y-TZP specimens, compared with 3-point bending test and to estimate the reliability of MSP testing used in dental ceramics. METHODS: The single-layer/bi-layer alumina/Y-TZP specimens were produced by the clinical methods. Strength of these specimens was determined by MSP testing and 3-point bending test respectively. Fractured pieces of each bi-layer specimen were collected and studied with optical microscope and SEM. RESULTS: The MSP fracture strength was lower than bending strength in all the specimens. The strength of single-layer Y-TZP was the highest and the strength of bi-layer samples was lower than that of the single-layer samples respectively. Delamination and interface destruction were found in bi-layer alumina specimens, and not in bi-layer Y-TZP specimens. CONCLUSION: MSP testing is a convenient and feasible method to evaluate mechanical properties of dental ceramics.
Subject(s)
Aluminum Oxide/chemistry , Ceramics/chemistry , Dental Veneers , Materials Testing/methods , Yttrium/chemistry , Zirconium/chemistry , Dental Materials , Dental Porcelain/chemistry , Dental Stress Analysis , Humans , Tensile StrengthABSTRACT
OBJECTIVE: To investigate the therapeutic effect of milkvetch injection (MI) combined with Captopril on early diabetic nephropathy (EDN). METHODS: A total of 69 EDN patients were randomly divided into three groups, with 23 in each group. Besides the conventional hypoglycemic therapy, patients in Group A Captopril, in Group B MI plus Captopril and in Group C MI were given respectively. The therapeutic course for all was 3 months. The related indices of EDN before and after treatment were measured and compared. RESULTS: After treatment, the blood pressure significantly lowered after treatment in Group A and B (P<0.01), but unchanged in Group C; the levels of blood glucose and HbA1c significantly decreased in Group B and C (P < 0.05 or P<0.01), and significant difference was shown in comparison of Group B with Group A (P<0.05); levels of 24hrs urinary albumin excretion (UAER), blood urea nitrogen (BUN) and serum creatinine (SCr) significantly decreased in all 3 groups, and the decrement in Group B was more significant than that in the other two groups (P <0.05). CONCLUSION: MI combined with Captopril can not only decrease blood pressure, blood glucose and HbA1c, but also significantly decrease the UAER in treating EDN.