Effect of music-based movement therapy on the freezing of gait in patients with Parkinson's disease: A randomized controlled trial.

Background: Progression of freezing of gait (FOG), a common pathological gait in Parkinson's disease (PD), has been shown to be an important risk factor for falls, loss of independent living ability, and reduced quality of life. However, previous evidence indicated poor efficacy of medicine and surgery in treating FOG in patients with PD. Music-based movement therapy (MMT), which entails listening to music while exercising, has been proposed as a treatment to improve patients' motor function, emotions, and physiological activity. In recent years, MMT has been widely used to treat movement disorders in neurological diseases with promising results. Results from our earlier pilot study revealed that MMT could relieve FOG and improve the quality of life for patients with PD. Objective: To explore the effect of MMT on FOG in patients with PD. Materials and methods: This was a prospective, evaluator-blinded, randomized controlled study. A total of 81 participants were randomly divided into music-based movement therapy group (MMT, n = 27), exercise therapy group (ET, n = 27), and control group (n = 27). Participants in the MMT group were treated with MMT five times (1 h at a time) every week for 4 weeks. Subjects in the ET group were intervened in the same way as the MMT group, but without music. Routine rehabilitation treatment was performed on participants in all groups. The primary outcome was the change of FOG in patients with PD. Secondary evaluation indicators included FOG-Questionnaire (FOG-Q) and the comprehensive motor function. Results: After 4 weeks of intervention, the double support time, the cadence, the max flexion of knee in stance, the max hip extension, the flexion moment of knee in stance, the comprehensive motor function (UPDRS Part III gait-related items total score, arising from chair, freezing of gait, postural stability, posture, MDS-UPDRS Part II gait-related items total score, getting out of bed/a car/deep chair, walking and balance, freezing), and the FOG-Q in the MMT group were lower than that in the control group and ET group (p < 0.05). The gait velocity, the max ankle dorsiflexion in stance, ankle range of motion (ROM) during push-off, ankle ROM over gait cycle, the knee ROM over gait cycle, and the max extensor moment in stance (ankle, knee) in the MMT group were higher than that in the control group and ET group (p < 0.05). However, no significant difference was reported between the control group and ET group (p > 0.05). The stride length and hip ROM over gait cycle in the MMT group were higher than that in the control group (p < 0.05), and the max knee extension in stance in the MMT group was lower than that in the control group (p < 0.05). Nevertheless, there was no significant difference between the ET group and MMT group (p > 0.05) or control group (p > 0.05). Conclusion: MMT improved gait disorders in PD patients with FOG, thereby improving their comprehensive motor function.

Improvement of freezing of gait in patients with Parkinson's disease by music exercise therapy: a study protocol for a randomized controlled trial.

BACKGROUND: Progression of freezing of gait, a common pathological gait in Parkinson's disease, is an important risk factor for diagnosing the disease and has been shown to predispose patients to easy falls, loss of independent living ability, and reduced quality of life. Treating Parkinson's disease with freezing of gait is very difficult, while the use of medicine and operation has been ineffective. Music exercise therapy, which entails listening to music as you exercise, has been proposed as a treatment technology that can change patients' behavior, emotions, and physiological activity. In recent years, music exercise therapy has been widely used in treatment of motor disorders and neurological diseases and achieved remarkable results. Results from our earlier pilot study revealed that music exercise therapy can improve the freezing of gait of Parkinson's patients and improve their quality of life. Therefore, we aim to validate clinical efficacy of this therapy on freezing of gait of Parkinson's patients using a larger sample size. METHODS/DESIGN: This three-arm randomized controlled trial will evaluate clinical efficacy of music exercise therapy in improving the freezing of gait in Parkinson's patients. We will recruit a total of 81 inpatients with Parkinson's disease, who meet the trial criteria. The patients will randomly receive music exercise with and without music as well as routine rehabilitation therapies, followed by analysis of changes in their gait and limb motor function after 4 weeks of intervention. We will first use a three-dimensional gait analysis system to evaluate changes in patients' gait, followed by assessment of their limb function, activity of daily living and fall risk. DISCUSSION: The findings of this trial are expected to affirm the clinical application of this therapy for future management of the disease. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR1900026063 . Registered on September 20, 2019.

[Discussion on the duration of needle retention].

Needle retention is an important step in the acupuncture procedure. How to optimize scientifically the duration of needle retention according to individual case has been considered in the medical circle. In this paper, by collecting the literatures on needle retention from the early Qin dynasty to the contemporary time, the evolution of the needle retention from a short duration to a long one with the productivity improvement was elaborated. On the base of the views of the medical scholars of all dynasties, it was concluded that the ultimate purpose of needle retention is to improve the effects of acupuncture on the premise of ensuring the safety of acupuncture. Hence, the clinical physician should optimize the duration of needle retention cautiously in compliance with the tolerance of patient so as to save the time cost of both physician and patient, avoid the occurrence of tolerable effect of acupuncture and reduce the potential safety hazard of acupuncture induced by the long duration of needle retention.

[Therapeutic effects on rheumatoid arthritis treated with shu-deep needling and bloodletting techniques].

OBJECTIVE: To observe the difference in the therapeutic effects on rheumatoid arthritis (RA) between the combined shu-deep needling and bloodletting technique and the regular needling technique. METHODS: A total of 70 patients were randomized into an observation group (35 cases) and a control group (35 cases, 4 cases dropped-out). Dazhui (GV 14), Shenzhu (GV 12), Zhiyang (GV 9), Jinsuo (GV 8), Ganshu (BL 18), Shenshu (BL 23), Zhibian (BL 54), Weizhong (BL 40), Taixi (KI 3) and Tianzong (SI 11), etc. were selected in the two groups. Additionally, in the observation group the shu-deep needling technique was adopted at Tianzong (SI 11) and Zhibian (BL 54), the bloodletting technique at the local swollen area and the even-needling technique at the rest acupoints. In the control group, the even-needling technique was applied to all of the acupoints. Acupuncture treatment was given once every two days, 3 times a week and for 12 weeks totally. The numbers of tender points at the knee joint, the numbers of swollen sites at the knee joint, the visual analogue scale (VAS) score and the American health assessment questionnaire (HAQ) score were observed in the two groups before and after treatment, as well as the changes in erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). The American College of Rheumatology (ACR) criteria was adopted to evaluate the therapeutic effects of the two groups. RESULTS: After treatment, the numbers of tender points, the numbers of swollen sites, VAS score and HAQ score were all improved as compared with those before treatment in the two groups (all P<0.01), and the results in the observation group were better than those in the control group (all P<0.05). After treatment, ESR and CRP levels were all reduced as compared with those before treatment in the two groups (all P<0.01), but there was no significant differences between the two groups (both P>0.05). The standard-reaching rates of ACR 20 and ACR 50 in the observation group were 94.3% (33/35) and 31.4% (11/35) respectively, which were better than 67.7% (21/31) and 6.5% (2/31) in the control group (P<0.01, P<0.05). CONCLUSION: The acupuncture with the shu-deep and bloodletting techniques and the acupuncture with regular needling technique are all effective on RA. The therapeutic effects of the acupuncture treatment with the shu-deep and bloodletting techniques are better than that with regular needling technique.

Electro-acupuncture improves psychiatric symptoms, anxiety and depression in methamphetamine addicts during abstinence: A randomized controlled trial.

BACKGROUND: It aimed to observe the effect of electro-acupuncture on the improvement of psychiatric symptoms, as well as anxiety and depression in methamphetamine (MA) addicts during abstinence using randomized controlled trials. METHODS: All patients in the present study received compulsory drug detoxification in Shanghai Drug Rehabilitation Center. All patients were enrolled consecutively from June 2014 to February 2015; data collection was completed in March 2015. According to the randomized, single-blind and control principle, 68 men MA addicts were randomly divided into 2 groups: electro-acupuncture (EA) and sham electro-acupuncture (sham-EA) groups. Patients were given 20 minutes EA or sham-EA treatment every Monday, Wednesday, and Friday, with a total of 4 weeks. Positive and Negative Syndrome Scale (PANSS), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD) were used to evaluate the patients' psychotic symptoms, anxiety and depression before treatment and after receiving treatment with 1 to 4 weeks, respectively. RESULTS: EA could effectively improve the symptoms of psychosis, anxiety, and depression during abstinence in patients with MA addiction. In terms of PANSS score, the scores for positive symptoms and general psychopathological symptoms in patients after receiving 1 to 4 weeks of treatment were significantly decreased compared with the control group, while the score for negative symptoms was significantly decreased after receiving 2 and 4 weeks of treatment. For the HAMA score, the psychotic anxiety scores in patients receiving 1 to 4 weeks of treatment were significant lower than the control group. In terms of HAMD score, there was a significant reduction in anxiety/somatization and sleep disturbance scores after the 4 weeks of EA treatment. CONCLUSION: Electroacupuncture helps to improve psychiatric symptoms and anxiety and depression in MA addicts during abstinence, and promote rehabilitation of patients.

[Guiding-qi acupuncture for dry eye syndrome].

OBJECTIVE: To observe the clinical efficacy differences between different needling methods for dry eye syndrome. METHODS: Sixty patients of dry eye syndrome were randomly divided into an observation group and a control group, 30 cases (60 eyes) in each group. Shangjingming (Extra), Xiajingming (Extra), Tongziliao (GB 1), Cuanzhu (BL 2), Fengchi (GB 20), Hegu (LI 4), Sanyinjiao (SP 6), Taixi (KI 3) and Taichong (LR 3) were selected in the two groups. The control group was treated with conventional acupuncture, while the observation group was treated with guiding-qi acupuncture. Electroacupuncture (EA) was used at bilateral Tongziliao (GB1) and Cuanzhu (BL 2), 30 min per treatment. The treatment was given three times per week. Totally 1-month treatment (12 treatments) was given. The eye symptom score, breakup time of tear film (BUT), Schirmer Ⅰ test (SⅠT) and visual analogue scale (VAS) score were compared before and after treatment in the two groups. The clinical efficacy was compared between the two groups. RESULTS: Compared before treatment, the eye symptom score, BUT, SⅠT and VAS score were improved after treatment in the two groups (all P <0.001); the improvements of eye symptom score and SⅠT in the observation group were superior to those in the control group (both P<0.05). The differences of BUT and VSA score between the two groups were not significant (both P>0.05). The total effective rate was 86.7% (52/60) in the observation group, which was superior to 73.3% (44/60) in the control group (P<0.05). . CONCLUSION: The conventional EA and guiding-qi acupuncture combined with EA are both effective for dry eye syndrome, and the efficacy of guiding-qi acupuncture combined with EA is superior to that of conventional EA.

[Clinical application and mechanism on the ghost points in the treatment of mental diseases].

In order to explore the clinical application and mechanism of the ghost points in the treatment of mental diseases, taking "the ghost points" and "mental diseases" as the theme and the key words, the literatures in recent 10 years on the treatment of mental diseases with the ghost points were collected from CNKI and Wanfang database and analyzed. It is discovered that the ghost points can treat schizophrenia, manic-depressive disorder, dementia, stroke, loss of consciousness, insomnia. anxiety, depression and hysteria and the efficacy is favorable. It is believed that the ghost points act on balancing yin and yang, regulating qi and blood, regaining consciousness and tranquilizing the mind and they achieve the very excellent effect on mental diseases. At present, the reports on this aspect are limited. Hence, it is required to promote the study on the clinical application and mechanism of the ghost points so as to enlarge the clinical indications of the ghost points and provide the powerful support on mechanism for the treatment of mental diseases.

[Clinical efficacy on peripheral facial paralysis at acute stage treated with opposing needling technique].

OBJECTIVE: To compare the differences in clinical efficacy on peripheral facial paralysis at acute stage between the opposing needling technique and routine acupuncture at the affected side so as to provide the evidence on the acupuncture treatment for peripheral facial paralysis at acute stage. METHODS: Forty patients were rando- mized into an opposing needling technique group (19 cases) and an affected side needling technique group (21 cases). The basic medication was same in the two groups. The acupoints were Fengchi (GB 20), Yangbai (GB 14) to Yuyao (EX-HN 4) (penetrating needling method), Jingming (BL 1), Chengqi (ST 1), Xiaguan (ST 7), Jiache (ST 6) to Dicang (ST 4), Hegu (LI 4) and Zusanli (ST 36). In supplementation, in the opposing needling technique group, the acupoints were stimulated on the face of healthy side. In the affected side needling technique group, the acupoints were stimulated on the face of the affected side. The treatment was given three times a week, for 4 weeks. House-Brackmann (H-B) facial nerve function assessment was used to evaluate facial nerve function before and after treatment in the patients of the two groups. The efficacy was compared between the two groups. RESULTS: The facial nerve function was recovered in the two groups and the total effective rate was 100.0% in the two groups (P>0.05). The curative rate was 68.4% (13/19) in the opposing needling technique group and better than 47.6% (10/21) in the affected side needling technique group (P<0.05). On the 7th and 14th day, scores of H-B in the opposing needling technique group were better than those in the affected side needling technique group (both P<0.05). The curative time in the opposing needling technique group was apparently shorter than that in the affected side needling technique group ((23.95 +/- 4.30) days vs. (29.14 +/- 5.43) days, P<0.01). CONCLUSION: The opposing needling technique accelerates the recovery of facial nerve function in peripheral facial paralysis at acute stage and apparently shortens the curative time. The efficacy is better than that in acupuncture on the affect- ed side of the face.

[Discussion on acupuncture for flaccid paralysis from "treating flaccid paralysis by yangming alone"].

Theories regarding"treating flaccid paralysis by yangming alone" are summarized, and the treatment effects of "yangming is the sea of five viscera and six organs", "yangming is in charge of smoothing the tendon and muscle, while tendon and muscle is in charge of connecting bones and movement" and "tendon and muscle is the crossing point of yin meridians and yang meridians, which is converged in yangming" are explained. With medical cases from later generations, it is summarized that besides "using yangming alone", "mainly using yang-ming" and "multiple meridians and acupoints" can also be recommend, indicating that focus should be paid not only on yangming, but also on,syndrome differentiation and treatment, and accompanying symptoms should be emphasized to regulate the body. The commonly used acupoints for flaccid paralysis are summarized to guide the clinical treatment and manipulation.

[Comparative study on effects between electroacupuncture and auricular acupuncture for methamphetamine withdrawal syndrome].

OBJECTIVE: To observe the efficacy difference of electroacupuncture and auricular acupuncture in the treatment of methamphetamine withdrawal syndrome. METHODS: Ninety male patients of methamphetamine addiction were randomized into an electroacupuncture group, an auricular acupuncture group and a control group, 30 cases in each one. In the electroacupuncture group, Neiguan (PC 6), Shenmen (HT 7), Zusanli (ST 36), Sanyinjiao (SP 6), Jiaji (EX-B 2) at T5 and L2 were selected bilaterally. In the auricular acupuncture group, jiaogan (AH(6a)), shenmen (TF4), fei (CO14) and gan (CO12) were selected unilaterally. The treatment was given 3 times a week, totally 12 treatments were required. In the control group, no any intervention was applied. Separately, before treatment and after 1, 2, 3 and 4 weeks treatment, the scores of methamphetamine withdrawal syndrome, Hamilton anxiety scale and Hamilton depression scale were observed in each group. RESULTS: The total score of methamphetamine withdrawal syndrome, anxiety score and depression score were obviously reduced in 2, 3 and 4 weeks of treatment as compared with those before treatment in the electroacupuncture group and the auricular acupuncture group (all P < 0.05), and showed a trend of gradual decline as the extension of treatment. In 1,2,3,4 weeks of treatment, the total score of withdrawal syndrome, anxiety score and depression score in the electroacupuncture group and auricular acupuncture group were lower significantly than those in the control group (all P < 0.05), in which, the total score of withdrawal syndrome in the electroacupuncture group was lower significantly than that in the auricular acupuncture group in the 4th week of treatment (3.69 +/- 2.446 vs 5.73 +/- 3.169, P < 0.05); the anxiety scores were lower significantly than those in the auricular acupuncture group in 3 and 4 weeks of treatment (8.19 +/- 4.57 vs 9.65 +/- 4.24, 5.27 +/- 2.89 vs 7.38 +/- 3.10, both P < 0.05); the depression scores were lower significantly than those in the auricular acupuncture group in 2, 3 and 4 weeks of treatment (15.35 +/- 5.64 vs 19.81 +/- 5.37, 10.96 +/- 4.52 vs 15.00 +/- 4.53, 7.96 +/- 2.69 vs 12.35 +/- 3.59, all P < 0.05). CONCLUSION: Electroacupuncture at the body points and auricular acupuncture play the therapeutic role in the treatment of methamphetamine withdrawal syndrome, anxiety and depression. The longer time the treatment is with electroacupuncture at the body points, the more obvious the efficacy will be on the above symptoms.

[Effects of acupuncture on behavior and striatal apoptosis in mice with Parkinson disease].

OBJECTIVE: To observe the effect of acupuncture of "Baihui" (GV 20), "Fengfu" (GV 16) and "Yanglingquan" (GB 34) on behavior and striatal apoptosis in Parkinson disease (PD) mice. METHODS: Twenty-eight adult male C57/ BL mice were randomly divided into normal control, PD model, acupuncture and medication (Levodopa and Benserazide Hydrochloride) groups. Acupuncture was applied to "Baihui"(GV 20), "Fengfu" (GV 16) and electroacupuncture (2 Hz, 1 mA) was applied to "Yanglingquan"(GB 34) for 15 min, once a day for 14 days. PD model was duplicated by intragastric administration of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). The locomotor test, pole test and swimming test were conducted for assessing the animals' locomotion behavior before and after MPTP administration and after the treatment. The apoptotic neurons of the striatum were detected by terminal deoxyncleotidyl transferase-mediated dUTP-biotin nick end labeling assay. RESULTS: In comparison with the normal control group, the pole test score and apoptotic neuronal percentage were increased significantly (P<0.01), and the locomotor count, swimming test score were decreased remarkably in the model group (P<0.01). Compared with the model group, the locomotor counts and swimming test scores were increased obviously (P<0.05, P<0.01) and the pole test scores decreased apparently (P<0.05) in both acupuncture and medication groups after the treatment. No significant differences were found between the acupuncture and medication groups in the motor behavior (P>0.05). The effect of acupuncture was significantly superior to that of the medication in reducing neuronal apoptosis of the striatum (P<0.01). CONCLUSION: Acupuncture of "Baihui" (GV 20), "Fengfu" (GV 16) and "Yanglingquan"(GB 34) can improve PD mice's locomotor function, which is closely associated with its function in reducing neuronal apoptosis of the striatum.

18α-Glycyrrhizin induces apoptosis and suppresses activation of rat hepatic stellate cells.

BACKGROUND: To investigate the potential mechanisms underlying the protective effects of 18α Glycyrrhizin (GL) on rat hepatic stellate cells (HSCs) and hepatocytes in vivo and in vitro. MATERIAL/METHODS: Sprague-Dawley (SD) rats were randomly divided into 5 groups: normal control group, liver fibrosis group, high-dose 18α GL group (25 mg/ kg/d), intermediate-dose 18α GL group (12.5 mg/kg/d) and low-dose 18α GL group (6.25 mg/ kg/d). The rat liver fibrosis model was induced by carbon tetrachloride (CCl4). The expressions of alpha-smooth muscle actin (αSMA) and NF-kappaB were determined by real-time PCR and immunohistochemistry. RESULTS: 18αGL dose-dependently inhibited the CCl4-induced liver fibrosis. There were significant differences in the mRNA and protein expressions of αSMA between the fibrosis group and 18α-GL treatment groups, suggesting that 18α GL can suppress the proliferation and activation of HSCs. Few HSCs were apoptotic in the portal area and fibrous septum in the liver fibrosis group. However, the double-color staining of a-SMA and TUNEL showed that 18α-GL treatment groups increased HSC apoptosis. NF-kappaB was mainly found in the nucleus in the fibrosis group, while cytoplasmic expression of NF-kappaB was noted in the 18αGL groups. In the in vitro experiments, 18α GL promoted the proliferation of hepatocytes, but inhibited that of HSCs. HSCs were arrested in the G2/M phase following 18α GL treatment and were largely apoptotic. CONCLUSIONS: 18α-GL can suppress the activation of HSCs and induce the apoptosis of HSCs by blocking the translocation of NF-kappaB into the nucleus, which plays an important role in the protective effect of 18α-GL on liver fibrosis.

Preliminary experimental research on the mechanism of liver bile secretion stimulated by peppermint oil.

OBJECTIVE: To investigate the choleretic effect and molecular mechanisms of action of peppermint oil (PO), the main component of Danshu capsules (Sichuan Jishengtang Pharmaceutical Co., Ltd., Pengzhou, Sichuan Province, China). METHODS: Bile secretion was measured by biliary drainage in rats. Total bile acids, total cholesterol and bilirubin in bile were determined. Cholesterol 7α-hydroxylase (CYP7A1), and farnesoid X receptor (FXR) messenger ribonucleic acid (mRNA) levels were assessed in HepG2 cells (a human hepatocellular carcinoma cell line) by reverse transcription polymerase chain reaction (RT-PCR). RESULTS: PO significantly promoted bile and bile acid secretion in rats. It also increased bile acid efflux and decreased cholesterol levels (P < 0.01) in bile. In HepG2 cells the mRNA levels of CYP7A1 and FXR were significantly upregulated after treatment with PO. CONCLUSIONS: PO stimulates bile fluid secretion and thus has a choleretic effect. PO might play a role in upregulating CYP7A1 and FXR mRNA levels, suggesting that the molecular mechanisms are related to gene expression involved in bile acid synthesis.

[Analysis on literature of acupuncture and moxibustion treatment of intractable eye diseases].

Acupuncture and moxibustion treatment has good therapeutic effects on the intractable eye diseases including pigmentary degeneration of retina, macular degeneration, glaucoma and optic atrophy, etc. This paper reviews acupuncture and moxibustion treatment of these diseases from selection of acupoints, treatment methods, effectiveness and mechanism studies, and raises the problems in existence and the prospect.