Advances of phytotherapy in ischemic stroke targeting PI3K/Akt signaling.

The pathogenesis of ischemic stroke is complex, and PI3K/Akt signaling is considered to play a crucial role in it. The PI3K/Akt pathway regulates inflammation, oxidative stress, apoptosis, autophagy, and vascular endothelial homeostasis after cerebral ischemia; therefore, drug research targeting the PI3K/Akt pathway has become the focus of scientists. In this review, we analyzed the research reports of antiischemic stroke drugs targeting the PI3K/Akt pathway in the past two decades. Because of the rich sources of natural products, increasing studies have explored the value of natural compounds, including Flavonoids, Quinones, Alkaloids, Phenylpropanoids, Phenols, Saponins, and Terpenoids, in alleviating neurological impairment and achieved satisfactory results. Herbal extracts and medicinal formulas have been applied in the treatment of ischemic stroke for thousands of years in East Asian countries. These precious clinical experiences provide a new avenue for research of antiischemic stroke drugs. Finally, we summarize and discuss the characteristics and shortcomings of the current research and put forward prospects for further in-depth exploration.

[Efficacy prediction of acupuncture in treatment of moderate-to-severe allergic rhinitis based on miRNA expression profile].

OBJECTIVE: To investigate the differential characteristics of plasma mircoRNA (miRNA) expression profile in the patients of moderate-to-severe allergic rhinitis treated with acupuncture so as to provide an index for screening the potential biomarkers of acupuncture efficacy. METHODS: Of 33 patients of moderate-to-severe allergic rhinitis underwent acupuncture, the superior efficacy patients (superior efficacy group, 3 cases) and the inferior efficacy patients (inferior efficacy group, 3 cases) were selected. Using human miRNA microarray technology, the differences in plasma miRNA expression before and after treatment were analyzed in the patients of two groups. Besides, 10 cases of superior efficacy and 10 cases of inferior one were selected respectively among the patients of moderate-to-severe allergic rhinitis treated with same acupuncture regimen; and the real-time PCR was used to validate miRNAs of differential expression determined by microarray technology. The bioinformatics analysis was performed for miRNAs of significant differences in expression so as to predict the potential functional target genes, and then, the predicted target genes were annotated in reference with the databases of gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG). RESULTS: Before treatment, there were 51 miRNAs of differential expression between two groups, of which, the expression levels of 26 miRNAs were up-regulated and those of 25 miRNAs were down-regulated. Compared with before treatment, 33 miRNAs presented differential expression in the superior efficacy group after treatment. The results of real-time PCR showed that the expression levels of hsa-miR-126-3p, hsa-miR-15a-5p, hsa-miR-494-3p and hsa-miR-574-5p were consistent with the results of microarray analysis in tendency. GO/KEGG analysis indicated that miRNAs with significant differences of expression between two groups were involved in regulating various biological processes, molecular functions and signaling pathways. CONCLUSION: Plasma miRNA-mediated biological processes may be associated with the efficacy response of acupuncture in treatment of moderate-to-severe allergic rhinitis. Plasma miRNAs of differential expression may be the potential non-invasive biomarkers to predict the effectiveness of acupuncture on moderate-to-severe allergic rhinitis.

[Ginger-separated moxibustion for chronic fatigue syndrome and its effect on intestinal flora].

OBJECTIVE: To observe the effect of ginger-separated moxibustion on fatigue state and intestinal flora in patients with chronic fatigue syndrome (CFS). METHODS: A total of 62 patients with CFS were randomly divided into an observation group (31 cases, 3 cases dropped off) and a control group (31 cases, 2 cases dropped off). The patients in the control group were treated with normal diet and moderate exercise; on the basis of the control group, the patients in the observation group were treated with ginger-separated moxibustion at Zhongwan (CV 12), Shenque (CV 8) and Guanyuan (CV 4), 30 min each time, once every other day, three times a week. Both groups were intervened for 4 weeks. Before and after treatment, the fatigue scale-14 (FS-14) was used to observe the improvement of fatigue state, and 16S rRNA detection technology was used to detect the distribution of intestinal flora. RESULTS: Compared before treatment, the FS-14 score was reduced after treatment in the observation group (P<0.01), and the reduction in the observation group was larger than that in the control group (P<0.01). The relative abundance of intestinal flora was similar between the observation group and control group at the phylum and genus level before treatment. After treatment, there was no significant change of intestinal flora in the control group. However, the enterobacteriaceae, corynebacterium, erysipelothrix, actinomycetes were increased in the observation group (P<0.05), and actinomycetes, ruminococcus, lactarius had obvious flora advantages compared with the control group (P<0.05). CONCLUSION: The ginger-separated moxibustion could significantly improve the fatigue state in CFS patients, which may be related to the regulation of intestinal flora structure and the repair of intestinal barrier.

[Effect of ginger-separated moxibustion on fatigue, sleep quality and depression in patients with chronic fatigue syndrome: a randomized controlled trial].

OBJECTIVE: To observe the effect of ginger-separated moxibustion on fatigue, sleep quality and depression in the patients with chronic fatigue syndrome. METHODS: A total of 62 patients with chronic fatigue syndrome were randomized into an observation group (31 cases, 3 cases dropped off) and a control group (31 cases, 2 cases dropped off). In the control group, the patients had normal diet and proper physical exercise. In the observation group, on the basis of the control group, the ginger-separated moxibustion was added at Zhongwan (CV 12), Shenque (CV 8) and Guanyuan (CV 4), 30 min each time, once every two days, 3 times weekly. Separately, before treatment and after 4 weeks of treatment, the MOS item short form health survey (SF-36), the Pittsburgh sleep quality index (PSQI) scale and the self-rating depression scale (SDS) were adopted to evaluate the degrees of fatigue, sleep quality and depression in the patients of the two groups. RESULTS: In the observation group, the score of each item of SF-36, the score of each item of PSQI and SDS score after treatment were all improved significantly as compared with those before treatment respectively (P<0.05, P<0.01). In the control group, the scores of overall health, vitality and mental health in SF-36 and the score of sleep time of PSQI after treatment were improved as compared with those before treatment respectively (P<0.05). After treatment, the score of each item of SF-36, the scores of sleep quality, sleep time, sleep efficiency and sleep disorders of PSQI, as well as SDS score in the observation group were all better than those in the control group respectively (P<0.01, P<0.05). The score of SF-36 was relevant to the scores of PSQI and SDS in the patients of chronic fatigue syndrome (r =0.331, P<0.05; r =-0.706, P<0.01). The improvement value of SF-36 score was closely related to the improvement value of SDS score in the observation group (r =-0.657, P<0.01). CONCLUSION: The ginger-separated moxibustion effectively relieves fatigue and depression condition and improves sleep quality in the patients with chronic fatigue syndrome. The fatigue condition is relevant with sleep quality and depression condition to a certain extent in the patients.

The Effectiveness of Acupoint Catgut Embedding Therapy for Abdominal Obesity: A Systematic Review and Meta-Analysis.

Acupoint catgut embedding is a useful therapy for weight management and widely applied in China. This review aimed to systematically evaluate the effects of acupoint catgut embedding on abdominal obesity. We searched the PubMed, Cochrane-Library, Embase, OVID, MEDLINE, ISI (web of science), Wanfang, VIP, CBM, and CNKI for randomized controlled trials that used acupoint catgut embedding to treat abdominal obesity before April 2019 with the language restriction of Chinese and English. The combination subject terms of abdominal obesity (or central obesity) and acupoint catgut embedding (or catgut implantation, catgut embedding) were used. We found 15 studies involving 1584 individuals. When acupoint catgut embedding plus electroacupuncture is compared with electroacupuncture alone, significant reductions in improvement rate (RR = 1.03, 95% CI = 0.99~1.08), body weight (MD = 5.20, 95%CI = 1.16~9.25), body mass index (MD = 1.73, 95%CI = 0.70~2.76), waist circumference (MD = 2.91, 95%CI = 1.36~4.46), and hip circumference (MD = 1.06, 95%CI = -0.18~2.30) were found. Mean values of body weight by acupoint catgut embedding were 1.35 kg compared with electroacupuncture. Less adverse events were reported in all included articles. In summary, pooled outcomes of acupoint catgut embedding presented a tendency of equal effects to other kinds of acupuncture, whereas acupoint catgut embedding plus electroacupuncture is more effective for abdominal obesity. This study is registered with PROSPERO 2017 (CRD42017082357).

Hypoglycemic Effect of the Degraded Polysaccharides from the Wood Ear Medicinal Mushroom Auricularia auricula-judae (Agaricomycetes).

Auricularia auricula-judae is an important culinary-medicinal mushroom. The A. auricula-judae polysaccharides (AAPs) were prepared from A. auricula-judae in the early stage through alkali extraction and deproteination with the Sevag method, and optimal acid hydrolysis conditions were established by Box-Behnken to prepare the degraded polysaccharides (AAPs-F) from AAPs. In this study, a nonenzymatic glycosylation reaction system was used for the evaluation of the inhibitory effects on the formation of advanced glycation end products (AGEs). In addition, high glucose resistance was assessed by glucose consumption of HepG2 cells and the lifespan of Caenorhabditis elegans under high sugar stress. It was found that both 0.5 mg·mL-1 AAPs and 0.2 mg·mL-1 AAPs-F could significantly inhibit AGE formation in short- and long-term glycosylation (P < .05) in a dose-dependent manner, determined by ultraviolet and fluorospectrophotometry. It indicated activity against AGE formation for different concentrations of AAPs and AAPs-F. AAPs-F at 0.5 mg·mL-1 significantly enhanced the glucose absorption of HepG2 cells by 24.4% (P < .05) in a dose-dependent manner at 24 h, and markedly extended the lifespan of C. elegans by 32.9% (P < 0.05) under high sugar stress conditions. This study demonstrated that the derived hydrolysates produced by the hydrolysis of acid had a prominent effect on the inhibition of AGE formation and relieved the stress state caused by high sugar levels.

Acupuncture and constraint-induced movement therapy for a patient with chronic stroke: One-year follow-up case report.

RATIONALE: Spasticity is a widespread problem in chronic stroke. To date, no study has reported the long-term (up to 1 year) outcomes of acupuncture in combination with constraint-induced movement therapy in patients with chronic stroke. This report describes the successful addition of acupuncture on spasticity and arm function in a patient with chronic stroke and arm paresis. PATIENT CONCERNS: At screening, the patient was unable to voluntarily extend her interphalangeal or metacarpophalangeal joints beyond the 10 degrees required for constraint-induced movement therapy. However, the BTX type A injection couldn't be used as she had ever suffered a severe allergic reaction in the injection of BTX type A for facial anti-wrinkle. DIAGNOSES: A 40-year-old female experienced arm paresis after an infarction in the right posterior limb of the internal capsule 2 years before the intervention. INTERVENTIONS: The BTX type A injection couldn't be used as she had ever suffered a severe allergic reaction in the injection of BTX type A for facial anti-wrinkle, so the patient received 1 hour of acupuncture as an alternative therapy before 5 hours of constraint-induced movement therapy for 12 weekdays. OUTCOMES: All outcome measures (Modified Ashworth Scale, Fugl-Meyer Assessment, Action Research Arm Test, Motor Activity Log) substantially improved over the 1-year period. Moreover, during the observation period, the patient's muscle tone and arm function did not worsen. LESSONS: As a result of a reduction in spasticity, a reduction of learned nonuse behaviors, or use-dependent plasticity after the combined therapy, the arm functions include volitional movements and coordination or speed of movements in the paretic arm have been improved. However, we can not rule out the possibility of an influence of the passage of time or the Hawthorne effect. The costs of the treatment of stroke may be reduced, if this combined therapy proved useful in future controlled studies.

Precise synthesis of unique polydopamine/mesoporous calcium phosphate hollow Janus nanoparticles for imaging-guided chemo-photothermal synergistic therapy.

Multifunctional polymer-inorganic Janus nanoparticles (JNPs) that simultaneously have therapeutic and imaging functions are highly desired in biomedical applications. Here, we fabricated spherical polydopamine/mesoporous calcium phosphate hollow JNPs (PDA/mCaP H-JNPs) via a novel and facile approach. The obtained PDA/mCaP H-JNPs were further selectively functionalized with indocyanine green (ICG) and methoxy-poly(ethylene glycol)thiol (PEG-SH) on PDA domains to achieve a superior photoacoustic (PA) imaging capability and stability, while the other mCaP sides with hollow cavities served as storage spaces and passages for the anti-cancer drug, doxorubicin (DOX). The resultant PEG-ICG-PDA/mCaP H-JNPs possess excellent biocompatibility, a competent drug loading capability, high photothermal conversion efficiency, strong near-infrared (NIR) absorbance, and pH/NIR dual-responsive properties, enabling the H-JNPs to be applied for PA imaging-guided synergistic cancer chemo-phototherapy in vitro and in vivo. Furthermore, the synthetic approach could be extended to prepare PDA/various mesoporous inorganic H-JNPs with spherical shapes for specific applications.

Acupuncture for moderate to severe allergic rhinitis: A non-randomized controlled trial.

OBJECTIVE: To evaluate the effect and safety of acupuncture therapy on patients with moderate to severe allergic rhinitis. METHODS: A non-randomized controlled design was used to compare between the acupuncture group and the medication group. The acupuncture group received 8-week acupuncture therapy, and the medication group received budesonide nasal spray with cetirizine tablets for 8 weeks. The clinical symptoms and signs were analyzed before treatment, at 4 and 8 weeks after the start of treatment, and at 12 weeks after the end of treatment. Furthermore, the clinical efficacy and safety indicators were compared between the two groups. RESULTS: A total of 76 participants consisting of 38 in each of the two groups were enrolled. The scores of each clinical symptom and sign, including sneezing, runny nose, stuffy nose, nasal itching, and turbinate edema, and the total scores decreased over time in both groups (all P<0.05); and no difference was found in the scores between the two groups (P>0.05). There was no statistically significant difference in the effective rates of the acupuncture group at 4 and 8 weeks after the start of treatment as well as at 12-week follow-up compared with those of the medication group (83.3% vs. 91.2%, and 94.4 % vs. 85.3%; and 80.6 % vs. 82.4%, all P>0.05). Experimental items including blood routine, urine routine, aspartate transaminase, alanine aminotransferase, urea nitrogen and creatinine were all in the normal reference ranges during the treatment in the acupuncture group. CONCLUSIONS: Acupuncture therapy has a comparable effect to the medication treatment on patients with moderate to severe allergic rhinitis, and it is safe with no severe adverse effects.

[Efficacy of acupuncture on moderate and severe allergic rhinitis].

OBJECTIVE: To observe the efficacy and safety of acupuncture therapy on moderate and severe allergic rhinitis via the comparison evaluation of western medicine. METHODS: Sixty cases of moderate and severe allergic rhinitis were divided into an acupuncture group (30 cases) and a western medicine group (30 cases). In the acupuncture group, the main acupoints included Yingxiang (LI 20), Shangxing (GV 23), Fengchi (GB 20), Quchi (LI 11), Xuehai (SP 10), Feishu (BL 13), Geshu (BL 17), Pishu (BL 20), etc. The supplementary points were selected according to syndrome differentiation. In the western medicine group, budesonide nasal spray and cetirizine tablets were prescribed. All the cases were treated for 8 weeks in the two groups. Separately, before treatment, in 4 weeks and 8 weeks of treatment, the scores of clinical symptoms and physical signs were observed and the clinical efficacy and safety were compared between the two groups. RESULTS: In 4 weeks and 8 weeks of treatment, the scores of symptoms such as sneezing, nasal discharge, nasal obstruction, nasal itching, eye itching and turbinate hypertrophy, the score of physical signs and total score were all reduced apparently as compared with those before treatment (all P<0. 05). The differences were not significant between the acupuncture group and the western medicine group (all P>0. 05). The total effective rates were 90. 0% (27/30) and 93. 4% (28/30) in the acupuncture group after 4 and 8 weeks of treatment, and were 76. 6% (23/30) and 80. 0% (24/30) in the western medicine group separately, without significant difference in comparison (all P>0. 05). CONCLUSION: Acupuncture achieves the similar efficacy on moderate and severe allergic rhinitis as western medicine. It is the safe therapy and has no apparent adverse reactions.