Reporting and methodological quality of meta-analyses of acupuncture for patients with migraine: A methodological investigation with evidence map.

BACKGROUND: Acupuncture has been widely used to relieve migraine-related symptoms. However, the findings of previous systematic reviews (SRs) and meta-analyses (MAs) are still not completely consistent. Their quality is also unknown, so a comprehensive study is needed. OBJECTIVE: To evaluate the reporting and methodological quality of these MAs concerning acupuncture for migraine, and summarize evidence about the efficacy and safety of acupuncture for migraine. SEARCH STRATEGY: PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Chinese Biomedical Databases, Wanfang Data, and VIP databases were searched from inception to September 2020, with a comprehensive search strategy. INCLUSION CRITERIA: The pairwise MAs of randomized controlled trials (RCTs) concerning migraine treated by acupuncture or acupuncture-based therapies, with a control group that received sham acupuncture, medication, no treatment, or acupuncture at different acupoints were included. DATA EXTRACTION AND ANALYSIS: Two independent investigators screened studies, extracted relevant data, and assessed reporting and methodological quality using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 and A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2), then all results were cross-checked. Spearman correlation test was used to evaluate the correlation between reporting and methodological quality scores. RESULTS: A total of 20 MAs were included in this study. The included MAs indicated that acupuncture was efficacious and safe in preventing and treating migraine when compared with control intervention. There was a high correlation between reporting and methodological quality scores (rs = 0.87, P < 0.001). The quality of the included SRs needs to be improved mainly with regard to protocol and prospective registration, using a comprehensive search strategy, summarizing the strength of evidence body for key outcomes, a full list of excluded studies with reasons for exclusion, reporting of RCTs' funding sources, and assessing the potential impact of risk of bias in RCTs on MA results. CONCLUSION: Acupuncture is an effective and safe intervention for preventing and treating migraine, and could be considered as a good option for patients with migraine. However, the reporting and methodological quality of MAs included in this overview is suboptimal. In the future, AMSTAR 2 and PRISMA tools should be followed when making and reporting an SR with MA.

Anti-inflammatory effect of Ganluyin, a Chinese classic prescription, in chronic pharyngitis rat model.

BACKGROUND: Ganluyin (GLY) is a famous classical prescription with a long history of use as a treatment for inflammatory conditions such as chronic pharyngitis (CP) in many parts of China. However, it has not been developed as a modern pharmaceutic and its anti-inflammatory mechanisms remain unclear. The aim of this study was to assess the anti-inflammatory efficacy of GLY and potential mechanisms in a rat model of CP. METHODS: The chemical profile of GLY was analyzed by HPLC-UV. We used a mouse model of ear edema and a rat model of paw edema. Specifically, xylene was used to induce edema on the surface of one ear in mice, and carrageenan was injected subcutaneously into the right hind paws of rats to induce paw edema. The paw thickness, ear weight, and ear perfusion were measured and recorded. The CP model in rats was induced by irritating the throat with 5% ammonia and was used to evaluate the therapeutic efficacy of GLY. Levels of interleukin-6 (IL-6), interleukin-1ß (IL-1ß), tumor necrosis factor (TNF-α), and prostaglandin E2 (PGE2) were measured by ELISA in serum, and protein expression of cyclooxygenase-2 (COX-2) and nuclear factor kappa-B p65 (NF-κB p65) in the throat were detected by immunohistochemistry and Western blot to evaluate the anti-inflammatory mechanism of GLY. Hematological assays were also conducted. RESULTS: There were four flavonoids identified in GLY: naringin, neohesperidin, baicalin, and wogonoside. The oral administration of GLY showed a significant inhibitory effect on xylene-induced ear swelling and ear blood flow in mice and significantly ameliorated rat right hind paw edema at doses of 6.2 and 12.4 g/kg. Mechanistic studies found that the anti-inflammatory activity of GLY was related to the inhibition of pro-inflammatory cytokines such as IL-1ß, IL-6, TNF-α, and PGE2 and that GLY reduced the expression of COX-2 and NF-κB p65 proteins in the throat, attenuated throat injury, and reduced inflammatory exudates. Hematological analysis showed that treatment with GLY prevented increases in white blood cell (WBC), neutrophil (NEUT), lymphocyte (LYMPH) and monocyte (MONO) levels. CONCLUSIONS: These studies indicated that GLY has beneficial anti-inflammatory effects on CP and that it acts through reducing pro-inflammatory factors such as IL-1ß, IL-6, TNF-α, and PGE2, as well as decreasing WBC, NEUT, LYMPH and MONO levels and decreasing the expression of COX-2 and NF-κB p65 proteins. These findings may lay the groundwork for further studies of GLY as a suitable candidate for the treatment of inflammatory diseases such as CP.

Beneficial Effects of Macroporous Resin Extract of Dendrobium candidum Leaves in Rats with Hyperuricemia Induced by a High-Purine Diet.

Objectives. The incidence of hyperuricemia (HUA) is increasing year by year, and there are no ideal drugs for the treatment; the existing ones can cause serious liver and kidney damage. We have confirmed that the water extract of Dendrobium candidum leaves could reduce the level of uric acid in rats, but the active ingredients remain unknown, and the mechanism is not well understood. This research investigated the therapeutic effect of the macroporous resin extract of the Dendrobium candidum leaf (DLE) on hyperuricemia. In this study, hyperuricemia was induced in rats by a 5-week high-purine diet. After that, DLE was administered continuously for 9 weeks. The result showed that biochemical parameters of liver and kidney function, especially serum uric acid (UA) levels, were significantly improved with DLE, which may relate to the reduction of xanthine oxidase (XOD) and adenosine deaminase (ADA) in the liver. Moreover, DLE could significantly prevent kidney and liver from damage, and intestinal injury and reduce inflammation in hyperuricemic rats by inhibiting the expression of both NF-κB and TLR4 proteins. These results showed that the macroporous resin extract of the Dendrobium candidum leaves may be effective for the treatment of hyperuricemia in rats by inhibiting uric acid production and decreasing inflammation.

[Dry eye syndrome of deficient lacrima production treated with the acupoint thread-embedding therapy: a randomized controlled trial].

OBJECTIVE: To compare the therapeutic effects on the relevant symtoms in the patients with dry eye syndrome treated with the acupoint thread-embedding therapy versus topical artificial tears eye drops. METHODS: A total of 88 patients with dry eye syndrome of deficiency lacrima production were randomized into an acupoint thread-embedding therapy group (thread-embedding group) and a control group with topical artificial tears eye drops (medication group), 44 cases in each one. In the thread-embedding group, 3 cases were dropped out. In the thread-embedding group, Ganshu (BL 18), Pishu (BL 20) and Shenshu (BL 23) etc. were selected and the acupoint thread-embedding therapy was operated once every 30 days, totally for two treatments. In the medication group, the topical artificial tears eye drops was used, 4 to 6 times a day, one drop each time, for 8 weeks totally. Separately, before treatment, after 4-week treatment and 8-week treatment as well as in 8 weeks and 12 weeks of the follow-up, the levels of lactoferrin in tears were determined and the scores of the relevant symptoms of ocular surface such as eye dryness, foreign body sensation in the eyes and eye fatigue were evaluated. RESULTS: In the thread-embedding group, after 4-week and 8-week of treatment as well as in 8-week and 12-week follow-up, the scores of eye dryness, foreign body sensation, burning sensation of eye, phengophobia and eye fatigue were reduced significantly as compared with those before treatment (all P<0.05). In the medication group, the relevant symptoms of ocular surface were reduced after 4-week and 8-week treatment as compared with those before treatment (all P<0.05). In the follow-up, the scores of the relevant symptoms of ocular surface in the thread-embedding group were significantly lower than the medication group (all P<0.05). Separately, after 4-week treatment and 8-week treatment as well as in 8 weeks and 12 weeks of the follow-up, the levels of lactoferrin in tears in the thread-embedding group were significantly increased as compared with those before treatment (all P<0.05). The change was not obvious as compared with that before treatment in the medication group (P>0.05). The levels of lactoferrin in tears at each time point after treatment in the thread-embedding group were higher than the medication group (P<0.05). CONCLUSION: The acupoint thread-embedding therapy effectively improves in the relevant symptoms of ocular surface, such as eye dryness, foreign body sensation, burning sensation of eye, phengophobia and eye fatigue, and increases the level of lactoferrin in tears in the patients with dry eye syndrome of deficiency aqueous production. In the follow-up, the therapeutic effects of the acupoint thread-embedding therapy are significantly better than artificial tears eye drops.

[Operating Characteristics of a DPR-SNED System Treating Low C/N Municipal Wastewater and Nitrate-containing Sewage].

In order to realize the simultaneous treatment of low C/N municipal wastewater and high nitrate wastewater, a sequencing batch reactor (SBR), inoculated with activated sludge, was used to initiate the denitrifying phosphorus removal coupled with simultaneous nitrification and endogenous denitrification (DPR-SNED). The anaerobic/anoxic/hypoxic durations and dissolved oxygen (DO) concentration were appropriately controlled, and the nitrogen and phosphorus removal characteristics were examined. The experimental results demonstrated that, in the anaerobic/hypoxia operation mode, with an anaerobic duration of 3 h and DO concentration of 0.5-1.0 mg·L-1, the simultaneous nitrification of phosphorus removal (SNEDPR) system successfully began in 60 d. The effluent PO43--P concentration was below 0.5 mg·L-1, the nutrient and COD removal efficiencies were stably maintained above 90% and 80%, respectively, and the SNED efficiency and CODins efficiency reached 70% and 95%, respectively. When the operation mode was anaerobic/anoxic/hypoxic and nitrate-containing sewage was added at the beginning of the anoxic stage, DPR-SNED was achieved with the effluent PO43--P concentration<0.5 mg·L-1, nutrient and COD removal efficiencies above 88% and 90%, respectively, and SNED efficiency and CODins efficiency maintained at 62% and 90%, respectively. After the successful initiation of DPR-SNED, enhanced intracellular carbons storage was achieved by phosphorus-and glycogen-accumulating organisms using the limited carbons in raw municipal wastewater to provide sufficient carbon sources for subsequent nutrient removal. In addition, the endogenous partial denitrification ensured the efficient nitrogen removal performance of the DPR-SNED system at low C/N conditions (average 4).

[Sacral nerve magnetic stimulation combined with extracorporeal shockwave for the treatment of type-â ¢B chronic prostatitis].

OBJECTIVE: To investigate the clinical therapeutic effects of sacral nerve magnetic stimulation (SNMS) combined with extracorporeal shockwave (ECSW) in the treatment of type-ⅢB chronic prostatitis. METHODS: This study included 65 cases of type-ⅢB chronic prostatitis treated in Renji Hospital between March 2017 and August 2018. The patients were aged 34.56 + 7.47 years and had an average disease course of 12.95 + 10.73 months. We randomly assigned the patients to an experimental (n = 33) and a control group (n = 32) to be treated by SNMS+ECSW and biofeedback combined with electrical stimulation, respectively, qd alt, 40 minutes once, for a total of 24 times. Before and after 4 and 8 weeks of treatment, we obtained the NIH-CPSI scores, maximum urinary flow rate (Qmax), average urinary flow rate (Qavg), Self-Rating Depression Scale (SDS) scores and Self-Rating Anxiety Scale (SAS) scores of the patients, recorded their adverse reactions and compared the clinical therapeutic effects between the two groups of patients. RESULTS: After treatment, the experimental group showed significant improvement in the pain score, urination score, quality of life (QOL) score and NIH-CPSI total scores in comparison with the baseline (P < 0.05), even more significant after 8 than after 4 weeks of treatment (P < 0.05), and in all the indexes as compared with the control group (P < 0.05). Qmax and Qavg were remarkably improved at 8 weeks (P < 0.05) and so were SDS and SAS scores at 4 and 8 weeks (P < 0.05), even more significantly in the experimental than in the control group (P < 0.05). Among the 33 patients in the experimental group, 25 (75.8%) responded (14 ［42.4%］ cured or with excellent effect), with a significantly higher effectiveness rate than the control group (7［46.9%］， P < 0.01). No obvious adverse events were observed in any of the patients during the treatment. CONCLUSIONS: SNMS+ECSW can effectively improve the clinical symptoms and QOL of the patients with type-ⅢB chronic prostatitis, without causing obvious adverse reactions. Its long-term therapeutic effect, however, remains to be further studied.