Exercise Plus Acupuncture on Consensus Acupoints Versus Acupoints Selected by the Theory of Equal Impact on Tendons, Bones, and Muscles for Knee Osteoarthritis.

Context: Knee osteoarthritis (KOA) is a degenerative disorder that significantly affects patients' quality of life. Acupuncture and exercise are the most popular treatments currently. The outcomes for acupuncture for KOA, however, are controversial, with some researchers finding that the addition of acupuncture to exercise therapy provided no additional improvement in pain scores. Objective: The study intended to evaluate the therapeutic effects for KOA of exercise in combination with acupuncture on acupoints selected using the Traditional Chinse Medicine (TCM) theory of Equal Impact on Tendons, Bones, and Muscles (EITBM) in comparison with that of acupoints selected using classical consensus for the treatment. Design: The research team performed a randomized controlled trial. Setting: The study took place in the Department of Acupuncture and Moxibustion at the First Affiliated Hospital of Hebei University of Chinese Medicine in Shijiazhuang, Hebei, China. Participants: Participants were 70 patients with KOA who visited the hospital between December 2020 and February 2021. Intervention: Participants in both group received acupuncture plus exercise therapy. The research team randomly assigned participants to one of two groups: (1) 35 to the intervention group, which received acupuncture using acupoints selected using EITBM, and (2) 35 to the control group, which received acupuncture using the classical consensus acupoints. Both groups performed a 25-min session of acupuncture three times weekly for 4 weeks, with the exercise therapy following the acupuncture each time. Outcome Measures: The research team assessed clinical efficacy at baseline and postintervention. The primary outcome measures included assessments: (1) of knee joint pain using a visual analog scale (VAS), (2) of knee joint pain, flexibility, and function using the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) pain subscale; and (3) joint range of motion (ROM). The secondary outcome measures included measurement of serum levels of interleukin-1 beta (IL-1ß), tumor necrosis factor alpha (TNF-α), and matrix metalloproteinase-13 (MMP-13) using enzyme-linked immunosorbent assays (ELISA). Results: The VAS and WOMAC scores significantly decreased for both groups between baseline and postintervention, and the intervention group's decrease was significantly greater than that of the control group. The ROM of knee flexion was significantly higher in both groups postintervention than at baseline, and the intervention group's increase was significantly higher than that of the control group. The serum IL-1ß, TNF-α, and MMP-13 also significantly decreased postintervention in both groups, and the intervention group's levels were significantly lower than those of the control group. The total effective rate was 94.1% in the intervention group, 32 out of 34 participants, and 75.8% in the control group, 25 out of 33 participants, which was significantly different. Conclusions: Acupuncture, in combination with exercise, can relieve symptoms, improve joint function, and reduce pro-inflammatory cytokines (IL-1ß and TNF-a) as well as MMP-13 for patients with KOA. The outcomes for acupuncture using EITBM acupoints were significantly better than those of the acupoints selected using classical consensus.

Exploring the structure evolution of MoS2 upon Li/Na/K ion insertion and the origin of the unusual stability in potassium ion batteries.

The recent revival of research on Na and K ion batteries has two benefits. It not only provides alternate energy storage technologies to Li ion batteries with potential cost advantages but also enhances our understanding of charge storage through systematic studies on alkali-metal ion batteries with increasing insertion ion sizes. Using MoS2 as a model material, the structure evolution upon the uptake of Li, Na, and K ions are compared through in situ TEM. Despite their larger size, insertion of K ions shows both the better electrochemical and structural stability. To understand this paradoxical and counter-intuitive phenomenon, in situ XRD is carried out to examine the phase transitions of MoS2 upon ion insertion, while ex situ TEM is further applied to closely examine the structures at the nanoscale. Complementary DFT calculations are performed to understand the kinetic/thermodynamic origins of the unusual stability. The result reveal that the less electrovalent K-S bond favors the intercalation process, resulting in preservation of the layered structure for stable cycling. This study provides a structural insight to design stable electrodes for the K-ion batteries.