Effect of temperature and air pressure on the incidence of Bell's palsy in Hangzhou: a distributed lag non-linear analysis.

The etiology of Bell's palsy (BP) is currently unknown, and the findings from previous studies examining the association between seasonal or meteorological factors and BP have been inconsistent. This research aims to clarify this relationship by analyzing a larger dataset and employing appropriate statistical methods. Data from 5387 patients with BP treated at Zhejiang Provincial Hospital of Traditional Chinese Medicine in Hangzhou, Zhejiang Province, from May 1, 2018, to June 30, 2023, was gathered. We assessed the temporal distribution of meteorological factors and the incidence of BP across seasons and months. A distributed lag non-linear model was used to further investigate the lagged and overall effects of temperature and air pressure on the onset of BP. The temporal distribution of BP incidence revealed the highest average number of cases occurring in December and the lowest in June. A correlation existed between BP episodes and temperature or air pressure. The model revealed a higher relative risk during periods of low temperature and high air pressure, characterized by a time lag effect. This correlation was notably more pronounced in female patients and individuals in the young and middle-aged groups. Our findings suggest that exposure to low temperatures and high air pressure constitute risk factors for BP development.

Timing of Acupuncture Treatment in Peripheral Facial Paralysis: A Systematic Review and Meta-Analysis.

OBJECTIVE: Investigate the optimum time of acupuncture treatment in peripheral facial paralysis in order to provide evidence for clinical treatment. METHODS: CNKI, Wanfang, PubMed, Cochrane Library, and EMBASE databases were systematically searched from the inception dates to February 20, 2020. Studies limited to participants with acute peripheral facial paralysis treated with acupuncture and patients without information of the stage were excluded. The primary outcomes were effective rate and cure rate (based on facial nerve function scores). This meta-analysis is registered with PROSPERO, number CRD42020169870. RESULTS: 15 randomized controlled trials that enrolled 2847 participants met the selection criteria. There was no significant differences in the effective rate (RR, 1.22; 95% CI, 0.70-2.11) when comparing acupuncture to prednisone therapy in acute facial paralysis. Acupuncture treatment in the acute stage increased both the effective rate (RR, 1.03; 95% CI, 1.00-1.07) and the cure rate (RR, 1.34; 95% CI, 1.14-1.58) compared to that in the nonacute stage. CONCLUSIONS: In this meta-analysis, acupuncture showed a better effect in the acute stage than the nonacute stage for participants with peripheral facial paralysis. There was no statistical difference in the effective rate no matter the choice of acupuncture or prednisone therapies in the acute stage. These findings encourage early acupuncture treatment in peripheral facial paralysis.

Efficacy and safety of thread embedding acupuncture for facial expression muscles atrophy after peripheral facial paralysis: study protocol for a randomized controlled trial.

BACKGROUND: Facial expression muscles atrophy is one kind of sequelae after peripheral facial paralysis. It causes critical problems in facial appearance of patient as well as social and psychological problems. This study aims to evaluate the efficacy and safety of Thread-embedding acupuncture (TEA) for the management of facial expression muscles atrophy after peripheral facial paralysis. METHODS: This is a patient-assessor blinded, randomized, sham-controlled trial. A total of fifty-six eligible patients will be randomly divided into TEA (n=28) and sham TEA (STEA) (n=28) groups. Both groups will receive TEA or STEA treatment at the frontal muscle and the depressor anguli oris muscle, at one predefined points once a week for eight weeks. Additionally, both groups will receive traditional acupuncture treatment at ten acupoints (GB20, LI4, LR3, GB12, ST7, SI18, LI20, BL2, SJ23, ST4) twice a week for eight weeks as a concurrent treatment. B-mode ultrasonography will be used to assess the changes in facial expression muscle thickness ratio of the affected/healthy side at baseline and at 10 weeks after screening, as the primary outcome. House-Brackmann Grade and lip mobility score will be measured and analyzed at baseline and 4, 8, 10, and 12 weeks after screening, as secondary outcomes. DISCUSSION: The study will compare TEA with sham TEA to explore the feasibility for TEA in improving facial expression muscles atrophy after peripheral facial paralysis. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR1900027170. Registered on 3 November 2019, http://www.chictr.org.cn/edit.aspx?pid=45173&htm=4.

Chemokine CXCL1 in serum mediates the antinociceptive effect of manual acupuncture at ST36.

BACKGROUND: Inflammatory pain is the most common type of pain encountered clinically. The analgesic effect of acupuncture has been well-documented. OBJECTIVE: The aim of this study was to investigate the involvement of chemokine CXCL1 in the serum on manual acupuncture (MA)-induced antinociception. METHODS: Rats with inflammatory pain of the right hind paw were induced by intraplantar (i.pl.) administration of complete Freund's adjuvant (CFA). After wards, the CFA-injected rats were treated daily with MA at ST36 from Day 1 to Day 7, and thermal nociceptive thresholds (paw withdrawal latency; PWL) were analyzed. The concentration of CXCL1 in the serum of the rats was measured by enzyme-linked immunosorbent assay (ELISA) after the first and the last MA treatment. Subsequently, the rats were injected with two doses (5 or 10 µg) of recombinant CXCL1 through the tail vein daily from Day 1 to Day 7 or injected with two doses (6.4 or 16 µg) of anti-CXCL1 antibody using the same methods and course at 30 min before MA, and the PWLs were measured again. Finally, naloxone (500 µg, 0.1 mL) was administered by i.pl. injection into the inflamed paw 5 min before the last MA treatment or last injection of recombinant CXCL1. RESULTS: MA significantly increased the PWLs and upregulated the expression of serum CXCL1 in the CFA-injected rats. Without acupuncture, repeated tail vein injection of recombinant CXCL1 showed an analgesic effect on CFA-induced inflammatory pain. Conversely, the neutralization of serum CXCL1 by anti-CXCL1 antibody decreased MA-induced antinociception in a time-dependent manner. Anti-CXCL1 antibody injected just once before the first MA did not affect MA-induced antinociception. The analgesic effects of MA and recombinant CXCL1 were reversed by an i.pl. injection of naloxone. CONCLUSION: This study indicates MA at ST36 had an analgesic effect on inflammatory pain and found a novel function of CXCL1. Increased serum CXCL1 had an antinociceptive effect on inflammatory pain induced by CFA. CXCL1 in serum appeared to be a key molecule involved in the peripheral mechanism of MA-induced antinociception. The analgesic effect of MA or recombinant CXCL1 on inflammatory pain might be mediated through a peripheral opioid pathway, which needs further investigation.

Bilateral electrical pudendal nerve stimulation as additional therapy for lower urinary tract dysfunction when stage II sacral neuromodulator fails: a case report.

BACKGROUND: Sacral neuromodulation (SNM) has become an effective therapy for patients with lower urinary tract dysfunction (LUTD) who do not respond to conservative treatment. However, an effective treatment strategy for patients who fail SNM has not yet been identified. An option for LUTD is needed when the clinical response to the SNM diminishes. CASE PRESENTATION: A 51-year-old Chinese man presented to an outpatient clinic complaining of difficulty in urination for > 3 years. The patient also complained of urinary frequency and urgency, accompanied by perineal discomfort. He was diagnosed with LUTD based on his symptoms and previous examinations. The patient underwent sacral neuromodulation with a permanent implantable pulse generator (IPG) (provided free of charge by Chengnuo Medical Technology Co., Ltd.; General Stim, Hangzhou, China) in the left buttock, as he participated in the company's clinical trial to test the long-term effects of IPG. He reported loss of efficacy of the device 3 months after the implantation. We performed bilateral electrical pudendal nerve stimulation (EPNS) therapy for him. After 2 weeks of treatment, he began to report smooth voiding within 2 h after EPNS, and a moderate improvement in urinary frequency, urgency, and perineal discomfort. After 4 weeks of EPNS, the patient reported > 50% improvement in his urination, evaluated with the short form of the International Consultation on Incontinence Questionnaire for Male Lower Urinary Tract Symptoms. He reported smooth voiding, moderate improvements in urinary frequency and urgency, and the disappearance of the perineal discomfort. He also reported improved sleep and erections. The patient was discharged after 8 weeks of EPNS treatment. CONCLUSION: EPNS could be an option as an additional therapy for patients with LUTD who have failed SNM.

Sacral electroacupuncture as a treatment for urge urinary incontinence: a prospective case series.

OBJECTIVE: To examine the impact of electroacupuncture (EA) at the 'four sacral points' on urge urinary incontinence (UUI). METHODS: Twenty-five patients diagnosed with UUI or urgency-predominant mixed urinary incontinence (MUI) were treated by EA at the 'four sacral points'. EA was performed in the sacrococcygeal region using disposable sterile 0.40-mm-diameter acupuncture needles that were either 100 or 125 mm in length. Treatments were delivered once every other day. Before and after treatment, a questionnaire measuring symptom severity and quality of life associated with UUI was administered. RESULTS: The median total score (interquartile range) from the severity of symptoms and the quality of life questionnaire (Q-score) of the participants was significantly reduced from 12 (7.5, 15) before treatment to 3 (0, 6) after 6 (6, 12) EA treatments. The Q-score of urgency-predominant MUI and UUI was 8 (5, 14.5) and 12.5 (11, 15), respectively, before treatment; after treatment these were reduced to 2 (0, 7.5) and 4.5 (2, 6), respectively. There was no statistically significant difference in the Q-score between urgency-predominant MUI and UUI before and after treatment. Upon treatment completion, seven patients (28%) were 'cured' (improvement rate 100%). Treatments were considered 'markedly effective' (improvement rate 75% to <100%) in four patients (16%), 'effective' (improvement rate 50% to <75%) in eight patients (32%), 'minimally effective' (improvement rate 25% to <50%) in three patients (12%), and 'ineffective' (improvement rate <25%) in three patients (12%). The overall success rate (comprising 'cured', 'markedly effective' and 'effective' categories) was 76%, and no adverse effects associated with acupuncture treatment were reported. CONCLUSION: EA at the 'four sacral points' was associated with statistically significant improvements in UUI.

Effect of Thick-Needle Therapy in Patients with Bell's Palsy at Recovery Stage: A Multi-center Randomized Controlled Trial.

OBJECTIVE: To compare the clinical effects of thick-needle therapy (TNT) and acupuncture therapy (AT) on patients with Bell's palsy (BP) at the recovery stage. METHODS: A total of 146 eligible participants from 3 hospitals in China were randomized into the TNT group (73 cases) and the AT group (73 cases) using a central randomization. Both groups received Western medicine thrice a day for 4 weeks. Moreover, patients in the TNT group received subcutaneous insertion of a thick needle into Shendao (GV 11) acupoint, while patients in the AT group received AT at acupoints of Cuanzhu (BL 2), Yangbai (GB 14), Dicang (ST 4), Xiaguan (ST 7), Jiache (ST 6), Yingxiang (LI 20) and Hegu (LI 4), 4 times a week, for 4 weeks. Both groups received 2 follow-up visits, which were arranged at 1 month and 3 months after treatment, respectively. The primary outcome measure was House-Brackmann Facial Nerve Grading System (HBFNGS) grade. And the clinical recovery rates of both groups were evaluated according to the HBFNGS grades after treatment. The secondary outcome measures included the facial disability index (FDI) and electroneurogram (EnoG). The adverse events were observed and recorded in both groups. RESULTS: Three cases withdrew from the trial, 2 in the TNT group and 1 in the AT group. There was no signifificant difference in the clinical recovery rates between the TNT and AT groups after 4-week treatment [40.85% (29/71) vs. 34.72% (25/72), P>0.05]. At the 2nd follow-up visit, more patients in the TNT group showed reduced HBFNGS grades than those in the AT group (P<0.01). No significant difference was observed between the two groups in FDI score, EnoG latency and maximum amplitude ratio at all time points (all P>0.05). CONCLUSION: The clinical effect of TNT was equivalent to that of AT in patients with BP at recovery stage, while the post-treatment effect of TNT was superior to that of AT. (Registration No. ChiCTR-INR-16008409).

[Acupoint application of herbal paste relieves symptoms and naso-mucosal inflammatory response by down-regulating serum TGF-ß1 in allergic rhinitis rats].

OBJECTIVE: To observe the effect of acupoint application of herbal paste on symptoms of allergic rhinitis (AR), serum immunoglobulin E (IgE) and transforming growth factor beta 1 (TGF-ß1) level, and number of nasal eosinophils (EOS) in rats with AR, so as to explore its underlying mechanisms. METHODS: Forty male Wistar rats were randomly divided into normal control, model, medication and acupoint application groups (n＝10 rats per group). The AR model was established by intraperitoneal (i.p.) injection of mixture solution of ovalbumin, aluminum hydroxide and normal saline (once every other day, for 7 times), and nasal drip plus spray inhalation of ovalbumin (on the following day of i．p., once daily for 9 days). For acupoint application, the prepared herbal paste (containing White Mustard Seed, Rhizoma Corydalis, unprocessed Radix Kansui, Herba Asari and ginger juice) was applied to bilateral "Feishu" (BL13), "Pishu" (BL20) and "Shenshu" (BL23) for 2 h, once every other day for 7 times. The rats in the medication group were given Fluticasone Propionate nasal spray daily for 14 days. Scores of nasal itching, sneezing and nasal discharge on the day after modeling and the ending of the intervention were used to evaluate behavioral changes. Enzyme linked immunosorbent assay (ELISA) was used to detect the levels of serum IgE and TGF-ß1, and the infiltration state of EOS in the nasal mucosa tissue was observed under light microscope after HE staining. RESULTS: After modeling and compared with the normal control group, the behavioral scores and the levels of serum IgE and TGF-ß1 were significantly higher (P<0.05), and the infiltration state of EOS got worse. Compared with the model group, the increased behavioral score and serum IgE and TGF-ß1 levels were evidently suppressed (P<0.05) and EOS infiltration severity in the nasal mucosa was obviously milder in both medication and acupoint application groups. No significant differences were found between the medication and acupoint application groups in behavioral score and serum IgE and TGF-ß1 levels (P>0.05). CONCLUSION: Acupoint application can improve the symptoms of AR rats, which may be associated with its effect in down-regulating the levels of serum IgE and TGF-ß1.

Acupoint Catgut Embedding Alleviates Insomnia in Different Chinese Medicine Syndrome Types: A Randomized Controlled Trial.

OBJECTIVE: To investigate the effects and safety of catgut embedding on alleviating insomnia. METHODS: Totally 510 patients with insomnia were divided into 5 Chinese medicine (CM) syndrome types: Xin (Heart) and Pi (Spleen) deficiency, yin deficiency with excess fire, Xin and gut qi deficiency, Wei (Stomach) disorder, and qi and blood deficiency, respectively. These 5 types of patients were randomly assigned to a catgut embedding group, an acupuncture group or a medication group (30 cases in Xin and Pi deficiency type, Wei disorder type, Xin and gut qi deficiency type, respectively; 40 cases in yin deficiency with excess fire type and qi and blood deficiency type, respectively). In the catgut embedding group, patients were treated by implanting catgut into acupoints once every 10 days for a total of 30 days. In the acupuncture group, patients were treated with acupuncture once per day over 30 days (excluding weekends); and patients in the medication group took 1 mg Eurodin Tablet orally every night for 30 days. Pittsburgh Sleep Quality Index (PSQI) was evaluated before treatment, on 30 and 60 days after the first treatment, respectively. The International Unified Sleep Efficiency Value (IUSEV) was measured at 30 and 60 days. The safety was evaluated after treatment and adverse events were analyzed. RESULTS: The objective PSQI scores including subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, daytime dysfunction, and total scores at 30 days were significantly improved compared with pre-treatment in the catgut embedding and acupuncture groups (P<0.01 or P<0.05). At 30 days, the PSQI scores in catgut embedding group were superior to the medication group in the patients with each type of insomnia, with the exception of sleep duration (P<0.01 or P<0.05). At 60 days, significant differences were found between the catgut embedding group and the medication group (P<0.01 for all indices). The IUSEV scores in the catgut embedding group were significantly higher than the acupuncture group at 60 days, and the scores in acupuncture group were higher than the medication group at 30 days (P<0.05 for all types). No severe adverse events were found in this study. CONCLUSIONS: Acupoint catgut embedding and acupuncture were more effective than medication in alleviating insomnia syndrome in different Chinese medicine syndrome type. However, the sustained effects of acupoint catgut embedding were superior to acupuncture.

Comparison of efficacy and safety between electroacupuncture at 'four sacral points' and conventional electroacupuncture for the treatment of urinary incontinence after stroke: study protocol for a randomised controlled trial.

INTRODUCTION: Electroacupuncture at 'four sacral points', also known as electrical pudendal nerve stimulation therapy, combines the advantages of pudendal nerve neuromodulation and the technique of deep insertion of long acupuncture needles. It has been used to treat stress urinary incontinence, female urgency-frequency syndrome, idiopathic urgency urinary incontinence and neurological bladders in previous studies. Here, we describe the protocol for a randomised controlled trial for evaluation of the efficacy and safety of electroacupuncture at 'four sacral points' for the management of urinary incontinence after stroke. METHODS AND ANALYSIS: This is an open-label randomised controlled trial with blinded assessments and analyses. A total of 140 eligible patients will be randomly allocated to two groups. The treatment group (n=70) will receive electroacupuncture at 'four sacral points' along with routine medical care, while the control group will receive conventional electroacupuncture along with routine medical care. Twenty treatment sessions will occur over a period of 4 weeks. The primary outcome measures will be the self-recorded findings in an incontinent episode diary at baseline and at 4 weeks after baseline. The secondary outcome measures will be the International Consultation on Incontinence Questionnaire Urinary Incontinence-Short Form (ICIQ-UI SF) score and the Barthel Activities of Daily Living Index (Barthel ADL Index) score at baseline and at 4 and 28 weeks after baseline. ETHICS AND DISSEMINATION: This protocol has been approved by the Ethics Committee of the First Affiliated Hospital of Zhejiang Chinese Medical University (approval No. 2018-K-059-01). Written informed consent will be obtained from each participant. The results of the study will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER: ChiCTR-IOR-17012847; Pre-result.

A Multicenter, Randomized, Controlled Trial of Electroacupuncture for Perimenopause Women with Mild-Moderate Depression.

OBJECTIVE: Up to 62% of perimenopausal women have depression symptoms. However, there is no efficacy treatment. The aim of this study is to compare the clinical efficacy and safety of EA therapy and escitalopram on perimenopause women with mild-moderate depressive symptom. METHOD: A multicenter, randomized, positive-controlled clinical trial was conducted at 6 hospitals in China. 242 perimenopause women with mild-moderate depressive symptom were recruited and randomly assigned to receive 36 sessions of EA treatment or escitalopram treatment. The primary outcome measure was the 17-item Hamilton Depression Rating Scale (HAMD-17). The secondary outcome measures include menopause-specific quality of life (MENQOL) and serum sexual hormones which include estrogen, follicle-stimulating hormone, and luteinizing hormone. RESULTS: 221 (91.3%) completed the study, including 116 in the EA group and 105 in the escitalopram group. The baseline levels of demographic and outcome measurements were similar in the two groups. In the intervention period, there was no difference between two groups. However, in the follow-up, both HAMD-17 and MENQOL were significantly decreased, and at week 24 the mean differences were -2.23 and -8.97, respectively. There were no significant differences in the change of serum sexual hormones between the two groups. No serious adverse events occurred. CONCLUSION: EA treatment is effective and safe in relieving depression symptom and improving the quality of life in the perimenopausal depression. Further research is needed to understand long-term efficacy and explore the mechanism of this intervention. This study is registered with ClinicalTrials.gov NCT02423694.

In Vivo Study on Site of Action of Sinapine Thiocyanate following Acupoint Herbal Patching.

OBJECTIVE: To investigate the site of action of sinapine thiocyanate (ST), following acupoint herbal patching (AHP). METHODS: Twenty Wistar rats were randomized into five groups (groups A, B, C, D, and E), and all groups received the same AHP in vivo. Skin samples were excised at 2 h, 4 h, 6 h, 10 h, and 26 h after AHP administration from group A to group E separately and the concentrations of ST in the skin were determined using a liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS) method. A pharmacokinetic profile of ST following AHP was performed at the same time in a group of five Wistar rats to detect plasma levels at the same time intervals. RESULTS: The mean ± SD ST concentrations (ng/ml) at 2 h (group A), 4 h (group B), 6 h (group C), 10 h (group D), and 26 h (group E) after AHP administration were 250.01 ± 61.99, 61.01 ± 30.41, 40.12 ± 26.94, 78.66 ± 59.43, and 19.55 ± 18.95, respectively. No ST was detected in rats' plasma samples at the same time points. CONCLUSIONS: The site of action of ST following AHP is in the skin.

[Effect of Electroacupuncture on Pain Reaction and Content of Proteinase-activated Receptors 2 in Dorsal Root Ganglion in Hyperalgesia Rats].

OBJECTIVE: To observe the effect of electroacupuncture (EA) on mechanical hyperalgesia threshold (MHTs) and thermal hyperalgesia threshold (THTs) and content of proteinase-activated receptors 2 (PAR 2) in dorsal root ganglia (DRG) in rats with inflammatory pain, so as to explore its peripheral mechanism underlying improvement of inflammatory pain. METHODS: The present study contains two parts. 1) In the first part, 27 male SD rats were randomized into sham hyperalgesic priming (sham-HP) group and real hyperalgesic priming (HP) group (n＝5 in the sham-HP group and n＝6 in the HP group for the test of MHTs, n＝8 in the two groups for the test of THTs). The sham-HP model was established by subcutaneous injection of normal saline into the left plantar part of the hind-paw, and the HP model established by subcutaneous injection of 1% carragenan (the first injection) into the same left hind paw, followed by injection of PGE2 (100 ng/25 µL, the second injection) into the dorsum pedis of the same hind paw 7 days after the first injection. The ipsilateral paw withdrawal latencies (MHTs and THTs) were detected before and 5 h, 3 d and 6 d after the first injection, 0.5, 4 and 24 h after the second injection. 2) In the second part, 64 male SD rats were randomly divided into sham-HP, HP, sham-EA and EA groups (n＝16 in each group). The sham-HP and HP models were made in the same way as the first part. Both"Zusanli"(ST 36)and "Kunlun"(BL 60) were punctured with filiform needles in the sham-EA group and also stimulated with EA: 2 Hz/100 Hz, 0.5－1.5 mA (0.5 mA increase per 10 min) for 30 min in the EA group, 1 time/d for 7 d. Both ipsilateral MHTs and THTs were observed at the same time-points of the first part and the PAR 2 protein content in the L 4－L 6 DRGs was assayed by ELISA 24 h after the second injection. RESULTS: 1) In the first part of the study, compared with the sham-HP group, the MHTs at 5 h and 3 d, and THT at 5 h after the first injection, and MHTs, and THTs at 4 and 24 h after the se-cond injection were significantly decreased in the HP group (P<0.01, P<0.05). 2) In the second part of the study, compared with the HP group, the MHTs at 4 and 24 h after the second injection and the THTs at 3 d after the first injection, 4 and 24 h after the second injection were significantly up-regulated in the EA group (P<0.01, P<0.05). The content of PAR 2 in the DRGs (L 4－L 6) was significantly higher in the HP group than in the sham-HP group (P<0.05), but considerably lower in the EA group than in the HP group (P<0.05). CONCLUSION: EA can suppress hyperalgesia priming in inflammatory pain rats which may be related to its effect in down-regulating PAR 2 level in the lumbar DRGs.

Effect and safety of stimulating acupoints in children with cough variant asthma: A Meta-analysis.

OBJECTIVE: To evaluate the efficacy and safety of stimulating acupoints in subjects with childhood cough variant asthma (CVA). METHODS: A Meta-analysis of randomized controlled trials (RCTs) about the comparison between acupoint sticking therapy and non-acupoint sticking therapy for childhood CVA was conducted. The trials' quality and risk bias were assessed using the Cochrane Handbook tool. Odds ratio (OR) or risk ratio (RR) with 95% confidence intervals (CIs), mean differences (MDs) or standardized mean differences (SMDs) of a random-effects model were calculated. Heterogeneity was assessed by P value and I 2 statistics. RESULTS: Thirteen studies were included in our review, indicating that the total effective rate of stimulating-acupoint group is better than that of control group [RR 1.19, 95% CI (1.13-1.26), P < 0.000 01]. The recurrence rate in two years [RR 0.31, 95% CI (0.19-0.51), P < 0.000 01] and cough duration [MD = -2.42, 95% CI (-3.75, -1.09), P = 0.0004] of childhood CVA in stimulating-acupoint group were significantly lower than those in control group. Besides, stimulating acupoints can reduce the level of IgE [SMD = -0.75, 95% CI (-1.21,-0.30), P = 0.001] and EOS [SMD = -0.36, 95% CI (-0.92, 0.21), P = 0.22]. CONCLUSION: Our findings suggest that stimulating acupoints had positive effects on childhood CVA and was relatively safe treatment. However, more RCTs with more useful indicators are warrant to confirm the current findings.

Efficacy and safety of manual acupuncture manipulations with different frequencies on epigastric pain syndrome (EPS) in functional dyspepsia (FD) patients: study protocol for a randomized controlled trial.

BACKGROUND: Manual acupuncture (MA) manipulations are one of the key factors influencing acupuncture effects in traditional Chinese medicine theory. Different MA manipulations contain different stimulating parameters, thus generating different acupuncture responses or effects. Evidence has demonstrated that acupuncture is effective for functional dyspepsia (FD). However, the effects of different stimulating parameters of MA manipulations on FD remain unclear. METHODS/DESIGN: This study is a randomized controlled trial with a four-arm, parallel-group structure. Patients with FD with epigastric pain syndrome (EPS) will be included and randomly allocated into four groups: three MA manipulation groups (separately treated with a frequency of 1 Hz, 2 Hz, or 3 Hz) and a control group. All groups will receive omeprazole as a basic treatment and acupuncture: in the MA manipulation groups, the needles will be manipulated manually with three different frequencies on the basis when de qi is reached, while in the control group, the needles will be inserted without any manipulation. All patients will receive acupuncture treatment of five consecutive sessions per week for 2 weeks and be followed up at 4, 8, and 12 weeks. The primary outcomes of the study include patients' response to the treatment. The secondary outcomes include dyspeptic symptoms, quality of life, mental status, fasting serum gastrin, motilin, and ghrelin concentrations, and adverse events. The protocol was approved by the Ethics committee of the First Affiliated Hospital of Zhejiang Chinese Medical University (2016-K-057-01). DISCUSSION: The aim of this study is to evaluate the efficacy and safety of MA manipulations with different stimulating parameters (different frequencies) on EPS in patients with FD. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR-IOR-16008189 . Registered on 30 March 2016.

[Acupuncture combined with western medication for mild cognitive disorder after stroke: a rando- mized controlled trial].

OBJECTIVE: To verify the clinical effect of the penetration acupuncture at the acupoints of governor vessel(GV) and bladder meridian on head for mild cognitive disorder after stroke. METHODS: One hundred and ten patients were randomly divided into an observation group and a control group, 55 cases in each one. Penetration acupuncture was used at the acupoints of GV and bladder meridian on head in the observation group,namely Wuchu (BL 5) to Chengguang (BL 6) and Tongtian (BL 7) to Luoque (BL 8) bilaterally, and Shenting (GV 24) to Xinhui (GV 22), Qianding (GV 21) to Baihui (GV 20), Houding (GV 19) to Qiangjian (GV 18). Body acupuncture and conventional western medication were applied in the both two groups. Acupuncture was adopted once a day, five times a week and eight weeks totally. The changes of Montreal Cognitive Assessment (MoCA), Mini mental state examination scale(MMSE), self-rating depressive scale (SDS) and activities of daily living scale (Barthel index) were compared between the two groups before treatment, in the middle of treatment(at the forth week) after treatment(at the eighth week) and in three weeks after treatment(follow-up). RESULTS: After treatment of four and eight weeks and at the time of follow-up, the results of MoCA, MMSE, SDS and Barthel index were apparently im proved compared with those before treatment in the two groups (all P < 0.01). After treatment of eight weeks and at the time of follow-up, the scores of MoCA and SDS were obviously improved in the observation group compared with those in the control group (P < 0.01, P < 0.05). The improvements of MMSE in the observation group were more marked than those in the control group at all times (P < 0.01, P < 0.05). But there was no statistical significance about the change of Barthel index between the two groups (all P > 0.05). CONCLUSION: Penetration acupuncture at the acupoints of GV and bladder meridian on head can remarkablely improve the cognitive function of the patients with mild cognitive disorder after stroke,and have some efficacy of relieving the bad mood such as depression.

[Development of Researches on Cytokine Mechanisms in Analgesia and Anti-inflammation in Acupuncture Therapy for Rheumatoid Arthritis].

Cytokines are closely related to the occurrence and development of rheumatoid arthritis(RA). Acupuncture exerts anti-inflammatory and analgesic effects via elevating anti-inflammatory cytokine level and reducing pro-inflammatory cytokine level and regulating Th 1/Th 2 balance, which reflects the dual directional regulatory effect of acupuncture. However, problems exist in the current researches, such as inadequate depth, limited breadth and not so up-to-date research focus. The mediocre research level and the phenomena of some contradictory results among studies also need being concerned. Therefore, progress may be attained if a holistic, dynamic and networked study is conducted on the influence of acupuncture on cytokines by combining the latest progress in the mechanisms of network of cytokines and neuroendocrine immune network, and high throughput cytokine capture assay. In this way, the mechanism of cytokines in multi-targets (such as local joints, peripheral blood circulation, central nervous system) involving the effects of acupuncture in improving RA will be known more.

[Primary dysmenorrhea treated with staging acupoint catgut embedment therapy: a randomized controlled trial].

OBJECTIVE: To observe the short-term and long-term efficacies on primary dysmenorrhea treated with staging acupoint embedment therapy. METHODS: Seventy cases of primary dysmenorrhea were randomized into an embedment therapy group and a fenbid group, 35 cases in each one. In the embedment therapy group, the embedment therapy was applied twice during the menstrual cycle, one treatment 3 days before menstruation and one treatment during the 12th-14th days of menstruation, respectively. Guanyuan (CV 4), Zigong (EX-CA 1), Diji (SP 8) and Ciliao (BL 32) were the main acupoints in the treatment 3 days before menstruation. Shenshu (BL 23), Ganshu (BL 18) and Pishu (BL 20) were the main acupoints in the treatment during menstruation. In the fenbid group, fenbid was prescribed for oral administration, 0.3 g each time, twice a day, starting 3 days before menstruation till pain was relieved. The treatment of one menstrual cycle was one session. The continuous treatment of 3 menstrual cycles was required. The short-term and long-term efficacies were evaluated at the end of the 3rd cycle and in 3 months after the treatment terminal. The dysmenorrhea score was used to evaluate the efficacy. Visual analogue scale (VAS) and SF-36 were for the assessment of pain degree and life quality. RESULTS: (1) The total effective rate was 91.4% (32/35) in the embedment therapy group after the 3 menstrual cycles, which was better than 74.3% (26/35) in the fenbid group (P < 0.01). In the follow-up stage, the total effective rate was 91.4% (32/35) in the embedment therapy group, which was better than 40.0% (14/35) in the fenbid group (P < 0.01). (2) The differences were not significant in dysmenorrhea score and VAS score after the 1st and 2nd menstrual cycle treatments between the two groups (all P > 0.05). In the 3rd menstrual cycle and the follow-up stage, the dysmenorrhea score and VAS score were reduced obviously in the embedment therapy group as compared with those in the fenbid group (P < 0.05, P < 0.01). The rebound effect occurred in the follow-up stage in the fenbid group. (3) In the 3rd menstrual cycle and the follow-up stage, the improvement in the total score of life quality of the embedment therapy group was superior apparently to the fenbid group (P < 0.05, P < 0. 01). CONCLUSION: The staging acupoint embedment therapy achieves the superior short-term and long-term efficacies as compared with the oral administration of fenbid in the treatment of primary dysmenorrhea. As the symptoms of dysmenorrhea and pain are relieved, the life quality is improved.

[Efficacy observation on abdominal acupuncture for adhesion-stage shoulder periarthritis].

OBJECTIVE: To evaluate the efficacy of abdominal acupuncture for adhesion-stage shoulder periarthritis. METHODS: One hundred and fifty-seven cases of shoulder periarthritis were randomly divided into an abdominal acupuncture group (79 cases) and a body acupuncture group (78 cases). The abdominal acupuncture was applied at Zhongwan (CV 12), Shangqu (KI 17) and Huaroumen (ST 24) in the abdominal acupuncture group while conventional acupuncture was applied at Jianyu (LI 15), Jianliao (TE 14) and Jianzhen (SI 9) in the body acupuncture group. The treatment was given three times a week for both groups and ten times made an observation course. Before and after treatment, visual analogue scale (VAS) was adopted for pain assessment and functional activity score (Mallet score) was used for shoulder joint function assessment for all the patients. Also the efficacy of both groups was compared. RESULTS: The total effective rate in the abdominal acupuncture group was 92.4% (73/79), which was superior to 71.8% (56/78) in the body acupuncture group. The score of VAS after the treatment was 2.58 +/- 1.64 in the abdominal acupuncture group while 3.12 +/- 1.93 in the body acupuncture group, which had no statistical significance between each other (P > 0.05). The functional activity score after the treatment was 8.34 +/- 3.02 in the abdominal acupuncture group while 7.49 +/- 3.36 in the body acupuncture group, which had no statistical significance between each other (P > 0.05). CONCLUSION: The abdominal acupuncture is an ideal treatment for adhesion-stage shoulder periarthritis, which has better total efficacy than conventional acupuncture. It achieves the same effect in relieving pain and improving functional activity as conventional acupuncture, but also has an advantage at fast selection of acupoint and less discomfort of needling sensation.

[Observation on clinical therapeutic effect of transcutaneous point electric stimulation on periarthritis of shoulder at different stages].

OBJECTIVE: To observe the therapeutic effect of transcutaneous point electric stimulation on periarthritis of shoulder at different stages and compare with electroacupuncture. METHODS: Three hundred and sixty cases of periarthritis of shoulder at different stages were divided into a treatment group (n=186) treated with transcutaneous point electric stimulation, and a control group (n=174) treated with electroacupuncture. Same acupoints were selected in the two groups. RESULTS: The total effective rate of transcutaneous point electric stimulation was 96.6% at the adhesion prophase and 96.9% at the adhesive stage, but electroacupuncture stimulation was 93.5% and 97.9%, respectively, with no significant differences between the two groups; transcutaneous point electric stimulation not only could relieve pain, but also significantly improve dysfunction of shoulder joints at the adhesive stage. CONCLUSION: Transcutaneous point electric stimulation is an effective and convenient therapy for periarthritis of shoulder.