[Effect of moxibustion on PI3K/Akt/mTOR signaling pathway in foot-pad synovium in rats with rheumatoid arthritis].

OBJECTIVE: To observe the effect of moxibustion on phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin protein (PI3K/Akt/mTOR) signaling pathway in the foot-pad synovial tissue in rats with rheumatoid arthritis (RA), and to explore the mechanism of moxibustion for treating RA. METHODS: Forty healthy SD rats were randomly divided into a control group, a model group, a moxibustion group, a cigarette-moxibustion group and a medication group, 8 rats in each group. The RA model was established with subcutaneous injection of complete Freund's adjuvant (CFA) in the left hind foot-pad under wind, cold and wet environment in the model group, the moxibustion group, the cigarette-moxibustion group and the medication group. The rats in the moxibustion group were treated with moxibustion at "Zusanli" (ST 36) for 20 min; the rats in the cigarette-moxibustion group were treated with moxibustion of ordinary cigarette at "Zusanli" (ST 36) for 20 min; the rats in the medication group were treated with tripterygium glycosides suspension (0.8 mg/100 g) by gavage. All the intervention was given once a day for 15 days. The left hind foot-pad volume was measured before and after modeling and after 15-day intervention. After 15-day intervention, the serum levels of IL-17 and IL-23 were detected by ELISA method, and the expression levels of PI3K, Akt and mTOR in synovial tissue of left hind foot-pad were detected by Western blot method. RESULTS: The volume of left hind foot-pad, the serum levels of IL-23 and IL-17 and the expression of PI3K, Akt and mTOR in synovial tissue of left hind foot-pad in the model group were higher than those in the control group (P<0.01). After intervention, the volume of left hind foot-pad and the expression of PI3K, Akt and mTOR protein in synovium tissue in the moxibustion group and medication group were lower than those in the model group (P<0.01, P<0.05), while the serum levels of IL-17 and IL-23 in the moxibustion group were lower than those in the model group (P<0.01). The volume of left hind foot-pad, the serum levels of IL-23 and the expression of mTOR protein in synovial tissue in the moxibustion group were lower than those in the medication group (P<0.01, P<0.05), while the volume of left hind foot-pad, the serum levels of IL-23 and the expression of PI3K, Akt and mTOR protein in synovium tissue in the moxibustion group were lower than those in the cigarette-moxibustion group (P<0.01). CONCLUSION: Moxibustion may play a therapeutic effect on RA by inhibiting the level of IL-23, IL-17 and the activity PI3K/Akt/mTOR, and regulating inflammatory response and autophagy.

Tai Chi for Chronic Pain Conditions: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Several studies reported that Tai Chi showed potential effects for chronic pain, but its role remains controversial. This review assessed the evidence regarding the effects of Tai Chi for chronic pain conditions. 18 randomized controlled trials were included in our review. The aggregated results have indicated that Tai Chi showed positive evidence on immediate relief of chronic pain from osteoarthritis (standardized mean difference [SMD], -0.54; 95% confidence intervals [CI], -0.77 to -0.30; P < 0.05). The valid duration of Tai Chi practice for osteoarthritis may be more than 5 weeks. And there were some beneficial evidences regarding the effects of Tai Chi on immediate relief of chronic pain from low back pain (SMD, -0.81; 95% CI, -1.11 to -0.52; P < 0.05) and osteoporosis (SMD, -0.83; 95% CI, -1.37 to -0.28; P = 0.003). Therefore, clinicians may consider Tai Chi as a viable complementary and alternative medicine for chronic pain conditions.

The immunomodulatory effect of acupoint application for childhood asthma: a systematic review and meta-analysis.

Objective. To evaluate the evidence on the immunomodulatory effect of acupoint application for childhood asthma. Methods. Five electronic databases through October 2014 were searched. The risk of bias in eligible studies was assessed using the Cochrane Collaboration tool. Standardised mean difference (SMD) and 95% confidence intervals (CI) of random-effects model were calculated. And heterogeneity was assessed using the Cochran Q statistic and quantified with the I (2) index. Results. Six studies were included in our review. The aggregated results suggested that acupoint application showed the beneficial effect for childhood asthma in improving IgA (SMD, -0.83; 95% CI -1.14 to -0.52; P < 0.00001), IgE (SMD, -0.52; 95% CI -0.76 to -0.29; P < 0.001), IgG (SMD, -1.17; 95% CI -1.61 to -0.74; P < 0.0001), IL-4 (SMD, -0.57; 95% CI -0.91 to -0.23; P = 0.0009), and IFN-γ (SMD, -0.38; 95% CI -0.71 to -0.04; P = 0.03) but not IgM (SMD, -0.40; 95% CI -0.98 to 0.18; P = 0.18). And the effective dose of acupoint application may be 2-6 hours/time and a total of 3 times within 4 weeks. Conclusions. This review showed the positive evidence that acupoint application had the favorable immunomodulatory effect for childhood asthma. However, more studies with long follow-up are warrant to confirm the current findings.

A Meta-Analysis on the Efficacy of Tai Chi in Patients with Parkinson's Disease between 2008 and 2014.

Objective. The purpose of this systematic review is to evaluate the evidence on the effect of Tai Chi for Parkinson's disease (PD). Methods. Six electronic databases up to June 2014 were searched. The methodological quality was assessed with PEDro scale. Standardised mean difference and 95% confidence intervals of random-effects model were calculated. Results. Nine studies were included in our review. The aggregated results are in favor of Tai Chi on improving motor function (P = 0.002) and balance (P < 0.00001) in patients with PD. However, there is no sufficient evidence to support or refute the value of Tai Chi on improving gait velocity (P = 0.11), stride length (P = 0.21), or quality of life (P = 0.40). And there is no valid evidence in follow-up effects of Tai Chi for PD. Conclusion. The current results suggest that Tai Chi can significantly improve the motor function and balance in patients with PD, but there is indeed not enough evidence to conclude that Tai Chi is effective for PD because of the small treatment effect, methodological flaws of eligible studies, and insufficient follow-up. Consequently, high-quality studies with long follow-up are warranted to confirm current beneficial findings.

[Effectiveness of manual therapy and traction for lumbar disc herniation: a meta-analysis].

OBJECTIVE: To evaluate the effectiveness of manual therapy and traction for lumbar disc herniation and analyze the current status of this kind of randomized clinical trial (RCT). METHODS: Database of CNKI, VIP, WANFANG, PubMed and OVID were searched. Some relevant journals were manually retrieved. A total of 2 874 literatures on manual therapy and traction for lumbar disc herniation were collected, of which 17 articles met the inclusion criteria. The Jadad score scale was used to evaluate the quality,and RevMan5.0 was used for meta-analysis of literatures. RESULTS: The results of the meta-analysis of all trials involved were as followed:the combined effect of the effective rate was RR = 1.10, 95% CI [1.06, 1.14], the combined effect of the cure rate was RR = 1.36, 95% CI [1.21,1.52], the combined effect of the VAS was RR = 1.37, 95% CI [1.28, 1.45], the combined effect of the JOA was RR = 4.75, 95% CI [4.40, 5.09]. CONCLUSION: The overall quality of the current RCT researches about manual therapy for lumbar disc herniation was lower,and did not support the conclusion that manual therapy was more effective than traction for lumbar disc herniation.