Experience of parents in delivering pediatric tuina to children with symptoms of attention deficit hyperactivity disorder during the COVID-19 pandemic: qualitative findings from focus group interviews.

BACKGROUND: Evidence suggests that pediatric tuina, a modality of traditional Chinese medicine (TCM), might have beneficial effects on the symptoms of attention deficit hyperactivity disorder (ADHD), such as overall improvements in concentration, flexibility, mood, sleep quality, and social functioning. This study was conducted to understand the facilitators and barriers in the delivery of pediatric tuina by parents to children with ADHD symptoms. METHODS: This is a focus group interview embedded in a pilot randomized controlled trial on parent-administered pediatric tuina for ADHD in preschool children. Purposive sampling was employed to invite 15 parents who attended our pediatric tuina training program to participate voluntarily in three focus group interviews. The interviews were audio-recorded and transcribed verbatim. The data were analyzed through template analysis. RESULTS: Two themes were identified: (1) facilitators of intervention implementation and (2) barriers to intervention implementation. The theme of the facilitators of intervention implementation included the subthemes of (a) perceived benefits to children and parents, (b) acceptability to children and parents, (c) professional support, and (d) parental expectations of the long-term effects of the intervention. The theme of barriers to intervention implementation included the subthemes of (a) limited benefits for children's inattention symptoms, (b) manipulation management difficulties, and (c) limitations of TCM pattern identification. CONCLUSION: Perceived beneficial effects on the children's sleep quality and appetite and parent-child relationships, as well as timely and professional support, mainly facilitated the implementation of parent-administered pediatric tuina. Slow improvements in the children's inattention symptoms and the possible inaccuracies of online diagnosis were the dominant barriers of the intervention. Parents have high expectations for the provision of long-term professional support during their practice of pediatric tuina. The intervention presented here can be feasibly used by parents.

Evaluating the safety, feasibility, and efficacy of non-invasive neuromodulation techniques in chemotherapy-induced peripheral neuropathy: A systematic review.

PURPOSE: This systematic review was conducted to evaluate the best available evidence regarding the use of non-invasive neuromodulation techniques for managing chemotherapy-induced peripheral neuropathy (CIPN). METHODS: A systematic literature search of the following databases from their inception to October 17, 2021 was performed and was updated on March 2, 2022: AMED via Ovid, CINAHL via the EBSCO Host, Cochrane Library, Embase, PEDro, PubMed, and Web of Science. Randomized controlled trials (RCTs) and quasi-experimental studies examining the safety, feasibility, and efficacy of non-invasive neuromodulation techniques for managing established CIPN were identified. Narrative synthesis was used to analyze data collected from the included studies. RESULTS: Nine RCTs and nine quasi-experimental studies were included. A variety of non-invasive peripheral and central neuromodulation techniques were investigated in those studies, including scrambler therapy, electrical stimulations, photobiomodulation, magnetic field therapy, therapeutic ultrasound, neurofeedback, and repetitive transcranial magnetic stimulation. Non-invasive neuromodulation techniques for the management of established CIPN are generally safe and feasible. The efficacy of peripheral neuromodulation techniques such as scrambler therapy and transcutaneous electrical nerve stimulation was mostly unsatisfactory, while central neuromodulation techniques such as neurofeedback and repetitive transcranial magnetic stimulation were promising. CONCLUSIONS: The use of non-invasive neuromodulation techniques for managing CIPN is still in its infancy. Non-invasive central neuromodulation techniques have significant potential for relieving chronic pain and neuropathic symptoms related to CIPN, meriting further exploration.

An oxidative analogue of gambogic acid-induced apoptosis of human hepatocellular carcinoma cell line HepG2 is involved in its anticancer activity in vitro.

The objective of this study was to investigate the apoptosis-inducing effect of an oxidative analogue of gambogic acid (GA) on the human hepatocellular carcinoma cell line HepG2 and explore the related molecular mechanisms. HepG2 cells were treated with the analogue of GA and the growth inhibition was analysed by MTT assay. The morphological changes in cells were observed under an inverted light microscope and a fluorescence microscope. In addition, both the cell-cycle arrest and the apoptosis rate were detected by flow cytometry. Western blot was used to evaluate the alteration of protein expression. The viability of HepG2 cells was markedly inhibited in a concentration-dependent manner and obvious morphological changes were confirmed, including condensed chromatin and reduced volume. Increased percentage of apoptotic cells was displayed and altered expression level of several apoptosis-associated proteins, P53, Bcl-2, Bax and pro-caspase-3, was obtained. The newly synthesized analogue of GA exhibited potential anticancer activity, induced remarkable apoptosis in HepG2 cells, probably through the intrinsic mitochondrial pathway, and promised to be a new candidate for future cancer therapy.