Acupuncture for menstruation-related migraine prophylaxis: A multicenter randomized controlled trial.

Objective: The aim of this study was to evaluate the efficacy of acupuncture, an alternative medicine therapy, as a preventive treatment for menstruation-related migraine (MRM). Patients and methods: This was a prospective, multicenter, double-dummy, participant-blinded, randomized controlled clinical trial conducted in China between 1 April 2013, and 30 April 2014. The participants were enrolled from four study centers and randomized to into either the acupuncture group, which received 24 sessions of acupuncture at traditional acupoints plus placebo, or the medication group, which received sham acupuncture plus naproxen. The primary endpoint was change from the baseline average number of migraine days per perimenstrual period over cycles 1-3. The secondary endpoints included changes from the baseline average number of migraine days outside the perimenstrual period, mean number of migraine hours during and outside the perimenstrual period, mean visual analog scale score during and outside the perimenstrual period, ≥50% migraine responder rate, and the proportion of participants who used acute pain medication over cycles 1-3 and 4-6. Results: A total of 172 women with MRM were enrolled; 170 in the intention-to-treat analyses. Our primary outcome reported a significant between-group difference that favored the acupuncture group (95% CI, 0.17-0.50; P < 0.001), with the average reduction of migraine days per perimenstrual period from the baseline was 0.94 (95% CI, 0.82-1.07) in the acupuncture group and 0.61 (95% CI, 0.50-0.71) in the medication group over cycles 1-3. Conclusion: This study showed that compared to medication, acupuncture reduces the number of migraine days experienced by patients with MRM. For patients who received the acupuncture treatment over three cycles, the preventive effect of the therapy was sustained for six cycles. Clinical trial registration: [https://www.isrctn.com/ISRCTN57133712], identifier [ISRCTN15663606].

[Effect of Tongluo Zhitong (, TLZT) gel preparation on p53 /miR-502-5p /NF-κBp65 in synovial tissue of knee osteoarthritis].

OBJECTIVE: To observe effects of Tongluo Zhitong (, TLZT) gel preparation on p53, miR-502-5p, NF-κBp65 in synovial tissue of knee osteoarthritis (KOA), and to explore mechanism of TLZT gel preparation in treating KOA. METHODS: Thirthy-six Wistar rats aged 8 weeks and weighed 200 to 220 g (meaned 208 g) were randomly divided into normal group, model group and traditional Chinese medicine (TCM) group, 12 rats in each group. KOA model was established by modified Hulth method. After 4 weeks of modeling, TCM group treated with TLZT gel preparation for external use, 3 times daily for 2 weeks;normal group and model group were fed normally without intervention. After treatment, morphological changes of specimens in each group were observed, changes of miR-502-5p in synovial tissue were detected by qPCR, and contents of p53, NF-κBp65, IL-1ß, TNF-α, MMP-13 in synovial tissue were detected by qPCR and Western Blot respectively. RESULTS: (1)Morphological observation of specimens showed that the articular cartilage in model group was hyaline and uneven, the synovial membranes were hypertrophic and proliferative with a large number of inflammatory cells infiltrating, the joint fluid was thicker in texture;the articular cartilage in TCM group was more transparent and smooth, synovial hyperplasia was mild with a small amount of inflammatory cell infiltration, the texture of articular fluid was clear and sparse. (2) Compared with normal group, content of miR-502-5p of synovial tissue in model and TCM group were increased, mRNA and expression of p53 decreased, expression of NF-κBp65, IL-1ß, TNF-α, MMP-13 increased. (3)Compared with model group, content of miR-502-5p in synovial tissue of TCM group decreased (P<0.05), mRNA and protein expression of p53 increased (P<0.05), mRNA and protein expression of NF-κBp65, IL-1ß, TNF-α, MMP-13 decreased (P<0.05). CONCLUSION: Expression of p53, miR-502 -5p, NF -κBp65 in synovial tissue is closely related to synovial hyperplasia and inflammatory reaction, TLZT gel preparation may reduce proliferation and inflammatory reaction of KOA synovium by regulating the expression of p53, miR- 502-5p, NF-κBp65 in synovial tissues.

Effect and Potential Mechanism of Electroacupuncture Add-On Treatment in Patients with Parkinson's Disease.

Objectives. To explore effectiveness and mechanisms of electroacupuncture (EA) add-on treatment in Parkinson's disease (PD) patients. Methods. Fifty PD patients were randomly assigned to drug plus EA (D + EA) group and drug alone (D) group. Subjects in D + EA group received stimulation in points of bilateral fengfu, fengchi, hegu, and central dazhui. Participants were evaluated by scales for motor and nonmotor symptoms. Levels of neuroinflammatory factors and neurotransmitters in serum were detected. Results. EA add-on treatment remarkably reduced scores of Unified Parkinson's Disease Rating Scale (UPDRS) III and its subitems of tremor, rigidity, and bradykinesia and conspicuously decreased UPDRS III scores in patients with bradykinesia-rigidity and mixed types and mild severity. Depression and sleep disturbances were eased, which were reflected by decreased scores of Hamilton Depression Rating Scale, Pittsburgh Sleep Quality Index, and elevated noradrenaline level. Effects of EA add-on treatment on motor symptoms and sleep disturbances were superior to drug alone treatment, markedly improving life quality of PD patients. EA add-on treatment decreased nitric oxide level in serum. Conclusions. EA add-on treatment is effective on most motor symptoms and some nonmotor symptoms and is particularly efficacious in PD patients at early stage. Antineuroinflammation may be a mechanism of EA add-on treatment.

Cytotoxic biflavones from Stellera chamaejasme.

Bioassay-guided phytochemical studies on Stellera chamaejasme led to the isolation of two new biflavones, chamaejasmenin E (1) and chamaejasmin D (2), together with ten known compounds. The structures of new compounds were elucidated by extensive spectroscopic analyses and their absolute configurations on 2, 3, 2″ and 3″ were confirmed by TDDFT quantum chemical calculated ECD spectra combined with experimental ECD spectra. All isolated biflavones were evaluated for their cytotoxic activities against Bel-7402 and A549 tumor cell lines, and sikokianin D (3) was found to possess the most potential cytotoxic activities against both the two cell lines with IC50 values of 1.29 ± 0.21 and 0.75 ± 0.25 µM, respectively. Moreover, some structure-function relationships of these bioflavones for cytotoxic activities were explored and summarized.

[Metabolomics analysis revealing multiple compounds changed in rhubarb after processing].

Untargeted metabolomics analysis of rhubarb and stewed rhubarb samples shows that the determined samples clearly clustered in to two groups, indicating that the processing procedures caused changes in the composition and/or content of components in rhubarb. Ten components were identified by UHPLC-Q-TOF-MS/MS and references, which intensity declined in rhubarb after processing. Targeted metabolomics analysis of rhubarb and stewed rhubarb samples indicated that aloe-emodin, rhein, emodin and physcion were detected with lower intensity in stewed rhubarb samples than in rhubarb samples. Metabolomics analysis of rhubarb and stewed rhubarb indicated the various components of rhubarb changed after processing.

Acupuncture as prophylaxis for menstrual-related migraine: study protocol for a multicenter randomized controlled trial.

BACKGROUND: Menstrual-related migraine is a common form of migraine affecting >50% of female migraineurs. Acupuncture may be a choice for menstrual-related migraine, when pharmacological prophylaxis is not suitable. However, the efficacy of acupuncture has not been confirmed. We design and perform a randomized controlled clinical trial to evaluate the efficacy of acupuncture compared with naproxen in menstrual-related migraine patients. METHODS/DESIGN: This is a multicenter, single blind, randomized controlled clinical trial. A total of 184 participants will be randomly assigned to two different groups. Participants will receive verum acupuncture and placebo medicine in the treatment group, while participants in the control group will be treated with sham acupuncture and medicine (Naproxen Sustained Release Tablets). All treatments will be given for 3 months (menstrual cycles).The primary outcome measures are the change of migraine days inside the menstrual cycle and the proportion of responders (defined as the proportion of patients with at least a 50% reduction in the number of menstrual migraine days). The secondary outcome measures are the change of migraine days outside the menstrual cycle, duration of migraine attack, the Visual Analogue Scale (VAS), and intake of acute medication. The assessment will be made at baseline (before treatment), 3 months (menstrual cycles), and 4 months (menstrual cycles) after the first acupuncture session. DISCUSSION: The results of this trial will be helpful to supply the efficacy of acupuncture for menstrual-related migraine prophylaxis. TRIAL REGISTRATION ISRCTN: ISRCTN57133712.

[Value of cerebral spinal fluid measurement of hypocretin-1 in the diagnosis of Chinese patients with narcolepsy].

OBJECTIVE: To evaluate the diagnostic value of cerebral spinal fluid (CSF) measurement of hypocretin-1 (hcrt-1) in Chinese patients with narcolepsy. METHODS: A total of 139 narcoleptic patients, including 111 narcolepsy with typical cataplexy (NC) and 28 narcolepsy without cataplexy (NWC), were diagnosed at the sleep centre of Peking University People's Hospital from April 2003 to March 2012. And 64 non-narcoleptic controls were recruited. CSF hcrt-1 levels were measured in all subjects.Receiver operating characteristic curve (ROC) was applied to determine the cutoff value of hcrt-1 for Chinese narcoleptic patients. The diagnostic utility of hcrt-1 ≤ 110.0 ng/L and hcrt-1 ≤ 30% of mean normal level defined by International Classification of Sleep Disorders-II and the new Chinese cutoff value were evaluated respectively. RESULTS: The level of hcrt-1 in narcolepsy patients was significantly lower than that of normal controls and the NC group was even lower than NWC group (20 (13, 36) vs 319 (244, 379) and 36 (15, 114) ng/L) (all P < 0.01).Using the international criteria of CSF hcrt-1 ≤ 110.0 ng/L or a level of 1/3 of mean normal control values, a specificity of 100% and sensitivity of 90.6% were generated.ROC curve indicated that CSF hcrt-1 level of 138.0 ng/L was the best cutoff value for the diagnosis of narcolepsy in Chinese narcoleptic patients. There were a specificity of 100%, a sensitivity of 92.8% and the area under the ROC curve of 0.98. CONCLUSIONS: CSF hcrt-1 measurement with high specificity and sensitivity is a useful diagnostic tool for Chinese narcoleptics. And the level of 138.0 ng/L may be the optimal cutoff for the diagnosis of narcolepsy in this group of patients.

[Clinical observation on cervical headache treated with acupuncture and fire needling technique].

OBJECTIVE: To observe the efficacy in cervical headache of acupuncture combined with fire needling and the simple acupuncture therapy. METHODS: One hundred and eighty cases were randomized into an acupuncture plus fire needling group (group A) and an acupuncture group (group B), 90 cases in each one. Baihui (GV 20), Wangu (GB 12), Fengchi (GB 20), Tianzhu (BL 10) and Neck-Jiaji (EX-B 2) were selected in the two groups. In group A, the fire needling technique was applied to all the above points before acupuncture with filiform needles. In group B, the acupuncture therapy was used only. The treatment was given once a day, the efficacy was compared between the two groups after 20 treatments. RESULTS: The total effective rate was 95.6% (86/90) in group A and was 84. 4% (76/90) in group B, indicating the significant difference in comparison (P<0.05). VAS were 7.44+/-1.26 and 0.73+/-l. 44 before and after treatment in group A separately, those were 7.56+/-1.07 and 2. 56+/-2. 99 in group B, indicating the significant difference in comparison (P<0.01). The difference in VAS after treatment was significant between the two groups. In group A, the follow-up visit was conducted at 3 months and 6 months after treatment for the cured cases. The total recurrence rate in the patients without bony pathological changes was 14.8% (4/27) and that in the patients with bony pathological changes was 43. 5% (10/23), there was significant difference between them (P<0. 05). CONCLUSION: The combined therapy of fire needling technique and filiform needle acupuncture improves the efficacy and sustains the efficacy especially on cervical headache without bony pathological changing.

Efficacy of acupuncture for acute migraine attack: a multicenter single blinded, randomized controlled trial.

OBJECTIVE: We aim to investigate the efficacy of acupuncture for acute migraine attacks comparing with sham acupuncture. DESIGN: The study was designed as a multicenter, single-blinded, randomized controlled clinical trial. SETTING AND PATIENTS: From March 2007 to February 2009, 150 patients were randomly allocated to verum or sham acupuncture group in a ratio of 1:1. INTERVENTIONS: Every patient received a verum or sham acupuncture treatment when having a migraine attack and, medications were allowed if the pain failed to be relieved two hours after the acupuncture. OUTCOME MEASURES: The primary outcome was visual analog scale (VAS) scores for pain, ranging from 0 (no pain) to 10 (worst pain ever). RESULTS: The mean VAS scores 24 hours after treatment decreased from 5.7 ± 1.4 to 3.3 ± 2.5 in the verum acupuncture group, and from 5.4 ± 1.3 to 4.7 ± 2.4 in the sham acupuncture group. Significant differences existed between the two groups (P = 0.001). CONCLUSIONS: This trial suggested that verum acupuncture group was superior to sham acupuncture group on relieving pain and reducing the usage of acute medication.

Efficacy of acupuncture for migraine prophylaxis: a single-blinded, double-dummy, randomized controlled trial.

Insufficient clinical trial data were available to prove the efficacy of acupuncture for migraine prophylaxis. A multicenter, double-dummy, single-blinded, randomized controlled clinical trial was conducted at the outpatient departments of acupuncture at 5 hospitals in China to evaluate the effectiveness of acupuncture. A total of 140 patients with migraine without aura were recruited and assigned randomly to 2 different groups: the acupuncture group treated with verum acupuncture plus placebo and the control group treated with sham acupuncture plus flunarizine. Treated by acupuncture 3 times per week and drugs every night, patients from both groups were evaluated at week 0 (baseline), week 4, and week 16. The primary outcome was measured by the proportion of responders (defined as the proportion of patients with a reduction of migraine days by at least 50%). The secondary outcome measures included the number of migraine days, visual analogue scale (VAS, 0 to 10 cm) for pain, as well as the physical and mental component summary scores of the 36-item short-form health survey (SF-36). The patients in the acupuncture group had better responder rates and fewer migraine days compared with the control group (P<.05), whereas there were no significant differences between the 2 groups in VAS scores and SF-36 physical and mental component summary scores (P>.05). The results suggested that acupuncture was more effective than flunarizine in decreasing days of migraine attacks, whereas no significantly differences were found between acupuncture and flunarizine in reduction of pain intensity and improvement of the quality of life.

[Observation on therapeutic effects of different treatments for sudden deafness].

OBJECTIVE: To search for the best acupuncture treatment for sudden sensorineural deafness. METHODS: One hundred and eighty-seven patients were randomly divided into an acupuncture group (group A), an electroacupuncture group (group B), an acupuncture pius acupoint injection group (group C), an electroacupuncture plus acupoint injection group (group D). Ermen (TE 21), Tinggong (SI 19), Tinghui (GB 2), Yifeng (TE 17), Fengchi (GB 20) on the affected side, and Shangxing (GV 23), Baihui (GV 20), Sishencong (EX-HN 1), Hegu (LI 4), Waiguan (TE 5), etc. were selected. The treatment was given once each day. Hearing was tested after treatment for 40 sessions and the therapeutic effects were compared. RESULTS: The total effective rate was 47.6% in the group A, 79.2% in the group B, 76.0% in the group C and 94.0% in the group D, the group D being the best and the group A being the worst, and with significant differences between the group D and the other groups (all P < 0.05). In the group D, the therapeutic effect for patients who received the treatment within 2 weeks after attack were superior to those who received the treatment over 2 weeks after attack (P < 0.05); the acupuncture therapeutic effect for the mild and moderate patients was superior to that of severe patients (P < 0.05); the acupuncture therapeutic effect for the patients less than 50 years old was superior to those more than 50 years old (P < 0.05). CONCLUSION: Electroacupuncture plus acupoint injection is the heat therapy for sudden sensorineural deafness, and the timely intervention of acupuncture, the severity degree of the illness and the patient's age are all related to the prognosis of this disease.

[Comparative observation on electroacupuncture combined with acupoint-injection for treatment of oculomotor paralysis induced by aneurysm of cerebral posterior communicating artery].

OBJECTIVE: To compare clinical therapeutic effects of electroacupuncture (EA) combined with acupoint-injection and simple acupuncture on oculomotor paralysis induced by aneurysm of cerebral posterior communicating artery. METHODS: Seventy-eight cases were randomly divided into an acupuncture group and an EA plus acupoint-injection group. In the acupuncture group, Jingming (BL 1), Qiuhou (EX-HN 7), Chengqi (ST 1), etc., were selected and the EA plus acupoint-injection group were treated by the same method as in the acupuncture group, in combination with EA and local acupoint injection of adenosine cobaltamine. After treatment of 3 months, their therapeutic effects were compared. RESULTS: The total effective rate was 41.7% in the acupuncture group and 77.8% in the EA plus acupoint-injection group, with a very significant difference between the two groups (P<0.01). The therapeutic effect in the patients who received the operation within 2 weeks after attack was better than that in those who received the operation over 2 weeks after attack (P<0.01); the therapeutic effect in the patients who received acupuncture treatment within 1 month after the operation was better than that over 1 month after the operation(P<0.01). CONCLUSION: EA plus acupoint-injection is an effective method for oculomotor paralysis induced by aneurysm of cerebral posterior communicating artery, with a better therapeutic effect than that of simple acupuncture, and early diagnosis, surgery and timely acupuncture treatment are closely related with its prognosis.

[Clinical observation on relation of different therapeutic methods with prognosis of acute idiopathetic facial paralysis].

OBJECTIVE: To find the optimal therapeutic program for treatment of acute idiopathetic facial paralysis. METHODS: Four hundred and seventy-seven cases were randomly divided into acupuncture group (group A) treated by routine point multiple needle shallow needling, electroacupuncture group (group B) treated by routine point plus electroacupuncture, drug group (group C), acupuncture plus drug group (group D), and electroacupuncture plus drug group (group E). After treatment of 40 sessions, their therapeutic effects were compared. RESULTS: The effective rate was 84.0%, 57.1%, 60.6%, 95.8% and 73.5% in the 5 groups respectively; the effective rate in the group D was the best with a very significant difference as compared with other groups (P < 0.01); and there were very significant differences in the therapeutic effect as the group A compared with the group B and C (both P < 0.01). CONCLUSION: Acupuncture combined with drug is the best program for treatment of acute idiopathetic facial paralysis, and the multiple needle shallow needling is better than electroacupuncture or simple medication.

Identification of ginsenosides in roots of Panax ginseng by HPLC-APCI/MS.

A new HPLC-APCI/MS method for the identification of ginsenosides has been developed. The analyses were performed on a reversed-phase C18 column using a binary eluent (acetonitrile and water) under gradient conditions. Although APCI is a high-temperature evaporative process, HPLC-APCI/MS could effectively identify thermo-labile ginsenosides. The [M-H]- ions and the thermal degradation ions of ginsenosides could be clearly observed under negative and positive ion conditions, respectively, and these were used to identify the molecular masses, the aglycone structures and the sugar groups of ginsenosides. APCI/MS can provide more explicit information than ESI/MS for identifying and distinguishing ginsenosides. Using the HPLC-APCI/MS method, 35 ginsenosides were identified in Panax ginseng.