Acupuncture for radicular pain: a review of analgesic mechanism.

Radicular pain, a common and complex form of neuropathic pain, presents significant challenges in treatment. Acupuncture, a therapy originating from ancient traditional Chinese medicine and widely utilized for various pain types, including radicular pain, has shown promising outcomes in the management of lumbar radicular pain, cervical radicular pain, and radicular pain due to spinal stenosis. Despite its efficacy, the exact mechanisms through which acupuncture achieves analgesia are not fully elucidated and are the subject of ongoing research. This review sheds light on the current understanding of the analgesic mechanisms of acupuncture for radicular pain, offering valuable perspectives for both clinical application and basic scientific research. Acupuncture is postulated to relieve radicular pain by several mechanisms: peripherally, it reduces muscle spasms, lessens mechanical pressure on nerve roots, and improves microcirculation; at the molecular level, it inhibits the HMGB1/RAGE and TLR4/NF-κB signaling pathways, thereby decreasing the release of pro-inflammatory cytokines; within the spinal cord, it influences synaptic plasticity; and centrally, it modulates brain function, particularly affecting the medial prefrontal cortex, anterior cingulate cortex, and thalamus within the default mode network. By acting across these diverse biological domains, acupuncture presents an effective treatment modality for radicular pain, and deepening our understanding of the underlying mechanisms regarding analgesia for radicular pain is crucial for enhancing its clinical efficacy and advancement in pain management.

[Efficacy of acupuncture-moxibustion on peripheral facial paralysis at different time points: a Meta-analysis].

OBJECTIVE: To systematically evaluate the efficacy and safety differences between acupuncture-moxibustion at acute stage and non-acute stage for peripheral facial paralysis. METHODS: The clinical trials regarding acupuncture- moxibustion for peripheral facial paralysis published before May 31st 2019 were searched in databases of CNKI, WF, VIP, SinoMed, PubMed, Cochrane Library and Google Scholar. The information of included studies was extracted and the quality was assessed by two independent researchers. The Meta-analysis was performed by using RevMan 5.3 software. RESULTS: A total of 11 trials were included, involving 1741 patients. The Meta-analysis results showed that: (1) the curative rate of acupuncture-moxibustion at acute stage was higher than that at non-acute stage (OR=2.45, 95%CI: 1.91-3.14, Z=7.06, P<0.01); (2) the average curative time of acupuncture-moxibustion at acute stage were shorter than that of non-acute stage (WMD=5.26, 95%CI: 3.44, 7.08, Z=5.67, P<0.01); (3) the incidence rate of sequelae in 6-month follow up of acupuncture-moxibustion at acute stage were lower than that of non-acute stage (OR=2.71, 95%CI: 1.26, 5.84, Z=2.56, P<0.05); (4) one study reported that there were no adverse reactions during treatment in both treatment group and control group. CONCLUSION: Based on current evidence, the efficacy of acupuncture-moxibustion at acute stage is superior to non-acute stage, which could promote the recovery of the disease and shorten the course of treatment, and reduce the occurrence of sequelae. More high-quality, large-sample randomized controlled trials are needed for further verification.

Clinical features and prognostic factors in patients with bone metastases from non-small cell lung cancer.

OBJECTIVE: To investigate the clinical features and evaluate the prognostic factors in patients with bone metastases from non-small cell lung cancer (NSCLC). METHODS: We retrospectively investigated 356 patients with NSCLC with bone metastases from January 2012 to December 2017. The overall survival (OS) and 1-year survival rate were calculated by Kaplan-Meier analysis and compared by univariate analysis using the log-rank test. Multivariate analysis was performed using the Cox proportional hazards model. RESULTS: A total of 694 sites of bone metastases were determined among the 356 patients. The most common site of bone metastases was the ribs. The median OS was 12.5 months and the 1-year survival was 50.8% in the overall population. Univariate analysis revealed that histological type, number of bone metastases, Eastern Cooperative Oncology Group performance status (ECOG PS), bisphosphonate therapy, and serum calcium, lactate dehydrogenase, and alkaline phosphatase were significantly correlated with prognosis. Multivariate analysis identified multiple bone metastases, ECOG PS ≥2, lactate dehydrogenase ≥225 U/L, and alkaline phosphatase ≥140 U/L as independent negative prognostic factors. CONCLUSION: Multiple bone metastases, high ECOG PS, and high serum alkaline phosphatase and lactate dehydrogenase are independent negative prognostic factors for bone metastases from NSCLC.

Dietary supplements during the cold season increase rumen microbial abundance and improve rumen epithelium development in Tibetan sheep.

Livestock on the Qinghai-Tibetan Plateau are faced with extreme harsh winters and are often in negative energy balance during this period. Dietary supplementation can improve growth performance of Tibetan sheep and, consequently, we hypothesized that it would also increase microbial abundance and rumen epithelium development. To test this hypothesis, we examined the effect of feed supplementation during the cold season on rumen microbes, fermentation, epithelium development, and absorptive capability in Tibetan sheep. Eighteen 1-yr-old ewes (BW = 29.4 ± 1.79, kg) were offered oat hay ad libitum for 60 d and divided randomly into three groups: 1) no supplement; control group (CON); 2) urea-molasses lick block supplement (BS); and 3) concentrate feed supplement (CS). The ADG of CS ewes (143.3, g/d) was greater (P < 0.05) than BS ewes (87.9, g/d), which was greater (P < 0.05) than CON ewes (44.5, g/d). Serum concentrations of GH, IGF-1, and IGF-2 in the CS and BS groups were greater than in the CON group (P < 0.05). Greater relative abundance of protozoa, Ruminococcus albus, Fibrobacter succinogenes, Streptococcus bovis, and Ruminobacter amylophilus was observed in the CS and BS groups than in the CON group (P < 0.05), and relative abundances of rumen fungi, Butyrivibrio fibrisolvens, and Prevotella ruminicola in the CS group were greater than in the BS and CON groups (P < 0.05). Ruminal total VFA, ammonia, and microbial protein concentrations in the CS and BS groups were greater than in the CON group (P < 0.05), and in the CS group were greater than in the BS group (P < 0.05). Ruminal papillae width and surface area in the CS and BS groups were greater than in the CON group (P < 0.05), while in the CS group were greater than in the BS group (P < 0.05). The mRNA expressions of IGFBP5, NHE1 (sodium/hydrogen antiporter, isoform 1), DRA (downregulated in adenoma), and Na+/K+-ATPase (sodium/potassium ATPase pump) in ruminal epithelium were greater in the CS and BS groups than in the CON group (P < 0.05), and in the CS group was greater than in the BS group (P < 0.05), while NHE3 (sodium/hydrogen antiporter, isoform 3), MCT1 (monocarboxylate transporter 1), and MCT4 (monocarboxylate transporter 4) mRNA expressions in the CS group were greater than in the BS and CON groups (P < 0.05). It was concluded that supplementing Tibetan sheep during the cold season increases rumen microbial abundance and improves fermentation parameters, rumen epithelium development, and absorptive capability.

[Cognitive impairment in earthquake brain injury treated with comprehensive program of acupuncture and rehabilitation: a randomized controlled trial].

OBJECTIVE: To explore the comprehensive program of integrated Chinese and western medicine in the treatment of cognitive impairment in earthquake brain injury. METHODS: The multi-central randomized controlled trial was adopted. The qualified subjects were randomized into an acupuncture + rehabilitation group (38 cases) and a rehabilitation group (35 cases). In the acupuncture + rehabilitation group, acupuncture, hyperbaric oxygen (HBO) and cognitive rehabilitation training were combined as the comprehensive program of integrated Chinese and western medicine in the treatment. In the rehabilitation group, HBO and cognitive rehabilitation training were adopted. The efficacy and safety were assessed. RESULTS: (1) After treatment of 2 months, the intelligent state, cognitive function and activity of daily life of patients were improved in the both groups (all P < 0.01). (2) After treatment of 2 months, the score of MMSE and the score of activity of daily life were (24.11 +/- 4.08) and (75.45 +/- 13.95) in the acupuncture + rehabilitation group, which were more significant as compared with (17.05 +/- 43.84), (66.06 +/- 12.75) in the rehabilitation group, respectively (both P < 0.01). In 6-month follow-up visit after treatment, the cognitive function and activity of daily life were improved continuously in the acupuncture + rehabilitation group, which was more significant as compared with the rehabilitation group (P < 0.01, P < 0.05). CONCLUSION: The integrated Chinese and western medicine of acupuncture, HBO and cognitive rehabilitation training is safe and effective in the treatment of cognitive impairment in earthquake brain injury. The therapeutic effect is more advantageous as compared with the simple rehabilitation program of western medicine.

Stir-fried white pepper can treat diarrhea in infants and children efficiently: a randomized controlled trial.

We evaluated the efficacy and safety of stir-fried white pepper in the treatment of infant and children diarrhea. This was a randomized trial conducted in the pediatric emergency department of the hospital affiliated to Jining Medical College. One hundred seventy four patients were selected from outpatients from 2011 to 2012. Participants were randomly assigned to treatment with stir-fried white pepper (n = 88) or montmorillonite powder (n = 86). The proportions of chronic diarrhea patients (n = 52) showing success of treatment were similar for both groups. There were great differences between the two groups in acute diarrhea (n = 62) and persistent diarrhea (n = 60), and the cure rate of stir-fried white pepper was higher than montmorillonite powder in both groups. The prescription of stir-fried white pepper significantly decreased the frequency of diarrhea in infants and children under 2.5 years with diarrhea compared to treatment with montmorillonite powder, especially for the patients with acute diarrhea or persistent diarrhea.

[Efficacy observation of fire needle combined with narrow band ultraviolet-B (NB-UVB) for vitiligo].

OBJECTIVE: To compare clinical efficacy difference between fire needle combined with narrow band ultraviolet-B (NB-UVB) and NB-UVB therapy for vitiligo. METHODS: Ninety-three cases of vitiligo were randomly divided into an observation group (n = 48) and a control group (n = 45). In the observation group, fire needle was applied to ashi points around the damaged skin and Zusanli (ST 36), meanwhile NB-UVB therapy irradiating the local area. The control group was treated by NB-UVB therapy. The clinical efficacy was evaluated after the treatment of 12 weeks. RESULTS: The total effective rate was 79.2% (38/48) in the observation group, which was superior to that 48.9% (22/45, P < 0.05) in the control group. CONCLUSION: The fire needle combined with NB-UVB for vililigo achieves a more obvious efficacy than NB-UVB therapy.

[Post-stroke flaccid limb dysfunction treated with the comprehensive therapy of acupuncture, Chinese herbal medicine and rehabilitation: muti-center randomized controlled trial].

OBJECTIVE: To evaluate the clinical value of the comprehensive therapy of acupuncture, Chinese herbal medicine and rehabilitation in the treatment of post-stroke flaccid limb dysfunction. METHODS: The four-center, single-blind, randomized and controlled research method was adopted, 240 qualified subjects were randomized into a comprehensive therapy group, an acupuncture group, a rehabilitation group and a Chinese herbal medicine group, 60 cases in each one, at the ratio of 1 1. In the comprehensive therapy group, the comprehensive therapy of acupuncture, Chinese herbal medicine and rehabilitation was applied. The acupuncture therapy included the scale acupuncture at middle line of vertex, lateral line 1 of vertex, lateral line 2 of vertex, etc. with the single reinforcing and reducing technique by the speed of needle insertion and withdrawal, and the body acupuncture therapy at the acupoints on the antagonistic muscles with the reinforcing and reducing technique by the needle rotation. The Chinese herbal medicine therapy included No. 1 stroke formula for the cases of liver and kidney yin deficiency and the upward disturbance of wind yang, No. 2 stroke formula for qi deficiency and blood stagnation, and the stagnation in meridians and No. 3 stroke formula for the interaction of phlegm and stasis and blockage of meridians according to the pattern/syndrome differentiation. The rehabilitation therapy focused on the promotion technique by putting the healthy limb. The simple acupuncture, rehabilitation and Chinese herbal medicine therapies as the comprehensive therapy group were applied in the acupuncture group, rehabilitation group and Chinese herbal medicine group separately. The Chinese medicine symptom, the limb motor function, the daily life activity, fainting needle reaction, allergic reaction and the others were taken as indices to evaluate the efficacy and safety of the treatment. RESULTS: (1) The results of the four indices named the Chinese medicine symptom, the limb motor function, the limb balance function, the daily life activity were all improved significantly after treatment as compared with those before treatment in four groups (all P < 0.01). (2) Concerning to the improvement degrees, the improvements of the above four indices in the comprehensive therapy group were more significant than those in the other three groups (P < 0.01, P < 0.05). The improvement in Chinese medicine symptom in the acupuncture group and the Chinese herbal medicine group were more significant than that in the rehabilitation group (both P < 0.05). The improvement of the upper limb motor function in the acupuncture group was more significant than that in the rehabilitation group and the Chinese herbal medicine group separately (both P < 0.05). CONCLUSION: The comprehensive therapeutic program of acupuncture, Chinese herbal medicine and rehabilitation is safe and effective in the treatment of post-stroke flaccid limb dysfunction. It is more advantageous in efficacy as compared with any simple therapy.

The needle-rolling therapy for treatment of non-organic chronic insomnia in 90 cases.

OBJECTIVE: To evaluate the therapeutic effects of needle-rolling therapy for chronic insomnia. METHODS: In the present multi-central randomly controlled clinical study, 180 cases of chronic insomnia were randomly divided into the following two groups, a treatment group (90 cases) treated by the needle-rolling therapy and a control group (90 cases) treated with clonopin. The treatment course for both the two groups was 4 weeks. The therapeutic effects were evaluated based on improvement of the TCM symptoms and the Pittsburgs's sleep-quality index (PSQI). RESULTS: After treatment, there were significant differences between the two groups in the effective rate (P<0.05), and in the total score of PSQI and in the scores of the 4 sub-items, i.e. sleep-quality, sleep-efficiency, hypnotic and daytime function (P<0.05). Although there was no significant difference between the two groups in the effective rate after a 3-month follow-up period, significant differences still existed in the 3 sub-items of sleep-efficiency, hypnotic, and daytime function of the PSQI (P<0.05). CONCLUSION: As compared with hypnotics of the second generation, the needle-rolling therapy may show better therapeutic effects for chronic insomnia patients.

[Observation on the therapeutic effect of a red-hot needle therapy combined with blood-letting puncture and cupping for treatment of neurodermatitis].

OBJECTIVE: To search for an effective therapy for neurodermatitis. METHODS: Ninety-six cases were divided into 2 groups by random number table. The treatment group (n = 54) were treated by hot-red needle therapy combined with blood-letting puncturing and cupping at skin-injured area, and the control group (n = 42) were treated with external smearing of halometasone cream. RESULTS: The cured rate and the total effective rate were 51.9% and 96.3% in the treatment group, and 28.6% and 81.0% in the control group, respectively, with a significant difference between the two groups in the therapeutic effect (P < 0.05). CONCLUSION: Red-hot needle therapy combined with blood-letting puncture and cupping has a definite therapeutic effect on neurodermatitis, without toxic and adverse effects.

The role of oxidative stress in hormesis induced by sodium arsenite in human embryo lung fibroblast (HELF) cellular proliferation model.

Hormetic dose-response relationships induced by environmental agents are often characterized by a low-dose stimulation and a high-dose inhibition. The mechanisms underlying hormesis induced by environmental agents still remain an enigma; however, hormetic consequences may have significant implications for health risk assessments. To investigate the role of oxidative stress in hormetic phenomena associated with cell proliferation induced by sodium arsenite, the levels of reactive oxygen species (ROS), lipid peroxidation (LPO), and heat-shock proteins (HSP) and the activities of glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) were measured in human embryo lung fibroblast (HELF) cells after treatment with sodium arsenite at various concentrations for differing times. Results showed that sodium arsenite induced significant cell proliferation at low concentrations (0.5 microM for 12, 24, and 48 h), but inhibited cell growth at high amounts (5 and 10 microM for 24 and 48 h), reflected as a beta concentration-response curve. Data indicated that the relationship between ROS levels and sodium arsenite exposure concentration displayed a positive correlation. It was found out that sodium arsenite at high concentrations induced LPO damage. The activities of SOD were enhanced at low metal concentrations but inhibited with high amounts in a concentration-dependent manner. Similarly, heat-shock protein 27 (HSP27) levels were increased by sodium arsenite of low concentrations with early exposure time (3, 6, and 12 h), but decreased with high metal concentrations with greater exposure time (24 and 48 h). Sodium arsenite decreased HSP70 expression at lower concentrations, but increased HSP70 expression at higher concentration. The results indicated that this cellular hormetic model of cell proliferation induced by sodium arsenite occurred in HELF cells, which may explain contradictory effects seen with this metal. Sodium arsenite at low concentrations induced enhanced ROS generation without cytotoxicity and a cellular protective effect. In contrast, sodium arsenite at high concentrations produced marked ROS formation, marked oxidative stress, and cellular damage, as evidenced by LPO.

[Transient analgesic effect of electroacupuncture at Taiyang (EX-HN 5) for treatment of migraine with hyperactivity of the liver-yang].

OBJECTIVE: To explore the difference of therapeutic effects between electroacupuncture (EA) and medication for treatment of migraine with hyperactivity of the liver-yang. METHODS: With 3-center randomized controlled study method, 300 cases were assigned to a treatment group and a control group, 150 cases in each group. They were treated respectively with EA at Taiyang (EX-HN 5) and oral administration of western medicine. Changes of the score for headache intensity, remission degree of headache and remission rate of headache after treatment were investigated. RESULTS: After once treatment, VAS score of the headache intensity showed dynamical decrease in the two groups; in the treatment group the score reached the lowest 3-4 h after treatment, with the decreasing degree better than the control group (P < 0.01). The lasting time of headache remission was (388.6 +/- 430.1) min and (163.3 +/- 182.3) min, respectively, the treatment group being significantly longer than that of the control group (P < 0.01). CONCLUSION: EA at Taiyang (EX-HN 5) has transient analgesic effect for treatment of migraine with hyperactivity of the liver-yang, which is better than that of routine western medication.

[Controlled study on treatment of cervical spondylopathy of the nerve root type with acupuncture, moxibustion and massage as main].

OBJECTIVE: To probe into clinical value of comprehensive program of acupuncture, moxibustion and massage as main for treatment of cervical spondylopathy of the nerve root type. METHODS: Five centers, single blind, randomized controlled method were used, 660 cases were divided into a treatment group of 317 cases and a control group of 311 cases. They were treated respectively with comprehensive program of acupuncture, moxibustion and massage as main, and comprehensive program of physical therapy as main. Establish syndrome detection scale and multiply dimensional effect assessment indexes, and evaluate the therapeutic effects and safety. RESULTS: The cured rate, the cured-markedly effective rate were 42.9%, 64.4% in the treatment group, respectively, better than 16.7%, 36.3% in the control group (P<0.01); after treatment of 2 weeks, clinical symptoms improved in the both groups, but the treatment group was better than the control group in the improvement degrees of neck-shoulder-limb pain, neck rigidity, abnormality of cervical anteflexion, etc. (P<0.01 or P<0.05); the treatment group was shorter than the control group in the time of producing the effect and therapeutic course (P<0.01). CONCLUSION: Comprehensive program of acupuncture, moxibustion and massage as main is safe and effective for treatment of cervical spondylopathy, with a better therapeutic effect compared with the comprehensive program of physical therapy.

[Effect of rolling needle therapy on quality of life in the patient of non-organic chronic insomnia: a randomized controlled trial].

OBJECTIVE: To probe therapeutic effect of rolling needle therapy on insomnia and standardize the therapeutic program. METHODS: Multi-central randomized blind controlled trials were used, and 180 cases were randomly divided into a rolling needle group and a medication group, 90 cases in each group. The rolling needle group were treated with rolling needle therapy at the Urinary Bladder Channel line 1 and 2 at the back and the Governor Vessel, and the medication group with clonopin 4-6 mg, for 4 weeks. Effective rates for sleep disturbance improvement and Spitzer index of life quality were evaluated after 4 weeks' treatment and 3 months' follow-up. RESULTS: The effective rate was 82.2% in the rolling needle group and 60.0% in the medication group with a significant difference between the two groups (P < 0.05), and with a significant difference between the two groups in Spitzer index of life quality (P < 0.05). After 3 months' follow-up, the effective rate was 40.0% in the rolling needle group and 30.3% in the medication group with no significant difference between the two groups (P > 0.05), and there was a significant difference between the two groups in Spitzer index of life quality. CONCLUSION: Rolling needle therapy can treat chronic insomnia and increase life quality of the patient.

[Clinical observation on Ashi points Sihua needling method for treatment of acute soft tissue injury].

OBJECTIVE: To observe therapeutic effect of Ashi points Sihua needling method for treatment of acute soft tissue injury. METHODS: The patients were randomly divided into a treatment group (n = 105) and a control group (n = 108). They were treated respectively with Ashi points Sihua needling method and routine needling method. Their therapeutic effects and safety were assessed. RESULTS: The cured rate was 79.0% in the treatment group, better than 65.7% in the control group (P < 0.05); after treatment, the improvement degrees of pain, dysfunction and the total cumulative score in the treatment group were better than those in the control group (P < 0.05 or P < 0.01); the treatment group produced more quickly the effect with a shorter cured period as compared with the control group (P < 0.05 or P < 0.01). CONCLUSION: Ashi points Sihua needling method is safe and effective for acute soft tissue injury.

[Multicenter randomized controlled study on acupuncture-massage comprehensive program for treatment of cervical spondylosis of arterial type].

OBJECTIVE: To probe into clinical value of the acupuncture-massage comprehensive program for treatment of cervical spondylosis of arterial type (CSA). METHODS: By using three-center, single-blind, randomized, controlled method, the eligible subjects were randomly divided into an acupuncture-massage group, an acupuncture group, a massage group, 60 cases in each group. They were treated with acupuncture-massage comprehensive program, simple acupuncture and simple massage, respectively. And multiple-dimensional indexes were established to evaluate the therapeutic effect and safety. RESULTS: The baselines of the general data were no different among the 3 groups. The cured-markedly effective and the effective rate were 68.3% and 88.3% in the acupuncture-massage group, 51.7% and 75.0% in the acupuncture group, and 50.0% and 76.7% in the massage group, respectively, the acupuncture-massage group being better than the other 2 groups (P<0.05); after treatment, the total cumulative scores for symptoms in the 3 groups decreased significantly (all P<0.01), the acupuncture-massage group being superior to the other 2 groups (P<0.05); and the physical signs in the 3 groups improved significantly (P<0.01), with no significant differences among the 3 groups (P>0.05); the time inducing the effect in the acupuncture-massage group was shorter than that in the other 2 groups (P<0.05 or P<0.01); and no adverse effects were found in the 3 groups. CONCLUSION: This acupuncture-massage comprehensive therapy has a definite therapeutic effect on CSA with safety, and it is of superiority as compared with the simple acupuncture or the simple massage.

[Influence of Qingdai compound on expression of bcr/abl and JWA in K562 cells].

To study the effects of Qingdai compound on proliferation and apoptosis of K562 cells, as well as the expression of bcr/abl and JWA mRNA, K562 cells were treated in culture with different concentrations of Qingdai compound (2.5, 5, 7.5, 10 and 20 mg/ml) and harvested at 24 hours. Then morphological changes were observed by light microscopy (LM); expressions of bcr/abl and JWA were detected with semi-quantitative RT-PCR. The results showed that morphological changes were observed as the increment of the Qingdai compound concentration. Inhibition effects on proliferation and apoptosis in K562 cells were seen. A concentration-dependent decreases were found in bcr-abl and JWA mRNA expression of K562 cells. Qingdai compound partially inhibited proliferation and induced apoptosis of K562 cells. Expressions of both bcr/abl and JWA, which took part in cell proliferation and apoptosis, were down-regulated in a dose dependent manner. In conclusion, Qingdai compound can partially inhibit the expressions of bcr/abl and JWA genes in K562 cells, and the clinical effect of Qingdai compound on CML may be associated with apoptosis of leukemic cells.