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BACKGROUND: Elderly rheumatoid arthritis (ERA) population faces multiple treatment dilemma. Here we aim to investigate if Gancao Nourishing-Yin decoction (GCNY) added to methotrexate (MTX) exhibit better effects in an ERA mice model. METHODS: ERA mice model was established by adding D-galactose (Dgal) to collagen-induced arthritis (CIA) mice. The model was then assigned into control group (CIA + Dgal), MTX treatment group (MTX), GCNY treatment group (GCNY), and integrative treatment group (MTX + GCNY). Pathological scoring was performed to evaluate the severity between the groups. Proteomic analysis was applied to investigate the secretory phenotype of the ERA mouse model and the underlying mechanism of GCNY, MTX and their combination. Representative cytokines related to proteomic results were further validated by ELISAs. RESULTS: CIA + Dgal mice showed more aggressive joints damage than the CIA mice. Besides changes in the inflammatory pathway such as Pi3k-Akt signaling pathway in both model, differential expressed proteins (DEPs) indicated metabolism-related pathways were more obvious in CIA + Dgal mice. Low-dose MTX failed to show pathological improvement in CIA + Dgal mice, while GCNY improved joints damage significantly. Besides down-regulated inflammation-related targets, GCNY-regulated DEPs (such as Apoc1 ~ 3, Grk2 and Creb3l3) were broadly enriched in metabolism-related pathways. MTX + GCNY showed the best therapeutic effect, and the DEPs enriched in a variety of inflammatory,metabolism and osteoclast differentiation signaling pathway. Notably, MTX + GCNY treatment up-regulated Dhfr, Cbr1, Shmt1 involved in folic acid biosynthesis and anti-folate resistance pathways indicated a coincidence synergic action. ELISAs confirmed CPR and Akt that elevated in CIA + Dgal mice were significantly ameliorated by treatments, and adding on GCNY elevated folic acid levels and its regulator Dhfr. CONCLUSION: Aging aggravated joints damage in CIA, which probably due to metabolic changes rather than more severe inflammation. GCNY showed significant effects in the ERA mice model especially when integrated with MTX to obtain a synergic action.
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Objective: To explore the clinical efficacy of muscle regions of meridians needling method for refractory facial paralysis affecting different locations.Methods: A total of 110 participants were randomized into an observation group and a control group, with 55 cases in each group. The observation group was treated with muscle regions of meridians needling method, and the control group was treated with conventional facial three-line needling method. The clinical efficacy was evaluated four weeks after the treatment. And the infrared imaging spectra of the two groups were examined. Results: The total effective rate of the observation group was higher than that of the control group (P<0.05), and its curative effect for refractory facial paralysis located above the geniculate ganglion was better than that of the control group (P<0.05). The color scale distribution of different disease locations in the two groups varied significantly (P<0.05), the higher the disease location, the higher the occurrence rate of cool zone and low temperature zone. After treatment, the reductions of the facial and periotic temperature difference between the healthy side and the affected side in the observation group were statistically different from those in the control group (P<0.05). Conclusion: Muscle regions of meridians needling method has a better effect than facial three-line needling method for refractory facial paralysis. It can promote the microcirculation of the affected side of the face, improve the blood and oxygen supply to local tissues, and thus promote the repair of the peripheral facial nerve.
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<p><b>OBJECTIVE</b>To evaluate clinical therapeutic effect of Guan-moxibustion on herpes simplex virus facial neuritis.</p><p><b>METHODS</b>One hundred and sixty cases were enrolled in 3 centers and 157 cases were completed the study. All he patients were randomly divided into 2 groups, a Guan-moxibustion group and a suspended moxibustion plus acupuncture group. All of them were treated with basic acupuncture, and the Guan-moxibustion group were added with Guan-moxibustion and the suspended moxibustion group with suspended moxibustion. They were treated for 8 weeks, and facial disability index (FDI) and House-Brackmann facial nerve grading system were used to assess therapeutic effects.</p><p><b>RESULTS</b>The effective rate was 91.0% in the Guan-moxibustion group and 72.2% in the suspended moxibustion group with a significant difference between the two groups (P < 0.05), the Guan-moxibustion being better than the suspended moxibustion group.</p><p><b>CONCLUSION</b>The therapeutic effect of Guan-moxibustion plus acupuncture on herpes simplex virus facial neuritis is better than that of suspended moxibustion plus acupuncture.</p>