Effects of Patient-Controlled Transcutaneous Electrical Acupoint Stimulation on Cancer Induced Bone Pain Relief in Patients with Non-Small Cell Lung Cancer: Study Protocol for a Randomized Controlled Trial.

Background: Transcutaneous Electrical Acupoint Stimulation (TEAS) therapy opens up the possibility for individuals with Cancer-induced bone pain (CIBP) to receive a home-based, patient-controlled approach to pain management. The aim of this study is designed to evaluate the efficacy of patient-controlled TEAS (PC-TEAS) for relieving CIBP in patients with non-small cell lung cancer (NSCLC). Methods/Design: This is a study protocol for a prospective, triple-blind, randomized controlled trial. We anticipate enrolling 188 participants with NSCLC bone metastases who are also using potent opioid analgesics from 4 Chinese medical centers. These participants will be randomly assigned in a 1:1 ratio to either the true PC-TEAS or the sham PC-TEAS group. All participants will receive standard adjuvant oncology therapy. The true group will undergo patient-controlled TEAS intervention as needed, while the sham group will follow the same treatment schedule but with non-conductive gel patches. Each treatment course will span 7 days, with a total of 4 courses administered. There will be 4 assessment time points: baseline, the conclusion of weeks 4, 8, and 12. The primary outcome of this investigation is the response rate of the average pain on the Brief Pain Inventory (BPI) scale at week 4 after treatment. Secondary outcomes include pain related indicators, quality of life scale, mood scales, and routine blood counts on the assessment days. Any adverse events will be promptly addressed and reported if they occur. We will manage trial data using the EDC platform, with a data monitoring committee providing regular quality oversight. Discussion: PC-TEAS interventions offer an attempt to achieve home-based acupuncture treatment and the feasibility of achieving triple blinding in acupuncture research. This study is designed to provide more rigorous trial evidence for the adjuvant treatment of cancer-related pain by acupuncture and to explore a safe and effective integrative medicine scheme for CIBP. Trial Registration: ClinicalTrials.gov NCT05730972, registered February 16, 2023.

Comparison of Essential and Toxic Metals Levels in some Herbal Teas: a Systematic Review.

In the present study, we reviewed the literature as a systematic review to investigate the concentration of some metals (essential, none essential, and toxic metals) in herbal teas and their health risks. The search extended the literature from the database, including Google Scholar, PubMed, and Scopus, using the terms "herbal teas" combined with "heavy metals, essential metals, thyme, rosemary, chamomile, and tea" also with "iron, zinc, aluminum, chromium, cobalt, nickel, manganese, arsenic, cadmium, and lead" in titles and abstracts. The search was limited to articles published from 2012 to 2023 years. Initially, 212 articles were found; by detailed consideration, only 49 papers fit the inclusion criteria and were selected for further study. The mean of metal concentration, standard deviation, data distribution, and sample size were applied to generate data from the articles. The results indicated that all commonly consumed herbal teas included metals. None of them meet the requirements of the WHO requirements. However, more than 70% of their health risks are acceptable. The risks of arsenic and lead in tea and cadmium in black tea were considerably higher than in others. According to the review results, it is important to prevent heavy metal contamination of herbal teas by modifying cultivation patterns and also to prevent to consumption of low-quality herbal teas.

Transcutaneous electrical acupoint stimulation attenuated neuroinflammation and oxidative stress by activating SIRT1-induced signaling pathway in MCAO/R rat models.

BACKGROUND: Silent information regulator 1 (SIRT1) plays a beneficial role in cerebral ischemic injury. Previous reports have demonstrated that transcutaneous electrical acupoint stimulation (TEAS) exerts a beneficial effect on ischemic stroke; however, whether SIRT1 participates in the underlying mechanism for the neuroprotective effects of TEAS against ischemic brain damage has not been confirmed. METHODS: The rat models of middle cerebral artery occlusion/reperfusion (MCAO/R) were utilized in the current experiment. After MCAO/R surgery, rats in TEAS, EC and EX group received TEAS intervention with or without the injection of EX527, the SIRT1 inhibitor. Neurological deficit scores, infarct volume, hematoxylin eosin (HE) staining and apoptotic cell number were measured. The results of RNA sequencing were analyzed to determine the differential expression changes of genes among sham, MCAO and TEAS groups, in order to investigate the possible pathological processes involved in cerebral ischemia and explore the protective mechanisms of TEAS. Moreover, oxidative stress markers including MDA, SOD, GSH and GSH-Px were measured with assay kits. The levels of the proinflammatory cytokines, such as IL-6, IL-1ß and TNF-α, were detected by ELISA assay, and Iba-1 (the microglia marker protein) positive cells was measured by immunofluorescence (IF). Western blot and IF were utilized to examine the levels of key molecules in SIRT1/FOXO3a and SIRT1/BRCC3/NLRP3 signaling pathways. RESULTS: TEAS significantly decreased brain infarcted size and apoptotic neuronal number, and alleviated neurological deficit scores and morphological injury by activating SIRT1. The results of RNA-seq and bioinformatic analysis revealed that oxidative stress and inflammation were the key pathological mechanisms, and TEAS alleviated oxidative injury and inflammatory reactions following ischemic stroke. Then, further investigation indicated that TEAS notably attenuated neuronal apoptosis, neuroinflammation and oxidative stress damage in the hippocampus of rats with MCAO/R surgery. Moreover, TEAS intervention in the MCAO/R model significantly elevated the expressions of SIRT1, FOXO3a, CAT, BRCC3, NLRP3 in the hippocampus. Furthermore, EX527, as the inhibitor of SIRT1, obviously abolished the anti-oxidative stress and anti-neuroinflammatory roles of TEAS, as well as reversed the TEAS-mediated elevation of SIRT1, FOXO3a, CAT and reduction of BRCC3 and NLRP3 mediated by following MCAO/R surgery. CONCLUSIONS: In summary, these findings clearly suggested that TEAS attenuated brain damage by suppressing apoptosis, oxidative stress and neuroinflammation through modulating SIRT1/FOXO3a and SIRT1/BRCC3/NLRP3 signaling pathways following ischemic stroke, which can be a promising treatment for stroke patients.

Consumption of herbal infusions/decoctions and tea in Greece: a Planeterranean perspective on the results of Hydria survey.

BACKGROUND: The consumption of various herbal infusions was and is common in the traditional Mediterranean diet, and apparently are used in many other regions of the world outside of the Mediterranean region. The present study aimed to investigate the consumption of herbal infusions/decoctions and tea in a nationally representative sample of Greece, considering also their Planetary use. METHODS: 3951 adult participants of the HYDRIA Survey (2013-2014) were included from the 13 regions of Greece. The diet of participants was assessed by two 24-h dietary recalls (24-HDR) and the Food Propensity Questionnaire (FPQ). All food items were analyzed through the HYDRIA Food Composition Tables. Information on socio-demographics, lifestyle, and health characteristics during the baseline was also provided. RESULTS: 26.9% of herbal infusions and decoctions consumers are ≥ 75 years old, pensioners with a low level of education, and residents of urban areas. However, 22.2% of tea consumers belong to the 18-34-year age group, being employed with an intermediate level of education and living in an urban area. Elderly men and women use more herbal infusions/decoctions (55.4%; 40.6%) compared to tea (41.8%; 25.2%). According to FPQ, 7.1% of men and 9.7% of women use herbal infusions and decoctions four times or more per week, while 7.1 and 10.9% of men and women, respectively, consume tea at the same frequency. Green tea, mountain tea (Sideritis spp.), and black tea are reported most frequently. In addition, mountain tea (61.2%), black tea (60.3%), mixed herbal infusions/decoctions (58.4%), and sage (59.4%) are consumed mostly at breakfast, while chamomile was reported mainly at dinner or during the night (42.4%). CONCLUSIONS: Based on the FPQ results, the moderate and high consumption of herbal infusions/decoctions and tea is low in Greece, especially among adults (18-64 years). Thus, our results indicate the existence of a generation gap to the attachment to the traditional Med Diet and the consumption of herbal infusions. The present study could encourage future research to focus on herbal infusions and decoctions consumption by other populations for cross-cultural comparison, as well as on emphasizing the value of consuming locally available herbs in a Planeterranean perspective.

Comparison of Pivot Profile (PP), Rate-All-That-Apply (RATA), and Pivot-CATA for the sensory profiling of commercial Chinese tea products.

Rapid sensory profiling methods relying on consumers' perceptions are getting prevalent and broadly utilized by labs and companies to supersede conventional sensory profiling methodologies. Till now, various intensity-based sensory methods such as the newly proposed Pivot-Check-All-That-Apply (CATA) are limitedly developed and compared. In this investigation, Pivot Profile (PP), Rate-All-That-Apply (RATA), and Pivot-CATA methods were applied and validated using tea consumers and commercial Chinese tea products as samples. Data from three approaches were collected, analyzed by correspondence analysis (CA), and used to compare the three methods assessing the panel assessment process, sensory maps, confidence ellipses, and practical applications. Pivot-CATA exhibited a high similarity with RATA (RV = 0.873), and a lower similarity with PP (RV = 0.629). Of the three intensity-related methods, confidence ellipses on the RATA sensory map were the smallest and overlapped the least. However, Pivot-CATA consumed less time in collecting data and its questionnaire was more friendly to participants compared with PP and made the difference in intensity of samples more noticeable to the participants than RATA due to the existence of the pivot sample. Its experimental versatility also allows for a wide range of applications, indicating that the Pivot-CATA is an approach with great promise for routine use.

Effects of transcutaneous electrical acupoint stimulation (TEAS) on postoperative pain in patients undergoing gastric and esophageal ESD surgery: a study protocol for a prospective randomized controlled trial.

BACKGROUND: Post-operative pain of endoscopic submucosal dissection (ESD) is always be overlooked and undertreated by endoscopists. However, the incidence of moderate to severe pain after ESD is as high as 44.9% to 62.8%, which can greatly affect the patient's recovery, reduce their satisfaction, and extend their hospital stay. Transcutaneous electrical acupoint stimulation (TEAS) have been shown to reduce postoperative pain and enhance gastrointestinal (GI) function recovery in patients undergoing abdomen surgery. However, there is no evidence regarding on the effect of TEAS on post-operative pain and complications in patients undergoing ESD. Therefore, we aim to investigate whether perioperative TEAS treatment is superior to the sham acupuncture in terms of post-ESD pain and GI function recovery. METHODS: This study is a prospective, randomized controlled trail, which is single-blinded and in single center. A total of 120 patients undergoing elective gastric and esophageal ESD surgery in Beijing Friendship Hospital, Capital Medical University, will be involved in this study. These individuals will be stratified according to the type of ESD surgery (i.e. gastric or esophageal procedure) and be randomly divided into two groups. L14, PC6, ST36 and ST37 will be stimulated at the TEAS treatment group, and the control group will receive simulation at four sham acupoints. The primary outcome is post-EDS VAS score at the time of entering PACU, 10 min, 20 min, 30 min, 1 h, 2 h, 4 h, 6 h, 18 h, 24 h, 48 h after the surgery. The secondary outcomes include the anesthesia-associated parameters, sedation score, nausea and vomiting score, shivering score, recovery of gastrointestinal function, satisfaction of patients to anesthesia, incidence of postoperative complications, QLQ-C30 life quality scale, and the economic indicators. DISCUSSION: The results of this study will confirm that continuous preventive application of TEAS can alleviate the postoperative pain among patients with gastric and esophageal ESD surgery and accelerate the recovery of post-ESD gastrointestinal function. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ID: ChiCTR2100052837, registered on November 6, 2021. http://www.chictr.org.cn/showproj.aspx?proj=135892 .

Cost-effective colorimetric sensor for authentication of protected designation of origin (PDO) Longjing green tea.

Traceability and authentication of protected designation of origin (PDO) tea is an important prerequisite to safeguard its production and distribution system. Here, indicator displacement array (IDA) sensors consisting of natural anthocyanidins and edible metal ions were developed to authenticate PDO and non-PDO Longjing from different origins. Five IDA elements were selected for constructing sensors, achieved by an indicator displacement reaction after adding epigallocatechin gallate solution. The obtained sensors were subsequently used for real tea samples. Unsupervised algorithms were used for data exploration among PDO and non-PDO teas. The supervised support vector machine (SVM) model further achieved accurate authentication of PDO and non-PDO Longjing with a correct classification rate of 100% for the 26 validated samples. The developed IDA sensor thus achieves accurate authentication of PDO tea in a hazard-free and cost-efficient way, providing a useful tool for origin authentication of other agricultural products.

Evaluation of Tropane Alkaloids in Teas and Herbal Infusions: Effect of Brewing Time and Temperature on Atropine and Scopolamine Content.

Atropine and scopolamine belong to the tropane alkaloid (TA) family of natural toxins. They can contaminate teas and herbal teas and appear in infusions. Therefore, this study focused on analyzing atropine and scopolamine in 33 samples of tea and herbal tea infusions purchased in Spain and Portugal to determine the presence of these compounds in infusions brewed at 97 °C for 5 min. A rapid microextraction technique (µSPEed®) followed by high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) was used to analyze the selected TAs. The results showed that 64% of the analyzed samples were contaminated by one or both toxins. White and green teas were generally more contaminated than black and other herbal teas. Of the 21 contaminated samples, 15 had concentrations above the maximum limit for liquid herbal infusions (0.2 ng/mL) set by Commission Regulation (EU) 2021/1408. In addition, the effects of heating conditions (time and temperature) on atropine and scopolamine standards and naturally contaminated samples of white, green, and black teas were evaluated. The results showed that at the concentrations studied (0.2 and 4 ng/mL), there was no degradation in the standard solutions. Brewing with boiling water (decoction) for 5 and 10 min allowed for higher extraction of TAs from dry tea to infusion water.

Effect of perioperative acupuncture-assisted general anesthesia on the anesthetic dosage required in adult surgical patients: a network meta-analysis of randomized controlled trials.

Objective: To determine the comparative effects of acupuncture and related techniques-assisted general anesthesia (GA) on the total dosage of main anesthetic drugs administered during surgery. Methods: The following data bases were searched on June 30, 2022: Embase, Cochrane, PubMed, Web of Science, CBM, CNKI, WANFANG and VIP to find randomized controlled trials (RCTs). A random-effects Bayesian network meta-analysis and subgroup analysis were employed. The GRADE system was applied to make evidence quality assessments. The intraoperative total doses of propofol and remifentanil were the primary and secondary outcomes, respectively. The weighted mean difference (WMD) with 95% confidence intervals (CI) were determined to measure the size of any potential effect. Results: Seventy-six RCTs that involved 5,877 patients were included in the analysis. Compared with GA, a significant decrease in the total dose of propofol was found for manual acupuncture (MA) assisted GA (WMD = -101.26 mg, 95% CI [-172.98, -27.06]) with moderate quality, electroacupuncture (EA) assisted GA (WMD = -54.25 mg, 95% CI [-87.25, -22.37]) with moderate quality and transcutaneous electrical acupoint stimulation (TEAS) assisted GA (WMD = -39.99 mg, 95% CI [-57.96, -22.73]) with moderate quality, respectively. A significant reduction in the total dose of remifentanil was found in favor of EA-assisted GA (WMD = -372.33 µg, 95% CI [-558.44, -196.43]) with low quality and TEAS-assisted GA (WMD = -215.77 µg, 95% CI [-305.23, -128.04]) with low quality. According to the surface under cumulative ranking area (SUCRA), MA-assisted GA and EA-assisted GA ranked first in the reduction of the total dosage of propofol and remifentanil administered, with a probability of 0.85 and 0.87, respectively. Conclusions: Both EA- and TEAS-assisted GA significantly reduced the intraoperative total dosage of propofol and remifentanil administered. EA produced the greatest reduction in these two outcomes compared to TEAS. Although all the comparisons are low to moderate based on GRADE evidence, EA seems to be an advisable acupuncture technique to reduce the dosage of anesthetic drugs required in surgical patients under GA.

Enantiomeric separation and precise quantification of chiral volatiles in Wuyi rock teas using an efficient enantioselective GC × GC-TOFMS approach.

Chiral volatiles play important roles in the formation of aroma quality of foods. To date, enantiomeric characteristics of chiral volatiles in Wuyi rock tea (WRT) and their aroma contributions are still unclear. In this study, an efficient enantioselective comprehensive two-dimensional gas chromatography-time-of-flight mass spectrometry (Es-GC × GC-TOFMS) approach to separate and precisely quantitate 24 pairs of chiral volatiles in WRTs was established, and the enantiomeric distribution and aroma contribution of chiral volatiles among WRTs from four representative cultivars were investigated. Enantiomeric ratio (ER) of R-α-ionone (80%) in Dahongpao (DHP), ER of S-α-terpineol (57%) in Jinfo (JF), ERs of R-γ-heptanolactone (69%), S-γ-nonanolactone (55%), (2R, 5S)-theaspirane B (91%), concentration of S-(E)-nerolidol (313.37 ng/mL) in Rougui (RG) and concentration of R-α-ionone (33.01 ng/mL) in Shuixian (SX) were unique from other types of WRTs, which were considered as the potential chemical markers to distinguish WRT cultivars. The OAV assessment determined 7 volatile enantiomers as the aroma-active compounds, especially R-α-ionone and R-δ-octanolactone in SX, as well as S-(E)-nerolidol and (1R, 2R)-methyl jasmonate in RG contribute much to aroma formation of the corresponding WRTs. The above results provide scientific references for discrimination of tea cultivars and directed improvement of the aroma quality of WRT.

Application and efficacy of transcutaneous electrical acupoint stimulation (TEAS) in clinical practice: A systematic review.

Transcutaneous electrical acupoint stimulation (TEAS) is an emerging therapeutic approach that combines the effects of transcutaneous electrical nerve stimulation (TENS) with acupuncture point stimulation. Due to its noninvasive nature, it possesses relative advantages over traditional acupuncture and needle-based electrostimulation. Despite the large number of randomized clinical trials (RCTs) describing the effectiveness of TEAS in different applications, its role and mechanism are still not fully understood. The aim of this study was to systematically compare and summarize the latest studies examining a variety of TEAS applications in clinical practice. Databases, including Medline (PubMed), Cochrane Library and Google Scholar were searched without any time restrictions (as of March 2021). The analysis was performed according to the Cochrane Collaboration criteria. Out of 637 studies, only 22 RCTs were selected. Nine studies evaluated the impact of TEAS on nausea and vomiting (NV), showing beneficial effects compared to standard therapy. Eight RCTs examined the effectiveness of TEAS in pain management, reporting pain alleviation described using the visual analog scale (VAS) and lowering of total opioid doses. Improvement of postoperative recovery, in vitro fertilization and pregnancy outcomes, as well as display of cardioprotective properties were found to positively correlate with TEAS. As a noninvasive modality with advantages over classical acupuncture and needle-based electrostimulation, TEAS may be a valuable tool in clinical practice, particularly for pain and NV management. However, considering the methodological quality of the RCTs, rigorous large-scale clinical trials are required to evaluate the clinical utility of this method.

Pesticides, trace elements and pharmaceuticals in tea samples available in Belgian retail shops and the risk associated upon acute and chronic exposure.

Over the last decade, the consumption of tea and herbal tea has gained more and more popularity across the globe, but the potential presence of chemical contaminants (e.g. pesticides, trace elements, synthetic drugs) may raise health concerns. This study analysed selected teas available in Belgian retail stores and performed a risk assessment for these samples. No chemical adulteration could be detected in dry tea material. More than 38% of the dry leaves samples contained at least one pesticide exceeding the maximal residue level (MRL) set by the EU. However, further risk assessment, based on the values of pesticide residues and the toxic trace elements encountered in the brew, demonstrate that the consumption of these teas will not give rise to health concerns. Nonetheless, attention should be given to the leaching potential of nickel from teas and the presence of arsenic in brews from algae containing teas.

Developing an ultrasensitive immunochromatographic assay for authentication of an emergent fraud aminopyrine in herbal tea.

Aminopyrine is a nonsteroidal anti-inflammatory drug only for medical purposes, however, it has been illegally added in traditional Chinese herbal teas for fraud activity recently. In this study, a specific antibody against aminopyrine with IC50 of 3.00 ng/mL was obtained for the first time by a rational hapten design. Furthermore, an ultrasensitive gold nanoparticles immunochromatographic assay (AuNPs-ICA) for determination of aminopyrine based on a portable reader was firstly developed, with cut-off value of 100.00 ng/mL, limit of detection (LOD) of 4.80 ng/mL and limit of quantification (LOQ) of 5.71 ng/mL for herbal tea, respectively. The recovery rates ranged from 93.21 % to 105.61 %, with inter-assay coefficient of variation (CV) from 1.08 % to 3.82 %. Additionally, 24 blind samples were examined simultaneously by AuNPs-ICA and LC-MS/MS, demonstrating a good consistency for each other. The proposed AuNPs-ICA is an ultrasensitive and reliable tool for on-site surveillance screening of fraud additives in herbal tea.

Comparison and Risk Assessment of Macroelements and Trace Metals in Commercial Teas from Different Regions of China.

Tea (Camellia sinensis L.) is one of the most widely consumed non-alcoholic beverages worldwide. In the present study, 73 commercial tea samples were collected from tea plantations in the Southwest, South, Jiangnan, and Jiangbei regions of China. The contents of four macroelements (phosphorus (P), potassium (K), calcium (Ca) and magnesium (Mg)) and 15 trace metals (arsenic (As), cadmium (Cd), chromium (Cr), mercury (Hg), lead (Pb), zinc (Zn), aluminium (Al), copper (Cu), manganese (Mn), iron (Fe), nickel (Ni), thorium (Th), thallium (Tl), rubidium (Rb) and barium (Ba)) in tea samples were determined. The mean concentrations of As, Cd, Cr, Hg, Pb, Zn, Al, Cu, Mn, Fe, Ni, Th, Tl, Rb and Ba were in the range of 0.02-0.61, 0.008-0.126, 0.09-1.12, 0.001-0.012, 0.07-1.62, 19.5-73.2, 170-2100, 5.9-43.3, 228-2040, 60-337, 2.09-17.95, 0.002-0.08, 0.004-0.409, 0-150.50 and 3.1-41.2 µg/g, respectively, which were all lower than the maximum permissible limits stipulated by China (NY/T 288-2012, NY 659-2003). The target hazard quotients of each heavy metal were lower than one, and the combined risk hazard index of all heavy metals for adults was in the range of 0.10-0.85; therefore, there was no significant carcinogenic health risks to tea drinking consumers under the current dietary intake. Significant differences were found in the content of trace elements (Zn, Cu, Fe, Ni, Th, Tl, Rb and Ba) (p < 0.05); however, no significant differences were found in the content of macroelements (P, K, Ca and Mg) and trace metals (As, Cd, Cr, Hg, Pb, Al and Mn) in teas from different regions. Therefore, the region did not affect the heavy metal exposure risk. Correlation coefficient and principal component analyses were performed to determine the source of the elements. Three principal factors were obtained: factor 1 was positively related to Ca, Mg, As, Cd, Cr, Hg, Pb, Al, Mn, Fe and Th (32.63%); factor 2 to P, Zn, Cu and Ni (18.64%) and factor 3 to K and Rb (10.10%). Thus, the elements in the same factor might originate from the same source. This study provides an essential basis to understand the variance and potential risks of different elements in tea from different regions of China.

Multi-commutated flow system for inorganic selenium speciation in infusion tea samples by chemical vapor generation atomic fluorescence spectrometry.

This work proposes an automated strategy for the inorganic selenium speciation in infusion tea samples, employing an MSFIA-CVG-AFS system and sodium tetrahydroborate for chemical vapor generation. The selenium total is determined after an online prereduction step of selenium (VI) to selenium (IV) in alkaline media, using a UV reactor with a 15 W Hg lamp. Selenium (IV) is quantified directly on the sample, and selenium (VI) is determined by the difference between the total selenium and selenium (IV) concentrations. The optimization of the chemical parameters: hydrochloric acid - hydrobromide acid solution concentration, potassium iodide concentration, sodium hydroxide concentration, and sodium tetrahydroborate concentration was performed using a (24-1) two-level fractional factorial design. The validation parameters were determined for total selenium and selenium (IV), and the results found were: limits of detection and quantification of 0.05 and 0.18 µg L-1, respectively; a linear range of 0.18-5.0 µg L-1, precision expressed as the relative standard deviation of 2.1% for a sample number of 10, for both analytes. The system allows the speciation analysis with an injection throughput of 15 injections per hour. This analytical method was applied for inorganic selenium speciation in nine infusions of tea samples purchased commercially in supermarkets in Palma de Mallorca City, Spain. The concentrations of selenium (IV) and total selenium varied from 0.2 to 0.6 µg L-1 and 0.4-2.0 µg L-1, respectively. The accuracy method was evaluated using spike tests, and the recoveries achieved varied from 91 to 111%.

Transcutaneous electrical acupoint stimulation to reduce opioid consumption in patients undergoing inguinal hernia repair: protocol for a randomized controlled trial.

BACKGROUND: The purpose of this study is to evaluate the efficacy and safety of transcutaneous electrical acupoint stimulation (TEAS) in the postoperative treatment of patients undergoing inguinal hernia repair compared with sham and no treatment group. METHODS: This study is a protocol for a three-armed, single-blinded, placebo-controlled randomized controlled trial. Ninety participants scheduled for inguinal hernia repair will be randomly assigned to the TEAS group (n = 30), sham group (n = 30), and control group (n = 30). The TEAS group will receive treatment using four portable coin-sized electro-stimulators at both local and distal acupuncture points. The sham group will receive sham treatment with mock electrostimulation. The treatment groups will receive mixed frequency stimulation (alternating at 2 and 100 Hz every 3 s) in continuous mode for 30 min at intervals of 2 h for 24 h postoperatively. The control group will receive postoperative pain control using patient-controlled analgesia (PCA) device. The primary outcome is the total morphine dose received in the postoperative period (mg) using PCA 24 h after surgery. The number of PCA demands (i.e., times the button will be pressed) and delivered bolus doses, score on the Visual Analogue Scale, opioid-related side effects, the requirement for supplemental medications, score on the Hospital Anxiety and Depression Scale (HADS), and blood levels of stress hormones cortisol and prolactin. DISCUSSION: The results of this trial will determine whether TEAS with intensified stimulation protocol is a safe and effective option for reducing analgesic consumption and postoperative pain. TRIAL REGISTRATION: ISRCTN76428396. Registered on 05 October 2020. https://www.isrctn.com/ISRCTN76428396.

[Auricular point sticking combined with transcutaneous electrical acupoint stimulation for smoking cessation：a randomized controlled trial].

OBJECTIVE: To compare the clinical efficacy between auricular point sticking combined with transcutaneous electrical acupoint stimulation (TEAS) and nicotine patch for smoking cessation. METHODS: Two hundred patients who voluntarily quit smoking were randomly divided into a combination group and a nicotine patch group, 100 cases in each group. In the combination group, auricular point sticking (Shenmen [TF4], Neifenmi [CO18], Pizhixia [AT4], Jiaogan [AH6a], etc., once every other day) combined with TEAS（Lieque [LU 7] and Zusanli [ST 36], with continuous wave, 20 Hz in frequency, 1 mA in current intensity, 30 min each time, once a day) were applied. In the nicotine patch group, nicotine patch was applied. Both groups were treated for 8 weeks. The immediate withdrawal rate and persistent withdrawal rate 8 weeks into treatment and in follow-up of 16 weeks after treatment in the two groups were compared; before treatment, 8 weeks into treatment and in follow-up of 16 weeks after treatment, the degree of nicotine dependence was evaluated by using Fagerström test for nicotine dependence (FTND); 1 week into treatment, 8 weeks into treatment and in follow-up of 16 weeks after treatment, the withdrawal symptoms and smoking craving were evaluated by using Minnesota nicotine withdrawal scale (MNWS); the safety and compliance (dropped off rate and treatment completeness) were evaluated in the two groups. RESULTS: There was no statistical significance of the differences in the immediate withdrawal rate and persistent withdrawal rate 8 weeks into treatment and during follow-up between the two groups (P>0.05). The FTND scores were decreased 8 weeks into treatment and during follow-up in the two groups compared with those before treatment (P<0.01); the FTND score during follow-up in the combination group was lower than the nicotine patch group (P<0.05). The MNWS scores were decreased 8 weeks into treatment and during follow-up in the two groups compared with those 1 week into treatment (P<0.05); the changes of MNWS scores 8 weeks into treatment and during follow-up in the combination group were greater than the nicotine patch group (P<0.05, P<0.01). There were no serious adverse reactions in either group. Eight weeks into treatment and during follow-up, the dropped off rates were all 16.0% (16/100) in the combination group, which were 20.0% (20/100) and 23.0% (23/100) in the nicotine patch group, there was no statistical significance of the differences in the two groups (P>0.05). There was no significant difference in treatment completeness between the two groups (P>0.05). CONCLUSION: Auricular point sticking combined with TEAS could effective decrease the degree of nicotine dependence, improve withdrawal symptoms in smokers, its effect is superior to nicotine patch.

Cytotoxicity and Genotoxicity of Senecio vulgaris L. Extracts: An In Vitro Assessment in HepG2 Liver Cells.

Senecio vulgaris L. is a herbaceous species found worldwide. The demonstrated occurrence of pyrrolizidine alkaloids in this species and its ability to invade a great variety of habitats result in a serious risk of contamination of plant material batches addressed to the herbal teas market; this presents a potential health risk for consumers. In light of the above, this work aimed to assess the cytotoxic and genotoxic activity of S. vulgaris extracts in HepG2 cells. Dried plants were ground and extracted using two different methods, namely an organic solvent-based procedure (using methanol and chloroform), and an environmentally friendly extraction procedure (i.e., aqueous extraction), which mimicked the domestic preparation of herbal teas (5, 15, and 30 min of infusion). Extracts were then tested in HepG2 cells for their cytotoxic and genotoxic potentialities. Results were almost superimposable in both extracts, showing a slight loss in cell viability at the highest concentration tested, and a marked dose-dependent genotoxicity exerted by non-cytotoxic concentrations. It was found that the genotoxic effect is even more pronounced in aqueous extracts, which induced primary DNA damage after five minutes of infusion even at the lowest concentration tested. Given the broad intake of herbal infusions worldwide, this experimental approach might be proposed as a screening tool in the analysis of plant material lots addressed to the herbal infusion market.

Effect of TEAS combined with general anesthesia on early postoperative cognitive function in elderly patients undergoing single-port thoracoscopic lobectomy.

Objective: To investigate the effect of transcutaneous electrical acupoint stimulation (TEAS) on early cognitive function in elderly patients after single port thoracoscopic lobectomy. Methods: One hundred and nine patients who underwent single whole thoracoscopic lobectomy in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2020 to October 2021 were included in this single-center, retrospective observational study. According to the treatment records, before anesthesia, 56 patients received TEAS (TEAS-group), and 53 patients applied electrodes at the same acupoint without electrical stimulation (control-group). Preoperative and postoperative cognitive function (Mini mental state examination, MMSE score), serum neuron specific enolase (NSE), S100ß protein and p-tau protein levels and postoperative complications were compared between the two groups. Results: After operation, the MMSE of the TEAS-group was significantly better than that of the Control-group, with the MMSE of the TEAS-group returned to the preoperative level 72 hours after operation. Serum NSE, S100ß and p-tau concentrations 24 hours and 72 hours after operation in the TEAS-group returned to their preoperative level and were significantly lower than those in the control-group. Hospitalization time of the TEAS-group was significantly shorter and hospitalization expenses were significantly lower comparing to the control-group. Conclusion: TEAS treatment could promote improved early postoperative cognitive function of elderly patients undergoing single port thoracoscopic lobectomy and could accelerate the recovery.

Organochlorine pesticides in therapeutic teas and human health risk assessment.

This study evaluated commercially available therapeutic teas for their organochlorine pesticides (OCPs) residue levels to estimate the potential health risks associated with their prolonged consumption. Tea samples that were produced for therapeutic uses were obtained commercially. Organochlorine pesticide residues were extracted from the samples using the modified QuEChERS (Quick, Easy, Cheap, Effective, Rugged, and Safe) method and analysed using Gas Chromatography with Electron Capture Detector (GC-ECD). Results showed that the tea samples contained a large number of OCPs residue at levels that were significantly higher than the maximum residue limits (MRLs) set by the European Union (p > 0.05). Aldrin was detected in all samples, methoxychlor, and p,p'-DDT were detected in ≥88% of the samples while γ-HCH, δ-HCH, endosulfan II, and endosulfan sulphate were detected in ≥69% of the samples. Health risk assessment indicated that the highest risk of cancer was associated with aldrin.