Huoxue Tongluo decoction combined with acupuncture in the treatment of lumbar disc herniation and its effect on JOA and VAS scores.

BACKGROUND: Lumbar disc herniation (LDH) is a common clinical disease of the skeletal system, and its prevalence has been on a rise. OBJECTIVE: To evaluate the efficacy of Huoxue Tongluo decoction plus acupuncture in the treatment of lumbar disc herniation and its effectiveness in improving the functional recovery of the patients' affected joints and mitigating their pain. METHODS: In this prospective study, 110 patients with lumbar disc herniation enrolled in our Hospital from June 2019 to June 2021 were collected and randomized to receive either conventional treatment (control group) or Huoxue Tongluo Decoction plus acupuncture (study group). RESULTS: Huoxue Tongluo Decoction plus acupuncture resulted in more rapid mitigation of lower extremity symptoms and lumbar symptoms versus conventional treatment (P< 0.05). Patients receiving traditional Chinese medicine (TCM) showed milder inflammatory responses than those with conventional medication, as evidenced by the lower serum concentrations of tumor necrosis factor-α (TNF-α), interleukin (IL)-6, and high-sensitivity C-reactive protein (hs-CRP) (P< 0.05). After treatment, the study group had higher Japanese Orthopedic Association (JOA) scores and lower visual analogue scale (VAS) scores than the control group (P< 0.05), suggesting that the combination of the herbal decoction and acupuncture provided better functional recovery of the affected joints and pain mitigation for the patients. Furthermore, the lower Pittsburgh sleep quality index (PSQI) scores in patients in the study group indicated better sleep quality of patients after TCM intervention than after conventional treatment (P< 0.05). Huoxue Tongluo Decoction plus acupuncture was associated with a significantly higher efficacy (94.55%) versus conventional treatment (80%) (P< 0.05). CONCLUSIONS: Huoxue Tongluo Decoction combined with acupuncture significantly offers a viable treatment alternative for lumbar disc herniation with promising treatment outcomes, mitigates patients' limb pain, and improves their lumbar function and sleep quality. Further trials are, however, required prior to general application in clinical practice.

Moxibustion for primary dysmenorrhea: A protocol for evidence-based clinical practice guideline.

BACKGROUND: Primary dysmenorrhea (PD) is a common gynecological disease characterized by lower abdominal pain. Moxibustion as a traditional Chinese treatment, can effectively treat PD with few adverse reactions. Nowadays, there is still no standard guideline for moxibustion treatment of PD, so related clinical practice guidelines need to be developed. METHODS: This guideline will be developed in line with the latest guideline definition from Institute of Medicine, and that applies the GRADE system as well as the World Health Organization handbook to appraise the quality of evidence and develop recommendations. We will set up a Guideline working group, put forward the corresponding problems based on the principle of Population, Intervention, Comparison, Outcomes (PICO), and complete the literature retrieval. After achieving consensus through evidence syntheses and 2 to 3 rounds of Delphi process, we will also consider patients values and preferences and implement peer review in the guideline. RESULT: We will put forward evidence-based best practice recommendations and moxibustion standard to improve the symptoms caused by primary dysmenorrhea in a more efficient way. At present, the research is still in progress, and there is no result to report. CONCLUSIONS: This guideline will be helpful to clinical acupuncturists and other professionals to further improve clinical efficacy in treating PD with moxibustion. Moreover, we will also constantly update and evaluate the evidence to both support recommendations and identify gap areas for future research. SYSTEMATIC REVIEW REGISTRATIONS: registration number: IPGRP-2020CN021.

Magnetic-induced graphene quantum dots for imaging-guided photothermal therapy in the second near-infrared window.

Graphene quantum dots (GQDs) are considered emerging nanomaterials for photothermal therapy (PTT) of cancer due to their good biocompatibility and rapid excretion. However, the optical absorbance of GQDs in shorter wavelengths (<1000 nm) limits their overall therapeutic efficacies as photothermal agent in the second near infrared window (1000-1700 nm, NIR-II). Herein, we report a type of GQDs with strong absorption (1070 nm) in NIR-II region that was synthesized via a one-step solvothermal treatment using phenol as single precursor by tuning the decomposition of hydrogen peroxide under a high magnetic field with an intensity of 9T. The obtained 9T-GQDs demonstrate uniform size distribution (3.6 nm), and tunable fluorescence (quantum yield, 16.67%) and high photothermal conversion efficacy (33.45%). In vitro and in vivo results indicate that 9T-GQDs could efficiently ablate tumor cells and inhibit the tumor growth under NIR-II irradiation. Moreover, the 9T-GQDs exhibited enhanced NIR imaging of tumor in living mice, suggesting the great probability of using 9T-GQDs for in vivo NIR imaging-guided PTT in the NIR-II window.

Comparing the Effectiveness of Electroacupuncture with Different Grades of Knee Osteoarthritis: A Prospective Study.

BACKGROUND: The electroacupuncture (EA) with different number of points significantly affected its efficacy on knee osteoarthritis (KOA), and the severity of KOA also influenced its response to treatments. Hence, we prospectively compared the clinical efficacy of EA on KOA with different severities. METHODS: A total of 132 KOA patients recruited from 181st Central Hospital of The Chinese People's Liberation Army between March 2014 and March 2015 were classified into 4 KOA stages according to Kellgren Lawrence grading scale. They were allocated into three treatment groups, including two-point group, four-point group and six-point group. Patients in the six-point group received treatment at six-points including ST34, SP10, SP9, ST36, ST35 and EX-LE4. Patients in the four-point group received treatment at ST34, SP10, ST35 and EX-LE5, while patients in the two-point group received treatment at ST35 and EX-LE4. Visual Analog Scale (VAS), McMaster Universities Osteoarthritis Index (WOMAC) and self-assessment questionnaire of patients were assessed after treatment. RESULTS: Three kinds of EA treatments all have significant clinical effects on KOA patients with down-regulated scores of VAS and WOMAC. Regarding post-treatment efficacy, the six point group exhibited lower VAS score and higher WOMAC score compared with the other two groups. For patients with different KOA grades, patients with higher KOA grades were associated with lower grade of treatment efficacy. CONCLUSIONS: Patients with KOA, especially those with lower KOA stages, could gain beneficial efficacies from EA treatments with two, four and six points, respectively.

[Effect of a chemical primer on the bond strength of a zirconia ceramic with self-adhesive resin cement].

OBJECTIVE: To evaluate the bond strength and durability of a self-adhesive resin cement with a zirconia ceramic pretreated by a zirconia primer. METHODS: Zirconia ceramic (Vita Inceram YZ) plates with a thickness of 2.5 mm were fired, polished, and then cleaned. Half of the polished ceramic plates were sandblasted with 50 µm alumina particles at 0.3 MPa for 20 s. The surface compound weight ratios were measured via X-ray fluorescence microscopy. The polished and sandblasted ceramic plates were directly bonded with self-adhesive resin cement (Biscem) or were pretreated by a zirconia primer (Z Primer Plus) before bonding with Biscem. The specimens of each test group were divided into two subgroups (n=10) and subjected to the shear test after 0 and 10,000 thermal cycles. The data were analyzed via three-way ANOVA. RESULTS: After air abrasion, 8.27% weight ratio of alumina attached to the zirconia surface. Compared with air abrasion, primer treatment more significantly improved the primary resin bond strength of the zirconia ceramic. The primary resin bond strength of the zirconia ceramic with no primer treatment was not affected by thermocycling (P>0.05). However, the primary resin bond strength of the zirconia ceramic with primer treatment was significantly decreased by thermocycling (P<0.05). CONCLUSION: Primer treatment can improve the primary resin bond strengths of zirconia ceramics. However, the bond interface of the primer is not stable and rapidly degraded during thermocycling.

[Post-stroke depression treated with acupuncture and moxibustion: an evaluation of therapeutic effect and safety].

OBJECTIVE: To evaluate the efficacy and safety of acupuncture and moxibustion in the treatment of post-stroke depression (PSD) by regulating the liver and strengthening the root prescription. METHODS: In light of the random controlled trial principle, 123 cases were randomized into an acupuncture-moxibustion group (42 cases), a medication group (40 cases) and an acupuncture + medication group (41 cases). In the acupuncture-moxibustion group, the therapy of regulating the liver and strengthening the root was applied. Acupuncture was given at Hegu (LI 4), Taichong (LR 3), Baihui (GV 20, Yintang (GV 29), etc. The granule moxibustion was applied at Zhongwan (CV 12), Xiawan (CV 10), Guanyuan (CV 4) and Qihai (CV 6). The treatment was given once a day and stopped in weekend. In the medication group, paroxetine hydrochloride tablets were prescribed for oral administration, 20 mg each day after breakfast. In the acupuncture + medication group, the therapies were adopted as the acupuncture-moxibustion group and the medication group. In the 2nd and 4th week of treatment, HAMD was used as the primary index and Barthel index as the secondary one for the efficacy assessment in the three groups respectively. The spleen and stomach syndrome scale of TCM was used for the assessment of TCM syndrome efficacy. Treatment emergent symptom scale (TESS) was applied for the safety assessment. RESULTS: In the 4th week of treatment, the markedly effective rates were 69.0% (29/42), 65.0% (26/40) and 70.7% (29/41) in the acupuncture-moxibustion group, the medication group and the acupuncture + medication group respectively. The efficacies of anti-depression were similar in comparison among groups (P > 0.05). In the 2nd week of treatment, the improvement of HAMD score was significant in the acupuncture + medication group as compared with that before treatment and in comparison with the medication group (P < 0.05, P < 0.01). As for improving Barthel index, reducing the spleen and stomach symptom score of TCM and decreasing the score of TESS, the results in the acupuncture-moxibustion group and the acupuncture + medication group were superior to those in the medication group (P < 0.05, P < 0.01). CONCLUSION: The therapy of acupuncture and moxibustion with regulating the liver and strengthening the root achieves the definite efficacy of anti-depression and presents the quite high safety in treatment.

[Observation on relations between onset seasons of peripheral facial paralysis and therapeutic courses and effect of acupuncture].

OBJECTIVE: To observe the influences of seasonal factors on peripheral facial paralysis by acupuncture. METHODS: Four hundred cases of facial paralysis were divided into spring, summer, autumn and winter groups, 100 cases in each group. All these cases were treated by routine puncture. Fengchi (GB 20), Yifeng (TE 17), Qianzheng (Extra), Jiache (ST 6), and Dicang (ST 4), etc. were applied at affect side, once a day. 2 months observation was carried on to compare the clinical therapeutic effects and average courses. The facial symptoms, physical sign and functional activities were taken as observation indexes of therapeutic effect. RESULTS: The effect rate was 78.0% (78/100) in spring group, 82.0% (82/100) in summer group, 89.0% (89/100) in autumn group and 92.0% (92/100) in winter group; the effect rate in summer or autumn group was superior to those in spring group and in summer group (all P < 0.05); the average course was (47.6 +/- 22.3) days in spring group, (43.7 +/- 18.4) days in summer group, (31.5 +/- 11.3) days in autumn group and (22.6 +/-9.2) days in winter group, indicating the significant differences between groups except that between spring and summer group (all P < 0.01). The cured and markedly effective rate was 80.1% (161/201) for wind cold type, 53.5% (61/114) for wind heat type, and 36.5% (31/85) for damp heat type, indicating that it of wind cold type was superior to that of wind heat type or damp heat type (P < 0.001, P < 0.05). CONCLUSION: The syndrome distribution and courses of peripheral facial paralysis are different in different seasons, hence, the diseases should be treated according to attack time and syndromes.

[Observation on therapeutic effect of acupuncture at Xuanzhong (GB 39) combined with Chinese herbs pyrogenic dressing therapy for treatment of calcaneus spur].

OBJECTIVE: To compare therapeutic effects of acupuncture at Xuanzhong (GB 39) combined with Chinese herbs pyrogenic dressing therapy and common acupuncture on calcaneus spur. METHODS: A single-blind, randomized and controlled trial was adopted. Sixty-six cases were randomly divided into an observation group (n=34) and a common acupuncture group (n=32). The observation group was treated with acupuncture at Xuanzhong (GB 39) combined with Chinese herbs pyrogenic dressing therapy and the common acupuncture group with common acupuncture, Yanglingquan (GB 34), Kunlun (BL 60) etc. selected. The markedly effective rate and the changes of heel pain scores, heel swelling scores, heel burning sensation scores, and walking function scores were compared between the two groups before and after treatment. RESULTS: The markedly effective rate of 64.7% (22/34) in the observation group was higher than 37.5% (12/32) in the common acupuncture group (P<0.05). After treatment, all the scores in the two groups were significantly improved as compared with before treatment (all P<0.05), and the observation group was better than the common acupuncture group (all P<0.05). CONCLUSION: The therapeutic effect of acupuncture at Xuanzhong (GB 39) combined with Chinese herbs pyrogenic dressing therapy on calcaneus spur is superior to that of common acupuncture.

[Spontaneous odontogenic differentiation and critical gene expression of mouse dental papilla mesenchymal cell in vitro].

OBJECTIVE: To observe the spontaneous odontogenic differentiation of mouse dental papilla mesenchymal cells in blood serum medium. And to detect the critical gene expression of correlated transcription factors what are specific to odontogenic and osteogenic differentiation. METHODS: The primary dental papilla mesenchymal cells what had been obtained from E16.5 d murine embryo were serially subcultivated in the simple serum medium and the serum medium supplemented with LIF (leukocyte inhibitory factor) respectively. It was observed whether the dental papilla mesenchymal cells differentiated into odontoblast phenotype or kept the undifferentiation phenotype. The mRNA expression of specific transcription factors were detected in cells with or without odontogenic differentiation. RESULTS: The fourth generation and behind of mouse dental papilla mesenchymal cells what were cultured in simple serum medium could spontaneously differentiate to odontoblast, while the undifferentiation phenotype of dental papilla mesenchymal cells could be lasting to ninth generation when they cultured in medium supplemented with 10(6) U/L LIF. Whether the dental papilla cells differentiate to odontogenic phenotype or not, the members of HOX gene family such as Msx1/Msx2, Pax9 and Lhx6/Lhx7 got completely expression. These transcription factors were specific to odontogenic mesenchymal cells. Also the specific gene of mineralized tissue cells such as DSPP, Sox9, Cbfa1 and Osx initiated to express after the odontoblast differentiation. CONCLUSION: Not only this spontaneous odontogenic differentiation model of mouse dental papilla mesenchymal cells can be the positive control, but also the mode of gene expression can provide an evidence for studying how gene changes when adult stem cells are induced to odontogenic differentiation.

[Observation on therapeutic effect of acupuncture at "cervical three points" combined with cake-separated moxibustion on cervical hyperosteogeny].

OBJECTIVE: To compare therapeutic effects of acupuncture at "cervical three points" combined with cake-separated moxibustion and routine acupuncture at Jiaji (EX-B 2) on cervical hyperosteogeny. METHODS: Single blind, randomized and controlled methods were used and 91 cases were divided into an observation group of 46 cases and a control group of 45 cases. The observation group was treated by acupuncture at "cervical three points" combined with cake-separated moxibustion, i.e. acupuncture at Chonggu (EX), Dazhui (GV 14), Taodao (GV 13) and moxibustion at pain points with cake made by Rhizoma Atractylodis Macrocephalae and Radix Paeoniae Alba; the control group was treated with acupuncture at Jiaji (EX-B 2). Changes of sourness and pain of the neck, the shoulder and back, pressure pain and cervical activity scores were used for assessment of therapeutic effects. RESULTS: The markedly cured rate of 76.1% in the observation group was better than 42.2% in the control group (P<0.05). After treatment, the scores of all the items were significantly improved in the two groups (all P<0.05), and the observation group in sourness and pain of the neck, the shoulder and back, and cervical activity were better than the control group (all P<0.05). CONCLUSION: The therapeutic effect of acupuncture at "cervical three points" combined with cake-separated moxibustion on cervical hyperosteogeny is superior to routine acupuncture at Jiaji (EX-B 2).