An acupuncture manipulation classification system based on three-axis attitude sensor and computer vision. / ä¸€ç§åŸºäºŽä¸‰è½´å§¿æ€ä¼ æ„Ÿå™¨å’Œè®¡ç®—æœºè§†è§‰çš„é’ˆåˆºæ‰‹æ³•åˆ†ç±»ç³»ç»Ÿ.

OBJECTIVES: To explore the action characteristics of acupuncture manipulations by combining visual and sensor technique, so as to improve the identification and classification accuracy of acupuncture manipulations and to quantificate the classifiations. METHODS: In this paper, the time domain features of acupuncture physical parameters and dynamic gesture features in the video of acupuncture manipulations are combined together to identify and classify acupuncture techniques. The acupuncture needle manipulation processes of 2 acupuncture experts and 3 young acupuncturists were selected as the study objects. The collected data included 4 basic manipulation techniques：lifting-thrusting reinforcing, lifting- thrusting reducing, twisting reinforcing and twisting reducing methods, all of which were performed by right-handed doctors. During acupuncture manipulation, a three-axis attitude sensor was used to acquire finger moving acceleration velocity and needle-rotating angle velocity, followed by analyzing the parameters of hand-moving velocity, amplitude, strength and angle. The mapping relationship among physical parameters and different manipulating methods was formed in time domain. The computer vision technology was employed to extract the spatio-temporal features of the acupuncture manipulation video images, and a hybrid model of three-dimensional convolutional neural network (3D CNN) and long- and short-term memory (LSTM) neural network were used for the recognition and classification of dynamic gestures of hand in acupuncture manipulation videos. Then the time-domain features of physical parameters were combined with the dynamic gestures in the classification process, with the manipulation classification realized. RESULTS: In performing the lift-thrusting reinforcing method, the needle insertion speed was faster and the force was larger, while the needle lifting speed was slower and the force was smaller. And in performing the lift-thrusting reducing method, the needle lifting speed was faster, the force was stronger, and the needle insertion speed was slower and the force was smaller. In the performance of twisting reinforcing, the leftward twisting force was bigger and the rotation amplitude was larger, while in performing the reducing method, the rightward twisting force was larger and the rotation amplitude was larger. When using the mean value of time of acceleration, speed, and amplitude as the basis of discrimination, the accuracy rates of lifting-thrusting reinforcing and reducing were 95.56% and 93.33%, while those of the two twisting manipulations were 95.56% and 91.11%, respectively. Compared with the classification method that only uses the sensor to obtain the manipulation information, the recognition accuracy was significantly improved. CONCLUSIONS: The acupuncture manipulation classification system can achieve quantitative analysis of physical parameters and dynamic recognition of acupuncture techniques, providing a certain foundation for the quantification and inheritance of acupuncture techniques.

Relationship between 25-hydroxy vitamin D and knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials.

Objective: In order to examine the relationship between 25-hydroxyl vitamin D and knee osteoarthritis (KOA), a meta-analysis of 8 randomized controlled trials (RCTs) publications was hereby performed. Methods: For the purpose of finding pertinent research, the databases of PubMed, Embase and the Cochrane Library were searched. Factors including tibial cartilage volume, joint space width (JSW), synovial fluid volume, and Western Ontario and McMaster Universities Arthritis Index (WOMAC) were correspondingly evaluated, and the results were expressed using SMD and 95% confidence intervals (CI). Results: The present meta-analysis evaluated the effects of vitamin D supplementation in patients with knee osteoarthritis, with 3,077 patients included. The results showed that vitamin D administration had a statistically significant impact on the amount of synovial fluid, Visual Analog Scale (VAS) and tibial cartilage. The pain and function scales of the WOMAC scale presented a statistically significant difference, and there was no discernible difference between the vitamin D and placebo groups in the stiffness scale. Additionally, bone marrow lesions and alterations in the diameter of the joint space were not influenced by the administration of vitamin D, and according to a subgroup study, a daily vitamin D supplement containing more than 2,000 IU significantly slowed the development of synovial tissue. Conclusion: Vitamin D supplementation did benefit those suffering from knee discomfort and knee dysfunction. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022332033, identifier: CRD42022332033.

Motor function and fALFF modulation in convalescent-period ischemic stroke patients after scalp acupuncture therapy: a multi-centre randomized controlled trial.

BACKGROUND: Scalp acupuncture has been found to be effective at improving motor function after ischemic stroke, but few studies examining its central mechanisms of action have been carried out. The aim of this study was to investigate the clinical effects of scalp acupuncture on motor dysfunction and changes in spontaneous brain activity in patients with ischemic stroke. METHODS: This was an evaluator- and analyst-blinded, multi-center randomized controlled trial. A total of 108 convalescent-stage ischemic stroke patients with motor dysfunction were allocated to receive either scalp acupuncture combined with rehabilitation treatment (SR group) or rehabilitation treatment alone (RE group). Patients in both groups received treatment 5 times per week for 8 weeks. The primary outcome measure was the Fugl-Meyer assessment (FMA). Secondary outcome measures included the modified Barthel index (mBI), modified Rankin scale (mRS) and values of fractional amplitude of low frequency fluctuation (fALFF) acquired using a resting-state functional magnetic resonance imaging (rs-fMRI) technique. RESULTS: Both groups showed significant improvements in motor function, daily life ability and degree of disability, as measured by FMA, mRS and mBI (p < 0.05), and the SR group showed a significantly greater improvement (p < 0.05). Compared with the RE group, the areas where the fALFF values increased in the SR group were located in the cerebellum, praecuneus, precentral gyrus, superior frontal gyrus and parietal lobe. The improvement in FMA scores had the strongest correlation with the baseline fALFF values of the ipsilateral precentral gyrus. CONCLUSION: Scalp acupuncture improved motor function in convalescent-period ischemic stroke patients, and effects were correlated with regulation of motor-relevant brain regions. The fALFF value of the ipsilateral precentral and postcentral gyri could be potential clinical indices for prognostication of motor dysfunction. TRIAL REGISTRATION NUMBER: NCT03120650 (http://www.clinicaltrials.gov).

Pyroptosis is a drug target for prevention of adverse cardiac remodeling: The crosstalk between pyroptosis, apoptosis, and autophagy.

Acute myocardial infarction (AMI) is one of the main reasons of cardiovascular disease-related death. The introduction of percutaneous coronary intervention to clinical practice dramatically decreased the mortality rate in AMI. Adverse cardiac remodeling is a serious problem in cardiology. An increase in the effectiveness of AMI treatment and prevention of adverse cardiac remodeling is difficult to achieve without understanding the mechanisms of reperfusion cardiac injury and cardiac remodeling. Inhibition of pyroptosis prevents the development of postinfarction and pressure overload-induced cardiac remodeling, and mitigates cardiomyopathy induced by diabetes and metabolic syndrome. Therefore, it is reasonable to hypothesize that the pyroptosis inhibitors may find a role in clinical practice for treatment of AMI and prevention of cardiac remodeling, diabetes and metabolic syndrome-triggered cardiomyopathy. It was demonstrated that pyroptosis interacts closely with apoptosis and autophagy. Pyroptosis could be inhibited by nucleotide-binding oligomerization domain-like receptor with a pyrin domain 3 inhibitors, caspase-1 inhibitors, microRNA, angiotensin-converting enzyme inhibitors, angiotensin Ⅱ receptor blockers, and traditional Chinese herbal medicines.

Effect of acupuncture with donepezil based on syndrome differentiation on cognitive function in patients with mild-to-moderate Alzheimer's disease: a study protocol for a multicenter randomized controlled trial.

BACKGROUND: There has been a rapid increase in the worldwide prevalence of Alzheimer's disease (AD). Previous studies have shown that acupuncture can improve neurological and cognitive function; however, the utility of applying acupuncture in patients with AD remains unclear. This study protocol describes a clinical trial for evaluating the efficacy and safety of acupuncture based on syndrome differentiation with donepezil hydrochloride on cognitive function in patients with AD. METHODS/DESIGN: This multicenter randomized controlled trial commenced on February 1, 2019, at the Shanghai Longhua Hospital of TCM, Shanghai Huashan Hospital of Fudan University, and Shanghai Mental Health Center, and will conclude on June 30, 2022. The study will recruit 184 patients randomly divided into an acupuncture group or a control group at a 1:1 ratio. All participants will receive donepezil hydrochloride (5 mg/day), and those in the acupuncture group will receive acupuncture based on syndrome differentiation with donepezil for 12 weeks. The primary outcome will be the post-treatment change in the Alzheimer's Disease Assessment Scale-cognition score at 12 weeks. The secondary outcomes will be the efficacy scores of the Minimum Mental State Examination, Alzheimer's Disease Cooperative Research Activity-Daily Life, and Quality of Life-Alzheimer's Disease. All assessments will be performed at baseline, after treatment (week 12), and at follow-up (weeks 24 and 36). DISCUSSION: This trial may provide high-quality evidence for the efficacy of acupuncture in the treatment of AD. The results of this study will be published in peer-reviewed journals. TRIAL REGISTRATION: ClinicalTrials.gov NCT03810794 . Registered on 17 January 2019.

Modulation of Brain Activity and Functional Connectivity by Acupuncture Combined With Donepezil on Mild-to-Moderate Alzheimer's Disease: A Neuroimaging Pilot Study.

Background: Functional brain imaging changes have been proven as potential pathophysiological targets in early-stage AD. Current longitudinal neuroimaging studies of AD treated by acupuncture, which is one of the growingly acknowledged non-pharmacological interventions, have neither adopted comprehensive acupuncture protocols, nor explored the changes after a complete treatment duration. Thus, the mechanisms of acupuncture effects remain not fully investigated. Objective: This study aimed to investigate the changes in spontaneous brain activity and functional connectivity and provide evidence for central mechanism of a 12-week acupuncture program on mild-to-moderate AD. Methods: A total of forty-four patients with mild-to-moderate AD and twenty-two age- and education-level-matched healthy subjects were enrolled in this study. The forty-four patients with AD received a 12-week intervention of either acupuncture combined with Donepezil (the treatment group) or Donepezil alone (the control group). The two groups received two functional magnetic resonance imaging (fMRI) scans before and after treatment. The healthy subject group underwent no intervention, and only one fMRI scan was performed after enrollment. The fractional amplitude of low-frequency fluctuation (fALFF) and functional connectivity (FC) were applied to analyze the imaging data. The correlations between the imaging indicators and the changed score of Alzheimer's Disease Assessment Scale-Cognitive Section (ADAS-cog) were also explored. Results: After the 12-week intervention, compared to those in the control group, patients with AD in the treatment group scored significantly lower on ADAS-cog value. Moreover, compared to healthy subjects, the areas where the fALFF value decreased in patients with AD were mainly located in the right inferior temporal gyrus, middle/inferior frontal gyrus, middle occipital gyrus, left precuneus, and bilateral superior temporal gyrus. Compared with the control group, the right precuneus demonstrated the greatest changed value of fALFF after the intervention in the treatment group. The difference in ADAS-cog after interventions was positively correlated with the difference in fALFF value in the left temporal lobe. Right precuneus-based FC analysis showed that the altered FC by the treatment group compared to the control group was mainly located in the bilateral middle temporal gyrus. Conclusion: The study revealed the key role of precuneus in the effect of the combination of acupuncture and Donepezil on mild-to-moderate AD for cognitive function, as well as its connection with middle temporal gyrus, which provided a potential treating target for AD. Trial Registration Number: NCT03810794 (http://www.clinicaltrials.gov).

[Electroacupuncture at Siguan points for migraine of liver yang hyperactivity: a randomized controlled trial].

OBJECTIVE: To compare the clinical effect of electroacupuncture at Siguan points and flunarizine hydrochloride capsule on migraine of liver yang hyperactivity. METHODS: A total of 110 patients with migraine of liver yang hyperactivity were randomly divided into an electroacupuncture group (55 cases, 2 cases dropped off) and a western medication group (55 cases, 2 cases dropped off). In the electroacupuncture group, electroacupuncture was applied at Siguan points (Hegu [LI 4] and Taichong [LR 3]), with disperse-dense wave of 2 Hz/100 Hz in frequency and current intensity of 0.1-1 mA, 30 min each time, once a day, 5 times per week for 4 weeks. Flunarizine hydrochloride capsule was given orally in the western medication group, 10 mg a day for 4 weeks. The visual analogue scale (VAS) score and the migraine attack days were observed before and after treatment, during follow-up of 1, 3 and 6 months, and the migraine symptom score was observed before and after treatment in the two groups. RESULTS: After treatment, during follow-up of 1, 3 and 6 months, the VAS scores and the migraine attack days in the two groups were decreased compared with before treatment (ï¼°<0.05), and above indexes in the electroacupuncture group were lower than the western medication group (ï¼°<0.05). After treatment, the migraine symptom scores in the two groups were decreased (ï¼°<0.05), the change in the electroacupuncture group was greater than the western medication group (ï¼°<0.05). CONCLUSION: Electroacupuncture at Siguan points could effectively reduce headache intensity and migraine attack days, relieve migraine symptoms in patients with migraine of liver yang hyperactivity, and the efficacy is superior to oral flunarizine hydrochloride capsules.

Acupuncture for migraine prophylaxis: A protocol for systematic review and Bayesian network meta-analysis.

BACKGROUND: Migraine causes health problems in 1 billion people worldwide and imposes a huge social burden. Acupuncture therapy has a good clinical effect in migraine prophylaxis and is recommended by authoritative journals. We plan to conduct a Bayesian network meta-analysis to compare the efficacies of different acupuncture therapies. METHODS: We will search PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, VIP database for Chinese technical periodicals, Chinese biological medical database, WanFang Data, Cochrane register of controlled trials, Chinese Clinical Trial Register, and ClinicalTrials.gov from their inception to July 1, 2022, for randomized controlled trials that studied different acupuncture therapies and other therapies for the preventive treatment of migraine. Migraine episodes, migraine days, headache intensity, and adverse events will be counted as outcomes. Two reviewers will independently complete the study selection, data extraction, and risk of bias assessment of all filtered trials. Pairwise meta-analysis and Bayesian network meta-analysis will be performed (if applicable) through Review Manager 5.3 and the "gemtc" and "rjags" packages of the R software. Confidence in Network Meta-Analysis will be used to evaluate the quality and credibility of the evidence for each outcome. RESULTS: The protocol will compare the efficacies of different acupuncture therapies for migraine prophylaxis. CONCLUSION: This study aims to help clinicians develop an effective and safe treatment plan for migraine prophylaxis.

Earlier Acupuncture Enhancing Long-Term Effects on Motor Dysfunction in Acute Ischemic Stroke: Retrospective Cohort Study.

Stroke is the leading fatal disease in China. This retrospective study aimed to explore the optimal acupuncture intervention time for long-term efficacy on motor dysfunction in patients suffering from acute ischemic stroke through 1-year of follow-up. Three hundred and nine patients collected at Longhua Hospital from January 2016 to December 2017 were classified into 3 groups based on the acupuncture intervention time, including groups A (within 2 days), B (within 3-7 days) and C (within 8-14 days). All patients had received standard treatment combined with acupuncture therapy. Specifically, acupuncture was performed at the acupoints including LI4 (Hegu), ST40 (Fenglong), DU20 (Baihui), and motor area of the scalp, followed by 2 electroacupuncture protocols based on different muscle tensions once a day for 5 days consecutively. The time-effect relationship was assessed using both the Fugl-Meyer Assessment (FMA) and the modified Barthel index (MBI) on the 90th day and 1st year, respectively. Meanwhile, the modified Rankin scale (mRS), high-sensitivity C-reactive protein (hs-CRP), and fibrinogen (FIB) were also measured during the 1-year follow-up. The favorable outcome rate was 74.4%. One-way univariate analysis of variance (ANOVA) revealed significant differences in FMA and MBI on the 90th day among the 3 groups ([Formula: see text] < 0.05), while no significant differences were observed in FMA, MBI or mRS at the 1st year between groups A and B. The levels of hs-CRP and FIB ([Formula: see text] < 0.05) were markedly reduced. Binary logistic regression analysis suggested that patients with atrial fibrillation (AF) (odds ratio (OR): 3.156), chronic kidney disease (CKD) (OR: 2.563), diabetes mellitus (DM) (OR: 2.174) or stroke history (OR: 1.883) were more inclined to recover poorly from nerve function deficit ([Formula: see text] < 0.05). Earlier acupuncture intervention may have a better long-term effect on motor dysfunction and inflammation during the 1-year follow-up. Moreover, acupuncture within 2 days is probably the optimal treatment time for early recovery on the 90th day.

Overview of Meta-Analyses of Five Non-pharmacological Interventions for Alzheimer's Disease.

Background: Alzheimer's disease (AD) is a neurodegenerative disease characterized by progressive memory deficits, cognitive decline, and spatial disorientation. Non-pharmacological interventions to treat AD have been reported in many meta-analyses (MAs), but robust conclusions have not been made because of variations in the scope, quality, and findings of these reviews. Objective: This work aimed to review existing MAs to provide an overview of existing evidence on the effects of five non-pharmacological interventions in AD patients on three outcomes: Mini-Mental State Examination (MMSE), activities of daily living (ADL), and Alzheimer's Disease Assessment Scale-cognitive section (ADAS-cog). Methods: The databases PubMed, Cochrane Library, Embase, and Web of Science were searched to collect MAs of non-pharmacological interventions for AD. Two reviewers independently conducted literature screening, data extraction, and quality assessment. We assessed the quality of MAs with the Measurement Tool to Assess Systematic Reviews (AMSTAR) 2 and assessed the evidence quality for significant outcomes using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Results: We found 10 eligible MAs, which included between three (133 patients) and 15 randomized trials (1,217 patients), and five non-pharmacological interventions, namely, acupuncture therapy (40%), exercise intervention (30%), music therapy (10%), cognitive intervention (10%), and repetitive transcranial magnetic stimulation (rTMS) (10%). All the included MAs were critically low to low quality by AMSTAR 2. Acupuncture therapy and exercise intervention showed the preliminary potential to improve ADL and MMSE. rTMS and acupuncture therapy show benefits in decreasing ADAS-cog, and there were some evidence of improved MMSE with cognitive intervention. All these outcomes scored very low quality to moderate quality of evidence on the GRADE system. Conclusions: Non-pharmacological therapy shows promise for the treatment of AD, but there is still a lack of high-quality evidence. In the future, the quality of the original research needs to be improved, and strictly designed MAs should be carried out following methodological requirements.

Acupuncture for diabetic peripheral neuropathy: study protocol for a randomized, placebo-controlled trial.

BACKGROUND: Diabetic peripheral neuropathy (DPN) is the most common chronic complication of diabetes mellitus that has a considerable impact on quality of life, but there are few effective therapeutic strategies. The aim of this trial is to determine the efficacy and safety of manual acupuncture (MA) versus sham acupuncture (SA) for DPN. METHODS/DESIGN: This is a study protocol for a randomized, placebo-controlled clinical trial. A total of 118 patients with DPN will be recruited and randomly assigned in a 1:1 ratio to either the MA group or SA group. All patients will receive 24 sessions over 12 weeks. Participants will complete the trial by visiting the research center at month 6 for a follow-up assessment. The primary outcome is peroneal motor nerve conduction velocity (peroneal MNCV) at week 12 compared with baseline. Secondary outcomes include peroneal motor nerve action potential amplitude (peroneal MNAP) and latent period (peroneal MNLP), sural sensory nerve conduction velocity (sural SNCV), action potential amplitude (sural SNAP) and latent period (sural SNLP), fasting plasma glucose (FPG), 2-h postprandial blood glucose (2hPG), glycated hemoglobin (HbAlc) at week 12 compared with baseline, Michigan Neuropathy Screening Instrument (MNSI) score and Diabetes Specific Quality of Life scale (DSQL) at week 12 and month 6 compared with baseline. Safety will be assessed during the whole trial. Masking effectiveness will be assessed by patients. DISCUSSION: This trial may provide high-quality evidence for evaluating the efficacy and safety of MA treatment for DPN compared with SA treatment. Results of this study will be published in peer-reviewed journals. TRIAL REGISTRATION: Chinese Clinical Trials Registry ChiCTR1800020444. First registered on 29 December 2018, retrospectively registered, http://www.chictr.org.cn/showproj.aspx?Proj=31063 .

The Prognostic Value of Traditional Chinese Medicine Symptoms in Acute Ischemic Stroke: A Pilot Study.

BACKGROUND: Stroke scales of traditional Chinese medicine (SSTCM) are promoted for use in the early prognosis. The current lines of evidence to support their performance evaluation are uneven. This pilot study aimed to investigate the correlation between traditional Chinese medicine (TCM) symptoms in the early stages of acute ischemic stroke and the prognosis of motor dysfunction through one-year of follow-up. METHODS: Three hundred and fifteen patients were retrospected at Longhua Hospital from January 2016 to December 2017. All patients had received standard treatments combined with acupuncture therapy, including both electroacupuncture and scalp acupuncture for a median course of five months. The observed outcomes were the Fugl-Meyer assessment (FMA), the modified Barthel index (MBI), and the modified Rankin scale (mRS) at one-year follow-up after stroke onset by multiple linear regression analysis combined with ROC curves. RESULTS: The favorable outcome rate was 74.3%, with the recurrence rate of 20.3% in the follow-up. In multiple linear regression, 10 TCM symptoms (MBI regression model) were related to the prognosis of MBI (DW 1.409, Ad. R 2 0.654) and 10 TCM symptoms (FMA regression model) were related to the FMA outcome (DW 1.446, Ad R 2 0.620). The two models were selected to have nine repeated symptoms (repeated model). In the ROC curves, the three models were compared with the NIHSS score, and the MBI regression model reflected the highest efficiency. CONCLUSIONS: The combination of 10 TCM symptoms, once onset occurred, including hemiplegia, restlessness, hemianesthesia, short breath, headache, constipation, night sweat, tinnitus, thirsty, and gurgling with sputum, may affect the recovery of motor dysfunction. Furthermore, the improvements of TCM symptoms dynamically after treatment would be observed in a large prospective cohort. This trial is registered with NCT01806233.

Predication of the underlying mechanism of Bushenhuoxue formula acting on knee osteoarthritis via network pharmacology-based analyses combined with experimental validation.

ETHNOPHARMACOLOGICAL RELEVANCE: Knee osteoarthritis (KOA) is the most common chronic joint disorder worldwide, which is also a principle consideration for disability. The Bushenhuoxue formula (BSHXF) is a traditional herbal formula which widely applied to the treatment of KOA. However, its pharmacological mechanisms of action have not been clarified. AIMS OF THE STUDY: The study aimed to identify the potential targets and mechanisms of BSHXF in the treatment of KOA through pharmacology-based analyses and experimental validation. MATERIALS AND METHODS: The TCMSP database was applied to obtain the chemical compounds and targets of BSHXF, while the protein targets in KOA were determined through GeneCards and OMIM databases. The herb-compound-target and protein-protein interaction (PPI) networks were constructed for topological analyses and hub-targets screening. GO and KEGG enrichment analyses were performed on these core nodes to identify the critical biological processes and signaling pathways. Then destabilization of medial meniscus (DMM)-induced C57BL/6J mice model was established to detect the level of apoptosis via TUNEL assessment, while the expressions of CASP3, CASP8 and CASP9 were determined by immunohistochemistry. RESULTS: A total of 154 active compounds and 58 targets were predicted. DAVID, ClueGO and Metascape enrichment analyses all proved that BSHXF plays an essential role in regulating apoptosis. Moreover, 3 central nodes of BSHXF are recognized as the active factors involved in the main biological functions, suggesting a potential mechanism of BSHXF for KOA treatment. In vivo experiment revealed that BSHXF significantly inhibited apoptosis and down-regulated the expressions of CASP3, CASP8 and CASP9. CONCLUSION: Based on network pharmacology and experimental validation, our study indicated that BSHXF exerted anti-apoptosis effect through inhibiting the expressions of CASP3, CASP8 and CASP9, which could be considered as an effective method for KOA treatment.

[Correlation between color and content of eight components of Gardeniae Fructus at different harvest time].

This research is to establish an HPLC method for determination of geniposidic acid, genipin-1-ß-D-gentiobioside, geniposide, p-trans-coumaroylgenipin gentiobioside, chlorogenic acid, crocin-Ⅰ, crocin-Ⅱ and crocin-Ⅲ in Gardeniae Fructus at different harvest time. The detection wavelength was 238, 320 and 440 nm. Principal component analysis(PCA), correlation analysis, regression analysis and partial least squares(PLS) analysis were used to explore the relationship of color and content of eight components in Gardeniae Fructus. The result showed that the trend of the eight components in Gardeniae Fructus at harvest time in different three years was varied similarly. According to the variation of eight components at different harvest time, the mature and immaturate Gardeniae Fructus were discriminated. The content of crocin-Ⅰwas correlated positively with a~* of color significance. The redder color of Gardeniae Fructus showed the higher value of a~* and content of crocin-Ⅰ, indicating the better quality of Gardeniae Fructus. This method provided reference for justifying the color and quality of Gardeniae Fructus and scientific evidence for "assessing quality by distinguishing color".

Acupuncture therapy for Alzheimer's disease: A protocol for an overview of systematic reviews.

BACKGROUND: Alzheimer's disease (AD) is the fifth-leading cause of death in people more than 65 years old. Acupuncture therapy has been traditionally used to treat various kinds of health problems including AD. This protocol aims to summarize the available evidence from current systematic reviews (SRs) for the efficacy of acupuncture therapy for AD. METHODS: Seven databases will be searched: PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), Wanfang Data, Chongqing VIP (CQVIP), and Chinese Biomedical Literature Database (CBM). SRs/meta-analyses (MAs) of acupuncture therapy for AD which were reported in Chinese or English will be included. Study selection, data extraction, and assessment of the study quality will be performed independently by 2 or more reviewers. And the methodological quality, report quality and evidence quality will be evaluated by Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) tool, Preferred Reporting Items for Systematic Reviews and Meta Analyses Statement (PRISMA) checklist and Grading of Recommendations Assessment, Development and Evaluation (GRADE) system, respectively. RESULTS: The article in this overview will be submitted for publication in a peer-reviewed journal. CONCLUSION: We expect to compile evidence from multiple systematic reviews of acupuncture therapy in AD patients in an accessible and useful document.Registration number: INPLASY202040035.

Acupuncture for Obstructive Sleep Apnea (OSA) in Adults: A Systematic Review and Meta-Analysis.

OBJECTIVE: Our aim was to assess the efficacy and safety of acupuncture for OSA patients with various severities of the disorder. METHODS: Eight databases including PubMed, Cochrane Library, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), Chongqing VIP (CQVIP), Wanfang Data, and Chinese Biomedical Literature Database (CBM) were comprehensively searched till July 2019. Randomized controlled trials (RCTs) testing acupuncture in the treatment of OSA were eligible for inclusion. Studies were selected for inclusion, and data were extracted by two authors independently. The Cochrane Collaboration's Risk of Bias Assessment Tool and RevMan software (version 5.3) were used to evaluate the quality of studies and conduct statistical analysis. RESULTS: Nine RCTs with 584 participants were included. The trials covered acupuncture and electropuncture. Acupuncture caused clinically significant reductions in AHI (MD: -6.18; 95% CI: -9.58 to -2.78; Z = 3.56, P = 0.0004) as well as in ESS (MD: -2.84; 95% CI: -4.80 to -0.16, Z = 2.09, P = 0.04). AHI was reduced more in the subgroup analysis of moderate OSA patients (MD: -9.44; 95% CI: -12.44 to -6.45; Z = 6.18, P < 0.00001) and severe OSA patients (MD: -10.09; 95% CI: -12.47 to -7.71; Z = 8.31, P < 0.00001). ESS was also reduced more in the subgroup analysis of moderate OSA patients (MD: -2.40; 95% CI: -3.63 to -1.17; Z = 3.83, P = 0.0001) and severe OSA patients (MD: -4.64; 95% CI: -5.35 to -3.92; Z = 12.72, P < 0.00001). Besides, acupuncture had a beneficial effect on LSaO2 (MD: 5.29; 95% CI: 2.61 to 7.97; Z = 3.86, P = 0.0001). The outcome of AHI and LSaO2 yielded consistent results after sensitivity analysis, but the direction of the outcome of ESS was reversed. And the quality of evidence was mainly low to very low. CONCLUSIONS: Acupuncture therapy is effective for OSA patients in reducing AHI and ESS and in improving the LSaO2 of various severities, especially in moderate and severe OSA patients. High-quality trials are urgently needed.

Moderators of the Association Between Serum Parathyroid Hormone and Metabolic Syndrome in Participants with Elevated Parathyroid Hormone: NHANES 2003-2006.

This cross-sectional study extracted data of 392 NHANES participants with elevated serum parathyroid hormone (PTH) concentrations from 2 cycles of the US National Health and Nutrition Examination Survey (NHANES) 2003-2006 and evaluated the association between serum (PTH) concentration and metabolic syndrome (MetS) to identify dietary and lifestyle factors that may modify that association. The primary outcome was MetS severity scores. Results of univariate linear regression analyses revealed that serum PTH concentrations correlated positively and significantly with MetS severity scores (ß=0.399, p=0.030). After adjusting for gender, age, race, and alcohol consumption, results of multivariate analysis revealed that increased serum PTH concentration correlated significantly with higher MetS severity scores (ß=0.413, p=0.045) in participants with moderate physical activity over the past 30 days. Serum PTH concentration also correlated significantly with higher MetS severity scores in participants with serum 25-hydroxyvitamin D deficiency (ß=0.456 and p=0.014), those without vitamin D supplementation (ß=0.524, p=0.028) and with higher protein intake (ß=0.586 and p=0.030). In conclusion, increased serum PTH concentration is associated with higher MetS severity scores in participants with elevated serum PTH at baseline. The association between PTH concentration and MetS severity is moderated by participants' physical activity levels, status of serum vitamin D, vitamin D supplementation, and daily protein intake.

[Acupressure with activating blood and dissipating blood stasis prescription for early swelling of calcaneal fractures].

OBJECTIVE: To observe clinical effects of acupressure combined with activating blood and dissipating blood stasis prescription for the treatment of early swelling of calcaneal fractures. METHODS: From June 2016 to April 2018, 78 patients with calcaneus were divided into observation group and control group. There were 39 patients in observation group, including 36 males and 3 females aged from 28 to 61 years old with an average of(41.7±13.3) years old; 20 patients were caused by falling down, 10 patients were caused by traffic accident and 9 patients were caused by other injuries; The time from injury to medical treatment ranged from 0.5 to 10.5 h with an average of(4.6±3.2) h; 15 patients were type II, 17 patients were type III and 7 patients were type IV according to Sanders classification; the patients began to be pressed the three points of "Xuehai(SP 10)" "Sanyinjiao(SP 6)" "Zusanli(ST 36)" for 10 min from the day of hospital admission to the day of operation, 3 times a day, and taken prescription of activating blood and dissipating blood stasis prescription orally for 5 days, one dose per day and twice a day. There were 39 patients in control group, including 34 males and 5 females aged from 26 to 62 years old with an average of (43.3±12.3) years old; 19 patients were caused by falling down, 12 patients were caused by traffic accident and 8 patients were caused by other injuries; the time from injury to medical treatment ranged from 1 to 11 h with an average of (4.4±3.7) h; 15 patients were typeII, 18 patients were type III and 6 patients were type IV according to Sanders classification; patients were given 20% mannitol intravenously for 5 days, twice a day, 125 ml each time from hospital admission. During the 5 days of admission, the degree of swelling of the affected ankle was measured and calculated by water spillover method every day. The result which was measured and calculated on the first day of admission without treatment was the degree of swelling before treatment, compared degree of swelling before operation and 1st, 2nd, 3rd and 4th day after treatment; the time needed for the first positive skin fold sign in the affected ankle and the number of cases of tension blisters between two groups before operation were observed. RESULTS: The swelling of the affected ankle on the1st, 2nd, 3rd and 4th day after treatment in the observation group separately were(12.67±0.82)%, (11.87±0.88)%, (10.65±0.92)%, (9.47±0.96)%, and lower than control group which separately were(13.31±0.98)%, (13.51±0.84)%, (12.22±0.94)%, (11.38±1.01)%; The time for the first appearance of the skin fold sign was (6.41±1.74) days in the observation group was earlier than that of the control group (8.15±2.01) days; There was no significant difference in occurrence of tension blisters between observation group(3 patients) and control group(9 patients). CONCLUSIONS: Acupressure combined with activating blood and dissipating blood stasis prescription for the treatment of early swelling of calcaneal fractures could accelerate the decline of swelling of the affected ankle, shorten the time of the first skin fold sign, reduce the incidence of tension blisters in the ankle, shorten the waiting time of operation, and the surgical treatment as soon as possible.

[Preparation instructions for Experts consensus statement on Cheezheng Xiaotong Tiegao in clinical practice].

As a topical plaster developed by modern pharmaceutical technology based on traditional Tibetan medicine,Cheezheng Xiaotong Tiegao has functions of promoting blood circulation,relieving swelling and relieving pain. Since its introduction in 1993,it has been widely used in the treatment of various types of acute and chronic musculoskeletal pain and various types of spinal,joint and soft tissue diseases. In order to better standardize the clinical application and improve the clinical efficacy of Cheezheng Xiaotong Tiegao,the research and development work of the Experts consensus statement on Cheezheng Xiaotong Tiegao in clinical practice was officially launched on October 19,2017,upon approval from China Association of Chinese Medicine. In this paper,main R&D process and related technical links for the experts consensus on Cheezheng Xiaotong Tiegao would be summarized,which will help the various medical workers understand,master and apply more accurately,and also provide reference for the development of experts consensus on clinical application of other topical Chinese medicines.

[Experts consensus statement on Cheezheng Xiaotong Tiegao in clinical practice].

Cheezheng Xiaotong Tiegao is a Tibetan traditional prescription,which has the functions of promoting blood circulation,relieving swelling and relieving pain. It has been widely used in various clinical departments such as orthopedics department,rheumatology department,pain management department,and rehabilitation department to treat all types of acute and chronic skeletal muscle pain. However,duet to the lack of detailed description of the specific use of various diseases in its manual,and in the published guidelines,monographs,and clinical reports,the introduction of the dominant clinical disease,usage,treatment,safety,etc. of Cheezheng Xiaotong Tiegao is not detailed. Therefore,this experts consensus statement has been prepared based on the research and analysis of clinicians and patients,evidence-based medical research and evaluation,combined with the experience of clinical experts. The experts consensus statement regulates usage,dosage,combination,safety,etc. in the treatment of acute and chronic contusion( soft tissue injury),osteoarthritis,low back pain,frozen shoulder,cervical spondylosis postoperative recovery pain and other pain relief and other skeletal muscle system diseases to provide evidence and reference for the rational and safety using of Cheezheng Xiaotong Tiegao.