Functional dyspepsia treated with acupuncture of different frequencies: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the clinical efficacy of acupuncture with different frequencies in the treatment of patients with functional dyspepsia (FD).@*METHODS@#A total of 90 patients with FD were randomly divided into a 3-time acupuncture treatment per week group (3-A group, 31 cases, 2 cases dropped off), a 1-time acupuncture treatment per week group (1-A group, 30 cases, 2 cases dropped off) and a control group (29 cases, 2 cases dropped off). In the two acupuncture groups, the acupoints were Zhongwan (CV 12) and bilateral Tianshu (ST 25), Neiguan (PC 6), Liangqiu (ST 34), Yanglingquan (GB 34), Zusanli (ST 36) and Taichong (LR 3), stimulated 3 times a week and once a week, respectively; and the treatment was given consecutively for 4 weeks. In the control group, no intervention was adopted, but the compensatory therapy was provided after the end of follow-up. The scores of the symptom index of dyspepsia (SID), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were compared among the 3 groups before treatment, after 4 weeks of treatment and in 4 and 8 weeks after treatment completion separately. The score of Nepean dyspepsia life quality index (NDLQI) was evaluated before treatment, after 2 and 4 weeks of treatment and in 4 and 8 weeks after treatment completion.@*RESULTS@#After 4 weeks of treatment and in 4 and 8 weeks after treatment completion, the scores of SID, SAS and SDS were all reduced in the 3-A group and the 1-A group when compared with the scores before treatment (P<0.000 1, P<0.05). After 4 weeks of treatment, the scores of SID, SAS and SDS in the two acupuncture groups were lower than those in the control group (P<0.000 1). After 2 and 4 weeks of treatment, the increased values of NDLQI score in the two acupuncture groups were all higher than those in the control group (P<0.05). In 4 and 8 weeks after treatment completion, the scores of SID, SAS and SDS in the 3-A group were lower than those in the 1-A group (P<0.001, P<0.05), and the increased values of NDLQI score in the 3-A group were higher than those in the 1-A group (P<0.000 1).@*CONCLUSION@#Acupuncture given 3 times per week is superior to the treatment given once per week in the aspects of relieving the clinical symptoms, improving the quality of life and regulating the emotional state in patients with FD. This efficacy is persistent for 8 weeks after treatment completion.

Acupuncture as adjuvant therapy for 32 cases of coronavirus disease 2019 / 中国针灸

OBJECTIVE@#To observe the clinical effect of acupuncture on coronavirus disease 2019 (COVID-19) based on the conventional treatment.@*METHODS@#A total of 35 patients with COVID-19 of mild or ordinary type were involved (3 cases dropped off). Acupuncture was applied on the basis of western medicine and Chinese materia medica treatment. Dazhui (GV 14), Fengchi (GB 20), Kongzui (LU 6), Hegu (LI 4), etc. were selected as the main acupoints, the supplementary acupoints and the reinforcing and reducing manipulations were selected according to syndrome differentiation. Acupuncture treatment was given once a day, 5 times a week. On day 3 and day 7 of acupuncture, relief condition of the main symptoms was observed. Before acupuncture and on day 3 and day 7 of acupuncture, efficacy evaluation scale of TCM on COVID-19 (efficacy evaluation scale) score was recorded. The effects of different intervention time of acupuncture on patients' hospitalization time were compared, the understanding of acupuncture treatment of patients discharged from hospital was recorded, the clinical efficacy and safety of acupuncture treatment were evaluated.@*RESULTS@#On day 3 and day 7 of acupuncture, the symptoms of lung system and non lung system were both relieved; the scores of efficacy evaluation scale were both decreased compared before acupuncture (P<0.05), and the efficacy evaluation scale score of day 7 of acupuncture were lower than day 3 of acupuncture (P<0.05). The average hospitalization time of patients received early acupuncture was shorter than late acupuncture (P<0.05). The total effective rate was 84.4% (27/32) on day 7 of acupuncture, which was higher than 34.4% (11/32) on day 3 of acupuncture (P<0.05). During the acupuncture treatment, there were neither adverse reactions in patients nor occupational exposures in doctors. The patients generally believed that acupuncture could promote the recovery of COVID-19 and recommended acupuncture treatment.@*CONCLUSION@#On the basis of the conventional treatment, acupuncture can effectively relieve the clinical symptoms in patients with COVID-19, early intervention of acupuncture can accelerate the recovery process. Acupuncture has good safety, clinical compliance and recognition of patients.

Brief analysis on main indications and compatibility rules of Ciliao (BL 32) based on data mining / 中国针灸

Based on the data mining technology, the main indications and compatibility rules of Ciliao (BL 32) were analyzed and summarized. The relevant literature was retrieved from the databases of CNKI, Wanfang, VIP, Cochrane Library, SinoMed, Scopus, Web of Science, EMbase and PubMed, from the date of establishment to September 8, 2021. Using the software of SPSS Modeler 18.0 and Gephi0.9.2, the included literature was analyzed by data mining. A total of 218 articles were included, of them, there were 36 articles using single-acupoint prescriptions and 182 articles using compound prescriptions. Acupuncture was the most frequently used intervention of Ciliao (BL 32), followed by electroacupuncture. Dysmenorrhea and labor analgesia were the dominant indications of single-acupoint prescriptions of Ciliao (BL 32), and 9 diseases i.e. dysmenorrhea, urinary incontinence, urinary retention, chronic pelvic inflammatory disease, chronic prostatitis and lumbar disc herniation were the dominant indications of compound prescriptions. The main indications of Ciliao (BL 32) involved diseases of reproductive system, urinary system and waist. There were 92 acupoints in compatibility with Ciliao (BL 32), which were main belonged to the bladder meridian, the conception vessel and the spleen meridian, the most frequently used acupoints were Sanyinjiao (SP 6), Guanyuan (CV 4), Shenshu (BL 23) and Zhongji (CV 3).

LIU Zhi-shun's experience in treatment of infertility with decreasing ovarian reserve with electroacupuncture / 中国针灸

To summarize LIU Zhi-shun's clinical experience in treatment of infertility with decreasing ovarian reserve (DOR) with electroacupuncture. LIU Zhi-shun believes that the location of infertility with DOR is the uterus, mainly involving the kidney, thoroughfare and conception vessels. He advocates to select acupoints by combining "disease-symptom-position" with prescription, and selects acupoint prescription of Bushen Tiaochong Zhuyun included Guanyuan (CV 4), Zigong (EX-CA 1), Tianshu (ST 25), Sanyinjiao (SP 6), Ciliao (BL 32) and Zhongliao (BL 33) for electroacupuncture treatment. The key points of operation are accurate positioning and deep acupuncture, focusing on regulating mind and getting qi, adopting electroacupuncture treatment and low frequency stimulation and treating slowly for long-term disease.

Simultaneous determination of seven effective components in Shenkui Tongmai granules based on UHPLC-MS/MS.

OBJECTIVES: The objective of the study was to establish the quality standard of the formulation of Shenkui Tongmai granules (SKTM) from the perspective of safety and effectiveness. METHODS: A sensitive and specific method to simultaneously detect seven effective components by ultra-high performance liquid chromatography-tandem-mass spectrometry (UHPLC-MS/MS) in SKTM, including calycosin 7-O-ß-d-glucopyranoside, icariin, sodium danshensu, hyperoside, astragaloside IV, hesperidin, and salvianolic acid, was developed and validated. A Kromasil 100-3.5 C18 column with a mobile phase of 6.5 mmol/l ammonium acetate in acetonitrile was used to separate these above-listed components. Gradient programming was used with a flow rate of 0.2 ml/min, and the components were achieved in 13 min. Multiple reaction monitoring (MRM) in positive/negative mode was applied for the MS/MS detection. KEY FINDINGS: The analytical method was satisfactorily validated for linearity, accuracy and precision, repeatability and stability. The developed UHPLC-MS/MS method had high repeatability and accuracy and it was in a good linear relationship within their respective ranges (r = 0.9999) with the RSD value of the sample recovery of less than 5%. CONCLUSIONS: The current method established here is suitable for use in determining seven effective components in SKTM simultaneously, which may provide a new reliable method for overall quality control of SKTM.

Comparative analysis of pharmacokinetics and intestinal absorption of six alkaloids between Sanmiao Pills and Simiao Pills in rats / 中国中药杂志

The present study investigated the differences in pharmacokinetics and intestinal absorption of six alkaloids in Sanmiao Pills and Simiao Pills in rats and explored the different efficacies of the two formulae. After oral administration of Sanmiao Pills and Simiao Pills in rats, blood samples were collected at different time points. Samples were prepared for the determination of six alkaloids in plasma by UPLC-MS/MS. The chromatography was performed on an ACE Excel 3 C_(18 )column with acetonitrile-0.1% formic acid in water as the mobile phase for gradient elution. Analytes were detected in the positive ion mode. Plasma concentrations and pharmacokinetic parameters were calculated. Intestinal absorption of alkaloids was investigated by single-pass intestinal perfusion and absorption parameters of ingredients were calculated. The results showed that the UPLC-MS/MS method for simultaneous determination of concentrations of six alkaloids in plasma was developed and validated by methodological investigations, such as specificity, calibration curves, precision, accuracy, recovery, matrix effect, and stability. The results of the pharmacokinetic assay revealed that C_(max) and AUC values of phellodendrine, berberine, magnoflorine, berberrubine, and jatrorrhizine in Simiao Pills were significantly increased, and CL/F values were reduced as compared with those in Sanmiao Pills, which indicated the increase in plasma concentrations of alkaloids. The intestinal absorption parameters K_(a )and P_(eff) values of phellodendrine, berberine, and jatrorrhizine in Simiao Pills were higher than those in Sanmiao Pills. The intestinal absorption and plasma concentrations of alkaloids in Simiao Pills were significantly higher than those in Sanmiao Pills, suggesting that the composition of Simiao Pills was more conducive to the alkaloids into the blood to resist inflammation and lower uric acid.

Long-term efficacy and safety of electroacupuncture on improving MMSE in patients with Alzheimer's disease / 中国针灸

OBJECTIVE@#To observe the efficacy and safety of electroacupuncture (EA) on improving mini-mental state examination (MMSE) in patients with Alzheimer's disease (AD), and to evaluate the efficacy during follow-up visit.@*METHODS@#Forty patients were randomly divided into a treatment group and a control group, 20 patients in each one (3 patients dropped off in the treatment group and 4 patients in the control group). The patients in the treatment group were treated with acupuncture at Baihui (GV 20), Fengfu (GV 16), Shenting (GV 24), Taiyang (EX-HN 5), Shangyintang (Extra 3) and Dazhong (KI 14); besides, EA was applied at Taiyang (EX-HN 5), Baihui (GV 20) and Shenting (GV 24) with dilatational wave, 10 Hz/50 Hz in frequency, 0.5 to 5.0 mA in intensity, once every two days, three treatments per week. The patients in the control group were treated with oral administration of donepezil hydrochloride tablets, once a day, taken before sleep. The treatment was given for 12 weeks in the two groups. The MMSE was evaluated before treatment, 12 weeks±3 days into treatment, and 24 weeks±7 days after treatment, respectively.@*RESULTS@#The difference of total score of MMSE before and 12 weeks±3 days into treatment was not significant between the two groups (>0.05); the total score of MMSE after treatment was higher than that before treatment (both <0.05); compared before treatment, the short-term memory score was increased in the treatment group (<0.05), and the increasing range was superior to that in the control group (<0.05). Compared before treatment, the total score of MMSE in the two groups were reduced 24 weeks ±7 days after treatment (both <0.05), and the reduction in the treatment group was less than that in the control group (<0.05); the differences of short-term memory score before and after treatment was significant between the two groups (<0.05). No adverse reaction occurred in the two groups.@*CONCLUSION@#The effect of EA on improving MMSE in patients with AD is similar to donepezil supported by evidence-based medicine. The effect of EA may have a certain continuous effect, and may have advantages in instantaneous memory. In addition, the EA is safe.

Pharmacokinetic characteristics of fourteen main components of Gegen Qinlian Decoction in rats / 中国中药杂志

A specific and selective UPLC-MS/MS method was developed and validated for the simultaneous determination of isoflavonoids(3'-hydroxy puerarin, puerarin, daidzin, daidzein, genistin, genistein), flavonoids (baicalin, baicalein, wogonoside, wogonin, liquiritin)and alkaloids(berberine, jatrorrhizine, palmatine)(14 bioactive compounds) of Gegen Qinlian Decoction(GQD) in plasma. The pharmacokinetics characteristics of 14 bioactive compounds were study after oral administration of GQD at a single dose to rats. Prednisolone was used as the internal standard of liquiritin, and naringin was used as the internal standard of the other thirteen analytes. After the plasma samples were processed by precipitation protein method, the constituents and internal standards were gradient eluted by using a Zorbax SB-18 column with a mobile phase of acetonitrile(A) and 0.1% formic acid aqueous solution(B) using a gradient elution of 0-2.5 min, 15%-30% A; 2.5-3.5 min, 30%-35% A; 3.5-5.0 min, 35%-40% A; 5.0-9.0 min, 40%-60% A; 9.0-11.0 min, 60%-15% A, and the flow rate was 0.4 mL·min⁻¹. The auto sampler was conditioned at 25 °C and the sample injection volume was 5 μL. A mass spectrometry was applied with electrospray ionization (ESI) ion source in the positive and negative ion multiple reaction monitoring(MRM) mode. All pharmacokinetic parameters were processed by non-compartmental analysis with DAS 3.2.2 software. The results showed that the linear correlation coefficient of the 14 components were all greater than 0.99, indicating that the method had good linearity in their respective concentration ranges. Post-preparative stability (25 °C, 24 h), short-term stability(25 °C, 12 h), long-term stability (-20 °C, 7 d), and freeze and thaw stability (3-cycles) of the fourteen constituents were examined to evaluate the stability of methodology. The results of the inner and inter-day relative standard deviations were both less than 10%, indicating legitimate precise and accuracy to the requirement of biological sample analysis. The assay method is proved to be sensitive, accurate and convenient. It can be applied to the pharmacokinetic study of the fourteen analytes. The kinetic parameters of the related drugs were calculated according to the blood concentration of the 14 components. The results showed that the MRT0-t of the isoflavones and flavonoids was 7.5-11.8 h, T1/2z were mainly in 11.0-29.7 h, and the AUC0-t flavonoids were larger than the isoflavones. The MRT0-t of alkaloids were between 4.3-7.2 h, T1/2z were 1.0-5.0 h, AUC0-t were less than flavonoids and isoflavones. The results suggest that flavonoids and isoflavones have a high concentration of blood and long time of action, which are beneficial to the anti-inflammatory and antipyretic effects. The concentration of alkaloids in the body is low and the time of action is short, and it may play its bacteriostasis in the intestinal tract.

Pivotal factors concerned in design of acupuncture clinical research: From two articles in JAMA / 中国结合医学杂志

Two randomized controlled trials of acupuncture concerning polycystic ovary syndrome (PCOS) and stress urinary incontinence (SUI) were published simultaneously in the 24th issue, 2017 of The Journal of the American Medical Association (JAMA). A trial involving PCOS indicated that active acupuncture did not increase live birth compared with sham acupuncture; meanwhile, another trial referring to SUI showed that electroacupuncture resulted in less urine leakage compared with sham electroacupuncture. With an eye to the negative and positive results of acupuncture, three pivotal factors should be contemplated: (1) proper illness for acupuncture, that is, a problem need to be solved in current medical science, and acupuncture may really work for it; (2) proper pre-studied primary outcome, which is better be objective and repeatedly measurable to reveal the therapeutic effect of acupuncture truly and objectively; (3) proper sham control, which can blind the patients to the upmost extent with minimal biological effects. Through the publication of clinical trials of acupuncture in high-impact journals in recent years, researchers should have confidence in their clinical trials by pondering over these three pivotal factors.

Efficacy of electroacupuncture in the treatment of functional constipation: A randomized controlled pilot trial / 中国结合医学杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of electroacupuncture at Tianshu (ST25) for patients with functional constipation (FC).</p><p><b>METHODS</b>Ninety-six patients with FC were randomized to receive deep needling on bilateral ST25 (group A, 48 cases) or shallow needling on bilateral ST25 (group B, 48 cases) with electroacupuncture once daily for 4 weeks. The proportion of patients with four or more complete spontaneous bowel movements (CSBMs) per week, and scores of constipation symptoms and satisfaction with treatment were compared between two groups. Safety was also assessed.</p><p><b>RESULTS</b>The proportion of patients with four or more CSBMs per week was 52.1% in group A, significantly higher than 25.0% in group B during the 4-week treatment (P<0.05). The constipation symptom score of patients were significantly improved in group A as compared with group B at week 2-4 (P<0.05). Patients in group A were more satisfied with their treatment compared with those in group B at week 1-4 (P<0.05). Five patients in group A felt significant pain and discomfort. No other adverse reaction was observed in both groups.</p><p><b>CONCLUSION</b>Using electroacupuncture at ST25 to treat patients with FC is effectively, and deep needling had more stable effect than shallow needling.</p>

On-site quality control of acupuncture randomized controlled trial: design of content and checklist of quality control based on PICOST / 中国针灸

To effectively guarantee quality of randomized controlld trial (RCT) of acupuncture and develop reasonable content and checklist of on-site quality control, influencing factors on quality of acupuncture RCT are analyzed and scientificity of quality control content and feasibility of on-site manipulation are put into overall consideration. Based on content and checklist of on-site quality control in National 11th Five-Year Plan Project Optimization of Comprehensive Treatment Plan for TCM in Prevention and Treatment of Serious Disease and Clinical Assessment on Generic Technology and Quality Control Research, it is proposed that on-site quality control of acupuncture RCT should be conducted with PICOST (patient, intervention, comparison, out come, site and time) as core, especially on quality control of interveners' skills and outcome assessment of blinding, and checklist of on-site quality control is developed to provide references for undertaking groups of the project.

Clinical research on fire filiform needle combined with mild moxibustion for postherpetic neuralgia / 中国针灸

<p><b>OBJECTIVE</b>To compare efficacy differences between fire filiform needle combined with mild moxibustion and gabapentin combined with sham acupuncture for postherpetic neuralgia (PHN).</p><p><b>METHODS</b>One hundred cases of PHN were randomly divided into a needle group and a medicine group, 50 cases in each one. In the needle group, pricking method of fire filiform needle was given at the Ashi points, and then mild moxibustion was applied for 15 min. In the medicine group, the oral administration of gabapentin capsule and sham acupuncture at non-acupoints in the distal end of lesions were applied. The treatment was required for 21 days in both groups. The visual analogue score (VAS) was recorded before treatment and on the 1st day, 2nd day, 3rd day, 6th day, 9th day and 12th day of treatment. The most severity of pain within last 24 h, preset severity of pain, immediate analgesia effect and starting time of pain relief were observed, also the efficacy was assessed and improvement of symptoms was observed in the follow-up visit.</p><p><b>RESULTS</b>The total effective rate was 94.0% (47/50) in the fire filiform needle group, which was superior to 86.0% (43/50) in the medicine group (P < 0.05). Compared with medicine group, the VAS of the most severity of pain within last 24 h was obviously reduced after the 2nd treatment in the fire filiform needle group while that of present severity of pain was relieved after the 1st treatment (both P < 0.05). The immediate analgesia effect in the fire filiform needle group was obviously superior to that in the medicine group in the first three times of treatment (all P < 0.05). The average time of pain relief was (3.91 +/- 0.82) days in the fire filiform needle group, which was significantly earlier to (6.53 +/- 1.13) days in the medicine group (P < 0.05). 26 cases were cured in the fire filiform needle group in the follow-up visit, which was superior to 2 cases in the medicine group (P < 0.05). The improvement of VAS, pain range and sleep quality in the needle group were also superior to those in the medicine group (all P < 0.05). The direct medical cost in the fire filiform needle group was (232.32 +/- 48.108) yuan, which was significantly lower than (466.00 +/- 41.09) yuan in the medicine group (P < 0.05). There was only one case of adverse effect in the medicine group during the treatment.</p><p><b>CONCLUSION</b>The fire filiform needle combined with mild moxibustion could obviously relieve the pain in PHN patients, which has superior immediate analgesia effect and pain relieving time compared with gabapentin, which also has less adverse effects and cheap cost.</p>

Comparison of efficacy on functional constipation treated with electroacupuncture of different acupoint prescriptions: a randomized controlled pilot trial / 中国针灸

<p><b>OBJECTIVE</b>To evaluate preliminarily the efficacy on functional constipation treated with electroacupuncture of different acupoint prescriptions.</p><p><b>METHODS</b>One hundred and four patients were randomized into a front-mu and back-shu points group (19 cases), a he-sea points group (34 cases), a he-sea, front-mu and back-shu points group (26 cases) and a western medication control group (25 cases). In the front-mu and back-shu points group, electroacupuncture was applied at bilateral Tianshu (ST 25) and Dachangshu (BL 25). In the he-sea points group, electroacupuncture was applied at bilateral Quchi (LI 11) and Shangjuxu (ST 37). In the he-sea, front-mu and back-shu points group, electroacupuncture was applied at unilateral Tianshu (ST 25), Dachangshu (BL 25), Quchi (LI 11) and Shangjuxu (ST 37). In the three groups above, the treatment was given 5 times a week in the first two weeks and 3 times a week in the next two weeks. In the western medication control group, mosapride citrate tablets were prescribed for oral administration, 1 table (5 mg) each time, 3 times a day, continuously for 4 weeks. The period of research was 9 weeks, including 1 week for baseline evaluation, 4 weeks for treatment and 4 weeks for follow-up. The weekly defecation frequency was taken as primary index, while the defecation difficulty and life quality score were taken as the secondary indices for the efficacy evaluation after treatment and in follow-up.</p><p><b>RESULTS</b>According to the intention-to-treat (ITT) analytic principle, 104 cases were all enrolled in the final analysis. (1) After treatment, the weekly frequency of defecation was all increased significantly in the four groups (P < 0.05, P < 0.01). The efficacy of the three electroacupuncture groups was similar to that of western medication control group (P > 0.05). In follow-up, the increasing effect on the weekly frequency of defecation was maintained in the he-sea points group (P < 0.01), superior to the front-mu and back-shu points group and the western medication control group (P < 0.05, P < 0.01); the weekly frequency of defecation was not improved in the rest three groups (P > 0.05). (2) After treatment, defecation difficulty was relieved in the he-sea points group, the he-sea, front-mu and back-shu points group and the western medication control group (P < 0.05, P < 0.01). In follow-up, the improvements were still significant in the he-sea points group and the he-sea, front-mu and back-shu points group (both P < 0.01). (3) After treatment, the life quality score was significantly improved in the patients of the he-sea points group (P < 0.05). The difference was not significant in the rest three groups as compared with that before treatment (all P > 0.05).</p><p><b>CONCLUSION</b>The weekly frequency of defecation is increased effectively after treatment in the three electroacupuncture groups and the efficacy is similar to mosapride citrate tablets. The bilateral Quchi (LI 11) and Shangjuxu (ST 37) in he-sea acupoints increase significantly the weekly frequency of defecation, relieve defecation difficulty and improve life quality. Acupuncture efficacy is sustained for 4 weeks. This acupoints prescription is the best in the treatment of functional constipation.</p>

Virtual reality simulator for training urologists on transurethral prostatectomy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>A virtual reality simulator provides a novel training model for improving surgical skills in a variety of fields. They can simulate a variety of surgical scenarios to improve the overall skills required for endoscopic operations, and also record the operative process of trainees in real-time and allow for objective evaluation. At present, some simulators for transurethral resection of the prostate (TURP) are available. The utility of virtual reality simulators in training of transurethral prostatectomy was investigated.</p><p><b>METHODS</b>Thirty-eight urologists were randomly selected to take part in a simulation based training of TURP using the TURPSim(TM) system. Pre and post-training global rate scale (GRS) scores and objective parameters recorded by the simulator were assessed. Then, questionnaires were filled out.</p><p><b>RESULTS</b>Compared with baseline levels, the GRS scores of trainees increased (18.0 ± 4.0 vs. 12.4 ± 4.2, P < 0.001), while the rate of capsule resection (26.3% ± 0.6% vs. 21.2% ± 0.4%, P < 0.001), amount of blood loss ((125.8 ± 86.3) ml vs. (83.7 ± 41.6) ml, P < 0.001), external sphincter injury (3.6 ± 2.9 vs. 2.0 ± 2.0, P < 0.001) decreased significantly after training. Most trainees were satisfied with the simulator based training and believed that the simulator accurately mimicked actual surgical procedures and could help improve their surgical skills.</p><p><b>CONCLUSIONS</b>As a new method of training on transurethral prostatectomy skills, training of TURP using a virtual simulator can help urologists improve their surgical skills and safety. Therefore, the application of the TURPSim(TM) system in education and training of urologic surgery is warranted.</p>

Analysis on follow-up efficacy and safety of slow transit constipation treated with individualized deep puncture at Tianshu (ST 25): a multi-central randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To evaluate the follow-up efficacy and safety on slow transit constipation (STC) treated with individualized deep puncture at Tianshu (ST 25).</p><p><b>METHODS</b>One hundred and twenty-eight cases of STC were randomized into a deep puncture group (64 cases), a western medication group (31 cases) and a shallow puncture group (33 cases) at the ratio of 2:1:1. In the deep puncture group, electroacupuncture of deep puncture was applied to bilateral Tianshu (ST 25). The needle was inserted perpendicularly and slowly at the acupoint and went deeply till penetrating the peritoneum, about 20 to 65 mm in depth. In the western medication group, lactulose oral liquid was prescribed for oral administration. In the shallow puncture group, electroacupuncture of shallow puncture was done at bilateral Tianshu (ST 25). The needle was inserted perpendicularly and slowly, 5 to 8 mm in depth. The treatment lasted 4 weeks in the three groups and the follow-up visit of 12 weeks and 6 month after treatment was performed respectively. The weekly defecation frequency, patient's satisfaction and safety of deep puncture at Tianshu (ST 25) were assessed before and after treatment in each group.</p><p><b>RESULTS</b>In the deep puncture group, the weekly defecation frequency was (1.79 +/- 1.05) times/week before treatment and was (3.90 +/- 1.43) times/week after 4-week treatment. It was (3.49 +/- 1.46) times/week in 12-week follow-up visit after treatment and was (3.51 +/- 1.42) times/week in 6-month follow-up visit after treatment. In the deep puncture group, the improvements in weekly defecation frequency, patient's satisfaction and short-term efficacy were same as those in the western medication group and the shallow puncture group (all P > 0.05). The long-term efficacy in follow-up visit was better remarkably than that in the western medication group (P < 0.05, P < 0.01). Besides, the combined medication was reduced and no adverse reaction occurred.</p><p><b>CONCLUSION</b>The individualized deep puncture at Tianshu (ST 25) is effective in the treatment of STC and achieves the satisfactory long-term efficacy. This therapy displays the good effective advantage and deserves to be promoted in clinical practice of acupuncture and moxibustion therapeutic program as compared with the first-tier line of medication, lactulose oral liquid, recommended at home and abroad, in terms of the evidence-based medicine.</p>

Thinking on controlled setting of plarebo acupuncture in clinical trial of acupuncture and moxibustion / 中国针灸

Differences and relations between effects of acupuncture therapy and sham acupuncture are systematically analyzed in this article through the influential factors of acupuncture effect. And it is held that sham acupuncture effect is not exactly equal to placebo effect. The effects of both acupuncture and sham acupuncture are composed by specific effects and non-specific effects, and the differences of non-specific effects between acupunc ture and sham acupuncture can be minimized furthest with blinding and randomized method. Therefore, the difference of acupuncture and sham acupuncture treatment rests with the degree of differences of the specific effects. Only when both of the specific effect of acupuncture and the effect of acupuncture are minimized, can it be applied as the ideal placebo control. Consequently when placebo acupunture are setted up, factors such as the body condition, site of stimulation and stimulation parameters which can influence the specific effect of acupuncture should be taken into consideration to produce the relatively minimum specific effect.

Extending the CONSORT Statement to moxibustion / 中西医结合学报

The STandards for Reporting Interventions in Clinical Trials Of Moxibustion (STRICTOM), in the form of a checklist and descriptions of checklist items, were designed to improve reporting of moxibustion trials, and thereby facilitating their interpretation and replication. The STRICTOM checklist included 7 items and 16 sub-items. These set out reporting guidelines for the moxibustion rationale, details of moxibustion, treatment regimen, other components of treatment, treatment provider background, control and comparator interventions, and precaution measures. In addition, there were descriptions of each item and examples of good reporting. It is intended that the STRICTOM can be used in conjunction with the main CONSORT Statement, extensions for nonpharmacologic treatment and pragmatic trials, and thereby raise the quality of reporting of clinical trials of moxibustion. Further comments will be solicited from the experts of the CONSORT Group, the STRICTA Group, acupuncture and moxibustion societies, and clinical trial authors for optimizing the STRICTOM.

Randomized controlled study on electroacupuncture compound anesthesia in radiofrequency ablation for hypertrophic inferior turbinate / 中国针灸

<p><b>OBJECTIVE</b>To explore the feasibility of electroacupuncture compound anesthesia in radiofrequency ablation for hypertrophic inferior turbinate.</p><p><b>METHODS</b>The patients confirmed to the enrolled criteria were randomly divided into an observation group (n = 31) and a control group (n = 30). The observation group was treated with electroacupuncture at Sibai (ST 2), Xiaguan (ST 7), Hegu (LI 4) and Zhigou (TE 6) on the left side and routine local anesthesia on the right side. The control group was treated with routine local anesthesia on the both side. The feelings of pain, circulatory index and operation effect were observed and compared.</p><p><b>RESULTS</b>During radiofrequency ablation, the pain grade of two measurements on the left side and the 2nd measurement on the right in the observation group were all lower than those in the control group (all P<0.05). In the observation group, the pain grades on the left side were lower than that on the right side (P<0.05), and the systolic blood pressure and the heart rate were lower than that in the control group when undergoing the 2nd radiofrequency ablation on the right side and on the left side, respectively (both P<0.05). There was no significant difference in operation effect between the two groups.</p><p><b>CONCLUSION</b>Electroacupuncture compound anesthesia can meet the analgesia requirement of radiofrequency ablation for treatment of hypertrophic inferior turbinate, and would be helpful to prevent cyclic fluctuation during the operation at the same time.</p>

Assessment of the operation standard and safety on the individual deep puncturing at Tianshu (ST 25) under CT / 中国针灸

<p><b>OBJECTIVE</b>To discuss the individual operation standard and safety on the deep puncturing at Tianshu (ST 25).</p><p><b>METHODS</b>The deep insertion through the peritoneum about 1-2 millimeter was taken as individual standard depth at Tianshu (ST 25) for 39 patients. Using CT cross-section scanning and image surveying, the regression analysis was conducted on the impacts of abdominal circumference (AC,cm) to the peritoneum depth.</p><p><b>RESULTS</b>It was concluded the formula for calculating the satisfactory depth of individual insertion at Tianshu (ST 25), depth = -0.562 + 0.045 x AC.</p><p><b>CONCLUSION</b>The depth of insertion, 1-2 millimeter through peritoneum at Tianshu (ST 25) is safe and feasible in acupuncture treatment, which can be used significantly as the reference and guidance for the assessment of clinical operation and safety on the deep puncturing of the other acupoints on the abdominal region.</p>

Observation on therapeutic effect of electroacupuncture at Tianshu (ST 25) with deep needling technique on functional constipation / 中国针灸

<p><b>OBJECTIVE</b>To probe into a better therapeutic method for functional constipation.</p><p><b>METHODS</b>Ninety-five cases of functional constipation were randomly divided into deep puncture at ST 25 group (48 cases), shallow puncture at ST 25 group (24 cases) and medication group (23 cases). In deep puncture at ST 25 group, Tianshu (ST 25) was punctured deeply to the peritoneum, with electric stimulation. In shallow puncture at ST 25 group, Tianshu (ST 25) was punctured shallowly, 5 mm beneath the skin, with electric stimulation. In medication group, Duphalac was administered orally. These cases were treated continuously for 4 weeks in 3 groups and followed up for 6 months. It was to observe the numbers of person who had defecation 4 times a week, difference in weekly defecation frequency and the difference in the Cleveland Clinic Score (CCS).</p><p><b>RESULTS</b>In deep puncture at ST 25 group, the frequency of weekly defecation and the numbers of person who had defecation 4 times a week increased and CCS decreased, which were similar to the efficacy in shallow puncture at ST 25 group (all P > 0.05). But the efficacy of both ST 25 groups was superior to that in medication group (both P < 0.05). In comparison, the deep puncture at ST 25 group acted more quickly than either shallow puncture at ST 25 group or medication group and its efficacy remained much longer.</p><p><b>CONCLUSION</b>The deep puncture at ST 25 with electric stimulation presents similar efficacy on functional constipation as shallow puncture at ST 25, but it acts more quickly than shallow puncture at ST 25, both of them are more advantageous than medication and the long-term efficacy is better.</p>