Effects of 12 weeks of Tai Chi Chuan intervention on the postural stability and self-reported instability in subjects with functional ankle instability: Study protocol for a randomized controlled trial.

Background: Tai Chi Chuan (TCC) is a physical activity modality that originated in China and is now widely popular around the world. Although there are a series of articles reporting that TCC can improve balance and other functional symptoms in a variety of populations, including the elderly, patients with stroke, and patients with Parkinson's disease, its efficiency has not been scientifically and methodically evaluated in subjects with functional ankle instability (FAI). Moreover, there is no literature directly comparing TCC and conventional balance training (CBT) interventions for FAI. The objective of this study is to investigate the comparative effects of TCC intervention and CBT protocols in improving postural balance and subjective instability feelings in patients with FAI. Methods: This study will be a single-center, parallel group, randomized controlled trial. Sixty-eight patients with FAI will be included and randomly assigned in a 1:1 ratio to either an intervention group (n =34) or a control group (n = 34). The participants in the intervention group will complete 12 weeks of TCC intervention (40 min/time, 3 times/week for 12 weeks) on the basis of health education treatment. The control group will receive health education and 36 CBT sessions during a 12-week period. Outcome measures include postural stability and self-reported feelings of instability at baseline, after the end of the intervention, and 3-month follow-up. The postural stability assessment of patients with FAI will be detected by performing static and dynamic postural tests, which will be carried out through a specific balance platform (TecnoBody ProKin). Self-reported feelings of instability will be assessed by Cumberland Ankle Instability Tool (CAIT), American Orthopedics Foot and Ankle Society's Ankle-Hindfoot Evaluation Scale (AOFAS-AHES), and the MOS item Short Form Health Survey (SF-36). Discussion: This trial will demonstrate whether a 12-week TCC intervention positively affects postural stability and self-reported outcomes in patients with FAI. At the same time, the superiority of its clinical efficacy will also be compared with that of CBT. This study may also help to redefine the value of traditional Chinese exercises in the treatment of chronic ankle instability. Clinical trial registration: Chinese Clinical Trial Registry: ChiCTR2100041790. Registration date: 22 March 2021. http://www.chictr.org.cn/edit.aspx?pid=119501&htm=4.

Postoperative analgesic effect of acupotomy combined with patient-controlled analgesia in patients undergoing video-assisted thoracoscopic surgery: a study protocol for a randomized controlled trial.

BACKGROUND: Postoperative acute pain is a common issue following thoracic surgery. Acupotomy is a common and safe intervention method for pain treatment in clinical practice. In previous preliminary experiments, we found that acupotomy has a good clinical effect and good safety in the treatment of pain after thoracoscopic surgery. However, due to a lack of a rigorous design and an adequate sample size, its efficacy still requires further confirmation. The purpose of this study will be to explore the efficacy and safety of acupotomy combined with patient-controlled analgesia (PCA) for the treatment of pain after video-assisted thoracic surgery (VATS). METHODS: The study will be a single-centre, parallel group, randomized controlled trial. Seventy patients with significant pain after thoracoscopic surgery with a visual analogue scale (VAS) score ≥ 7 will be included and randomly distributed into two groups: G1, the acupotomy combined with PCA group; and G2, the conventional PCA group. The primary outcome measure is pain scores at rest and coughing evaluated with the VAS by a blinded observer in the postanaesthesia care unit (PACU) and postoperatively at 1, 2, 4, 8, 12, 24, 48, and 72 h. The secondary outcome measures are postoperative requirements for rescue analgesia, the cumulative amount of self-administered analgesics, the level of sedation (LOS), the Bruggemann comfort scale (BCS), and the functional activity score (FAS) concerning adverse effects and patient satisfaction. DISCUSSION: This trial has the potential to identify an innovative and effective analgesic method for postoperative pain management for VATS. The findings may advocate for the inclusion of the treatment of comorbid pain after thoracoscopy in current pain management practice guidelines. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR1900027191 . Registered on 4 November 2019.

Acupotomy therapy for lumbar disc herniation: Protocol for a systematic review and meta-analysis.

BACKGROUND: Lumbar disc herniation (LDH) is a clinically common degenerative spinal disease that adversely affects patients' quality of life and work ability. Although several articles have reported that acupotomy can improve the clinical symptoms of LDH, the efficiency of acupotomy has not been scientifically or methodically evaluated. The primary objective of this study is to evaluate and synthesize evidence on the effectiveness and safety of acupotomy therapy in patients with LDH. METHOD: We plan to search eight English and Chinese electronic databases, including the Web of Science, Cochrane Library, PubMed, EMBASE, SinoMed, Wanfang, China Science and Technology Journal (VIP), and China National Knowledge Infrastructure (CNKI) databases, for potentially eligible studies. Randomized controlled trials (RCTs) on acupotomy treatment in LDH patients will be searched for independently by 2 reviewers in the databases from their inception to August 2018. We will combine data from clinically homogenous studies in a fixed effect meta-analysis using RevManV.5.3.5, and the evidence level will be assessed by using the method for Grading of Recommendations Assessment, Development, and Evaluation (GRADE). RESULTS: This systematic review and meta-analysis will use high-quality evidence-based medicine to assess the efficacy and safety of acupotomy therapy in LDH. CONCLUSION: This study protocol will provide strong evidence to determine whether acupotomy therapy is an effective and safe intervention for patients with LDH.

The First Comprehensive Phylogeny of Coptis (Ranunculaceae) and Its Implications for Character Evolution and Classification.

Coptis (Ranunculaceae) contains 15 species and is one of the pharmaceutically most important plant genera in eastern Asia. Understanding of the evolution of morphological characters and phylogenetic relationships within the genus is very limited. Here, we present the first comprehensive phylogenetic analysis of the genus based on two plastid and one nuclear markers. The phylogeny was reconstructed using Bayesian inference, as well as maximum parsimony and maximum likelihood methods. The Swofford-Olsen-Waddell-Hillis and Bayesian tests were used to assess the strength of the conflicts between traditional taxonomic units and those suggested by the phylogenetic inferences. Evolution of morphological characters was inferred using Bayesian method to identify synapomorphies for the infrageneric lineages. Our data recognize two strongly supported clades within Coptis. The first clade contains subgenus Coptis and section Japonocoptis of subgenus Metacoptis, supported by morphological characters, such as traits of the central leaflet base, petal color, and petal shape. The second clade consists of section Japonocoptis of subgenus Metacoptis. Coptis morii is not united with C. quinquefolia, in contrast with the view that C. morii is a synonym of C. quinquefolia. Two varieties of C. chinensis do not cluster together. Coptis groenlandica and C. lutescens are reduced to C. trifolia and C. japonica, respectively. Central leaflet base, sepal shape, and petal blade carry a strong phylogenetic signal in Coptis, while leaf type, sepal and petal color, and petal shape exhibit relatively higher levels of evolutionary flexibility.

An HPLC-DAD method for simultaneous quantitative determination of four active hydrophilic compounds in Magnoliae officinalis cortex.

Magnoliae officinalis cortex (MOC), derived from Magnolia officinalis and its variation M. officinalis var. biloba, is an important traditional Chinese medicine. In our previous work, 11 hydrophilic ingredients of MOC were isolated and structurally elucidated and four, namely syringin (SG), magnoloside A (MA), magnoloside B (MB) and magnoflorine (MF), showed bioactive effects. Herein, we describe an HPLC-DAD method for the simultaneous quantitative determination of MA, MB, MF and SG in MOC for the first time. The chromatographic separation of samples was performed on an Agilent Zorbax SB-C18 column (250 × 4.6 mm i.d., 5 µm) by gradient elution with water-acetic acid (pH 3.0) and methanol at a flow rate of 1.0 mL/min. The wavelengths were set at 265 nm for MF and SG, and 328 nm for MA and MB. The average recovery of the four compounds was from 97.63 to 103.84%. Nearly 100 MOC samples harvested from eight habitats were analyzed in which the contents of the tested compound varied in the range of 0.016-0.350% (MF), 0.010-0.337% (SG), 0.017-3.009% (MB) and 0.077-2.529% (MA). The analysis also indicated that MOC contains a significant amount of phenylethanoid glycosides. This was an unexpected finding because previously lignan was considered to be the main component of MOC.

Bioactive polar compounds from stem bark of Magnolia officinalis.

Two new phenylethanoid glycosides magnoloside D (1) and E (2), together with nine known compounds, were isolated from the polar part of methanol extract of the stem bark of Magnolia officinalis. The structures of the new compounds were established on the basis of spectral analysis. Anti-spasmodic activity of four major constituents (3, 4, 9 and 11) was tested in isolated colon of rat, compounds 3, 4, and 9 showed inhibition against acetylcholine, with the effect similar to that of magnolol and honokiol. At the same time, antioxidant activity of the isolated compounds was investigated using a DPPH and an ORAC assay. All of the compounds, except compound 8 showed potent antioxidant capacity in the ORAC assay, while compounds 1-5 and 11 exhibited potent antioxidant activity in the DPPH assay.

Antioxidant flavonoids from the seed of Oroxylum indicum.

Three new flavonoid glycosides (1-3) and nineteen known compounds (4-22) were isolated from the aqueous ethanolic extract of the seed of Oroxylum indicum. The structures of 1-3 were elucidated on the basis of spectroscopic analysis. Antioxidant activities of all the isolated compounds were evaluated using a DPPH and an ORAC assay. Compounds 3, 5-7, 9 and 12 exhibited potent antioxidant activity in the DPPH assay, while compounds 3-15 showed potent antioxidant capacity in the ORAC assay, and seven antioxidant flavonoids (4-6, 8, 9, 11, 12) were detected as the main ingredients in the methanolic extract of seed of O. indicum using an HPLC analysis.

[Population genetic study of Magnolia officinalis and Magnolia officinalis var. biloba].

OBJECTIVE: population genetic study of Magnolia officinalis and M. officinalis var. biloba was performed in this paper. The objectives of this study are to provide baseline data of molecular pharmaceutics for quality control of Cortex Magnoliae Officinalis. METHOD: A total of 15 populations of M. officinalis and M. officinalis var. biloba were collected. PCR amplification and sequencing were performed with two chloroplast intergenic spacers psbA-trnH and trnL-trnF. Chloroplast haplotype frequencies were calculated, genetic diversity and genetic structure were estimated by using the program HAPLONST, and a haplotype network depicting the mutational relationships among distinct haplotypes was drawn following the principle of parsimony by TCS version 1.13. RESULT: The differentiation of haplotype frequencies between M. officinalis and M. officiunalis var. biloba was significant although there was no private haplotypes of themselves. CONCLUSION: There was certain genetic divergence between M. officinalis and M. offcinalis var. biloba although the monophyletic clade of themselves was not still formed.

[Effects of primary processing on quality of cortex Magnolia officinalis].

In this paper, the changes of volatile oil and non-volatile ingredients in Cortex Magnolia Officinalis before and after primary processing were determined by an HPLC and a GC-MS method. The method is based on quantitative determination of three index ingredients, beta-eudesmol, honokiol and magnolol, and on qualitative fingerprinting analysis using HPLC and GC. Big differences were observed between processed and unprocessed samples according to their chromatographic fingerprinting data calculated by statistic software. Compared with unprocessed samples, the contents of honokiol and magnolol in processed samples increased, whereas the contents of beta-eudesmol and magnoloside A in processed samples decreased. Magnoloside A was isolated from this plant for the first time.

[Effects of tree ages and geographic area on quality of bark of Magnolia officinalis and M. officinalis var. biloba].

The effects of tree ages and geographic area on quality of bark of Magnolia officinalis (MO) and M. officinalis var. biloba (MOB) were studied. The volatile oils of samples extracted by a water stream distillation method were analyzed using a GC/MS method. The non-volatile ingredients of samples were determined by an HPLC method. Seven and twenty characteristic peaks were detected in the HPLC and GC fingerprint of MO, respectively, and the similar HPLC and GC fingerprint were showed in MOB. For samples collected in the same geographic area with different ages, the concentrations of active ingredients varied barely, whereas for those samples collected from different geographic area, differences on the concentrations of active ingredients were observed, for example, the concentrations of the amount of magnolol and honokiol in samples collected in Hubei province were higher than those collected in other areas. Big differences on the concentrations of active ingredients were found between MO and MOB, for MO, the ratio of honokiol/ magnolol was more than 0.7, whereas the ratio-was less than 0.7 in the case of MOB, and the concentrations of honokiol in MO were higher than those in MOB.