Efficacy and safety comparison of infrared laser moxibustion and traditional moxibustion in knee osteoarthritis: study protocol for a Zelen-design randomized controlled non-inferiority clinical trial.

BACKGROUND: Knee osteoarthritis (KOA) is the most common chronic degenerative joint disease and places a substantial burden on the public health resources in China. The purpose of this study is to preliminarily evaluate whether infrared laser moxibustion (ILM) is non-inferior to traditional moxibustion (TM) in the treatment of KOA. MATERIALS AND METHODS: In the designed Zelen-design randomized controlled non-inferiority clinical trial, a total of 74 patients with KOA will be randomly allocated to one of two interventions: ILM treatment or TM treatment. All participants will receive a 6-week treatment and a follow-up 4 weeks after treatment. The primary outcomes will be the mean change in pain scores on the numeric rating scale (NRS) measured at baseline and the end of last treatment at week 6. The secondary outcomes will be the pain scores on the NRS from weeks 1 to 5 after the start of treatment and the changes from baseline to endpoints (weeks 6 and 10) in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), SF-36, knee circumference, and 6-min walking test. In addition, safety assessment will be performed throughout the trial. CONCLUSION: The results of our study will help determine whether a 6-week treatment with ILM is non-inferior to TM in patients with KOA, therefore providing evidence to verify if ILM can become a safer alternative for TM in clinical applications in the future. TRIAL REGISTRATION: Clinical Trial Registration Platform (ChiCTR2200065264); Pre-results. Registered on 1 November 2022.

[Effects of moxa smoke through olfactory pathway on learning and memory ability in rapid aging mice].

OBJECTIVE: To observe the effects of moxa smoke through olfactory pathway on learning and memory ability in rapid aging (SAMP8) mice, and to explore the action pathway of moxa smoke. METHODS: Forty-eight six-month-old male SAMP8 mice were randomly divided into a model group, an olfactory dysfunction group, a moxa smoke group and an olfactory dysfunction + moxa smoke group, with 12 mice in each group. Twelve age-matched male SAMR1 mice were used as the blank group. The olfactory dysfunction model was induced in the olfactory dysfunction group and the olfactory dysfunction + moxa smoke group by intraperitoneal injection of 3-methylindole (3-MI) with 300 mg/kg, and the moxa smoke group and the olfactory dysfunction + moxa smoke group were intervened with moxa smoke at a concentration of 10-15 mg/m3 for 30 min per day, with a total of 6 interventions per week. After 6 weeks, the emotion and cognitive function of mice was tested by open field test and Morris water maze test, and the neuronal morphology in the CAI area of the hippocampus was observed by HE staining. The contents of neurotransmitters (glutamic acid [Glu], gamma-aminobutyric acid [GABA], dopamine [DA], and 5-hydroxytryptamine [5-HT]) in hippocampal tissue of mice were detected by ELISA. RESULTS: The mice in the blank group, the model group and the moxa smoke group could find the buried food pellets within 300 s, while the mice in the olfactory dysfunction group and the olfactory dysfunction + moxa smoke group took more than 300 s to find them. Compared with the blank group, the model group had increased vertical and horizontal movements (P<0.05) and reduced central area residence time (P<0.05) in the open field test, prolonged mean escape latency on days 1-4 (P<0.05), and decreased search time, swimming distance and swimming distance ratio in the target quadrant of the Morris water maze test, and decreased GABA, DA and 5-HT contents (P<0.05, P<0.01) and increased Glu content (P<0.05) in hippocampal tissue. Compared with the model group, the olfactory dysfunction group had increased vertical movements (P<0.05), reduced central area residence time (P<0.05), and increased DA content in hippocampal tissue (P<0.05); the olfactory dysfunction + moxa smoke group had shortened mean escape latency on days 3 and 4 of the Morris water maze test (P<0.05) and increased DA content in hippocampal tissue (P<0.05); the moxa smoke group had prolonged search time in the target quadrant (P<0.05) and increased swimming distance ratio, and increased DA and 5-HT contents in hippocampal tissue (P<0.05, P<0.01) and decreased Glu content in hippocampal tissue (P<0.05). Compared with the olfactory dysfunction group, the olfactory dysfunction + moxa smoke group showed a shortened mean escape latency on day 4 of the Morris water maze test (P<0.05). Compared with the moxa smoke group, the olfactory dysfunction + moxa smoke group had a decreased 5-HT content in the hippocampus (P<0.05). Compared with the blank group, the model group showed a reduced number of neurons in the CA1 area of the hippocampus with a disordered arrangement; the olfactory dysfunction group had similar neuronal morphology in the CA1 area of the hippocampus to the model group. Compared with the model group, the moxa smoke group had an increased number of neurons in the CA1 area of the hippocampus that were more densely packed. Compared with the moxa smoke group, the olfactory dysfunction + moxa smoke group had a reduced number of neurons in the CA1 area of the hippocampus, with the extent between that of the moxa smoke group and the olfactory dysfunction group. CONCLUSION: The moxa smoke could regulate the contents of neurotransmitters Glu, DA and 5-HT in hippocampal tissue through olfactory pathway to improve the learning and memory ability of SAMP8 mice, and the olfactory is not the only effective pathway.

Moxibustion ameliorated age-related alterations in neurological behavior and gut microbiota in mice.

OBJECTIVE: To observe the anti-aging effects of moxibustion on age-related alterations in middle-aged mice. METHODS: Thirty, 9-month-old, male ICR mice were randomly divided into the moxibustion and control groups (N = 15). Mice in the moxibustion group were given mild moxibustion at the Guanyuan acupoint for 20 minutes every other day. After 30 treatments, neurobehavior tests, lifespan, gut microbiota composition and splenic gene expression were observed in the mice. RESULTS: Moxibustion improved the locomotor activity as well as motor function, activated the SIRT1-PPARα signaling pathway, ameliorated age-related alterations in gut microbiota, and affected the expression of genes related to energy metabolism in spleen. CONCLUSION: Moxibustion ameliorated age-related alterations in neurobehavior and gut microbiota in middle-aged mice.

[Development and application of a new digital electric fire needle instrument].

In view of the limitations of the high operational difficulty, safety hazards and adverse reactions of traditional fire needle, and unclear treatment parameters of existing electric fire needles, a new digital electric fire needle instrument was designed and developed in this study. This instrument is a gun type structure, consisting of a gun body, a power supply interface on the gun body, a display unit and a drive unit, a heating unit, a cooling unit, a positioning unit, and a needle inserting unit in the gun body. This instrument can digitally realize the regulation of parameters such as fire needle inserting temperature, depth and speed, and it has the advantageous features of intelligent needle burning, precise positioning, and safe and easy operation. This instrument meets the needs of more patients, medical professionals and scientific researchers, and is conducive to promoting the development of fire needle acupuncture therapy.

Efficacy and Safety of a Novel Plum Blossom Needling with Mild Moxibustion Device for Upper Limb Pain Disorder and Motor Dysfunction in Patients with Stage 1 Post-Stroke Shoulder-Hand Syndrome: Study Protocol for a Multi-Center, Single-Blind, Randomized Sham-Controlled Trial.

Background: Post-stroke shoulder-hand syndrome (PS-SHS), a common neurological comorbidity after stroke episodes, poses a grave threat on patients' functional recovery. Preliminary trials have demonstrated that the acupuncture and moxibustion treatment, including a dermal acupuncture tapping method known as plum blossom needling (PBN) can improve pain and motor dysfunctions in patients with PS-SHS. However, there are few reports describing simultaneous moxibustion treatment in combination with PBN. Hence, a novel plum blossom needle device with mild moxibustion (PBNMM) was developed to evaluate its potential efficacy and safety in patients with stage 1 PS-SHS. Materials and Methods: This multicenter, sham-controlled, randomized controlled trial (RCT) will recruit 102 eligible patients with stage 1 PS-SHS from three clinical centers, randomly allocated in a ratio of 1:1:1 to the PBNMM group, PBNMM with no moxa smoke (PBNMM-NMS) group and sham control group. Patients in each group will receive a 30-minute treatment once per day for 4 weeks, with 5 consecutive sessions per week, for a total of 20 sessions. The primary outcome measure will be defined as the decreased scores from baseline in the visual analog scale (VAS) assessment at week 4. Secondary outcome measures will include scores on the Fugl-Meyer Assessment of the Upper Extremity Scale (FMA-UE), the Modified Barthel Index (MBI), and the somatosensory evoked potential (SEP) records. All outcomes will be evaluated at baseline and weeks 4, 5, 6 and 10, and the intention-to-treat analysis will be applied. Conclusion: This study aims to provide robust evidence for the efficacy and safety of the PBNMM for PS-SHS treatment, as well as the specific impact of moxibustion smoke itself in dealing with PS-SHS. Clinical Trial Registration: Chinese Clinical Trial Registry No. ChiCTR2200062441. Registered on 7 August 2022.

Effectiveness of acupuncture for fatigue in patients with relapsing-remitting multiple sclerosis: a randomized controlled trial.

BACKGROUND: Fatigue is experienced by more than 65% of individuals with multiple sclerosis (MS). Some studies have supported the effectiveness of acupuncture in improving the symptoms of MS. OBJECTIVE: The present research was intended to investigate the effectiveness of acupuncture plus amantadine compared with amantadine alone on fatigue in patients with relapsing-remitting MS (RRMS) in the remission stage of the disease. METHODS: In this randomized controlled trial, 60 participants with RRMS suffering from fatigue were recruited and randomized equally to acupuncture (n = 30) and control (n = 30) groups. The acupuncture group received treatment 2 to 3 times per week for 10 sessions over 4 weeks. Both the acupuncture and control groups received amantadine 100 mg daily and routine treatment with immuno-modulators. The primary outcome was the fatigue severity scale (FSS) score, which was evaluated at baseline, and after 2 and 4 weeks. The secondary outcome was the Multiple Sclerosis Quality of Life 54 (MSQOL-54) questionnaire score, measured at baseline and the end of the 4-week treatment period. RESULTS: The severity of fatigue was reduced in both groups. However, after 4 weeks of treatment, the reduction of fatigue in the acupuncture group was more significant than in the control group (P < 0.01, mean difference (MD) = -1.14, 95% confidence interval (CI): -1.83 to -0.45). Quality of life, including mental and physical status, was significantly improved in the acupuncture group compared with the control group (P < 0.05, MD = 9.09, 95% CI: 0.46 to 17.73). No adverse events occurred in any of the participants. CONCLUSIONS: Acupuncture combined with amantadine and routine care compared with amantadine and routine care alone appears to be an effective short-term treatment for reducing fatigue and enhancing quality of life, including physical function and mental status, in patients with RRMS.

Effect of moxa smoke on sperm parameters and oxidative stress in rats with asthenozoospermia.

Asthenozoospermia is a leading cause of male infertility, characterized by reduced sperm motility. In this study, we determined sperm motility and the activities of antioxidant enzymes and oxidation products in the testis of rats with ornidazole (ORN)-induced asthenozoospermia and further examined and compared the differential effects of moxa smoke (MS) and cigarette smoke (CS) on sperm motility and oxidative stress (OS) of asthenozoospermic rats. The smoke intervention was initiated 11 days after intragastric administration of ORN, followed by the examination of testis index, sperm parameters, OS-related gene levels, and testicular histopathology. Sperm motility and antioxidant enzyme activities, as well as oxidation products significantly decreased in ORN-induced rats compared with MS-treated rats (p < .05-.001). MS treatment restored the reduced sperm motility and activities of glutathione peroxidase, superoxide dismutase, and catalase, but increased the malondialdehyde and nitric oxide synthetase levels in ORN-induced rats (p < .05-.001). Also, the histopathological changes in the testis of ORN-induced rats were improved by MS treatment. The study highlighted that MS was an effective factor in moxibustion therapy, which notably improved the sperm motility of asthenozoospermic rats by inhibiting OS in the reproductive system.

[Comparison of the four pairs of "phleps" in ancient Greek medicine and the eleven "mai" in Mawangdui silk manuscripts].

Using the philological method, the comparison was conducted between the internal canals of human body, meaning the four pairs of "phleps" in the ancient Greek medicine, and the eleven "mai" (meridians, vessels, channels) of Mawangdui silk manuscripts. It is believed that they refer to the initial understanding on the connecting passages of the human body in Western medicine and Chinese medicine respectively. Although they have their own unique characteristics, there are many similarities in running courses, related indications, diagnosis and treatment, as well as theoretic foundation. Both of them represent the duality of tangible blood vessels and intangible pathways, reflecting the common cognitive mode of human body and diseases in early human medicine, with the similar characteristics, e.g.analogy, examining the exterior to deduce the conditions in the interior, holistic connection and natural balance. The four pairs of "phleps" of ancient Greek medicine, with the preliminary features of meridians, were substituted by the blood circulation theory afterwards; whereas, the eleven "mai" of Mawangdui silk manuscripts were developed into a twelve-meridian system. These different evolution paths and outcomes may be associated with the distinct medical philosophies and cultural backgrounds between ancient Greek medicine and Chinese medicine. This summary provides a new approach and new perspectives for the study on the regularity of the early human medical origin, especially the origin of meridians.

Acupuncture for multiple sclerosis: A literature review.

BACKGROUND: Acupuncture as a complementary and alternative medicine (CAM) modality appears to be a helpful integrative therapy for multiple sclerosis (MS). Due to the chronicity of the disease and persistent symptoms, a large number of patients seek to use CAM for the MS treatment. Therefore, the present review aimed to determine the effectiveness of acupuncture in the treatment of multiple sclerosis. METHODS: PUBMED database was searched for English articles (at least English abstracts) in September 2021, including all articles published since the earliest literature until September 2021. Review articles were searched for relevant data. The searched keywords in titles and abstracts included ((acupuncture) OR (electroacupuncture)) AND (multiple sclerosis). RESULTS: Totally, out of 75 studied articles, 31 were included in this research. The advantages of acupuncture are mainly reflected in regulating neuro-immune system, improving the quality of life, reducing fatigue, improving the bladder function, reducing the spasm and pain of the limbs, delaying the progression of the disease, and reducing relapses. CONCLUSIONS: According to the review of the recent articles, traditional Chinese acupuncture and scalp acupuncture appear to help improve the symptoms of multiple sclerosis (including fatigue, neural functional deficits, pain, gait impairments, and bladder dysfunction) and reduce relapses. Therefore, acupuncture could be used as an integrative therapy in patients with MS.

Moxibustion for treating patients with post-stroke depression: a systematic review and meta-analysis.

BACKGROUND: To assess the effectiveness and safety of moxibustion for post-stroke depression (PSD). METHODS: A search was conducted in the following English and Chinese databases: Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature (CBM), VIP and Wanfang. The outcomes included Hamilton Depression Rating Scale (HAMD), effective rate, and Modified Edinburgh-Scandinavian Stroke Scale (MESSS) scale. The formulation of search strategy, data extraction, and quality evaluation of involved studies was performed according to Cochrane handbook guidelines. The software RevMan 5.4 and Stata 16 were used for data analysis. The evidence quality of each outcome was evaluated by GRADEpro guideline development tool (GDT). RESULTS: A total of 14 trials with 863 participants were included. A certain risk of bias of unclear or high was detected in the included studies. Compared with the control group, adding moxibustion could change the value of HAMD [standardized mean difference (SMD) =-1.17; 95% confidence interval (CI): -1.55 to -0.79; I2=85.5%; P<0.01] and the effective rate [risk ratio (RR) =1.22; 95% CI: 1.13 to 1.32; I2=0.0%; P=0.56], and the differences in the MESSS scale (SMD =-0.72; 95% CI: -1.06 to -0.38; I2=0.0%; P=0.80) had statistical differences. The certainty was low in effective rate, and very low in HAMD and MESSS. Besides, moxibustion was shown to be generally safe. DISCUSSION: This review found that moxibustion may be an effective intervention for PSD. However, the results of this study have a certain limitation. The benefits of moxibustion for PSD need to be confirmed in the future by more high-quality randomized controlled trials (RCTs).

Acupuncture for cancer pain: an evidence-based clinical practice guideline.

BACKGROUND: This study aims to develop an evidence-based clinical practice guideline of acupuncture in the treatment of patients with moderate and severe cancer pain. METHODS: The development of this guideline was triggered by a systematic review published in JAMA Oncology in 2020. We searched databases and websites for evidence on patient preferences and values, and other resources of using acupuncture for treatment of cancer pain. Recommendations were developed through a Delphi consensus of an international multidisciplinary panel including 13 western medicine oncologists, Chinese medicine/acupuncture clinical practitioners, and two patient representatives. The certainty of evidence, patient preferences and values, resources, and other factors were fully considered in formulating the recommendations. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was employed to rate the certainty of evidence and the strength of recommendations. RESULTS: The guideline proposed three recommendations: (1) a strong recommendation for the treatment of acupuncture rather than no treatment to relieve pain in patients with moderate to severe cancer pain; (2) a weak recommendation for the combination treatments with acupuncture/acupressure to reduce pain intensity, decrease the opioid dose, and alleviate opioid-related side effects in moderate to severe cancer pain patients who are using analgesics; and (3) a strong recommendation for acupuncture in breast cancer patients to relieve their aromatase inhibitor-induced arthralgia. CONCLUSION: This proposed guideline provides recommendations for the management of patients with cancer pain. The small sample sizes of evidence limit the strength of the recommendations and highlights the need for additional research.

Moxibustion may delay the aging process of Wistar rats by regulating intestinal microbiota.

As one of the important treatments of health care and anti-aging in traditional Chinese medicine (TCM), moxibustion has been proved to have the effects of scavenging free radicals, anti-oxidation, reducing inflammatory reaction, regulating immunity and so on. Recent studies have shown that intestinal microbiota affect the process of aging. The relationship between aging, moxibustion and intestinal microbiota is still unclear. In this study, we explored the effects of moxibustion at Guanyuan (RN4) acupoint on intestinal microbiota, short-chain fatty acids and immunological characteristics of young and elder female Wistar rats to explore the relationship between aging, moxibustion and intestinal microbiota. Six 12-week-old female Wistar rats were young group (Y), and twelve 36-week-old female Wistar rats were randomly divided into elder group (C) and moxibustion group (M). The rats in M group were received mild moxibustion at Guanyuan (RN4) acupoint, 20 min/d for 40 days. The rats in Y group and C group were not given any therapeutic intervention. The results showed that moxibustion increased the abundance of intestinal probiotics (mainly Lactobacillus) and the level of short chain fatty acids, the microcirculation blood flow around Guanyuan (RN4) acupoint was also significantly improved in elder rats. In addition, the expression of MyD88, MAPK, TRAF6, NF-κB in intestinal tissue was down-regulated, and the levels of inflammatory cytokines in intestinal were decreased.

Effect of transcutaneous electrical acupoint stimulation on bone metabolism in patients with immobilisation after foot and ankle fracture surgery: a randomised controlled trial study protocol.

INTRODUCTION: Fracture is a disease with a high incidence worldwide. Foot and ankle fractures are common among fractures of the lower extremities. Foot and ankle fractures usually require surgical fixation and a period of fixed treatment, which can lead to decreased bone density. Although transcutaneous electrical acupoint stimulation (TEAS) is widely used for movement system diseases, there is minimal evidence to show the effectiveness of TEAS on patients after surgical fixation of ankle and foot fractures. This trial aims to evaluate whether TEAS can reduce bone loss in patients with immobilisation after ankle and foot fractures. METHODS AND ANALYSIS: A randomised controlled trial will be conducted in which 60 patients will be randomly divided into two groups: (a) the control group will be treated according to the routine procedures of basic orthopaedics treatment; (b) in the treatment group, bilateral SP36, BL23 and ST36 will be performed on the basis of the control group, and the test will be performed for 30 min every other day for a total of 8 weeks. Bone turnover markers will be used as primary outcome. Secondary outcomes are composed of blood phosphorus, blood calcium and bone mineral density. Treatment safety will be monitored and recorded. ETHICS AND DISSEMINATION: This trial is approved by the Ethics Committee of Beijing University of Chinese Medicine (2020BZYLL0611) and the Ethics Committee of Beijing Luhe Hospital (2020-LHKY-055-02), and inpatients who meet the following diagnostic and inclusion criteria are eligible to participate in this study. TRIAL REGISTRATION NUMBER: ChiCTR 2000039944.

Moxibustion therapy for treating patients with postpartum urinary retention: A protocol for systematic review and meta-analysis.

BACKGROUND: Postpartum urinary retention (PUR) is one of the most common complications after parturition which affect women's recovery after childbirth. Many clinical trials have shown that moxibustion, a traditional Chinese medicine therapy, is effective in treating PUR. But its effectiveness has not been evaluated scientifically and systematically. Therefore, this review aims to evaluate the safety and effectiveness of moxibustion therapy in treating patients with PUR. METHODS: We will search the following electronic databases, regardless of publication status and languages, from their respective inception dates to February 2021: the Cochrane Central Register of Controlled Trails, Pubmed, EMBASE, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journal Database, and Wan-Fang Database. Clinical randomized controlled trials (RCTs) related to moxibustion therapy for treating PUR will be included. Study selection, data collection, and quality assessment will be independently conducted by 2 researchers. For data synthesis, we will select either the fixed-effects or random-effects model according to heterogeneity assessment. Cure rates and postvoid residual volume (PVRV) will be the primary outcomes. The total effective rate and first urination time will be the second outcomes. Review Manager Software (RevMan) V.5.3 will be used if it is appropriate for meta-analysis. Otherwise, a systematic narrative synthesis will be conducted. The results will be presented as risk ratio (RR) with 95% confidence interval (CI) for dichotomous data and weight mean difference (WMD) or standard mean difference (SMD) 95% CI for continuous data. TRIAL REGISTRATION NUMBER: INPLASY 202140037.

Study of Thermal Behavior of Moxa Floss Using Thermogravimetric and Pyrolysis-GC/MS Analyses.

Moxa floss is a type of biomass used as the main combustion material in moxibustion, a therapy that applies heat from moxa floss combustion to points or body areas for treatment. Safety concerns regarding moxa smoke have been raised in recent years. Since moxa floss is the source material in moxibustion, its thermal behavior and pyrolysis products would be related to the products formed in moxa smoke. This work aims to understand the thermal behavior of moxa floss and investigate the pyrolysis products generated from moxa floss combustion. Six commercial moxa floss samples of 3 storage years and 10 storage years, and of low, medium, and high ratios, were selected. The kinetic data from moxa floss combustion was carried out by a thermogravimetric analyzer. Pyrolysis-gas chromatography and mass spectroscopy using a gas chromatograph and mass spectrometer equipped with a pyroprobe were used to examine the pyrolysis products. Thermogravimetric profiles for all the samples were overall similar and showed a monotonic weight decrease. The range of intensive reaction temperature occurred between 150°C and 450°C, which was characterized by a major weight loss and accompanied by an exothermal degradation of the main components. The average ignition temperature for the samples of 3 and 10 storage years was 218.3°C and 222.6°C, respectively, which was lower than most herbaceous plants. The identified pyrolysis products include monocyclic aromatic hydrocarbons, polycyclic aromatic hydrocarbons, ketones, acids, and alkanes. All were of relatively low intensities of below 5% in relative abundance. No volatiles were detected in the samples of 10 storage years. The relatively low values of ignition temperature suggested that moxa floss is more combustible and can be ignited more easily than other herbaceous plants. This may explain why moxa floss has remained as the preferred material used for moxibustion over the years.

A Urinary Metabolomics Analysis Based on UPLC-MS and Effects of Moxibustion in APP/PS1 Mice.

OBJECTIVE: Alzheimer's disease (AD) is a common neurodegenerative disorder with the symptoms of cognitive impairment and decreased learning and memory abilities. Metabolomics can reflect the related functional status and physiological and pathological changes in the process of AD. Moxibustion is a unique method in traditional Chinese medicine, which has been used in the treatment and prevention of diseases for thousands of years. METHODS: A total of 32 APP/PS1 mice were randomly divided into the model group, moxibustion group, moxa smoke group and smoke-free moxibustion group (n=8/group), using the random number table method, while eight C57BL/6 mice were used as the control group. The five groups were measured for 20 min/day, 6 days/week, for 4 weeks. After 4 weeks' experiment, all the mice were placed in metabolic cages to collect urine continuously for 24 hours, for UPLC-MS analysis. RESULTS: Principal component analysis (PCA) was used to identify the different metabolites among the five groups, and partial least squares discriminant analysis (PLS-DA) was performed to reveal the effects on the metabolic variance. Sixteen potential biomarkers were identified among the five groups, primarily related to amino acid metabolism, starch metabolism, sucrose metabolism, interconversion of pentose and glucuronate, and aminoacyl biosynthesis. There were 17 differences in the potential metabolites between the control and model groups, involving the metabolism of amino acid, purine, pyrimidine, nicotinic acid and nicotinamide, and biosynthesis of pantothenate and coenzyme A. Fifteen potential biomarkers were identified between the model and moxibustion groups, related to starch metabolism, sucrose metabolism, interconversion of pentose and glucuronate, glyoxylate, dicarboxylate anions and some amino acid metabolism. CONCLUSION: Moxibustion can regulate the metabolism of substance and energy by improving the synthesis and decomposition of carbohydrates and amino acids in APP/PS1 transgenic AD model mice.

Quality grade classification of China commercial moxa floss using electronic nose: A supervised learning approach.

Moxa floss is the primary material used in moxibustion, an important traditional Chinese medicine therapy that uses ignited moxa floss to apply heat to the body for disease treatment. Till date, there is no available data regarding quality control of different grades of moxa floss. The objectives of this study were to explore the probative value of the electronic nose (e-nose) in differentiating different quality grades of commercial moxa floss sold in China, and to investigate if data mining techniques could be used to optimize the sensor array while retaining classification accuracy of the samples. The e-nose with 12 metal oxide semiconductor type sensors was used to analyze the odor profiles of 15 commercial moxa floss samples of different quality grades. Feature selection algorithms using principal component analysis (PCA) and BestFirst (BC) coupled with correlation-based feature subset selection (CfsSubsetEval) method were used to obtain the most efficient feature subsets. Results for the BC feature selection method identified 3 optimized sensors (S2, S6, and S11), suggesting that aromatic compounds relate more to the identification of the samples. Radial basis function (RBF), multilayer perceptron (MLP), and random forests (RF) performed well in discriminating the samples, retaining prediction accuracies above 85%, which achieved cost-effectiveness and operational simplicity, while retaining prediction accuracy. The e-nose could be a rapid and nondestructive method for objective preliminary classification of quality grades of moxa floss and may be used for future studies related to moxa products safety and quality.

Effectiveness of Acupuncture Treatment on Chemotherapy-Induced Peripheral Neuropathy: A Pilot, Randomized, Assessor-Blinded, Controlled Trial.

Objective: This pilot study aims to evaluate the effectiveness and safety of acupuncture in the treatment of chemotherapy-induced peripheral neuropathy (CIPN). Methods: This study was a pilot randomized controlled trial, which was conducted with cooperation between Beijing University of Chinese Medicine (BUCM), China, and Tehran University of Medical Science (TUMS), Iran. Forty participants with CIPN were randomly assigned (1 : 1) to receive twelve sessions of acupuncture (20 minutes each session over 4 weeks) or take one 300 mg tablet of vitamin B1 and three 300 mg capsules of gabapentin per day for 4 weeks, after which both groups were followed up for 4 weeks. The primary endpoint was CIPN symptom severity measured by the Numerical Rating Scale (NRS). The secondary endpoints included sensory neuropathy grade evaluated by the National Cancer Institute-Common Toxicity Criteria for Adverse Events (NCI-CTCAE), neurophysiological assessment of CIPN by the nerve conduction study (NCS), and the patient overall satisfaction with treatment. Safety was assessed at each visit. Results: The NRS and NCI-CTCAE sensory neuropathy grading scales decreased significantly over time in both groups (both P < 0.001), with a significantly higher reduction in the acupuncture group (P < 0.001 and P = 0.03, respectively). In addition, the acupuncture group showed a higher overall satisfaction with the treatment at the end of treatment and after 4 weeks follow-up, in comparison with the vit B1 and gabapentin group (P = 0.01 and P = 0.001, respectively). The NCS (except for the latency of the sural nerve) in the acupuncture group improved significantly (P < 0.05), while improvement in the vit B1 and gabapentin group was not observed (P > 0.05). Conclusion: Our study revealed that acupuncture, as a kind of traditional Chinese therapeutic method, is significantly effective and safe in the treatment of CIPN. Moreover, acupuncture is more effective than using vitamin B1 and gabapentin as the conventional treatment. Trial registration. This trial is registered with the Iranian Registry of Clinical Trials (IRCT20190615043900N1).

Acupuncture treatment for chemotherapy-induced nausea and vomiting: A protocol for systematic review and meta-analysis.

BACKGROUND: Chemotherapy-induced nausea and vomiting (CINV) make many patients have negative adherence of treatment. Acupuncture has been widely applied in treatment of CINV, but its efficacy has not been evaluated scientifically and systematically in recent years. Hence, evaluating the safety and effectiveness of acupuncture treatment in patients with CINV is the main purpose of this review. METHODS AND ANALYSIS: We will search the following electronic databases from inception to Mar 2020: the Cochrane Central Register of Controlled Trials, EMBASE, PubMed, the Web of Science, China National Knowledge Infrastructure (CNKI), Traditional Chinese Medicine, Chinese Biomedical Literature Database (CBM), Wan-Fang Database and Chinese Scientific Journal Database (VIP database). All published academic data about clinical randomized controlled trials in English or Chinese related to acupuncture for treating CINV will be obtained. The primary outcomes are defined as frequency and severity of CINV during chemotherapy. The secondary outcomes are defined as any adverse events and quality of life of CINV during chemotherapy. The study selection, data extraction, and assessment of study quality will be conducted by 2 researchers independently. Review Manager Software (RevMan) V.5.3 will be performed for meta-analysis. RESULTS: The results of this review will provide a high-quality synthesis of current available evidence to evaluate acupuncture is an effective and safe treatment for CINV. CONCLUSION: The conclusion of this review will provide the highest level of evidence to judge whether acupuncture is an effective and safe treatment for patients suffered from CINV. PROSPERO REGISTRATION NUMBER: CRD42020153993.

Moxibustion at 'Danzhong' (RN17) and 'Guanyuan' (RN4) for fatigue symptom in patients with depression: Study protocol clinical trial (SPIRIT Compliant).

BACKGROUND: Fatigue is one of the most prevalent and debilitating symptoms of major depressive disorder (MDD). The effective management of depression-related fatigue has an important impact on the patient's abilities, functioning, and quality of life (QOL). Moxibustion has been widely used in Traditional Chinese Medicine to manage fatigue. Recent studies have also demonstrated that moxibustion is effective for treating cancer-related fatigue and chronic fatigue syndrome. However, there is not sufficient data supporting the effect of moxibustion for depression-related fatigue. Therefore, this randomized, assessor-blinded, wait-list controlled trial is designed to evaluate the effectiveness, safety, and feasibility of moxibustion treatment for depression-related fatigue. METHODS: One hundred and seventy-six participants who meet the diagnostic criteria for depression in the International Classification of Diseases, tenth revision (ICD-10), and who also have a score of ≥1 on the 13 item of the Hamilton Depression Rating Scale-17 (HAMD-17), will be enrolled. At study entry, participants will undergo anti-depressant treatment for at least 1 month. Then those who still have a score of ≥1 on the 13 item of the HAMD-17 will be randomly allocated to either a moxibustion group or wait-list control group in a ratio of 1:1. Anti-depressants will be provided for both groups during the whole process of the study period. Participants in the moxibustion group will undergo 14 sessions of moxibustion (over 2 weeks) with anti-depressant treatment, and participants in the wait-list control group will receive only anti-depressant treatment. Subsequently, participants in the moxibustion group will be followed-up for 4 weeks. The primary outcome measure will be the Fatigue Severity Scale (FSS). The secondary outcome measure will be the HAMD-17. Safety will be assessed by monitoring adverse events during the study. Trial feasibility will also be assessed in this study. DISCUSSION: The results of this study may provide evidence for the efficacy of moxibustion as an adjunct to antidepressants for depression-related fatigue, and promote a more widespread foundation for the selection of moxibustion in the clinical setting as well as for future research in moxibustion therapy. TRIAL REGISTRATION: This study protocol was registered at the Chinese Clinical Trial Registry (ChiCTR1800016905).