[Acupuncture for treatment of tobacco withdrawal syndrome: systematic review and Meta-analysis].

OBJECTIVE: To systematically review the efficacy of acupuncture for the treatment of tobacco withdrawal syndrome. METHODS: The randomized controlled trials (RCTs) regarding acupuncture for treatment of tobacco withdrawal syndrome were searched in CNKI, Wanfang, VIP, SinoMed, PubMed, Cochrane, Medline and EMbase databases. The search period was from January 1st of 2011 to December 31st of 2021. After data extraction and bias risk assessment of the included literature, the Meta-analysis was performed using RevMan5.4.1 software. RESULTS: Totally 23 RCTs were included, including 2 120 patients. The Meta-analysis results showed that compared with medication, acupuncture showed no significant difference at improving Fagerström test for nicotine dependence (FTND) score (MD=0.16, 95%CI: -0.08, 0.41), heaviness of smoking index (HSI) score (MD=0.11, 95%CI: -0.13, 0.36), Minnesota nicotine withdrawal scale (MNWS) score (MD=0.12, 95%CI: -0.11, 1.35), questionnaire of smoking urges (QSU) score (MD=-0.30, 95%CI: -2.78, 2.18), Hamilton depression scale (HAMD) score (MD=0.76, 95%CI: -1.54, 3.06), abstinence rate (RR=0.95, 95% CI: 0.82, 1.10) and effective rate (RR=1.01, 95%CI: 0.95, 1.07). Acupuncture was superior to sham acupuncture in reducing MNWS score (MD=-4.88, 95%CI: -5.21, -4.55, P<0.000 01). Acupuncture was superior to cognitive behavioral therapy in reducing FTND score (MD=-1.41, 95%CI: -1.74, -1.08), MNWS score (MD=-4.28, 95%CI: -5.31, -3.25) and increasing abstinence rate (RR=2.19, 95%CI: 1.39, 3.45, P<0.000 01, P<0.001). CONCLUSION: Acupuncture could effectively improve tobacco withdrawal syndrome, increase abstinence rate and effective rate. Limited by the quantity and quality of the included studies, this conclusion needs to be verified by more studies.

[Auricular point sticking combined with transcutaneous electrical acupoint stimulation for smoking cessation：a randomized controlled trial].

OBJECTIVE: To compare the clinical efficacy between auricular point sticking combined with transcutaneous electrical acupoint stimulation (TEAS) and nicotine patch for smoking cessation. METHODS: Two hundred patients who voluntarily quit smoking were randomly divided into a combination group and a nicotine patch group, 100 cases in each group. In the combination group, auricular point sticking (Shenmen [TF4], Neifenmi [CO18], Pizhixia [AT4], Jiaogan [AH6a], etc., once every other day) combined with TEAS（Lieque [LU 7] and Zusanli [ST 36], with continuous wave, 20 Hz in frequency, 1 mA in current intensity, 30 min each time, once a day) were applied. In the nicotine patch group, nicotine patch was applied. Both groups were treated for 8 weeks. The immediate withdrawal rate and persistent withdrawal rate 8 weeks into treatment and in follow-up of 16 weeks after treatment in the two groups were compared; before treatment, 8 weeks into treatment and in follow-up of 16 weeks after treatment, the degree of nicotine dependence was evaluated by using Fagerström test for nicotine dependence (FTND); 1 week into treatment, 8 weeks into treatment and in follow-up of 16 weeks after treatment, the withdrawal symptoms and smoking craving were evaluated by using Minnesota nicotine withdrawal scale (MNWS); the safety and compliance (dropped off rate and treatment completeness) were evaluated in the two groups. RESULTS: There was no statistical significance of the differences in the immediate withdrawal rate and persistent withdrawal rate 8 weeks into treatment and during follow-up between the two groups (P>0.05). The FTND scores were decreased 8 weeks into treatment and during follow-up in the two groups compared with those before treatment (P<0.01); the FTND score during follow-up in the combination group was lower than the nicotine patch group (P<0.05). The MNWS scores were decreased 8 weeks into treatment and during follow-up in the two groups compared with those 1 week into treatment (P<0.05); the changes of MNWS scores 8 weeks into treatment and during follow-up in the combination group were greater than the nicotine patch group (P<0.05, P<0.01). There were no serious adverse reactions in either group. Eight weeks into treatment and during follow-up, the dropped off rates were all 16.0% (16/100) in the combination group, which were 20.0% (20/100) and 23.0% (23/100) in the nicotine patch group, there was no statistical significance of the differences in the two groups (P>0.05). There was no significant difference in treatment completeness between the two groups (P>0.05). CONCLUSION: Auricular point sticking combined with TEAS could effective decrease the degree of nicotine dependence, improve withdrawal symptoms in smokers, its effect is superior to nicotine patch.

[Impacts of nicotine metabolite rate and acupuncture frequency on smoking cessation: a randomized controlled trial].

OBJECTIVE: To compare the efficacy of different acupuncture frequencies in tobacco-dependent patients and explore the impact of nicotine metabolite rate (NMR) on smoking cessation in the intervention with acupuncture. METHODS: A total of 120 cases of tobacco-dependent patients were randomly divided into a high-frequency group (60 cases, 12 cases dropped off) and a low-frequency group (60 cases, 6 cases dropped off). In the two groups, smoking cessation counseling was provided prior to acupuncture. Acupuncture was applied to Baihui (GV 20), Lieque (LU 7), Zusanli (ST 36), etc. Additionally, electric stimulation was added at Lieque (LU 7) and Zusanli (ST 36), with continuous wave, 15 Hz in frequency. The duration of treatment was 8 weeks in either group. In the high-frequency group, the treatment was given 5 times weekly from week 1 to week 4, and was 3 times weekly from week 5 to week 8. In the low-frequency group, the treatment was given 3 times weekly from week 1 to week 4, and was twice a week from week 5 to week 8. The immediate withdrawal rate, persistent withdrawal rate, the score of Fagerstrom test for nicotine dependence (FTND) before and after treatment, as well as the score of Minnesota nicotine withdrawal scale (MNWS) in 1 and 8 weeks of treatment were compared among the patients with high and low NMR between the two groups separately. The Logistic regression analysis was used to screen the influencing factors of smoking cessation in the intervention with acupuncture. RESULTS: After treatment, there was no statistical significance of the differences in the immediate withdrawal rate (35.4% [17/48] vs 29.6% [16/54]) and the persistent withdrawal rate (33.3% [16/48] vs 25.9% [14/54]) between the high-frequency group and the low-frequency group (P>0.05). The difference in withdrawal rate had no statistical significance between high and low NMR patients (P>0.05). FTND scores after treatment were lower than those before treatment (P<0.01) and MNWS scores were lower than those in 1 week of treatment (P<0.01) in the two groups. However, the differences had no statistical significance between the two groups and between the patients with high NMR and low NMR (P>0.05). Age, education level and NMR were the influencing factors of smoking cessation in the intervention with acupuncture (P<0.05). CONCLUSION: Acupuncture with different frequencies has no obvious impact on the efficacy in tobacco-dependent patients. The lower nicotine metabolite rate in individuals, the better efficacy of acupuncture. The smokers with high nicotine metabolite rate may obtain a better effect of cessation in the high-frequency intervention with acupuncture.

Progress of SLFN family proteins in tumor and virus infection.

Schlafen (SLFN) family genes were initially found in humans and rats to regulate cell growth and T cell differentiation, and exist widely in mice, horses, humans and other species and exhibit high homology. Lines of evidence suggest that SLFN proteins play important roles in inhibiting cell proliferation, promoting meiosis, regulating hematopoietic cells, reducing platelet numbers and the immune response, and also exert antiviral functions against several virus species including HIV-1, influenza virus and others. In addition, SLFN proteins have also been found to be closely related to cancer therapy, and act as a molecular marker to predict tumor development and the sensitivity to chemotherapy drugs. In this review, we discuss the classification, structures, characteristics, location and functions of SLFN family proteins, and focus on progress related to tumor and virus infection, aiming to provide new thoughts on exploration of SLFN protein functions and the underlying mechanisms.

Effects of Cinnamaldehyde on the Viability and Expression of Chemokine Receptor Genes in Temozolomide-treated Glioma Cells.

BACKGROUND/AIM: The effects of cinnamaldehyde on glioma are still unclear. We aimed to investigate the effects of cinnamaldehyde on the viability and expression of chemokine receptors CXCR4 and CXCR7 in temozolomide (TMZ)-treated glioma cells. MATERIALS AND METHODS: Cell viability and CXCR4 and CXCR7 expression were measured by western blotting at 72 h after treatment with various concentrations of cinnamaldehyde and TMZ. RESULTS: Cell viability was significantly lower after treatment with 300 µM TMZ, 50 µM cinnamaldehyde, 75 µM cinnamaldehyde, or combined treatment with 300 µM TMZ plus 50 µM or 75 µM cinnamaldehyde than after no treatment (i.e., without TMZ or cinnamaldehyde); and significantly lower after combined treatment with 300 µM TMZ plus 75 µM cinnamaldehyde but not 50 µM cinnamaldehyde, than treatment with 300 µM TMZ alone. Western blotting showed that either single treatments or combined treatments had lower CXCR4 expression (compared to the no-treatment control). Compared to 300 µM TMZ alone, both combined treatment of 300 µM TMZ plus 50 µM cinnamaldehyde or 75 µM cinnamaldehyde had significantly lowered CXCR4 expression. However, CXCR7 expression was not significantly different in all groups. CONCLUSION: Cinnamaldehyde, acting with TMZ, reduces glioma cell viability possibly via decreasing CXCR4 expression.

Microbes Associated With Black Soldier Fly (Diptera: Stratiomiidae) Degradation of Food Waste.

Black soldier fly (Hermetia illucens L.) larvae are capable of valorizing waste by converting it into insect biomass that can be used as animal feed, leaving undigested residue that can be used as soil enrichment. Evidence is conflicting over whether larvae fed substrate containing pathogenic microbes emerge uncontaminated. Studies also differ on which clades comprise the species' gut microbiome, and on whether and how diet affects these microbes. Using culturing and metabarcoding, the bacterial microbiota of black soldier fly larvae reared on two different kinds of food waste (postproduction soy pulp and postconsumer cafeteria waste) were analyzed, along with the microbes of their substrates. Little to no overlap was found between the wastes, the larvae, and the residues, but the larvae fed different foods had a significant percentage of their microbes in common. The data, in line with other works on this species, suggest the larvae have a conserved microbiota whose components vary geographically.

The dangers of hemilithotomy positioning on traction tables: case report of a well-leg drop foot after contralateral femoral nailing.

BACKGROUND: Postoperative contralateral morbidities after fracture fixation surgery by hemilithotomy positioning on traction table is uncommon. We'd report a case of unexpected common peroneal nerve palsy developed on the contralateral side manifesting with drop foot after a common orthopedic femoral nailing. CASE REPORT: A 28-year-old female sustained an unusual common peroneal nerve palsy manifesting contralateral drop foot after prolonged femoral nailing. Although the initial presentations were similar to the notorious well-leg compartment syndrome, a benign course with complete recovery in functions was observed 3 months later. After neurophysiologic exam and review of pertinent literature, this iatrogenic and transient dysfunction was delineated to be position-related neuropraxia. CONCLUSION: Position adjustment at intervals or complete avoidance of prolonged knee hyperflexion is recommended to prevent contralateral common peroneal nerve morbidity.

Precision pinch performance in patients with sensory deficits of the median nerve at the carpal tunnel.

To investigate how sensory symptoms impact the motor control of hands, in this study we examined the differences in conventional sensibility assessments and pinch force control in the pinch-holding-up activity (PHUA) test between carpal tunnel syndrome (CTS) patients and healthy controls. CTS patients (n = 82) with 122 affected hands and an equal number of control subjects were recruited to participate in the threshold, discrimination, and PHUA tests. The patients showed significantly poorer hand sensibility and lower efficiency of force adjustment in the PHUA test as compared with the control subjects. Baseline pinch strength and the percentage of maximal pinch strength for the PHUA were significantly higher for the subgroup of sensory nerve action potential (SNAP) of <16 µV than for the subgroup of SNAP of 16 µV. Using a PHUA perspective to analyze the efficiency of force-adjustment could assist the clinical detection of sensory nerve dysfunction.

Detection of early cognitive impairment using AD8 in a young patient with stroke with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy syndrome: a case report.

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) syndrome is a hereditary disease resulting from NOTCH3 gene mutation. The clinical presentations include migraine, recurrent stroke, and cognitive impairment. The severity of cognitive impairment varies in different stages, and early recognition poses a challenge. A 47-year-old lady presented with chronic migraine and sudden onset of hemiparesis. Magnetic resonance imaging revealed compatible findings of CADASIL, which was confirmed by mutation analysis of NOTCH3 gene. Early cognitive impairment was detected by her score of 3 in Ascertain Dementia 8 (AD8) questionnaire and confirmed by detailed neuropsychological assessments. After 21 months of follow-up, deterioration in her cognition and ability to perform instrumental activities of daily living were significant with a follow-up AD8 score of 7. Ascertain Dementia 8 questionnaire is an easy and valid screening tool for early cognitive impairment in patients with CADASIL syndrome.

Effect of acetazolamide for long-lasting paroxysmal dystonia in a patient with multiple sclerosis: a case report and review of literature.

Dystonia is a rare manifestation of multiple sclerosis (MS), but it always interferes with the functional performance and quality of life. We report a rare case of long-lasting paroxysmal dystonia associated with MS. The patient was a 40-year-old woman with relapsing- remitting MS for 6 years. During the latest attack of MS, she suffered from long-lasting paroxysmal dystonia in her left hand. Despite treatment with pulse high-dose intravenous methylprednisolone, interferon, and baclofen, along with occupational therapy, the dystonia persisted and significantly bothered her daily activities. Finally, she was treated with oral acetazolamide (250 mg, three times a day for 4 days), which was very effective for the control of her dystonia. The dystonic movement subsided without recurrence in a follow-up of 17 months. We advocate this effective and safe treatment for patients with paroxysmal dystonia associated with MS.

Establishment of a proper manual tactile test for hands with sensory deficits.

OBJECTIVES: To (1) develop the Manual Tactile Test (MTT) for evaluating the hand perception to distinguish objects' characteristics; (2) establish the reliability and validity of the MTT for patients with carpal tunnel syndrome (CTS); and (3) integrate a normative database into the test. DESIGN: Cohort and case-control studies. SETTING: Hospital and local community. PARTICIPANTS: Participants included patients with CTS (n=70) and healthy volunteers (n=125). Twenty young volunteers were enrolled to evaluate the reliability of the test. Seventy patients with CTS and 70 age- and sex-matched controls were recruited to establish the discriminate validity and receiver operating characteristic (ROC) curves for the MTT. A normative database was constructed from 125 healthy, right-handed participants. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The MTT was designed to discriminate the characteristics of the objects' weight (barognosis test), texture (roughness differentiation test), and shape (stereognosis test) via active hand exploration. The times required discriminating the characteristics of objects and the accuracy of judgment were recorded and analyzed. RESULTS: High Cronbach alpha values (.83-.91) and small coefficient of variation (.10-.16) values showed that the MTT is a reliable testing tool. The results significantly discriminated the patients from the control group (P<.001). The sensitivity and specificity were .64 to .81 and .73 to .76, respectively, for the 3 subtests. The ROC curve area for the 3 subtests ranged from .70 to .84. The results of the MTT obtained from 125 healthy subjects showed that age significantly affects hand perceptive function (P<.001). CONCLUSIONS: The MTT is a reliable, accurate, and valid tool for determining the impairment of manual touch sensibility for CTS and can help clinicians understand age-related degradation in sensorimotor control of the hand in the elderly population.

Therapeutic effects of lidocaine patch on myofascial pain syndrome of the upper trapezius: a randomized, double-blind, placebo-controlled study.

OBJECTIVE: The aim of this study was to compare topical 5% lidocaine patch with placebo patch in the treatment of myofascial pain syndrome of the upper trapezius. DESIGN: In this prospective, randomized, double-blind, placebo-controlled study, 60 participants were randomly assigned, placing 31 subjects in the 5% lidocaine patch group and 29 subjects in the placebo patch group. We used the Verbal Rating Scale (VRS), the Pressure Pain Threshold, the ranges of motion of the neck, and the Neck Disability Index to evaluate the subjective pain intensity, objective pain intensity, ranges of motion, and disability of the neck, respectively. Outcome measures were performed before (day 0) the treatment course, 12 hrs after removal of the final patch on the seventh day (day 7), and 1 wk (day 14) and 3 wks (day 28) after the completion of treatment course. RESULTS: The characteristics of the participants did not differ at baseline. Pain intensity assessed by the VRS decreased at day 7 in both the lidocaine patch and placebo patch groups. There was no significant difference between the two groups in the VRS, the Pressure Pain Threshold, the ranges of motion, and the Neck Disability Index. At day 14, the experimental group continued to improve in the VRS (1.06), but the pain of the placebo group aggravated (VRS, 1.5). The difference is significant (P = 0.03). In addition, the Neck Disability Index in the lidocaine patch group decreased significantly as compared to that in the placebo group. The pain-relieving effect of the lidocaine patch attenuated, and it was not significantly different between the two groups at day 28 in the VRS and the Neck Disability Index. Neither the Pressure Pain Threshold nor the ranges of motion were significantly different through the periods of this study. CONCLUSIONS: The application of the 5% lidocaine patch is probably superior to the placebo patch in relieving pain and in reducing associated neck disability for a period of longer than 1 wk for treating patients with myofascial pain syndrome of the upper trapezius.

Genomewide association study of leprosy.

BACKGROUND: The narrow host range of Mycobacterium leprae and the fact that it is refractory to growth in culture has limited research on and the biologic understanding of leprosy. Host genetic factors are thought to influence susceptibility to infection as well as disease progression. METHODS: We performed a two-stage genomewide association study by genotyping 706 patients and 1225 controls using the Human610-Quad BeadChip (Illumina). We then tested three independent replication sets for an association between the presence of leprosy and 93 single-nucleotide polymorphisms (SNPs) that were most strongly associated with the disease in the genomewide association study. Together, these replication sets comprised 3254 patients and 5955 controls. We also carried out tests of heterogeneity of the associations (or lack thereof) between these 93 SNPs and disease, stratified according to clinical subtype (multibacillary vs. paucibacillary). RESULTS: We observed a significant association (P<1.00x10(-10)) between SNPs in the genes CCDC122, C13orf31, NOD2, TNFSF15, HLA-DR, and RIPK2 and a trend toward an association (P=5.10x10(-5)) with a SNP in LRRK2. The associations between the SNPs in C13orf31, LRRK2, NOD2, and RIPK2 and multibacillary leprosy were stronger than the associations between these SNPs and paucibacillary leprosy. CONCLUSIONS: Variants of genes in the NOD2-mediated signaling pathway (which regulates the innate immune response) are associated with susceptibility to infection with M. leprae.

Motion tracking on elbow tissue from ultrasonic image sequence for patients with lateral epicondylitis.

In this study, Kinesio Tape(R) is used in patients with lateral epicondylitis. The ultrasonic image sequences of elbow are recorded dynamically, and then motion tracking is applied to assist in understanding the effect of the therapy. Motion tracking, based on optical flow method, is used to track certain landmark on the ultrasound image, which is very ambiguous, for estimating the motion of muscle. Hierarchical block tracking technique is proposed to perform this task. The motions with and without Kinesio Taping are compared and can be used as quantitative indicators for the treatment. The experimental results show that Kinesio Taping makes the motion of muscle on the ultrasonic images enlarge. It means that the performance of muscle motion gets improve.

Dry needling to a key myofascial trigger point may reduce the irritability of satellite MTrPs.

OBJECTIVE: To investigate the changes in pressure pain threshold of the secondary (satellite) myofascial trigger points (MTrPs) after dry needling of a primary (key) active MTrP. DESIGN: Single blinded within-subject design, with the same subjects serving as their own controls (randomized). Fourteen patients with bilateral shoulder pain and active MTrPs in bilateral infraspinatus muscles were involved. An MTrP in the infraspinatus muscle on a randomly selected side was dry needled, and the MTrP on the contralateral side was not (control). Shoulder pain intensity, range of motion (ROM) of shoulder internal rotation, and pressure pain threshold of the MTrPs in the infraspinatus, anterior deltoid, and extensor carpi radialis longus muscles were measured in both sides before and immediately after dry needling. RESULTS: Both active and passive ROM of shoulder internal rotation, and the pressure pain threshold of MTrPs on the treated side, were significantly increased (P < 0.01), and the pain intensity of the treated shoulder was significantly reduced (P < 0.001) after dry needling. However, there were no significant changes in all parameters in the control (untreated) side. Percent changes in the data after needling were also analyzed. For every parameter, the percent change was significantly higher in the treated side than in the control side. CONCLUSIONS: This study provides evidence that dry needle-evoked inactivation of a primary (key) MTrP inhibits the activity in satellite MTrPs situated in its zone of pain referral. This supports the concept that activity in a primary MTrP leads to the development of activity in satellite MTrPs and the suggested spinal cord mechanism responsible for this phenomenon.

The myofascial trigger point region: correlation between the degree of irritability and the prevalence of endplate noise.

OBJECTIVE: This study was designed to investigate the correlation between the irritability of the myofascial trigger point (MTrP) and the prevalence of endplate noise (EPN) in the MTrP region of human skeletal muscle. DESIGN: Twenty normal subjects with latent MTrPs and 12 patients with active MTrPs in the upper trapezius muscles were recruited for this study. The patients reported the subjective pain intensity of the active MTrP (0-10). The MTrP and an adjacent non-MTrP site were confirmed and marked for the measurement of pressure pain threshold (with a pressure algometer) and the prevalence of EPN (with electromyographic recordings). RESULTS: The prevalence of EPN in the MTrP regions was significantly higher (P < 0.01) in the active MTrPs than in the latent ones. However, no EPN could be found in the non-MTrP region near either the active or the latent MTrPs. The pain intensity and the pressure pain threshold were highly correlated with the prevalence of EPN in the MTrP region (r = 0.742 and -0.716, respectively). CONCLUSIONS: The irritability of an MTrP is highly correlated with the prevalence of EPN in the MTrP region of the upper trapezius muscle. The assessment of EPN prevalence in an MTrP region may be applied to evaluate the irritability of that MTrP.

The spinal cord connections of the myofascial trigger spots.

BACKGROUND: Recent electrophysiological studies revealed that endplate noise (EPN) could be specifically recorded from a myofascial trigger point (MTrP) region. EPN has been considered as the focal graded potentials due to excessive acetylcholine release in neuromuscular junction. A recent histological study has demonstrated a free nerve ending at the vicinity of the site, from where EPN could be recorded in an MTrP region. However, the sensory (afferent) and the motor (efferent) connections between an MTrP and the spinal cord still has never been fully studied. AIMS: The aim of this study was to delineate both motor and sensory connections between an MTrP and the spinal cord by applying the stain with horseradish peroxidase (HRP). METHODS: Nine Wistar rats were studied. When the rat was anesthetized, its biceps femoris muscles were exposed for localizing the myofascial trigger spot (MTrS, equivalent to MTrP in human). In one side, a monopolar Teflon-coated, hollow-needle electrode was used for searching EPN in an MTrS region, and then HRP was injected via this hollow-needle electrode into the site where EPN was recorded. HRP was also injected into a normal (non-taut band, non-MTrS) site in the contralateral side to obtain the control data. Two days after HRP injection, the rats were sacrificed and their spinal cords and dorsal root ganglia (DRG) were sectioned for the identification of the sites where neurons were labeled with HRP. RESULTS: The HRP-labeled neurons were found in the ventral horn of the spinal cord and in the DRG over L3, L4, and L5, while most were found in the L5 level. The mean numbers of HRP-labeled neurons in the EPN side looked smaller than that in the control side, but the difference did not reach statistically significant level (P>0.05). The mean values of the diameters of the HRP-labeled neurons in the DRG were not significantly different between the EPN side and the control side (P>0.05). However, HRP-neurons in the ventral horn of the spinal cord in the EPN side showed mild tendency to be smaller than that in the control side. CONCLUSIONS: The spinal cord connections of an MTrS are basically similar to that for a normal tissue region. The motor neurons related to MTrS tended to be smaller in their diameters. The findings in this study further supported the previously proposed hypotheses for the pathogenesis of an MTrP.