[Effects of thunder-fire moxibustion on the motor function in the patients of osteoporosis with low skeletal muscle mass： a randomized controlled trial].

OBJECTIVE: To observe the effects of thunder-fire moxibustion on the visual analogue scale (VAS) score, Young's modulus of multifidus and 6 m walking speed in the patients of osteoporosis with low skeletal muscle mass. METHODS: Sixty patients of osteoporosis with low skeletal muscle mass were randomly divided into a medication group (30 cases) and a medication+thunder-fire moxibustion group (30 cases). In the medication group, caltrate was prescribed for oral administration, 2 tablets/day （600 mg/tablet）, for 4 weeks. In the medication+thunder-fire moxibustion group, on the base of oral administration with caltrate, thunder-fire moxibustion was exerted at Mingmen (GV4), Yaoyangguan(GV3), and bilateral Shenshu (BL23), Ganshu (BL18) and Dachangshu (BL25), 30 minutes at GV4, GV3 and BL18, and another 30 minutes at BL23 and BL25, once every other day, 3 times a week for 4 weeks. Before and after the treatment, VAS score, Young's modulus of the 4th lumbar multifidus and the average speed of 6 m walking were assessed. RESULTS: After the treatment, the VAS score was decreased (P<0.05, P<0.01) and the speed of 6 m walking was increased (P<0.05, P<0.01) in both groups in comparison with their own pre-treatment. Compared with the medication group, VAS score was decreased remarkably (P<0.05) and the speed of 6 m walking remarkably increased (P<0.01) in the medication+thunder-fire moxibustion group after the treatment. Self-comparison showed that, compared with the same side before the treatment, the value of Young's modulus after the treatment was decreased on both sides in the medication+thunder-fire moxibustion group (P<0.01). After the treatment, compared with the medication group on the same side, the value of Young's modulus was decreased on both sides (P<0.01) in the medication+thunder-fire moxibustion group. CONCLUSION: Thunder-fire moxibustion can relieve pain intensity, decrease the tension of the multifidus, and increase the walking speed.

[Effect of moxibustion of "Ganshu"(BL18) and "Shenshu" (BL23) on musculoskeletal interaction in osteoporosis rats].

OBJECTIVE: To observe the effect of moxibustion of "Ganshu" (BL18)and "Shenshu" (BL23) on bone mineral density (BMD), biomechanics, bone metabolism and musculoskeletal morphology of osteoporosis (OP) rats, so as to explore its mechanism underlying treatment of OP via bone-muscle interaction. METHODS: Thirty-two female SD rats were randomly divided into sham operation, OP model, moxibustion and medication (nilestriol) groups, with 8 rats in each group. For rats of the sham operation group, a small amount of fat around the ovaries was removed, and those of the other 3 groups received removal of bila-teral ovaries for establishing OP model. Moxibustion was applied to bilateral BL18 and BL23 for 30 min, once every other day, 3 times a week for 12 weeks. Rats of the medication group received gavage of nilestriol (1 mg/kg) once a week for 12 weeks.After the interventions, a dual-energy absorptiometry was used to determine the BMD and bone mineral content of the rats' right femur and the fourth lumbar vertebrae under anesthesia, and three-point bending test used to detect the biomechanical properties (including load, displacement, stiffness) of the right femur. The levels of serum type I collagen C-terminal peptide (CTX-I), acid-resis-tant tartrate phosphatase (TRACP) and estradiol (E2) were determined using enzyme-linked immunosorbent assay, and histopathological changes of the left femur and the quadriceps observed after hematoxylin-eosin (H.E.) staining. RESULTS: Compared with the sham operation group, the BMD and bone mineral contents of the right femur and the fourth lumbar vertebra, the load and stiffness of the right femur, and concentration of serum E2 were significantly decreased (P<0.01, P<0.05), and the displacement of the right femur, and concentrations of serum CTX-Ⅰ and TRACP notably increased in the model group (P<0.01). After the interventions, the decreased levels of BMD and bone mineral contents, the load and stiffness and concentration of serum E2, and the increased levels of the displacement, and concentrations of serum CTX-Ⅰ and TRACP were all reversed by both moxibustion (except the bone mineral content of the fourth lumbar vertebra) and medication (P<0.01,P<0.05). No signi-ficant differences were found between moxibustion and medication in up-regulating the levels of BMD and bone mineral contents, the load and stiffness (except serum E2) and down-regulating the levels of the displacement, and concentrations of serum CTX-Ⅰ and TRACP (P>0.05). H.E. staining revealed that rats in the sham operation group showed mild thinness of the bone cortex, uneven thickness of trabecular bone, with distortion, fracture and osteoporosis of the left femur, and different size of rhabdomyocytes in the right quadriceps femoris muscle, with obvious proliferation of interstitial fibrous tissue and inflammatory cell infiltration, which were relatively and clearly milder in both moxibustion and medication groups. CONCLUSION: Moxibustion of BL18 and BL23 can increase the BMD and bone mineral content, improve biomechanical performance, adjust bone metabolism, and mitigate bone and the attached muscle histopathological changes in OP rats, suggesting that modulating interaction between bones and muscles is probably one of the ideas in the treatment of OP.

[Effect of thunder-fire moxibustion combined with vibration training on low back pain of primary osteoporosis].

OBJECTIVE: To compare the therapeutic effect of thunder-fire moxibustion combined with vibration training and simple vibration training on low back pain of primary osteoporosis by Young's modulus of ultrasonic wave, and seek an objective evaluating method. METHODS: A total of 60 patients were randomized into an observation group and a control group, 30 cases in each one. The patients in the two groups were treated with vibration training using whole body vibration treatment bed. In the observation group, thunder-fire moxibustion was applied at Yaoyangguan (GV 3), Mingmen (GV 4), Ganshu (BL 18), Shenshu (BL 23) and Dachangshu (BL 25). The treatment was given once every other day, 3 times a week for 4 weeks. The visual analogue score (VAS), real-time shear wave elastography (RTSWE) and medical outcomes study 36-item short-form hearth survey (SF-36) were used to evaluate pain intensity, multifidus muscle tone (Young's modulus) and quality of life before treatment, after 4-week treatment and 1 month after treatment. RESULTS: Compared before treatment, the VAS scores, Young's modulus of multifidus muscle and 5 dimensions of SF-36 (physical condition, body pain, general health, social function and mental health) after 4-week treatment and 1 month after treatment were significantly improved in the two groups (all P<0.05), the physiological role in the observation group after 4-week treatment and 1 month after treatment were improved (both P<0.05). In the observation group, the VAS scores, Young's modulus of multifidus muscle and 3 dimensions of SF-36 (physiological role, body pain and general health) after 4-week treatment and 1 month after treatment were superior to the control group (all P<0.05). CONCLUSION: The therapeutic effect of thunder-fire moxibustion combined with vibration training is superior to simple vibration training in relieving low back pain intensity and multifidus muscle tone, and improving quality of life for primary osteoporosis. RTSWE technique can be an objective examination method to evaluate pain.

Identify the signature genes for diagnose of uveal melanoma by weight gene co-expression network analysis.

AIM: To identify and understand the relationship between co-expression pattern and clinic traits in uveal melanoma, weighted gene co-expression network analysis (WGCNA) is applied to investigate the gene expression levels and patient clinic features. Uveal melanoma is the most common primary eye tumor in adults. Although many studies have identified some important genes and pathways that were relevant to progress of uveal melanoma, the relationship between co-expression and clinic traits in systems level of uveal melanoma is unclear yet. We employ WGCNA to investigate the relationship underlying molecular and phenotype in this study. METHODS: Gene expression profile of uveal melanoma and patient clinic traits were collected from the Gene Expression Omnibus (GEO) database. The gene co-expression is calculated by WGCNA that is the R package software. The package is used to analyze the correlation between pairs of expression levels of genes. The function of the genes were annotated by gene ontology (GO). RESULTS: In this study, we identified four co-expression modules significantly correlated with clinic traits. Module blue positively correlated with radiotherapy treatment. Module purple positively correlates with tumor location (sclera) and negatively correlates with patient age. Module red positively correlates with sclera and negatively correlates with thickness of tumor. Module black positively correlates with the largest tumor diameter (LTD). Additionally, we identified the hug gene (top connectivity with other genes) in each module. The hub gene RPS15A, PTGDS, CD53 and MSI2 might play a vital role in progress of uveal melanoma. CONCLUSION: From WGCNA analysis and hub gene calculation, we identified RPS15A, PTGDS, CD53 and MSI2 might be target or diagnosis for uveal melanoma.