Application of clinical value assessment of treatment protocols in guideline development: taking the WFAS Clinical Practice Guideline of Acupuncture and Moxibustion for Migraine as an example / 中国针灸

To enhance the clinical applicability of guidelines and provide more effective guidance for clinical practice, a clinical value assessment was conducted during the development of the World Federation of Acupuncture-Moxibustion Societies (WFAS) Clinical Practice Guideline of Acupuncture and Moxibustion for Migraine, which involved the evaluation of 59 acupuncture and moxibustion treatment protocols from randomized controlled trials (RCTs). This article introduced the methodology, content and results of the clinical value assessment of RCT-based acupuncture and moxibustion treatment protocols, which involved the integration of historical and contemporary medical evidence and expert consensus. It served as a methodological reference for the future development of acupuncture and moxibustion clinical practice guidelines.

Developing process and term analysis of WFAS standard: General Requirements for the Risk Control in the Safe Use of Acupuncture / 中国针灸

In order to promote the application of WFAS standard, General Requirements for the Risk Control in the Safe Use of Acupuncture and the safe practice of acupuncture technology worldwide, the paper introduces the developing process and main contents of this standard, explains the developing purpose, scope, ideas, methods and basis, and analyzes the definition of the relevant terms. Through strictly complied with the development procedure of standard, the terms related to acupuncture risk in this standard are defined. The connotations of 5 special terms are clarified, i.e. "acupuncture risks" "adverse events of acupuncture" "adverse reactions of acupuncture" "acupuncture accidents" and "acupuncture negligence". The range, rank, control flow and source of risk, as well as the control measures are determined. The standard extracts the underlying common problems and basic requirement of the safe practice of acupuncture so as to lay a framework for the development of the relevant technical standards of acupuncture.

Problems in randomized controlled trial on acupuncture and moxibustion for migraine in the development of international standard of Guideline for Clinical Practice of Acupuncture and Moxibustion: Migraine / 中国针灸

Regarding the development of international standard of Guideline for Clinical Practice of Acupuncture and Moxibustion: Migraine, the existing problems of the design and methodology of randomized controlled trial (RCT) on acupuncture and moxibustion for migraine were summarized in views of participant, intervention, control, outcome and study design. Four directions need to be further explored, (1) research of adolescent migraine, special subtype of migraine and migraine in a special population; (2) research of the immediate analgesic effect of acupuncture and moxibuation at the attack stage of migraine and the therapeutic effect of migraine at each stage; (3) research on safety and health economics; (4) clinical trial registration of acupuncture and moxibustion. In study, the target population should be further determined and specialized, the diagnosis criteria of western medicine and traditional Chinese medicine be generalized and concentrated, the staging and type division of disease be accurate, the intervention procedure be integrated, the control design be rationalized, the outcomes be validated, and the description of randomization and blinding be clarified.

WU Zhong-chao's clinical experience of "dredging stagnation and collaterals" acupuncture for migraine / 中国针灸

Professor WU Zhong-chao's clinical experience of "dredging stagnation and collaterals" acupuncture for migraine is summarized. Professor WU proposes that occiput-nape dysfunction, meridians-tendons dysfunction and stagnation of collaterals due to obstruction of excess-evil could lead to migraine. As such, migraine is treated by comprehensive treatment of adjusting occiput-nape functional zone, relaxing meridians-tendons and blood-letting combined with fire acupuncture.

Effects of Wuwei-Xiaodu Decoction on limb swelling and fracture healing in intra-articular calcaneal fractures after open reduction and internal fixation / 国际中医中药杂志

Objective:To investigate the effect of Wuwei-Xiaodu Decoction in treating intra-articular calcaneal fractures after open reduction and internal fixation and its effect on hemodynamics. Methods:A total of 88 intra-articular calcaneal fractures patients admitted to Langfang People's Hospital and the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from April of 2016 to February of 2019 were selected and randomly divided into the control group and the observation group (44 patients in each group) by the method of random number table. Both groups received open reduction and internal fixation for intra-articular calcaneal fractures. The control group received conventional treatment after surgery. The observation group were treated with Wuwei-Xiaodu Decoction on the basis of treatment in the control group. Both groups were treated for 12 weeks. The Gissane Angle, Bohler Angle and calcaneal height were detected by X-ray and CT. The hemodynamic analyzer was used to determine ESR, Fibrinogen (Fb), and whole blood viscosity. The recovery of foot function was evaluated by using the Ankle-posterior foot scoring system of the American Orthopaedic Association, and the fracture healing time and complications were recorded. Results:After treatment, the Gissane Angle (130.01°± 15.76° vs. 121.33°± 14.33°, t=2.793), Bohler Angle (33.04°± 5.03° vs. 28.93°± 4.31°, t=4.189) and calcaneal height (44.13 ± 6.13 mm vs. 40.06 ± 5.87 mm, t=6.556) in the observation group were significantly higher than those in the control group ( P<0.01). The fracture healing time (66.85 ± 8.17 d vs. 78.04 ± 9.44 d, t=5.945) in the observation group was significantly lower than that of the control group ( P<0.01). After treatment, serum ESR (13.65 ± 1.94 mm/h vs. 18.99 ± 2.30 mm/h, t=11.772), Fb (301.83 ± 32.04 g/L vs. 319.85 ± 33.62 g/L, t=2.536) levels and whole blood viscosity (7.04 ± 0.82 mPa?s vs. 8.34 ± 0.92 mPa?s, t=6.997) in the observation group were significantly lower than those in the control group ( P<0.01). The effective rate of foot function recovery 6 months after operation in the observation group was 97.7% (43/44) and 81.8% (36/44) in the control group, and the difference between the two groups was statistically significant ( χ2=4.456, P=0.035). The complication rate was 4.6% (2/44) in the observation group and 20.5% (9/44) in the control group, and the difference between the two groups was statistically significant ( χ2=5.091, P=0.024). Conclusions:The Wuwei-Xiaodu Decoction can promote the recovery of bone shape after open reduction and internal fixation of intra-articular calcaneal fractures, reduce the complications after operation, promote fracture healing, and improve the hemodynamics.

Expression of Wnt1 and β-catenin in the gingival tissure with gingival overgrowth induced by nifedipine / 实用口腔医学杂志

Objective:To study the expression of Wnt/β-catenin signaling pathway related proteins Wnt1 and β-catenin protein in gingival tissues of the patients with drug-induced gingival overgrowth(DGO) caused by nifedipine.Methods:Wnt1 and β-catenin expression were tested with Western Blot and RT-PCR in gingival tissues of 10 cases of DGO induced by nifedipine,10 cases of high blood pressure with gingival hyperplasia(without use of any medicine) and 10 cases of healthy control.Results:In the gingival tissues of DGO group the levels of Wnt1 and β-catenin protein and mRNA were significantly higher than those of the healthy control group(P ＜ 0.05) and the high blood pressure group (P ＜ 0.05).Conclusion:The levels of Wnt1 and β-catenin are increased in nifedipine induced gingival hyperplasia.The gingival hyperplasia may be caused by the promotion of gingival fibroblast proliferation through Wnt/β-catenin signaling pathway.

The development and application of stabilizers for ELISA test kit / 国际检验医学杂志

Objective To develop ELISA kit stabilizer for each component ,with which the shelf life of kit could meet the com-mercial need .Methods A series of stabilizers for microplate ,enzyme-labeled antibody and standards were prepared by the means of experience and orthogonal approach ,through controlled trials ,screening out the best stabilizer formulations .Results A kind of coa-ted stabilizer (mass fraction :bovine serum albumin 0 .5% ,gelatin 0 .25% ,trehalose 5% ,PEG4000 0 .1% ) and a kind of enzyme la-beled antibody stabilizer (mass fraction :Bovine serum albumin 1% ,peptone 1% ,sucrose 10% ,trehalose 5% ,PEG4000 0 .25% ) were screened out .Conclusion The ELISA kits can be stable at 4 ℃ for 1 year after treated with the obtained stabilizers .

Effects of co-expression of molecular chaperones on heterologous soluble expression of the cold-active lipase Lip-948.

The cold-active lipase gene Lip-948, cloned from Antarctic psychrotrophic bacterium Psychrobacter sp. G, was ligated into plasmid pColdI. The recombinant plasmid pColdI+Lip-948 was then transformed into Escherichia coli BL21. SDS-PAGE analysis showed that there was substantive expression of lipase LIP-948 in E. coli with a yield of about 39% of total protein, most of which was present in the inclusion body. The soluble protein LIP-948 only consisted of 1.7% of total LIP-948 with a specific activity of 66.51U/mg. Co-expression of molecular chaperones with the pColdI+Lip-948 were also carried out. The results showed that co-expression of different chaperones led to an increase or decrease in the formation of soluble LIP-948 in varying degrees. Co-expression of pColdI+Lip-948 with chaperone pTf16 and pGro7 decreased the amount of soluble LIP-948, while the soluble expression was enhanced when pColdI+Lip-948 was co-expressed with "chaperone team" plasmids (pKJE7, pG-Tf2, pG-KJE8), respectively. LIP-948 was most efficiently expressed in soluble form when it was co-expressed with pG-KJE8, which was up to 19.8% of intracellular soluble proteins and with a specific activity of 108.77U/mg. The soluble LIP-948 was purified with amylase affinity chromatography and its enzymatic characters were studied. The optimal temperature and pH of LIP-948 was 35°C and 8, respectively. The activity of LIP-948 dropped dramatically after incubation at 50°C for 15min and was enhanced by Sr(2+), Ca(2+). It preferentially hydrolyzed 4-nitrophenyl esters with the shorter carbon chain.