Auricular vagus nerve acupressure for patients with emotional distress under the COVID-19 pandemic:A smartphone-based,randomized controlled trial

Objective: To confirm whether self-administered AVNA treatment is effective in improving emotional distressunder the COVID-19 pandemic.Methods: A smartphone-based online, randomized, controlled trial was designed from 26 February 2020 to 28April 2020 in four study sites, including Wuhan, Beijing, Shenyang, and Guangzhou of China. Local residentswho had considerable emotional distress with a score of the Hospital Anxiety and Depression Scale (HADS) ≥9 were recruited. Participants were randomly assigned to three times of AVNA (n = 191) per day, in morning,around noon, and in evening or usual care (UC, n = 215) once daily for 14 days. The primary outcome was theresponse rate, which was the proportion of participants whose Hospital Anxiety and Depression Scale (HADS)score reduced from baseline by ≥ 50%. The assessment was conducted at baseline, 3 days, and 14 days.Results: The AVNA group had a markedly higher response rate than the UC group at 3 days (35.6% vs. 24.9%,P = 0.02) and at 14 days (70.7% vs. 60.6%, P = 0.02). The AVNA group showed significantly greater reductionin scores of HADS at the two measurement points and BAI at 3 days (P ≤ 0.03), with average respective effectsize of 0.217 and 0.195. Participants with AVNA spent less time falling asleep and rated their sleep qualitybeing remarkably higher than those with UC at endpoint.Conclusion: During COVID-19 pandemic period, treatment with self-administrated AVNA was more effectivethan UC in reducing emotional distress of isolated populations. These findings support self-administered AVNAas a treatment option for patients with emotional distress under the COVID-19 pandemic or other emergentevents.

Activation of hypothalamic gono-like neurons in female rats during estrus

In mammals, gonadal function is controlled by the activity of hypothalamic gonadotropin-releasing hormone neurons, which control the secretion of adenohypophyseal and gonadal hormones. However, there are a number of unanswered questions in relation to gonadal function. It is currently unknown how erotogenic stimulation of the genitals influences the subpopulation of hypothalamic medial preoptic area neurons, antidromically identified as projecting to the median eminence at different periods of the estrous cycle. Additionally, the distinctiveness of hypothalamic medial preoptic area neurons, with respect to methods of feedback control by exogenous hormones, is also unknown. In this study, spontaneous discharges from individual neurons encountered within the medial preoptic area, gono-like neurons, were recorded extracellularly using glass microelectrodes. To confirm the cellular and histochemical properties of the recording units, antidromic stimulation was performed using a side-by-side bipolar stimulating electrode placed into the median eminence, alongside microiontophoretic injections of the conventional tracer, horseradish peroxidase. In addition, further immunohistochemical analyses were performed. Results showed that elevated gono-neuron activity was accompanied by increased background activity and greater responses to erotogenic stimuli during estrus. Application of clitoral traction stimulation resulted in increased activation of the gono-like neurons. This neuronal activity was noticeably inhibited by β-estradiol administration. Immunohistochemical analyses revealed the presence of gonadotropin-releasing hormone-reactive protein in hypothalamic cells in which electrophysiological recordings were taken. Thus, medial preoptic area neurons represent the subset of hypothalamic gonadotropin-releasing hormone neurons described from brain slices in vitro, and might serve as a useful physiological model to form the basis of future in vivo studies.

不忘本来、吸收外来、面向未来——试论中医药走向世界

2018年6月,世界卫生组织(WHO)首次将中国、日本、韩国和世界其他地区应用的中医药纳入其最新修订的国际疾病分类第11次修订版(ICD-11).修订版已通过在2019年5月举行的世界卫生大会批准,计划于2022年1月1日生效[1].国际疾病分类(International Classification of Diseases,ICD)是WHO发布的疾病分类手册,作为权威的国际标准供全球卫生专业人员从事医疗、教学和科研使用,并通过通用语言交换世界各地卫生信息[2].WHO此举是中医药突破性成果,将为中医药知识资源的国际化奠定基础.

Mechanism of acupuncture regulating visceral sensation and mobility

Chinese ancient medical scientists have long focused on the internal and external contacts between acupoints on the surface of the body and the viscera.The Miraculous Pivot(it is one of the earliest medical classics in China)stated,“Twelve regular channels belong to the zang-fu organs internally,and connect to the extremities and joints externally.”Traditional Chinese medicine considers acupoints as defined areas where the Qi of viscera and meridians are transfused.These include the reaction points of visceral diseases on the body surface as well as the acupuncture trigger points that promote the flow of Qi and blood,and regulate visceral function.Chinese ancient medical scientists classified the specificity of the main acupoints in the body based on the meridian doctrine,which has been instructing clinical application for about 2000 years.Laws on the domino effect of acupoints have mainly focused on conclusions to clinical experiences.Indications of some acupoints exceed the practical paradigm since the excessive extension occurred during theory derivation.The current research direction on acupuncture focuses on three aspects:the effectiveness of acupuncture and moxibustion;the relevances and associations between meridians and viscera;and the physical and chemical properties and relevant physical basis of acupoints.The relevance between meridians and viscera is the central theory in the meridian doctrine,and acupoints are regarded as an important link in the relationship between meridians and viscera.Specific relationships between acupoints and target organs exist.Stimulating different acupoints on the body surface can help deal with different diseases,especially visceral diseases.In addition,acupoints have a dual function of reflecting and treating visceral diseases.There is no systemic research available on acupoint specificity,despite current knowledge and clinical experiences,which results in a weak foundation for acupuncture theory.This study focuses on the relevance and associations between meridians and viscera.A summary of the mechanisms of acupuncture regulating visceral sensation and mobility and the specific relationships between acupoints and their target organs are presented in this review.

Electroacupuncture of Neiguan(PC 6) inhibits enhanced voltage-gated sodium currents in ischemic ventricular myocytes

OBJECTIVE: To examine the effect of electroacupuncture(EA) at bilateral Neiguan(PC 6) on voltage-gated Na+currents(INa) and channels(Nav) in ischemic ventricular myocytes.METHODS: EA serum was prepared from six male adult Sprague-Dawley rats that had received EA at bilateral Neiguan(PC 6). Eighteen ventricular myocytes were prepared from six SD rats using an enzymolysis approach. Myocardial ischemia was mimicked by perfusion of ischemic solution. Whole-cell patch-clamping was used to record three currents evoked from isolated cells. The first current was the control, and recorded in absence of ischemic solution current. The second was the ischemic current,and recorded after perfusion of ischemic solution for 5 min, while the EA current was last, and recorded after perfusion of EA serum for 5 min. Navkinetic curves were fitted using related formulas.RESULTS: Compared with those in controls, in the presence of ischemic solution, peak amplitudes of INasignificantly increased from ﹣40 m V to +30 m V,and half-maximal inactivation potentials of Navincreased significantly, while half-maximal activation potentials, slope factors and the recovery time from inactivation to activation of Navwere unchanged. Compared with those in the ischemic solution, in the presence of EA serum, peak ischemic current amplitudes significantly reduced from ﹣40m V to + 40 m V, and half-maximal inactivation potentials were restored, while half-maximal activation potentials, slope factors and the recovery time from inactivation to activation of Navwere unchanged.CONCLUSION: EA at bilateral Neiguan(PC 6) can reduce enhanced INavia restoration of delayed Navinactivation in ischemic ventricular myocytes.

Review of controlled clinical trials on acupuncture versus sham acupuncture in Germany

OBJECTIVE: To examine German controlled clinical trials on the therapeutic effects of acupuncture vs sham acupuncture, and to find whether there are problems with the conclusion that sham acupuncture has no significant deviation from acupuncture. METHODS: We focused on literature from the last ten years (2002-2011) included in PubMed about controlled clinical trials on acupuncture vs sham acupuncture carried out in Germany. The methods applied in sham acupuncture are summarized, and the difference between the acupuncture and sham groups were analyzed. We measured effects based on the following criteria: acupuncture is effective and superior to sham, acupuncture is effective but similar to sham, both of them have uncertainty regarding treatment effect, or no significant effect. Finally, we reviewed the hypotheses of different scholars on sham acupuncture and analyzed their results.RESULTS: Four types of controlled clinical trials including sham acupuncture on non-Traditional Chinese Medicine acupoints, minimal acupuncture on non-acupoints, placebo needle and sham laser acupuncture had varying results in the 57 articles analyzed. Some showed that acupuncture had a better effect than sham, while some suggest acupuncture and sham had similar effects. In all studies using sham acupuncture on non-therapeutic points, sham electrodes, and sham electro-acupuncture, the therapeutic effect was better than sham. Of the trials, 37 demonstrated that acupuncture had a better effect than sham acupuncture. Only nine trials found no significant difference between acupuncture and sham. Two controlled trials for the same condition (neck pain) conducted by two different German research institutes used the same control method, but reached contradictory conclusions. CONCLUSION: We found problems in conclusions based on results of controlled clinical trials of sham acupuncture in Germany. Therefore, there is still not enough evidence to support the statements that "acupuncture and sham acupuncture have no difference in treatment effect" and "acupuncture is just a placebo effect." The control methods of sham acupuncture used in Germany may not be standardized and may not be suitable for acupuncture clinical trial research. We suggest that research on the methodology of sham acupuncture should be given priority in the design of acupuncture trials in the future.

A novel classification method for aid decision of traditional Chinese patent medicines for stroke treatment

Traditional Chinese patent medicines are widely used to treat stroke because it has good efficacy in the clinical environment. However, because of the lack of knowledge on traditional Chinese patent medicines, many Western physicians, who are accountable for the majority of clinical prescriptions for such medicine, are confused with the use of traditional Chinese patent medicines. Therefore, the aid-decision method is critical and necessary to help Western physicians rationally use traditional Chinese patent medicines. In this paper, Manifold Ranking is employed to develop the aid-decision model of traditional Chinese patent medicines for stroke treatment. First, 115 stroke patients from three hospitals are recruited in the cross-sectional survey. Simultaneously, traditional Chinese physicians determine the traditional Chinese patent medicines appropriate for each patient. Second, particular indicators are explored to characterize the population feature of traditional Chinese patent medicines for stroke treatment. Moreover, these particular indicators can be easily obtained by Western physicians and are feasible for widespread clinical application in the future. Third, the aid-decision model of traditional Chinese patent medicines for stroke treatment is constructed based on Manifold Ranking. Experimental results reveal that traditional Chinese patent medicines can be differentiated. Moreover, the proposed model can obtain high accuracy of aid decision.