Acupuncture for olfactory dysfunction in infected COVID-19 patients:Study protocol for a randomized,sham-controlled clinical trial

Background:Olfactory dysfunction(OD)is a common symptom of Corona Virus Disease 2019(COVID-19).It is defined as the reduced or distorted ability to smell during sniffing(orthonasal olfaction)and represents one of the early symptoms in the clinical course of COVID-19 infection.A large online questionnaire-based survey has shown that some post-COVID-19 patients had no improvement 1 month after discharge from the hospital.Objective:To explore the efficacy of acupuncture for OD in COVID-19 infected patients and to determine whether acupuncture could have benefits over sham acupuncture for OD in post-COVID-19 patients.Methods:This is a single-blind,randomized controlled,cross-over trial.We plan to recruit 40 post-COVID-19 patients with smell loss or smell distortions lasting for more than 1 month.Qualified patients will be randomly allocated to the intervention group(real acupuncture)or the control group(sham acupuncture)at a 1:1 ratio.Each patient will receive 8 sessions of treatment over 4 weeks(Cycle 1)and a 2-week follow-up.After the follow-up,the control group will be subjected to real acupuncture for another 4 weeks(Cycle 2),and the real acupuncture group will undergo the 4-week sham acupuncture.The primary outcomes will be the score changes on the questionnaire of olfactory functioning and olfaction-related quality of life at week 6,8,12,and 14 from the baseline.The secondary outcomes will be the changes in the olfactory test score at week 6 and 12 from the baseline measured by using the Traditional Chinese version of the University of Pennsylvania Smell Identification Test(UPSIT-TC).Discussion:The results of this trial will help to determine the effectiveness of acupuncture for OD in post-COVID-19 patients.This may provide a new treatment option for patients.

Emerging roles of NRBF2/PI3KC3 axis in maintaining homeostasis of brain and guts

NRBF2 has been identified as the fifth component of PI3KC3 complex and is required for maintaining the kinase activity to promote autophagy.However,the physiological and pathological roles of NRBF2are largely unknown.

Transparency and reporting characteristics of randomized controlled trials with Chinese herbal medicine formulas interventions

To enhance the clarity and transparency of reporting in trials involving Chineseherbal medicine(CHM)formulas,the CONSORT extension specifically tailored for CHM formulas(CONSORT-CHM Formulas 2017)was introduced in 2017[1].This statement,along with its corresponding checklist,outlines key elements essential for reporting in randomized controlled trials(RCTs)related tothe rationale,design,analysis,and interpretation of interventions using CHM formulas.The CONSORT-CHM Formulas 2017 elaborated on 7 of 25 CONSORT checklist items,namely title,abstract and keywords,backgrounds and objectives,participants,interventions,outcomes,generalizability,and interpretation.

Bioactive natural compounds against human coronaviruses: a review and perspective

Coronaviruses(CoVs),a family of enveloped positive-sense RNA viruses,are characterized by club-like spikes that project from their surface,unusually large RNA genome,and unique replication capability.Co Vs are known to cause various potentially lethal human respiratory infectious diseases,such as severe acute respiratory syndrome(SARS),Middle East respiratory syndrome(MERS),and the very recent coronavirus disease 2019(COVID-19)outbreak.Unfortunately,neither drug nor vaccine has yet been approved to date to prevent and treat these diseases caused by CoVs.Therefore,effective prevention and treatment medications against human coronavirus are in urgent need.In the past decades,many natural compounds have been reported to possess multiple biological activities,including antiviral properties.In this article,we provided a comprehensive review on the natural compounds that interfere with the life cycles of SARS and MERS,and discussed their potential use for the treatment of COVID-19.

Would integrated Western and traditional Chinese medicine have more benefits for stroke rehabilitation? A systematic review and meta-analysis

Background Stroke is a major cause of death or long-term disability worldwide.Many patients with stroke receive integrative therapy consisting of Western medicine(WM)and routine rehabilitation in conjunction with Chinese medicine(CM),such as acupuncture and Chinese herbal medicine.However,there is no available evidence on the effectiveness of the combined use of WM and CM interventions in stroke rehabilitation.Aims The purpose of this meta-analysis is to evaluate the results of all individual studies to assess the combined use of CM and WM in stroke rehabilitation compared with WM only.Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed.MEDLINE,EMBASE,Cochrane and China National Knowledge Infrastructure(CNKI)were searched.The included outcomes were dependency,motor function,depression and swallowing function.Subgroup analysis was performed,and publication bias was assessed using funnel plots.Summary of review 58 studies and 6339 patients were included in the meta-analysis.Subgroup analysis revealed that combined therapy comprising both acupuncture and WM had a superior effect on improving dependency and swallowing function compared with standard WM therapy alone.Potential superiority of combined therapy comprising CM and WM in improving depression compared with standard WM therapy was also found.Conclusions Our results indicate that the combined use of CM and WM could be more efficacious in stroke rehabilitation compared with the use of WM therapy alone.However,most studies were short in duration(2 to 4 weeks)and prone to different types of biases,which prevents making any conclusion regarding the long-term effects and raises concerns regarding true efficacy in context of high likelihood of Hawthorn bias.So,more randomised controlled trials with more rigorous design and longer duration of treatment and follow-up need to be conducted to compare WM alone versus WM and CM combined.

Developing new drugs from annals of Chinese medicine

Developing new pharmaceuticals requires massive amounts of time,money and efforts.The key step is how to find a safe and effective entity for a disease condition and how to develop it as new drug effectively.Unfortunately,the FDA’s rate of approving new entities has declined dramatically in the last three decades.There is a strong need to review the current strategy and to optimize process in developing new drugs,both to shorten the process and increase the success rate.Chinese medicine has used natural products to treat patients for thousands of years,and Chinese medicine practitioners have chronicled the patients and treatment methods for thousands of years.There is much information that has not yet been used.The success stories of artimisinin and arsentic trioxide are wonderful examples of how the annals of Chinese medicine can provide leads for discovering new drugs.This paper argues that the annals of Chinese medicine are valuable and describes how they can be used in modern drug discovery.The major topics addressed are:(i)why Chinese medicine is a rich resource for finding new drugs;(ii)how to identify a potential valuable record from Chinese medicine annals;(iii)when a potential valuable record is identified from annals,how to proceed;and(iv)both why and how the approach used for chemical drugs should be revised for drugs based on the historical documents related to herbal medicine.In conclusion,we argue here that the annals of Chinese medicine offer not only a rich resource for new drugs,but also several centuries of patient data with regard to safety and efficacy,that in effect represent pilot studies.Acknowledging and using these data can shorten new drug discovery time and improve efficiency of the drug development process,bringing more effective,safe drugs to market much more quickly and cheaply.

Suboptimal reporting of randomized controlled trials on non-pharmacological therapies in Chinese medicine

With the successive release of the CONSORT extensions for acupuncture,moxibustion,cupping,and Tuina/massage,this review aims to assess the reporting characteristics and quality of randomized controlled trials(RCTs)based on these specific guidelines.A comprehensive review was conducted by searching multiple databases,including Embase,Ovid MEDLINE(R),All EBM Reviews,AMED,CNKI,VIP Chinese Medical Journal Database,and Wanfang Data,for publications from January 1 to December 31,2022.Two reviewers independently evaluated the eligibility of the records,extracted predetermined information,and assessed the reporting based on the STRICTA,STRICTOM,STRICTOC,and STRICTOTM checklists.Among the included 387 studies(acupuncture,213;Tuina/massage,85;moxibustion,73;cupping,16),the overall reporting compliance averaged 56.0%,with acupuncture leading at 62.6%,followed by cupping(60.2%),moxibustion(53.1%),and Tuina/massage(47.9%).About half of the evaluated items showed poor reporting(compliance rate<65%).Notably,international journals demonstrated significantly higher reporting quality than Chinese journals(P<0.05).Although acupuncture trials had relatively higher compliance rates,deficiencies persist in reporting non-pharmacological therapies of Chinese medicine,particularly in areas like treatment environment details and provider background information.