Efficacy and safety of acupuncture in treating low back and pelvic girdle pain during pregnancy:a systematic review and meta-analysis of randomized controlled trials

Objectives:Low back and pelvic girdle pain(LBPGP)is common during pregnancy.Acupuncture is an effective and safe therapy for pain relief.However,further evidence is required to confirm the efficacy and safety of acupuncture in treating LBPGP during pregnancy.This study aimed to systematically review and investigate the clinical efficacy and safety of acupuncture for the treatment of pregnancy-related LBPGP.Methods:The PubMed,EMBASE,Cochrane Library,CNKI,VIP,and WanFang databases were searched from January 2000 to August 2023.Only the randomized controlled trials(RCTs)involving pregnant women between 16 and 34 weeks of gestation diagnosed with LBPGP were included in the study.A meta-analysis was conducted and pooled risk ratios(RRs)or mean differences(MDs)with 95%confidence intervals(CIs)were compared.Results:Meta-analysis included 12 RCTs involving 1,641 participants.Eleven trials compared acupuncture alone or acupuncture combined with standard care(SC),of which three trials also used non-penetrating or placebo acupuncture as the control group.One trial compared acupuncture alone with non-penetrating acupuncture.Compared with SC,acupuncture combined with SC group significantly decreased visual analog scale score(mean difference(MD)=−2.83,95%CI=−3.41 to−2.26,P<0.00001),cesarean section rate(RR=0.69,95%CI=0.49–0.97,P=0.03),preterm birth rate(RR=0.42,95%CI=0.27–0.65,P<0.0001),labor duration(MD=−1.97,95%CI=−2.73 to−1.20,P<0.0001),and Oswestry disability index score(MD=−9.14,95%CI=−15.68 to−2.42,P=0.008).In addition,acupuncture combined with SC significantly improved 12-Items Short Form Health Survey of physical component summaries(SF12-PCS).No significant differences were observed in the spontaneous delivery rate,newborn weight,drowsiness,and 12-Items Short Form Health Survey of mental component summaries(SF12-MCS)between the two groups.Adverse events such as needle pain and needle bleeding were aggravated in both the SC and acupuncture treatment groups but none were associated with acupuncture during or after the treatment period.Conclusions:Meta-analysis showed that acupuncture combined with SC had better efficacy than SC alone and could be a potential therapy for LBPGP during pregnancy.The safety results imply that acupuncture caused few adverse reactions;however,more evidence is required for further confirmation.

Research on the Different Frequencies of Transcutaneous Electrical Acupoint Stimulation for Postpartum Pelvic Girdle Pain

Objective:To observe the clinical effect of different frequencies of transcutaneous electrical acupoint stimulation in treating postpartum pelvic girdle pain and promoting postpartum rehabilitation.Methods:From January to September 2022,300 patients with pelvic girdle pain after spontaneous delivery in a hospital in Shaanxi Province were selected and randomly divided into three groups,low frequency,high frequency,and alternating frequency,with 100 cases in each group.In addition to routine postpartum care and psychological counseling,the three groups received transcutaneous electrical acupoint stimulation at low-frequency(2 Hz,)high-frequency(100 Hz),and alternating frequency(2/100 Hz),respectively.The differences in initial pain,pain scores before and after treatment,satisfaction with analgesic effect,and postpartum rehabilitation effect were evaluated among the three groups of patients.Results:There was a significant correlation between maternal age and postpartum pelvic girdle pain(P<0.001),but no correlation was observed between newborn birth weight and postpartum pelvic girdle pain(P>0.05).After 1d/2d of treatment,the pain scores and rehabilitation effect of patients in the alternating-frequency group and low-frequency group were significantly better than those in the high-frequency group,and the postpartum curative effect of patients in the alternating-frequency group was the best,followed by the low-frequency group,and the high-frequency group;the differences were statistically significant(P<0.001).Among the three groups,the alternating-frequency group had the highest satisfaction with the analgesic effect and the highest rate of selecting the same analgesic regimen the next time;the differences were statistically significant(P<0.001).Conclusion:Transcutaneous electrical acupoint stimulation at different frequencies is safe and effective in treating postpartum pelvic girdle pain and beneficial to postpartum rehabilitation.Sparse-dense wave stimulation is effective in treating postpartum pelvic girdle pain.It has the best effect in promoting postpartum rehabilitation and the highest patient satisfaction.Therefore,its application in clinical practice is highly recommended.

Effect of Regeneration After Girdling on Tree Growth in Eucommia ulmoides

Annual trunk diameters and tree heights were measured in July after initial_girdling and regirdling in Eucommia ulmoides Oliv. And the percentages of fallen leaves in all leaves and burst buds in all buds were estimated respectively on every autumn or spring. The results indicated that although the tree growth slowed down in the first year after girdling, but in the second year after girdling, the growth of the girdled trees tended to become normalized and up to the third year, it was similar to that of the normal trees. According to its developmental trait after girdling, the authors suggested that optimal girdling of the trees is in every 4 or 5 year intervals. With this method it was able to improve bark production and to protect the resource from extinction as well.

Effects of Primary and Secondary Trunk Girdling on the Status and Distribution Regularity of Nutrients in Grape

Objective] The study aimed to investigate the effects of primary and sec-ondary trunk girdling on the status and distribution regularity of nutrients in grape. [Method] Using grape cultivar ‘Rose Honey’ as the experimental material, the ef-fects of primary and secondary trunk girdling on carbon and nitrogen nutrition, min-eral nutrition and nutrient distribution regularity in leaves and branches above the girdling wound and roots below the girdling wound were analyzed. [Result] Girdling could significantly increase non-structural carbohydrate content （such as soluble sugar and starch） in branches above the girdling wound, reduce soluble protein and total nitrogen contents, and significantly improve C/N ratio. Specifical y, the highest C/N ratio in primary girdling group and secondary girdling group was 9.04 and 5.35, respectively, but C/N ratio in control group was only 4.89 in the same period. Girdling not only significantly decreased the content of non-structural carbohydrates （such as soluble sugar and starch） in roots, but also significantly declined soluble protein and total nitrogen content, which also reduced C/N ratio in various degrees. Specifical y, the lowest C/N ratio in primary girdling group and secondary girdling group was 1.16 and 3.06, respectively, while that in control group was 3.15 in the same period. ln addition, primary girdling exerted much greater effects on carbon and nitrogen nutrition than secondary girdling. Moreover, girdling significantly de-creased the contents of phosphorus, potassium, ferrum and copper in grape leaves, branches and roots. Specifical y, primary girdling exerted greater effects on ferrum and copper contents in leaves and branches. The contents of ferrum and copper in the first batch of samples exhibited significant differences between primary girdling group and control group： ferrum content in leaves was 75.05 μg/g DW in primary girdling group and that in control group was 85.29 μg/g DW; ferrum content in branches was 76.45 ？g/g DW in primary girdling group and copper content was 7.82 μg/g DW, while ferrum and copper contents in control group were 95.96 and 10.74 μg/g DW, respectively. [Conclusion] This study provided the basis for accu-rately regulating tree nutrition and ensuring safe and effective use of girdling tech-nique in ‘Rose Honey’ production.

Gibberellic Acid₄₊₇and Benzyladenine, Cambium Disconnection, Nitrogen, and Tip Removal Influence on Branch Induction in Newly Planted Poorly Feathered “Fuji” Apple Trees

The use of well-feathered nursery trees on dwarfing rootstocks is crucial for establishing high-density apple orchards to ensure early production. Training trees to develop a tall spindle canopy architecture has gained popularity in high-density orchards during the past decade. However, commercially produced nursery trees often lack feathers or are unevenly branched, making initial training decisions difficult and delaying precocious fruiting. In this project, we studied the vegetative meristem activation response to partial scoring or partial girdling of the bark cambium above the bud, with and without application of 500 ppm Promalin (gibberellin4+7 + benzyladenine), tip removal of the tree leader at the silver tip stage on April 23, 2019, Promalin spray at 500 ppm at post-bloom stage on May 7, 2019, and nitrogen (N) as UAN-32 (32% N) application at five levels (60, 80, 100, 120, or 140 g actual N/tree) on June 20, 2019, in newly planted un-feathered or unevenly branched “Aztec Fuji” trees on Budagovsky 9 (Bud 9) in southwest Idaho, USA. Grower’s Short Cut trees received a heading cut to the leader at 60 cm above the ground and resulted in the emergence of 5 - 6 strong branches near the heading cut. These trees had larger trunk cross-sectional areas than scored or girdled trees. Scoring or girdling, with or without Promalin, significantly improved branching by increasing the number of branches and bourse shoots. In many cases, the effects of partial scoring, with or without Promalin, were similar to those of bark girdling which is a more risky and time-consuming process. Branches induced by scoring and girdling had sharper crotch angles relative to the vertical leader. Spraying Promalin during the post-bloom stage at 500 ppm was not as effective as scoring or girdling to initiate branches. Additional N rates or removal of the leader tip did not significantly impact branch induction.

Accessory Placental Structures—A Review

Many studies have reported on the different types of placenta in different species, but accessory or paraplacental structures are mentioned only in species that have such a nutrient-exchanging mechanism. Hystricomorph rodents possess a subplacenta, swine and equines have the placental areola, equines have the chorionic girdle, and carnivores have hemophagous organs that are equivalent to the placental hematoma in ruminants. These accessory structures are specialized tissues for specific nutrient exchanges in different species, and they are adaptive modifications exhibited by domestic and wild species to remedy the nutritional deficiencies that are related to permeability of the main placenta to important nutrients for the growth and development of the fetus during the gestation.

Change in the Muscle Tension of the Shoulder Girdle Muscles in Patients with Spinal Pain, Using the Tone Control® Technique

The aim of the study was to verify the efficacy of the Tone-Control method in inducing a reduction in the tension of the muscles of the shoulder girdle,and therefore a normalisation of posture in the segment.The authors analysed the change in posture,which was related to the muscle tension of the pectoralis major muscle and the trapezius muscle,resulting from the administration of a programme of encoded exercises known as the Tone Control method.The study was conducted on 70 patients with postural back pain,aged between 25 and 81 years and with a mean age of 61.9 years,11 male patients and 59 female patients,who attended group rehabilitation for a minimum of 10 and a maximum of 15 sessions.Acute phase patients,patients on anti-inflammatory pharmacological treatment and patients with hernias or bulging causing thecal sac impingement were excluded from the study.Measurements were taken of the angles of the joints in the scapulohumeral segment during the first and last sessions.The NRS(numeric rating scale)pain scale was administered at the start and end of the cycle of sessions.Conclusions:Patients in the study group experienced improvements in the angle measurements that were proportionally greater than those of the control group,together with a considerable reduction in perceived pain,with an overall improvement in posture and shoulder girdle function.

Alternancy Study on Rambutan(Nephelium lappaceum L.)Tree in Mexico

Rambutan growing in the state of Chiapas has brought about a demand for new plantations;however, this species has several biotic and abiotic factors that limit its production. These factors include phytosanitary problems, deficient agronomical handling, and production alternancy. Because of this, the objective of the present study was to evaluate the effect of the application of agronomical practices such as pruning, ringing, water stress, and their interaction on the rambutan alternancy. The experiment was carried out in the “La Chinita” commercial orchard located on KM. 4.5 the Huehuetan Station, municipality of Huehuetan, Chiapas, Mexico. We used 48 rambutan trees in production with an age of 14 years. Two production cycles were evaluated. The experiment was established under a divided plot experimental design in random complete blocks with a factorial arrangement and six replicates;each tree being a replicate. The study factors were: water stress, pruning, girdling, irrigation (control), and their combinations, resulting in eight treatments. The evaluation was done during flowering, fruit set, and harvest. In flowering, the treatments with permanent irrigation in both evaluated cycles (2010-2011 and 2011-2012) manifested a production alternancy behavior, with an average 36.4% flowering in the first evaluation cycle and increased to 82.1% in the second cycle. The treatments with water stress kept a proportional flowering during the first and second cycles of 97.9% and 95.3%, respectively. The water stress influenced the bunch weight (PR) variable fruit set with bigger fruits and higher bunch weight than the irrigated treatments. In production, pruning and girdling together with water deficit had no alternancy in both production cycles.

The Economic Profitability of Cereal Production Systems in the Context of Adaptation to Climate Change:the Case of Millet

This article studies the economic profitability of the millet production in a context of adaptation to climatic changes by considering the techniques of adaptation to soil protection,namely,low wall girdles tree and halfmoon in order to determine their impact on the economic profitability of the production of this cereal.

Exercise and pelvic girdle pain during pregnancy.Are there any associations?

Background: To date, there is scant knowledge and inconsistent results about physical activity, exercise and job strain in relation to pelvic girdle pain (PGP). Hence, the aims of the present study were: 1) determine prevalence of PGP and severe PGP during pregnancy and 2) compare background and lifestyle factors in addition to total physical activity level (at work, commuting, housework and recreational exercise) in those who experienced PGP and those who did not in pregnancy. Methods: Healthy pregnant women (n = 467) were allocated to the study from Oslo University Hospital, Norway. The participants filled in a validated self-administered questionnaire, Physical-Activity-Pregnancy-Questionnaire (PAPQ) in gestation-week 32 - 36. The questionnaire contained 53 questions with nine specific questions addressing PGP. The key question on PGP was asked cross-sectionally and also posed retrospectively for pre-pregnancy, 1st and 2nd trimester (During this pregnancy, did you experience any PGP?) (“Yes versus No”). Results: More than half of the women (57.5%) reported to suffer from PGP, with 18.4% reporting severe PGP. Compared the no-PGP group, women with PGP were significantly more likely to be sick-listed, multiparous, they perceived their job to be physically demanding, as well as had physically demanding household chores, including childcare. In addition, they were more prone to have experienced PGP in previous pregnancies and suffered from urinary incontinence (UI) in the current pregnancy. Most women with severe PGP reported to be sedentary in the 3rd trimester;however they performed more strengthening exercises at home than the women without PGP. Severe PGP also showed an association with standing/walking ≥50% at work. Conclusion: Women who exercised regularly in the 3rd trimester were less likely to report PGP, while job strain was associated with higher prevalence of PGP. There is a need for a prospective study with larger sample size to further evaluate if exercise has any causal association with PGP.

Contribution of Root Respiration to Total Soil Respiration in a Cotton Field of Northwest China

To measure the contribution of root respiration (Rr) to total soil respiration (Rt) in arid cotton fields, eighteen plots, nine for girdling and nine control, were built in an arid cotton field in the Aksu National Experimental Station of Oasis Farmland Ecosystem, Xinjiang of China. Given the difference of soil respiration between girdled plots and non-girdled control plots, the components of soil respiration, root respiration (Rr) and respiration originating from decomposition (Rd) were divided. The temperature sensitivities of R r and R d were analyzed, respectively. The results showed that the average contribution of R r to R t in arid cotton field was about 32% during the study period. The temperature-response curve of R r differed from that of Rd . The dynamic variation of R d was more related to the change of soil temperature as compared to Rr . Rr and Rd had different responses to the variation of environment, and thus new models capable of differentiating between Rr and Rd are needed for evaluating the different factors controlling these two components of soil respiration in arid cotton field.