Feasibility of acupuncture as an adjunct intervention for ovulatory disorder infertility:A systematic review and meta-analysis

BACKGROUND Acupuncture(AT)is widely used in treatment of ovulatory disorder infertility(ODI),but the safety and efficacy of AT for ODI still lack an evidence-based basis.AIM To evaluate the feasibility and effectiveness of AT as an adjunct intervention for ODI.METHODS The Cochrane Library,Embase,PubMed,VIP,China National Knowledge Infrastructure,WanFang Data,and Chinese biomedical literature databases were searched from inception to January 20,2024.Two reviewers independently selected studies,collected data,and evaluated methodological quality through the Cochrane Risk of Bias tool.Revman 5.4 was used for meta-analysis,and the Grade system was performed to evaluate the level of evidence for the outcomes of the meta-analysis.RESULTS A total of 20 randomized controlled trials with 1677 ODI patients were included.Compared with the clomiphene citrate(CC)group,the AT plus CC group exhibited significant improvement of the pregnancy rate[relative risk(RR)=1.68,95%confidence interval(CI):1.45-1.95,P<0.00001,I^(2)=23%],ovulation rate(RR=1.34,95%CI:1.22-1.47,P<0.00001,I^(2)=32%),serum E2 level[mean difference(MD)=31.36,95%CI:21.83-40.88,P<0.00001,I^(2)=97%],thickness of endometrium(MD=1.76,95%CI:0.71-2.81,P=0.001,I^(2)=98%)and decreasing miscarriage rate(RR=0.25,95%CI:0.09-0.65,P=0.005,I^(2)=0%),serum follicle-stimulating hormone level(MD=-2.10,95%CI:-3.27 to-0.94,P=0.0004,I^(2)=99%),serum luteinizing hormone level(MD=-6.94,95%CI:-9.89 to-4.00,P<0.00001,I^(2)=100%),and serum progesterone level(MD=-1.66,95%CI:-2.98 to-0.34,P=0.01,I^(2)=96%).The AT group had a more favorable effect than CC group for improving pregnancy rate(RR=1.52,95%CI:1.33-1.73,P<0.00001,I^(2)=0%),thickness of endometrium(MD=2.48,95%CI:2.15-2.81,P<0.00001,I^(2)=0%)and reducing miscarriage rate(RR=0.23,95%CI:0.13-0.44,P<0.00001,I^(2)=0%),serum follicle-stimulating hormone level(MD=-0.55,95%CI:-0.86 to-0.24,P=0.0005,I^(2)=0%),and serum progesterone level(MD=-0.24,95%CI:-0.28 to-0.20,P<0.00001).However,the level of evidence was predominantly assessed as very low to moderate.CONCLUSION AT can improve the pregnancy outcomes and sex hormone levels for patients with ODI.However,further studies are needed to confirm these findings.

Meta-analysis and sequential analysis of acupuncture compared to carbamazepine in the treatment of trigeminal neuralgia

BACKGROUND In this randomized controlled trial(RCT)comparing current acupuncture with carbamazepine for trigeminal neuralgia,meta-and sequential analyses were utilized.AIM To guide clinical decision making regarding the treatment of trigeminal neuralgia with carbamazepine.METHODS The RCT literature on needle comparison was searched in various Chinese biomedical databases including Chinese Biomedical Literature Database,Wanfang Data,VIP Database,as well as international databases such as Excerpt Medica Database,Cochrane Library,PubMed,and Web of Science,along with related clinical registration platforms such as World Health Organization International Clinical Trial Registry Platform,ChiCTR,and Clinical Trials up to 1 April 2020.Risk of bias was evaluated using the Cochrane Collaborative Risk Bias tool,primary outcome measures(pain reduction)were analyzed using STATA metaanalysis,outcome measures were analyzed using trial sequential analysis 0.9.5.10 Beta sequential analysis,GRADE was used to assess the evidence,and adverse reactions were documented.RESULTS This study analyzed 16 RCTs with a total of 1231 participants.The meta-analysis revealed a statistically significant difference in pain reduction between acupuncture and carbamazepine[standardized mean difference(SMD)=1.47;95%confidence interval(CI):0.99-1.95],although the quality of evidence was deemed to be of extremely low quality.Cumulative meta-analysis based on the year of publication indicated that carbamazepine treatment first demonstrated a statistically significant difference in pain reduction in 2014 and remained relatively stable over time[SMD=1.84;95%CI:0.22-3.47].Additionally,the number of adverse events associated with acupuncture was significantly lower compared to carbamazepine.CONCLUSION Acupuncture for trigeminal neuralgia is better than analgesia and safer than carbamazepine;however,firm conclusions still require a high-quality,multicenter,large-sample RCT to confirm these findings.

Clinical research progress on acupuncture for the treatment of otogenic vertigo

Otogenic vertigo is a common disorder that affects the vestibular system,which often results in considerable discomfort and impaired daily functioning.Traditional Chinese medicine(TCM),including acupuncture and moxibustion,has been historically utilized to manage the symptoms of vertigo.However,the effectiveness and methodology of these treatments have rarely been investigated in the medical literature.This study reviews the existing literature on the point selection,method,and therapeutic effect of acupuncture and moxibustion to provide a reference for the TCM treatment of otogenic vertigo.A literature search was performed using the PubMed search engine.The terms used included otogenic vertigo,acupuncture treatment,and acupuncture point selection.A total of 34 relevant articles were retrieved from PubMed.These suggest that the clinical treatment of otogenic vertigo should consider the functions of zang-fu organs and meridians and select different acupuncture treatment methods according to syndrome differentiation based on the difference between deficiency and excess.Acupuncture and moxibustion therapy should be based on acupoint selection,considering the syndrome differentiation,supplemented with experience.The treatment of otogenic vertigo with acupuncture and moxibustion refers to the selection of appropriate acupuncture methods under the guidance of TCM theory and following the principles of syndrome,disease,and meridian differentiation.Common acupuncture methods include body acupuncture,auricular acupuncture,scalp acupuncture,acupoint injection,electroacupuncture,and moxibustion.There are many acupuncture and moxibustion acupoints selected for the treatment of otogenic vertigo.Individualized treatment according to the patient’s specific condition is effective and safe,which can help to improve the patient’s vertigo symptoms and cerebral blood perfusion.

Mechanism of acupoint penetration acupuncture therapy regulating chondrocyte autophagy via the PI3K/Akt-mTOR pathway in KOA rats

Objective To investigate whether acupoint penetration acupuncture(APA)could regulate chondrocyte autophagy and apoptosis via the PI3K/Akt-mTOR signaling pathway to reduce cartilage degeneration in knee osteoarthritis(KOA)rats.Methods KOA was induced in rats via intra-articular injection of sodium iodoacetate resolution.Forty male Sprague-Dawley rats were randomly assigned to blank control,model,APA,electro-acupuncture(EA),and sham model groups(n=8)and those in the APA and EA groups received their respective therapies.Following completion of the treatment course,histological examinations of cartilage and muscle were conducted.Levels of apoptosis-and autophagy-related factors,including Bax,Bcl-2,mTOR,ULK-1,and Beclin-1 protein,and mRNAs were assessed.Additionally,β-endorphin(β-EP)concentrations in the brain and serum were measured.Results Histological analysis revealed that APA alleviated cartilage and muscle damage compared with the model group.APA inhibited cartilage degeneration by modulating the expression of apoptosis-and autophagy-related proteins and mRNA,thus preventing chondrocyte apoptosis.In the APA group,Bax and mTOR protein levels were significantly lower than those in the model group(both P=.024).Conversely,the Bcl-2 expression level was significantly higher than that in the EA group(P=.035).Additionally,ULK-1 expression was significantly lower than that in the EA group(P=.045).The mRNA level of Bax was significantly higher than that in the blank control group(P<.001).However,Beclin-1 levels were significantly higher than those in both the model and EA groups(both P<.001).ELISA results showed a significant decrease in the concentration ofβ-EP in the brains of the rats in the APA group compared with those in the model group(P=.032).Conclusions APA reduced osteoarthritis-related pain and alleviated cartilage damage by upregulating chondrocyte autophagy and down-regulating apoptosis via signaling pathways involving PI3K/Akt-mTOR in KOA rats.

International Communication of Acupuncture and Moxibustion Popular in the West

With the development of traditional Chinese medicine(TCM)acupuncture and moxibustion,research on acupuncture and moxibustion in the Western world is deepening.The concept of acupuncture and moxibustion popular in the West is formed.By investigating the localization of acupuncture and moxibustion in the Western world,this paper introduces several kinds of acupuncture and moxibustion popular in the West and concludes the spread of acupuncture and moxibustion popular in the West through hospitals and clinics,academic works,social organizations,education,and training.This paper provides a global vision developing domestic acupuncture and moxibustion and promoting academic prosperity and technical progress of world acupuncture and moxibustion system.

Future directions:combination of acupuncture with mesenchymal stem cells for Parkinson’s disease

Parkinson’s disease(PD)is a progressive chronic disease currently with no radical cure drugs and means due to the complex pathological mechanisms and limited regenerative capacity of neurons.Acupuncture aids in neuronal regeneration via various signaling routes like ROCK,Wnt,and Notch,safeguarding dopaminergic neurons against inflammation,oxidative stress,and cell death,which in turn enhances the progression of PD progression.Numerous research findings indicate that integrating acupuncture with mesenchymal stem cells(MSCs)transplantation is more effective than using either acupuncture or MSCs infusion alone.The combined treatment improves the survival rate of MSCs,promotes the generation of functional neural networks by stimulating the secretion of neurotrophic factors,and ultimately improves the disease microenvironment.In this review,we state the neuroprotective effects of acupuncture or MSCs treament alone in PD,then summarize the application of acupuncture combined with MSCs therapy in other diseases.Consequently,we anticipate that integrating acupuncture with MSCs transplantation may emerge as a novel and efficient approach for managing PD.This possibility needs to be verified through further basic and clinical research.

Clinical effect of acupuncture at ghost points combined with fluoxetine hydrochloride on mild-to-moderate depression

BACKGROUND Depression is a common,chronic,and recurrent mood disorder that has become a worldwide health hazard.Fluoxetine hydrochloride,a common treatment method,can inhibit 5-hydroxytryptamine(5-HT)recycling in the presynaptic membrane;however,the efficacy of a single drug is inadequate.At present,mildto-moderate depression can be treated with acupuncture of ghost caves,but the clinical curative effect of combined therapy with fluoxetine hydrochloride has not been sufficiently reported.AIM To evaluate the clinical effect of acupuncture at ghost points combined with fluoxetine hydrochloride in the treatment of mild-to-moderate depression.METHODS This retrospective study included 160 patients with mild-to-moderate depression who were admitted to Shanghai Hospital of Integrated Traditional Chinese and Western Medicine,Affiliated to Shanghai University of Traditional Chinese Medicine,between January 2022 and June 2023.Patients were separated into a single-agent group(fluoxetine hydrochloride treatment,n=80)and a coalition group(fluoxetine hydrochloride treatment combined with acupuncture at ghost points,n=80).Pre-treatment symptoms were recorded,and the clinical curative effect and adverse reactions[Asberg Antidepressant Side Effects Scale(SERS)]were assessed.Depression before and after treatment[Hamilton Depression Scale(HAMD)-24],neurotransmitter levels[5-HT,norepinephrine(NE),dopamine(DA)],oxidative stress indicators[superoxide dismutase(SOD),malondialdehyde(MDA)],and sleep quality[Pittsburgh Sleep Quality Index(PSQI)]were compared.RESULTS The total efficacy rate was 97.50%in the coalition group and 86.25%in the single-agent group(P<0.05).After 2,4,6,and 8 wk of treatment,the HAMD,self-rating depression scale,and SERS scores of the coalition and single-agent groups decreased compared with pre-treatment,and the decrease was more significant in the coalition group(P<0.05).After 8 wk of treatment,the levels of NE,DA,5-HT,and SOD in the coalition and single-agent groups increased,while the levels of MDA decreased;the increases and decrease in the coalition group were more significant(P<0.05).The PSQI scores of the coalition and single-agent groups decreased,and the decrease was more significant in the coalition group(P<0.05).CONCLUSION Acupuncture at ghost points combined with paroxetine tablets can safely improve depressive symptoms and sleep disorders,regulate neurotransmitter levels,and reduce stress responses in patients with mild-to-moderate depression.

Research progress of acupuncture analgesia based on autonomic nerve regulation pathway

The autonomic nervous system(ANS)includes the sympathetic,parasympathetic,and enteric nervous systems,and its senior regulatory center includes the brainstem,cingulate gyrus,and hypothalamus.Acupuncture can affect visceral,vascular,and glandular functions via the autonomic nervous regulatory pathway.In this paper,the relationship between pain and autonomic nervous function,the application of acupuncture guided by the autonomic nervous system,and the basis and clinical research on acupuncture analgesia are reviewed.

Wrist-ankle acupuncture combined with pain nursing for the treatment of urinary calculi with acute pain

BACKGROUND Urological calculi often cause renal colic,which is characterized by paroxysmal or persistent severe pain in the upper abdomen or lumbar region.Development of methods to quickly relieve these pain symptoms has garnered clinical attention.Wrist-ankle acupuncture is a type of floating acupuncture therapy administered at selected points in the carpal and ankle areas,and it has good pain-relieving effects.We used wrist-ankle acupuncture combined with pain nursing for pain intervention in patients with renal calculi to confirm its application and safety.AIM To study the effect of wrist-ankle acupuncture combined with pain nursing in the treatment of urinary calculi with acute pain.METHODS Eighty-two patients with urinary calculi with acute pain as the first symptom followed at our hospital from November 2019 to June 2021 were enrolled in the study and classified into two groups according to the odd and even numbers of the visit sequences,each with 41 cases.The control group received a routine nursing intervention and intramuscular injection of nonsteroidal anti-inflammatory drugs,whereas the observation group received pain management nursing and wrist-ankle acupuncture.Subsequently,the pain-relieving effect was compared between the two groups.RESULTS The score on the visual analog scale(VAS)at 24,48,and 72 h postintervention was decreased in both groups compared with the baseline data;moreover,the observation group scored significantly lower than the control group on the VAS at each time point after the intervention(P<0.05).The clinical efficacy at 24 h postintervention was not significantly different between the two groups(P>0.05).In turn,the pain recurrence rate at 72 h postintervention was lower in the observation group compared with the control group(P<0.05).Finally,the nursing satisfaction rate in the observation group was significantly higher than that observed in the control group(P<0.05).No serious adverse reactions occurred during the treatment and the safety of treatment was high in both groups.CONCLUSION Wrist-ankle acupuncture combined with pain nursing for treating urolithiasis with acute pain effectively alleviated the degree of pain and reduced the recurrence rate,which was worthy of clinical application.

Application of urinary N-acetyl-β-D-glucosaminidase combined with serum retinol-binding protein in early detection of diabetic nephropathy

BACKGROUND Diabetic nephropathy(DN)is a microangiopathy of type 2 diabetes mellitus(T2DM),which can damage the kidney through various ways and mechanisms due to the nature of the disease,involving the renal interstitium and glomeruli.However,in the early stage of the disease,patients only showed kidney volume increase and glomerular hyperthyroidism,and typical symptoms that are difficult to arouse individual attention were noticed.AIM To observe the expression of serum retinol-binding protein(RBP)and urinary Nacetyl-β-D-glucosaminidase(NAG)in patients with DN,and to analyze their value in disease prediction,so as to provide new targets for early diagnosis and treatment of DN.METHODS The baseline data of 50 T2DM patients treated in our hospital between January 2021 and December 2022 were retrospectively reviewed and included in group A.The baseline data of 50 patients with type 2 DN admitted to our hospital during the same period were collected and included in group B.The baseline data and serum RBP and urine NAG expression were compared between the two groups to analyze their value in the early prediction of DN.RESULTS There was no significant difference in age,gender,duration of diabetes,combined hyperlipidemia and combined hypertension between the two groups(P>0.05);the expression of urinary NAG and serum RBP in group B was higher than that in group A,and the difference was statistically significant(P<0.05);a multiple logistic regression model was established,and the results showed that urinary NAG and serum RBP were related to the presence or absence of injury in diabetic patients,and overexpression of urinary NAG and serum RBP may be risk factors for renal injury in T2DM patients(OR>1,P<0.05);receiver operating curve curve was plotted,and the results showed that the area under the curve of urinary NAG and serum RBP expression alone and in combination for predicting DN was>0.80,and the predictive value was satisfactory;bivariate Spearman linear correlation analysis showed that there was a positive correlation between urinary NAG and serum RBP expression in patients with DN(r=0.566,P=0.000).CONCLUSION The increased expression of urinary NAG and serum RBP may be the risk factors leading to the progression of T2DM to DN.The possibility of DN can be considered in patients with urinary NAG and serum RBP overexpression by examining the expression of urinary NAG and serum RBP in patients with T2DM in clinical practice.

Acupuncture inhibits Notch1 and Hes1 protein expression in the basal ganglia of rats with cerebral hemorrhage

Notch pathway activation maintains neural stem cells in a proliferating state and increases nerve repair capacity. To date, studies have rarely focused on changes or damage to signal transduc- tion pathways during cerebral hemorrhage. Here, we examined the effect of acupuncture in a rat model of cerebral hemorrhage. We examined four groups： in the control group, rats received no treatment. In the model group, cerebral hemorrhage models were established by infusing non-hep-arinized blood into the Brain. In the acupuncture group, modeled rats had Baihui （DU20） and Qubin （GBT） acupoints treated once a day for 30 minutes. In the DAPT group, modeled rats had 0.15 μg/mL DAPT solution （10 mL） infused into the brain. Immunohistochemistry and western blot results showed that acupuncture effectively inhibits Notch 1 and Hesl protein expression in rat basal ganglia. These inhibitory effects were identical to DAPT, a Notch signaling pathway inhibitor. Our results suggest that acupuncture has a neuroprotective effect on cerebral hemorrhage by in- hibiting Notch-Hes signaling pathway transduction in rat basal ganglia after cerebral hemorrhage.

Improvement in acupoint selection for acupuncture of nerves surrounding the injury site: electro-acupuncture with Governor vessel with local meridian acupoints

Peripheral nerve injury not only affects the site of the injury, but can also induce neuronal apop- tosis at the spinal cord. However, many acupuncture clinicians still focus only on the injury site, selecting acupoints entirely along the injured nerve trunk and neglecting other regions; this may delay onset of treatment efficacy and rehabilitation. Therefore, in the present study, we compared the clinical efficacy of acupuncture at Governor vessel and local meridian acupoints combined （GV/LM group） with acupuncture at local meridian acupoints alone （LM group） in the treatment of patients with peripheral nerve injury. In the GV/LM group （n = 15）, in addition to meridian acupoints at the injury site, the following acupoints on the Governor vessel were stimulated： Baihui （GV20）, Fengfu （GV16）, Dazhui （GV14）, and Shenzhu （GV12）, selected to treat nerve injury of the upper limb, and Jizhong （GV6）, Mingmen （GV4）, Yaoyangguan （GV3）, and Yaoshu （GV2） to treat nerve injury of the lower limb. In the LM group （n = 15）, only me- ridian acupoints along the injured nerve were selected. Both groups had electroacupuncture treatment for 30 minutes, once a day, 5 times per week, for 6 weeks. Two cases dropped out of the LM group. A good or excellent clinical response was obtained in 80% of the patients in the GV/ LM group and 38.5% of the LM group. In a second study, an additional 20 patients underwent acupuncture with the same prescription as the GV/LM group. Electomyographic nerve conduc- tion tests were performed before and after acupuncture to explore the mechanism of action of the treatment. An effective response was observed in 80.0% of the patients, with greater motor nerve conduction velocity and amplitude after treatment, indicating that electroacupuncture on specific Governor vessel acupoints promotes functional motor nerve repair after peripheral nerve injury. In addition, electromyography was performed before, during and after electroacu- puncture in one patient with radial nerve injury. After a single session, the patient＇s motor nerve conduction velocity increased by 23.2%, indicating that electroacupuncture at Governor vessel acupoints has an immediate therapeutic effect on peripheral nerve injury. Our results indicate that Governor vessel and local meridian acupoints used simultaneously promote functional repair after peripheral nerve injury. The mechanism of action may arise from an improvement of the local microenvironment in injured nervous tissue, as well as immediate effects of Governor vessel and local meridian acupoint stimulation to ensure the continuity between the peripheral and central nervous systems.

Electroacupuncture at Fengchi(GB20) inhibits calcitonin gene-related peptide expression in the trigeminovascular system of a rat model of migraine

Most migraine patients suffer from cutaneous allodynia; however, the underlying mechanisms are unclear. Calcitonin gene-related peptide（CGRP） plays an important role in the pathophysiology of migraine, and it is therefore, a potential therapeutic target for treating the pain. In the present study, a rat model of conscious migraine, induced by repeated electrical stimulation of the superior sagittal sinus, was established and treated with electroacupuncture at Fengchi（GB20）（depth of 2–3 mm, frequency of 2/15 Hz, intensity of 0.5–1.0 m A, 15 minutes/day, for 7 consecutive days）. Electroacupuncture at GB20 significantly alleviated the decrease in hind paw and facial withdrawal thresholds and significantly lessened the increase in the levels of CGRP in the trigeminal ganglion, trigeminal nucleus caudalis and ventroposterior medial thalamic nucleus in rats with migraine. No CGRP-positive cells were detected in the trigeminal nucleus caudalis or ventroposterior medial thalamic nucleus by immunofluorescence. Our findings suggest that electroacupuncture treatment ameliorates migraine pain and associated cutaneous allodynia by modulating the trigeminovascular system ascending pathway, at least in part by inhibiting CGRP expression in the trigeminal ganglion.

Annual advances of acupuncture research in 2022

This article reviews the major advances in acupuncture research in 2022,including clinical reports,basic research,and reviews.In terms of the type of literature,most of them are systematic reviews and clinical trials,while high-quality basic studies can also be found.The innovative inventions and researches in this field are of increasing quality and in a wide range of fields,acupuncture is attracting more and more attention in the international arena.In particular,some acupuncture combined sensors such as H2-EC/SD co-therapy,precise positioning,and vivo monitoring of neurotransmitter has been used for oncological diseases and neuropathic pain.Acupuncture has been shown to be beneficial in the treatment of pain,stroke,psychiatric disorders,cancer,COVID-19 and others.Most of the studies show that acupuncture can play a positive role in various diseases and provide evidence for clinical applications and mechanism research.

Influence of Acupuncture on Autonomic Balance in Adult Tinnitus Patients:An Exploratory Study

Acupuncture is an alternative therapy for tinnitus in clinical practice.The mechanism by which acupuncture can alleviate tinnitus is still unknown.Autonomic nervous system was reported to be responsible for tinnitus.The aim of this study was to explore the effect of acupuncture on autonomic balance in adult tinnitus patients.Thirty patients were randomly assigned into either the deep acupuncture(DA)group or the shallow acupuncture(SA)group.Each patient received 6 acupuncture sessions(a-f phase)over three weeks.Measures of heart rate variability and Tinnitus Handicap Inventory(THI)were obtained at baseline and after the sixth acupuncture session in all patients.The results showed that the low frequency/high frequency(LF/HF)pattern was increased at b-f phase until the sixth acupuncture session when compared with that at the first acupuncture session in DA group.However,it continuously increased at b-f phase in SA group even at the sixth acupuncture session,which was not significantly different from that at the first acupuncture session.The decrease in THI in DA group was greater than that in SA group after 3-week treatment(P=0.043).Our preliminary study suggests three-week deep acupuncture can improve tinnitus symptoms in adult tinnitus patients,which may be related to the regulation of autonomic nervous system balance.

Value of ultrasound guided biopsy combined with Xpert Mycobacterium tuberculosis/resistance to rifampin assay in the diagnosis of chest wall tuberculosis

BACKGROUND The thoracic wall lesions,particularly chest wall tuberculosis,and chest wall tumors and other pyogenic wall and actinomycetes infections,almost always present as a diagnostic challenge.AIM To explore the value of ultrasound-guided biopsy combined with the Xpert Mycobacterium tuberculosis/resistance to rifampin(MTB/RIF)assay to diagnose chest wall tuberculosis.METHODS We performed a retrospective study of patients with chest wall lesions from March 2018 to March 2021.All patients received the ultrasound-guided biopsy for pathology examination,acid-fast Bacillus staining,mycobacterial culture,and Xpert MTB/RIF analysis.The sensitivity,specificity,and area under the curve(AUC)were calculated for these diagnostic tests,either individually or combined.Rifampicin resistance results were compared between the mycobacterial culture and the Xpert MTB/RIF assay.RESULTS In 31 patients with the chest wall lesion biopsy,22 patients were diagnosed with chest wall tuberculosis.Of them,3,6,and 21 patients tested positive for mycobacterial culture,acid-fast stain,and Xpert MTB/RIF assay,respectively.The rifampicin resistance results of the 3 culture-positive patients were consistent with their Xpert MTB/RIF assay results.When considering the sensitivity,specificity,and AUC value,the Xpert MTB/RIF assay(95.5%,88.9%,and 0.92,respectively)was a better choice than the acid-fast Bacillus stain(27.3%,100.0%,and 0.64,respectively)and mycobacterial culture(13.6%,100.0%,0.57,respectively).No complications were reported during the procedure.CONCLUSION Ultrasound guided biopsy combined with Xpert MTB/RIF has high value in the diagnosis of chest wall tuberculosis,and can also detect rifampicin resistance.

Clinical study of acupuncture combined with surface anesthesia using proparacaine in geriatric cataract phacoemulsification

BACKGROUND During anesthesia administration for cataract surgery,low pH of proparacaine may induce pain or complications such as corneal damage and poor wound healing,with the use of additional drops intraoperatively increasing the risk of complications.Accordingly,there is a clinical need for adjuncts to local anesthesia needs to improve the efficiency of anesthesia and reduce the required amount of intraoperative proparacaine.AIM To identify a method of anesthesia for geriatric cataract phacoemulsification that provides more efficient analgesia and improves clinical efficacy.METHODS A total of 130 geriatric patients with cataracts who attended Hebei Eye Hospital from December 2020 to December 2022 were included in the present study.Patients were divided into the proparacaine surface anesthesia(SA)group(65 cases)and the compound acupuncture-medicine anesthesia group(CAMA group,65 cases).Patients in the CAMA group were provided acupuncture analgesia in addition to SA.Preoperative anxiety[Self-Rating Anxiety Scale(SAS)score and state anxiety inventory(SAI)score],intraoperative stress,vital signs,analgesia,and cooperation,as well as postoperative adverse events,were compared between groups.RESULTS More marked reductions in anxiety were observed among patients in the CAMA group,with corresponding reductions in SAS and SAI scores.During the operation,no change in the secretion of E,NE,or Cor group compared to the preoperative period was observed in the CAMA,which was markedly lower than that in the SA group.Heart rate,blood pressure,and respiratory rate were more stable intraoperatively in the CAMA group.In addition,the incidence of intraoperative pain and the number of additional doses of anesthesia required in the CAMA group were markedly lower than in the SA group.Accordingly,patients in the CAMA group were able to avoid eye movements and eyelid closing leading to greater cooperation with surgeons during surgery.Furthermore,marked reductions in intraoperative adverse effects were observed in the CAMA group,indicating greater overall safety.CONCLUSION Proparacaine SA combined with acupuncture as an analgesic provides improved analgesia with greater safety compared to surface anesthesia with proparacaine during geriatric cataract phacoemulsification.

Effects of electro-acupuncture on Noxa and caspase-3 expression in hippocampal CA1 region of a vascular dementia rat model

BACKGROUND：Noxa, a pro-apoptotic member of the Bcl-2 protein family, has been shown to induce the mitochondrial pathway of apoptosis and to mediate hypoxic cell death in a rat model of cerebral ischemia. This suggests that Noxa could participate in apoptosis during vascular dementia （VD）. OBJECTIVE： To detect Noxa and caspase-3 expression after electro-acupuncture in VD rats to further validate the mechanism of electro-acupuncture-induced effects in the treatment of VD. DESIGN, TIME AND SETTING： A randomized, controlled study was performed at the Center for the Neurobiology of Fujian Medical University between January 2006 and March 2007. MATERIALS： A total of forty adult, male, Sprague Dawley rats were included in this study. The following equipment was used： confocal laser scanning microscope （Sp5, Leica, Germany）, water maze （Bejing Suntendy Science and Technology Co., Ltd., China）, and SDZ-II electronic acupuncture treatment instruments （Suzhou Medical Appliance Factory, China）. METHODS： Thirty-eight rats with sufficient learning and memory abilities were selected by Morris water maze criteria. Twelve rats received sham-surgery; the remaining 26 rats were used to establish a VD model by bilateral occlusion of the common carotid arteries. The rats that survived the occlusion procedure were randomly assigned into an electro-acupuncture group （n = 11） and a VD model group （n = 12）. MAIN OUTCOME MEASURES： Neuropathological changes were observed with hematoxylin-eosin staining of the hippocampus and expression of Noxa and caspase-3 in the hippocampal CA1 region was analyzed by confocal laser scanning microscope following immunofluorescence staining. RESULTS： Expressions of Noxa and caspase-3 in the electro-acupuncture group and sham-operated group were less than in the VD model group （P 〈 0.01）. Electro-acupuncture reduced the amount of apoptotic neurons in hippocampal CA1 area of rats with VD. The average latency in the Morris water maze test was significantly shorter, and escape strategies improved from edge and random searches to more linear swim pathways in the electro-acupuncture group compared with the VD model group （P 〈 0.01）. CONCLUSION： Electro-acupuncture can improve learning and memory ability and inhibit the occurrence of apoptosis by blocking expression of Noxa and caspase-3 in the hippocampal CA1 region of VD rats.

Effects of acupuncture on Alzheimer’s disease: the mechanistic study

Introduction Alzheimer’s disease(AD)is a degenerative disease of the central nervous system characterized by memory loss and cognitive impairment,often accompanied by emotional apathy,agitation,depression,delusions aggression,and other psychological symptoms[1–3].Psychological symptoms such as apathy,agitation,and depression tend to increase with the duration and severity of AD.

A study on the mechanism of acupuncture treatment of acne based on immune inflammation

Acne is a chronic inflammatory skin disease involving hair follicle sebaceous glands,which is characterized by acne,papules,pustules,nodules,cysts and so on.The disorder of immune inflammation is the key link.A variety of factors participate in the immune inflammatory response of acne and interact with each other,leading to the occurrence and development of acne inflammation.Acupuncture can regulate the immune and inflammatory response through many links and improve the skin lesions.This study explains potential mechanisms of acupuncture in the treatment of acne by regulating the body's immune inflammatory response,in order to provide new ideas.