Magnesium-based biomaterials for coordinated tissue repair:A comprehensive overview of design strategies,advantages,and challenges

Magnesium-based biomaterials(MBMs)are one of the most promising materials for tissue engineering due to their unique mechanical properties and excellent functional properties.This review describes the development,advantages,and challenges of MBMs for biomedical applications,especially for tissue repair and regeneration.The history of the use of MBMs from the beginning of the 20th century is traced,and the transformative advances in contemporary applications of MBMs in areas such as orthopedics and cardiovascular surgery are emphasized.The review also provides insight into the signaling pathways affected by MBMs,such as the PI3K/Akt and RANKL/RANK/OPG pathways,which are critical for osteogenesis and angiogenesis.The review advocates that future research should focus on optimizing alloy compositions,surface modification and exploring innovative technologies such as 3D printing to improve the efficacy of MBMs in complex tissue repair.The potential of MBMs to tissue engineering and regenerative medicine is significant,urging further exploration and interdisciplinary collaboration to maximize their therapeutic effects.

Efficacy and safety of awn needle in the treatment of lumbar disc herniation:A meta-analysis

Objective:To evaluate the intervention effect of awn needle in the treatment of lumbar disc herniation through meta-analysis.Methods:In CNKI,Wanfang Data,PubMed,VIP and other databases,we searched the clinical observation studies on the treatment of patients with lumbar disc herniation with awn needle.The methodological quality of the included studies was evaluated using Cochrane 5.1.0 bias risk assessment criteria and Jadad scale.Revman 5.3 software was used for meta-analysis.Results:A total of 14 randomized controlled trials involving 1186 patients were included,with 595 in the awn needle treatment group and 591 in the control group.Meta-analysis showed that the awn needle treatment group was better than that of the control group in the total effective rate[RR=1.17;95%CI(1.12,1.22);Z=6.66;P<0.00001];the awn needle treatment group was better than the control group in ameliorating VAS score[WMD=-1.07,95%CI(-1.19,-0.95),Z=17.87,P<0.00001];the awn needle treatment group was better than the control group in ameliorating JOA score[WMD=3.18,95%CI(2.64,3.71),Z=11.57,P<0.00001];the awn needle treatment group was better than the control group in the amelioration of ADL score[SMD=2.44,95%CI(0.54,4.35),Z=2.52,P=0.01];the awn needle treatment group was better than the control group in the improvement of SLRT angle[WMD=12.71,95%CI(3.21,22.21),Z=2.62,P=0.009].Conclusion:Awn needle treatment can improve the total effective rate of patients with lumbar disc herniation,relieve the pain of patients,improve the straight leg elevation angle of patients,alleviate the disease development,relieve the symptoms,and improve the quality of life of patients.It is worthy of clinical application.

Effects of electroacupuncture of acupoints of the neiguan and ximen on ischemic myocardium energy metabolism with acute myocardial ischemia rats

Objective:To observe the effect of Electroacupuncture of Acupoints of the Neiguan(PC6)and Ximen(PC4)on its myocardial energy metabolism with acute myocardial ischemia rats caused by coronary artery ligation.Methods:Forty standard Spargue-Dawely(SD)rats were divided into four groups randomly,namely,group of Neiguan,group of Ximen,model group,sham group.The group of rats of myocardial ischemia were induced by coronary ligation,and the model rat of acute myocardial ischemia was prepared.The sham group had no ligation of the needle.After anesthesia was awakened,acupuncture was applied bilateral at Neiguan and Ximen of the group of Neiguan and Ximen,once a day at a fixed time for 14 days.The rats of model group and the sham group were not given acupunctured,but use the samely methods of Neiguan and Ximen groups to grap the rats at the same time everyday.After 14 days the experiment was over,observed the pathological changes of myocardial tissue by HE staining,detected the levels of free fatty acid(FFA),adenosine triphosphate(ATP)content,and the activities of Na^(+)-K^(+)-ATPase according to the reagents´demand.Results:Pathological results showed that acupuncuted at Neiguan and Ximen could improve the ischemic cardiomyocyte injury.Compared with the sham group,the levels of FFA in model group were increased(p<0.01),the levels of ATP,the activities of Na^(+)-K^(+)-ATPase were all decreased(p<0.01);Compared with the model group,the levels of FFA were decreased(p<0.05,p<0.01),the levels of ATP,the activities of Na^(+)-K^(+)-ATPase were improved.Conclusion:Acupuncturing at the Pericardium Meridian can alleviate the cell injury by myocardial ischemia,and also can improve the myocardial energetic metabolism in acute myocardial ischemia.

Clinical Study on the Acupotomy for Iliotibial Band Release in the Treatment of Valgus Knee Osteoarthritis

[Objectives]To observe the clinical effect of acupotomy for iliotibial band release in the treatment of valgus knee osteoarthritis.[Methods]Sixty patients with mild valgus knee osteoarthritis who met the inclusion criteria were randomly divided into control group(n=30)and treatment group(n=30).The control group was treated with celecoxib capsule,and the treatment group was treated with acupotomy.The visual analogue score(VAS),modified American knee society score(KSS)and anatomic valgus angulation(AVA)were observed and compared between the two groups before and after treatment to evaluate the curative effect.[Results]Compared with those before treatment,there were significant differences in VAS and KSS between the two groups after treatment(P<0.05).There was no significant difference in AVA between the two groups before and after treatment.There were significant differences in the above-mentioned indexes between the two groups(P<0.05).The comprehensive curative effect of the treatment group was better than that of the control group(P<0.05),and there was significant difference between the two groups one month after treatment(P<0.05).[Conclusions]The acupotomy for iliotibial band release was effective in the treatment of valgus knee osteoarthritis,and it was found to delay the progression of knee valgus deformity through long-term observation.

Promotion and Mechanism of Acupotomy on Chondrocyte Autophagy in Knee Osteoarthritis Rabbits

Objective:To explore the effect of acupotomy intervention on autophagy of chondrocytes in rabbits with knee osteoarthritis(KOA),and to determine the possible mechanisms of acupotomy to alleviate cartilage degeneration.Methods:The modified Videman method was used to construct a KOA rabbit model.After modeling,40 rabbits were randomly divided into 4 groups by a random number table:control;KOA(model);KOA+acupotomy(acupotomy),and KOA+sham acupotomy(sham),10 in each group.After a 3-week treatment course,the knee joint activity was determined by the modified Lequesne MG index.Hematoxylin-eosin staining staining was used to examine the morphological changes of chondrocytes.Autophagy of chondrocytes was observed by transmission electron microscopy.The surface morphology of cartilage tissue was observed by scanning electron microscope.The mRNA and protein levels of AMP kinase/mammalian target of rapamycin/Unc-51(AMPK/mTOR/ULK1)signal pathway key proteins,autophagy-related factor Beclin-1 and microtubule-associated protein 1A/1B light chain 3(LC3)in rabbit knee cartilage were assessed by real-time fluorescence quantitative polymerase chain reaction and Western blot,respectively.Results:The modified Lequesne MG score of acupotomy group was significantly lower than that of model group(P<0.05).Pathological results showed that chondrocyte autophagy decreased and cartilage surface was rough in the model group,which recovered after acupotomy treatment.The mRNA expressions of AMPK,ULK1,Beclin-1 and the protein levels of p-AMPK,p-ULK1,Beclin-1,and LC3Ⅱ/LC3Ⅰwere decreased in the model group,while the mRNA and protein expressions of mTOR were increased(P<0.01).However,acupotomy treatment reversed these abnormal changes(P<0.05).Conclusions:Acupotomy could effectively up-regulate the expressions of AMPK,ULK1 and Beclin1,reduce the expression of mTOR,promote autophagy,and alleviate joint degeneration.Acupotomy is a promising complementary and alternative therapy for KOA.

World Federation of Acupuncture-Moxibustion Societies(WFAS)Technical Benchmark of Acupuncture and Moxibustion:Moxibustion

Technical Benchmark of Acupuncture and Moxibustion:Moxibustion was organized by the World Federation of Acupuncture-Moxibustion Societies and the revision was led by Anhui University of Chinese Medicine.This document was first issued in 2013,known as Moxibustion Manipulation.The technical benchmark of moxibustion include scope,normative reference,terms and definitions,operation and requirement and safety.This article introduces the above contents,explains the difficulties in the revision and give the suggestions for the application and popularization of this standard.

Clinical observation of acupuncture plus repetitive transcranial magnetic stimulation in the treatment of post-stroke insomnia

Objective:To evaluate the clinical efficacy of the Governor Vessel-unblocking and mind-regulating acupuncture method plus repetitive transcranial magnetic stimulation(rTMS)in the treatment of post-stroke insomnia.Methods:A total of 72 patients with post-stroke insomnia were randomly divided into 2 groups,with 36 cases in each group.The control group received rTMS treatment with a frequency of 1 Hz and a motion threshold value of 90%.The observation group received acupuncture with Governor Vessel-unblocking and mind-regulating method based on the rTMS treatment of the control group.The points were Baihui(GV 20),Shenting(GV 24),Yintang(GV 29),Fengfu(GV 16),Sishencong(EX-HN I),Shenmen(HT I),Sanyinjiao(SP 6);Shenmai(BL 62)and Zhaohai(Kl 6).The treatment was performed once a day for 5 d a week followed by 2 d of rest for 4 weeks.The improvements of Pittsburgh sleep quality index(PSQI),self-rating anxiety scale(SAS)and self-rating depression scale(SDS)scores were observed after treatment,and the clinical efficacy was compared between the two groups.Results:After 4 weeks of treatment,the PSQI,SAS,and SDS scores of the two groups were all reduced,and the intra-group differences were statistically significant(all P<0.001).After treatment,the three scores in the observation group were all lower than those in the control group,and the differences between the two groups were statistically significant(P<0.05,P<0.05,P<0.001).There was a statistically significant difference between the observation group and the control group comparing the clinical efficacy(P<0.05).Conclusion:The therapeutic effect of the Governor Vessel-unblocking and mind-regulating acupuncture method plus rTMS in treating post-stroke insomnia is better than rTMS alone,and it can better improve the anxiety and depression of patients.

Effect of warming yang and supplementing kidney moxibustion therapy on the NF-κB signaling pathway of vascular dementia rats

Objective： To observe the effect of warming yang and supplementing kidney moxibustion therapy on the behavioristics and the expression levels of hippocampal IL-1β, TNF-α and NF-κB related genes and proteins of vascular dementia（VD） rats, and to explore the mechanism of warming yang and supplementing kidney moxibustion therapy in inhibiting VD inflammatory response. Methods Seventy-eight SD rats, except 10 rats as sham operation group（group A）, were established into VD models by applying the ischemia reperfusion method in bilateral common carotid arteries. 30 models were successful and were randomly divided into model group（group B）, moxibustion group（group C） and western medication group（group D）, with 10 rats in each group. After modeling, suspended moxibustion was conducted at ＂Dàzhuī（大椎GV 14）＂,＂Mìngmén（命门GV 4）＂ and ＂Guānyuán（关元CV 4）＂ of the rats in group C for15 min/time. The intervention was performed for once a day, and intervention for 4 consecutive weeks was needed. Intragastric administration with nimodipine（2 mgkg-1d-1） was carried out in the rats in group D for 4 consecutive weeks. Morris water maze test was adopted for behavioral test in the rats in each group. HE staining was conducted in order to observe the pathological changes. RT-qPCR method and Western blot method were used for detecting the expression levels of hippocampal IL-1β, TNF-αand NF-κB related genes and proteins.Results： After modeling, the Morris water maze escape latency of rats in operation groups was obviously longer than that in group A（P〈0.05）. According to HE staining results, the arrangement of neurons in group B was incompact, the cell membranes were undefined, the cytoplasm was heterogeneous, karyopyknosis was found, the amount of necrosis increased, and the number of inflammatory cells significantly increased. Compared with group B, the number of inflammatory cells significantly reduced in group C and group D, and the amount of neuron necrosis also reduced. After intervention, compared with group B, the expression levels of TNF-a, p-IκB and NF-κBp65 mRNA in the hippocampal of the rats in group C and group D significantly decreased（all P〈0.05）, compared with group B, the expression levels of IL-1β, TNF-α and NF-κBp65 mRNA in the hippocampal of rats in group C and group D also significantly decreased（all P〈0.05）.Conclusion： Warming yang and supplementing kidney moxibustion therapy may inhibit the NF-κB signaling pathway and reduce the inflammatory response through lowering the expression levels of IL-1β,TNF-α and NF-κB mRNA in the brain, thus achieving the purpose of treating VD.

Acupuncture for dysmenorrhea of adenomyosis:A randomized clinical trial

Objective:To compare the difference in the clinical therapeutic effect on dysmenorrhea in the patients with adenomyosis between acupuncture and ibuprofen sustained release capsules.Methods:A total of 40 patients were randomized into an acupuncture group and an ibuprofen group,20 cases in each one.The treatment was given consecutively for 3 menstrual cycles and the follow-up lasted for 2 menstrual cycles.The score of visual analogue scale(VAS) at the most painful time during menstruation,menstrual flow,the score of COX menstrual symptom scale(CMSS) and the score of endometriosis health profile-5(EHP-5),as well as the patients’ satisfaction and acceptance were compared between the two groups.Results:Three menstrual cycles after treatment,the VAS score at the most painful time,menstrual flow,CMSS score and EHP-5 score were all lower than those before treatment in either group,with statistical significance(all P <0.05).Three menstrual cycles after treatment,compared with the ibuprofen group,in the acupuncture group,the VAS score at the most painful time was slightly higher(P> 0.05),the menstrual flow was lower(P> 0.05),CMSS score was higher(P <0.05) and EHP-5 was higher(P> 0.05).The score of the patients’ satisfaction and acceptance in the acupuncture group were all higher than the ibuprofen group(both P <0.05).In 2-menstrual cycles follow-up,the VAS score at the most painful time,menstrual flow,CMSS score and EHP-5 score in the acupuncture group were all lower than those in the ibuprofen group(all P <0.05).Conclusion:Acupuncture is effective for analgesia and symptom-relief and the long-term effect is superior to the oral administration of ibuprofen.

Effects of moxibustion on miRNA-133b,Pitx3/TH,and neurotransmitters in the midbrain of rats with diarrhea-predominant irritable bowel syndrome

Objective:To investigate the mechanism of moxibustion in the treatment of diarrhea-predominant irritable bowel syndrome(IBS-D),by observing the effects of moxibustion at Tianshu(ST25)and Shangjuxu(ST37)on microRNA-133b(miRNA-133b),pituitary homeobox family factor 3(Pitx3)/tyrosine hydroxylase(TH),and neurotransmitters in the brain tissue of IBS-D rats.Methods:Healthy Sprague-Dawley rats were randomly divided into a normal group,a model group,a moxibustion group,and a Western medicine group,with 12 rats in each group.Except for the normal group,the IBS-D rat model was established by mother-offspring separation and acetic acid enema combined with restraint stress stimulation in all the other groups.No intervention was performed in the normal and model groups.Mild moxibustion was applied to both Tianshu(ST25)and Shangjuxu(ST37)in the moxibustion group.Rifaximin was given by gavage in the Western medicine group.The physical status of rats in each group was observed at different periods.After the intervention,hematoxylineosin staining was performed to observe the histopathological morphology of rat colon;enzyme-linked immunosorbent assay was used to measure the levels of dopamine(DA),noradrenaline(NE),and 5-hydroxytryptamine(5-HT)in plasma,colon,and midbrain tissue of rats;the relative expression levels of miRNA-133b,Pitx3 mRNA,and TH mRNA in the midbrain tissue were measured by real-time fluorescence quantitative polymerase chain reaction,and the relative expression levels of Pitx3 and TH proteins in the midbrain tissue were measured by Western blotting and immunofluorescence.Results:The body weights of rats among groups and at different time points were statistically different(P<0.01).The body weight of the normal group was higher than that of the other groups over time(P<0.01).After modeling,the minimum volume threshold of abdominal withdrawal reflex(AWR)was significantly lower(P<0.01)and the loose stool rate was significantly higher(P<0.01)in the model,moxibustion,and Western medicine groups compared with the normal group;the miRNA-133b expression in the midbrain tissue was significantly lower(P<0.01),the expression levels of Pitx3 and TH in the midbrain tissue were significantly higher(P<0.01),and the levels of DA,NE,and 5-HT in plasma,colon and midbrain tissue were significantly higher(P<0.01).After the intervention,the minimum volume threshold of AWR was significantly higher(P<0.01),the loose stool rate was significantly lower(P<0.01),the miRNA-133b expression was significantly increased(P<0.01 or P<0.05)and the expression levels of Pitx3 and TH were significantly decreased(P<0.01)in the midbrain tissue,the levels of DA,NE,and 5-HT in plasma,colon,and midbrain tissue were significantly reduced(P<0.01)in the moxibustion and Western medicine groups compared with the model group;the levels of 5-HT in the colon and midbrain tissue of the moxibustion group were significantly lower than those in the Western medicine group(P<0.05),and there was no statistical difference compared with the remaining groups(P>0.05).Linear correlation analysis showed that miRNA-133b was negatively correlated with Pitx3(r<0,P<0.01);Pitx3 with TH,TH with DA,and NE with 5-HT were positively correlated(r>0,P<0.01).Conclusion:Moxibustion at Tianshu(ST25)and Shangjuxu(ST37)improves diarrhea symptoms and visceral hypersensitivity in IBS-D rats.The mechanism may be related to up-regulating miRNA-133b,inhibiting Pitx3/TH,and reducing neurotransmitter expression levels in the midbrain tissue.

Governor vessel-unblocking and mind-regulating acupuncture therapy for sensory and motor dysfunction after spinal cord injury

Objective： To observe the difference in clinical efficacy between governor vessel-unblocking and mind- regulating acupuncture therapy combined with conventional rehabilitation therapy and simply conventional rehabilitation therapy for sensory and motor dysfunction of patients with spinal cord injury. Methods： Forty patients with spinal cord injury （SCI） were randomly assigned into rehabilitation combined with acupuncture group （group A） and rehabilitation group （group B）, with 20 patients in each group. In group A, governor vessel-unblocking and mind-regulating acupuncture therapy combined with conventional rehabilitation therapy was adopted, and Baihui（百会 GV 20）, Fengffu （风府GV 16）, Dazhui （大椎GV 14）, Zhiyang （至阳GV 9）, Mingmen （命门 GV 4） and Yfioyangguan （腰阳关 GV 3） were adopted as the main acupoints. Conventional rehabilitation therapy was also applied, including the rehabilitation training of joint, motion, respiration, urinary bladder and intestinal tract. In group B, conventional rehabilitation therapy was adopted as same as the group A. Treatment in the two groups was conducted for once a day, 6 times a week, and 12 weeks in total. ASIA motor score （MS）, ASIA sensory score （SS） and activity of daily living （ADL） score of patients in the two groups were observed before and after the treatment. Results： Before treatment, the differences in MS, SS and ADL score of patients in the two groups were not statistically significant （all P 〉 0.05）, and the results were comparable. After treatment, MS, SS and ADL score of patients in the two groups were all higher than that before the treatment （all P 〈 0.05）, and MS, SS and ADL score of the patients in group A were all higher than that in group B （all P 〈 0.05）. Conclusion： The curative effect of governor vessel-unblocking and mind-regulating acupuncture therapy combined with conventional rehabilitation therapy was superior to that of simply conventional rehabilitation therapy in the treatment of sensory and motor dysfunction of the patients with SCI.

百会穴久留针对中风后认知障碍的影响

目的:观察针刺百会穴久留针治疗中风后认知障碍(PSCI)的临床疗效,以及对患者认知和生活能力的影响.方法:将62例PSCI患者以随机数字表法分为对照组和观察组,每组31例.对照组接受常规中风恢复期治疗联合认知训练,观察组在对照组干预基础上加用针刺百会穴久留针.治疗前后采用蒙特利尔认知评估量表(MoCA)评估患者的认知水平;采用日常生活活动(ADL)量表评估患者生活能力;采用简易智力状态评价量表(MMSE)评估患者精神状态及注意力、语言能力和抽象认知能力.治疗4周后观察两组疗效;比较两组认知水平、生活能力、精神状态以及注意力、语言、抽象理解等评分.结果:研究过程中两组各有1例因个人原因无法继续治疗而退出研究.治疗4周后,观察组总有效率为83.3%,对照组为66.7%,两组差异有统计学意义(P<0.05);两组MoCA、ADL、MMSE以及注意力、语言能力、抽象理解能力评分均增加,与本组治疗前均有统计学差异(P<0.05),且观察组各项评分均高于对照组,组间差异有统计学意义(P<0.05).结论:在常规治疗及认知训练基础上加用针刺百会穴久留针治疗PSCI的临床疗效优于常规治疗联合认知训练,可更好地改善患者认知功能和精神状态,提高患者的生活能力.