Research progress of Chinese and Western Medicine on tic disorder in children

Tic disorder is one of the common neuropsychiatric disorders that affect children’s physical and mental health.If it is not tested,diagnosed and treated early,it will have a serious impact on children themselves,their families,and even the whole society.Simple western medicine treatment methods include drugs,nerve regulation,psychological and behavioral therapy,but the results are not ideal.Traditional Chinese medicine takes systematic treatment based on syndrome differentiation and it uses methods of traditional Chinese medicine,massage and acupuncture to regulate five viscera and six bowels in order to harmonized Yin and Yang.These methods make up for the deficiencies of western treatment.In recent years,the clinical treatment of children with Tic disorders involving a variety of combined therapy has achieved significant results.As a result,the rehabilitation of children with Tic disorders has been significantly improved.By consulting the available literature at home and abroad in recent years,the author elaborates the etiology,pathogenesis and treatment of tic disorder in children,in order to further guide the clinical diagnosis and treatment.

Clinical study of warm acupuncture combined with massage in treatment of periathritis of shoulder

Objective: To analyze the clinical efficacy of warm acupuncture and moxibustion combined with manipulation in the treatment of periarthritis of shoulder. Methods: In this study, 120 patients with periarthritis of shoulder who were admitted to the department of orthopedics of the second affiliated hospital of Heilongjiang university of traditional Chinese medicine from June 2018 to June 2019 were selected, and the patients were divided into warm acupuncture group, massage group, combined treatment group and control group with a random number table, with 30 patients in each group. Warm acupuncture and moxibustion group received 4 weeks of warm acupuncture and moxibustion treatment, massage group received 4 weeks of massage treatment, patients in the combined treatment group received 4 weeks of warm acupuncture and moxibustion treatment, patients in the control group received 4 weeks of ultrashort wave combined plaster treatment. The use of ibuprofen, VAS score, Melle score, TCM syndrome score and serum inflammatory factors before and after treatment were analyzed and compared in each group of patients to evaluate the clinical efficacy. Results:shoulder joint pain and activity limitation were significantly improved in each group, VAS score, Melle score, TCM syndrome score and serum inflammatory factor levels were significantly decreased compared with before treatment (P < 0.05), and the improvement in the combined treatment group was significantly better than that in other groups (P < 0.05). Conclusion: Warm acupuncture combined with manipulation can significantly improve the clinical symptoms of periarthritis of shoulder, improve the mobility of shoulder joint, and inhibit the internal inflammatory response, which is significantly better than using warm acupuncture or manipulation alone and conventional physical therapy.

Effect of Shengsui Jiangu Capsule on bone conversion in rats with alcoholic osteoporosis

Objective:To study the mechanism of Shengsui Jiangu Capsule promoting vitamin D_(3)regulating bone turnover in rats with alcoholic osteoporosis.Methods:120 SD rats were randomly divided into four groups:model group(alcoholic osteoporosis model group),blank control group,western medicine control group(calcium carbonate tablet and affa D_(3)control group),Chinese medicine experimental group(Shengsui Jiangu capsule experimental group),30 rats in each group.After 8,12 and 16 weeks,the serum levels of 25 hydroxyvitamin D_(3)(25(OH)D_(3)),1,25dihydroxyvitamin D_(3)(1,25(OH)_(2)D_(3)),cross-linked carboxy-terminal peptide of type 1 collagen(β-CTX)and N-terminal propeptide of type 1 collagen(P1NP)in rats and the density of the femur of rats were detected and compared.The correlation between vitamin D_(3)markers(25(OH)D_(3)and 1,25(OH)_(2)D_(3))and bone turnover indices(P1NP andβ-CTX)and bone mineral density was analyzed.Results:In the experimental group,bone mineral density(BMD)was significantly increased(P<0.01),bone repair and mineral stability and balance were maintained during bone turnover,the level of bone formation marker P1NP was significantly increased(P<0.01),and the level of bone resorption markerβ-CTX was significantly decreased(P<0.01).Serum levels of 25(OH)D_(3)and 1,25(OH)_(2)D_(3)were increased(P<0.01),and significantly higher than those in western medicine control group(P<0.05).Conclusion:Shengsui Jiangu capsule can effectively improve bone density in alcoholic osteoporosis(AOP)rats,and its mechanism may be related to promoting bone calcium absorption and regulating bone conversion.

Network pharmacology approach on the mechanism of Sanwu Huangqin Decoction in treating Behcet's disease

Objective:To analyze the main compounds of Sanwu Huangqin decoction based on the method of network pharmacology and to predict its possible target and mechanism of action in the treatment of Behcet's disease(BD).Methods:TCMSP,TCMID and literatures were used to search the main compounds and their corresponding targets of Sanwu Huangqin Decoction;the disease targets of BD were searched by GeneCards database;the intersection targets of Sanwu Huangqin Decoction and BD were visualized by String database and Cytoscape software;the intersection targets were enriched by GO and KEGG by DAVID database;BD mouse model was established,RT-PCR was used to verify the regulatory effect of Sanwu Huangqin Decoction on the core target genes.Results:A total of 81 main active compounds and 50 drug-disease-target were retrieved from the databases.There were 531 biological function information and 96 signal pathways were enriched by GO and KEGG.Among them,the top 5 signal pathways were Fluid shear stress and atherosclerosis、AGE-RAGE signaling pathway in diabetic complications、IL-17 signaling pathway、TNF signaling pathway、Malaria、Chagas disease(American trypanosomiasis).RT-PCR results showed that the expression of IL-4,IL-1β,IL-6,INF-γmRNA in the spleen of BD mice was significantly up-regulated,and the expression of Caspase 3 and Caspase 8 mRNA was significantly down regulated when compared with the control group(P<0.01).Compared with the model group,the expression of IL-4,IL-1β,IL-6,INF-γmRNA in the Sanwu Huangqin decoction group was significantly down regulated,and the expression of caspase 3 and caspase 8 mRNA was significantly up regulated(P<0.01).Conclusion:Sanwu Huangqin decoction can treat BD through multi-target and multi-channel therapy,and our study and our research provides bioinformatics basis for further revealing its mechanism and treatment.

Characteristic changes of intestinal flora and its correlation with clinical indexes in patients with Behcet's disease based on TCM syndromes

Objective: To analyze the characteristics of intestinal microflora in patients with Behcet's disease of damp heat syndrome by 16S rRNA technique and its correlation with clinical indexes;Methods: 49 patients with Behcet's disease were divided into Shire group (SR, n =19) and non-shire group (Non-SR, n = 30), and 43 healthy subjects were selected as control group. The basic information and laboratory test indexes of three groups were collected, and fecal samples were collected to detect the diversity and abundance of intestinal flora in each group by 16S rRNA. Results: Compared with Non-SR group, the incidence of ocular involvement was higher in SR group (P<0.05). At the same time, WBC, CRP, ESR and IgG in SR group were significantly higher than those in Non-SR group (P<0.05). The results of alpha diversity showed that the ace, Chao 1 and Shannon indexes of the SR group were significantly lower than those of the healthy group and the Non-SR group, while the Simpson index was significantly higher (P<0.05). Compared with the Non-SR group, the abundance of Actinobacteria phylum increased in the SR group (P<0.05);the level abundance of Collinsella, Intestinimonas and Enterobacteriaceae_ unclassified genus were increased, and the level abundance of Clostridiales_unclassified, Ruminococcaceae_UCG009, and Ruminococcus_gauvre auii_group genus were decreased (P<0.05). Pearson correlation analysis showed that Oscillospira abundance was positively correlated with WBC, CRP, ESR and IgG levels, while Eubacterium and Cetobacterium abundance were negatively correlated with WBC, CRP, ESR and IgG levels. Conclusion: The change of intestinal flora is involved in the pathogenesis of BD. At the same time, there are differences in intestinal flora in different types of BD patients. In addition, the specific flora in intestinal tract is closely related to the serum inflammation and immune indexes of BD.

Effect of Sanwu Huangqin Decoction on IFN-γ and IL-17A levels in mice with Behcet's disease

Objective:To investigate the effect of Sanwu Huangqin Decoction on IFN-γand IL-17A levels in mice with Behcet's disease;Methods:Clinical samples of patients with Behcet's disease were collected and mononuclear cells were isolated.High throughput RNA-seq was used to identify the different genes between Behcet's disease and healthy subjects.Mouse model was constructed by shrimp myosin sensitization and treated with Sanwu Huangqin decoction.The levels of IFN-γand IL-17A in peripheral blood and mononuclear cells were detected by ELISA and flow cytometry.The expression level of TBX21 gene in spleen was detected by RT-PCR;Results:Compared with healthy subjects,31 differential genes were identified in BD patients,of which 19 genes were up-regulated and 12 genes were down regulated.PPI analysis showed that the top 5 genes were TBX21,STAT3,IL15,PRF1 and IFNG.The results of animal experiments showed that the levels of IFN-γand IL-17A in the peripheral blood and PBMC of the model group were significantly higher compared with the control group(P<0.01).Sanwu Huangqin decoction could significantly reduce the levels of IFN-γand IL-17A in the peripheral blood and PBMC of mice(P<0.05 or P<0.01).RT-PCR results showed that the expression of TBX21 mRNA in spleen tissue of model group was significantly higher than that of the control group(P<0.01).Sanwu Huangqin decoction could significantly down-regulate the expression of TBX21 mRNA in spleen(P<0.05 or P<0.01);Conclusion:Sanwu Huangqin decoction reduce the levels of IFN-γand IL-17A by inhibiting the expression of TBX21 mRNA,so as to achieve the effect of treating BD.

Effect of electroacupuncture at Jiaji (EX-B2) points on the expression of microRNA-21 and neuronal apoptosis in rats with acute spinal cord injury

Objective:To observe the effect of electroacupuncture at Jiaji (EX-B2) points on the expression of microRNA-21 and neuronal apoptosis in rats with acute spinal cord injury. Methods:SD rats were randomly divided into sham-operated group, model group, electro-acupuncture group and methylprednisolone group. The model of acute spinal cord injury was reproduced by modified Allen's method. Each group was given corresponding intervention treatment 2 hours after modeling. The electroacupuncture group was treated with electro-acupuncture at Jiaji (EX-B2) points in T8 to T12, the methylprednisolone group was given intraperitoneal injection of 30 mg/kg methylprednisolone sodium succinate, and the sham operation group and model group were not treated. After treatment, BBB scores were observed to evaluate the motor function of posterior limb in each group, and the injured spinal cord tissues were taken. The pathological changes of spinal cord neuropathy were observed by Nissl staining. The expression of microRNA-21 was detected by RT-qPCR, and the expression of apoptotic proteins (Bax, Bcl-2 and cleaved-Caspase-3) was detected by Western-Blot. Result:Compared with sham operation group, BBB, neuron survival rate and expression of microRNA-21 were significantly lower, apoptotic rate of neurons was significantly higher, expression of Bax, Bcl-2, cleaved Caspase-3 protein and Bax/Bcl-2 ratio were significantly increased in model group (P< 0.05). Electroacupuncture could significantly increase BBB score, neuron survival rate and expression of microRNA-21, reduce apoptotic rate of neurons and the ratio of Bax/Bcl-2, and inhibit the expression of Bax, Bcl-2 and cleaved Caspase-3 protein in tissues, which were significantly different from those of model group (P< 0.05). Conclusions: Electroacupuncture at Jiaji (EX-B2) points can significantly promote the recovery of neurological function in rats after ASCI, and its mechanism may be closely related to the up-regulation of the expression of microRNA-21 in tissues and the inhibition of the activation of Bax/Bcl-2/cleaved Caspase-3 signaling pathway.

Clinical efficacy of HEGU needling method combined with tendon-stretching and plucking massage on trigger point in the treatment of acute thoracodorsal myofascitis

Objective:To observe the effect of Hegu neediling method combined with tendon-stretching and plucking massage on trigger point in the treatment of acute thoracodorsal myofascitis. Methods: A total of 84 patients with acute thoracodorsal myofascitis who met the diagnostic and inclusion criteria were assigned into the treatment group and the control group randomly, the treatment group was treated with Hegu neediling method combined with tendon-stretching and plucking massage, while the control group was treated with conventional electroacupuncture. Two groups of patients were treated for two weeks. VAS score and ODI were compared before treatment, after the first treatment and after the treatment course, and the clinical efficacy was evaluated after treatment.Results: The total effective rates of the treatment group and the control group were 97.62% and 80.95%, respectively. The treatment group was significantly better than the control group. The VAS and ODI scores of the treatment group decreased after the first treatment and the end of the treatment, and the treatment group was significantly better than the control group.Conclusion:Hegu neediling method combined with tendon-stretching and plucking massage can relieve pain and improve limb dysfunction in patients with acute thoracodorsal myofascitis.

A Prospective Randomized Multicenter Controlled Trial on Salvianolate for Treatment of Unstable Angina Pectoris in A Chinese Elderly Population

Objective: To evaluate the efficacy and safety of salvianolate in elderly patients with unstable angina pectoris(UAP). Methods: A prospective double-blind randomized placebo-controlled multicenter trial in elderly patients with UAP from 13 third-grade class-A hospitals in China was performed. A total of 318 patients were randomly allocated in a 1:1 ratio to an experimental group(160 patients) and a control group(158 patients). The experimental group was treated with salvianolate for 14 days on the basis of conventional medicine, and the control group was given a placebo for 14 days with the same criteria. Follow-up was lasted 28 days in both groups. The primary endpoint was biweekly frequency of angina pectoris attacks. The secondary endpoints included biweekly dosage of nitroglycerin, the Seattle Angina Questionnaire, angina pectoris severity and duration, myocardial injury markers, high-sensitivity C-reactive protein(hs-CRP) and N-terminal pro-B-type natriuretic peptide(NT-proBNP), as well as major adverse cardiovascular events(MACEs). Safety was assessed according to adverse events and serious adverse events. Results: Baseline characteristics were similar between treatment groups. Compared with those in the control group, the frequency of biweekly angi na attacks(2.92 vs. 4.08, P =0.025), th e biweekly dosage of nitroglycerin, as well as the severity and duration of angina attacks(P <0.01) were reduced by salvianolate. The Seattle Angina Questionnaire score was also significantly improved in the experimental group than in the control group(P <0.05). No significant differences were observed between the two groups with respect to the incidence of MACEs. Salvianolate was well tolerated. Conclusions: Salvianolate appear to have efficacy and well tolerated for elderly patients with UAP.

Integrated'omics analysis for the gut microbiota response to moxibustion in a rat model of chronic fatigue syndrome

OBJECTIVE:To observe the efficacy of moxibustion in the treatment of chronic fatigue syndrome(CFS)and explore the effects on gut microbiota and metabolic profiles.METHODS:Forty-eight male Sprague-Dawley rats were randomly assigned to control group(Con),CFS model group(Mod,established by multiple chronic stress for 35 d),MoxA group(CFS model with moxibustion Shenque(CV8)and Guanyuan(CV4),10 min/d,28 d)and MoxB group(CFS model with moxibustion Zusanli(ST36),10 min/d,28 d).Open-field test(OFT)and Morris-water-maze test(MWMT)were determined for assessment the CFS model and the therapeutic effects of moxibustion.16S rRNA gene sequencing analysis based gut microbiota integrated untargeted liquid chromatograph-mass spectrometer(LC-MS)based fecal metabolomics were executed,as well as Spearman correlation analysis,was utilized to uncover the functional relevance between the potential metabolites and gut microbiota.RESULTS:The results of our behavioral tests showed that moxibustion improved the performance of CFS rats in the OFT and the MWMT.Microbiome profiling analysis revealed that the gut microbiomes of CFS rats were less diverse with altered composition,including increases in pro-inflammatory species(such as Proteobacteria)and decreases in anti-inflammatory species(such as Bacteroides,Lactobacillus,Ruminococcus,and Prevotella).Moxibustion partially normalized these changes in the gut microbiota.Furthermore,CFS was associated with metabolic disorders,which were effectively ameliorated by moxibustion.This was demonstrated by the normalization of 33 microbiota-related metabolites,including mannose(P=0.001),aspartic acid(P=0.009),alanine(P=0.007),serine(P=0.000),threonine(P=0.027),methionine(P=0.023),5-hydroxytryptamine(P=0.008),alpha-linolenic acid(P=0.003),eicosapentaenoic acid(P=0.006),hypoxanthine(P=0.000),vitamin B6(P=0.000),cholic acid(P=0.013),and taurocholate(P=0.002).Correlation analysis showed a significant association between the perturbed fecal microbiota and metabolite levels,with a notable negative relationship between LCA and Bacteroides.CONCLUSIONS:In this study,we demonstrated that moxibustion has an antifatigue-like effect.The results from the 16S rRNA gene sequencing and metabolomics analysis suggest that the therapeutic effects of moxibustion on CFS are related to the regulation of gut microorganisms and their metabolites.The increase in Bacteroides and decrease in LCA may be key targets for the moxibustion treatment of CFS.

Cross electro-nape-acupuncture ameliorates cerebral hemorrhageinduced brain damage by inhibiting necroptosis

BACKGROUND Receptor interacting protein kinase 1(RIPK1)-mediated cell death,including apoptosis and necroptosis,belongs to programmed cell death.It has been reported that RIPK1-mediated necroptosis exists in lesions of cerebral hemorrhage(CH).Electroacupuncture,a treatment derived from traditional Chinese medicine,could improve neurological impairment in patients with brain injury.AIM To investigate the protective role of cross electro-nape acupuncture(CENA)in CH,and clarify the potential mechanism.METHODS CH rat models were established,and CENA was applied to the experimental rats.Neurological functions and encephaledema were then measured.Necrotic cells in the brain of rats with CH were evaluated by propidium iodide staining.Necroptosis was assessed by immunofluorescence.Activation of the necroptosisrelated pathway was detected by western blot.Extraction of brain tissue,cerebrospinal fluid and serum samples was conducted to measure the expression and secretion of inflammatory cytokines by quantitative real-time polymerase chain reaction and enzyme-linked immunosorbent assay.RESULTS The necroptotic marker p-MLKL was detectable in the brains of rats with CH.Next,we found that CENA could ameliorate neurological functions in rat models of CH.Moreover,the upregulation of RIPK1-mediated necroptosis-related molecules in the brains of rats with CH were inhibited by CENA.Further investigation revealed that CENA partially blocked the interaction between RIPK1 and RIPK3.Finally,in vivo assays showed that CENA decreased the expression of the inflammatory cytokines tumor necrosis factor-α,interleukin-6 and interleukin-8 in CH rat models.CONCLUSION These findings revealed that CENA exerts a protective role in CH models by inhibiting RIPK1-mediated necroptosis.

Therapeutic Evaluation on Needling Method of Regulating the Conception Vessel and Calming the Mind for Perimenopausal Sleep Disorder

Objective: To observe the clinical efficacy of needling method of regulating the Conception Vessel and calming the mind in treating sleep disorder in perimenopausal women, and to provide clinical evidence for future treatment of the disease. Methods: Sixty eligible subjects with perimenopausal sleep disorder were enrolled and randomized into an observation group and a control group, 30 cases in each group. The observation group was intervened by needling method of regulating the Conception Vessel and calming the mind, and the control group was treated by taking Yi Kun Yin orally. Two-week treatment was considered as a treatment course. Major symptoms of traditional Chinese medicine and Pittsburgh Sleep Quality Index (PSQI) were observed, and clinical efficacies were compared. Results: After treatment, the difference in total effective rate between the two groups was statistically significant (P<0.05); except for flaccidity of lumbar and knees, both groups achieved significant improvements in the other 5 symptoms of traditional Chinese medicine (P<0.05 or P<0.01); PSQI global score and component scores dropped in both groups, and the improvements in the observation group were markedly superior to that in the control group (P<0.05 or P<0.01). Conclusion: The needling method of regulating the Conception Vessel and calming the mind is better than Yi Kun Yin in improving traditional Chinese medicine symptoms and sleep quality in patients with perimenopausal sleep disorders.

Detection of an anti-angina therapeutic module in the effective population treated by a multi-target drug Danhong injection:a randomized trial

It's a challenge for detecting the therapeutic targets of a polypharmacological drug from variations in the responsed networks in thedfferentiated populations with complex diseases,as stable coronary heart disease.Here,in an adaptive,31-center,randomized,double-blind trial invoving 920 patients with moderate symptomatic stable angina treated by 14-day Danhong injection(DHI),a kind of polyphamacological drug with high quality control,or placebo(0.9%saline),with 76-day following-up,we firstly confrmed that DHl couldincrease the proportion of patients with clinically significant changes on angina-frequency assessed by Seattle Angina Questionnaire(ASAQ-AF220)(12.78%at Day 30,95%confidence interval[C]5.86-19.71%,P=0.0003,13.82%at Day 6C0,95%CI 6.82-20.82%,P=0.0001and 8.95%at Day 90,95%CI 2.06-15.85%,P=0.01).We also found that there were no significant differences in new-onset major vascularevents(P=0.8502)and serious adverse events(P=0.9105)between DHl and placebo.After performing the RNA sequencing in 62 selectedpatients,we developed a systemic modular approach tp identfy differentilly expressed modules(DEMs)of DHI with the Z_(summay)valueless than 0 compared with the control group,calculated by weighted gene co-expression network analysis(WGCNA),and sketched out thebasic framework on a modular map with 25 functional modules targeted by DII.Furthermore,the effective therapeutic module(ETM),defined as the highest corelation value with the phenotype alteration(SAQ-AF,the change in SAQ-AF at Day 30 from baseline)calculatedby WGCNA,was identifed in the population with the best effect(ASAQ-AF240),which is related to anticoagulation and regulation ofcholesterol metabolism.We assessed the modular flexbility of this ETM using the global topological D value based on Euclidean distance,which is corelated with phenotype alteration(r^(2):0.8204,P=0.019)by linear regression.Our study identified the ant-angina therapeuticmodule in the effective population treated by the multi-target drug.Modular methods facilitate the discovery of network pharmacologicalmechanisms and the advancement of precision medicine.(ClinicalTrials.gov identifier:NCTO1681316).

Electroacupuncture Treatment for Obstructive Sleep Apnea Syndrome

Obstructive sleep apnea syndrome (OSAS) means that patients suffer from repetitive pauses in breathing, even hypoxemia and hypercapnia because of upper airway obstruction during sleep. The clinical symptoms are known as snoring, awakening from difficulty breathing, daytime sleepiness, morning headaches, memory loss, hypertension,