Acupuncture for postprandial distress syndrome (APDS): study protocol for a randomized controlled trial

Background

Postprandial distress syndrome (PDS) is referred to as meal-related functional dyspepsia (FD) and causes a reduced quality of life (QoL) for patients. Several randomized controlled trials (RCTs) have suggested that acupuncture is an effective treatment for FD, but few studies were particularly for PDS. This pilot study was designed to determine the feasibility and efficacy of acupuncture in patients with PDS characterized by postprandial fullness and early satiation according to the Rome III criteria.

Methods

This is a multi-center, two-arm, blinded (participants), pilot RCT. Forty-two participants who meet the inclusion criteria will be randomly assigned to the verum acupuncture group or minimal acupuncture group in a 1:1 ratio. Both treatments consist of 12 sessions of 20 min duration over four weeks (three sessions per week). The primary outcome measurement is the proportion of persons who improve as assessed using the global outcome by the overall treatment effect (OTE) at end-of-treatment (EOT) (four weeks after randomization). Global assessment at weeks 8 and 16 after randomization is one of the secondary outcomes. The other secondary outcomes including symptoms, disease-specific QoL, and depression and anxiety will be assessed at weeks 4, 8, and 16 after randomization.

Discussion

This pilot study will help determine the feasibility and efficacy of acupuncture in patients with PDS.

Trial registration

ISRCTN Registry, ISRCTN18135146. Registered on 7 July 2016.

Electronic supplementary material

The online version of this article (doi:10.1186/s13063-017-2285-9) contains supplementary material, which is available to authorized users.

Detection of peripheral and central sensitisation at acupoints in patients with unilateral shoulder pain in Beijing: a cross-sectional matched case-control study

OBJECTIVE

To investigate the pattern of experimental pain responses at acupoints in patients with unilateral shoulder pain.

DESIGN

A cross-sectional matched study.

SETTING

Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University.

PARTICIPANTS

Volunteer samples of 60 participants (30 patients with unilateral shoulder pain, 30 healthy controls).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Pressure pain thresholds (PPTs) were measured at four acupoints-namely, Tianzong (SI 11), Jianliao (SJ 14), Jianyu (LI 15) and Jianzhen (SI 9), on the painful/non-painful side in patients with unilateral shoulder pain or healthy controls, respectively. The correlations between the Peripheral Sensitisation Index (PSI) and Central Sensitisation Index (CSI) were compared.

RESULTS

Analysis showed significantly lower PPT values at acupoints on the painful side compared with the non-painful side in patients with shoulder pain (p<0.025). Meanwhile, PPTs on the non-painful side of these patients were lower than those on the ipsilateral side of healthy controls (p<0.025). No significant differences in PPT values were found between the non-acupoint of the painful/non-painful side in patients with shoulder pain and the ipsilateral side of healthy controls (p>0.05). Additionally, it was observed that the pressure pain assessment acupoints have a strong association with PSI and CSI; three acupoints, in particular, SJ 14, LI 15 and SI 9, showed a correlation with PSI and CSI.

CONCLUSION

The results suggest the presence of peripheral and central sensitisation at acupoints in participants with unilateral shoulder pain. There exists an obvious relationship among the three acupoints SJ 14, LI 15 and SI 9, which are usually chosen to treat shoulder pain. The results provide evidence for the selection of acupoints to treat shoulder pain by acupuncture.

Acupuncture Attenuated Vascular Dementia–Induced Hippocampal Long-Term Potentiation Impairments via Activation of D1/D5 Receptors

Background and Purpose—

Emerging evidence suggests that acupuncture could improve cognitive impairment in vascular dementia by enhancing synaptic plasticity in the hippocampus. The purpose of this study is to investigate whether dopamine, a key mediator of synaptic plasticity, is involved in this cognitive improvement.

Methods—

Vascular dementia model was established by bilateral common carotid arteries occlusion in male Wistar rats. Three days after the operation, animals received acupuncture treatment for 2 weeks, once daily. The D1/D5 receptors antagonist SCH23390 was administered intraperitoneally 15 minutes before each acupuncture treatment. Morris water maze was examined after acupuncture. Long-term potentiation was studied by an electrophysiological technique. Dopamine and metabolites levels were detected by microdialysis and high-performance liquid chromatography from brain tissue. The expression of D1R and D5R was analyzed by immunofluorescence.

Results—

Acupuncture remarkably reversed cognitive deficits in 2-vessel occlusion model (2VO) rats, and the acupuncture points Zusanli (ST36) and Baihui (GV20) were confirmed to be the most effective combination. Electrophysiological recording data showed that 2VO-induced impairments of long-term potentiation were prevented by acupuncture. In addition, acupuncture promoted the release of dopamine and its major metabolites in the hippocampus of 2VO rats. The immunofluorescence experiment showed that the decrease of D1R and D5R in hippocampal dentate gyrus region of 2VO rats was reversed by acupuncture. Furthermore, we found that the effects of acupuncture against 2VO-induced impairments in cognition and synaptic plasticity were abolished by SCH23390.

Conclusions—

Improvement in cognition and hippocampal synaptic plasticity induced by acupuncture was achieved via activation of D1/D5 receptors in 2VO rats.

Traditional Chinese acupuncture versus minimal acupuncture for mild-to-moderate knee osteoarthritis: a protocol for a randomised, controlled pilot trial

INTRODUCTION

Knee osteoarthritis (KOA) is one of the most common musculoskeletal disorders. Acupuncture is a popular form of complementary medicine for musculoskeletal conditions, although the evidence is inconclusive. Our objective is to evaluate the efficacy of traditional Chinese acupuncture for pain relief and function improvement in mild-to-moderate knee osteoarthritis (TCAKOA) participants.

METHODS/ANALYSIS

42 patients will be recruited who have been diagnosed with mild-to-moderate KOA and randomly allocated in equal proportions to traditional Chinese acupuncture or minimal acupuncture. They will receive acupuncture for 24 sessions over 8 weeks. The primary end point is success rate, which will be calculated according to a change from baseline in Western Ontario and McMaster Universities Osteoarthritis Index pain and function scores at 8 weeks. Secondary end points include pain and function measurement, global change, the quality of life and the use of non-steroidal anti-inflammatory drugs (Celebrex, Pfizer) at 8, 16 and 26 weeks.

ETHICS AND DISSEMINATION

Ethical approval of this study has been granted by the Research Ethical Committee of Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University (permission number: 2016BL-010-02). Written informed consent will be obtained from all participants. Outcomes of the trial will be disseminated through peer-reviewed publications.

TRIAL REGISTRATION NUMBER

ISRCTN14016893; Pre-results.

[Intervention of systolic pressure and left ventricular hypertrophy in rats under cold stress]

OBJECTIVE

To investigate the effects of different drugs on systolic blood pressure (SBP) and left ventricular hypertrophy (LVH) in spontaneously hypertensive rats under cold stress.

METHODS

A total of 40 male spontaneously hypertensive rats aged 10 weeks (160~200 g) were given adaptive feeding for 7 days at a temperature of 20±1°C and then randomly divided into control group, cold stress group, metoprolol group, amlodipine group, and benazepril group, with 8 rats in each group. SBP, body weight, and heart rate were measured once a week. After the rats were sacrificed by exsanguination, left ventricular weight (LVW) was measured, and left ventricular weight index (LVWI; mg/g) was calculated. Radioimmunoassay was used to measure the concentrations of endothelin-1 (ET-1) and angiotensin-II (Ang-II) in plasma and myocardium, and the chemical method was used to measure the concentrations of nitric oxide (NO) in plasma and myocardium. RT-PCR was used to measure the mRNA expression of endothelin-A receptor.

RESULTS

Compared with the cold stress group, all medication groups showed significant reductions in SBP since week 5 (P<0.05). The cold stress group showed a significant increase in LVWI compared with the control group (3.38±0.27 mg/g vs 2.89±0.19 mg/g, P<0.05). The amlodipine group showed a significant reduction in LVWI compared with the cold stress group (2.98±0.28 mg/g vs 3.38±0.27 mg/g, P<0.05). The cold stress group showed a significant reduction in plasma NO concentration compared with the control group (104.9±19.5 μmol/L vs 129.3±17.8 μmol/L, P<0.05) ; compared with the cold stress group, all the medication groups showed significant increases in blood NO concentration (P<0.05). The cold stress group showed a significant increase in myocardial ET-1 concentration compared with the control group (6.3±1.5 pg/100 mg vs 4.5±1.9 pg/100 mg, P<0.05) ; compared with the cold stress group, the amlodipine group showed a significant reduction in myocardial ET-1 concentration (4.4±1.0 pg/100 mg vs 6.3±1.5 pg/100 mg, P<0.05). The cold stress group had significantly higher mRNA expression of endothelin-A receptor than the control group (0.86±0.23 vs 0.45±0.16, P<0.01) ; compared with the cold stress group, the amlodipine group showed a significant reduction in the mRNA expression of endothelin-A receptor (0.41±0.14 vs 0.86±0.23, P<0.01).

CONCLUSION

Amlodipine can reduce the increase in SBP and inhibit LVH in spontaneously hypertensive rats under cold stress.

ZBTB20 is required for anterior pituitary development and lactotrope specification

The anterior pituitary harbours five distinct hormone-producing cell types, and their cellular differentiation is a highly regulated and coordinated process. Here we show that ZBTB20 is essential for anterior pituitary development and lactotrope specification in mice. In anterior pituitary, ZBTB20 is highly expressed by all the mature endocrine cell types, and to some less extent by somatolactotropes, the precursors of prolactin (PRL)-producing lactotropes. Disruption of Zbtb20 leads to anterior pituitary hypoplasia, hypopituitary dwarfism and a complete loss of mature lactotropes. In ZBTB20-null mice, although lactotrope lineage commitment is normally initiated, somatolactotropes exhibit profound defects in lineage specification and expansion. Furthermore, endogenous ZBTB20 protein binds to Prl promoter, and its knockdown decreases PRL expression and secretion in a lactotrope cell line MMQ. In addition, ZBTB20 overexpression enhances the transcriptional activity of Prl promoter in vitro. In conclusion, our findings point to ZBTB20 as a critical regulator of anterior pituitary development and lactotrope specification.

Efficacy and safety of the Chaihuguizhiganjiang-suanzaoren granule on primary insomnia: study protocol for a randomised controlled trial

INTRODUCTION

Insomnia is a highly prevalent, often debilitating and economically burdensome sleep disorder with limited effective therapies. Few data are available to understand which of the therapeutic alternatives is the most effective for patients with insomnia, especially for Traditional Chinese Medicine (TCM). Chinese herbal medicine, as a typical TCM, is one of the most popular complementary and alternative therapies for insomnia. We aim to evaluate the efficacy and safety of the Chaihuguizhiganjiang-suanzaoren granule (CSG), a Chinese herbal medicine treatment, in patients with primary insomnia.

METHODS AND ANALYSIS

This is a multicentre, placebo-controlled, double-blinded, randomised controlled clinical trial. A total of 258 participants are randomly allocated to two groups: the intervention group or the placebo group. The intervention group receives CSG and the placebo group receives a placebo granule. The patients receive either CSG or placebo two times daily for 8 weeks. The primary outcome is the Pittsburgh sleep quality index (PSQI). Secondary outcomes include the Insomnia Severity Index (ISI), Total Sleep Time (TST) and the Short-Form Health Survey (SF-36). The assessment is performed at baseline (before randomisation), 4, 8 and 12 weeks after randomisation.

ETHICS AND DISSEMINATION

The protocol has been approved by the Research Ethical Committee of Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University (reference: 2014BL-003-01). The trial will be helpful in identifying the efficacy and safety of CSG in patients with primary insomnia.

TRIAL REGISTRATION NUMBER

ISRCTN22001145; Pre-results.

Acupuncture elicits neuroprotective effect by inhibiting NAPDH oxidase-mediated reactive oxygen species production in cerebral ischaemia

In the current study, we aimed to investigate whether NADPH oxidase, a major ROS-producing enzyme, was involved in the antioxidant effect of acupuncture on cognitive impairment after cerebral ischaemia. The cognitive function, infract size, neuron cell loss, level of superoxide anion and expression of NADPH oxidase subunit in hippocampus of two-vessel occlusion (2VO) rats were determined after 2-week acupuncture. Furthermore, the cognitive function and production of O2(-) were determined in the presence and absence of NADPH oxidase agonist (TBCA) and antagonist (Apocynin). The effect of acupuncture on cognitive function after cerebral ischaemia in gp91phox-KO mice was evaluated by Morris water maze. Acupuncture reduced infarct size, attenuated overproduction of O2(-), and reversed consequential cognitive impairment and neuron cell loss in 2VO rats. The elevations of gp91phox and p47phox after 2VO were significantly decreased after acupuncture treatment. However, no differences of gp91phox mRNA were found among any experimental groups. Furthermore, these beneficial effects were reversed by TBCA, whereas apocynin mimicked the effect of acupuncture by improving cognitive function and decreasing O2(-) generation. Acupuncture failed to improve the memory impairment in gp91phox KO mice. Full function of the NADPH oxidase enzyme plays an important role in neuroprotective effects against cognitive impairment via inhibition of NAPDH oxidase-mediated oxidative stress.

Acupuncture ameliorates cognitive impairment and hippocampus neuronal loss in experimental vascular dementia through Nrf2-mediated antioxidant response

Emerging evidence suggests acupuncture could exert neuroprotection in the vascular dementia via anti-oxidative effects. However, the involvement of Nrf2, a master regulator of antioxidant defense, in acupuncture-induced neuroprotection in vascular dementia remains undetermined. The goal of our study was to investigate the contribution of Nrf2 in acupuncture and its effects on vascular dementia. Morris water maze and Nissl staining were used to assess the effect of acupuncture on cognitive function and hippocampal neurodegeneration in experimental vascular dementia. The distribution of Nrf2 in neurons in hippocampus, the protein expression of Nrf2 in both cytosol and nucleus, and the protein and mRNA levels of its downstream target genes NQO1 and HO-1 were detected by double immunofluorescent staining, Western blotting and realtime PCR analysis respectively. Cognitive function and microglia activation were measured in both wild-type and Nrf2 gene knockout mice after acupuncture treatment. We found that acupuncture could remarkably reverse the cognitive deficits, neuron cell loss, reactive oxygen species production, and decreased cerebral blood flow. It was notable that acupuncture enhanced nuclear translocation of Nrf2 in neurons and up-regulate the protein and mRNA levels of Nrf2 and its target genes HO-1 and NQO1. Moreover, acupuncture could significantly down-regulated the over-activation of microglia after common carotid artery occlusion surgery. However, the reversed cognitive deficits, neuron cell loss and microglia activation by acupuncture were abolished in Nrf2 gene knockout mice. In conclusion, these findings provide evidence that the neuroprotection of acupuncture in models of vascular dementia was via the Nrf2 activation and Nrf2-dependent microglia activation.

What is the Acupoint? A preliminary review of Acupoints

BACKGROUND

According to traditional Chinese medicine (TCM) theory, acupoints are specifically chosen sites of acupuncture manipulation, and also the basis for studying the mechanism of acupuncture. Stimulating different acupoints on the body surface could provide various therapeutic benefits. However, what is the acupoint? This question is not clear.

REVIEW SUMMARY

We focuse on examining the function of acupoints from different perspectives, including the local and the systemic effects of stimulating acupoints. For example, acupoints may release certain substances or incur some changes, which could adjust the function of organs, maintain homeostasis. Furthermore, the therapeutic effects of verum acupoints versus sham acupoints were discussed. However, due to insufficience in evidence and in current methodologies, research into mechanisms of acupuncture is still incomplete.

CONCLUSION

This review might explain, to some extent, what an acupoint is. Further research into the identity of acupoints is warranted, and multidisciplinary methods using novel technologies may yield significant advances over existing knowledge.

Neural mechanisms of acupuncture as revealed by fMRI studies

As an ancient therapeutic method, acupuncture has been used to treat many diseases as an adjunctive therapy. However, its clinical efficacy remains controversial and the neural mechanisms have not been well understood. Accumulating studies have revealed that fMRI has made it possible to study brain responses to acupuncture. This review aims to provide scientific evidence to support the notion and discuss how these findings contribute to the neural mechanisms of acupuncture.

Effect of acupuncture treatment on vascular cognitive impairment without dementia: study protocol for a randomized controlled trial

Background

Vascular cognitive impairment, no dementia (VCIND) is a condition at risk for future dementia and should be the target of preventive strategies. Preliminary evidence suggests that acupuncture may be a clinically effective intervention for people with early-stage vascular cognitive impairment. We will do a multicenter, 6-month, drug-controlled, nonblinded, randomized, parallel-group trial to determine whether acupuncture is effective for improving cognitive function and quality of life for patients with VCIND.

Methods/Design

A total of 216 eligible patients will be recruited and randomly assigned acupuncture for two sessions/week (n = 108) or citicoline 300 mg/day (n = 108) in a multicenter, 6-month trial. The primary endpoint is cognition (Alzheimer's Disease Assessment Scale, Cognitive Subscale (ADAS-cog)). Secondary endpoints include assessments of activities of daily living and behavioral symptoms (Clock Drawing Test (CDT), Activities of Daily Living (ADL) and Instrumental Activities of Daily Living scale (IADL)).

Discussion

This will be the first large-scale trial specifically evaluating acupuncture therapy in VCIND. If the study confirms the effectiveness and safety of acupuncture treatment, it will be important to examine how the acupuncture approach could most effectively be integrated into the provision of routine healthcare.

Trial registration

This study is registered as an International Standard Randomised Controlled Trial on 17 January 2014, number ISRCTN 82980206

Electronic supplementary material

The online version of this article (doi:10.1186/1745-6215-15-442) contains supplementary material, which is available to authorized users.

[Development of studies on influence of patients' expectations on therapeutic effects of acupuncture and moxibustion interventions]

The patient's expectations (placebo effects) refer to the anticipation or the belief about what is to be encountered in a consultation in the healthcare system. Currently, it is a hot-spot for researching its influence on clinical outcomes of acupuncture and moxibustion interventions. How to evaluate the magnitude of patients'expectations is a problem needing to be solved urgently at the moment. The authors of the present paper make a summary about researches on the mechanism of expectations. For example, placebo analgesia was related to decreased brain activity in pain-sensitive brain regions (thalamus, insula, and anterior cingulate cortex), and to the increased activity of the prefrontal cortex showed by fMRI, and to the release of endogenous opioids. In addition, the authors also introduce some methods (psychological scales) for assessing expectations and related influencing factors (physicians or acupuncturists, and medical environment) for future research in this area. In the coming clinical trials on acupuncture or moxibustion treatment of clinical disorders, we should further better our experimental design, and try our best to exclude placebo effect-associated or expectation-induced bias of clinical outcomes for confirming the therapeutic effects in the treatment of different clinical problems.

Acupuncture at local and distal points for chronic shoulder pain: study protocol for a randomized controlled trial

Background

Chronic shoulder pain (CSP) is the third most common type of musculoskeletal pain. It has a major impact on health-related quality of life. In Chinese medicine, CSP is considered one of the conditions most amenable to treatment with acupuncture. The purpose of this study is to evaluate the efficacy of local acupoints in combination with distal acupoints in pain relief and shoulder function improvement in CSP patients.

Methods/Design

This is a multicenter, single blind, factorial randomized controlled clinical trial. A total of 164 participants will be randomly allocated to four different groups: Group A will receive acupuncture at local acupoints in combination with distal acupoint. Group B will receive acupuncture at local acupoints in combination with distal non-acupoint. Group C will receive acupuncture at local non-acupoints in combination with distal acupoint. Group D will receive acupuncture at local non-acupoints in combination with distal non-acupoint. Each group will receive 12 treatments of acupuncture one to three times per week for six weeks in total. The primary outcome is shoulder pain intensity, which is graded using a 100 -mm Visual Analogue Scale. The assessment is at baseline (before treatment initiation), 6 weeks after the first acupuncture, 10 weeks after the first acupuncture and 18 weeks after the first acupuncture.

Discussion

This trial will be helpful in identifying whether acupuncture at local acupoints in combination with distal acupoints may be more effective than needling points separately.

Trial registration

International Standard Randomized Controlled Trial Number Register: ISRCTN61861069 (http://www.controlled-trials.com).

A randomized controlled trial of single point acupuncture in primary dysmenorrhea

BACKGROUND

Acupuncture is often used for primary dysmenorrhea. But there is no convincing evidence due to low methodological quality. We aim to assess immediate effect of acupuncture at specific acupoint compared with unrelated acupoint and nonacupoint on primary dysmenorrhea.

METHODS

The Acupuncture Analgesia Effect in Primary Dysmenorrhoea-II is a multicenter controlled trial conducted in six large hospitals of China. Patients who met inclusion criteria were randomly assigned to classic acupoint (N = 167), unrelated acupoint (N = 167), or non-acupoint (N = 167) group on a 1:1:1 basis. They received three sessions with electro-acupuncture at a classic acupoint (Sanyinjiao, SP6), or an unrelated acupoint (Xuanzhong, GB39), or nonacupoint location, respectively. The primary outcome was subjective pain as measured by a 100-mm visual analog scale (VAS). Measurements were obtained at 0, 5, 10, 30, and 60 minutes following the first intervention. In addition, patients scored changes of general complaints using Cox retrospective symptom scales (RSS-Cox) and 7-point verbal rating scale (VRS) during three menstrual cycles. Secondary outcomes included VAS score for average pain, pain total time, additional in-bed time, and proportion of participants using analgesics during three menstrual cycles.

FINDINGS

Five hundred and one people underwent random assignment. The primary comparison of VAS scores following the first intervention demonstrated that classic acupoint group was more effective both than unrelated acupoint (-4.0 mm, 95% CI -7.1 to -0.9, P = 0.010) and nonacupoint (-4.0 mm, 95% CI -7.0 to -0.9, P = 0.012) groups. However, no significant differences were detected among the three acupuncture groups for RSS-Cox or VRS outcomes. The per-protocol analysis showed similar pattern. No serious adverse events were noted.

CONCLUSION

Specific acupoint acupuncture produced a statistically, but not clinically, significant effect compared with unrelated acupoint and nonacupoint acupuncture in primary dysmenorrhea patients. Future studies should focus on effects of multiple points acupuncture on primary dysmenorrhea.

Comparison of cognitive performance between two rat models of vascular dementia

BACKGROUND AND PURPOSE

An ideal animal model to explore that pathogenesis and prevention of dementia is essential. The present study was designed to compare the difference of behavior and cerebral blood flow of the two vascular dementia rat models at different time intervals.

METHODS

The rats were randomly allocated to three groups: bilateral common carotid artery occlusion (BCCAO) group, thromboembolism (TE) group and sham-operated (SHAM) group. The performance in the Morris water maze (MWM) was analyzed at 7, 14 and 28 d after operation and cerebral blood flow (CBF) was analyzed at 28 days after operation.

RESULT

The results showed that the two models exhibited longer latency, less times to crossing platform in MWM and lower CBF than the SHAM rats. Compared with the TE rats, the BCCAO rats have a significant prolongation of escape latency at 7 days and 28 days. In the probe trial, the BCCAO rats showed less number of times across the platform.

CONCLUSION

The BCCAO rats maybe provide a more useful model to study the physiopathological mechanisms of cognitive impairment related to chronic cerebral ischemia.

Efficacy and safety of acupuncture for chronic dizziness: study protocol for a randomized controlled trial

Background

Dizziness is one of the most challenging symptoms in medicine. No medication for dizziness in current use has well-established curative or prophylactic value or is suitable for long-term palliative use. Unconventional remedies, such as acupuncture, should be considered and scientifically evaluated. However, there has been relatively little evidence in randomized controlled clinical trials on acupuncture to treat chronic dizziness. The aim of our study is to evaluate the efficacy and safety of acupuncture in patients with dizziness.

Methods/Design

This trial is a randomized, single-blind, controlled study. A total of 80 participants will be randomly assigned to two treatment groups receiving acupuncture and sham acupuncture treatment, respectively, for 4 weeks. The primary outcome measures are the Dizziness Handicap Inventory (DHI) and the Vertigo Symptom Scale (VSS). Treatment will be conducted over a period of 4 weeks, at a frequency of two sessions per week. The assessment is at baseline (before treatment initiation), 4 weeks after the first acupuncture session, and 8 weeks after the first acupuncture session.

Discussion

The results from this study will provide clinical evidence on the efficacy and safety of acupuncture in patients with chronic dizziness.

Trial registration

International Standard Randomized Controlled Trial Number Register: ISRCTN52695239

Improvement of the dynamic responses of heart rate variability patterns after needle and laser acupuncture treatment in patients with burnout syndrome: a transcontinental comparative study

We investigated manual needle and laser needle acupuncture as a complementary therapy for patients with burnout syndrome. Twenty patients with a mean age ± SD of 38.7 ± 8.4 years were assigned to two groups, each consisting of ten patients. One group was treated with manual needle acupuncture and the other with laser needle acupuncture. Heart rate, heart rate variability (HRV), and a new score called dynamic acupuncture treatment score (DATS) served as evaluation parameters. The study documented significant effects on heart rate after needle acupuncture treatment and significant effects on HRV caused by both needle and laser needle acupuncture. Based on new neurovegetative acupuncture treatment evaluation scores, it can be stated that both noninvasive laser needle acupuncture and manual needle acupuncture have the potential to be a powerful approach for evidence-based complementary treatment of patients with burnout syndrome. Further transcontinental studies to verify or refute the preliminary findings are in progress.

[Cumulative analgesic effects of EA stimulation of sanyinjiao (SP 6) in primary dysmenorrhea patients: a multicenter randomized controlled clinical trial]

OBJECTIVE

To compare the cumulative analgesic effect of electroacupuncture (EA) stimulation of Sanyinjiao (SP 6), Xuanzhong (GB 39) and non-acupoint for primary dysmenorrhea patients.

METHODS

A total of 200 patients with primary dysmenorrhea were randomly assigned to Sanyinjiao (SP 6, a dysmenorrheal-relieving related acupoint) group, Xuanzhong (GB 39, an unrelated acupoint) group, non-acupoint group and control group, with 50 cases in each group. The participants were administered with EA (2 Hz/100 Hz, 0.5-1.6 mA) at SP 6, GB 39 and non-acupoint for 30 min, once daily for 3 consecutive days. The intensity of the pain was ranked from 0 (no pain) to 100 (intolerable) using visual analogue scale (VAS) and RSS (Cox retrospective symptom scale) severity rating scores (RSS-COX 2) before and after three interventions.

RESULTS

In comparison with the control group, VAS and RSS-COX 2 scores were significantly lower in the SP 36, GB 39 and non-acupoint groups (P < 0.001, P < 0.05), suggesting an alleviation of the pain severity after EA treatment. No significant differences were found among the three treatment groups in both VAS and RSS-COX 2 scores (P > 0.05).

CONCLUSION

EA stimulation of SP 6, GB 39 and non-acupoint has a good cumulative analgesic effect in patients with primary dysmenorrhea.

Effects of deqi on autonomic balance in adult tinnitus patients: study design of a randomized controlled trial

Background. Recent reports suggest that a proportion of tinnitus patients suffer from mental illness. Autonomic nervous system plays a useful role in tinnitus therapy since electrical vagal nerve stimulation (VNS) has been frequently used to alleviate tinnitus-induced depression in clinic. heart rate variability (HRV), which is reflective of autonomic nervous system function, has been proved to be modulated by acupuncture. In the present study, we aim to compare the effect of deqi sensation on heart rate variability in adult tinnitus patients. Methods. Thirty participants are randomly assigned to verum acupuncture (creating deqi) or shallow acupuncture (not creating deqi) at Baihui (Du-20), Shenting (Du-24), Tinghui (GB-2), Waiguan (SJ-5), and Zulinqi (GB-41) for 3 weeks. The primary outcome measure is heart rate variability, which is measured at the first acupuncture, as well as the last acupuncture. Discussion. Completion of this trial will help to identify the role of deqi sensation in acupuncture effect for tinnitus and reveal an autonomic modulation mechanism for acupuncture effect. Trial Registration. This trial is registered with International Standard Randomised Controlled Trial Number ISRCTN58013563.

Characterization of deqi sensation and acupuncture effect

Acupuncture stimulation elicits deqi, a composite of unique sensations. According to traditional Chinese medicine (TCM), deqi experienced by patients is often described as suan (aching or soreness), ma (numbness or tingling), zhang (fullness, distention, or pressure), and zhong (heaviness) and is felt by the acupuncturists (needle grasping) as tense, tight, and full. It is believed that deqi may be an important variable in the studies of the mechanism and efficacy of acupuncture treatment. In recent years, great efforts have been made to understand deqi, which include a couple of questionnaires to qualify and quantify deqi sensations, neuroimaging studies of deqi and acupuncture, physiological mechanisms of deqi, and the relation between deqi and clinical efficacy. However, many problems need to be resolved, and more researches are required to be made in the future.

Acupuncture at local and distant points for tinnitus: study protocol for a randomized controlled trial

Background

Tinnitus is the perception of a sound in the absence of an objective physical source. Up to now, there is no generally accepted view how these phantom sounds come about, and also no efficient treatment. Patients are turning to complementary or alternative medical therapies, such as acupuncture. Based on the theory of traditional Chinese medicine, acupoints located on both the adjacent and distal area of the disease can be needled to treat disease. Furthermore, the way of combining acupoints is for strengthening the curative effect. We aim to evaluate the efficacy of acupuncture at local points in combination with distal points in subjective tinnitus patients.

Method

This trial is a randomized, single-blind, controlled study. A total of 112 participants will be randomly assigned to one of four treatment groups receiving acupuncture treatment for 4 weeks. The primary outcome measure is subjective tinnitus loudness and annoyance perception, which is graded using the Visual Analogue Scale (VAS). The assessment is at baseline (before treatment initiation), 4 weeks after the first acupuncture session, and 8 weeks after the first acupuncture session.

Discussion

Completion of this trial will help to identify whether acupuncture at local acupoints in combination with distal acupoints may be more effective than needling points separately.

Trial registration

International Standard Randomized Controlled Trial Number Register: ISRCTN29230777

Factors contributing to therapeutic effects evaluated in acupuncture clinical trials

Acupuncture treatment has been widely used for many conditions, while results of the increasing numbers of randomized trials and systematic reviews remain controversial. Acupuncture is a complex intervention of both specific and non-specific factors associated with therapeutic benefit. Apart from needle insertion, issues such as needling sensation, psychological factors, acupoint specificity, acupuncture manipulation, and needle duration also have relevant influences on the therapeutic effects of acupuncture. Taking these factors into consideration would have considerable implications for the design and interpretation of clinical trials.

Modification of glycosylation reduces microvilli on rat liver epithelial cells

Effect of glycosylation modification on the shape of microvillus was investigated on rat liver epithelial cell line WB-F344. Since rat ER alpha-mannosidase has 89% identity to human 6A8 alpha-mannosidase, we used an antisense 6A8 cDNA fragment to inhibit expression in WB-F344 cells. Cells were transfected with antisense 6A8, the relevant sense fragment or the mock plasmid. Genomic PCR for neo(R) demonstrated integration of the transfected gene into host DNA. Enzymatic activity assay on p -nitro-phenyl-alpha-D-mannopyranoside showed suppression of ER alpha-mannosidase expression in the cells transfected with antisense 6A8. Concanavalin A binding to these cells was enhanced, indicating a modification in glycosylation. Number reduction and blunting of microvillus on these cells was observed. Transduction with the sense fragment or the mock had no effect. Cells with suppressed ER alpha-mannosidase expression grew slower in culture. Our results indicate an obvious effect of glycosylation modification on microvilli, which might be related with malfunctioning of cells.

Accumulation and acute toxicity of silver in Potamogeton crispus L

In the present study, Potamogeton crispus L. plants exposed to various concentrations of silver (Ag) (5, 10, 15, and 20 microM) for 5d were investigated to determine the accumulating potential of Ag and its influence on nutrient elements, chlorophyll pigments and fluorescence, various antioxidant enzymes and compounds, adenosine triphosphate (ATP), protein content and ultrastructure. The accumulation of Ag was found to increase in a concentration dependent manner with a maximum of 29.3 microg g(-1) at 20 microM. The nutrient elements (except Ca), photosynthetic pigments, chlorophyll a fluorescence parameters (Fo, Fv, Fv/Fm, Fv/Fo), malondialdehyde (MDA), ATP, peroxidase (POD) activity, ascorbate (AsA), reduced glutathione (GSH) and protein contents decreased significantly as concentration of Ag augmented. In contrast, an induction in SOD activity was recorded, while an initial rise in Ca content and CAT activity was followed by subsequent decline. Morphological symptoms of senescence phenomena such as chlorosis and damage of chloroplasts and mitochondria were observed even at the lowest concentration of Ag, which suggested that Ag hastened the senescence of the tested plants. The loss of nutrients and chlorophyll content and damage of chloroplasts were associated with disturbances in photosynthetic capacity as indicated by the quenching of chlorophyll a fluorescence. Decreased chlorophyll and protein contents suggest oxidative stress induced by Ag. In addition, both the reduction of ATP and the damage to the ultrastructure of organelles were indicative of general disarray in the cellular functions exerted by Ag.

Inhibition of 6A8 alpha-mannosidase gene expression resulted in telomere length shortening in nasopharyngeal carcinoma cell CNE-2L2

Telomere length shortening was observed in the nasopharyngeal carcinoma cell CNE-2L2 when 6A8 alpha-mannosidase expression was inhibited by antisense 6A8 DNA. Transduction with mock or an irrelevant DNA did not affect the telomere length in the carcinoma cells. Telomerase activity and mRNA transcription of TRF 1 and 2 were not changed in the cells treated with antisense 6A8. The Con A binding test showed an enhancement on the proteins isolated from the cells treated with antisense 6A8, but not on those from mock- or irrelevant DNA-treated cells. The data imply an association between glycosylation modification with telomere shortening in antisense 6A8-treated cells.

[Growth inhibition of human nasopharyngeal carcinoma cell CNE-2L2 caused by suppression of 6A8 alpha-mannosidase expression]

OBJECTIVE

To study the relationship between 6A8 alpha-mannosidase expression and growth of CNE-2L2 cells, a human nasopharyngeal carcinoma cell line.

METHODS

Recombinant adeno-associated virus vector (rAAV) was used as a mediator to transfer an antisense or a sense fragment of 6A8 cDNA into CNE-2L2 cells. 6A8 alpha-mannosidase expression was detected by means of mAb 6A8a staining, alpha-mannosidase activity assay and ConA binding test. Cell growth was examined by means of MTT and colony formation. Tumor growth at the inoculated site of the cells in nude mice was detected after 8 weeks.

RESULTS

Transduction of antisense 6A8 could reduce the expression of 6A8 alpha-mannosidase. In comparison to those in controls, the wild type, the mock-transduced and the sense 6A8-transduced cells, the MTT value, the colony number formed and the tumor weight grown at the inoculated site of cells were significantly decreased in the antisense 6A8-transduced cells (P < 0.001).

CONCLUSION

Decreased expression of 6A8 alpha-mannosidase caused an inhibition of CNE-2L2 cell growth.

[6A8 alpha-mannosidase catalyzes p-nitrophenyl-alpha-D-mannopyranoside]

OBJECTIVE

To confirm the alpha-mannosidase nature of the protein encoded by 6A8 cDNA.

METHODS

1) To construct a full-length 6A8 cDNA based on the three cloned DNA fragments by means of gene recombinant technique; 2) To insert the 6A8 cDNA into eukaryotic expression vector pCDI; 3) To transfect the recombinant pCDI-6A8 into COS-7 cells; 4) To characterize the nature of the protein encoded by 6A8 cDNA by means of enzymic activity assay and Western blotting assay.

RESULTS

The constructed 6A8 cDNA was the right cDNA in sequence. The enzymetic activity of the homogenate of COS-7 cells transfected with pCDI-6A8 was 3-4 times higher than that of the cells transfected with the mock or the wild cells. The enzymetic reaction could not be inhibited by swainsonine. Western blot showed a band of 120,000 recognized by mAb 6A8. The band in the cells transfected with pCDI-6A8 cDNA was much darker than that in the cells transfected with the mock or in the wild cells.

CONCLUSION

The protein encoded by 6A8 cDNA is a kind of alpha-mannosidase, which belongs to type II alpha-mannosidase.

Long-term expression of a transferred gene in Epstein-Barr virus transformed human B cells

Delivering a gene into the Epstein-Barr virus (EBV)-transformed B cells is useful in studying effects of the gene on B-cell functions. However, although people have been able to efficiently transfer genes into and get them expressed in B-lympho blastoid cells for a time probably long enough to kill the cells using vectors harbouring oriP, the expression time of the delivered gene is not long enough in order to study the gene function in B cells. To solve this problem, we constructed an adeno-associated virus (AAV) plasmid pAGX(+) based on plasmids pSub201 and pRc/CMV. We developed and packaged recombinant AAV (rAAV) expression vectors containing an antisense or a sense DNA fragment of 6A8 cDNA encoding a human alpha-mannosidase, or an antisense fragment of 5D4 cDNA encoding a human cell membrane protein, or EYFP DNA. EBV-transformed B cell SKW6 and 3D5 were transduced with those rAAV or the mock. Transduction with the rAAV-EYFP showed an infection frequency of 64 +/- 3.5% and 58 +/- 6.2% for SKW6 and 3D5 cell, respectively. Genomic polymerase chain reaction (PCR) for neoR gene indicated an integration of the transferred gene into the host DNA. After being cultured and propagated for over 12 months, the cells were detected for the expression of the transferred gene. The RT-PCR, enzymatic assay and Con A binding test demonstrated an inhibition of 6A8 alpha-mannosidase in both SKW6 and 3D5 cells transduced with the antisense 6A8 DNA. Immunofluorescence staining with monoclonal antibodies (MoAb) 5D4 showed a reduction of the 5D4 protein expression on both the cells transduced with the antisense 5D4 DNA. The DNA fragmentation assay showed a resistance of the cells with 6A8 alpha-mannosidase inhibition to apoptosis induction by anti-Fas antibody. The data indicate that the AAV vector pAGX(+) can efficiently introduce genes into EBV-transformed B cells and the delivered gene can be expressed in the cells for more than 12 months which may be long enough for the study of gene functions in B cells.

Cloning, expression and characterization of a cDNA (6A8) encoding a novel human alpha-mannosidase

A 3300-bp cDNA (6A8) has been isolated from a human tonsil cell lambdagt11 cDNA library (GenBank accession number: AF044414). The 6A8 gene is localized on human chromosome 13q31-32. Its cDNA has an open reading frame from position 57 bp to 3243 bp, encoding a 1062 amino-acid polypeptide. The sequence of the polypeptide has 89% identity to rat liver ER alpha-mannosidase. Homogenates of COS-7 cells transfected with 6A8 cDNA showed an enhanced enzymatic activity with p-nitro-phenyl-alpha-D-mannopyranoside, which was not inhibited by swainsonine. These data suggest that 6A8 alpha-mannosidase belongs to the class II alpha-mannosidase. Western blot analysis showed a band for 6A8 cDNA encoded protein of approximately 120 kDa. Northern blot analysis revealed two 6A8 mRNA transcripts with different tissue distribution. Enhanced concanavalin A (ConA) binding to CNE-2L2 cells transfected with a reverse 6A8 DNA was observed, indicating that the 6A8 protein is an important cellular alpha-mannosidase.

Metabolites of Colletotrichum gloeosporioides, an endophytic fungus in Artemisia mongolica

A new antimicrobial metabolite, named colletotric acid (1), was isolated from a liquid culture of Colletotrichum gloeosporioides, an endophytic fungus colonized inside the stem of Artemisia mongolica. The structure was determined using spectroscopic methods (EIMS and FABMS,(1)H and (13)C NMR, (1)H-(1)H COSY, HMBC, and HMQC). Compound 1 inhibited the growth of Bacillus subtilis, Staphylococcusaureus, and Sarcina lutea with minimal inhibitory concentrations (MICs) of 25, 50, and 50 microg/mL, respectively, and the crop pathogenic fungus Helminthosporium sativum (MIC: 50 microg/mL).