Comparative effectiveness of different acupuncture courses in functional constipation: A Bayesian network meta-analysis of clinical trials

AimThe purpose of this study was to examine the comparative effectiveness of different acupuncture courses for functional constipation (FC).BackgroundThere is a need to optimize the treatment course of acupuncture for FC to improve efficacy and save health resources.MethodsWe performed a systematic electronic search of eight databases from inception to April 2021. Randomized controlled trials comparing acupuncture treatment with sham acupuncture were included. The main outcome indicators were complete spontaneous bowel movement (CSBM), spontaneous bowel movement, Bristol Stool Form Scale (BSFS), responder rate and safety evaluation (SE).ResultsIn this network meta-analysis, 19 studies with 1753 participants and 8 different acupuncture treatments were included. Using the consistency model via Monte Carlo simulation iterations, we found that the effect of acupuncture treatment at 3/4 weeks may be better in terms of CSBM and BSFS. The results of rank probability analysis showed that 6 weeks of treatment may be better for the responder rate, and 2 weeks of treatment may be better for SE. And, subgroup analysis found that, for patients with chronic severe functional constipation (CSFC), 8 weeks of acupuncture treatment may be the best for CSBM.ConclusionsBy indirect comparison, 3/4 weeks of acupuncture treatment may be the optimal course of treatment for FC in terms of improving bowel frequency and stool shape. And for CSFC, 8 weeks of acupuncture treatment may be the best. However, there is still a lack of direct comparison and publication bias that affects the accuracy of research results.     

罗格列酮钠对葡萄糖胺诱导的HIT-T15细胞超微结构损伤的保护作用

目的:观察罗格列酮钠(RSGN)对葡萄糖胺(GLcN)诱导的HIT-T15细胞超微结构损伤及其保护作用。方法:以叙利亚仓鼠胰岛β细胞株HIT-T15细胞作为研究对象,实验分组:正常对照组;GLcN+高浓度葡萄糖培养组;GLcN+高浓度葡萄糖+RSGN10-6M培养组;GLcN+高浓度葡萄糖+RSGN10-8M培养组。各组培养48h,透射电镜观察HIT-T15细胞线粒体超微结构。结果:透射电镜观察HIT-T15细胞,GLcN组可见凋亡细胞及较多的坏死细胞,多数线粒体模糊不清,个别线粒体有肿胀,核周隙变宽内质网空泡变性的病理变化;RSGN10-8M组的HIT-T15细胞超微结构病变明显减轻,与RSGN10-8M组比较,RSGN10-6M组病变无明显改变。结论:GLcN可使胰岛β细胞株HIT-T15细胞超微结构损伤,RSGN可部分地阻止这种损伤的形态改变,且和其剂量有一定关系。     

中医学视角下的衰弱研究述评及展望

衰弱是多因素影响、多系统受累的介于健康和失能的一种中间状态,表现为老年人生理储备下降导致机体易损性增加和抗应激能力减退,是当前老年医学的研究热点之一。尽管目前现代医学的研究已取得较大的进展,但在诊断、干预等方面均面临着一定的困难。作为一种非特异性的整体状态,中医学对此具有丰富的理论和实践认识。文章从中医学的整体观念和辨证论治的学术特色以及已有的理论、实践出发,针对衰弱的概念、诊断、干预等,提出可从扩大内涵、开放视野、中年振复、动态精准以及丰富手段等方面进一步深入研究的愿景。     

手法复位小夹板联合中立板双重外固定治疗Colles骨折

Colles骨折是临床上最常见的骨折之一,多见于中老年人。保守治疗是Colles骨折的首选或主要治疗方法[1-2]。通过手法整复,绝大多数骨折可获得满意复位,但骨折满意复位后如何维持整复后骨折满意的位置(骨折的对位、对线)以及防止骨折再移位是非手术治疗Colles骨折成功的关键,也是临床上面临的棘手问题。自1999年7月至2011年6月采用手法复位小夹板联合中立板双重外固定治疗移位性Colles骨折162例,疗效满意,现总结报告如下。1临床资料本组162例,男51例,女111例;年龄20～82岁,平均     

RNAi敲低小鼠睾丸雄激素结合蛋白SHBG对生精功能影响的研究

目的通过干扰小鼠睾丸雄激素结合蛋白(Sex hormone-binding globulin,SHBG)的表达,研究Shbg基因对雄性小鼠生精功能的影响。方法构建有效的Shbg基因干扰质粒,以Western Blot检测干扰效果,通过RNAi干扰小鼠睾丸Shbg基因的表达,研究干扰Shbg基因的表达对小鼠体内胎仔数和精子数量、精子活力、睾丸重量和体外受精率的影响。结果 RNAi干扰Shbg-mRNA的表达能使小鼠睾丸SHBG蛋白表达明显下调,SHBG蛋白表达下调使雄性小鼠自然交配后胎仔数降低,附睾精子的数量和体外受精率也明显下降。结论SHBG蛋白与雄性小鼠的生育力密切相关。     

马齿苋挥发油对辣椒素诱导瘙痒相关胞内通路的影响

目的：本研究通过马齿苋挥发油干预辣椒素诱导角质层细胞内瘙痒模型,探究马齿苋对抗湿疹瘙痒的作用机制。方法：采用辣椒素诱导的SD大鼠角质层细胞作为胞内瘙痒模型,模型细胞分为模型组、马齿苋挥发油高、低剂量组,另设正常角质层细胞作为空白对照。实验结束后采用免疫荧光技术检测角质层细胞形态,采用流式细胞技术测定细胞内Ca²⁺浓度,采用酶联免疫法法测定白三烯、白细胞介素-31和H1羟色胺含量,RT-PCR测定角质层细胞中辣椒素受体蛋白基因表达,western blot测定辣椒素受体蛋白表达。结果：与模型组相比,马齿苋挥发油干预组的阳性角质层细胞数量明显减小（P<0.05）,胞内Ca²⁺浓度明显降低（P<0.05）,白三烯、白细胞介素-31和H1羟色胺含量均有明显减少（P<0.05）,角质层细胞中辣椒素受体蛋白的基因和蛋白表达均明显减少（P<0.05）。结论：马齿苋挥发油可能通过下调辣椒素受体蛋白表达,减少炎症继发反应而产生止痒效应。     

Can acupuncture enhance therapeutic effectiveness of antidepressants and reduce adverse drug reactions in patients with depression? A systematic review and meta-analysis

BackgroundSome depressed patients receive acupuncture as an adjunct to their conventional medications.ObjectiveThis review aims to provide evidence on whether acupuncture can enhance the therapeutic effectiveness of antidepressants for treating depression, and explore whether acupuncture can reduce the adverse reactions associated with antidepressants.Search strategyEnglish and Chinese databases were searched for randomized controlled trials (RCTs) published until December 1, 2021.Inclusion criteriaRCTs with a modified Jadad scale score ≥ 4 were included if they compared a group of participants with depression that received acupuncture combined with antidepressants with a control group that received antidepressants alone.Data extraction and analysisMeta-analysis was performed, and statistical heterogeneity was assessed based on Cochran’s Q statistic and its related P-value. Primary outcomes were the reduction in the severity of depression and adverse reactions associated with antidepressants, while secondary outcomes included remission rate, treatment response, social functioning, and change in antidepressant dose. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework was used to evaluate the overall quality of evidence in the included studies.ResultsThis review included 16 studies (with a total of 1958 participants). Most studies were at high risk of performance bias and at low or unclear risk of selection bias, detection bias, attrition bias, reporting bias, and other bias. Analysis of the 16 RCTs showed that, compared with antidepressants alone, acupuncture along with antidepressants reduced the Hamilton Depression Rating Scale-17 (HAMD-17) scores (standard mean difference [SMD] ?0.44, 95% confidence interval [CI] ?0.55 to ?0.33, P < 0.01; I² = 14%), Self-rating Depression Scale (SDS) scores (SMD ?0.53, 95% CI ?0.84 to ?0.23, P < 0.01; I² = 79%), and the Side Effect Rating Scale (SERS) scores (SMD ?1.11, 95% CI ?1.56 to ?0.66, P < 0.01; I² = 89%). Compared with antidepressants alone, acupuncture along with antidepressants improved World Health Organization Quality of Life-BREF scores (SMD 0.31, 95% CI 0.18 to 0.44, P < 0.01; I² = 15%), decreased the number of participants who increased their antidepressant dosages (relative risk [RR] 0.32, 95% CI 0.22 to 0.48, P < 0.01; I² = 0%), and resulted in significantly higher remission rates (RR 1.52, 95% CI 1.26 to 1.83, P < 0.01; I² = 0%) and treatment responses (RR 1.35, 95% CI 1.24 to 1.47, P < 0.01; I² = 19%) in terms of HAMD-17 scores. The HAMD-17, SDS and SERS scores were assessed as low quality by GRADE and the other indices as being of moderate quality.ConclusionAcupuncture as an adjunct to antidepressants may enhance the therapeutic effectiveness and reduce the adverse drug reactions in patients receiving antidepressants. These findings must be interpreted with caution, as the evidence was of low or moderate quality and there was a lack of comparative data with a placebo control.Systematic review registration: INPLASY202150008.     

Spectrum-effect relationships between UPLC fingerprints and bioactivities of crude secondary roots of Aconitum carmichaelii Debeaux (Fuzi) and its three processed products on mitochondrial growth coupled with canonical correlation analysis

Ethnopharmacological relevance: The crude secondary roots of Aconitum carmichaelii Debeaux (Fuzi), together with its processed products, including Yanfuzi, Heishunpian and Paofupian, are commonly applied in clinic using for thousands of years, such as collapse, syncope, rheumatic fever, painful joints and various tumors.Aim of the study: To explore the different effects of Fuzi and its processed products on energy metabolism, with mitochondria as the model with the aim of guiding the clinical use of Fuzi and its products. fingerprints of Fuzi, Yanfuzi, Heishunpian and Paofupian were established by Ultra-high Performance Liquid Chromatography (UPLC) and effects of Fuzi and its processed products on rat’s liver׳s mitochondrial metabolism were studied by microcalorimetry. Spectrum-effect relationships between UPLC fingerprints and energy metabolism of mitochondria were investigated using canonical correlation analysis (CCA).Results: Because of their inherent differences in chemical compositions, the main activities of energy metabolism of mitochondria were different among Fuzi and its processed products. The potential bioactivity sequence of the tested products was Fuzi>Heishunpian>Paofupian>Yanfuzi. Results of CCA showed that compounds mesaconitine, benzoylaconitine, and benzoylhypacoitine might be the principal active components.Conclusion: Altogether, this work provides a general model of combination of UPLC and microcalorimetry to study the spectrum-effect relationships of Fuzi and its processed products which can offer some references for detecting principal components of traditional Chinese medicine on bioactivity to mitochondrial growth.     

成都某部一起感染Yamagata系乙型流感病毒血凝素基因分析

目的 分析成都某部感染乙型流感病毒遗传进化与血凝素（HA）基因突变位点。方法 通过犬肾上皮细胞（MDCK细胞）体外分离患者咽拭子标本流感病毒毒株,用PCR获取乙型流感病毒HA基因并测序,与NCBI数据库在线比对并利用MEGA 6.06软件构建系统发育进化树,分析突变位点。结果 通过MDCK细胞接种,分离出1株乙型流感病毒株,以感染病例咽拭子核酸及分离毒株的核酸为模板进行PCR扩增得到1 755 bp全长HA基因,获得的序列提交至GenBank数据库,获得基因登录号为MH236281。通过在线比对及系统发育树构建,该病例感染的病毒为Yamagata系乙型流感病毒。与乙型流感病毒Yamagata系的代表毒株Influenza B/Yamagata/16/88（GenBank No.M36105）相比,HA基因点突变碱基为57个;与世界卫生组织（WHO）推荐的疫苗株Influenza B/Utah/08/2014（GenBank No.KU592766）相比,突变碱基数为20个。进一步对HA1氨基酸突变位点进行分析,与四川地区往年流行株相比均发生了不同程度的突变,其中与2010年四川温江的分离株（GenBank No.KP461138）相比突变位点较少,仅有4处点突变;与WHO推荐的疫苗株Influenza B/Utah/08/2014相比,有2个氨基酸位点发生了变异,分别为L176Q和M255V,但突变没有处于HA1上的抗原决定簇区域。其中176位点是一个全新的突变,以往四川流行毒株、Yamagata系的代表毒株Influenza B/Yamagata/16/88及WHO推荐的疫苗株Influenza B/Utah/08/2014的HA1 176位点均为亮氨酸（L）,而本研究病例感染的乙型流感毒株HA1 176位点突变为谷氨酰胺（Q）。结论 成都地区驻地部队2017-2018流行季感染的乙型流感病毒HA基因已发生一些突变,但突变尚未造成抗原性的改变。