1.Up-regulation of Proinflammatory Cytokines in Rostral Ventromedial Medulla Contributes to Chronic Postsurgical Pain by Promoting 5-HT Release
Juanli DAI ; Zhen WANG ; Chaoxiong DONG ; Yuying LI ; Xuhong WEI
Journal of Sun Yat-sen University(Medical Sciences) 2024;45(1):54-62
ObjectiveTo investigate the role of proinflammatory cytokines tumor necrosis factor alpha (TNFα) and interleukin-1β (IL-1β) in rostral ventromedial medulla (RVM) in chronic postsurgical pain (CPSP) induced by skin/muscle incision and retraction (SMIR). MethodsSD rats were randomly divided into 5 groups: ① Sham group; ② SMIR group; ③ SMIR+TNFα/IL-1β neutralizing antibody group; ④ SMIR+TNFα/IL-1β group and ⑤ SMIR+vehicle group. 50% paw mechanical withdrawal threshold (MWT) was measured by the up-down method, immunofluroscence was used to detect the TNFα and IL-1β expression and ELISA for the 5-Hydroxytryptamine (5-HT) level. ResultsSMIR elicited persistent nociceptive sensitization, upregulated TNFα and IL-1β expression in RVM neurons and astrocytes. Microinjection of TNFα or IL-1β neutralizing antibody into RVM inhibited the development of nociceptive sensitization and decreased the level of 5-HT in both RVM and spinal dorsal horn. While microinjection of recombinant TNFα or IL-1β into RVM enhanced the development of nociceptive sensitization and increased the level of 5-HT in both RVM and spinal dorsal horn. ConclusionUp-regulation of proinflammatory cytokines in RVM may contribute to SMIR induced CPSP by promoting 5-HT release.
2.Quality Evaluation and Analysis of Different Forms of Reference Substances in Classic Prescription Huangqi Guizhi Wuwu Decoction
Simei XIE ; Shengjun CHEN ; Qianqian ZHU ; Xiehe WANG ; Mei LI ; Yuqing HE ; Hongmei WEN
Journal of Nanjing University of Traditional Chinese Medicine 2024;40(7):710-721
OBJECTIVE To ascertain the substance benchmarks of the classic prescription Huangqi Guizhi Wuwu Decoction(HGWD),examine the quantitative value transfer throughout the entire process of HGWD,from herb pieces to decoction,concentrated solution and finally freeze-dried powder,and provide a valuable reference for the preparation method and scientific evaluation of bench-mark samples of classic prescriptions containing volatile substances.METHODS According to the Key information table of Ancient Classic Prescriptions(25 prescriptions)released by China,15 batches of HGWD were prepared.The multi-index content determination and characteristic chromatogram analysis methods were established,and the characteristic peak attribution and similarity evaluation were carried out.The multi-index contents of HGWD and its freeze-dried powder were investigated and compared,and the quantitative value transfer in the preparation process of decoction-concentrated solution-freeze-dried powder was analyzed.The physical form of the benchmark samples were scientifically and reasonably determined,and the content and transfer rate range of each component in the HGWD benchmark samples were determined,and the HGWD substance benchmarks were established.RESULTS The contents of cinnamaldehyde and cinnamyl alcohol in HGWD decreased significantly during the concentration and drying process,and the other in-dex components could be transferred more completely between the decoction,concentrated solution and freeze-dried powder.The simi-larity of the characteristic chromatograms of 15 batches of HGWD benchmark samples were all over 0.9,and 8 characteristic peaks were identified,which were from Paeoniae γadix Alba,Cinnamomi γamulus and Ginger.The paste-forming rate ranged from 8.0%to 11.0%.The content of Astragaloside Ⅳ was 0.04%-0.07%and the transfer rate was 9.0%-18.0%.The content of paeoniflorin was 1.5%-3.0%and the transfer rate was 33.0%-62.0%.The content of cinnamyl alcohol was 0.02%-0.04%,and the transfer rate was 25.0%-47.0%.The content of cinnamic aldehyde was 0.02%-0.05%and the transfer rate was 0.7%-1.5%.The content of cinnamic acid was 0.03%-0.06%and the transfer rate was 17.5%-34.0%.The content of 6-gingerol was 0.04%-0.08%and the transfer rate was 7.0%-14.0%.CONCLUSION The physical form of the decoction as the HGWD benchmark sample is deter-mined,which provides reference for the scientific selection of the physical form of the benchmark sample of classic prescriptions contai-ning volatile substances.The quality indexes of HGWD substance benchmarks are established,and the quantitative value transfer is an-alyzed,which provides the basis for the development of the classic prescription compound preparation.
3.Establishment of UPLC characteristic chromatogram and component analysis of the volatile oil in the standard decoction of Qingshang juantong decoction
Zhiying FAN ; Qianqian ZHU ; Xiehe WANG ; Yanjuan ZHAI ; Huimin WANG ; Yangxin GU ; Haiqin ZHOU ; Tulin LU ; Kewei ZHANG ; Song LI
China Pharmacy 2024;35(9):1082-1086
OBJECTIVE To establish the characteristic chromatogram of the volatile oil in the standard decoction of Qingshang juantong decoction, and preliminarily infer the main active components of volatile oil that affect the clinical therapeutic effect. METHODS The volatile oil in the standard decoction of Qingshang juantong decoction was extracted by steam distillation. The ultra-high performance liquid chromatography (UPLC) characteristic chromatograms of 15 batches of samples were established by the Similarity Evaluation System of TCM Chromatographic Fingerprint (2012 edition), and the similarity evaluation was carried out. The volatile oil of standard decoction was identified by UPLC coupled with quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF/MS). Then the volatile oil components were analyzed by GC-MS. RESULTS The similarities of UPLC characteristic chromatograms for volatile oil of 15 batches of Qingshang juantong decoction were between 0.949 and 0.997. A total of 12 common peaks were obtained. According to the UPLC-Q-TOF/MS, the main components were methyl eugenol, E-ligustilide, E-butylidenephthalide and so on. A total of 23 components were identified by GC-MS, which were mainly 3,4,5-trimethoxy- methylbenzene, patchouli alcohol, Z-ligustilide and so on. CONCLUSIONS The characteristic chromatograms of the volatile oil in the standard decoction of Qingshang juantong decoction is established, and it is inferred that methyl eugenol, ligustilide, E- butylidenephthalide, patchouli alcohol, 3,4,5-trimethoxy-methylbenzene might be the main active components affecting the clinical therapeutic effect of the volatile oil of Qingshang juantong decoction.
4.Effect of electroacupuncture combined with repetitive transcranial magnetic stimulation on limb dysfunction in patients with ischemic stroke
Yiling ZHAO ; Yuemei XU ; Chuanjie WANG ; Mulei QIU ; Benmei CHEN ; Danqing PAN ; Xiehe KONG
Journal of Acupuncture and Tuina Science 2024;22(6):454-461
Objective:To observe the effect of electroacupuncture(EA)combined with repetitive transcranial magnetic stimulation(rTMS)on limb dysfunction in ischemic stroke patients. Methods:A total of 63 stroke patients were divided into an observation group and a control group using the random number table method.Thirty-one patients in the control group were treated with routine Western medicine combined with rTMS;32 patients in the observation group were treated with EA in addition to the intervention in the control group.The duration of treatment was 3 months.The National Institutes of Health stroke scale(NIHSS),the Fugl-Meyer assessment(FMA),the modified Barthel index(MBI),and the motor evoked potential(MEP)latency of transcranial magnetic stimulation were observed before and after treatment in both groups. Results:Two cases withdrew from the observation group and 1 case withdrew from the control group.After treatment,the NIHSS score in both groups was lower than that before treatment,the FMA and MBI scores were higher than those before treatment,and the latency period of MEP was shorter than that before treatment,and the differences were statistically significant(P<0.05).After treatment,the NIHSS,FMA,and MBI scores and MEP latency period of the observation group improved more than those of the control group,and the differences between the groups were statistically significant(P<0.05). Conclusion:EA combined with rTMS can improve the motor function of limbs in ischemic stroke patients and improve their self-care ability.The mechanism may be related to increasing the excitability of the motor cortex and improving the electrophysiological function of the central nervous system.
5.Clinical observation of Tuina combined with Bu Zhong Yi Qi Tang in the treatment of rectocele
Danyang ZHAO ; Qiang WANG ; Xiehe KONG
Journal of Acupuncture and Tuina Science 2023;21(3):217-223
Objective:To observe the clinical effect of Tuina(Chinese therapeutic massage)combined with Bu Zhong Yi Qi Tang(Middle Jiao-supplementing and Qi-boosting Decoction)in the treatment of rectocele of Qi sinking due to spleen deficiency.Methods:A total of 108 patients with rectocele(grades Ⅰ and Ⅱ)were randomly divided into a Chinese medicine group and a Tuina+Chinese medicine group,with 54 cases in each group.Both groups were treated with Bu Zhong Yi Qi Tang,and the Tuina+Chinese medicine group was treated with additional Tuina manipulation.The score of clinical symptoms and grade of rectocele were observed and compared between the two groups.Results:After treatment,39 cases were cured,10 cases were effective,and 5 cases failed in the Tuina+Chinese medicine group,making a total effective rate of 90.7%.In the Chinese medicine group,26 cases were cured,16 cases were effective,and 12 cases failed,making a total effective rate of 77.8%.The efficacy difference between the two groups was statistically significant,checked by the rank-sum test(P<0.05).After treatment,the grades of rectocele in the two groups were statistically different from those before treatment(P<0.05),and the difference between the two groups was statistically significant(P<0.05).After treatment,the score of each item and the total score of traditional Chinese medicine symptoms in the two groups were lower than those before treatment,and the differences within the group were statistically significant(P<0.05).The score of each item and the total score of the Tuina+Chinese medicine group were lower than those of the Chinese medicine group,and the differences between the two groups were statistically significant(P<0.05).Conclusion:Tuina plus Bu Zhong Yi Qi Tang has better clinical efficacy than Bu Zhong Yi Qi Tang alone in the treatment of rectocele of Qi sinking due to spleen deficiency.
6.Clinical observation of acupuncture treatment for children with accommodative myopia
Xiaopeng ZHANG ; Rong HAN ; Xiaodi QIU ; Xiehe KONG ; Yaojiani CAO ; Xuejun WANG ; Yue ZHAO ; Feng ZHAO ; Xiaopeng MA
Journal of Acupuncture and Tuina Science 2023;21(3):224-228
Objective:To observe the effect of acupuncture in the treatment of accommodative myopia in children.Methods:A total of 76 children with accommodative myopia who met the inclusion criteria were divided into a control group or a test group according to the random number table method,with 38 cases in each group.The control group was given education on eye hygiene,and the test group was treated with acupuncture twice a week for 2 months in addition to the intervention used in the control group.The patient's uncorrected visual acuity(UCVA),refraction,and axial length(AL)were measured before treatment and 1 month and 2 months after treatment.Results:After 1 month of treatment,there was no significant difference in the UCVA between the two groups(P>0.05);after 2 months of treatment,the UCVA of the test group was better than that of the control group(P<0.05).After 1 and 2 months of treatment,the refraction of the two groups was significantly different from that before treatment(P<0.01),but there was no significant difference between the two groups(P>0.05).After 1 and 2 months of treatment,the AL in the control group was increased compared with that before treatment(P<0.05),while there was no significant change in the test group(P>0.05),and there was no significant difference between the two groups(P>0.05).Conclusion:Acupuncture treatment can improve UCVA in children with accommodative myopia.
7.Clinical study of Tuina combined with functional training to improve the clinical symptoms and balance function in patients with meniscus injury
Xiaojie SU ; Hua XING ; Xiaojun ZHU ; Siyu WANG ; Guangyuan ZHANG ; Jianhua LI ; Li GONG ; Xiehe KONG
Journal of Acupuncture and Tuina Science 2023;21(6):491-499
Objective:To observe the effect of Tuina(Chinese therapeutic massage)combined with functional training in improving clinical symptoms and balance function in patients with meniscus injury. Methods:A total of 93 patients with grade Ⅰ-Ⅱ meniscus injury were randomly divided into a functional training group,a Tuina group,and a combination group,with 31 cases in each group.The Tuina group received Tuina manipulation.The functional training group underwent functional training under the supervision of physicians.The combination group received Tuina manipulation in addition to the functional training.The treatment course of all three groups was 8 weeks.The clinical symptoms were observed before the intervention and after 4 and 8 weeks of interventions,and the changes in knee injury and osteoarthritis outcome score(KOOS)and Y-balance test(YBT)were compared. Results:There was no statistically significant difference in the total response rate among the three groups after treatment(P>0.05).The total and subscale KOOS in the three groups were significantly higher than those before treatment after 4 and 8 weeks of interventions(P<0.05).There was a statistically significant difference in the total KOOS between the combination group and the functional training group after 4 and 8 weeks of interventions(P<0.05);there was a statistically significant difference in the score of daily living ability and sports and recreation function between the two groups after 8 weeks of interventions(P<0.05).The YBT balance coefficients of the affected and non-affected knees of the three groups were significantly improved after 4 and 8 weeks of interventions(P<0.05),and there was no statistically significant difference among the groups(P>0.05). Conclusion:Tuina,functional training,and their combination can improve clinical symptoms and balance function in patients with grade Ⅰ-Ⅱ meniscus injury.Tuina combined with functional training is significantly effective in improving daily living ability and sports and recreation function.
8.Clinical efficacy of electroacupuncture in controlling myopia in children and its influence on retinal blood flow
Rong HAN ; Xuejun WANG ; Xiehe KONG ; Xiaopeng ZHANG ; Yaojiani CAO ; Yunqiong LU ; Li LIU ; Xingtao ZHOU ; Feng ZHAO ; Xiaopeng MA
Journal of Acupuncture and Tuina Science 2022;20(3):229-235
Objective: To observe the clinical efficacy of electroacupuncture (EA) in controlling myopia in children and its effect on retinal blood flow. Methods: Sixty-eight myopic children were randomly divided into an observation group and a control group, with 34 cases in each group. The control group was given auricular acupressure treatment alone, and the observation group was treated with EA once a week in addition to the treatment used in the control group. The spherical equivalent refraction (SER) and axial length (AL) were measured at baseline, and after 3 months and 6 months of treatment. Optical coherence tomography angiography was used to measure the vessel density (VD) and perfusion density (PD) in the surface layer of the retina. Results: After 3 months and 6 months of treatment, the changes in SER between the two groups were not statistically significant (P>0.05). After 3 months of treatment, the changes in AL between the two groups were not statistically significant (P>0.05); after 6 months of treatment, the change amount of AL in the observation group was smaller than that in the control group (P<0.05); after 3 months and 6 months of treatment, the changes in VD and PD in the surface layer of the retina in the observation group were significantly greater than those in the control group (P<0.01). Conclusion: EA treatment once a week for 6 months can delay the increase of AL and improve the retinal surface blood flow in myopic children.
9.Clinical study of acupuncture plus Dang Gui Bu Xue Qu Feng Tang for benign essential blepharospasm
Yuelan ZOU ; Xiehe KONG ; Xiaocong GUO ; Xuejun WANG ; Xiaoying LI ; Rong HAN ; Xiaopeng ZHANG ; Guang YANG ; Yanting YANG ; Xiaopeng MA
Journal of Acupuncture and Tuina Science 2022;20(1):79-86
Objective: To evaluate the therapeutic efficacy of acupuncture plus Dang Gui Bu Xue Qu Feng Tang for benign essential blepharospasm (BEB). Methods: A prospective randomized controlled trial was performed. A total of 105 participants were randomized 1:1:1 into an acupuncture group, a herbal medicine group and an acupuncture plus herbal medicine group. Participants in the acupuncture group received manual acupuncture treatment, twice a week. Participants in the herbal medicine group received Dang Gui Bu Xue Qu Feng Tang, oral administration, once a day. Participants in the acupuncture plus herbal medicine group received both treatments. The therapeutic effects of the three groups were evaluated after four weeks of treatment. The primary outcome was the Jankovic rating scale (JRS) score, and the secondary outcome was the blepharospasm disability index (BSDI) score. Results: After four weeks of treatment, the JRS total scores significantly decreased in all three groups versus baseline (P<0.05). A greater reduction in the JRS total score was reported in participants in the acupuncture plus herbal medicine group (P<0.05), but there was no significant difference between the acupuncture group and the herbal medicine group (P>0.05). The acupuncture plus herbal medicine group had a greater decrease in the JRS severity score than the herbal medicine group (P<0.05). The reduction in the JRS frequency score was not significantly different among the three groups (P>0.05). The BSDI scores significantly decreased in all three groups versus baseline (P<0.05), but the reduction in the BSDI score was insignificantly different among the three groups (P>0.05). Conclusion: It is effective in the treatment of BEB either to use acupuncture and Dang Gui Bu Xue Qu Feng Tang alone or in combination. The combination therapy shows a more significant effect than either of the treatment alone.
10.Home-based Telerehabilitation Guidance for Stroke Patients
Hui-lin LIU ; Bin ZHOU ; Zheng ZHAO ; Yan YANG ; Xue-qin LÜ ; Yue WANG ; Ting YU
Chinese Journal of Rehabilitation Theory and Practice 2021;27(7):807-811
Objective:To explore the effects of home-based telerehabilitation guidance on physical function and activities of daily living for stroke patients. Methods:From September, 2015 to March, 2018, 240 stroke recovering patients from three community health service centers in Fengtai District, Beijing for outpatient rehabilitation were randomly divided into control group (

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