OBJECTIVE: To observe the clinical efficacy of Daoqi (directing qi flowing) acupuncture technique in Huangdi Neijing (Yellow Emperor's Inner Classic) for moderate-to-severe obstructive sleep apnea-hypopnea syndrome (OSAHS). METHODS: Sixty patients with moderate-to-severe OSAHS were randomly divided into a Daoqi acupuncture group (30 cases) and a conventional acupuncture group (30 cases, 1 case dropped out). In the Daoqi acupuncture group, Daoqi acupuncture technique in Huangdi Neijing was applied at Shanglianquan (Extra), Fengfu (GV16), and bilateral Lieque (LU7), Zhaohai (KI6); in the conventional acupuncture group, conventional acupuncture was applied at Shanglianquan (Extra), Fengfu (GV16), Yamen (GV15), and bilateral Lieque (LU7), Zhaohai (KI6), Zusanli (ST36), Fenglong (ST40). The treatment was adopted once every other day, 3 times a week, 4 weeks as one course and 3 courses were required totally in both groups. Before and after treatment, the polysomnography (PSG) indexes [apnea-hypopnea index (AHI), hypopnea index (HI), apnea index (AI), longest apnea duration, lowest nocturnal SaO₂ (LSaO₂)], and scores of Epworth sleepiness scale (ESS), Pittsburgh sleep quality index (PSQI), World Health Organization quality of life-BREF (WHOQOL-BREF) were observed, and the clinical efficacy was evaluated after treatment in the two groups. RESULTS: After treatment, the AHI, HI, AI and longest apnea duration were reduced compared with those before treatment in the two groups (P<0.01), the LSaO₂ was increased in the Daoqi acupuncture group (P<0.01); in the Daoqi acupuncture group, the AHI, HI, AI and longest apnea duration were lower than those in the conventional acupuncture group (P<0.05), and the LSaO₂ was higher than that in the conventional acupuncture group (P<0.05). After treatment, the ESS and PSQI scores were decreased compared with those before treatment (P<0.01), while the WHOQOL-BREF scores were increased compared with those before treatment (P<0.01) in the two groups; in the Daoqi acupuncture group, the ESS and PSQI scores were lower than those in the conventional acupuncture group (P<0.05, P<0.01), and the WHOQOL-BREF score was higher than that in the conventional acupuncture group (P<0.05). The total effective rate was 93.3% (28/30) in the Daoqi acupuncture group, which was higher than 82.8% (24/29) in the conventional acupuncture group (P<0.01). CONCLUSION Daoqi acupuncture technique in Huangdi Neijing can effectively treat moderate-to-severe OSAHS patients, improve the clinical symptoms and quality of life, and has the advantages i.e. simpler acupoints selection and gentler stimulation.
Humans ; Sleep Apnea, Obstructive/physiopathology* ; Male ; Female ; Middle Aged ; Acupuncture Therapy ; Adult ; Acupuncture Points ; Treatment Outcome ; Aged ; Quality of Life

Mitochondria play a crucial role as organelles, managing several physiological processes such as redox balance, cell metabolism, and energy synthesis. Initially, the assumption was that mitochondria primarily resided in the host cells and could exclusively transmit from oocytes to offspring by a mechanism known as vertical inheritance of mitochondria. Recent scholarly works, however, suggest that certain cell types transmit their mitochondria to other developmental cell types via a mechanism referred to as intercellular or horizontal mitochondrial transfer. This review details the process of which mitochondria are transferred across cells and explains the impact of mitochondrial transfer between cells on the efficacy and functionality of cancer cells in various cancer forms. Specifically, we review the role of mitochondria transfer in regulating cellular metabolism restoration, excess reactive oxygen species (ROS) generation, proliferation, invasion, metastasis, mitophagy activation, mitochondrial DNA (mtDNA) inheritance, immune system modulation and therapeutic resistance in cancer. Additionally, we highlight the possibility of using intercellular mitochondria transfer as a therapeutic approach to treat cancer and enhance the efficacy of cancer treatments.

Objective:To observe the effects of kidney-tonifying and mind-calming acupuncture therapy on sleep,mood,sex hormone levels,and traditional Chinese medicine(TCM)symptoms in patients with perimenopausal insomnia(PMI). Methods:A total of 90 patients with PMI were randomly divided into a treatment group and a control group,with 45 cases in each group.Patients in the treatment group were treated with acupuncture at Shenshu(BL23),Taixi(KI3),Baihui(GV20),and Anmian(Extra).The control group was treated with sham acupuncture.Both groups were treated 3 times a week for 4 weeks.Pittsburgh sleep quality index(PSQI)and insomnia severity index(ISI)were used to evaluate the sleep quality of the subjects before treatment,after treatment,and 1 month after treatment(follow-up).Beck depression inventory(BDI)and Beck anxiety inventory(BAI)were used to evaluate the depression and anxiety of the subjects before treatment,after treatment,and at 1-month follow-up.The TCM symptom scale was used to evaluate the TCM symptoms of the subjects before treatment,after treatment,and 1 month after treatment.Serum levels of estradiol(E2),follicle-stimulating hormone(FSH),and luteinizing hormone(LH)were measured before and after treatment. Results:During the study,2 cases dropped out of the treatment group,and no cases dropped out of the control group.The PSQI scores of the treatment group were significantly lower after treatment and at 1-month follow-up compared with those before treatment(P<0.05),and the difference was statistically significant compared with that of the control group(P<0.05).In the control group,the PSQI score was significantly lower after treatment compared with before treatment(P<0.05),and the difference was not statistically significant at 1-month follow-up compared with before treatment(P>0.05).Compared with the pre-treatment,the ISI,BDI,BAI,and TCM symptom scale scores of the treatment group were lower after treatment and at 1-month follow-up(P<0.05),and the differences with the control group at the same time point were statistically significant(P<0.05).The differences in ISI,BDI,BAI,and TCM symptom scale scores of the control group before treatment,after treatment,and at 1-month follow-up were not statistically significant(P>0.05).After treatment,the serum E2 level in the treatment group was significantly higher than that before treatment(P<0.05),and the difference with the control group was statistically significant(P<0.05).The difference in the serum E2 level before and after treatment in the control group was not statistically significant(P>0.05).The differences in the serum FSH and LH levels between before and after treatment were not statistically significant in either group of subjects(P>0.05). Conclusion:Kidney-tonifying and mind-calming acupuncture therapy can improve sleep quality,relieve anxiety and depression,delay the decrease of serum E2 level,and improve related TCM symptoms in patients with PMI.

Objective To establish a quantitative analysis of multi-compounds by single-marker(QAMS)method for the simultaneous determination of four compounds in formula granules of Pteris multifida and optimize the extraction process of total flavonoids.Methods The relative correction factors(RCFs)of lonicerin,luteolin and apigenin in the formula granules of Pteris multifida were calculated by using the UPLC method with rhoifolin as the internal reference,and their durability was investigated.The external standard method(ESM)was used to determine the content of four compounds in the formula granules of Pteris multifida,and the difference between the calculated values and the measured values was compared.The effects of ultrasonic time,ethanol volume fraction,solid-liquid ratio and ultrasonic power on the extraction rate of total flavonoids were studied by single factor experiment.On this basis,Box-Behnken test with three factors and three levels was conducted to optimize the extraction process of total flavonoids,and the verification experiment was conducted.Results The content of rhoifolin in the formula granules was 0.035%-0.056%,and the content of lonicerin,luteolin and apigenin by QAMS method was 0.085%-0.167%,0.014%-0.028%and 0.004%-0.008%,respectively,which had no significant difference with the external standard method.The optimal extraction conditions of total flavonoids were 80%ethanol water,solid-liquid ratio 1:20,40 minutes extraction,the average extraction rate was 24.46 mg·g-1.Conclusion The established QAMS method was accurate and feasible,and the optimized extraction process of total flavonoids based on Box-Behnken response surface method was simple and feasible,which could lay a foundation for the quality evaluation of the Pteris multifida formula granules.

Humans ; Soft Tissue Neoplasms ; Mesenchymoma/diagnostic imaging* ; Paraneoplastic Syndromes/pathology*

Objective:To study the effects of electron beam irradiation and 60Co irradiation on the composition changes of four alkaloids in Sophorae Flavescentis Radix, intermediate extracts of Sophorae Flavescentis Radix and Lixieling Tablets. Methods:Sophorae Flavescentis Radix, intermediate extracts of Sophorae Flavescentis Radix and Lixieling Tablets were irradiated at different doses of 0, 1.5, 3, 5, 7, 10, 20, 30, 40 kGy by electron beam irradiation and 60Co irradiation. The contents of oxymatrine, oxysophocarpine, matrine and sophocarpine were determined by HPLC, and the changes of the components before and after irradiation were compared. Results:Oxymatrine, oxysophocarpine, matrine and sophocarpine were among 0.046 9-0.937 4 μg, 0.020 5-0.410 4 μg, 0.098 9-1.977 9 μg, 0.048 7-0.973 1 μg, respectively. The linear relationship was good. The average recovery rates were 98.1%, 100.1%, 100.5%, 96.6%, respectively, and the RSDs were 1.69%, 2.03%, 3.14% and 1.10%, respectively. Electron beam irradiation and 60Co irradiation had no statistical significance on the changes of oxymatrine, oxysophocarpine, matrine and sophocarpine in Sophora flavescens, but had statistical significance in the contents of intermediate extracts of Sophorae Flavescentis Radix and Lixieling Tablets. Conclusion:The established method for the determination of matrine is accurate, reproducible, simple and practical, and can be used for the quality control of Lixieling Tablets. Irradiation has no significant effect on the content of Sophorae Flavescentis Radix, while high dose irradiation has significant effect on the intermediates and finished products of Sophorae Flavescentis Radix, which can provide a basis for quality control and sterilization irradiation of enterprises.

Objective:To explore the effect of Xingnao Kaiqiao acupuncture treatment on brain network reorganization for the patients with stroke recovery, and therefore understand the neural mechanism underlying Xingnao Kaiqiao acupuncture treatment.Methods:Prospective case series study. Thirteen acute ischemia stroke patients were recruited from the Department of Neurology, Shanghai Minhang Hospital of Integrated Traditional Chinese and Western Medicine from Aug 2018 to Oct 2019. They were treated with Xingnao Kaiqiao acupuncture once a day for 10 consecutive days in addition to routine treatments, and received clinical assessments before treatment and 14 days after treatment onset. EEG signals were recorded during the first acupuncture treatment, from before inserting the needles (the baseline), during needle retention, to after removal of the needles. The brain network was constructed using phase locking index, and its clustering coefficient (CC), characteristic path length (PL) and small-worldness (S) were analyzed using one-way repeated ANOVA.Results:Compared with the baseline, the CC of delta-band network (sparsity=0.10: t=3.306, P=0.006; 0.12: t=2.909, P=0.013; 0.14: t=2.331, P=0.038) and the PL of delta-band (sparsity=0.12: t=3.236, P=0.007; 0.14: t=2.754, P=0.017, 0.18: t=2.878, P=0.014) and alpha-band (sparsity=0.10: t=2.432, P=0.032) networks were significantly decreased during the needle retention stage. Clinical assessments demonstrated a significant treatment efficacy of Xingnao Kaiqiao acupuncture, and its efficacy which was indicated by improved NIHSS score, was significantly correlated with the CC changes in the delta band network from baseline to needle retention. The correlation was strongest when the network sparsity was 0.12 ( r=0.78, P=0.002). Conclusion:Xingnao Kaiqiao acupuncture can regulate the brain network of stroke patients in real time, and this immediate regulation maybe associated with its treatment effect.

OBJECTIVE To establish the quality standard of Lixieling tablets. METHODS Thin layer chromatography was used to identify Bistortae Rhizoma, Andrographis Herba and Sophorae Flavescentis Radix in Lixieling tablets. The components of andrographolium and matrine were determined by HPLC. RESULTS The thin layer spots of Bistortae Rhizoma, Andrographis Herba and Sophorae Flavescentis Radix were clear, with good separation effect and repeatability. The linear relationship between andrographolide, neoandrographolide, 14-deoxygenated andrographolide, dehydrated andrographolide, sophorine, oxymatrine, sophorine and oxysophorine and their respective concentration ranges was good. The RSDs of instrument precision, repeatability, stability and recovery all met the requirements. CONCLUSION The method is simple and reproducible, and can be used for the quality control of Lixieling tablets.

OBJECTIVE：To optimi ze the optimal composition proportion of 4 ingredients （Panax ginseng ，Astragalus membranaceus，Polygonatum sibiricum ，Lycium chinensis ）in Compound ginseng immune-enhancing formula （CGIF），and to study immune activity and acute toxicity of the extracts with the optimal ratio. METHODS ：The cell activity test was used to screen the crude drug concentration range of 4 ingredients. After treated with different crude drug concentrations of each medicinal material，using the contents of NO ，IL-6 and TNF-α as indexes，uniform design was used to determine the optimal ratio of each ingredient in CGIF. Totally 240 mice were taken and randomly divided into 4 batches，with 60 mice in each batch. Each batch of mice was randomly divided into blank group （normal saline ），model group （normal saline ），positive drug group [levamisole ，4 mg/（kg·d）]，and optimal proportion extract of CGIF low-dose ，medium-dose and high-dose groups [ 0.952 8，1.905 6，3.811 2 g/（kg·d）]，with 10 mice in each group ；they were given medicine intragastrically ，qd，for consecutive 30 d. Except for blank group，mice in the other groups were intraperitoneally injected with cyclophosphamide [ 40 mg/（kg·d）] on the 24th day after first administration，qd，for consecutive 3 d to induce immunocompromised model. The immune activity of the optimal proportion extract was evaluated by determining visceral coefficients ，spleen lymphocyte transformation capacity ，serum contents of hemolysin，IL-2，IgM，IgG and IgA ，phagocytosis function of peritoneal macrophages. Another 20 mice were collected and given the optimal proportion extract 20 mL/kg intragastrically ，twice；acute toxicity of the formula was investigated with oral maximum tolerated dose （MTD）. RESULTS ：The optimal ratio of CGIF was that crude drug mass ratio of P. ginseng ， membranaceus，P. sibiricum ，L. chinensis was 1 ∶ 2 ∶ 2 ∶ 4. The immunological activity experiment showed that theoptimal proportion extract can significantly improve visceral indexes of mice ， spleen lymphocyte proliferation ability serum contents of hemolysin ，IL-2，IgM，IgG and IgA as well as macrophage phagocy tosis ability （P＜0.05 or P＜ 0.01）. The acute toxicity test indicated that oral MTD was over 15 g/kg，which was non-toxic. CONCLUSIONS ：The optimal proportion extract of CGIF can significantly enhance the immune function of mice and are non-toxic.

Objective To observe the clinical effect on sleep improvement about acupoint application in treating the chronic insomnia of Liver-stagnation and Spleen-deficiency Syndrome.Methods A total of 68 patients with chronic insomnia with Liver-stagnation and Spleen-deficiency Syndrome were randomly and blindly divided into treatment group and control group by registration order. In the treatment process, 1 was eliminated and 33 were completed in the treatment group, 2 were eliminated and 32 were completed in the control group. The treatment group underwentAn Mian Tietherapy half an hour before bed and the control group underwent placebo therapy in the same way of treatment group. Two groups were treated for 40 days and followed-up visit six months. The change of Pittsburgh Sleep Quality (PSQI), Index Insomnia Severity Index (ISI) and TCM Syndromes Scale were detected.Results The clinical total effective rate of treatment group was 72.7% and the control group was 9.4%, and the difference was statistically significant (χ2=46.977,P<0.01). The PSQI scores after treatment (7.55 ± 1.52vs. 13.90 ± 2.44,t=148.165), and follow up 1 month (8.97 ± 2.51vs. 13.17 ± 2.79,t=37.926) in the treatment group were significantly lower than those in the control group (P<0.01). The ISI scores after treatment (7.03 ± 3.37vs. 20.89 ± 4.40,t=73.75), and follow up 1 month (9.81 ± 3.16vs. 19.41 ± 3.66,t=40.79) in the observation group were significantly lower than those in the control group (P<0.01). The TCM Syndromes Scale scores after treatment (2.05 ± 1.09vs. 6.98 ± 1.23,t=17.116), and follow up 1 month (4.06 ± 1.59vs. 6.83 ± 0.91,t=68.055) and follow up 6 month (5.12 ± 1.84vs. 7.19 ± 1.07,t=27.716) in the observation group were significantly lower than those in the control group (P<0.01).Conclusions Acupoint application could obviously change the sleep quality and Chinese medicine symptom in chronic insomnia of Liver-stagnation and Spleen-deficiency Syndrome.