To systematically evaluate the efficacy and safety of acupuncture versus Flunarizine hydrochloride in the treatment of migraine. Four Chinese databases(CNKI, VIP, WanFang, CBM), three English databases(Cochrane Library, EMbase, Medline) and ClinicalTrail.gov were systematically and comprehensively retrieved. The retrieval time was from the establishment of each database to January 8, 2020. Randomized controlled trial(RCT) for acupuncture versus Flunarizine in the treatment of migraine were screened out according to inclusion criteria and exclusion criteria. The included studies were evaluated with the Cochrane bias risk assessment tool. The included studies was conducted by RevMan 5.3, and the outcome indicators were evaluated for evidence quality and strength of recommendation by the GRADE system. A total of 1 033 literatures were retrieved, and 23 studies were finally included. Except for 4 multiarm tests, the total sample size was 1 548, including 785 in acupuncture group and 763 in Flunarizine group. The overall quality of the included studies was not high. Meta-analysis results showed that the acupuncture group was superior to the Flunarizine group in reduction of headache frequency(SMD=-1.00, 95%CI[-1.45,-0.54], P<0.000 1). In reduction of headache intensity, acupuncture group was superior to Flunarizine group(SMD=-1.05, 95%CI[-1.41,-0.68], P<0.000 01). In reduction of headache duration, acupuncture group was superior to Flunarizine group(SMD=-1.42, 95%CI[-1.83,-1.02], P<0.000 1). The acupuncture group was superior to Flunarizine group(MD=-0.17, 95%CI[-0.21,-0.13], P<0.000 01) in reduction of the painkillers taking frequency. The acupuncture group was superior to Flunarizine group(SMD=-0.94, 95%CI[-1.35,-0.52], P<0.000 1) in allevia-tion of paroxysmal symptoms, such as nausea and vomiting. The GRADE system showed that the evidence level of the above indicators was extremely low, and the strength of recommendation was low. As for the occurrence of adverse reactions, the adverse reactions reported in the acupuncture group included in the study were all mild adverse reactions, like drowsiness, subcutaneous bleeding, local pain, subcutaneous hematoma and dizziness needle. The available evidence showed that acupuncture has a better efficacy than Flunarizine hydrochloride in the treatment of migraine in adult patients. However, due to the high bias risk in the included studies, the conclusions of this study shall be adopted with caution, and more high-quality studies shall be carried out for verification in the future.
Acupuncture Therapy ; Flunarizine/therapeutic use* ; Humans ; Migraine Disorders/therapy* ; Treatment Outcome

To evaluate the efficacy and safety of Yangxue Qingnao Granules alone or combined with calcium channel blocker in treatment of migraine. In this study, four Chinese databases(CNKI, VIP, WanFang, CBM), three English databases(Cochrane Library, EMbase, Medline) and clinical trials registration center(ClinicalTrials.gov) were retrieved. The retrieval time was from the establishment of each database to January 8, 2020. According to the set inclusion criteria and exclusion criteria,the randomized controlled trial(RCT) of Yangxue Qingnao Granules alone or combined with calcium channel blocker was selected. The "Cochrane bias risk assessment" tool was used to evaluate the quality of the included studies. RevMan 5.3 was used to conduct Meta-analysis of the included studies and grade system was used to evaluate the evidence quality of the outcome indicators. A total of 583 documents were retrieved and finally included in 23 studies, with a total sample size of 2 308 cases, 1 171 cases in the treatment group and 1 137 cases in the control group. The overall quality of the research included was not high. Meta-analysis showed that,(1)in terms of effective rate, Yangxue Qingnao Granules combined with calcium channel blocker was better than calcium channel blocker(RR=1.24, 95%CI[1.17, 1.32], P<0.000 01), and there was no significant difference between Yangxue Qingnao Granules and calcium channel blocker(RR=1.36, 95%CI[0.91, 2.03], P=0.14).(2)In terms of reducing headache frequency, when the unit of headache frequency was times per month, Yangxue Qingnao Granules combined with calcium channel blocker was better than calcium channel blocker(MD=-1.39, 95%CI[-1.83,-0.95], P<0.000 01), when the unit of headache frequency was times daily, Yangxue Qingnao Granules combined with calcium channel blocker was better than calcium channel blocker(MD=-2.08, 95%CI[-2.34,-1.82], P<0.000 01).(3)In terms of headache intensity, when headache intensity was scored by pain intensity, Yangxue Qingnao Granules combined with calcium channel blocker was better than calcium channel blocker(MD=-0.70, 95%CI[-0.81,-0.59], P<0.000 01), when headache intensity was scored by VAS score, Yangxue Qingnao Granules combined with calcium channel blocker was better than calcium channel blocker(MD=-1.59, 95%CI[-2.13,-1.06], P<0.000 01).(4)In terms of reducing headache duration, Yangxue Qingnao Granules combined with calcium channel blocker was better than calcium channel blocker(SMD=-3.13, 95%CI[-4.12,-2.15], P<0.000 01). GRADE system showed that the evidence level of the above outcome indicators was low and extremely low. Twelve cases of adverse reactions were reported, all of which were mild. The results showed that the combination of Yang-xue Qingnao Granules can improve the effective rate, reduce the headache frequency, the headache intensity and the headache duration, and had good safety and low incidence of adverse reactions compared with the single calcium channel blocker. However, there was no difference in the effective rate between Yangxue Qingnao Granules alone and calcium channel blocker. In view of the low quality of this study, which affects the reliability of the conclusion, it is necessary to use the conclusion of this study carefully, and more high-quality randomized controlled trials are needed to further verify in the future.
Drugs, Chinese Herbal/adverse effects* ; Humans ; Migraine Disorders/drug therapy* ; Reproducibility of Results

MicroRNAs (micro-ribonucleic acid,miRNAs) are small non-coding RNA molecules,which play an important role in regulating gene transcription.Recent research has found that miRNAs can be used as a new biomarker because of being involved in the progresses of cardiomyocyte development,proliferation and apoptosis.They play an important role in the early diagnosis,prognosis and treatment of acute myocardial infarction.However,there are still many problems and challenges in detection technology,mechanism research and clinical trials of miRNAs.

Objective To investigate the expression changes of myeloid-related protein-8 (MRP-8) and myeloid-related protein-14 (MRP-14) in children with Kawasaki disease (KD) and to obtain laboratory diagnostic serum markers and new targets for its drug therapy.Methods A total of 46 patients with KD(KD group) were enrolled from Jul.2009 to Dec.2010 and divided into the coronary artery dilatation(CAD) group(n =15) and the normal coronary artery group(n =31) ;Meanwhile,25 febrile patients with acute respiratory tract infection but without disease in the circulatory,blood,immune systems formed the non-KD febrile group.Twenty healthy children from the out-patient department formed the healthy control group.Peripheral venous blood was collected in the acute and subacute stage of KD.Levels of MRP-8/MRP-14 were detected with enzyme-linked immunosorbnent assay (ELISA).Gene expressions of MRP-8,MRP-14 in leukocytes were analyzed by semi-quantitative reverse transcription-polymerase chain reaction(RTPCR).Results The serum levels of MRP-8/MRP-14 along with mRNA expressions of MRP-8 and MRP-14 in the leukocytes in the out-patient acute and subacute stage of KD were significantly higher than those in the non-KD febrile group and the healthy control group(all P ＜ 0.05) ;There was no significant difference between non-KD febrile group and healthy control group (P ＞ 0.05).The serum levels of MRP-8/MRP-14 along with mRNA expressions of MRP-8 and MRP-14 in leukocyte in actue stage of KD were significantly higher than those in subacute stage(all P ＜ 0.001).The serum levels of MRP-8/MRP-14 as well as mRNA expressions of MRP-8 and MRP-14 in the acute and the subacute stage of CAD group were significantly higher than those in the normal coronary artery group(P ＜ 0.05).Conclusions MRP-8/MRP-14 may probably play a role in the pathogenesis of KD and can be used as a diagnostic indicator for KD;MRP-8/MRP-14 may be involved in the formation of coronary artery lesion and can be used as an effective predictor for the coronary artery lesion.

Objective To explore the relationship between serum YKL-40 levels and endothelial function in patients with essential hypertension (EH).Method Sixty EH patients [34 male,aged between 43-76 years,mean(59 ±7)years]and 30 healthy subjects [17 male,mean age (57 ±5) years] were enrolled in this study.Serum YKL-40 levels were measured by enzyme immunoassay (ELISA).Endothelial function [endothelin-1 (ET-1),nitric oxide (NO),flow-mediated dilatation (FMD)] was also measured.EH patients were further divided to no metabolic syndrome and metabolic syndrome group.Results Serum uric acid,ET-1,hs-CRP were significantly higher while serum NO,FMD and NMD were significantly lower in EH group than in control group (all P ＜ 0.05).YKL-40 was significantly higher in EH group than in the control group [51.7 (35.6-341.9) μg/L vs.33.2 (23.3-167.3) μg/L,P ＜ 0.05] and significantly higher in EH patients with metabolic syndrome than in EH patients without metabolic syndrome(152.3 μg/L vs.94.2 μg/L,P ＜0.05).In this cohort,serum YKL-40 level was positively correlated with SBP,DBP,BMI,TG and hsCRP(r =0.360,0.303,0.281,0.216,0.530,all P ＜ 0.05) but not correlated with FMD,ET-1 and NO (all P ＞ 0.05).Conclusions Serum YKL-40 levels are increased compared to normal controls and positively correlated with blood pressure level but not with endothelial function parameters in hypertensive patients.Serum YKL-40 level might thus be used as a biomarker reflecting inflammation status other than endothelium function in hypertensive patients.

Objective To explore the ability and mechanism of insulin-like growth factor l (IGF-1) induced bone mesenchymal stem cells ( BMSCs) differentiation into cardiomyocyte-like cells ( CLCs).Methods BMSCs were isolated and purified in vitro.BMSCs were treated with control medium and 15 ng/ml IGF-I for 3,7, 14 and 21 d, respectively. The expression of Troponin-T ( TNT), Troponin-I (TNI) and pIGF-1R were c~etected by immunocytochemistry and Westem blot.In another experimental setting,BMSCs were treated with control medium and 15 ng/ml IGF-l,ICF-1 antaS;onist I-Ome AG538 (300 nmol/L) and 300 nmol/L I-Ome AG538 + 15 ng/ml IGF-1 for 3 t0 48 h,respectively.Phosphorylation status of ERKl/2 and AKT,the two downstream mediators of mitogen-activated protein kinase ( MAPK) kinase and phosphatidylinositol 3-kinase ( PBK) pathways,were detected by immunocytochemistry and Yvestem blot.Results After 3 t0 21 d exposrue to IGF-1, the expression of pIGF1R,TNT and TNI were significandy higher in 'IGF-1 group than those in control group,pIGF-IR peaked 14 d (all P ＜0.05).After 3 and 6 h treatment,the ratio of pAKT/AKT(0.17 ± 0.03)and pERK1/2/ERK1/2(0.06 ± 0.03)were significantly downregulated in I-Ome AG538 group compared to control group (1.00 ±0.05) (all P ＜ 0.05).The ratio of pAKT/AKT(1.00 ± 0.07) and pERK1/2/ERK1/2 (1.00 ± 0.09) were significantly upregulated in IGF-1 group compared to control group (0.72 ± 0.05) (all P ＜ 0.05),but the ratio of pAKT/AKT(0.31 ± 0.10)and pERK1/2/ERK1/2 (0.39 ±0.04) were significantly downregulated in I-Ome AG538 group compared to control group (0.63 ± 0.05) (all P ＜ 0.05),the value of gray scale of TNT (195.06 ± 5.98) and TNI (198.32 ± 3.46) in I-Ome AG538 + IGF-1 group were significantly upregnlated than that in IGF-1 group for TNT (188.70 ± 5.35) and TNI (176.10 ± 4.96) (all P ＜ 0.05).Conclusions IGF-1 could induce BMSCs differentiation into CLCs in vitro by activating MAPK and PI3K signaling pathways.

Objective To compare the diagnostic value of renal ultrasound scan (RUS) and 99Tcmdimercaptosuccinic acid (DMSA) renal scintigraphy in children with acute pyelonephritis (APN). Methods In all, 165 children with initial clinical diagnosis of APN, aged from 1.5 months to 11 yrs ( median 20 months), were included in the study, all of which were examined with RUS and DMSA renal scientigraphy. The diagnosis with DMSA renal scientigraphy results was taken as the standard reference to evaluate the diagnostic sensitivity and specificity of RUS. Results Of 99 out of all 330 kidneys that were found abnormal on DMSA renal scientigraphy, 31 were abnormal on RUS. Of the rest normal kidneys on DMSA scans renal scientigraphy, 4 were abnormal on RUS. Thus diagnostic sensitivity of RUS for APN was 31.3%(31/99) and specificity was 98.3% (227/231). Conclusions Although RUS provides with high diagnostic specificity for children with APN, its low sensitivity may underestimate the clinical evaluation of APN.More often than not, 99Tcm-DMSA renal scientigraphy is a clinical necesscity for the definite RUS diagnosis.

Objective To observe the exercise single photon emission computed tomograpby (SPECT)myocardial perfusion imaging of patients with myocardial bridge and assess the association between myocardial ischemia and extent of myocardial systolic compression.Methods Seventeen patients with myocardial bridge diagnosed by coronary angiogram were included and underwent exercise SPECT myocardial perfusion imaging.Results Abnormal SPECT perfusion imaging was evidenced in 12 out of 17 patients with myocardial bridge(2 out of 6 patients with systolic compression induced stenosis＜50%,3 out of 4 patients with systolic compression induced stenosis between 50%-75%and 7 out of 7 patients with the systolic compression induced stenosis between 75%-100%).Conclusion Exercise stress SPECT myocardial perfusion imaging could detect myocardial ischemia in patients with myocardial bridge and abnormal perfusion is positively related to the extent of systolic compression induced stenosis.

Objective To determine the prevalence and to identify risk factors of peri-procedure electrical storm (ES) in patients with acute myocardial infarction (AMI) underwent emergency percutaneous coronary intervention (PCI).Methods The clinical data of 228 AMI patients underwent emergency PCI were retrospectively analyzed and patients were divided into ES group (n = 39) and non-ES (n = 189) group.ES was referred to spontaneous ventricular tachycardia or ventricular fibrillation occurring twice or more within 24 h and requiring emergency treatment including anti-arrhythm medicine and/or cardioversion or defibrillation.Results ES was diagnosed in 39 out of 228 patients (17.1%) during peri-procedure stage.The incidence of ES in patients with various infarct related arteries (IRA) was as follows:55.6% with left main artery (LM),23.7% with right coronary artery (RCA),12.4% with anterior descending branch (LAD) and 0 with left circumflex artery (LCX).Older age,lager diameter of IRA,higher concentration of CK-MB and cTnT,higher incidence of reporfusion arrhythmia (RA),lower grade of TIMI after PCI and higher mortality were associated with increased risks of ES (The P value was 0.043,0.012,0.036,0.018,0.001,0.049,respectively).Gender,systolic pressure,diastolic pressure,random blood glucose level,white blood count and concentration of hs-CRP were similar between ES and non-ES patients.Logistic analysis showed that the diameter of IRA (OR 2.381,95% CI 1.127-5.028,P = 0.023),TIMI grade of IRA after PCI (OR 4.744,95% CI 1.773-12.691,P = 0.002) and RA (OR 12.680,95% CI 4.360-36.879,P =0.000)were the independent risk factors of per-procedure ES in AMI patients underwent emergency PCI.Conclusions The AMI patients with LM as IRA had the highest incidence of ES during emergency PCI and the diameter of IRA,TIMI grade of IRA after PCI and RA were independent risk factors for the development of ES during peri-PCI stage.

Objective To analyze the feasibility of local LINGO-1 polyclonal antibody administration for treatment of spinal cord injury in adult rats. Methods Twenty-four adult female SD rats were randomized into sham-operated group, rabbit IgG group and LINGO-1 antibody group. In the latter two groups, partial transaction of the T9 segment of the spinal cord was performed to completely sever the dorsal eorticospinal tract, followed immediately by administration of rabbit IgG and anti-LINGO polyclonal antibody via a mini-osmotic pump, respectively. At 3 and 28 days after the operation, the T8～10 segments of the spinal cord were harvested to prepare cryosections, and immunofluorescence staining was used to analyze the penetration of LINGO-1 polyclonal antibody into the spinal cord tissue and its specific binding to LINGO-1 molecules. Results In LINGO-1 antibody group, the presence of rabbit antibodies was detected at the injured sites of the spinal cord at 3 and 28 days after the operation. The mean immunofluorescence density was significantly lower in L1NGO-1 antibody group than in rabbit IgG group at 3 days after the operation (P<0.05). In rabbit IgG group, the mean immunofluorescence density for LINGO-1 in the crysections pre-treated with LINGO-1 polyclonal antibody was significantly lower than that in sections pre-treated with rabbit IgG(P<0.05). Conclusion Locally administered LINGO-1 polyclonal antibody can penetrate into the injured sites in the spinal cord in a wide time window and recognizes LINGO-1 molecule specifically, suggesting the feasibility of passive immunotherapy for spinal cord injury.