BACKGROUND: The effects of acupuncture have varied in different randomized controlled trials (RCTs), and there are many factors that influence treatment effect of acupuncture in different outcomes, with conflicting results. OBJECTIVE: To identify factors and their impact on the treatment effect of acupuncture in different outcomes. METHODS: Acupuncture RCTs were searched from 7 databases including Medline (PubMed), Embase, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang Database, VIP Database, and China Biology Medicine disc between January 1st, 2015 and December 31st, 2019. Eligible studies must compare acupuncture to no acupuncture, sham acupuncture, or waiting lists, and report at least 1 patient-important outcome. A multi-level meta-regression was conducted using a 3-level robust mixed model and univariate analyses were performed for all independent variables, even those excluded from the multivariable model due to collinearities. We used thresholds of 0.2 and 0.4 for the difference of standardized mean differences (SMDs), categorising them as small (<0.2), moderate (0.2-0.4), or large (>0.4) effects. RESULTS: The pain construct analysis involved 211 effect estimates from 153 studies and 14 independent variables. High-frequency acupuncture treatment sessions produced larger effects compared to low-frequency sessions [large magnitude, the difference of adjusted SMDs 0.46, 95% confidence interval (CI) 0.07 to 0.84; P=0.02]. The non-pain symptoms construct analysis comprised 323 effect estimates from 231 studies and 15 independent variables. Penetrating acupuncture showed moderately larger effects when compared to non-penetrating acupuncture (0.30, 95% CI 0.06 to 0.53; P=0.01). The function construct analysis included 495 effect estimates from 274 studies and 14 independent variables. Penetrating acupuncture and the flexible acupuncture regimen showed moderately larger effects, compared to non-penetrating acupuncture and fixed regimen, respectively (0.40, 95% CI 0 to 0.80; P=0.05; 0.29, 95% CI 0.06 to 0.53; P=0.01). CONCLUSIONS High-frequency acupuncture sessions appear to be a more effective approach to managing painful symptoms. Penetrating acupuncture demonstrated greater effect in relieving non-painful symptoms. Both penetrating acupuncture type and flexible acupuncture regimen were linked to significant treatment effects in function outcomes. Future studies should consider the factors that are significantly associated with the effects of acupuncture in patient-important outcomes.
Humans ; Randomized Controlled Trials as Topic ; Acupuncture Therapy/methods* ; Pain ; Pain Management ; China

Tweety-homolog 1 (Ttyh1) is expressed in neural tissue and has been implicated in the generation of several brain diseases. However, its functional significance in pain processing is not understood. By disrupting the gene encoding Ttyh1, we found a loss of Ttyh1 in nociceptors and their central terminals in Ttyh1-deficient mice, along with a reduction in nociceptor excitability and synaptic transmission at identified synapses between nociceptors and spinal neurons projecting to the periaqueductal grey (PAG) in the basal state. More importantly, the peripheral inflammation-evoked nociceptor hyperexcitability and spinal synaptic potentiation recorded in spinal-PAG projection neurons were compromised in Ttyh1-deficient mice. Analysis of the paired-pulse ratio and miniature excitatory postsynaptic currents indicated a role of presynaptic Ttyh1 from spinal nociceptor terminals in the regulation of neurotransmitter release. Interfering with Ttyh1 specifically in nociceptors produces a comparable pain relief. Thus, in this study we demonstrated that Ttyh1 is a critical determinant of acute nociception and pain sensitization caused by peripheral inflammation.

Objective:To observe the effect of 3 Hz and 10 Hz repetitive transcranial magnetic stimulation (rTMS) on upper limb motor function and activities of daily living in patients with ischemic stroke. Methods:From June, 2016 to September, 2017, 60 inpatients with ischemic stroke were randomly divided into sham rTMS group (n = 19), 3 Hz-rTMS group (n = 21) and 10 Hz-rTMS group (n = 20). All the patients received routine training and their own rTMS for two weeks. Their rest motor threshold (RMT) was measured, and they were assessed with modified Ashworth Scale (MAS), Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel Index (MBI) before and after treatment, and at six weeks follow-up. Results:There were 48 patients completing the trial, while five in 3 Hz-rTMS group, five in 10 Hz-rTMS group and two in the sham rTMS group dropped. The RMT increased in 3 Hz and 10 Hz rTMS groups (t > 2.390, P < 0.05) after treatment, but there was no significantly difference among the three groups (F = 0.164, P > 0.05). The MAS scores of elbow and wrist decreased gradually over time in 3 Hz and 10 Hz rTMS groups (P < 0.05), and the MAS scores of elbow was less in 3 Hz and 10 Hz rTMS groups than in the sham rTMS group at follow-up (P < 0.05). The interaction of time and group was significant on the FMA-UE scores (F = 14.243, P < 0.001), and the FMA-UE scores improved more in 3 Hz and 10 Hz rTMS groups than in the sham rTMS group at different stages (P < 0.01). The interaction of time and group was not significant in MBI score (F = 1.481, P > 0.05), and there was no significant difference among the three groups at any time (F < 2.925, P > 0.05). Conclusion:Both 3 Hz and 10 Hz rTMS can promote the recovery of upper limb motor function in ischemic stroke patients safely and effectively, and 10 Hz rTMS is recommended as less time is needed.

OBJECTIVETo investigate the inhibition effect of curcumin on the proliferation of the human esophageal carcinoma cell line Ec109 and its impact on PEN/PI3K/Akt signaling pathway.

METHODSEsophageal carcinoma Ec109 cells were cultured in vitro conventionally and were treated with curcumin at different concentrations. The cell proliferation level was examined by MIT colorimetry, the ultrastructure of curcumin-treated Ec109 cells were detected with transmission electron microscope (TEM) and cell apoptosis was observed by FCM with AnnexinV-FITC/PI double staining. The protein levels of PTEN, Akt, GSK3P and Caspase 3 of curcumin-treated Ec109 cells were detected by Western blot.

RESULTSMTT test showed that curcumin could inhibit the proliferation of Ec109 cells in a time and concentration-dependent manner. TEM examination indicated that curcumin could induce Ec109 cell apoptosis. FCM detection showed that Ec109 cell apoptotic rate increased significantly with the increase of drug concentration. On the other hand, curcumin could promote the expression of PTEN, GSK3beta and Caspase 3 yet reduce the expression of Akt.

CONCLUSIONCurcumin could obviously up-regulate the expression of PTEN, GSK3beta and Caspase 3, surpress PI3K/Akt signaling pathway and hence inhibit the proliferation of Ec109 cells.

Apoptosis ; drug effects ; Caspase 3 ; metabolism ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Curcumin ; pharmacology ; Glycogen Synthase Kinase 3 ; metabolism ; Glycogen Synthase Kinase 3 beta ; Humans ; Oncogene Protein v-akt ; metabolism ; PTEN Phosphohydrolase ; metabolism ; Phosphatidylinositol 3-Kinases ; metabolism ; Signal Transduction ; drug effects

OBJECTIVETo evaluate the efficacy and safety of itraconazole for secondary prophylaxis of previous proven or probable invasive fungal infection (IFI) in patients undergoing chemotherapy or allogeneic hematopoietic stem cell transplantation (HSCT) in agranulocytosis state.

METHODSA phase IV prospective, open-label, multicenter trial was conducted to evaluate itraconazole (200 mg q12h intravenously d1-2, 200 mg/d) as secondary antifungal prophylaxis in patients (18-65 years old) undergoing chemotherapy or HSCT with previous proven or probable IFI. Itraconazole was started when patients' neutrophils＜1.5 × 10⁹/L, and stopped when chemotherapy patients' neutrophils ＞0.5 × 10⁹/L and stem cell transplant recipients' neutrophils＞1.0 × 10⁹/L. The primary end-point of the study was the incidence of proven, probable or possible IFI.

RESULTSSeventy one patients from November 2008 to September 2010 were enrolled in the trial. The median duration of itraconazole prophylaxis was 14 (4-35) days. No patients died of drug-related toxicity within trial. Five cases occurred IFI during the trial. The cumulative incidence of invasive fungal disease was 7.0%. One patient was withdrawn from the study due to treatment-related adverse events (liver malfunction and severe phlebitis).

CONCLUSIONItraconazole appears to be safe and effective for secondary prophylaxis of systemic fungal infection after chemotherapy and allogeneic HSCT. The observed incidence of 7.0% is considerably lower than the relapse rate reported in historical controls, suggesting that itraconazole is a promising prophylactic agent in this population.

Adolescent ; Adult ; Aged ; Antifungal Agents ; therapeutic use ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; Itraconazole ; therapeutic use ; Male ; Middle Aged ; Mycoses ; prevention & control ; Prospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVETo carry out a preliminary study on the emotional problems and parenting locus of control among children with anxiety disorders.

METHODSA total of 110 children with simple anxiety disorders (AD group) and 113 normal children (control group) from September to December 2005 were enrolled. Children were asked to complete the Depression Self-Rating Scale for Children (DSRSC), the Screen for Child Anxiety Related Emotional Disorders (SCARED), and the Parenting Locus of Control Scale (PLOC).A total of 197 valid scales were returned.

RESULTSThe scores of somatic, generalized anxiety, separation anxiety, social phobia anxiety, school phobia anxiety, total anxiety, and total depression were all higher in the AD group than in the control group (P<0.01). The score of "education effects" for parents was significantly higher in the AD group than that in the control group (P<0.01).

CONCLUSIONSChildren with anxiety disorders tend to have more emotional problems and poorer parental education effects.

Adolescent ; Affective Symptoms ; etiology ; Anxiety Disorders ; psychology ; Child ; Female ; Humans ; Internal-External Control ; Male ; Parenting

OBJECTIVETo investigate the prevalence of psychiatric disorders in a representative sample of primary and middle school students in Hunan Province.

METHODSA total of 9 495 children aged 5-17 years from Hunan urban and rural schools were enrolled by a cluster sampling and a two-phase design. The students' psychiatric status was assessed using the Investigation Screening Inventory for Child Mental Disorder and a semi-structured interview designed based on the DSM-IV criteria.

RESULTSThe overall prevalence of psychiatric disorders was 16.22%. Attention-deficit and disruptive behavior disorders were the commonest in the diagnostic categories of psychiatric disorders (10.69%). Regarding specific disorders, the most prevalent was attention-deficit/hyperactivity disorder (5.95%). Psychiatric disorders were more prevalent in boys than in girls (20.49% vs 11.16%; p<0.01). The prevalence of attention-deficit and disruptive behavior disorders in boys was higher than in girls (14.76% vs 5.87%; p<0.01). The prevalence of psychiatric disorders in middle school students (12-17 years) was significantly higher than in primary students (5-11 years) (18.38% vs 14.64%; p<0.01). There were no significant differences in the prevalence of psychiatric disorders between urban and rural students.

CONCLUSIONSPsychiatric disorders are common among primary and middle school students in Hunan Province. The prevalence of this disorder in boys is higher than in girls. The middle school students have higher prevalence than primary students.

Adolescent ; Age Factors ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Male ; Mental Disorders ; epidemiology ; Prevalence ; Sex Factors

Objective To understand the work pressure status in community nursing personnel in Longgang district of Shenzhen, to look for the ways to reduce their work pressure. Methods Through questionnaire, with work pressure source quantity table of China nurses, 200 community nurses in Longgang district of Shenzhen were randomly investigated, the effective questionnaire of 198 community nurees in Longgang district of Shenzhen were collected for statistical analysis. Results The social position of nursing jobs is low, the quantity of nurses on duty is not enough, the work load of nurses is too heavy, non-nursing work is too much; the opportunity of further education is rare. Conclusions The structure of human resources in community nursing personnel should be properly adjusted; community nursing management model should be perfected.

Objective To study the family rearing pattern of attention deficit hyperactivity disorder(ADHD)with or without anxiety disorder and to explore its risk factors.Methods 9495 children and their parents were sampled at random in Hunan province,using two-stage investigation.Those who were diagnosed ADHD and the normal control filled out Egna Minnen av Barndoms Uppfostran and family adaptability and cohesion scale bv themselves.Results The comparison of factors as:actual family cohesion,parents' punishments,reiection,mother's excessive protection,intervention and father's excessive protection were significantly difierent between ADHD with or without anxiety disorder and normal children(P＜0.05).The comparison of parents' punishments,reiection,excessive protection and intervention were obviously different between ADHD with anxiety disorder and simple ADHD(P＜0.05).Mother's reiection was the influencing factor of simple ADHD,with OR as 1.122.Ideal family cohesion,mother's rejection and father's punishments were the influencing factors of ADHD with anxiety disorder,with OR as 0.966.1.215 and 1.089 respectively.Conclusion There were some problems in the parental rearing pattern of ADHD with or without anxiety disorder.Mother's rejection,father's punishments and ideal family cohesion were suggested to be correlated with ADHD and anxiety disorder.

Objective To investigate the role of nasal mucosa fibrosis on radiation induced nasal mucosa injury. Methods Seventy two male rats were randomly divided into two groups, control group and irradiation injured group (radiation dose were 40 Gy);the rats were killed 1 week, 2 weeks, 4 weeks, 8 weeks, 3 months and 6 months after the finish of radiation. The middle turbinates of the animals were removed. The pathological change of the nasal mucosa were observed with scanning electron microscope, transmission electron microscope, hematoxylin and eosin (HE), alcian blue-periodic acid-Sehif (AB-PAS), and Masson Trichrome (MT). The Hyp content in nasal mucosa was measured with chemo-chromatometry. Results After radiation, the pathological characteristics in early stage (within 4 weeks) was acute inflammatory reaction. The repair of nasal mucosa started 4 weeks after radiation, lasted to 6 months. The deposition of collagen in nasal mucosa could be found 1 week after irradiation and increased gradually. Conclusion Irradiation could induce a serials of pathological changes on nasal mucosa. The nasal mucosa fibrosis may be one of the reasons of persistent irradiation induced nasal mucosa injury.