Expert Consensus on Clinical Diseases Responding Specifically to Traditional Chinese Medicine：Fibromyalgia Syndrome / 中国实验方剂学杂志

Fibromyalgia syndrome （FMS） is a refractory， chronic non-articular rheumatic disease characterized by widespread pain throughout the body， for which there are no satisfactory therapeutic drugs or options. There are rich Chinese medical therapies， and some non-drug therapies， such as acupuncture， Tai Chi， and Ba-Duan-Jin， have shown satisfactory efficacy and safety and definite advantages of simultaneously adjusting mind and body. FMS is taken as a disease responding specifically to traditional Chinese medicine （TCM） by the National Administration of Traditional Chinese Medicine in 2018. In order to clarify the research progress in FMS and the clinical advantages of TCM/integrated Chinese and Western medicine， the China Academy of Chinese Medicine organized a seminar for nearly 20 experts in Chinese and Western medicine， including rheumatology， psychology， acupuncture and moxibustion， and encephalopathy， with the topic of difficulties in clinical diagnosis and treatment of FMS and advantages of TCM and Western medicine. The recommendations were reached on the difficulties in early diagnosis and solutions of FMS， mitigation of common non-specific symptoms， preferential analgesic therapy， TCM pathogenesis and treatment advantages， and direction of treatment with integrated Chinese and Western medicine. FMS is currently facing the triple dilemma of low early correct diagnosis， poor patient participation， and unsatisfactory benefit from pure Western medicine treatment. To solve the above problems， this paper suggests that rheumatologists should serve as the main diagnostic force of this disease， and they should improve patient participation in treatment decision-making， implement exercise therapy， and fully utilize the holistic and multidimensional features of TCM， which is effective in alleviating pain， improving mood， and decreasing adverse events. In addition， it is suggested that FMS treatment should rely on both TCM and Western medicine and adopt multidisciplinary joint treatment， which is expected to improve the standard of diagnosis and treatment of FMS in China.

Quality value transmitting of substance benchmarks in Danggui Buxue Decoction / 中国中药杂志

To clarify the key quality attributes of substance benchmarks in Danggui Buxue Decoction(DBD), this study prepared 21 batches of DBD substance benchmarks, and established two methods for detecting their fingerprints, followed by the identification of peak attribution and similarity range as well as the determination of extract and transfer rate ranges and contents of index components ferulic acid, calycosin-7-O-β-D-glucoside, and astragaloside Ⅳ. The mass fractions and transfer rates of DBD substance benchmarks from different batches were calculated as follows: ferulic acid(index component in Angelicae Sinensis Radix): 0.037%-0.084% and 31.41%-98.88%; astragaloside Ⅳ(index component in Astragali Radix): 0.021%-0.059% and 32.18%-118.57%; calycosin-7-O-β-D-glucoside: 0.002%-0.023% and 11.51%-45.65%, with the extract rate being 18.4%-36.1%. The similarity of fingerprints among 21 batches of DBD substance benchmarks was all higher than 0.9. The quality control method for DBD substance benchmarks was preliminarily established based on the HPLC fingerprint analysis and index component determination, which has provided a basis for the subsequent development of DBD and the quality control of novel related preparations.

Problems in randomized controlled trial on acupuncture and moxibustion for migraine in the development of international standard of Guideline for Clinical Practice of Acupuncture and Moxibustion: Migraine / 中国针灸

Regarding the development of international standard of Guideline for Clinical Practice of Acupuncture and Moxibustion: Migraine, the existing problems of the design and methodology of randomized controlled trial (RCT) on acupuncture and moxibustion for migraine were summarized in views of participant, intervention, control, outcome and study design. Four directions need to be further explored, (1) research of adolescent migraine, special subtype of migraine and migraine in a special population; (2) research of the immediate analgesic effect of acupuncture and moxibuation at the attack stage of migraine and the therapeutic effect of migraine at each stage; (3) research on safety and health economics; (4) clinical trial registration of acupuncture and moxibustion. In study, the target population should be further determined and specialized, the diagnosis criteria of western medicine and traditional Chinese medicine be generalized and concentrated, the staging and type division of disease be accurate, the intervention procedure be integrated, the control design be rationalized, the outcomes be validated, and the description of randomization and blinding be clarified.

Analysis on development necessity and key points for / 中国针灸

This paper analyzes the development necessity of a series of international technical specification of acupuncture-moxibustion from three aspects, the development status of global

Triple needling combined with thermo-electroacupuncture at Huantiao (GB 30) for trunk-sciatica / 中国针灸

OBJECTIVE@#To compared the clinical effect between triple needling combined with thermo-electroacupuncture at Huantiao (GB 30) and triple needling combined with electroacupuncture at Huantiao (GB 30) for trunk-sciatica.@*METHODS@#A total of 56 patients with trunk-sciatica were randomized into a triple needling combined with thermo-electroacupuncture group and a triple needling combined with electroacupuncture group, 28 cases in each group. In the triple needling combined with thermo-electroacupuncture group, triple needling combined with thermo-electroacupuncture at Huantiao (GB 30) was applied. In the triple needling combined with electroacupuncture group, triple needling combined with electroacupuncture at Huantiao (GB 30) was applied. Both groups were treated with acupuncture at Weizhong (BL 40), Yanglingquan (GB 34) and Chengshan (BL 57). The treatment was given once every 2 days, 10 days as one course for 2 courses. Before treatment, 1, 2 courses into treatment, the scores of pain rating index (PRI), pain visual analogue scale (VAS) and present pain intensity (PPI) were observed, and the clinical efficacy was evaluated in the two groups.@*RESULTS@#The PRI, VAS and PPI scores 1, 2 courses into treatment were decreased in the two groups (@*CONCLUSION@#Triple needling combined with thermo-electroacupuncture at Huantiao (GB 30) could effectively relieve pain in patients with trunk-sciatica, and the curative effect maybe better than triple needling combined with electroacupuncture at Huantiao (GB 30).

Needle-embedding treatment for hemifacial spasm: research progress / 中国针灸

The articles regarding needle-embedding treatment for hemifacial spasm published before September 30, 2019 were searched from SinoMed, Wanfang, CNKI, VIP and PubMed database, and were analyzed and summarized from treatment methods, acupoint selection, stage differentiation and action mechanism. As a result, 45 Chinese articles were obtained. The needle-embedding treatment was divided into intradermal needling and acupoint thread-embedding; the top five acupoints were Sibai (ST 2), Taiyang (EX-HN 5), Dicang (ST 4), Jiache (ST 6) and spasm trigger points. The basic research of needle-embedding treatment for hemifacial spasm is weak, and the literature regarding stage differentiation is insufficient, which are in need of further study.

Bibliometric analysis of refractory facial paralysis based on CNKI database / 中国针灸

The current development situation and the hotspot of the relevant research on refractory facial paralysis are explored. The articles on refractory facial paralysis are retrieved from CNKI database. The bibliographic items co-occurrence matrix builder (BICOMB) 2.0 is adopted to extract and analyze statistically literature characteristics and generate the high-frequency keywords matrix. The graphical clustering toolkit (gCLUTO) 1.0 is used to cluster the high-frequency keywords. A total of 750 articles are included, mostly published in

Analysis on international demand investigation for technical specification of acupuncture- moxibustionthe and its general rules of drafting / 中国针灸

The electronic questionnaire was adopted to survey the international demand on

Analysis of the results of international demand survey on / 中国针灸

The survey is conducted prior to the development of international standard,

Transformation of the domestic standard ( / 中国针灸

Through analyzing the differences in the clinical questions of

Correlation analysis of serum inflammatory factors and prognosis of elderly patients with severe pneumonia / 中国基层医药

Objective@#To investigate the correlation between serum inflammatory cytokines interleukin-6 (IL-6), IL-10, tumor necrosis factor alpha (TNF-alpha), C reactive protein (CRP) and prognosis in elderly patients with severe pneumonia.@*Methods@#From May 2015 to September 2017, 82 cases with severe pneumonia in Shanxi Dayi Hospital were selected as severe pneumonia group, during the same period, 67 elderly patients with common pneumonia in Shanxi Dayi Hospital were selected as common pneumonia group.According to the outcome of severe pneumonia, the patients were divided into survival group and death group.The serum levels of IL-10, IL-6, TNF-alpha and CRP were detected.The correlation between the inflammatory factors and the prognosis of elderly patients with severe pneumonia was analyzed.@*Results@#The serum levels of IL-6, IL-10, TNF-alpha, CRP in the severe pneumonia group were (88.34±11.62)pg/mL, (16.87±3.52)pg/mL, (69.35±10.26)ng/L, (27.81±5.54)mg/L, respectively, which in the common pneumonia group were (35.61±10.45)pg/mL, (8.12±1.37)pg/mL, (27.79±6.34)ng/L, (5.93±1.42)mg/L, respectively, the differences between the two groups were statistically significant (t=12.154, 8.637, 10.872, 6.993, all P<0.05). Of 82 elderly patients with severe pneumonia, 12 cases died, 70 cases survived, the serum levels of IL-6, IL-10, TNF-alpha, CRP in the survival group were (75.93±10.21)pg/mL, (12.93±2.31)pg/mL, (58.32±8.17)ng/L, (23.42±3.38)mg/L, respectively, which in the death group were (94.11±15.32)pg/mL, (19.12±3.78)pg/mL, (72.16±11.59)ng/L, (34.91±6.54)mg/L, respectively, the differences between the two groups were statistically significant (t=10.976, 5.618, 8.742, 9.013, all P<0.05). The correlation analysis showed that IL-6, IL-10, TNF-alpha, CRP were positively correlated with the prognosis of senile patients with severe pneumonia (r=0.793, 0.332, 0.528, 0.814, all P<0.05).@*Conclusion@#There is a significant correlation between IL-6, IL-10, TNF-alpha, CRP and prognosis of elderly patients with severe pneumonia, which is helpful for the prognosis evaluation of elderly patients with severe pneumonia.

Pharmacokinetic behaviors of four constituents in sugar-free Xinnaosu Granules in rat plasma / 中成药

AIM To investigate the pharmacokinetic behaviors of four constituents in sugar-free Xinnaosu Granules in rat plasma.METHODS Rats intragastrically administered with the 0.5％ CMC-Na suspension of this drug (3 g/kg) had their blood collected for the determination of plasma concentration by UHPLC-MS/MS,after which pharmacokinetic parameters were calculated by DAS2.0 software.RESULTS The plasma concentrationtime curves for tanshinone Ⅱ A,salvianolic acid B,ginsenoside Rg1,notoginsenoside R1 accorded with two compartment model,with the t1/2values of (1.68 ±0.56),(4.13 ±0.87),(3.62 ±0.87),(9.77 ±3.12) h,Tmax values of (0.51 ±0.19),(1 ±0),(6 ±0),(4.00 ±1.09) h,Cmax values of (0.42 ±0.08),(0.17 ±0.02),(0.46±0.11),(0.41 ±0.12) mg/L,respectively.CONCLUSION All the four constituents in sugar-free Xinnaosu Granules demonstrate high bioavailabilities.

Research status of the effect mechanism on catgut-point embedding therapy / 中国针灸

This paper aims to review the research status of the effect mechanism of catgut-embedding therapy. The literature was retrieved from China Academic Journal Network Publishing Database with the keywords as "catgut-point embedding" "embedding", dated from the database establishment to December 2015. Totally, over 5 000 papers had been collected. It was summarized that TCM effect mechanism of catgut-point embedding therapy includes the effects of needle retaining and embedding, harmonizingand, balancingorgans, promoting meridian, regulatingand blood, tonifying for the deficiency and reducing for the excess, strengthening the antipathogenicand eliminating pathogens. From the point of view of western medicine, the effect mechanism of catgut-embedding therapy refers to recovering nerve function, regulating neural reflex, increasing human immunity, improving local circulation, inhibiting the release of inflammatory factors, reducing apoptosis, regulating cellular factor and improving body metabolism. It was found that the effects of catgut-embedding therapy were not only related to the effects induced by common acupuncture, but also to the persistent treatment through prolonged stimulation duration, especially in the treatment of chronic diseases with many systems involved. This therapy reduces or complements to the use of western medicine to certain extent. However, the longitude theoretic study on the catgut-embedding therapy is limited; the specific statement is less predominant and the clinical controlled trial is insufficient at present. Hence, further studies are requested.

Efficacy on primary trigeminal neuralgia treated with triple puncture technique and electroacupuncture at trigger points / 中国针灸

<p><b>OBJECTIVE</b>To compare the clinical efficacy on primary trigeminal neuralgia between the combined therapy of electroacupuncture and triple puncture and the routine electroacupuncture therapy.</p><p><b>METHODS</b>Thirty-six patients of primary trigeminal neuralgia were randomly assigned into an electroacupuncture and triple puncture group (group A) and a routine electroacupuncture group (group B), 18 cases in each one. In the group A, the triple puncture technique was used at the trigger points (the positive reactive points to trigger facial pain) and stimulated with electricity. In the group B, the regular needling technique was used at the trigger points, stimulated with electricity. The treatment was given once every two days, the treatment for 10 days made one session and two sessions were required. Separately, before treatment, at the end of the first session of treatment and at the end of the second session, the score of comprehensive symptoms, the score of visual analogue scale (VAS) and the cli-nical efficacy were evaluated in the two groups.</p><p><b>RESULTS</b>Compared with those before treatment, the comprehensive symptom score and VAS score were all reduced after treatment in the two groups (<0.05,<0.01). The scores were reduced much more apparently in the group A as compared with those in the group B (both<0.01). The curative and remarkably effective rate was 44.4% (8/18) and the total effective rate was 88.9% (16/18) in the group A, better than 27.8% (5/18) and 66.7% (12/18) in the group B respectively (both<0.05).</p><p><b>CONCLUSIONS</b>The combined therapy of triple puncture and electroacupuncture at trigger points achieves the better efficacy on primary trigeminal neuralgia as compared with the routine electroacupuncture therapy.</p>

Nasal resorption of prim-O-glucosylcimifugin and 5-O-methylvisammioside in rats / 中国中药杂志

In this experiment, rat nasal mucosa absorption characteristics of prim-O-glucosylcimifugin and 5-O-methylvisammioside were studied to provide a basis for drug delivery of Toutongning nasal spray. The nasal mucosa absorption test in rats was conducted with in situ nasal perfusion method after pH 6 buffer solution was used to prepare high, medium and low concentrations of prim-O-glucosylcimifugin, 5-O-methylvisammioside mixed solution as liquid circulation in nasal cavity. Then the concentrations of the circulating liquid compositions to be measured were determined by HPLC, and the absorption rates of prim-O-glucosylcimifugin and 5-O-methylvisammioside under different pH conditions were also investigated. According to the results, the absorption rate constant was (0.588±0.041)×10⁻³, (0.547±0.023)×10⁻³, (0.592±0.063)×10⁻³ min⁻¹ for prim-O-glucosylcimifugin high, middle and low concentrations, and (0.438±0.041)×10⁻³, (0.407±0.023)×10⁻³, and (0.412±0.063)×10⁻³ min⁻¹ for 5-O-methylvisammioside high, middle and low concentrations. There was no significant difference among high, middle and low concentration groups, and the absorption under pH 6 was better than that under other pH conditions. Therefore, we can get the conclusion that the main active ingredient of Toutongning nasal sprays can be absorbed through the nasal mucosa, and it is feasible to make nasal spray; in addition, pH 6 of nasal spray is scientific and reasonable.

Screen absorption enhancer for intranasal administration preparations of paeoniflorin based on nasal perfusion method in rats / 中国中药杂志

This experiment was aimed to screen the absorption enhancer for intranasal administration preparations of paeoniflorin. In this study, HPLC method for determination of paeoniflorin in perfusion liquid was established and the improved model of nasal perfusion in rats was used to screen out the species and amounts of absorption enhancer. In order to avoid the influence of the secretion and absorption of nasal cavity on the volume of perfusion fluid, the residual dose was calculated by using the volume correction method. Linear regression was carried out between the logarithm to the percentage of the residual dose and the corresponding time, and the slope of the regression line was exactly the absorption rate constant. Experimental results showed that hydroxypropyl-β-cyclodextrin and water-soluble azone can significantly improve the nasal absorption of paeoniflorin. Furthermore, water-soluble azone had the highest absorption rate constant and the best promoting penetration effect on intranasal administration preparations of paeoniflorin. It was also found that when the mass concentration of water-soluble azone in the perfusion liquid increased from 5 g•L⁻¹ to 20 g•L⁻¹, the absorption rate constant was gradually increased and peaked at 20 g•L⁻¹. When the mass concentration was increased to 30 g•L⁻¹, the absorption rate constant was decreased, indicating that the best mass concentration of water-soluble azone was 20 g•L⁻¹.

In vitro transdermal delivery of Qingfei Xiaocuo gel based on principal component analysis / 中国中药杂志

The objective of the present study was to establish a method based on principal component analysis (PCA) for the study of transdermal delivery of Chinese medicinal formulae, and to choose the best penetration enhancers for Qingfei Xiaocuo gel depend on this method. Using improved Franz type diffusion cell and excised rat skin in vitro as transdermal barrier, the receptive solution fingerprint was established by HPLC, harvesting the areas of the common peaks in the fingerprint, then the total factor scores of the concentrations at different times were calculated using PCA and were employed instead of the concentrations to compute the cumulative amounts (Q12) and enhancement ratio (ER), the latter of which were considered as the indexes for optimizing penetration enhancers. Compare to the control group, the ER of the other groups increased significantly and furthermore, 2.5% azone with 2.5% menthol manifested the best effect. PCA represent most information in the receptive solution, the method above could choose the best penetration enhancers, it could be a reference for the study of transdermal delivery of Chinese medicinal formulae.

Questionnaire investigation on cost-effectiveness analysis of acupuncture for migraine / 中国针灸

<p><b>OBJECTIVE</b>By using questionnaire method to understand the evaluation regarding cost-effectiveness of acupuncture for migraine in both doctors and patients.</p><p><b>METHODS</b>By using questionnaire method, questionnaires for doctors and patients were made respectively; by using network platform, two sets of questionnaires were publicly released, which were filled in online. The results were real-time background collected and then analyzed.</p><p><b>RESULTS</b>Totally 696 effective questionnaires for patients and 114 questionnaires for doctors were collected. The results indicated that (1)the direct cost (including treatment fee and material fee) for preventive treatment of migraine was 109 yuan per time in regular acupuncture, 152 yuan per time in regular acupuncture + electroacupuncture (EA) and 238 yuan per time in acupoint catgut embedding. The travelling expense was 42 yuan per time within the city and 193 yuan per time between cities. The indirect cost included cost for loss of working time (208 yuan per time), cost for treatment time (acupoint catgut embedding: 10 to 30 min per time, once one to three weeks; the remaining two treatments: 20 to 50 min per time, once to 5 times every week), time cost for arriving and departing hospital (1 to 3 hours per time within the city and 4 hours per time between cities). From the angle of treatment course, acupoint catgut embedding reduced the treatment frequency, leading to a lower total cost. (2)A mong the reasons to select different acupuncture methods to treat migraine, the results of patient questionnaire indicated that the focus in the patients who selected acupoint catgut embedding was different from that in the patients who selected two other treatments. The main advantage of acupoint catgut embedding was superior and lasting efficacy with low cost. The results of doctor questionnaire indicated the main reason to select acupoint catgut embedding was "lasting efficacy after single treatment" (87. 5%) and "lower frequency of treatment" (75. 0%). (3) The main reason to obstruct the popularization of acupoint catgut embedding was this method was not widely known.</p><p><b>CONCLUSION</b>The acupoint catgut embedding is one ideal preventive treatment for migraine, which has higher cost-effectiveness, however, currently it is not widely applied. In future advertisement and training program should be strengthened to perform targeted popularization of acupoint catgut embedding for migraine.</p>

Transurethral enucleation plus pneumo-cystostomy rotary cut for large benign prostatic hyperplasia / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the feasibility, effectiveness and practicability of transurethral enucleation plus pneumocystostomy rotary cut (TUE + PCRC) for large benign prostatic hyperplasia (BPH).</p><p><b>METHODS</b>We performed TUE + PCRC for 26 BPH patients aged 62 - 85 years with the prostate volume of 80 - 165 ml. We conducted transurethral enucleation of the hyperplastic prostate glands and pushed them into the bladder, followed by bladder puncture for pneumo-cystostomy rotary cut.</p><p><b>RESULTS</b>All the surgical procedures were successfully accomplished, with the mean surgical time of 41 (32 - 54) minutes and intraoperative blood loss < 60 ml in all the cases. Twenty-three of the patients were followed up for 2 - 8 months, which revealed no stricture of the urethra or any other severe complications. Compared with the preoperative baseline, significant improvement was achieved in the IPSS (6.5 +/- 2.2 vs 26.2 +/- 2.4), QOL (1.4 +/- 0.9 vs 4.6 +/- 1.2) and Qmax ([5.8 +/- 1.0 ] vs [19.6 +/- 2.8] ml/s) of the patients after surgery (P < 0.01).</p><p><b>CONCLUSION</b>TUE + PCRC, with its advantages of short operation time and less severe complications, is a safe and effective approach to the management of large BPH.</p>

Enantioselective hydrolysis of epichlorohydrin using whole Aspergillus niger ZJB-09173 cells in organic solvents.

The enantioselective hydrolysis of racemic epichlorohydrin for the production of enantiopure (S)-epichlorohydrin using whole cells of Aspergillus niger ZJB-09173 in organic solvents was investigated. Cyclohexane was used as the reaction medium based on the excellent enantioselectivity of epoxide hydrolase from A. niger ZJB- 09173 in cyclohexane. However, cyclohexane had a negative effect on the stability of epoxide hydrolase from A. niger ZJB-09173. In the cyclohexane medium, substrate inhibition, rather than product inhibition of catalysis, was observed in the hydrolysis of racemic epichlorohydrin using A. niger ZJB-09173. The racemic epichlorohydrin concentration was markedly increased by continuous feeding of substrate without significant decline of the yield. Ultimately, 18.5% of (S)-epichlorohydrin with 98% enantiomeric excess from 153.6 mM of racemic epichlorohydrin was obtained by the dry cells of A. niger ZJB-09173, which was the highest substrate concentration in the production of enantiopure (S)-epichlorohydrin by epoxide hydrolases using an organic solvent medium among the known reports.