Blood-Letting Therapy for Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials / 中国结合医学杂志

OBJECTIVE@#To evaluate the efficacy and safety of blood-letting therapy (BLT) in treatment of hypertension.@*METHODS@#A comprehensive electronic and manual bibliographic searches were performed in Cochrane Central Register of Controlled Trials, Excerpt Medica Database (EMBASE), PubMed, China National Knowledge Infrastructure, Chinese Scientific Journal Database, Chinese Biomedical Literature Database, and Wanfang Database to identify randomized controlled trials (RCTs) in which hypertensive patients were treated with BLT or BLT plus antihypertensive drugs (BPAD) against placebo, no treatment or antihypertensive drugs. The Cochrane Risk Assessment Tool was used to assess the methodological quality of trials. The Review Manager 5.3 software was used for meta-analysis.@*RESULTS@#A total of 7 RCTs with 637 hypertensive patients from 1989 to 2017 were identified. Compared with antihypertensive drugs, blood pressure was significantly reduced by BLT (RR=1.21, 95% CI: 1.01 to 1.44, P=0.03; heterogeneity: P=0.06, I=60%) and BPAD (RR=1.25, 95% CI, 1.02 to 1.53, P=0.03; heterogeneity: P= 0.01, I=71%). Moreover, a significant improvement in Chinese medicine syndrome by BLT (RR=1.32; 95% CI: 1.14 to 1.53, P=0.0002; heterogeneity: P=0.53, I=0%) and BPAD (RR=1.47; 95% CI: 1.06 to 2.04, P=0.02; heterogeneity: P=0.13, I=56%) was identified. The reported adverse effects were well tolerated.@*CONCLUSION@#Although some positive findings were identified, no definite conclusions regarding the efficacy and safety of BLT as complementary and alternative approach for treatment of hypertension could be drew due to the generally poor methodological design, significant heterogeneity, and insufficient clinical data. Further rigorously designed trials are warranted to confirm the results.

Therapeutic Observation of Bai Xiao Moxibustion plus Electroacupuncture for Lumbar Intervertebral Disc Herniation / 上海针灸杂志

Objective To observe the clinical efficacy of Bai Xiao moxibustion plus electroacupuncture in treating lumbar intervertebral disc herniation (LIDH). Method Ninety-six LIDH patients were randomized into a treatment group and a control group, 48 cases each. The treatment group was intervened by Bai Xiao moxibustion plus electroacupuncture, while the control group was intervened by electroacupuncture alone. Before and after the treatment, the lower back pain scores of Japanese Orthopedic Association (JOA) and Visual Analogue Scale (VAS) were evaluated, and the clinical efficacies of the two groups were compared. Result The JOA and VAS lower back pain scores were changed significantly after the treatment in both groups (P<0.05). After the treatment, the JOA and VAS lower back pain scores of the treatment group were significantly different from those of the control group (P<0.05). The pain release time was (2.95±0.59)d after the intervention in the treatment group versus (4.26±0.68)d in the control group, and the between-group difference was statistically significant (P<0.05). The total effective rate was 95.7％ in the treatment group versus 91.7％ in the control group, and the between-group difference was statistically significant (P<0.05). Conclusion Bai Xiao moxibustion plus electroacupuncture is an effective method in treating LIDH and it can reduce the lower back pain.

Activation of necroptosis in a rat model of acute respiratory distress syndrome induced by oleic acid / 生理学报

The present study was aimed to investigate the role of necroptosis in the pathogenesis of acute respiratory distress syndrome (ARDS). The rat model of ARDS was induced by intravenous injection of oleic acid (OA), and observed for 4 h. The lung injury was evaluated by arterial blood gas, lung wet-dry weight ratio (W/D) and histological analyses. Simultaneously, bronchoalveolar lavage fluid (BALF) was collected for total and differential cell analysis and total protein determination. Tumor necrosis factor alpha (TNF-α) level in BALF was determined with a rat TNF-α ELISA kit. Expressions of receptor interacting protein kinase 1 (RIPK1), RIPK3 and mixed lineage kinase domain-like protein (MLKL) in lung tissue were determined by Western blot and immunohistochemical staining. The interaction between RIPK1 and RIPK3 was explored by immunoprecipitation. The results showed that, compared with those in control group, total white blood cells count (WBC), polymorphonuclear percentage (PMN%), total protein concentration, TNF-α level in BALF, W/D, and the alveolar-arterial oxygen tension difference (P(A-a)O) in OA group were significantly increased at 4 h after OA injection. Western blot and immunostaining further showed remarkably increased expressions of RIPK1, RIPK3 and MLKL in lung tissue from OA group. Additionally, immunoprecipitation results indicated an enforced interaction between RIPK1 and RIPK3 in OA group. Collectively, the TNF-α level in BALF and the RIPK1-RIPK3-MLKL signaling pathway in lung tissue were found to be upregulated and activated with the process of ARDS. These findings implicate that RIPK1/RIPK3-mediated necroptosis plays a possible role in the pathogenesis of ARDS, which may provide a new idea to develop novel drugs for the therapy of ARDS.