The Effect of Traditional Chinese Exercises on Blood Pressure in Patients with Hypertension: A Systematic Review and Meta-Analysis.

In the context of the increasing number of patients with hypertension, exercise intervention is an excellent alternative or adjunctive treatment for hypertension. Traditional Chinese exercises are excellent physical and mental exercise methods. Although some studies have reviewed the effects of Chinese traditional exercise on patients with hypertension, most of the reviews only involved a single category of traditional exercise. Furthermore, few studies have conducted in-depth analysis of the combined intervention methods of traditional Chinese exercise, and there are high heterogeneity. This study evaluates the current clinical evidence of Chinese traditional exercises in the treatment of essential hypertension. A total of 49 randomized controlled trials with 4207 hypertensive patients were selected according to the inclusion criteria by searching all relevant studies from the establishment of six electronic databases until September 10, 2022. Among them, 24 used tai chi and 25 used Qigong, including Yijinjing, Wuqinxi, Liuzijue, Baduanjin, and Guolin Qigong. This study divided four subgroups according to the type of intervention to explore the source of heterogeneity among studies and found that traditional Chinese exercises can assist or even may replace traditional treatments. The results of meta-analysis showed that compared with the use of antihypertensive drugs alone or in health education, the addition of Chinese traditional exercises showed significant effects in regulating the systolic blood pressure and diastolic blood pressure in hypertensive patients. Although the results show that traditional Chinese exercise are effective, the clinical evidence will be affected by the low quality of most randomized controlled trials. More rigorously designed trials are needed in the future to further validate it.

Safety and efficacy of acupuncture for the treatment of chronic obstructive pulmonary disease: A systematic review protocol.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a common chronic respiratory disease with increasing morbidity and mortality that cause huge social and economic loss. Although recommended by guidelines, pulmonary rehabilitation has not been widely applied in clinics because of its inherent limitations. Acupuncture therapy (AT) as one of the most popular treatments in traditional Chinese medicine has been used to treat COPD. We aim to evaluate the safety and efficacy of acupuncture in the treatment of COPD. METHODS: Web of science, PubMed, Springer, Medline, Cochrane Library, EBASE, WHO International Clinical Trials Registry Platform (ICTRP), China National Knowledge Infrastructure Database (CNKI), Wan Fang Database, Chinese Scientific Journal Database (VIP), and Chinese Biomedical Literature Database will be searched from their inception to May 10, 2019. Randomized controlled trials that evaluated the safety and efficacy of acupuncture for the treatment on patients with COPD will be included. The primary outcome measures will include Dyspnea scores, lung function and blood eosinophils. The secondary outcome measures will include St George's Respiratory Questionnaire and 6-minute walk distance. Study selection, data extraction, and risk of bias assessment will be independently undertaken, respectively. Statistical analysis will be conducted by RevMan software (version 5.3). RESULTS: This study will provide high-quality synthesis based on current evidence of acupuncture treatment for COPD in several aspects, including symptom score, quality of life score, side effects and laboratory examination, such as lung function text, blood eosinophils (EOS) etc. CONCLUSION:: The results of this study will provide updated evidence for weather acupuncture is an effective and safe intervention for COPD. ETHICS AND DISSEMINATION: It is not necessary for this systematic review to acquire an ethical approval. This review will be disseminated in a peer-reviewed journal or conference presentation. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42019136087.

Efficacy and safety of Chinese medicines for asthma: A systematic review protocol.

BACKGROUND: Asthma is a complex disease associated with many factors such as immunologic, environmental, genetic, and other factors. Common medicines used to treat asthma include ß-agonist and glucocorticoid. However, in the long-term treatment, the effect of the above-mentioned drugs is not satisfactory, so many patients choose oral Chinese medicines instead of western medicines. The introduction of Chinese medicines therapies, a rapid proliferation of the literature on management of asthma in general, call for novel ways of evidence synthesis in this area. This systematic review is to systematically summarize and evaluate a large number of evidences for Chinese herbal interventions for asthma. Evaluate the efficacy and safety of Chinese medicines in the treatment of asthma and inform a decision aid for the clinical encounter between patients and clinicians. In addition, it helps to establish a future research agenda. METHODS: Five English databases (PubMed, Web of science, EBASE, Springer Cochrane Library, and WHO International Clinical Trials Registry Platform) and 4 Chinese databases (Wanfang Database, Chinese Scientific Journal Database, China National Knowledge Infrastructure Database, and Chinese Biomedical Literature Database) will be searched normatively according to the rule of each database from the inception to the present. The literature screening, data extraction, and quality assessment will be conducted by 2 researchers independently. Data will be synthesized by either the fixed-effects or random-effects model according to a heterogeneity test. Asthma control test symptom score will be assessed as the primary outcome. The curative effect of single symptom and sign; Withdrawal and reduction of western medicines in a course of treatment, including: time, type, and quantity; Maintenance of western medicines after the course of treatment, including: type, quantity; Asthma Quality of Life Questionnaire; laboratory efficacy indexes as the secondary outcome. General physical examination; routine examination of blood, urine, and stool; electrocardiogram; liver and kidney function examination; possible adverse reactions and related detection indicators as the security indexes. Meta-analysis will be performed using RevMan5.3.5 software provided by the Cochrane Collaboration. RESULTS: This study will provide high-quality synthesis based on current evidence of Chinese medicines treatment for asthma in several aspects, including asthma control score, side effects and laboratory examination such as lung-function test, serum total immunoglobulin, and so on. CONCLUSION: The results of this study will provide updated evidence for whether Chinese medicines is an effective and safe intervention for asthma. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42019136074.

Tai Chi for the treatment of chronic obstructive pulmonary disease: A systematic review protocol.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a common chronic respiratory disease with increasing morbidity and mortality that cause huge social and economic loss. Although recommended by guidelines, pulmonary rehabilitation has not been widely applied in clinics because of its inherent limitations. Free from restrictions of specific training venues and equipment, Tai Chi, as a kind of pulmonary rehabilitation, has been used to cure the COPD, yet the efficacy and safety of Tai Chi remains to be assessed. In this study, we aim to draw up a protocol for systematic review to evaluate the efficacy and safety of Tai Chi for COPD. METHODS: We will search the following electronic databases from inception to December 31, 2018: PubMed, Web of Science, Medline, Cochrane Central Register of Controlled Trials, Springer, EMBASE, the China National Knowledge Infrastructure Database, Wan Fang Database, the Chinese Scientific Journal Database, and Chinese Biomedical Literature Database. Clinical trial registrations, potential gray literatures, relevant conference abstracts and reference list of identified studies will also be searched. The literature selection, data extraction, and quality assessment will be completed by 2 independent authors. Either the fixed-effects or random-effects model will be used for data synthesis based on the heterogeneity test. Changes in lung function will be evaluated as the primary outcome. Symptom assessment, quality of life (SGRQ), medication usage, exacerbations, and adverse events will be assessed as the secondary outcomes. The RevMan V.5.3.5 will be used for Meta-analysis. RESULTS: This study will provide a synthesis of current evidence of Tai Chi for COPD from several aspects, such as lung function, SGRQ, medication usage, exacerbations, and adverse events. CONCLUSION: The conclusion of our study will provide updated evidence to judge whether Tai Chi is an effective solution to COPD patients. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42019122791.

Acupuncture for the treatment of allergic rhinitis: A systematic review protocol.

BACKGROUND: Allergic rhinitis is a major chronic inflammatory disease of the respiratory tract. A large number of epidemiological investigations have shown that the prevalence of allergic rhinitis (AR) is increasing, resulting in a large burden of disease. Desensitizing drugs such as nasal glucocorticoids and antihistamines are commonly used to treat allergic rhinitis, but this method has a long treatment period and is prone to repeated attacks, and there are certain adverse reactions. Acupuncture can be used to treat a wide variety of diseases including allergic rhinitis without the occurrence of drug damage. We aim to evaluate the efficacy and safety of acupuncture in the treatment of allergic rhinitis. METHODS: Relevant databases include the English databases incorporating Web of science, PubMed, Springer, Medline, Cochrane Library, EBASE, WHO International Clinical Trials Registry Platform (ICTRP), as well as the Chinese databases like the China National Knowledge Infrastructure Database (CNKI), Chinese Scientific Journal Database (VIP), Wanfang Database, and Chinese Biomedical Literature Database will be searched normatively according to the rule of each database from the inception to September 1, 2018. Reference list of identified studies, potential gray literatures, relevant conference abstracts, and clinical trial registrations will also be searched. The literature screening, data extraction, and quality assessment will be conducted by 2 researchers independently. Data will be synthesized by either the fixed-effects or random-effects model according to a heterogeneity test. Symptom score will be assessed as the primary outcome. Rhinoconjunctivitis quality of life questionnaire (RQLQ), participants with asthma can use asthma control test (ACT), medicine usage and scoring, laboratory examination, and side effects or adverse events will be evaluated as the secondary outcome. Meta-analysis will be performed using RevMan5.3.5 software provided by the Cochrane Collaboration. RESULTS: This study will provide high-quality synthesis based on current evidence of acupuncture treatment for allergic rhinitis in several aspects, including symptom score, drug score, quality of life score, asthma control score, side effects and laboratory examination such as nasal function test, serum total immunoglobulin (IgE), nasal secretion smear, etc. CONCLUSION:: The results of this study will provide updated evidence for weather acupuncture is an effective and safe intervention for allergic rhinitis. ETHICS AND DISSEMINATION: It is not necessary for this systematic review to acquire an ethical approval. This review will be disseminated in a peer-reviewed journal or conference presentation. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42018109105.

Wentong decoction cures allergic bronchial asthma by regulating the apoptosis imbalance of EOS.

BACKGROUND: Eosinophils (EOS) is one of the most important cells involved in the pathogenesis of chronic airway inflammation in asthma, and its apoptosis is part of the mechanisms of asthma. Therefore, this study aimed to observe the effect of Chinese medicine Wentong decoction (WTD) in EOS apoptosis in asthmatic rats. This work also explored the mechanism of WTD regulation in EOS apoptosis and provided a new target for clinical treatment of asthma. METHODS: Asthmatic rats induced by ovalbumin were treated with WTD. Lung function of rats in each group was detected, and lung tissue pathology, EOS counts in blood and bronchoalveolar lavage fluid were observed. The degree of the EOS apoptosis in rats was detected. The expression content of interleukin (IL)-5, IL-10, chemokine (C-C motif) ligand 5 (CCL5), granulocyte-macrophage colony-stimulating factor (GM-CSF), transforming growth factor beta 1 (TGF-ß1), interferon (IFN)-γ, and other cytokines in rat serum and the genes of Eotaxin mRNA, Fas mRNA, FasL mRNA, Fas/FasL and Bcl-2 mRNA in the lung tissues were determined. RESULTS: WTD can reduced airway resistance in rat models and improved airway compliance. The pathological changes of lung tissue in WTD group were significantly alleviated, at the same time, WTD could reduce the EOS count in the blood and BALF smears of the asthmatic model rats. Compared with the model group, the apoptosis degree of EOS significantly increased in rats in the WTD group. The expression of IL-5, CCL5, and GM-CSF in the serum and the expression of Eotaxin mRNA, Bcl-2 mRNA in the lung tissues in rats in the WTD group rats decreased. Moreover, the expression of IL-10, TGF-ß1, and IFN-γ in the serum and the expression of Fas mRNA, FasL mRNA in the lung tissues in rats in the WTD group rats increased compared with that in rats in the model group. CONCLUSIONS: Wentong decoction may accelerate EOS apoptosis, reduce asthma inflammation, and alleviate the disease through regulating and controlling the factors related to the anti-apoptosis and pro-apoptosis.

Recuperating lung decoction attenuates inflammation and oxidation in cigarette smoke-induced COPD in rats via activation of ERK and Nrf2 pathways.

Oxidative/antioxidative imbalance and chronic inflammation are the main contributors to the pathogenesis of chronic obstructive pulmonary disease (COPD). This study evaluated the effect of recuperating lung decoction (RLD) on inflammation and oxidative stress in rats with COPD induced by cigarette smoke and lipopolysaccharides (LPS). We used intravenous infusion of LPS combined with cigarette smoke exposure as a COPD rat model. We observed that RLD treatment increased the protein level of GSH and the ratio of GSH/GSSG but decreased 8-OHdG and 4-HNE in the serum. Furthermore, RLD significantly inhibited the expressions of IL-1ß, IL-6, TNF-α, and TGF-ß induced by cigarette smoke exposure, reduced the number of inflammatory cells in the bronchoalveolar lavage fluid, and alleviated the severity of cigarette smoke-induced emphysema. Mechanistically, RLD treatment prevented disease through downregulation of phosphorylated-ERK and Nrf2 expression, which regulates the production of proinflammatory cytokines. RLD treatment exerted a dramatic therapeutic effect on COPD. This study revealed a mechanism that RLD functions on the regulation of ERK signalling to inhibit inflammation.

Acupuncture for asthma: Protocol for a systematic review.

BACKGROUND: Asthma is a common chronic disease in both adults and children. Inhaled corticosteroids (ICS) and ß2-agonists are the major medications treating asthma with many side effects. Acupuncture has been used in many diseases including asthma. We aim to assess the efficacy and safety of acupuncture for asthma. METHODS: The following electronical databases will be searched from inception to January 1, 2017: Medline, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), SinoMed, the China National Knowledge Infrastructure Database (CNKI), the Chinese Scientific Journal Database (VIP database), and the Wanfang database. We will also search reference lists of identified studies, potential gray literatures, relevant conference abstracts, and registers of clinical trials. Two reviewers will independently undertake study selection, data extraction, and quality assessment. Data will be synthesized by either the fixed-effects or random-effects model according to a heterogeneity test. Changes in lung function will be assessed as the primary outcome. The level of control, medication usage, quality of life, exacerbations, symptoms, adverse events will be evaluated as the secondary outcomes. The RevMan V.5.3.5 will be employed for meta-analysis. Continuous outcomes will be presented as mean difference or standard mean difference, while dichotomous data will be expressed as relative risk. RESULTS: This study will provide a high-quality synthesis of current evidence of acupuncture for asthma from several aspects including lung function, the level of control, medication usage, quality of life, exacerbations, symptoms and adverse events. CONCLUSION: The conclusion of our study will provide updated evidence to judge whether acupuncture is an effective intervention for children with asthma. ETHICS AND DISSEMINATION: It is not necessary for ethical approval because individuals cannot be identified. The protocol will be disseminated in a peer-reviewed journal or presented at a relevant conference. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42017054562.

Recuperating Lung Decoction Attenuates the Oxidative Stress State of Chronic Obstructive Pulmonary Disease by Inhibiting the MAPK/AP-1 Signal Pathway and Regulating γ-GCS.

Purpose/Objective. To evaluate the effects of Recuperating Lung Decoction (RLD) on the indices of oxidative stress in a rat model of COPD and detect the indices of the MAPK/AP-1/γ-GCS signal pathway for a further survey of the possible targeting site of RLD. Methods/Materials. The rats of COPD were treated with RLD. The protein levels of glutathione (GSH), oxidized glutathione (GSSG), 8-hydroxy-2-deoxyguanosine (8-OHdG), and 4-hydroxynonenal (4-HNE) were measured. In addition, the levels of key signaling molecules (extracellular signal-regulated kinases [ERK], the c-jun N-terminal kinase [JNKs signal pathway], and p38 MAP kinase [p38MAPK], AP-1 proteins [C-fos, C-jun], and γ-glutamyl-cysteine synthetase [γ-GCS-h]) of the MAPK/AP-1/γ-GCS-h signal pathway were assessed. Results. After treatment, the protein level of GSH and the ratio of GSH/GSSG were increased and the amounts of 8-OHdG and 4-HNE were decreased significantly in lung tissues when compared with the nontreated COPD group. Further results showed that the RLD could effectively inhibit the MAPK pathway by inactivation of p38MAPK and ERK and could also downregulate the AP-1 and the γ-GCS-h genes expressions in both protein and mRNA levels. Conclusion. RLD might improve the state of oxidative stress by downregulation of the expression of γ-GCS-h gene by inhibition of the MAPK/AP-1 pathway, thereafter enhancing the ability of antioxidation in COPD.

The potential role of 'Candidatus Microthrix parvicella' in phosphorus removal during sludge bulking in two full-scale enhanced biological phosphorus removal plants.

We investigated the bacterial community compositions and phosphorus removal performance under sludge bulking and non-bulking conditions in two biological wastewater treatment systems (conventional A²/O (anaerobic/anoxic/aerobic) and inverted A²/O (anoxic/anaerobic/aerobic) processes) receiving the same raw wastewater. Sludge bulking resulted in significant shift in bacterial compositions from Proteobacteria dominance to Actinobacteria dominance, characterized by the significant presence of filamentous 'Candidatus Microthrix parvicella'. Quantitative real-time polymerase chain reaction (PCR) analysis revealed that the relative abundance of 'Candidatus Accumulibacter phosphatis', a key polyphosphate-accumulating organism responsible for phosphorus removal, with respect to 16s rRNA genes of total bacteria was 0.8 and 0.7%, respectively, for the conventional and inverted A²/O systems when sludge bulking occurred, which increased to 8.2 and 12.3% during the non-bulking period. However, the total phosphorus removal performance during the bulking period (2-week average: 97 ± 1 and 96 ± 1%, respectively) was not adversely affected comparable to that during the non-bulking period (2-week average: 96 ± 1 and 96 ± 1%, respectively). Neisser staining revealed the presence of large polyphosphate granules in 'Candidatus Microthrix parvicella', suggesting that this microbial group might have been responsible for phosphorus removal during the sludge bulking period when 'Candidatus Accumulibacter phosphatis' was excluded from the systems.

Dynamics of the microfauna community in a full-scale municipal wastewater treatment plant experiencing sludge bulking.

We investigated the dynamics of the microfauna community in activated sludge, with special reference to sludge bulking, in two parallel municipal wastewater treatment systems in Beijing, China over a period of 14 months. Annual cyclic changes in microfauna community structures occurred in both systems. RELATE analysis based on Spearman's Rank correlation indicated that microfauna community structures were highly correlated with the sludge volume index (SVI) (p<0.001), which indicates sludge settleability. Nutrient conditions of raw sewage (p<0.01) and hydraulic retention time (HRT) (p<0.05) were also related to microfauna community structures. Abundances of the species Epistylis plicatilis and Vorticella striata increased significantly with an increase in SVI (p<0.001) and decrease in water temperature (p<0.001), suggesting that sludge bulking may have created favorable conditions for the two species, even under unfavorable temperature conditions. Sludge de-flocculation primarily due to the excessive growth of Microthrix parvicella-like filaments could be an important driving force for the microfauna community changes. The release of flocculated non-filamentous bacteria may represent a suitable food source for these species. The two species may be considered as potential bioindicators for sludge bulking.