Association between relative muscle strength and hypertension in middle-aged and older Chinese adults.

BACKGROUND: The association between muscle defects and hypertension is well-established. However, the absence of pertinent and uncomplicated clinical indicators presents a challenge. Relative muscle strength (RMS) may offer a viable indicator. This study aimed to explore the association between RMS and hypertension. METHODS: A total of 12,720 individuals aged ≥ 45 years from the 2011 wave of the China Health and Retirement Longitudinal Study (CHARLS) were included. Grip strength was recorded and appendicular skeletal muscle mass (ASM) was estimated using a validated mathematical formula. The RMS was calculated as the ratio of grip strength to ASM. Hypertension was determined based on previous diagnosis, history of hypertension medication use, and current blood pressure. Logistic regression models were employed to investigate the relationship between RMS and hypertension. RESULTS: The prevalence of hypertension was 41.7% (5,307/12,720 patients). RMS was negatively correlated with hypertension with an OR (95% CI) of 0.68 (0.59-0.79) for males, 0.81 (0.73-0.90) for females, and 0.78 (0.72-0.85) for the entire population after adjusting for related covariates including age, education, marital history, smoking history, drinking history, diabetes, hyperlipidemia, and obesity. The trend test showed a linear association among males, females, or the entire population. Stratified analysis showed a consistent negative correlation between RMS and hypertension. CONCLUSIONS: Higher RMS is an independent protective factor against hypertension and efforts to promote RMS may be beneficial for the prevention and management of hypertension.

Neuroprotective Effects of Electroacupuncture Preventive Treatment in Senescence-Accelerated Mouse Prone 8 Mice.

OBJECTIVE: To investigate the preventive treatment effects of electroacupuncture (EA) on cognitive changes and brain damage in senescence-accelerated mouse prone 8 (SAMP8) mice. METHODS: The 5-month-old male SAMP8 and age-matched homologous normal aging mice (SAMR1) were adopted in this study. EA stimulation at Baihui (GV 20) and Yintang (EX-HN 3) was performed every other day for 12 weeks, 4 weeks as a course. Morris water maze test and Nissl-stained with cresyl violet were used for cognitive impairments evaluation and brain morphometric analysis. Amyloid-ß (A ß) expression in hippocampus and parietal cortex was detected by immunohistochemistry, and apoptosis was observed by TUNEL staining. RESULTS: After 3 courses of EA preventive treatment, the escape latencies of 8-month-old SAMP8 mice in EA group were significantly shortened than those of un-pretreated SAMP8 mice. Compared with SAMR1 mice, extensive neuronal changes were visualized in the CA1 area of hippocampus in SAMP8 mice, while these pathological changes and attenuate cell loss in hippocampal CA1 area of SAMP8 mice markedly reduced after EA preventive treatment. Furthermore, A ß expression in hippocampus and parietal cortex of SAMP8 mice decreased significantly after EA treatment, and neuronal apoptosis decreased as well. CONCLUSION: EA preventive treatment at GV 20 and EX-HN 3 might improve cognitive deficits and neuropathological changes in SAMP8 mice, which might be, at least in part, due to the effects of reducing brain neuronal damage, decreasing neuronal apoptosis and inhibiting A ß-containing aggregates.

Use acupuncture to treat functional constipation: study protocol for a randomized controlled trial.

BACKGROUND: Whether acupuncture is effective for patients with functional constipation is still unclear. Therefore, we report the protocol of a randomized controlled trial of using acupuncture to treat functional constipation. DESIGN: A randomized, controlled, four-arm design, large-scale trial is currently undergoing in China. Seven hundred participants are randomly assigned to three acupuncture treatment groups and Mosapride Citrate control group in a 1:1:1:1 ratio. Participants in acupuncture groups receive 16 sessions of acupuncture treatment, and are followed up for a period of 9 weeks after randomization. The acupuncture groups are: (1) Back-Shu and Front-Mu acupoints of Large Intestine meridians (Shu-Mu points group); (2) He-Sea and Lower He-Sea acupoints of Large Intestine meridians (He points group); (3) Combining used Back-Shu, Front-Mu, He-Sea, and Lower He-Sea acupoints of Large Intestine meridians (Shu-Mu-He points group). The control group is Mosapride Citrate group. The primary outcome is frequency of defecation per week at the fourth week after randomization. The secondary outcomes include Bristol stool scale, the extent of difficulty during defecating, MOS 36-item Short Form health survey (SF-36), Self-Rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS). The first two of second outcomes are measured 1 week before randomization and 2, 4, and 8 weeks after randomization. Other second outcomes are measured 1 week before randomization and 2 and 4 weeks after randomization, but SF-36 is measured at randomization and 4 weeks after randomization. DISCUSSION: The result of this trial (which will be available in 2012) will confirm whether acupuncture is effective to treat functional constipation and whether traditional acupuncture theories play an important role in it. TRIALS REGISTRATION: Clinical Trials.gov NCT01411501.

[Thinking on methodologies and problems existed in clinical study of acupuncture and moxibustion].

The modernization and internationalization of acupuncture and moxibustion is inevitable trends to develop acupuncture and moxibustion. However, the acupuncture research findings in China are not accepted by the mainstream medicine abroad. The major problems are that the study purposes are not specific and the modern scientific research methods are not rationally used in acupuncture clinical study. Two major issues in acupuncture clinical study in China are the evaluation of the specificity of acupuncture and the overall effect of acupuncture treatment. The core and basis of acupuncture clinical study are the clarity of study purpose, following the law of evidence-based medicine and rational selection of modern scientific methods. On the basis of the characteristics of acupuncture and the specialty of acupuncture clinical study, for instance, the types of trial design, blind methods, the selection of control group and outcome assessment system, the objective of this paper provides research strategies for researchers and to improve the overall level of research in the acupuncture clinical study.

[Differences in thinking model of treatment based syndrome differentiation between acu-moxibustion and internal medicine of TCM].

The founding of clinical syndrome differentiation treatment system for acu-moxibustion is an important issue for the development of clinical acupuncture practices, and it has attracted extensive attention in the domestic and overseas circles in acu-moxibustion field. At present, the syndrome differentiation treatment system of internal medicine of TCM is literally carried out in clinical acu-moxibustion practices, syndrome differentiation according to zang-fu is used instead of syndrome differentiation according to meridian, hence, it is difficult to reflect the features and advantages of acupuncture and moxibustion. Although the goals of acu-moxibustion and Chinese herbal medicine treatments are consistent, but the methods and approaches of the treatment are different. Therefore, the syndrome differentiation treatment system are not in concordance. Acu-moxibustion has gradually established unique thinking model of treatment based syndrome differentiation including principle, methods, prescription, points and technique which are different from principle, methods, prescription and drugs of internal medicine of TCM.

[Influence of electroacupuncture of meridian acupoints on the related hormones of the hypothalamus-pituitary-adrenal axis in rats with cerebral ischemia reperfusion injury].

OBJECTIVE: To observe the effect of electroacupuncture (EA) on the related hormones of the hypothalamus-pituitary-adrenal (HPA) axis in rats with cerebral ischemia-reperfusion injury (CI-RI). METHODS: Ninety Wistar rats were randomly divided into normal control, sham-operation (sham), model, EA acupoint and EA non-acupoint groups. CI-RI model was established by using modified middle cerebral artery occlusion (MCAO) and reperfusion. These rats were further divided into 1 day (d), 3 d and 7 d subgroups, with 6 cases in each. EA (1 mA, 2 Hz/30 Hz) was applied to acupoint "Zusanli" (ST 36) and "Quchi" (LI 11), and non-acupoints (5 mm lateral to ST 36 and 5 mm apart from LI 11 on the radial side respectively) for 30 min, once daily for 1 d, 3 d and 7 d separately. Serum cortisole (CORT) content was assayed by enzyme linked immunosorbent assay (ELISA), and the expression of hypothalamic adrenocorticotropic releasing factor (CRF) mRNA and glucocorticoid receptor (GR) mRNA, and pituitary adrenocorticotrophic hormone (ACTH) mRNA was assayed by reverse transcription polymerase chain reaction (RT-PCR) method. RESULTS: Compared with normal and sham groups, serum CORT levels of model and EA non-acupoint groups on the 1st, 3rd and 7th day increased significantly (P < 0.05), while compared with model groups, serum CORT level of EA acupoint groups decreased apparently (P < 0.05). Compared with normal and sham groups, hypothalamic CRF mRNA and pituitary ACTH mRNA expression of model groups were upregulated significantly on the 1st, 3rd and 7th d after CI-RI (P < 0.01, P < 0.05), and hypothalamic GR mRNA expression of model groups were obviously downregulated (P < 0.01, P < 0.05). In comparison with model groups, hypothalamic CRF mRNA and pituitary ACTH mRNA expression of EA acupoint groups at the 3 time-points, and their expression of EA non-acupoint groups on the 1st and 3rd day were remarkably downregulated (P < 0.01, P < 0.05), and hypothalamic GR mRNA expression of EA acupoint groups was upregulated significantly at the 3 time-points (P < 0.01, P < 0.05). Comparison between EA acupoint and EA non-acupoint groups showed that the effect of EA acupoint groups was obviously superior to that of EA non-acupoint groups in downregulating CRF mRNA and ACTH mRNA expression and in upregulating GR mRNA expression at the 3 time-points (P < 0.01, P < 0.05). CONCLUSION: EA of meridian-acupoints can effectively downregulate serum CORT content, hypothalamic CRF mRNA and pituitary ACTH mRNA expression and upregulate hypothalamic GR mRNA expression in CI-RI rats, which may contribute to its effect in relieving CI-RI.

[A preliminary study on the early diagnosis of sinus dysfunction in patients with obstructive sleep apnea syndrome].

OBJECTIVES: To observe the characteristics of sinus dysfunction (SD) in patients with obstructive sleep apnea syndrome (OSAHS) and to explore the method for early detection of SD in these patients. METHODS: From January 2007 to June 2008, 119 snorers were recruited. All of them underwent polysomnography (PSG) examination and received atropine test under ultramicroelectrocardiogram (UMECG). Based on the results of atropine test, they were divided into 2 groups: the UMECG group (n = 78) including subjects diagnosed as having SD by a positive result of atropine test with UMECG, and the non-UMECG group (n = 41) including subjects with a negative result of atropine test. Comparison was made for the incidence of OSAHS between the 2 groups and the diagnostic sensitivities for SD between UMECG and PSG electrocardiogram (SD(PSG)). The association was also observed between PSG parameters and SD(PSG). RESULTS: The incidence of OSAHS in the non-UMECG group was significantly higher than that in the UMECG group (31% vs 55%, P < 0.05). SD(PSG) was not detected in the non-UMECG group. In the UMECG group, SD(PSG)/UMECG was 26/43 (60%) in the OSAHS subjects and 29/35 (83%) in the non-OSAHS subjects (P < 0.05). Of the OSAHS subjects in the UMECG group, SD(PSG)/UMECG was 10/20 (50%) in the mild to moderate OSAHS subjects and 16/23 (70%) in the severe OSAHS subjects (P < 0.05). Compared with the OSAHS subjects with UMECG but without SD(PSG), the average duration of apnea events as well as the longest apnea event were prolonged while the minimal SaO2 was lower in those OSAHS patients with SD(PSG). Among all of the 17 OSAHS subjects with SD(UMECG) but with out SD(PSG), there were 13 subjects (76%) with a fastest sinus heart rate slower than 90 beats/min even though they also had hypoxemia during sleep. CONCLUSIONS: SD was associated with OSAHS. The actual incidence of SD may be underestimated by PSG only, especially in those with mild to moderate OSAHS. SD should be suspected in OSAHS patients whose fastest sinus rate is lower than 90 beats/min in spite of hypoxemia. UMECG was more sensitive for early detection of SD.

[Clinical study on acupuncture combined with rehabilitation therapy for treatment of poststroke shoulder-hand syndrome].

OBJECTIVE: To observe therapeutic effect of acupuncture combined with rehabilitation therapy on poststroke shoulder-hand syndrome. METHODS: One hundred and twenty cases of poststroke shoulder-hand syndrome were randomly divided into an acupuncture-rehabilitation group, an acupuncture group and a rehabilitation group, 40 cases in each group. The acupuncture-rehabilitation group were treated with acupuncture at Jianyu (LI 15), Jianqian, Jianliao (TE 14), etc. in combination with motor therapy (rehabilitation training), the acupuncture group with simple acupuncture therapy, and the rehabilitation group with simple motor therapy. Upper extremity motor function, pain, joint activity were used for assessment of therapeutic effects. RESULTS: The total effective rate of 87.5% in the acupuncture-rehabilitation group was significantly better than 67.5% in the acupuncture group and 65.0% in the rehabilitation group (P<0.01); acupuncture combined with rehabilitation therapy could significantly improve upper limb motor function, pain and joint activity with very significant differences as compared with the acupuncture group and the rehabilitation group (P<0.01). CONCLUSION: Acupuncture combined with rehabilitation therapy has a high cured rate and an obvious therapeutic effect on poststroke shoulder-hand syndrome.

[Association between severe obstructive sleep apnea syndrome and sinus dysfunction].

OBJECTIVE: To preliminarily investigate the association between severe obstructive sleep apnea syndrome (OSAS) and sinus dysfunction (SD). METHODS: From March of 2005 to June of 2006, 70 patients with severe OSAS and 36 simple snorers underwent electrocardiography by polysomnography. In order to compare their sinus function and analyse the risk factors of SD, atropine test with simultaneous monitoring of ultramicroelectrocardiogram (UMECG) was performed in those with the lowest heart rate < 40 pbm, or the highest sinus heart rate < 90 bpm, or the longest R-R interval > 2.0 seconds. All data were statistically analyzed with SPSS 13.0 software. RESULTS: Sixteen of the 70 severe OSAS patients were diagnosed as with SD with an incidence of 22.9%, significantly higher than that in the patients with simple snore (2/36, 5.6%, P = 0.025). In 70 patients with severe OSAS (16 patients with SD), single factor analysis indicated that there was a significant difference between those with SD and those without SD in Nadir pulse oxygen saturation, longest apnea duration and incidence of coronary artery disease (T test, P = 0.002; T test, P = 0.029; Fisher's Exact test, P = 0.043), and Logistic regressive analysis showed that the risk factors of SD were the decrease of Nadir pulse oxygen saturation (P = 0.003, OR < 0.001, 95% CI 0.000 - 0.016) and age (P = 0.055, OR = 1.053, 95% CI 1.007 - 1.125). CONCLUSIONS: The incidence of SD in patients with severe OSAS is higher than that in simple snore. Lower Nadir pulse oxygen saturation during sleep was the major risk factor for occurrence of SD in patients with severe OSAS.

[Effects of head point-through-point electroacupuncture on SOD and LPO in the patient of Parkinson's disease].

OBJECTIVE: To observe clinical therapeutic effect of head point-through-point electroacupuncture on Parkinson's disease and the mechanism. METHODS: Seventy-six cases of Parkinson's disease were randomly divided into a treatment group (n=37) treated with head point-through-point electroacupuncture and oral administration of madopa, and a control group (n=39) with only oral administration of madopa. Superoxide dismutase (SOD) and lipids peroxides (LPO) were determined before and after treatment. RESULTS: The effective rate was 97.3% in the treatment group and 61.5% in the control group with a very significant difference between the two groups (P < 0.01). SOD activity and LPO content were significantly improved after treatment in the treatment group (P < 0.01), with a significant difference between the two groups (P < 0.01). CONCLUSION: Head point-through-point electroacupuncture can improve SOD activity and LPO content in the body so as to cure Parkinson's disease.

[Therapeutic effect of point-through-point acupuncture on migraine and its effects on brain blood flow velocity].

OBJECTIVE: To study the clinical therapeutic effect of point-through-point acupuncture on migraine and its mechanisms. METHODS: Ninety cases of migraine were randomly divided into a treatment group and a control group, 45 cases in each group. The treatment group were treated with point-through-point acupuncture and the control group with normal needling method. Brain blood flow velocity was determined by TCD before and after treatment. RESULTS: The effective rate was 97.8% in the treatment group, which was better than 80.0% in the control group (P < 0.05). And the point-through-point acupuncture could significantly improve the highest mean blood flow velocity of main arteries, with a significant difference between the two groups after treatment (P < 0.05). CONCLUSION: Point-through-point acupuncture can be used for treatment of migraine, with a high cured rate and obvious therapeutic effect.

[Observation on therapeutic effect of point-through-point acupunture on strephenopodia after apoplexy].

OBJECTIVE: To observe clinical therapeutic effect of point-through-point acupuncture on strephenopodia after apoplexy. METHODS: Ninety-six cases of strephenopodia after apoplexy were divided into a treatment group (n=50) treated with point-through-point acupuncture and a control group (n=46) treated with normal acupuncture. Their clinical therapeutic effects and motor functions of lower limbs were investigated. RESULTS: Both the methods could restore foot functional activities of various directions in the patient of strephenopodia after apoplexy (P < 0.01, P < 0.05), and the therapeutic effect of the treatment group was more obvious (P < 0.05). CONCLUSION: The point-through-point acupuncture has obvious therapeutic effect on foot functional activities of various directions in the patient of strephenopodia after apoplexy.

[Clinical observation on point-through-point acupuncture for treatment of cerebellar ataxia after apoplexy].

OBJECTIVE: To observe therapeutic effect of point-through-point acupuncture on cerebellar ataxia after apoplexy and evaluate the safety. METHODS: Random, parallel control, single blind and multicentral study method was used and 224 cases from 4 hospitals were divided equally into a treatment group and a control group, 112 cases in each group. The treatment group were treated with point-through-point acupuncture and the control group with general needling method. Their symptoms and signs, and the effect on transcranial Doppler's method (TCD) were investigated. RESULTS: The total effective rate was 93.3% in the treatment group which was better than 77.4% in the control group, with a significant difference between the two groups (P < 0.01), and the point-through-point acupuncture could significantly improve TCD of basilar artery, vertebral artery and posterior inferior cerebellar artery (Vs, Vm, Vd, PI, RI), superior to the control group. CONCLUSION: The point-through-point acupuncture has obvious therapeutic effect on cerebellar ataxia after apoplexy and good safety.