[Point-pricking method with fire needle for knee osteoarthritis: a randomized controlled trial].

OBJECTIVE: To observe the effects of point-pricking method with fire needle on the symptoms of knee joint and physio-psychological health in the patients with knee osteoarthritis (KOA). METHODS: Sixty six patients with KOA were randomly divided into a fire needling group (33 cases) and a filiform needling group (33 cases). The patients received the point-pricking method with fire needle in the fire needle group while the conventional acupuncture with filiform needle was provided in the filiform needling group. The basic health management was performed in both groups. The acupoints included bilateral Liangqiu (ST34), Xuehai (SP10), Dubi (ST35), Neixiyan (EX-LE4), Yanglingquan (GB34) and Zusanli (ST36) as well as Ashi points. The treatment was conducted twice a week for 6 weeks consecutively. Before and after treatment, the scores of Western Ontario and McMaster University Osteoarthritis Index (WOMAC), traditional Chinese medicine (TCM) symptoms and visual analogue score (VAS), the numbers of affected areas of knee joint pain and the scores of 12-item short-form health survey (SF-12) were assessed and the incidence of adverse effects was recorded. RESULTS: The score for pain, stiffness and function, as well as the total score of WOMAC were all reduced (P<0.05), the score of TCM symptoms, VAS score and the numbers of the affected areas of knee joint pain were lower (P<0.05) after treatment when compared with those before treatment within group. After treatment, the score of each domain of SF-12 (i.e. general health, physical function, role-physical, vitality, role-emotional, physical component summary and mental component summary) was higher in comparison to those before treatment in both groups (P<0.05), while the scores of bodily pain, mental health and social functioning in SF-12 were increased in the fire needling group (P<0.05). Compared with the filiform needling group, the score of joint function and the total score in WOMAC and VAS score were reduced remarkably (P<0.05), and general health score in SF-12 was more obviously increased (P<0.05) in the fire needling group after treatment. None adverse effects were found in either group. CONCLUSION: The point-pricking method with fire needle is safe and effective when compared with conventional acupuncture with filiform needle. In the aspects of improving knee joint function, relieving joint pain and advancing the quality of life, the point-pricking method with fire needle is superior to the conventional acupuncture with filiform needle.

Expression and Clinical Value of miR-185 and miR-424 in Patients with Acute Ischemic Stroke.

BACKGROUND: To investigate the expression of serum miR-185 and miR-424 in patients with acute ischemic stroke (AIS) and their predictive value. A total of 142 patients with AIS and 50 healthy controls were enrolled. METHODS: According to the modified Rankin scale (mRS) score, AIS patients were divided into the good prognosis group and the poor prognosis group. Based on the National Institutes of Health Stroke Scale (NIHSS) score, AIS patients were divided into the mild group, the moderate group, and the severe group. RT-qPCR was used to determine the expression. ROC curve and Pearson correlation analysis were adopted to predict poor prognosis and analyze the correlation between the expression and NIHSS, mRS score. RESULTS: Compared with the control group, the expression of miR-185 and miR-424 in the AIS group was significantly higher (P<0.01). Similarly, significantly higher expressions could be found in the poor prognosis group and the severe group (P<0.01). The ROC curve revealed that the optimal cut-off values were 2.14 and 4.08, respectively. The area under the ROC curve (0.928, 95% CI: 0.870-0.993) was the largest, with sensitivity and specificity of 92.0% and 85.7%. Pearson correlation analysis showed that their expression was positively correlated with NIHSS score and mRS score in AIS patients (r=0.735, 0.802, 0.796, 0.873, P<0.01). CONCLUSION: There are two factors related to the up-regulated expression of serum miR-185 and miR-424, one is the severity degree of neurological impairment of patients with AIS and the other is their prognosis. These two combined indicators can contribute to predicting the prognosis of AIS patients.

Evaluation of the efficacy and safety of fire needle compared to filiform needle on knee osteoarthritis: study protocol for a randomized controlled trial.

BACKGROUND: Knee osteoarthritis is a common clinical chronic degenerative disease associated with high morbidity and long-term disability. Previous studies have confirmed the efficacy of acupuncture on knee osteoarthritis. Fire needle acupuncture is a combination of heat and acupuncture, which may be more effective than the commonly used filiform needle acupuncture. This study is designed as a randomized controlled trial to evaluate the efficacy and safety of fire needle acupuncture compared to filiform needle acupuncture in knee osteoarthritis patients. METHODS AND ANALYSIS: This is a prospective randomized controlled superiority clinical trial to evaluate the efficacy and safety of fire needle acupuncture compared to filiform needle acupuncture for knee osteoarthritis. A total of 100 participants will be randomly assigned to two different groups. Participants will receive fire needle acupuncture treatment in the fire needle group, while participants in the filiform needle group will be treated with a filiform needle at the same acupuncture points as the fire needle group. All participants will receive 6 weeks of treatment (2 times per week). The primary outcome is the change of the Western Ontario and McMaster Universities Osteoarthritis Index, and the secondary outcomes include the change of the visual analog scale and 12-item Short Form Health Survey from baseline to endpoint. ETHICS AND DISSEMINATION: Ethical approval of this study was granted by the Research Ethical Committee of Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University (2018SB-066). Written informed consent will be obtained from all participants. Outcomes of the trial will be disseminated through peer-reviewed publications. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR1800019579 . Registered on November 18, 2018.

[Expressions and neural function prognostic evaluation of serum microRNA-24 and microRNA-29b in elderly patients with acute ischemic stroke].

OBJECTIVE: To investigate the expressions of serum microRNA-24 (miR-24) and microRNA-29b (miR-29b) in elderly patients with acute ischemic stroke (AIS) and their neural function prognostic value. METHODS: A prospective study was conducted. 170 elderly patients with AIS admitted to department of neurology of Danzhou People's Hospital from January 1st, 2017 to March 31st, 2019 were enrolled. According to modified Rankin scale (mRS) score, the patients were divided into good neural function prognosis group (mRS score ≤ 2, n = 105) and poor neural function prognosis group (mRS score > 2, n = 65). According to National Institutes of Health stroke scale (NIHSS) score, the patients were divided into mild group (NIHSS score < 5, n = 50), moderate group (NIHSS score 5-20, n = 76) and severe group (NIHSS score > 20, n = 44). Sixty-five healthy volunteers in the same period were enrolled as the control group. The expressions of serum miR-24 and miR-29b were determined by real-time fluorescent quantitative reverse transcription-polymerase chain reaction (RT-qPCR). Receiver operating characteristic (ROC) curve was plotted to analyze the value of serum expressions of miR-24 and miR-29b for predicting the poor neural function prognosis of elderly patients with AIS. Pearson correlation was used to analyze the correlation between the expressions of serum miR-24, miR-29b and NIHSS, mRS scores in elderly patients with AIS. RESULTS: The expressions of serum miR-24 and miR-29b in the AIS group were significantly lower than those in the healthy control group [miR-24 (2-ΔΔCt): 0.64±0.17 vs. 2.18±0.85, miR-29b (2-ΔΔCt): 0.72±0.21 vs. 3.05±0.96, both P < 0.01]. The expressions of serum miR-24 and miR-29b in the poor neural function prognosis group were significantly lower than those in the good neural function prognosis group [miR-24 (2-ΔΔCt): 0.20±0.05 vs. 1.16±0.48, miR-29b (2-ΔΔCt): 0.18±0.03 vs. 1.41±0.56, both P < 0.01]. The expressions of serum miR-24 and miR-29b in the severe group were significantly lower than those in the mild and moderate groups [miR-24 (2-ΔΔCt): 0.13±0.02 vs. 1.30±0.51, 0.56±0.14; miR-29b (2-ΔΔCt): 0.09±0.01 vs. 1.52±0.60, 0.62±0.13; all P < 0.01], and they were significantly lower in the moderate group than those in the mild group (all P < 0.01). ROC curve analysis showed that the optimal cut-off values of serum miR-24 and miR-29b expressions for predicting poor neural function prognosis in elderly AIS patients were 0.53 and 0.48, respectively. The area under ROC curve (AUC) of the two combined prognoses was 0.920 [95% confidence interval (95%CI) was 0.861-0.982], and it was significantly higher than that of miR-24 (AUC was 0.802, 95%CI was 0.742-0.860) or miR-29b (AUC was 0.835, 95%CI was 0.778-0.890) alone (Z values were 6.513 and 4.902, respectively, both P < 0.05), with sensitivity and specificity of 92.0% and 85.7%. Pearson correlation analysis showed that the expressions of serum miR-24 and miR-29b were negatively correlated with NIHSS score (r values were -0.758 and -0.794, respectively) and mRS score (r values were -0.817 and -0.860, respectively) in elderly AIS patients (all P < 0.01). CONCLUSIONS: The down-regulated expressions of serum miR-24 and miR-29b are correlated with the severity degree of neurological impairment and neural function prognosis of elderly AIS patients, and the two combined have certain value for predicting the neural function prognosis of elderly AIS patients.