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1.
Molecules ; 29(10)2024 May 15.
Article in English | MEDLINE | ID: mdl-38792176

ABSTRACT

Utilizing online gradient pressure liquid extraction (OGPLE) coupled with a high-performance liquid chromatography antioxidant analysis system, we examined the antioxidative active components present in both the aerial parts and roots of dandelion. By optimizing the chromatographic conditions, we identified the ferric reducing-antioxidant power system as the most suitable for online antioxidant reactions in dandelion. Compared to offline ultrasonic extraction, the OGPLE method demonstrated superior efficiency in extracting chemical components with varying polarities from the samples. Liquid chromatography-mass spectrometry revealed twelve compounds within the dandelion samples, with nine demonstrating considerable antioxidant efficacy. Of these, the aerial parts and roots of dandelion contained nine and four antioxidant constituents, respectively. Additionally, molecular docking studies were carried out to investigate the interaction between these nine antioxidants and four proteins associated with oxidative stress (glutathione peroxidase, inducible nitric oxide synthase, superoxide dismutase, and xanthine oxidase). The nine antioxidant compounds displayed notable binding affinities below -5.0 kcal/mol with the selected proteins, suggesting potential receptor-ligand interactions. These findings contribute to enhancing our understanding of dandelion and provide a comprehensive methodology for screening the natural antioxidant components from herbs.


Subject(s)
Antioxidants , Molecular Docking Simulation , Plant Extracts , Taraxacum , Antioxidants/chemistry , Chromatography, High Pressure Liquid/methods , Taraxacum/chemistry , Plant Extracts/chemistry , Plant Roots/chemistry , Plant Components, Aerial/chemistry
2.
Int Wound J ; 21(4): e14746, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38654547

ABSTRACT

Refractory wounds present complex and serious clinical dilemmas in plastic and reconstructive surgeries. Currently, there are no standard guidelines for the treatment of refractory wounds. To observe the clinical effects of ultraviolet (UV) therapy combined with autologous platelet-rich plasma (PRP) on chronic refractory wounds. Between January 2021 and December 2022, 60 inpatients with chronic refractory wounds were enrolled. Twenty patients were assigned to each of control groups 1 and 2 and treatment group according to whether they received PRP or UV treatment. All the patients underwent thorough debridement. Control group 2 received UV radiation. The treatment group underwent UV radiation combined with PRP gel covering the wound. Control group 1 underwent routine dressing changes after surgery, followed by skin grafting or skin key transfer if needed. One month later, we observed the wound healing in the two groups. After 2-4 PRP gel treatments, the wounds of patients in the treatment group healed. The healing time was 25.25 ± 4.93 days, and the dressings were changed 4.15 ± 3.30 times, both of which were better outcomes than in both control groups. In the treatment group, epidermal growth factor (EGF), insulin-like growth factor (IGF), platelet-derived growth factor (PGF), and transforming growth factor ß (TGF-ß) were slightly higher, and the concentration of vascular endothelial growth factor (VEGF) was significantly higher than in the control group (p < 0.05). PRP combined with UV therapy significantly increased the concentration of wound growth factors, accelerated wound healing, shortened treatment time, reduced treatment costs, and alleviated pain in patients.


Subject(s)
Platelet-Rich Plasma , Ultraviolet Therapy , Wound Healing , Humans , Male , Female , Middle Aged , Ultraviolet Therapy/methods , Aged , Adult , Chronic Disease , Wounds and Injuries/therapy , Combined Modality Therapy , Treatment Outcome
3.
Se Pu ; 41(8): 690-697, 2023 Aug.
Article in Chinese | MEDLINE | ID: mdl-37534556

ABSTRACT

Fraxini Cortex is a traditional Chinese herbal medicine that has been used for thousands of years to treat dampness-heat diarrhea, dysentery, red or white vaginal discharge, painful swelling or redness of the eyes, and nebula. It contains various chemical components, including coumarins, iridoids, phenolic acids, and flavonoids. Coumarins are important active ingredients in Fraxini Cortex and have antibacterial, anti-inflammatory, antioxidant, antitumor, and antiviral activities. Aesculin and aesculetin are two major coumarin components of Fraxini Cortex that are widely used in its quality evaluation. Previous HPLC methods for determination of aesculin and aesculetin present several limitations, such as long analysis times and high solvent and reference compound consumption. In this study, a rapid, eco-friendly and cost saving HPLC method for the determination of aesculin and aesculetin in Fraxini Cortex was established by using the core-shell column and equal absorption wavelength (EAW). Different factors influencing the extraction process, such as the extraction solvent, temperature, and time, were assessed to obtain the optimal extraction conditions. The results showed that Fraxini Cortex samples could be well extracted by ultrasonic extraction for 5 min with a 25% ethanol aqueous solution. A core-shell column was used, and different mobile phases and flow rates were investigated to obtain the best rapid-HPLC separation conditions. The optimized HPLC conditions were as follows: a Poroshell 120 EC-C18 column (50 mm×4.6 mm, 2.7 µm), acetonitrile-0.1% formic acid aqueous solution (6∶94, v/v) as the eluent, a flow rate of 1.5 mL/min, and a column temperature of 25 ℃. The EAW of aesculin and aesculetin was a key factor in their determination using a single reference compound. EAW selection was performed in two steps. First, the UV spectra of two equimolar concentrations of the reference compounds (aesculin and aesculetin) were compared to determine the EAW of the two analytes. The EAW results were then verified by the HPLC analysis of the reference compound solutions. The final EAW of aesculin and aesculetin was 341 nm. The determination of aesculin and aesculetin using only one reference compound (i. e., aesculin) was achieved by HPLC-UV at this EAW. The newly developed HPLC method revealed a good linear relationship between the two target analytes (r=1.0000). The limits of detection (LODs) and limits of quantification (LOQs) were 1.5 µmol/L and 3.0 µmol/L, respectively, and the average recoveries of aesculin and aesculetin were 99.0% and 97.5%. The stabilities of the sample solutions were examined, and the two analytes demonstrated good stability for 24 h. The contents of the target analytes in 10 batches of Fraxini Cortex were determined using the proposed EAW method and the classic external standard method (ESM), and comparable concentrations were obtained. The contents of aesculin and aesculetin in the 10 batches of Fraxini Cortex were 0.26%-2.80% and 0.11%-1.47%, respectively. A t-test was conducted to compare the results of the proposed EAW technique with those obtained via the method reported in the Chinese Pharmacopoeia, and no significant difference between the two assay methods was noted (P>0.05). Comparison of the newly established EAW method with those reported in the literature revealed that our method required only 10 min to complete and used as little as 0.5 mL of the solvent and only one standard. Therefore, the developed EAW method is a rapid, simple, eco-friendly, and cost-effective analytical method that is suitable for the determination of aesculin and aesculetin in Fraxini Cortex and its related products. The proposed technique is an improved method for determining aesculin and aesculetin and contributes to the enhancement of the quality evaluation of Fraxini Cortex.


Subject(s)
Drugs, Chinese Herbal , Esculin , Female , Humans , Esculin/analysis , Chromatography, High Pressure Liquid , Drugs, Chinese Herbal/analysis , Coumarins , Solvents
4.
Molecules ; 28(10)2023 May 18.
Article in English | MEDLINE | ID: mdl-37241909

ABSTRACT

Polygoni Cuspidati Rhizoma et Radix (PCR), the rhizome and root of Polygonum cuspidatum Sieb. et Zucc., has been used as an herbal medicine for a long time. In this study, the ultrafiltration combined with high performance liquid chromatography (UF-HPLC) method was developed to screen tyrosinase (TYR), α-glucosidase (α-GLU), and xanthine oxidase (XOD) inhibitors from PCR. Firstly, the inhibitory activity of 50% methanol PCR extract on TYR, α-GLU, XOD, and acetylcholinesterase (ACHE) was tested. The extract showed a good inhibition on the enzymes, except for ACHE. Therefore, UF-HPLC experiments were carried out to screen TYR, α-GLU, and XOD inhibitors from PCR extract. Seven potential bioactive components were discovered, including methylgallate (1), 1,6-di-O-galloyl-D-glucose (2), polydatin-4'-O-D-glucoside (3), resveratrol-4'-O-D-glucoside (4), polydatin (5), malonyl glucoside resveratrol (6), and resveratrol-5-O-D-glucoside (7). Most of them were found as enzyme inhibitors from PCR for the first time, except polydatin (5), which had been reported as an α-GLUI in PCR in the literature. Finally, molecular docking analysis was applied to validate the interactions of these seven potential active components with the enzymes. Compounds 1-7 were proven as TYR inhibitors, compounds 2, 4-7 were identified as XOD inhibitors, and compounds 4-6 were confirmed as α-GLU inhibitors. In short, the current study provides a good reference for the screening of enzyme inhibitors through UF-HPLC, and provides scientific data for future studies of PCR.


Subject(s)
Drugs, Chinese Herbal , Rhizome , Rhizome/chemistry , Monophenol Monooxygenase , Drugs, Chinese Herbal/chemistry , Glycoside Hydrolase Inhibitors/pharmacology , Glycoside Hydrolase Inhibitors/analysis , Chromatography, High Pressure Liquid/methods , Xanthine Oxidase , Resveratrol/analysis , Acetylcholinesterase , Molecular Docking Simulation , Ultrafiltration , Glucosides/analysis
5.
Arch Phys Med Rehabil ; 104(1): 151-159, 2023 01.
Article in English | MEDLINE | ID: mdl-35636518

ABSTRACT

OBJECTIVE: The purpose of this review was to systematically assess the effectiveness of 10-Hz repetitive transcranial magnetic stimulation (rTMS) in fibromyalgia. DATA SOURCES: We searched PubMed, Cochrane Library, Embase, Web of Science, and Ovid databases as of November 6, 2021. STUDY SELECTION: The inclusion criteria for this review were randomized controlled trials of 10-Hz rTMS for fibromyalgia, exploring the effects of 10-Hz rTMS on pain, depression, and quality of life in patients with fibromyalgia. DATA EXTRACTION: Data extraction was performed independently by 2 evaluators according to predefined criteria, and the quality of the included literature was assessed using the Cochrane Bias Risk Assessment Tool. The measurement outcomes include visual analog scale, Hamilton Depression Rating Scale, and Fibromyalgia Impact Questionnaire, and so on. DATA SYNTHESIS: A total of 488 articles were screened, and the final 7 selected high-quality articles with 217 patients met our inclusion criteria. Analysis of the results showed that high-frequency transcranial magnetic stimulation at 10 Hz was significantly associated with reduced pain compared with sham stimulation in controls (standardized mean difference [SMD]=-0.72; 95% confidence interval [CI], -1.12 to -0.33; P<.001; I2=46%) and was able to improve quality of life (SMD=-0.70; 95% CI, -1.00 to -0.40; P<.001; I2=15%) but not improve depression (SMD=-0.23; 95% CI, -0.50 to 0.05; P=.11; I2=33%). In addition, a subgroup analysis of pain conducted based on stimulation at the primary motor cortex and dorsolateral prefrontal cortex showed no significant difference (SMD=-0.72; 95% CI, -1.12 to -0.33; P=.10; I2=62%). CONCLUSIONS: Overall, 10-Hz rTMS has a significant effect on analgesia and improved quality of life in patients with FMS but did not improve depression.


Subject(s)
Fibromyalgia , Transcranial Magnetic Stimulation , Humans , Transcranial Magnetic Stimulation/methods , Fibromyalgia/therapy , Quality of Life , Pain , Pain Management/methods , Randomized Controlled Trials as Topic
6.
Zhen Ci Yan Jiu ; 47(3): 216-23, 2022 Mar 25.
Article in Chinese | MEDLINE | ID: mdl-35319838

ABSTRACT

OBJECTIVE: To observe the effect of electroacupuncture (EA) of "Baihui"(GV20), "Dazhui"(GV14), "Shenshu" (BL23)and "Zusanli"(ST36) on the intestinal flora and serum interleukin (IL)-1ß and IL-18 contents in vascular dementia (VD) rats. METHODS: SD rats were randomized into sham operation, VD model, GV20+GV14+BL23 (EA-basic acupoints), and EA-basic acupoints+ST36 and EA-basic acupoints+probiotics groups (n=10 in each group). EA (10 Hz/50 Hz) was conducted for 30 min, once daily for 4 consecutive weeks. Rats of the EA-basic acupoints+probiotics received gavage of probiotics (2 mL/d containing 2.0×109 CFU of live bifidobacterium), once a day for 4 weeks, and those of the EA-basic acupoints and EA-basic acupoints+ST36 groups received gavage of the same dose of normal saline. The Morris water maze test was used to evalua-te the rats' lear-ning and memory ability before and after the treatment. The serum IL-1ß and IL-18 levels were determined by ELISA, and the histopathological changes of the intestinal mucosa were observed by H.E. staining. The ultrastructural changes of hippocampal neurons were observed by using transmission electron microscopy and 16S rDNA sequencing technique was used to analyze the composition of intestinal microbiome. RESULTS: Compared with the sham operation group, the escape latency, serum levels of IL-1ß and IL-18, as well as the relative abundance of harmful bacteria (including Catabacter, obinsoniella and Desulfovibrio) in the intestine were significantly increased (P<0.01). In comparison with the model group, the escape latency, serum levels of IL-1ß and IL-18 in the three treatment groups, and the relative abundance of harmful bacteria (such as the Catabacter, Robinsoniella and Desulfovibrio) in the EA-basic acupoints+ST36 group were down-regulated obviously(P<0.05,P<0.01), and the relative abundance of Clostridiales-unclassified in both EA-basic acupoints+probiotics and EA-basic acupoints+ST36 groups was significantly up-regulated (P<0.05). The effects of EA-basic acupoints+ST36 and EA-ba-sic acupoints+probiotics were significantly superior to that of EA-basic acupoints in down-regulating IL-18 content (P<0.05). H.E. staining showed atrophy of the whole mucosal layer, loss of goblet cells, destruction of glands, infiltration of a large number of inflammatory cells, and transmission microscope displayed fuzziness of the nucleus membrane boundary, cystic dilation of the rough endoplasmic reticulum with unclear structure swelling of the mitochondria, and disordered arrangement or dissolution of the inner cristae in the model group, which was relatively milder in the EA-basic acupoints+ST36 and EA-basic acupoints+probiotics groups. CONCLUSION: EA of GV20+GV14+BL23+ ST36 can improve the cognitive dysfunction of VD model rats, which may be related to its function in regulating the imbalance of intestinal microbiota, thereby inhibiting the peripheral inflammatory factor.


Subject(s)
Dementia, Vascular , Electroacupuncture , Gastrointestinal Microbiome , Animals , Dementia, Vascular/genetics , Dementia, Vascular/therapy , Electroacupuncture/methods , Interleukin-18/genetics , Intestines , Rats , Rats, Sprague-Dawley
7.
Front Aging Neurosci ; 13: 755665, 2021.
Article in English | MEDLINE | ID: mdl-34658846

ABSTRACT

Neurons are highly specialized post-mitotic cells that are inherently dependent on mitochondria due to their higher bioenergetic demand. Mitochondrial dysfunction is closely associated with a variety of aging-related neurological disorders, such as Alzheimer's disease (AD), and the accumulation of dysfunctional and superfluous mitochondria has been reported as an early stage that significantly facilitates the progression of AD. Mitochondrial damage causes bioenergetic deficiency, intracellular calcium imbalance and oxidative stress, thereby aggravating ß-amyloid (Aß) accumulation and Tau hyperphosphorylation, and further leading to cognitive decline and memory loss. Although there is an intricate parallel relationship between mitochondrial dysfunction and AD, their triggering factors, such as Aß aggregation and hyperphosphorylated Tau protein and action time, are still unclear. Moreover, many studies have confirmed abnormal mitochondrial biosynthesis, dynamics and functions will present once the mitochondrial quality control is impaired, thus leading to aggravated AD pathological changes. Accumulating evidence shows beneficial effects of appropriate exercise on improved mitophagy and mitochondrial function to promote mitochondrial plasticity, reduce oxidative stress, enhance cognitive capacity and reduce the risks of cognitive impairment and dementia in later life. Therefore, stimulating mitophagy and optimizing mitochondrial function through exercise may forestall the neurodegenerative process of AD.

8.
Anat Rec (Hoboken) ; 304(11): 2552-2558, 2021 11.
Article in English | MEDLINE | ID: mdl-34324795

ABSTRACT

Fu's subcutaneous needling (FSN) is a new acupuncture therapy developed from acupuncture and Traditional Chinese Medicine models. The aim of this study was to investigate the effect of FSN on shoulder pain. In this retrospective comparative study, patient case files with shoulder pain (Group A) treated with FSN were analyzed and compared with the same number of patients with shoulder pain (Group B) treated with conventional acupuncture and physical therapy. Motion-related pain (MRP), pain under pressure (PUP), and Range of motion (ROM) were collected before and after intervention. In the 68 patients, there were 39 males and 29 females, aged 21-53 years old (mean ± SD = 36.4 ± 8.15) with onset time ranging from 1 day to 7 days (mean ± SD = 3.15 ± 1.73). MRP, PUP, and ROM scores were improved after FSN intervention (p < .05). There were significant differences between group A and group B in MRP, PUP, and ROM scores after FSN intervention and 1 week follow-up (p < .05). No adverse events, such as fainting and sharp pain, occurred during the treatment process. FSN can be an effective rehabilitation intervention for improving shoulder pain and shoulder range of motion.


Subject(s)
Acupuncture Therapy , Shoulder Pain , Adult , Female , Humans , Male , Middle Aged , Pilot Projects , Range of Motion, Articular , Retrospective Studies , Shoulder Pain/therapy , Treatment Outcome , Young Adult
9.
Anat Rec (Hoboken) ; 304(11): 2531-2537, 2021 11.
Article in English | MEDLINE | ID: mdl-34192418

ABSTRACT

The aim of the study was to explore the effect of acupuncture combined with rehabilitation on cognitive and motor functions in poststroke patients. All patients were divided into Group A and Group B based on different interventions (Group A: acupuncture + conventional rehabilitation, Group B: conventional rehabilitation alone). Acupuncture was conducted once a day, five times a week for 8 weeks, and rehabilitation (including physical therapy and occupational therapy) was conducted for 2 hr per session, once a day, five times a week for 8 weeks. Mini-mental State Examination (MMSE) and Fugl-Meyer Assessment (FMA) were used to assess the motor and cognitive functions at baseline and the end of 8 weeks. After the intervention, FMA and MMSE scores were improved significantly in the two groups (p <.05), compared with the scores prior to intervention. After 8 weeks of intervention, a statistically significant difference in the FMA and MMSE scores was observed between the Group A and the Group B. The results suggested that the combined intervention is more effective than the conventional rehabilitation alone in improving cognitive and motor functions in poststroke patients.


Subject(s)
Acupuncture Therapy , Stroke Rehabilitation , Stroke , Acupuncture Therapy/methods , Cognition , Humans , Stroke/complications , Stroke/therapy , Stroke Rehabilitation/methods , Treatment Outcome
10.
RSC Adv ; 11(41): 25646-25652, 2021 Jul 19.
Article in English | MEDLINE | ID: mdl-35478912

ABSTRACT

In the present study, a simple and efficient approach based on the online extraction-high performance liquid chromatography coupled with ABTS antioxidant assay (OLE-HPLC-ABTS) was established to quickly and directly analyze the antioxidants in S. baumii. Through this system, the HPLC mobile phase via a guard column packed with a S. baumii sample was used for online extraction (OLE). The separation was performed on an Agilent Poroshell EC-C18 column with a gradient elution using 0.1% formic acid (A) and 0.1% formic acid-acetonitrile (B) as mobile phase systems and detected at a wavelength of 254 nm. Then, the separated compounds were reacted with the antioxidant solution (ABTS), and the response was recorded at a wavelength of 400 nm. The developed analytical method was successfully applied to S. baumii samples, and eight antioxidants were identified. The established system integrated the online extraction, separation and online antioxidant detection, which is rapid, efficient, and suitable for the rapid screening of antioxidant compounds from solid sample mixtures.

11.
Article in English | MEDLINE | ID: mdl-32831867

ABSTRACT

OBJECTIVE: Osteoporosis (OP) is a well-established age-related disease, pathologically characterized by bone microarchitectural deterioration, increased fragility, and low BMD. Primary osteoporosis (POP) is the most common type of OP. METHODS: Publications pertaining to the effectiveness of kinesitherapy on BMD in POP from PubMed, SCI, Cochrane Library, Embase, VIP, CNKI, and Wanfang Database were retrieved from their inception to October 2019. RESULTS: A total of 21 studies with 1840 participants were included. The results of the meta-analysis revealed that kinesitherapy plus antiosteoporosis medications had a positive effect on lumbar spine BMD when the duration of intervention was 6 months (MD = 0.11 g/cm2; 95% CI: 0.06-0.15; P < 0.0001) or >6 months (MD = 0.04 g/cm2; 95% CI: 0.02-0.06; P < 0.0001) compared with antiosteoporosis medications alone. Additional kinesitherapy plus antiosteoporosis medications were associated with improved femoral neck BMD compared with antiosteoporosis medications alone (MD = 0.09 g/cm2; 95% CI: 0.03-0.16; P=0.004). CONCLUSIONS: Kinesitherapy plus antiosteoporosis medications significantly improved lumbar spine and femoral neck BMD in the current low-quality evidence. Additional high-quality evidence is required to confirm the effect of kinesitherapy on BMD in patients with POP.

12.
Zhongguo Zhen Jiu ; 39(11): 1235-8, 2019 Nov 12.
Article in Chinese | MEDLINE | ID: mdl-31724363

ABSTRACT

OBJECTIVE: To observe the effect of the interaction teaching mode integrated with Visible Body virtual anatomy platform in teaching Meridian and Acupoints. METHODS: A total of 60 students in the class of 2017 in the discipline of acupuncture-moxibustion and tuina, Xiangnan University were recruited and randomized into an observation group and a control group, 30 students in each one. In the control group, the traditional practical teaching mode was used. In the observation group, the interaction teaching mode integrated with virtual anatomy platform was adopted. The teaching duration was 10 class hours in both groups. After accomplishing the teaching schedule, the practical examination was conducted in the localization of commonly-used acupoints, very useful acupoints and the dangerous acupoints as well as acupuncture manipulation techniques. Moreover, the degree of satisfaction was investigated among the students in the two groups and the self-learning ability was evaluated in 3-month follow-up visit. RESULTS: In the observation group, the scores for the localization and acupuncture manipulation of commonly-used acupoints, very useful acupoints and the dangerous acupoints, as well as the degree of satisfaction of the 3 items, i.e. interesting, interaction and leaning-assistance were all higher than those in the control group (P<0.05). The degree of satisfaction in the acceptance and leaning-participation, as well as the scores of self-learning ability in 3-month follow-up visit were not different statistically between the two groups (P>0.05). CONCLUSION: The interaction teaching mode integrated with virtual anatomy platform improves the effect on teaching Meridian and Acupoints and achieves the high student satisfaction.


Subject(s)
Acupuncture Points , Acupuncture Therapy , Acupuncture/education , Meridians , Teaching , Humans , Moxibustion
13.
Zhongguo Zhen Jiu ; 27(12): 898-900, 2007 Dec.
Article in Chinese | MEDLINE | ID: mdl-18271232

ABSTRACT

OBJECTIVE: To compare therapeutic effects of electroacupuncture (EA) treatment and medication on acute gouty arthritis (AGA), so as to search for a therapeutic method for treatment of gout with renal insufficiency. METHODS: Ninety cases of AGA were randomly divided into an EA group, an allopurinol group and a probenecid group, 30 cases in each group. The EA group were treated by EA at Sanyinjiao (SP 6), Fenglong (ST 40), Yinlingquan (SP 9), once a day; the allopurinol group by oral administration of Allopurinol, twice a day, 100 mg each time and the probenecid group by oral administration of Probenecid, twice daily, 0.25 g each time. Contents of blood uric acid (BUA) and urinary uric acid (UUA) in each group were detected. RESULTS: In all groups, there were significant differences in BUA and UUA levels before and after treatment (P < 0.01). There was no significant difference between the EA group and the allopurinol group in blood uric acid level after treatment (P > 0.05) and there was no significant difference between the EA group and the probenecid group in the urinary innary uric acid level (P > 0.05). Comparison of therapeutic effects among the 3 groups indicated that the mean rank was 56.23 in the EA group, 43.17 in the allopurinol group and 37.10 in the probenecid group, indicating that the therapeutic effect in the EA group was better than that in the allopurinol group, and the allopurinol group was better than that in the probenecid group. CONCLUSION: EA can reduce the production of uric acid and promote the excretion of uric acid and has a better treatment effect. And there are no harmful effects on renal function. EA is an effective therapeutic method for treatment of gout with renal insufficiency.


Subject(s)
Arthritis, Gouty/therapy , Electroacupuncture , Acute Disease , Adult , Aged , Arthritis, Gouty/metabolism , Female , Humans , Male , Middle Aged , Uric Acid/blood , Uric Acid/urine
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