Mechanism of Qihuang needle therapy in the management of tic disorders: a clinical trial protocol.

Background: Qihuang needle therapy is a newly developed acupuncture therapy to treat tic disorders in clinical practice. However, the mechanism to reduce tic severity remains unknown. Changes in intestinal flora and circulation metabolites are perhaps the potential pathogenesis of tic disorders. As a result, we present a protocol for a controlled clinical trial using multi-omics analysis to probe the mechanism of the Qihuang needle in managing tic disorders. Methods: This is a matched-pairs design, controlled, clinical trial for patients with tic disorders. Participants will be allocated to either an experimental group or a healthy control group. The main acupoints are Baihui (GV20), Yintang (EX-HN3), and Jueyinshu (BL14). The experimental group will receive Qihuang needle therapy for a month, while the control group will receive no interventions. Expected outcomes: The change in the severity of the tic disorder is set as the main outcome. Secondary outcomes include gastrointestinal severity index and recurrence rate, which will be calculated after a 12-week follow-up. Gut microbiota, measured by 16S rRNA gene sequencing; serum metabolomics, assessed via LC/MS; and serum zonulin, assessed by enzyme-linked immunosorbent assay (ELISA), will be used as biological specimen analysis outcomes. The present study will investigate the possible interactions between intestinal flora and serum metabolites and the improvement of clinical profiles, which may elucidate the mechanism of Qihuang needle therapy for tic disorders. Trial registration: This trial is registered at the Chinese Clinical Trial Registry (http://www.chictr.org.cn/). Registration number: ChiCTR2200057723, Date: 2022-04-14.

Case report: Tongdu Xingshen acupuncture for a patient with persistent vegetative state after herpes simplex virus encephalitis.

Introduction: A persistent vegetative state (PVS) can be caused by traumatic or non-traumatic brain injury. PVS is a complex clinical condition with numerous complications. Nursing care, medical treatment, and comprehensive rehabilitation are necessary to improve the outcomes of PVS. However, the prognosis remains unsatisfactory. Acupuncture therapy has been used as a rehabilitation strategy to treat patients with PVS in China, showing better results in the recovery of consciousness, intellectual capability, and motor function. Case description: We present the case of a 4-month-long PVS after herpes simplex virus encephalitis (HSVE) in a 3.5-year-old boy who underwent Tongdu Xingshen acupuncture integrated with Western medicine and rehabilitation. The patient regained consciousness post-treatment. His intelligence and motor function gradually recovered after seven treatment sessions. Conclusion: Tongdu Xingshen acupuncture is a potential complementary therapy to optimize clinical outcomes in PVS.

Effectiveness and safety of anti-tau drugs for Alzheimer's disease: Systematic review and meta-analysis.

OBJECTIVE: To assess the cognitive effectiveness and safety of tau-targeting drugs for Alzheimer's disease (AD) METHODS: The MEDLINE, Embase, Cochrane Library, PsycINFO, ClinicalTrials.gov, and WHO International Clinical Trials Registry Platform databases were searched from inception to 22 November 2021. A systematic review and meta-analysis of randomized controlled trials were performed RESULTS: Thirty-four randomized controlled trials comprising 5549 participants, of which fifteen (51.7%) had a low risk of bias, were included. The meta-analysis showed no differences in the cognitive subscale of the AD: Assessment Scale (ADAS-Cog) between anti-tau drugs and placebo (mean difference [MD]: -0.77, 95% CI: -1.64 to 0.10; minimal important difference 3.1-3.8 points, moderate certainty evidence). For ADAS-Cog, the results subgroup analysis suggested a statistical effect of tau posttranslational modifications on drug inhibition (MD: -0.80, 95% CI: -1.43 to -0.17), which was not seen with tau aggregation inhibitors or immunotherapy (interaction p = 0.24). A total of 11.0%, 5.2%, and 4.8% of drugs inhibiting tau aggregation, immunotherapy, and drugs targeting posttranslational modifications, respectively, had a reduced risk of dropouts due to adverse events (AEs). DISCUSSION: Current evidence suggests that anti-tau drugs are unlikely to have an important impact on slowing cognitive impairment. Although the subgroup analysis suggested that inhibition of tau posttranslational modifications is statistically effective and generally safer because of reduced dropouts due to AEs, the analysis has limited credibility. Additional large-scale and well-designed randomized and placebo-controlled trials will be necessary to explore the benefit of a certain type of anti-tau drug for AD.

Psychological Interventions on Abstinence in Patients with Alcohol Use Disorder: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials.

Purpose: Accumulating research suggests that psychotherapy helps improve abstinence but the difference in the efficacy of multiple psychotherapies in alcohol use disorder (AUD) remains to be explored. Patients and Methods: A systematic search of databases (Pubmed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and EBSCO) for studies (published from inception to April 10th.) of adults diagnosed with AUD accepting psychotherapies was conducted. Studies covering 9 countries and regions. The qualitative analysis pooled 2646 individuals from 34 randomized controlled trials (RCTs) and the networks included 1928 participants (23 RCTs). The outcomes included percentage of days abstinent (PDA), change in drinks per drinking day (change in DDD), and change in craving compared among individuals accepting various psychotherapies. The protocol followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and was registered on the International Prospective Register of Systematic Reviews (PROSPERO). Results: For the network of PDA, motivational enhancement treatment (MET) (35.44, 11.78 to 59.09, high-certainty) and couple therapy (CT) (28.89, 13.42 to 44.36, moderate-certainty) were significantly different from treatment as usual (TAU) with the surface under the cumulative ranking curve (SUCRA) mean rank 1.9 and 1.9 respectively. TAU+supportive psychotherapy (SP) was better than TAU for the change in DDD in the high-quality direct comparison. Conclusion: The motivational enhancement and the couple therapy show potential amelioration for alcohol abstinence. Additionally, the preferred interventions are different for improving PDA and change in DDD. The evidence network remains to be strengthened.

Abdominal Acupuncture as an Adjunctive Therapy for the Recovery of Motor Function After Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Background: Bo's abdominal acupuncture (BAA) is a novel therapy in alternative and complementary medicine and has been frequently used for stroke recovery in recent decades. However, no systematic evidence has been performed to confirm the effect and safety of BAA as an adjunctive therapy for post-stroke motor dysfunction (PSMD). Objectives: This review aimed to assess the efficacy and safety of BAA as an adjunctive therapy for improving allover motor function, upper limb motor function, lower limb motor function, and activities of daily living (ADL) in patients with PSMD. Methods: Seven databases were searched from inception to December 2020: Embase, PubMed, Cochrane Library, Chinese Biological Medicine Database, Chinese Scientific Journal Database, WAN FANG, and the China National Knowledge Infrastructure. All randomized controlled trials (RCTs) involving BAA plus another therapy vs. the same other therapy alone were identified. The methodological quality of the included trials was assessed according to the Cochrane risk of bias criteria. If more than half of the domains in a study are at low risk of bias, the overall quality of the study is low risk. We conducted a meta-analysis for primary outcomes using a random effects model and performed a narrative summary for the secondary outcome. We also conducted subgroup analysis for primary outcomes based on different add-on treatments to BAA. Random effects and fixed effects models were used to test the robustness of the pooled data. We also tested the robustness of the meta-analysis using specific methodological variables that could affect primary outcome measures. Results: Twenty-one trials with 1,473 patients were included in this systematic review. The overall quality of the 14 included trials (66.7%) was low risk. Meta-analyses indicated that the effect of the BAA group was better than that of the non-EA group on the Fugl-Meyer Assessment Scale (FMA) (weight mean difference (WMD) 9.53, 95% confidence interval (CI) 7.23 to 11.83, P < 0.00001), FMA for upper extremities (WMD 11.08, 95% CI 5.83 to 16.32, P < 0.0001), FMA for lower extremities (WMD 5.57, 95% CI 2.61 to 8.54, P = 0.0002), and modified Barthel Index (standardized mean difference (SMD) 1.02, 95% CI 0.65 to 1.39, P < 0.00001). Two trials (9.5%) reported BAA-related adverse events, and the most common adverse event was local subcutaneous ecchymosis. Conclusions: BAA as an adjunctive therapy may have clinical benefits for improving allover motor function, upper limb motor function, lower limb motor function, and ADL in patients with PSMD. BAA-related adverse events were rare, tolerable, and recoverable. However, our review findings should be interpreted with caution because of the methodological weaknesses in the included trials. High-quality trials are needed to assess the adjunctive role of BAA in patients with PSMD.

Current state of research about acupuncture for the treatment of COVID-19: A scoping review.

BACKGROUND: Since the outbreak of coronavirus disease (COVID-19), acupuncture has been widely used in the treatment of COVID-19. The research community has responded rapidly and has already published many research articles about this topic. METHODS: We searched PubMed, Embase, Cochrane Library as well as CNKI, Wanfang and VIP from January 1, 2020 to July 31, 2021. The dates of publication, language of publication, methodological characteristics and the key findings were analyzed separately. The data are presented as bar graphs, structured tables and figures. RESULTS: In this scoping review, 16 research articles were included: 7 case reports, 6 observational studies, 1 review, 1 RCT and 1 nonrandomized clinical trial. The majority of the articles (81.3%) were published by Chinese scholars, 12.5% articles were by scholars in the United States, and 6.3% articles were by scholars in Iran. The included studies reported that acupuncture could alleviate the symptoms of COVID-19 patients, shorten their hospitalization days, and is effective for the elderly. There were no side effects reported. The most frequent acupoints used were LI4, PC6, ST36 and KI3. They reported many obstacles in implementing acupuncture therapy for treating COVID-19 patients. CONCLUSION: Acupuncture has a good effect for the treatment of COVID-19, but high-quality evidence support is still lacking. Coupled with the difficulties that acupuncturists experienced during the process of treatment, the promotion of acupuncture treatment for COVID-19 faces many obstacles.

Formation Mechanism and Control Method of Residual Stress Profile by Laser Shock Peening in Thin Titanium Alloy Component.

In the laser shock peening process of titanium alloy thin blades, a shock wave will be repeatedly reflected and coupled in the blades, resulting in the failure of the formation of a gradient residual compressive stress layer, which is the key to improve fatigue performance and resist foreign object impact. This paper takes TC17 titanium alloy sheet as the research object to reveal the influence mechanism on residual stress-strain profile of shock wave reflection-coupling by shock wave propagation and key position dynamic response. Based on the result of influence mechanism, two wave transmission methods are proposed to regulate shock wave in order to reduce the intensity of shock wave reflection. The analysis shows that the high strength stress be formed when the shock wave is reflected and coupled in the sheet, which causes the re-plastic deformation and the decrease of transverse plastic strain. This eventually leads to residual tensile stress up to 410 MPa being formed within a 0.5 mm radial direction and 0.3 mm deep of the spot range. The use of "soft" and "hard" wave-transmitting layers greatly reduces the shock wave reflection intensity, and under the condition of the "hard" wave-transmitting layer, a better impedance matching is achieved, resulting in a residual compressive stress of about 400 MPa.

Formation, characteristics, and applications of environmentally persistent free radicals in biochars: A review.

Due to abundant biomass and eco-friendliness, biochar is exemplified as one of the most promising candidates to mediate the degradation of environmental contaminants. Recently, environmentally persistent free radicals (EPFRs) have been detected in biochars, which can activate S2O82- or H2O2 to generate reactive oxygen species for effective degradation of organic and inorganic contaminants. Comprehending the formation mechanisms of EPFRs in biochars and their interactions with contaminants is indispensable to further develop their environmental applications, e.g., direct and indirect EPFR-mediated removal of organics/inorganics by biochars. With reference to the information of EPFRs in environmental matrices, this article critically reviews the formation mechanisms, characteristics, interactions, and environmental applications of EPFRs in biochars. Synthesis conditions and loading of metals/organics are considered as key parameters controlling their concentrations, types, and activities. This review provides new and important insights into the fate and emerging applications of surface-bound EPFRs in biochars.