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Formulating critical clinical questions and outcomes is essential for developing clinical practice guidelines (CPGs). This study aims to formulate the key clinical questions and outcomes for the CPG on acupuncture and moxibustion for allergic rhinitis (AR). PICO (patient, intervention, comparator, and outcome) question survey, Delphi survey, and consensus conference of the guideline development group (GDG) were employed. PICO questionnaires were used to gather and analyze the target users' key demands and interests. The GDG then selected the critical clinical questions and outcomes via a mixed method of Delphi survey and consensus conference. Fifteen potential clinical questions and ten types of outcomes were formulated based on the analysis of 123 responses from seventeen countries on five continents. After two rounds of the Delphi survey and complete discussions, a consensus was reached by the GDG that all potential questions were included. After three rounds of the Delphi survey and complete debate, the consensus was reached that nine outcomes were considered important. Fifteen key clinical questions and nine important outcomes were formulated for the CPG. These covered issues elicited the most attention from global users in acupuncture therapy and AR. The results will contribute to the CPGs development and future clinical studies. [ABSTRACT FROM AUTHOR]

Objectives. This study aimed to examine the efficacy and safety of acupoint catgut embedding (ACE) for obesity over a 16-week treatment period using sham stimulation as the control. Methods. A multicenter, randomised, parallel, sham-controlled trial was conducted from February 10, 2017, to May 15, 2018. Men with waistlines ≥85 cm and women with ≥80 cm at three sites were randomised to receive eight sessions (over 16 weeks) of ACE (n = 108) or sham ACE (n = 108) with skin penetration at sham acupoints. The catgut was embedded once every two weeks using two alternating sets of acupoints. The follow-up lasted for an additional 24 weeks. The primary outcome was the percentage waistline reduction from baseline to week 16. Results. We included 216 individuals in the intention-to-treat analysis. At 16 weeks, the rate of waistline reduction was 8.80% (95% confidence interval (CI), 7.93% to 9.66%) in the ACE group and 4.09% (95% CI, 3.18% to 5.00%) in the sham control group, with a between-group difference of 4.71% (95% CI, 3.47% to 5.95%; P < 0.0001). This difference persisted throughout the entire follow-up period (between-group difference after 24-week additional weeks, 4.94% (95% CI, 3.58% to 6.30%); P < 0.001). The subgroup analyses of waistline by sex (male/female) revealed treatment effects of 1.93 (95% CI, −0.37 to 4.23, P = 0.1) in the male group and 3.19 (95% CI, 1.99 to 4.39, P < 0.001) in the female group. The adverse event analysis suggested that ACE and laboratory tests confirmed the safety of ACE. Discussion. ACE for 16 weeks could decrease the waistline and weight and was safe for the treatment of obesity. Further research is needed to evaluate the long-term efficacy and sex differences. This trial is registered with NCT02936973. [ABSTRACT FROM AUTHOR]

The survey aims to collect clinical questions for the clinical practice guideline on acupuncture and moxibustion in treating urinary incontinence in women. The survey is consisted of multiple-choice questions, ranking questions and open questions. We hope you can help us to complete the questions using PICO (Patients, Intervention, Comparator and Outcome) framework referring to the examples. The survey might take about 30 min, and the responses from you will greatly contribute to the formation of this guideline. [ABSTRACT FROM AUTHOR]

The survey aims to collect clinical questions for the clinical practice guideline on acupuncture and moxibustion in treating allergic rhinitis. The survey is consisted of multiple-choice questions, ranking questions, and open questions. Readers are recommended to complete the open questions using PICO (Patients, Intervention, Comparator and Outcome) framework, referring to the examples. The survey might take about 30 min, and the responses from readers will greatly contribute to the formation of this guideline. [ABSTRACT FROM AUTHOR]

An acid‐free N‐nitrosation/nitration of the N−H bonds in secondary amines with Fe(NO3)3 ⋅ 9H2O as the nitroso/nitro source through an electrocatalyzed radical coupling reaction was developed. Cyclic aliphatic amines and N‐heteroaromatic compounds were N‐nitrosated and N‐nitrated, respectively, under mild conditions. Control and competition experiments, as well as kinetic studies, demonstrate that N‐nitrosation and N‐nitration involve two different radical reaction pathways involving N+ and N. radicals. Moreover, the electrocatalysis method enables the preferential activation of the N−H bond over the electrode and thus provides high selectivity for specific N atoms. Finally, this strategy exhibits a broad scope and provides a green and straightforward approach to generate useful N‐nitroso/nitro compounds in good yields. [ABSTRACT FROM AUTHOR]

Purpose. The MRI features of epithelioid glioblastoma (eGBM) were analyzed. The apparent diffusion coefficient (ADC), MR perfusion-weighted imaging (PWI), and magnetic resonance spectroscopy (MRS) findings were quantitatively analyzed.Methods. The MRI images of 8 cases of eGBM were analyzed retrospectively. The location and edge, signal, peritumoral edema, adjacent meningeal invasion, and enhancement of the lesions were observed. The ADC value, relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF), and N-acetylaspartate/acetylcholine (NAA/Cho) value were analyzed.Results. Among the 8 patients, the tumors were mainly located in the temporal lobe (n = 3), frontal lobe (n = 3), and parietal lobe (n = 2). The lesion boundary was clear in 6 cases and unclear in 2. The lesions were superficial in 5 cases and in the deep white matter in 3. Internal hemorrhage was observed in 4 cases. There was cystic necrosis in 7 cases, and only 1 case was solid without cystic necrosis. There was no edema around the lesion in 1 case, severe edema in 5, and moderate edema in 2. In 4 cases, the adjacent meninges were involved, and in 1 case, the ependyma was involved. Two patients developed leptomeningeal metastasis within 2 months after the operation. The average ADC value of the tumor parenchyma among all 8 patients was 7.15 × 10 − 4 m m 2 / s ,which was 17.6% lower than that of the contralateral side. The Cho/NAA metabolite ratio was 5.27 and 0.81 in the lesions of 2 patients. The rCBV was 3.51 ml/100 g and 3.32 ml/100 g of lesions in 2 patients; these values were 36% and 29% higher, respectively, than those of the contralateral side. The rCBF was 31.5 ml/100 g/min and 82.1 ml/100 g/min of lesions in two patients; these values were 49% and 203% higher, respectively, than those of the contralateral side.Conclusion. eGBM characteristics include a superficial location, easy cyst degeneration, easy necrosis and hemorrhage, and clear boundaries. It easily invades adjacent meninges and shows cerebrospinal fluid dissemination and metastasis. Combining new MR techniques, such as ADC values, PWI, and MRS, could be helpful for improving diagnostic accuracy. [ABSTRACT FROM AUTHOR]

Professor Jiping ZHAO has unique thoughts on the diagnosis and treatment of peripheral facial paralysis. She pays the great attention to clinical differentiation in treatment with acupuncture, especially meridian differentiation. She believes that the differentiation of lesion is core and the early judgment is critical for the better therapeutic effects on intractable facial paralysis. The local acupoints are selected in the guide of the theory of meridian sinew and stimulated on the base of three-needling theory. The distal acupoints are decided in light of the syndrome differentiation, of which, Hégŭ (合谷 LI 4), Zúsānlĭ (足三里 ST 36) and Tàichōng (太冲 LR 3) are the basic acupoints. Additionally, Professor ZHAO lays the emphasis on the 5th branch of facial nerve (cervical branch) in diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Abstract Objective To explore the tenderness response at the acupoints on the medial crus in the patients of pelvic inflammatory disease. Methods A total of 30 patients of pelvic inflammation and 30 healthy people were included. WAGNER FDX body mechanics algometer was used to determine the score of the visual analogue scale (VAS) and tenderness threshold value at Yīnlíngquán (阴陵泉 SP 9), Sānyīnjiāo (三阴交SP 6) and Lígōu (蠡沟 LR 5). The changes in the tenderness on the body surface at the relevant acupoints were compared and analyzed in the patients of pelvic inflammation. Results The occurrence rate of tenderness at LR 5 at the pelvic inflammation group was higher significantly than the health group (86% Vs 42%, P <0.01). In SP 9, SP 6 and LR 5,the VAS scores at the acupoints in the pelvic inflammation group were higher significantly than the health group (test 1:55.00 ± 15.12 vs 27.25 ± 10.31, 47.07 ± 18.38 vs 29.75 ± 14.30, 47.16 ± 19.4 vs 20.16 ± 10.76; test 2:53.40 ± 17.23 vs 33.42 ± 13.07, 45.95 ± 15.74 vs 29.15 ± 11.97, 42.50 ± 21.67 vs 21.05 ± 11.97; test 3: 48.50 ± 14.97 vs 40.08 ± 13.20, 38.24 ± 15.29 vs 29.29 ± 12.37, 37.93 ± 19.17 vs 23.09 ± 12.26) , P < 0.01, P < 0.05.In SP 9, SP 6 and LR 5,the tenderness threshold values at the acupoints in the pelvic inflammation group were higher significantly than the health group (test 1:0.86 ± 0.95 vs 0.53 ± 0.39, 0.86 ± 0.95 vs 0.53 ± 0.39, 0.85 ± 0.77 vs 0.47 ± 0.47; test 2:0.88 ± 0.81 vs 0.44 ± 0.32, 0.98 ± 0.83 vs 0. 44 ± 0. 32, 0.85 ± 0.77 vs 0.47 ± 0.47; test 3:0.98 ± 0.80 vs 0.36 ± 0.26, 1.11 ± 0.92 vs 0. 36 ± 0. 26, 0.85 ± 0.77 vs 0.47 ± 0.47), P < 0.01, P < 0.05 (P < 0.05). Conclusion The VAS scores and tenderness threshold values at SP 9, SP 6 and LR 5 in the patients of pelvic inflammation are higher significantly than those in the healthy people. The occurrence rate of tenderness at LR 5 is higher significantly as compared with the healthy people. [ABSTRACT FROM AUTHOR]

Abstract Background Allergic rhinitis (AR) is defined as an immunoglobulin led atopic disorder that affects the nasal mucosa. Moxibustion on herbs, a common complementary and alternative medicine approach, is frequently used for treating AR in clinical practice. Western medicine is good at quick symptomatic relief, while offer little or no sustainable and steady long-term effect. Little established evidence is available to support the long-term effectiveness of moxibustion on herbs for AR. Objective This study is a randomized controlled trial to assess the long-term effectiveness of moxibustion on herbs in moderate-severe persistent AR population. Methods The study sample size is 56 patients. Eligible patients with moderate-severe persistent AR will be randomized into a moxibustion on herbs combined with conventional treatment group (MOHCT group) and a conventional treatment group (CT group) in a 1:1 ratio. Patients in the MOHCT group will receive a 30-min moxibustion on herbs treatment on Zhìyáng (至阳 GV 9), Dàzhuī (大椎 GV 14) and bilateral Shènshū (肾俞 BL 23), Fèishū (肺俞 BL 13) for a total of 12 times on the basis of conventional treatment, while those in the CT group will receive conventional treatment alone. The primary outcome measure is VAS score for total nasal symptoms, which will be obtained via a self-recorded AR diary. The secondary outcome measures include the average occurrence of symptoms per week, use of medication and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ). Discussion The objectives of this study include (1) to evaluate the long-term effectiveness and safety of moxibustion on herbs for treating AR; (2) to evaluate whether moxibustion on herbs can reduce the frequency of AR symptoms in patients with moderate-severe persistent allergic rhinitis. The finding of this study will provide evidence on the long-term effectiveness of moxibustion on herbs for moderate-severe persistent AR. [ABSTRACT FROM AUTHOR]

Since acupuncture came to western countries, research has been done to try and prove whether or not it is effective. Current Acupuncture research is most often based on the sham needle which was first designed by K Streitberger and J Kleinhenz in 1998. The sham acupuncture needles are developed for the control group and do not penetrate the skin. Sham acupuncture has been used in randomized controlled trial (RCT) for diseases which normally benefit from acupuncture treatment. The sham needle is not the best placebo needle though. Because of the use of sham acupuncture, the result of those research shows acupuncture having no effect or it shows there is no significant difference between real acupuncture (verum) and sham acupuncture (placebo). However, a detailed introduction of the Nine Classical Needles (ancient) and the Nine Modern Needles (SHI's nine needles) shows that the use of sham acupuncture in RCT research is flawed by design. This then casts doubt on the findings and conclusions reached by using sham acupuncture in RCT acupuncture research. [ABSTRACT FROM AUTHOR]

This systematic review is aim to comprehensively evaluate the efficacy of acupoint stimulation in managing of post-stroke spasticity. The eligible randomized controlled clinical trials (RCTs) and quasi-randomized controlled clinical trials (quasi-RCTs) will be searched from the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), Wanfang Database, Chinese BioMedical Literature Database (CBM). The Cochrane risk of bias tool will be used to assess the trials. No patients or their family will be bothered in this systematic review, so there is no need for the permission of institutional review board (IRB). The completed systematic review will be published in a peer-reviewed journal. [ABSTRACT FROM AUTHOR]

Background: Asthma is a chronic inflammatory disease of the airway that is mediated by T-helper 2(TH2) cells. Thymic stromal lymphopoietin (TSLP) can aggravate asthmatic lung inflammation by activating dendritic cells (DCs) to promote TH2 differentiation. TSLP promoter polymorphisms are associated with susceptibility to bronchial asthma in Japanese population. We sought to determine whether single nucleotide polymorphisms (SNPs) in TSLP gene are associated with asthma in Chinese Han population. Objective: To analyze the polymorphism of the two SNPs Rs2289276 and Rs2289278 in TSLP gene and to evaluate the association between the two SNPs and asthma susceptibility in Chinese Han population by using case-control study. Methods: five hundred and thirty one asthmatic patients and 540 age-sex matched normal controls were collected and DNA were extracted from peripheral blood, then the genotypes of SNPs Rs2289276 and Rs2289278 in TSLP gene were detected with polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP), genotype and allele frequencies were calculated and analyzed with Chi-square test. Results: Frequencies of CC/CT/TT genotypes at Rs2289276 site were 0.4706/0.4392/0.0902 in the asthmatic patients and 0.5604/0.3800/0.0595 in the healthy controls. Frequencies of CC/CG/GG genotypes at Rs2289278 site were 0.6502/0.2966/0.0532 in the asthmatic patients and 0.5795/0.3428/0.0777 in the healthy controls. The genotype and allele frequencies of the two SNPs in asthma patients were significantly different from those in the healthy controls. Rs2289278 C allele was correlated with decreased FEV1: FVC ( P ≤ .05). Conclusions: TSLP variants are significantly associated with bronchial asthma. TSLP might be a new therapeutic target molecule for asthma. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To observe the clinical therapeutic effects of acupuncture at single point Shiqizhui (EX-B8) and multi-points in time-varying treatment for primary dysmenorrhea. Methods: 600 patients with primary dysmenorrhea were randomly assigned to the single point group (n=200) including group A (treating before the menstruation, n=100) and group B (immediately treating as soon as pain occurrence, n=100), the multi-points group (n=200) including group C (treating before the menstruation, n=100) and group D (immediately treating as soon as pain occurrence, n=100), or the control group, group E (n=200, no treatment). The therapeutic effects were analyzed after treatment for three menstrual cycles and interviewed for three follow-up periods. Results: Acupuncture could effectively relieve menstrual pain for primary dysmenorrhea compared with the control group (P<0.05, P<0.01). Immediate pain relief occurred following acupuncture within 5min in group B (P<0.01) and group D (P<0.01), and the two groups obviously relieved menstrual pain for VAS scores. Both group A and group C obviously relieved menstrual pain (P<0.01), and group C was better than group A (P<0.05). Compared with group D, Group C was much better for CMSS scores in cycle 1. Conclusion: Treating before the menstruation is better than immediately treating as soon as pain occurrence at the improvement in symptoms of dysmenorrheal at multi-points. And single point is better than multi-points when immediately treating as soon as pain occurrence. The present trial suggest Shiqizhui (EX-B8) should be chosen as a convenient point. [Copyright &y& Elsevier]

Taking the recommendations development of the World Federation of Acupuncture-Moxibustion Societies (WFAS) standard Clinical Practice Guideline for Female Urinary Incontinence as an example, this study analyzed the consensus expert composition, specific consensus process, and results in the development of the guideline's recommendations. It systematically examined the advantages of using the modified Delphi method in the formation of recommendations for acupuncture and moxibustion clinical practice guideline, with the aim of providing reference for the development of acupuncture and moxibustion guidelines in the same field.

Rationale: Cerebrotendinous xanthomatosis (CTX) is a rare autosomal recessive lipid deposition disorder characterized by systemic signs and neurological dysfunction. The radiological features of CTX are infrequently summarized in the literature., Patient Concerns: We described a 40-year-old male patient who repeatedly engaged in wrestling matches and presented with progressive difficulty in walking and reduced balance with egg-sized, hard, smooth, and painless masses in both ankles., Diagnosis: Neuroimaging examination showed abnormalities both supra- and infratentorially. Bilateral ankle joint magnetic resonance imaging showed bilateral xanthomata of the Achilles tendon. The diagnosis was confirmed by the detection of a sterol 27-hydroxylase gene mutation., Interventions: The patient was treated with chenodeoxycholic acid (250 mg 3 times per day)., Outcomes: To date, the patient's bilateral xanthomas of the Achilles tendon have begun to diminish, and his neurological impairment has not deteriorated further but has not yet improved., Lessons: We report a rare case of CTX and summarize the clinical and imaging features of this disease. Our findings suggest that the abnormal signals in the dentate nucleus or a long spinal cord lesion involving the central and posterior cord, combined with tendon xanthoma, are important clues for the diagnosis of CTX., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)