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The purpose of this study was to review the literature on the effect of scraping therapy on chronic low back pain (LBP) from randomized controlled trials (RCTs).Three English medical electronic databases (PubMed, Embase, and the Cochrane Library) and 2 Chinese databases (China National Knowledge Infrastructure and Wanfang) were searched. Only randomized controlled trials related to the effects of scraping therapy on chronic LBP were included in this systematic review. Study selection, data extraction, and validation were conducted independently by 2 reviewers. The methodological quality of the studies was evaluated by the Cochrane risk-of-bias tool. RevMan 5.3 software was applied to perform meta-analysis of the data.Ten studies comprising 627 participants were included. Overall, the quality of evidence was moderate owing to a lack of blinding and allocation concealment in some studies and unclear risk of selective reporting. Meta-analysis of 9 RCTs indicated that scraping therapy had a statistically significant effect on pain reduction (standard mean difference = -0.66, 95% confidence interval [CI], -0.83 to -0.49, P.001). However, if only a single scrape treatment was carried out, the results did not show that scraping was superior to the control group regarding pain relief (mean difference = -0.35, 95% CI, -1.23 to 0.53, P = .44). Moreover, the results of 6 RCTs involving 468 participants showed significantly greater improvement in lumbar dysfunction (mean difference = -10.05, 95% CI, -13.52 to -2.32, P.001). In addition, the results of 5 RCTs involving 393 participants showed a favorably significant effect on the overall efficacy (odds ratio = 4.74, 95% CI, 2.34-9.62, P.001). As for follow-up effects, meta-analysis of 3 RCTs involving 241 participants showed a promising effect on pain reduction and lumbar function improvement at 1 month and 3 months after the end of treatment, respectively. Only 1 study reported adverse effects, and none were serious.Scraping therapy may have a therapeutic effect for some individuals with chronic LBP. However, due to the limited amount of research and the low methodological quality of the included studies, additional large-scale, multicenter, high-quality RCTs on relieving pain intensity and improving lumbar dysfunction are still necessary.

Purpose: To evaluate the effects of dezocine on the prevention of postoperative catheter-related bladder discomfort (CRBD). Patients and methods: Ninety-six adult patients undergoing abdominal surgery with urinary catheterization under general anesthesia were randomized into dezocine and control (flurbiprofen) groups. The postoperative CRBD, pain score, sedation score and adverse effects were evaluated at 0, 1, 2 and 6 hrs after tracheal extubation. Results: The primary outcome showed a lower incidence of CRBD at 1 hr post-extubation in the dezocine group (29.17%) than the control group (58.33%, P 0.05); however, the overall severity of CRBD was decreased in the dezocine group compared with the control group (P

Myocardial fibrosis plays a central role in the development of heart failure. It has been shown that recurrent exposure to subclinical lipopolysaccharide (LPS) increases mortality and induces cardiac fibrosis in mice, which is not mediated by the common renin-angiotensin system. LPS increased NADPH oxidase2 (NOX2) in isolated adult mouse cardiac fibroblasts and NOX2 may mediate LPS-induced cardiac fibrosis. Therefore, the current study was designed to delineate the role of NOX2 in LPS-induced fibrosis model and to investigate the preventive role of Tanshinone IIA (TIIA) on the development of cardiac fibrosis. The protective mechanism of TIIA was determined to be associated with the inhibition of NOX2, by comparing its effects with the NADPH oxidase inhibitor, apocynin. The results revealed remarkable effects of apocynin and TIIA on attenuating the development of myocardial fibrosis and fibrosis-related genes and mediators. Furthermore, TIIA and apocynin decreased the expression of NADPH oxidase subunits (NOX2 and P67phox) expression and the ROS levels. The anti-fibrotic effect of apocynin suggested that NOX2 inhibition may be a potential preventive strategy for attenuating the progression of LPS-induced cardiac fibrosis. Our results demonstrate that TIIA may be a potent agent against subclinical LPS-induced cardiac fibrosis in mice partially via inhibition of NADPH oxidase 2.

In acidic soil, plant aluminum (Al) tolerance and nitrogen (N) fertilizer form play the important roles in influencing plant growth. Diazotrophs as plant growth promoting rhizobacteria can contribute to plant available N, but the response to plant growth differences resulting from plant Al tolerance or N fertilizer form in acidic soil is poorly understood. Here, we investigated this response. Three maize cultivars with different Al-tolerance levels were grown in an acidic soil that was added with nitrate (NO3−-N) or ammonium (NH4+-N) fertilizers. After 42 days, maize biomasses and root morphologies as well as the physicochemical properties of bulk and rhizosphere soils were determined. Based on nifH gene, soil diazotroph abundance was determined by quantitative RT-PCR and community composition was assayed using high-throughput sequencing. For the same maize cultivar, application of NO3−-N fertilizer relative to NH4+-N fertilizer increased maize biomass, root length, root surface area, and rhizosphere pH, but not significantly affect rhizosphere nifH copy number and community composition. The nifH copy numbers did not show significant differences among rhizosphere samples of three maize cultivars, but community composition was obviously different between Al-tolerant and Al-sensitive cultivars. In acidic soil, maize cultivars depending on Al tolerance altered rhizosphere diazotrophic community composition, but this effect seemed to be not susceptible to N fertilizer forms.

Phosphorus (P) deficiency is an important factor that limits the agricultural production potential in acidic soils. The bacterial phoC gene encodes non-specific acid phosphatase (ACP), which participates in the mineralization of soil organic P and is therefore important for the improvement of soil P availability. However, the function and community population of phoC-harboring bacteria and their driving factors in acidic soil remain largely unknown. For this study, 51 soil samples and 207 plant samples were collected from four locations in the acidic soil region of southern China. Quantitative PCR and high-throughput sequencing were employed to analyze abundance and community composition of phoC-harboring bacteria. The results showed that soil P availability was the important nutrient element limiting the growth of both plants and soil bacteria. Soil ACP activity was clearly higher than alkaline phosphatase, indicating the important effect of phoC-harboring bacteria in acidic soils. ACP activity and phoC gene abundance showed a significant positive correlation, and both were closely related to soil available P, total carbon, and total nitrogen. The dominant genera of phoC-harboring bacteria involved Cupriavidus, Stenotrophomonas, and Xanthomonas. Compared to land-use pattern, sampling location, and soil parent material, soil property played a more important role in affecting phoC-harboring bacterial community structure, where N-related variables including soil NO 3 - -N, NH 4 + -N, and C/N ratio appeared to be the main factors. These findings suggest that phoC-harboring bacteria should provide an important contribution to soil P availability in acidic soil, and its function and community composition were strongly associated with soil nutrients.

Ammonium (NH4+) alleviates manganese (Mn) toxicity in various plant species, but the underlying mechanisms are still unclear. In this study, we compared the effects of NH4+ and nitrate (NO3−) on rice (Oryza sativa L.) growth, accumulation and distribution of Mn, accumulation of iron (Fe), zinc (Zn) and copper (Cu), root cell wall components, and expression of Mn and Fe transporter genes. After rice seedlings were grown in non-pH-buffered nutrient solution for 2 days, the pH of growth medium changed from an initial value of 4.5 to 3.5 and to 5.5 in the presence of NH4+ and in the presence of NO3−, respectively. Compared with NO3−, ammonium decreased nutrient-solution pH and alleviated Mn toxicity and accumulation in rice under non-pH-buffered conditions. This alleviation disappeared when 5 mM Homo-PIPES pH buffer was added. Regardless of N form, roots, shoots, root cell sap, and xylem sap accumulated much lower Mn at pH 3.5 than at pH 5.5, whereas Mn distribution in different leaves and Mn accumulation in root cell walls was affected by neither N form nor pH. Ammonium decreased the expression of the Mn influx transporter gene OsNramp5 in roots under non-pH-buffered conditions, but not under pH-buffered ones. OsNramp5 expression was down-regulated at pH 3.5 compared with pH 5.5. Another efflux Mn transporter gene, OsMTP9, was not regulated by either N form or pH. High pH (5.5) enhanced the expression of the Fe transporter gene OsIRT1 and increased the accumulation of Zn but not Fe or Cu in shoots compared with pH 3.5. Taken together, our results indicate that NH4+ alleviates Mn toxicity and accumulation in rice through the down-regulatory effects of rhizosphere acidification on the Mn influx transporter gene OsNramp5. In addition, the up-regulation of OsIRT1 expression may contribute to the increased Zn uptake by rice at high pH of nutrient solution.

Introduction The primary purpose of this survey was to investigate the attitudes of patients undergoing elective surgery, towards the application of acupuncture to reduce perioperative complications, and to identify the possible factors that influenced their attitudes. Methods The survey was conducted in the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine in China. A 20-item questionnaire was developed and piloted over a period of eight weeks. Results 176 adult surgical inpatients completed the survey with a response rate of 98.9%. Only about one quarter of the participants had past experience of acupuncture treatment (n = 46, 26.1%) and one third thought acupuncture was effective (n = 61, 34.7%). Less than half of them were willing to use acupuncture for postoperative nausea and vomiting (PONV) (n = 70, 39.8%), postoperative pain (n = 79, 44.9%), preoperative anxiety and insomnia (n = 65, 36.9%), postoperative gastrointestinal dysfunction (n = 76, 43.2%), postoperative urinary retention (n = 81, 46.0%). Patients who were professionals or office workers (chi square = 26.181, p = 0.001) or with better education (chi square = 14.583, p = 0.024) were more willing to use acupuncture, while age or gender did not affect their attitudes. A majority of patients would follow the doctor’s advice about acupuncture (n = 111, 63.1%). Those who had history of PONV were less likely to receive acupuncture (chi square = 10.664, p = 0.005). Conclusions Overall, the surveyed Chinese patients had limited experience and knowledge of acupuncture, and less than half had positive attitudes towards using acupuncture for reducing perioperative complications. Education of patients and their doctors may be promising strategies for improving patients’ willingness to use acupuncture.

Small artery occlusion (SAO) is responsible for 31.3% of all ischemic strokes in China. However, reports regarding the recurrence rate of SAO in China are rare. We aimed to assess the recurrence rate and factors associated with SAO in China. All consecutive patients with SAO hospitalized at Tianjin Huanhu Hospital from 2005 to 2014 were recruited. We assessed the association between stroke subtype, severity, and disease history with recurrence at 3, 12, and 36 months of onset using multivariate logistic regression analysis. A total of 2,524 SAO patients were included in this study, including 1696 (67.2%) men and 828 (32.8%) women. The recurrence rates were 3.1% at 3 months, 12.7% at 12 months, and 36.5% at 36 months. Compared with women, men had a higher risk of recurrence at 3 months after SAO (P = 0.003). Old age and severity of stroke were also associated with a higher risk of recurrence (P

BACKGROUND The aim of this study was to study the feasibility and acceptability of electroacupuncture (EA) for preventing postoperative gastrointestinal complications in patients undergoing thoracoscopic segmentectomy/lobectomy. MATERIAL AND METHODS Sixty patients who underwent video-assisted thoracoscopic (VATS) segmentectomy/lobectomy received either EA treatments plus usual care (EA group) or usual care alone (UC group). Patients in the EA group were given 30 minutes of bilateral electroacupuncture on 3 acupoints [Neiguan (PC6), Zusanli (ST36), and Shangjuxu (ST37)] at 3 time points (24 hours before surgery, and 4 hours and 24 hours after surgery). The primary outcomes were recruitment, retention, acceptability of the EA intervention, incidence and severity of abdominal distension (AD), and time to first flatus and defecation. Secondary outcomes included postoperative nausea and vomiting (PONV), pain intensity, and duration of hospital stay. RESULTS We recruited 60 participants and 59 were randomized into 2 groups for this study: 30 in the EA group and 29 in the UC group. In total, 57 participants completed the study. With the exception of one participant in the EA group, all participants completed all three sessions of EA. The one exclusion was a case where a paravertebral block was not used during the surgery. Qualitative findings from the acceptability questionnaire indicated that participants viewed the EA treatment as acceptable. After EA treatment, there was a small but statistically significant improvement in participants' acceptance of EA for alleviating postoperative gastrointestinal discomfort (P=0.001). The EA group showed improved outcomes compared to the UC group in terms of time to first flatus (20.8±4.6 versus 24.1±6.2 hours, P=0.026) and defecation (53.9±6.0 versus 57.5±7.2 hours, P=0.046). No significant differences appeared regarding AD, rescue medication, or duration of hospitalization. PONV and pain intensity were similar in both groups at the recorded time periods. CONCLUSIONS EA is feasible and acceptable to patients undergoing VATS surgery. Our preliminary findings of EA promoting postoperative recovery of gastrointestinal function warrants large randomized controlled trials.

Background Acute postoperative pain remains a major clinical problem that affects patient recovery. Distal acupoint and peri-incisional stimulation are both used for relieving acute postoperative pain in hospital. Our objective was to assess and compare the effects of distal and peri-incisional stimulation on postoperative pain in open abdominal surgery. Methods MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Chinese databases CNKI and Wanfangdata were searched to identify eligible randomized controlled trials. Intensity of postoperative pain, opioid consumption and related data were extracted and analyzed using a random effects model. Risk of bias was assessed. Subgroup analyses were conducted when data were enough. Results Thirty-five trials were included, in which 17 trials studied distal stimulation, another 17 trials studied peri-incisional stimulation and one studied the combination of the two approaches. No studies that directly compared the two approaches were identified. Subgroup analysis showed that both distal and peri-incisional stimulation significantly alleviated postoperative resting and movement pain from 4 h to 48 h after surgery by 6 to 25 mm on a 100 mm visual analogue scale. Peri-incisional stimulation showed a better reduction in postoperative opioid consumption. No studies compared the effects of the combined peri-incisional and distal stimulation with either mode alone. Overall the quality of evidence was moderate due to a lack of blinding in some studies, and unclear risk of allocation concealment. Conclusion Both distal and peri-incisional modes of stimulation were effective in reducing postoperative pain. Whether a combined peri-incisional stimulation and distal acupuncture has superior results requires further studies.

Introduction Auricular acupuncture has been used for pain management but a more recent technique which buries an intradermal needle into the skin may provide longer lasting stimulation and enhance analgesia. The purpose of this study was to evaluate the efficacy and feasibility of perioperative auricular acupuncture technique via intradermal needling buried on postoperative movement-evoked pain reduction in patients with advanced gastric cancer following open radical gastrectomy. Methods This research is a protocol for a prospective, assessor- and analyst-blinded, randomized controlled pilot trial with two parallel groups. Forty patients who undergo elective open radical gastrectomy will be recruited from 210-bed oncology surgery ward at a 2500-bed medical center between 2019/8/23 and 2020/2/20. Patients will be randomized to either the control group receiving non-invasive sham auricular acupuncture or to the experimental group receiving auricular acupuncture technique via intradermal needling buried, delivered 24 h before surgery and retained & replaced every 3 days for 6 consecutive days. A standard general anesthetic technique will be used for both groups. Rescue analgesia will be given when the VAS score is≥4. Primary outcome measures are Functional Activity Score (FAS) and Numerical Rating Scale score (NRS) for movement-evoked pain. Secondary outcome measures are NRS score for pain at rest, use of rescues analgesic, total opioid consumption, postoperative nausea and vomiting, physiological recovery Outcomes, Quality of Recovery-9 (QoR-9) and patient’s satisfaction. Ethics and dissemination This protocol has been approved by the Institutional Review Board (IRB) of the Clinical Research Centre (Affiliated Hospital of Nanjing University of Chinese Medicine, IRB No. 2019NL-032-02). In addition, the results of the preliminary study will be disseminated through peer-reviewed publications.