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Objective This study is conducted to investigate the effects of occupational therapy (OT) with or without combined acupuncture for upper limb pain and hand functions among children with spastic hemiplegic cerebral palsy. Methods A total of 90 patients who met the inclusion criteria were enrolled in a three-arm randomized, placebo-controlled trial, and were allocated to mono-occupational therapy (OT) group (patients= 30), OT combined with real-acupuncture (ORA) group (patients= 30), and OT combined with placebo-acupuncture (OPA) group (patients= 30), respectively. In addition to receiving the conventional OT program as the basic treatment for total 8 weeks, patients in ORA and OPA group also received corresponding acupuncture treatment 5 days per week for the first two weeks, 3 days per week for the next two weeks, 2 days per week for another two weeks, and 1 day per week for the last two weeks. Non-communicating children's pain checklist-revised scale (NCCPC-R) was used for assessing the upper limb pain among patients. Squeeze dynamometry, modified Ashworth scale (MAS), manual muscle testing (MMT), Jebsen-Taylor hand function test (JTHFT) and box and block test (BBT) were used for assessing various aspects of upper limb and hand functions among patients. Meanwhile, adverse effects were monitored and recorded. Results After 8-week treatment, NCCPC-R global scores witnessed a dramatic decline in ORA group (P 0.05) or OT group (P > 0.05). Dramatic increases were identified in both squeeze dynamometry scores and MMT scores in all three groups (all P 0.05). The BBT global scores of all three groups significantly increased (all P Conclusion ORA is a potential and promising alternative therapy for mitigating upper limb pain as well as improving both upper limb and hand functions among children with spastic hemiplegic cerebral palsy.

Background. Alzheimer’s disease (AD) is a common health condition affecting senile people and leads to severe cognitive dysfunctions. Acupuncture has been shown to be a possible alternative natural remedy for AD in some animal studies. Objective. To perform a systematic review to identify the effect of verum-acupuncture compared with sham-acupuncture on learning and memory performance among animal models of AD. Methods. Experimental animal studies of treating AD via verum- and sham- acupuncture were searched in nine electronic databases, including Sciverse ScienceDirect, PubMed, Springer, Ebsco Medline, AMED, EMBASE (Elsevier), Scopus (Elsevier), PsycINFO (ProQuest), and OVID from the dates of the databases’ inception to June 2019. The Morris water maze test was considered as an outcome measure. The software Revman 5.3 and Stata 16.0 were used to conduct the meta-analysis. Heterogeneity was examined by using I2 statistics. The publication bias was assessed via Begg’s test by Stata 16.0. Results. Twelve studies involving 229 animals met the inclusion criteria. Most of the studies had a moderate quality according to SYRCLE's risk of bias tool for animal studies. The results of the meta-analysis indicated that verum-acupuncture could reduce the escape latency (MD = −12.90, 95% CI (−17.08, −8.71), ) and increase the time spent in the original platform quadrant (MD = 7.28, 95% CI (4.23, 10.33), ) and frequency of the crossing former platform (MD = 2.01, 95% CI (1.53, 2.50), ) compared with the sham-acupuncture. Conclusions. Acupuncture is effective in improving cognitive functions in AD animal models, and this benefit is more than just a placebo effect. Further clinical trials are needed to confirm the findings. This work was sponsored by the Teaching and Research Award Program for Outstanding Young Teachers, Shanghai Sanda University (No. 2018zz13) and Special Project for Clinical Research, Shanghai Municipal Health Commission (No. 20174Y0009). The publication of this article was funded by the Qatar National Library. The authors would like to extend their gratitude to Yuen-Shan Ho, from School of Nursing, The Hong Kong Polytechnic University, for inspiring them to seek the underlying research directions. Besides, the authors thank Hai-Dong Guo, from School of Basic Medicine, Shanghai University of Traditional Chinese Medicine, for providing help in organizing the data and Yan Xu, the chair of Nursing Department, Shanghai Sanda University, for providing general support.

Background Acupuncture combined with Chinese herbal medicine was performed on 24 patients with post-schizophrenia comorbid depressive disorder and insomnia admitted to the Psychiatry Department, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine from 2016 to 2020, and provided satisfactory results. Considering post-schizophrenia comorbid depressive disorder and insomnia is not a common clinical disorder in hospital of traditional Chinese medicine, the treatment and follow-up cycle is long, and the dropout rate is high, a retrospective case series based on Joanna Briggs Institute (JBI) reporting checklist were conducted instead of a randomized controlled trial. Objective To retrospectively summary the short-, mid- and long-term effects of acupuncture combined with Chinese herbal medicine for post-schizophrenia comorbid depressive disorder and insomnia, and analyze the principles of the prescriptions. Methods A retrospective analysis based on case series JBI reporting checklist were performed to investigate effects of 24 patients with post-schizophrenia comorbid depressive disorder and insomnia undergoing 12-week combined acupuncture and Chinese herbal medicine treatment (patients did not receive full dosage treatments, or received western medicine or other physical and psychological therapies during the treatment period were excluded). The psychotic symptoms, depression, insomnia, and self-care ability for daily living were measured by the Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), Pittsburgh Sleep Quality Index (PSQI), and Activity of Daily Living Questionnaire (ADL-Q), respectively. Follow-ups were conducted at 8 and 16 weeks after treatment. Meanwhile, Acupuncture Beliefs Scale (ABS) was assessed at pre- and post- treatment as well as 16-week follow-up to investigate patients' beliefs and expectations for acupuncture treatment. Results (1) compared with pre-treatment, the PANSS global scores did not decrease significantly at post-treatment and follow-up periods (P> 0.05). (2) compared with pre-treatment, the global scores of CDSS and PSQI decreased significantly at post-treatment and follow-up periods (both P Conclusions Acupuncture combined with Chinese herbal medicine can significantly improve the insomnia and depressed mood following schizophrenia, with satisfactory short-, medium- and long-term effects; effective treatment experience can increase patients' beliefs and expectations for acupuncture therapy.

Comorbid depression and insomnia are ubiquitous mental complaints among women going through the perimenopausal stage of life and can result in major decline in quality of life. Antidepressive agents combined with/without hypnotics, and/or hormone therapy are currently the most common treatment for perimenopausal depression (PMD) and insomnia (PMI). Balancing the benefits of these pharmacotherapies against the risk of adverse events (AEs) is a difficult task for both clinicians and women. There has been a growing body of research regarding the utilization of acupuncture for treatment of PMD or PMI, whereas no studies of acupuncture for comorbid PMD and PMI have appeared. In this review, we summarize the clinical and preclinical evidence of acupuncture as a treatment for PMD or PMI, and then discuss the potential mechanisms involved and the role of acupuncture in helping women during this transition. Most clinical trials indicate that acupuncture ameliorates not only PMD/PMI but also climacteric symptoms with minimal AEs. It also regulates serum hormone levels. The reliability of trials is however limited due to methodological flaws in most studies. Rodent studies suggest that acupuncture prolongs total sleep time and reduces depression-like behavior in PMI and PMD models, respectively. These effects are possibly mediated through multiple mechanisms of action, including modulating sex hormones, neurotransmitters, hypothalamic-pituitary-adrenal axis/hypothalamic-pituitary-ovary axis, oxidative stress, signaling pathways, and other cellular events. In conclusion, acupuncture is a promising therapeutic strategy for comorbid depression and insomnia during perimenopause. Neuroendocrine modulation is likely to play a major role in mediating those effects. High-quality trials are required to further validate acupuncture’s effectiveness.

Background The effectiveness of acupuncture for insomnia and insomnia-related anxiety and depression has been widely investigated in clinical trials. However, whether higher dosage (more frequent) acupuncture can bring greater responses (a greater size of effect) is less understood. Objective This study is designed to investigate whether a five-times weekly (5 Ts/w) electroacupuncture (EA) treatment is better than a three-times weekly (3 Ts/w) EA in alleviating sleep deprivation, and sleep disturbance-induced cognitive dysfunctions and negative emotions in rats through four various behavioral tests. Methods Forty-six male Sprague-Dawley rats were randomly divided into control group (n = 10), model group (n = 12), EA-3 Ts/w group (n = 12), and EA-5 Ts/w group (n = 12). Except for the control group, the other three groups were established as chronic sleep deprivation models via the modified multi-platform water environment methodology. Then, rats in both EA-3 Ts/w group and EA-5 Ts/w group received corresponding dosage of EA therapy, respectively. After modeling and interventions, all four groups received four behavioral tests as follows: (1) sleep behavioral monitoring and evaluation was achieved by Comprehensive Lab Animal Monitoring System (CLAMS). (2) Cognitive functions were assessed by Novel Object Recognition (NOR) test. (3) Depressive-like behaviors was evaluated by Open-Field (OF) test. (4) Anxiety-like behaviors was appraised by Elevated Plus-Maze (EPM) test. After finishing the behavioral tests, the hippocampus of each rat was removed and its synaptic structure changes were observed under electron microscope. Results (1) CLAMS: two EA groups derived more sleep time within 24 h than the model group (both P 0.05). (2) NOR test: NOR ratio in the EA-3 Ts/w group was higher than that of the model group (P 0.05), although both of them were lower than that of the control group (both P 0.05) but was found in both the model group (P Conclusion (1) Five-week EA treatment can partially mitigate cognitive dysfunctions, anxiety-like behaviors, and depressive behaviors in rats with sleep deprivation, and this effect might be associated with the repairs on mitochondrial damage in hippocampal neurons. (2) There is insufficient evidence supporting 3 Ts/w EA treatment is less effective than 5 Ts/w EA treatment in mitigating sleep deprivation symptoms and depressive behaviors induced by sleep deprivation among rats. (3) 5 Ts/w EA treatment might be more effective than 3Ts/w EA treatment in attenuating sleep deprivation-induced cognitive impairments while it might further increase rat's anxiety-like behaviors at the same time.

To investigate the effect of electroacupuncture (EA) on cognitive function in D-galactose (D-gal)-induced aging rats, and the correlation between the effect and nucleotide-binding oligomerization domain (NOD)-like receptor protein 3 (NLRP3)-ASC-Caspase-1 signaling pathway. Forty-six male Sprague-Dawley (SD) rats were randomly divided into a control group (n=10), a model group (n=12), an EA-7 d group (n=12) and an EA-21 d group (n=12). Except the control group, the other three groups received 42 consecutive days of intraperitoneal injection of D-gal to establish aging rat models with cognitive dysfunction. The control group received the same amount of normal saline via intraperitoneal injection. Two EA groups were given EA therapy for 21 consecutive days (began from the 22nd day of modeling) or 7 consecutive days (began from the 36th day of modeling) accordingly at Dazhui (GV 14), Baihui (GV 20), Shenshu (BL 23) and Zusanli (ST 36). After modeling/intervention, all four groups received behavioral evaluations by Morris water maze (MWM) test, novel object recognition (NOR) test and step-down passive avoidance (SDPA) test followed by the Western blot (WB) detection of the expression levels of hippocampal NLRP3 inflammasome-associated proteins NLRP3, ASC and Caspase-1. MWM (place navigation test, PNT) results showed that the escape latency in the model group was significantly longer than that in the other three groups (P 0.05). From the 2nd day to the 4th day of the test, there was no significant difference between the EA-21 d group and the control group (P>0.05) in the escape latency; the escape latency was significantly shorter in the EA-21 d group than in the model group and the EA-7 d group (P 0.05). NOR results showed that there was no significant difference in the recognition ratio between the EA-7 d group and the EA-21 d group (P>0.05), and the recognition ratio was significantly higher in the two EA groups than in the model group (P 0.05). The model group had the shortest step-down latency, followed by the EA-7 d group, the EA-21 d group and the control group in order (P 0.05). NLRP3 inflammasome may be involved in the development of cognitive decline in aging rats; 7 consecutive days of EA intervention can partially improve the cognitive impairment in aging rats though the effect is rather limited; 21 consecutive days of EA intervention may improve the learning and memory abilities in aging rats via down-regulating the expression levels of NLRP3 inflammasome-associated proteins in hippocampus.

Objective This study is conducted to investigate the effects differences of escitalopram with or without combined electroacupuncture (EA) among male inpatients with a diagnosis of alcohol dependence and comorbid protracted alcohol withdrawal symptoms (PAWS). Methods A total of 62 participants who met the inclusion criteria were enrolled in a two-arm randomized, placebo controlled, patients-blind trial and allocated to an escitalopram with real-EA group (real-EA group, patients= 31) and an escitalopram with sham-EA group (sham-EA group, patients= 31), respectively. In addition to the oral administration of escitalopram for total four weeks, patients in each group received corresponding EA treatment five days per week and two days off for consecutive four weeks. Both serum homocysteine (Hcy) test and electrophysiological tests, including event-related potentials (ERPs) and exploratory eye movement (EEM) were performed at pre- and post-treatment. Additionally, the global scores of Penn Alcohol Craving Scale (PACS), 17-items Hamilton Depression Rating Scale (HAMD-17), and Hamilton Anxiety Scale (HAMA) were used for assessing the subjective emotion experience of patients, respectively. Meanwhile, adverse effects were monitored and recorded. Results After four-week treatment, the global scores of PACS and HAMD-17 declined significantly in both groups (both P 0.05). According to the parameters of ERPs, significant declines for N2PL, P3PL, and P3amp were observed in both two groups (all P Conclusion (1) Escitalopram with EA may be a potential alternative therapy for mitigating PAWS among male inpatients with alcohol dependence. (2) Escitalopram with EA might improve the alcohol-dependence induced cognitive dysfunctions via upregulating the expression of Hcy.

To investigate the effects of electroacupuncture (EA) on the behaviors of rat with anxiety disorder, and the expressions of hippocampal neurotransmitters including 5-hydroxytryptamine (5-HT), norepinephrine (NE) and dopamine (DA), and the expressions of hippocampal B-cell lymphoma-2 (Bcl-2) and Bcl-2 associated X (Bax). Forty-six male Wistar rats were randomly divIDed into a control group (n=10), a model group (n=12), an EA group (n=12), and a drug group (n=12). Except the control group, the other three groups were established into rat models of anxiety disorder using uncertain empty bottle stimulation. Rats in the EA group and the drug group received corresponding interventions for 15 consecutive days [EA group was given EA at Baihui (GV 20) and Sanyinjiao (SP 6); the drug group was given aqueous solution of alprazolam via intragastric administration]. After intervention, all four groups received open-field test (OFT) and elevated plus-maze (EPM) for behavioral evaluations. The expressions of 5-HT, NE and DA in hippocampus were determined by fluorescence spectroscopy (FS) while the expressions of Bcl-2 and Bax proteins in hippocampus were determined by Western blot (WB). The OFT horizontal scores in the control group, EA group and drug group were significantly higher than that in the model group (all P 0.05); the OFT vertical scores in the model group, EA group and drug group were significantly lower than the score in the control group (all P 0.05); though the percent of open-arm total time (OT%) in the EA group was lower than that in the control group (P 0.05), and it was significantly higher than that in the model group (P 0.05). The expression of NE in the model group was significantly higher than that in the other three groups (P 0.05). The expression of DA in the EA group was significantly higher than that in the control group and the drug group (both P 0.05). The expression of Bax in the model group was significantly higher than that in the other three groups (all P 0.05). Bax/Bcl-2 in the EA group was significantly higher than that in the control group (P 0.05). EA shows promising effects in attenuating rats' anxiety disorder, which may be achieved by the downregulation of the expressions of 5-HT and NE in the hippocampus and/or inhibition of hippocampal neuronal apoptosis. The efficacy is comparable to that of intervention with alprazolam.

Objective This study is conducted to determine effects of manual acupuncture (MA) in patients with a diagnosis of major depressive disorder (MDD) and comorbid insomnia. Methods A total of 67 participants who met the inclusion criteria were randomly enrolled in a two-arm randomized, placebo controlled, patients-blind trial and allocated to a real-MA group (patients = 34) and a sham-MA group (patients = 33). Patients in the real-MA group were treated on ‘Five-shen acupoints’, including Sishencōng (四神聪 EX-HN 1), Shenting (神庭 GV 24), Shendao (神道 GV 11), bilateral Běnshen (本神 GB 13), and bilateral Shenmen (神门 HT 7). Though being punctured on the same acupoints, patients in the sham-MA group were treated by a placebo acupuncture approach (Streitberger Placebo-needle). Each group received corresponding interventions every other day, three times a week for total eight weeks. Both polysomnography (PSG) and testing of serum biological markers such as neuropeptide Y (NPY) and substance P (SP) were performed at pre- and post-treatment. Additionally, the global scores of Pittsburgh sleep quality index (PSQI) and the global scores of 17-items Hamilton Depression Rating Scale (HAMD17) were used for assessing the subjective sleep and emotion experience of patients, respectively. Meanwhile, adverse effects were monitored and recorded. Results After eight-week treatment, the global scores of PSQI and global scores of HAMD17 declined significantly (both P 0.05). According to the parameters of PSG, striking decline were observed in sleep latency (SL) and wake after sleep onset (WASO) and striking climb were observed in total sleep time (TST) and sleep efficiency (SE) in the real-MA group after treatment (P 0.05, respectively). Additionally, there were no significant differences in awakening times (ATs) and rapid eyes movement sleep latency (REM-SL) in both two groups after treatment (both P > 0.05). Meanwhile, the expression of NPY increased significantly and the expression of SP decreased significantly in the real-MA group after interventions (both P 0.05). No serious adverse event was reported in either real- or sham- MA group. Conclusion (1) MA may be a potential alternative therapy for improving MDD and comorbid insomnia (particularly in extending total sleep time and shortening wake-up duration and sleep latency) via upregulating the expression of NPY and downregulating the expression of SP; more importantly, this efficacy of acupuncture can not be replaced by sham-acupuncture acting on the same acupoints with the same treatment frequency. (2) There is insufficient evidence to prove that MA can effectively reduce the number of arousals.

Postoperative cognitive dysfunction (POCD) is a common sequela following surgery and hospitalization. The prevention and management of POCD are important during clinical practice. POCD more commonly affects elderly patients who have undergone major surgery and can result in major decline in quality of life for both patients and their families. Acupuncture has been suggested as an effective intervention for many neurological disorders. In recent years, there are increasing interest in the use of acupuncture to prevent and treat POCD. In this review, we summarized the clinical and preclinical evidence of acupuncture on POCD using a narrative approach and discussed the potential mechanisms involved. The experimental details and findings of studies were summarized in tables and analyzed. Most of the clinical studies suggested that acupuncture before surgery could reduce the incidence of POCD and reduce the levels of systematic inflammatory markers. However, their reliability is limited by methodological flaws. Animal studies showed that acupuncture reduced cognitive impairment and the associated pathology after various types of surgery. It is possible that acupuncture modulates inflammation, oxidative stress, synaptic changes, and other cellular events to mitigate POCD. In conclusion, acupuncture is a potential intervention for POCD. More clinical studies with good research design are required to confirm its effectiveness. At the same time, findings from animal studies will help reveal the protective mechanisms, in which systematic inflammation is likely to play a major role.

Objective This study is conducted to determine the effects of SOOJI CHIM (Koryo hand acupuncture, KHA) therapy on sleep structures and perimenopause symptoms among insomniacs. Methods Totally 49 participants who met the inclusion criteria were enrolled in a two-arm randomized, placebo controlled, patients-blind trial, with 24 cases allocated to a real-KHA group and 25 cases allocated to a sham-KHA group. Patients in each group received corresponding treatment every other day, three times a week for total eight weeks. Both actigraphy and testing of serum hormones level reflected by biological markers such as follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) were performed at pre- and post-treatment. Additionally, the scores of Pittsburgh sleep quality index (PSQI) was used for assessing the subjective sleep experience of insomniacs. Meanwhile, adverse effects were monitored and recorded. Results After eight-week treatment, the global scores of PSQI declined significantly (P 0.05). According to the outcomes of actigraphy, a striking increase was observed in both sleep efficiency (SE) and total sleep time (TST) in the real-KHA group (both P 0.05). However, no significant changes of sleep awakenings (SA) in both groups was found after treatment (both P>0.05). Meanwhile, FSH and LH in the real-KHA group decreased markedly after intervention (both P 0.05). The fluctuation of E2 levels were not significant in both groups (both P>0.05). No serious adverse event was reported in either real- or sham- KHA group. Conclusion KHA may be a potential alternative therapy for improving perimenopausal insomnia via down regulating the levels of FSH and LH.

Objective To investigate if manual acupuncture can improve the primary insomnia-induced impairments of attention network function and its safety. Methods Totally 64 eligible participants were enrolled in a randomized controlled trial, with 32 cases allocated to the treatment group and 32 cases allocated to the control group, respectively. The participants in the treatment group received real-acupuncture therapy [acupuncture at ‘Five Spirits Acupoints’ including Shenting (神庭 GV 24), Běnshen (本神 GB 13), Sishencōng (四神聪 EX-HN 1), Shendao (神道 GV 11) and Shenmen (神门 HT 7)] whereas participants in control group received sham-acupuncture therapy with Streitberger placebo-needle and same acupoints. Interventions were offered every two days and three times a week for total 8 weeks. Both Pittsburgh sleep quality index (PSQI) and Attention Network Task (ANT) were employed to assess the changes of sleep quality and attention network function at pre-treatment and post-treatment, respectively. Meanwhile, adverse effects were monitored and recorded. Results (1) After 8-week treatment, the total score of PSQI in the treatment group decreased from 14.22±3.46 to 8.19±3.34 (P 0.05). (4) No serious adverse events were reported in this trial, except 2 patients from treatment group had slight hematoma after receiving acupuncture therapy. Conclusion Acupuncture represents a safe and useful non-pharmacologic intervention option for primary insomniacs with impairments of attention network function (alertness and conflict processing/ executive control).

To observe the effectiveness and safety of electroacupuncture (EA) plus Luohua Anshen oral liquid for patients with perimenopausal insomnia. A total of 66 participants who met the inclusion criteria were enrolled in the randomized controlled trial and allocated to a treatment group and a control group at a ratio of 1:1, with 33 cases in each group. Both groups were given Luohua Anshen oral liquid as a basic treatment. The treatment group was additionally given EA every other day, three times a week. Both groups were treated for four weeks and a four-week follow-up was conducted. The scores of Pittsburgh sleep quality index (PSQI), Kupperman index (KI) and traditional Chinese medicine sleep syndrome scale (TCMSSS) were recorded at pre- and post-treatment, and at the follow-up. Meanwhile, adverse effects were monitored and recorded. After four-week treatment, the global scores of PSQI, KI and TCMSSS in both groups declined significantly (all P 0.05). The total effective rate was 93.9% in the treatment group, significantly higher than 72.2% in the control group (P

To observe the efficacy and safety of dexzopiclone plus auricular acupressure in intervening primary insomnia. A total of 72 participants who met the inclusion criteria were enrolled in a randomized controlled trial, with 36 cases allocated to a treatment group and 36 cases allocated to a control group. Both groups were given dexzopiclone as the routine treatment. Patients in the treatment group were given auricular acupressure with Wang Bu Liu Xing (Semen Vaccariae) seeds at the auricular acupoints related to sleep and emotion based on meridian theory, whereas for patients in the control group, the medical plasters with Wang Bu Liu Xing (Semen Vaccariae) seeds were only gently stuck to acupoints unrelated to sleep without stimulation. Patients in both groups were required to visit the hospital once a week for replacing the seeds and plasters. The course of intervention lasted for 8 weeks and the patients were followed up for another 4 weeks. Pittsburgh sleep quality index (PSQI) and Karolinska sleep diary (KSD) were used to evaluate the outcomes. Meanwhile, adverse effects were monitored and recorded. In the enrolled 72 cases, 4 patients (one in the treatment group and three in the control group) reported thirst and a bitter taste, and one case in the control group reported nausea and vomiting. At last, 3 cases in the control group dropped out for adverse reactions, and 69 cases completed the clinical trial. After 8 weeks of treatment, the global scores of PSQI in both treatment and control groups decreased significantly compared with the baseline (both P 0.05). According to KSD, both treatment protocols could prolong the total sleep time, shorten sleep-onset latency, improve sleep efficacy and sleep quality significantly, and the changes in the treatment group were more significant. The total effective rate was 88.9% in the treatment group, higher than 81.8% in the control group, though the difference was statistically insignificant (P>0.05). Dexzopiclone plus auricular acupressure is effective and safe for patients with primary insomnia both in short and long terms, and it is more effective than monotherapy of dexzopiclone.

To investigate the effectiveness and safety of manual acupuncture for memory loss and sleep quality in chronic insomniacs. A total of 60 eligible participants were enrolled and randomized into either a treatment group or a control group, with 30 cases in each group. The treatment group was intervened by manual acupuncture whereas the control group was given sham acupuncture. In the two groups, the interventions were offered once every other day and three times a week, for 8 weeks in total. Before and after the treatment, Pittsburgh sleep quality index (PSQI) and eventrelated potentials (ERPs) were used to assess the patients’ sleep quality and memory, respectively. Meanwhile, adverse events were monitored and recorded. After 8-week treatment, both the treatment group and the control group showed a significant decrease in the PSQI global score (P 0.05). The between-group comparisons of ERPs showed that the treatment group was more effective than the control group in shortening the latency of P3 (P

Objective To investigate if electroacupuncture (EA) preconditioning can mitigate cognitive impairments and reduce the incidence of postoperative cognitive dysfunction (POCD) following knee replacement and its safety among elderly. Methods Totally 60 participants met the inclusion criteria were enrolled in a randomized controlled trial a ratio of 1:1, with 30 cases allocated to the treatment group and 30 cases allocated to the control group, respectively. The participants in the treatment group were provided with real-EA therapy whereas participants in control group were provided with placebo-EA therapy (Streitberger Placebo-needle). In both groups, Tou sanshen (头三神) acupoints, including Sishencōng (四神聪EX-HN1), Shenting (神庭 GV24), and bilateral Běnshen (本神GB13) were adopted as the main acupoints, while Bǎihui (百会GV20), bilateral Hegǔ (合谷LI4), and bilateral Taichōng (太冲LR3) were adopted as matching acupoints. Interventions were offered 5 days prior to the surgery, once daily, and continued for total 5 days. The global scores of Mini-Mental State Examination (MMSE), and levels of serum inflammatory cytokines including interleukin 1β (IL-1β) and tumor necrosis factor-α (TNF-α), and S100-β protein were observed at 24 h prior to the surgery, and postoperative 24 and 72 h respectively for assessing the incidence of POCD and the severity of cognitive impairments among patients. Meanwhile, adverse effects were monitored and recorded. Results (1) Compared with baseline, MMSE global scores in both treatment and control groups markedly decreased at postoperative 24 h. MMSE global scores in treatment group decreased from 29.43 ± 0.97 to 27.10 ± 1.95 while that in control group decreased from 29.27 ± 1.01 to 26.83 ± 2.25 (all ?P 0.05). (3) There was no statistical difference in POCD incidence at postoperative 24 h and postoperative 72 h between two groups (P > 0.05), though the incidence of POCD in patients receiving real-EA therapy was indeed much lower than that in patients receiving placebo-EA therapy, particularly at postoperative 72 h (POCD incidence rate at postoperative 24 h in treatment group was 26.67%, 30.00% in control group; POCD incidence rate at postoperative 72 h in treatment group was 30.00%, 46.67% in control group). (4) No serious adverse events were reported in this trial. No one dropped out from this trial. Conclusion EA preconditioning can mitigate cognitive impairments at post-knee replacement surgery 24 and 72 h in elderly through inhibiting expression of inflammation. However, there is insufficient evidence to support that EA pretreatment can reduce the incidence of POCD.

Background. Many women with perimenopausal insomnia (PMI) have sought alternative therapies such as acupuncture because of concerns about risks associated with hormone replacement therapy (HRT) and/or psychotropic drugs. This systematic review aimed to clarify if acupuncture alone or combined with standard Western pharmacotherapy (HRT and/or psychotropic drugs) is more effective in ameliorating PMI in comparison to pharmacotherapy alone. Methods. Randomized controlled trials (RCTs) of PMI treatment via acupuncture alone or combined with Western pharmacotherapy versus Western pharmacotherapy were searched for from eleven databases from inception to March 2020. Cochrane criteria were followed. Results. Fifteen studies involving 1410 women were analyzed. Meta-analysis indicated that acupuncture significantly reduced the global scores of Pittsburgh Sleep Quality Index (PSQI) [MD = −2.38, 95% CI (−3.38, −1.37), p p = 0.01], compared with hypnotics. Acupuncture combined with hypnotics was more effective than hypnotics alone in decreasing PSQI scores [MD = −3.13, 95% CI (−5.43, −0.83), p

The efficacy of acupuncture for treating primary insomnia (PI) has been explored in several meta-analyses where the outcomes measures were based on subjective self-reported sleep rating scales. Sleep state misperception is common in PI and self-reports underestimate sleep duration and quality. No systematic reviews or meta-analyses have investigated the efficacy of acupuncture in improving objective sleep measures in PI.To perform a systematic review to determine whether objective sleep parameters are improved by acupuncture in patients with PI.Randomized controlled trials treating PI via verum-acupuncture versus sham-/placebo-acupuncture or waitlist control were searched for in English [MEDLINE (via PubMed), Sciverse ScienceDirect, Cochrane Central Register of Controlled Trials (CENTRAL), AMED, Springer, EMBASE (Elsevier), Ebsco Medline, and PsycINFO (ProQuest)] and Chinese (SinoMed, CNKI, Wanfang and CQVIP) databases, from the dates of the databases' inception to January 2020. The parameters of polysomnography (PSG), actigraphy, or micromovement sensitive mattress/pillow sleep monitoring systems were considered as the primary outcome measures. Revman 5.3 and Stata 16.0 software were used to conduct the meta-analysis. Heterogeneity was examined by using IEleven studies involving 775 patients met the inclusion criteria. The results of meta-analysis suggested that acupuncture can increase total sleep time [MD = 55.29, 95%CI (29.16, 81.42), p 0.01], increase sleep efficiency [MD = 8.96, 95%CI (3.97, 13.95), p 0.01], decrease wake after sleep onset [MD = -49.54, 95%CI (-82.98, -16.09), p 0.01], and reduce number of awakening times [MD = -6.29, 95%CI (-10.75, -1.82), p 0.01] compared with either sham-/placebo-acupuncture or waitlist control. Subsequent analysis indicated a superior effect for verum-acupuncture in comparison with sham-/placebo-acupuncture or waitlist-control when the recommended lowest threshold dosage (12 sessions) was met. Despite positive outcomes, most studies reviewed were heterogeneous and at risk of bias due to methodological issues.Despite limited evidence, acupuncture was significantly associated with improvements in several objective sleep parameters (increases in total sleep time and sleep efficiency, and reductions in wake after sleep onset and number of awakening times) as well as subjective sleep quantity and quality in patients with PI. A minimum therapeutic threshold dosage (≥12 sessions) is recommended. Well-designed RCTs using PSG are required to clarify the influence of acupuncture on sleep architecture/structure and to promote better application of acupuncture as a treatment for PI.

A palladium-catalyzed multi-acetoxylation of 1,3-disubstituted 1 H -pyrazole-5-carboxylate derivatives containing multiple potential reactive sites is described. Therein, the sequence of this process has been appropriately investigated. The protocol mainly provides the di- and tri-acetoxylated products for 1,3-diarylpyrazoles. Besides, it is found that the acetoxylation of C(sp 3 ) H bond is prior to that of C(sp 2 ) H bond under structurally competitive conditions.

A highly site-selective palladium-catalyzed ortho-mono-aroyloxylation of O-aralkyl substituted acetoxime ethers via direct Csp2–H bond activation has been developed with simple exo-acetoxime as a directing group. The broad scope of masked aralkylalcohols and various aromatic acid partners are compatible with this transformation, which should undergo a mechanistic pathway of six, seven, or even eight-membered exo-cyclopalladated intermediates. In addition, the acetoxime directing group can be readily removed through N–O bond selective cleavage at a late stage, providing a potential utility for the preparation of valuable functionalized aromatic alcohols.

A DREB-type transcription factor gene GmDREBL has been characterized for its functions in oil accumulation in seeds. The gene is specifically expressed in soybean seeds. The GmDREBL is localized in nucleus and has transcriptional activation ability. Overexpression of GmDREBL increased the fatty acid content in the seeds of transgenic Arabidopsis plants. GmDREBL can bind to the promoter region of WRI1 to activate its expression. Several other genes in the fatty acid biosynthesis pathway were also enhanced in the GmDREBL-transgenic plants. The GmDREBL can be up-regulated by GmABI3 and GmABI5. Additionally, overexpression of GmDREBL significantly promoted seed size in transgenic plants compared to that of WT plants. Expression of the DREBL is at higher level on the average in cultivated soybeans than that in wild soybeans. The promoter of the DREBL may have been subjected to selection during soybean domestication. Our results demonstrate that GmDREBL participates in the regulation of fatty acid accumulation by controlling the expression of WRI1 and its downstream genes and manipulation of the gene may increase the oil contents in soybean plants. Our study provides novel insights into the function of DREB-type transcription factors in oil accumulation in addition to their roles in stress response.