Effects of traditional Chinese exercises on blood glucose and hemoglobin A1c levels in patients with prediabetes: A systematic review and meta-analysis

BackgroundTraditional Chinese exercises (TCEs) have a positive effect on glycemic control and hemoglobin A1c (HbA1c), but there is no consensus on the benefits of TCEs for patients with prediabetes.ObjectiveThe objective of this study was to systematically investigate the effects of TCEs on blood glucose control in patients with prediabetes.Search strategyComprehensive retrieval of randomized controlled trials (RCTs) was carried out using PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals, Wanfang Data Knowledge Service Platform, China Biology Medicine disc, Google Scholar and Baidu academic databases. The retrieval window ranged from the establishment of the database to December 2018, and references related to the included trials were searched without language restrictions.Inclusion criteriaThe study included RCTs with a clinical diagnosis of prediabetes that was also treated with TCEs.Data extraction and analysisLiterature screening, data extraction and literature quality assessment were performed independently by two researchers. In the case of disagreement, a third party was invited to negotiate and make a decision. Standardized mean difference (SMD) was used to estimate the therapeutic effect. Meta-analysis was performed using Review Manager 5.3.5 and Stata 15.0. Heterogeneity was assessed using Q test and I², and the source of heterogeneity was determined using Galbraith diagram and sensitivity analysis. A Q test resulting in P < 0.1 and I² > 50% indicated significant difference and random effect model analysis was performed. Otherwise, a fixed effect model was applied. Begg’s and Egger’s tests were used to assess publication bias.ResultsNine RCTs involving 485 participants were included in this study. The results showed that TCEs could reduce fasting blood glucose (FBG), 2 h blood glucose (2hPBG) and HbA1c in patients with prediabetes. The treatment subgroup showed that an intervention of 6 months had better results, while the Gongfa subgroup showed that the TCE Baduanjin yielded better results. (1) FBG: SMD = −0.73, 95% confidence interval (CI) [−0.97, −0.50], P < 0.00001; Baduanjin: SMD = −0.83, 95% CI [−1.13, −0.53], P < 0.00001; 6 month treatment: SMD = −0.73, 95% CI [−1.20, −0.26], P = 0.002. (2) 2hPBG: SMD = −0.75, 95% CI [−0.94, −0.57], P < 0.00001; Baduanjin: SMD = −0.62, 95% CI [−0.91, −0.32], P < 0.00001; 6 month treatment: SMD = −0.91, 95% CI [−1.39, −0.44], P = 0.0002. (3) HbA1c: SMD = −0.56, 95% CI [−0.89, −0.23], P = 0.00008; Baduanjin: SMD = −0.46, 95% CI [−0.83, −0.08], P = 0.02; 6 month treatment: SMD = −0.77, 95% CI [−1.24, −0.29], P = 0.002.ConclusionTCEs had positive effects in improving blood glucose levels in patients with prediabetes. Hence, TCEs may be of potential therapeutic value for patients with prediabetes, as an adjuvant therapy along with other treatments. Although the evidence suggests that the intervention is effective for 6 months, the mechanism of TCEs on glycemic control, the minimum exercise dose and their safety remain to be further studied.     

Effects of curcumin/turmeric supplementation on obesity indices and adipokines in adults: A grade-assessed systematic review and dose–response meta-analysis of randomized controlled trials

In the present study, we explored the effect of curcumin/turmeric supplementation on anthropometric indices of obesity, leptin, and adiponectin. We searched PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar up to August 2022. Randomized clinical trials (RCTs) investigating the impact of curcumin/turmeric on obesity indices and adipokines were included. We applied the Cochrane quality assessment tool to evaluate the risk of bias. The registration number is CRD42022350946. Sixty eligible RCTs, with a total sample size of 3691 individuals were included for quantitative analysis. We found that supplementation with curcumin/turmeric significantly reduced body weight (WMD: −0.82 kg, 95% CI: −1.30, −0.35; p = 0.001), body mass index (WMD: −0.30 kg/m², 95% CI: −0.53, −0.06, p = 0.013), waist circumference (WMD: −1.31 cm, 95% CI: −1.94, −0.69, p < 0.001), body fat percentage (WMD: −0.88%, 95% CI: −1.51, −0.25, p = 0.007), leptin (WMD = −4.46 ng/mL; 95% CI: −6.70, −2.21, p < 0.001), and increased adiponectin (WMD = 2.48 μg/mL; 95% CI: 1.34, 3.62, p < 0.001). Overall, our study shows that supplementation with curcumin/turmeric significantly improves anthropometric indices of obesity and adiposity-related adipokines (leptin and adiponectin). However, due to high between-studies heterogeneity, we should interpret the results with caution.     

Laser acupuncture combined with auricular acupressure improves low-back pain and quality of life in nurses: A randomized controlled trial

Background:Low-back pain (LBP) in nurses is a major health concern that affects their quality of life and ability to work, with consequences for their economic status.Objective:This study evaluates the effect of low-level laser acupuncture combined with auricular acupressure (LAA) on pain intensity, pain interference and quality of life in nurses with LBP.Design, setting, participants and interventions:This randomized controlled trial recruited a convenience sample of hospital-based nurses from ...     

Can acupuncture enhance therapeutic effectiveness of antidepressants and reduce adverse drug reactions in patients with depression? A systematic review and meta-analysis

BackgroundSome depressed patients receive acupuncture as an adjunct to their conventional medications.ObjectiveThis review aims to provide evidence on whether acupuncture can enhance the therapeutic effectiveness of antidepressants for treating depression, and explore whether acupuncture can reduce the adverse reactions associated with antidepressants.Search strategyEnglish and Chinese databases were searched for randomized controlled trials (RCTs) published until December 1, 2021.Inclusion criteriaRCTs with a modified Jadad scale score ≥ 4 were included if they compared a group of participants with depression that received acupuncture combined with antidepressants with a control group that received antidepressants alone.Data extraction and analysisMeta-analysis was performed, and statistical heterogeneity was assessed based on Cochran’s Q statistic and its related P-value. Primary outcomes were the reduction in the severity of depression and adverse reactions associated with antidepressants, while secondary outcomes included remission rate, treatment response, social functioning, and change in antidepressant dose. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework was used to evaluate the overall quality of evidence in the included studies.ResultsThis review included 16 studies (with a total of 1958 participants). Most studies were at high risk of performance bias and at low or unclear risk of selection bias, detection bias, attrition bias, reporting bias, and other bias. Analysis of the 16 RCTs showed that, compared with antidepressants alone, acupuncture along with antidepressants reduced the Hamilton Depression Rating Scale-17 (HAMD-17) scores (standard mean difference [SMD] ?0.44, 95% confidence interval [CI] ?0.55 to ?0.33, P < 0.01; I² = 14%), Self-rating Depression Scale (SDS) scores (SMD ?0.53, 95% CI ?0.84 to ?0.23, P < 0.01; I² = 79%), and the Side Effect Rating Scale (SERS) scores (SMD ?1.11, 95% CI ?1.56 to ?0.66, P < 0.01; I² = 89%). Compared with antidepressants alone, acupuncture along with antidepressants improved World Health Organization Quality of Life-BREF scores (SMD 0.31, 95% CI 0.18 to 0.44, P < 0.01; I² = 15%), decreased the number of participants who increased their antidepressant dosages (relative risk [RR] 0.32, 95% CI 0.22 to 0.48, P < 0.01; I² = 0%), and resulted in significantly higher remission rates (RR 1.52, 95% CI 1.26 to 1.83, P < 0.01; I² = 0%) and treatment responses (RR 1.35, 95% CI 1.24 to 1.47, P < 0.01; I² = 19%) in terms of HAMD-17 scores. The HAMD-17, SDS and SERS scores were assessed as low quality by GRADE and the other indices as being of moderate quality.ConclusionAcupuncture as an adjunct to antidepressants may enhance the therapeutic effectiveness and reduce the adverse drug reactions in patients receiving antidepressants. These findings must be interpreted with caution, as the evidence was of low or moderate quality and there was a lack of comparative data with a placebo control.Systematic review registration: INPLASY202150008.     

Low-level laser acupuncture reduces postoperative pain and morphine consumption in older patients with total knee arthroplasty: A randomized placebo-controlled trial

BackgroundPatients commonly develop postoperative pain after total knee arthroplasty (TKA). Acupuncture-related techniques and low-level laser therapy could be beneficial for pain management for older individuals.ObjectiveTo examine the effect of low-level laser acupuncture (LA) in reducing postoperative pain, pain-related interference in daily life, morphine consumption, and morphine-related side effects in older patients with knee osteoarthritis who underwent TKA.Design, setting, participants and interventionA single-blind randomized placebo-controlled trial was conducted. Patients (N = 82) were recruited and randomly assigned via a computer-generated list to the LA group or a placebo group. The LA group received low-level laser therapy at Sanyinjiao (SP6), Taixi (KI3), Kunlun (BL60), Fengshi (GB31), Futu (ST32) and Neiguan (PC6) after TKA, while the placebo acupuncture group received the same treatment procedure without laser energy output.Main outcome measuresThe primary outcome was postoperative pain intensity, and it was measured at baseline and hours 2, 6, 10, 24, 48 and 72 after TKA. The secondary outcomes, including relative pain, postoperative pain-related interference in daily life and morphine consumption, were measured at hours 24, 48 and 72 after TKA.ResultsGeneralized estimating equations revealed significant between-group differences in pain intensity (P = 0.01), and trend differences in pain intensity for the LA group starting at hours 10 to 72 (P < 0.05) and morphine consumption at hours 48 and 72 (P < 0.05). The changes in pain-related interference in daily life were significant (P < 0.05) at 72 h, with the exception of the parameters for worst pain, mood, and sleep. Nausea and vomiting side effects from morphine had significant between-group differences at hours 10 and 24 (P < 0.05).ConclusionLow-level LA gradually reduced older patients’ postoperative pain intensity and morphine consumption within the first 72 h after their TKA for osteoarthritis. Low-level LA may have benefits as an adjuvant pain management technique for clinical care.Trial registrationClinicalTrials.gov registration number NCT03995446.     

Chinese herbal medicine for chronic heart failure: a multicenter,randomized, double-blind,placebo-controlled trial

ObjectiveThe purpose of this study was to assess the efficacy and safety of Chinese herbal medicine (CHM) in the treatment of chronic heart failure (CHF) patients according to syndrome differentiation.MethodsIn this multicenter, randomized, double-blind, placebo-controlled clinical trial, a total of 220 CHF patients were assigned to receive CHM or placebo granules without decoction according to syndrome differentiation in addition to their standard western treatment for 4 weeks. The change in the left ventricular ejection fraction (LVEF) was the primary outcome, and the changes in the TCM syndrome scores (TCM-SS) and New York Heart Association functional classification (NYHA-FC) were the secondary outcomes.ResultsAfter 4 weeks of treatment, the mean changes in the LVEF (13.1 ± 9.78 vs. 7.34 ± 7.40, P < 0.001) and the TCM syndrome scores (−34.2 ± 24.6 vs. −23.5 ± 25.2, P = 0.002) were better in the CHM group than in the placebo group. After two weeks of treatment, the mean changes in the LVEF (9.26 ± 7.83 vs. 4.72 ± 5.60, P < 0.001) and the TCM syndrome scores (−23.5 ± 18.6 vs. −14.0 ± 15.9, P < 0.001) were better in the CHM group than in the placebo group. In addition, repeated-measures analysis of variance (ANOVA) indicated significant time course effects of CHM versus placebo in the LVEF and TCM syndrome cores (P < 0.001 for all). The distention of the jugular vein (P = 0.021), expectoration (P = 0.044), abdominal distention (P = 0.004), and rib pain (P = 0.005) were significantly less in the CHM group than in the placebo group after two weeks of treatment. Fatigue (P = 0.001), less gas and lazy words (P = 0.001), dizziness (P = 0.003), gasping for breath (P = 0.027), abdominal distention (P = 0.011), nausea (P = 0.001) and emesis (P = 0.012) were significantly less in the CHM group than in the placebo group after treatment for four weeks. After four weeks of treatment, the change in the NYHA functional classification in the CHM group was better than that in the placebo group (P < 0.001). There was one death in the placebo group, and one patient in the CHM group experienced atrial fibrillation.ConclusionCHM treatment according to syndrome differentiation effectively improved the LVEF, TCM-SS, and NYHA-FC in patients with CHF and also appeared to be safe. Thus, CHM treatment could be used as an adjuvant therapy in the treatment of CHF (Clinical trial registration: NCT01939236).     

Effects of l-arginine supplementation on glycemic profile: Evidence from a systematic review and meta-analysis of clinical trials

BackgroundThe effects of l-arginine supplementation on indices of glycemic control and the role of many factors influencing this intervention have been controversial in clinical trials.ObjectiveThis meta-analysis was performed to assess the effects of l-arginine supplementation on indices of glycemic control, including fasting blood glucose (FBG), hemoglobin A1c (HbA1c), serum insulin and homeostatic model assessment of insulin resistance (HOMA-IR) levels in randomized controlled trials (RCTs).Search strategyThis study conducted a systematic review of RCTs published in PubMed, Scopus, Web of Science, Cochrane Library and Embase, up to 5 May, 2018.Inclusion criteriaStudies were included in this meta-analysis if they were RCTs with parallel design and reported sufficient data on participants before and after intervention, and outcomes of glycemic profile parameters in both the arginine supplementation and control groups.Data extraction and analysisThe screening of titles and abstracts was performed independently by two reviewers. Selected articles were considered if they met the study’s inclusion criteria. The quality of included studies was assessed by using the Cochrane Collaboration modified tool. From 710 articles retrieved in the initial search, only 10 trials were suitable for pooling the effects of arginine supplementation on serum glucose, insulin, HOMA-IR and HbA1c levels, with effect sizes of nine, eight, five and five, respectively.ResultsPooled random-effect analysis revealed that l-arginine supplementation could significantly decrease FBG level (weighted mean difference [WMD]: 3.35 mg/dL; 95% confidence interval [CI] = [−6.55, −0.16]; P = 0.04) and serum insulin level (WMD: −2.19 μIU/mL; 95% CI = [−3.70, −0.67]; P = 0.005). However, the effects of l-arginine supplementation on HOMA-IR and HbA1c were not significant. Results of subgroup analysis showed that supplementation with l-arginine could significantly decrease serum insulin levels when the dosage of l-arginine is > 6.5 g/d (WMD: −3.49 μIU/mL; 95% CI = [−5.59, −1.38]; P = 0.001), when the duration of supplementation is ≤ 12.8 weeks (WMD: −3.76; 95% CI = [−6.50, −0.98]; P = 0.008), when the participants are not diabetic patients (WMD: −2.54 μIU/mL; 95% CI = [−4.50, −0.50]; P = 0.01) and when the baseline serum level of insulin was > 20 μIU/mL (WMD: −3.98; 95% CI = [−6.31, −1.65]; P = 0.001).ConclusionAlthough the results of this study confirmed that supplementation with l-arginine could have significant effects on some glycemic profile indices of participants in clinical trials, the clinical importance of this reduction may not be meaningful.     

Chinese herbal medicine for COVID-19: Current evidence with systematic review and meta-analysis

BackgroundThere is currently no drug or therapy that cures COVID-19, a highly contagious and life-threatening disease.ObjectiveThis systematic review and meta-analysis summarized contemporary studies that report the use of Chinese herbal medicine (CHM) to treat COVID-19.Search strategySix electronic databases (PubMed/MEDLINE, Cochrane Library, ScienceDirect, Google Scholar, Wanfang Data and China National Knowledge Infrastructure) were searched from their beginning to May 15, 2020 with the following search terms: traditional Chinese medicine, Chinese medicine, Chinese herbal medicine, COVID-19, new coronavirus pneumonia, SARS-CoV-2, and randomized controlled trial.Inclusion criteriaRandomized controlled trials (RCTs) from peer-reviewed journals and non-reviewed publications were included. Further, included RCTs had a control group that was given standard care (SC; such as conventional Western medicine treatments or routine medical care), and a treatment group that was given SC plus CHM.Data extraction and analysisTwo evaluators screened and collected literature independently; information on participants, study design, interventions, follow-up and adverse events were extracted, and risk of bias was assessed. The primary outcomes included scores that represented changes in symptoms and signs over the course of treatment. Secondary outcomes included the level of inflammatory markers, improvement of pneumonia confirmed by computed tomography (CT), and adverse events. Dichotomous data were expressed as risk ratio or hazard ratio with 95% confidence interval (CI); where time-to-event analysis was used, outcomes were expressed as odds ratio with 95% CI. Continuous data were expressed as difference in means (MD) with 95% CI, and standardized mean difference (SMD) was used when different outcome scales were pooled.ResultsSeven original studies, comprising a total of 732 adults, were included in this meta-analysis. Compared to SC alone, CHM plus SC had a superior effect on the change of symptom and sign score (−1.30 by SMD, 95% CI [−2.43, −0.16]; 3 studies; n = 261, P = 0.03), on inflammatory marker C-reactive protein (CRP, mg/L; −11.82 by MD, 95% CI [−17.95, −5.69]; 5 studies; n = 325, P = 0.0002), on number of patients with improved lung CT scans (1.34 by risk ratio, 95% CI [1.19, 1.51]; 4 studies; n = 489, P < 0.00001). No significant adverse events were recorded in the included RCTs.ConclusionCurrent evidence shows that CHM, as an adjunct treatment with standard care, helps to improve treatment outcomes in COVID-19 cases.     

Tiaozhi Tongmai Granules reduce atherogenesis and promote the expression of ATP-binding cassette transporter A1 in rabbit atherosclerotic plaque macrophages and the liver

ObjectiveATP-binding cassette transporter A1 (ABCA1) is an integral membrane protein that plays a key role in cellular lipid metabolism, preventing the accumulation of lipids that contribute to the initiation and progression of atherosclerosis. Tiaozhi Tongmai Granules are a Chinese herbal compound that is capable of treating atherosclerosis. This study was designed to explore the potential pharmacological mechanism by which Tiaozhi Tongmai Granules protect against atherosclerosis.MethodsForty-nine male New Zealand rabbits were randomly divided into seven groups: normal control group, normal diet; model groups 1 and 2: balloon injury and high-fat diet for 6 or 12 weeks; statin groups 1 and 2: balloon injury and high-fat diet plus atorvastatin for 6 or 12 weeks; and Chinese herb groups 1 and 2: balloon injury and high-fat diet plus Tiaozhi Tongmai Granules for 6 or12 weeks. The granules were administered at a dose of 1.14 g/kg/d, with atorvastatin (1.14 mg/kg/d) serving as positive control. Serum lipid profiles and liver function indices were measured. Atherogenesis was viewed after H&E staining and quantified by thickened intimal area percentage and maximal intimal thickness percentage. The ABCA1 protein expression in atherosclerotic plaque macrophages of the common carotid arteries (CCA), thoracic aortae (TA), and liver tissues were observed by immunohistochemical staining and evaluated using mean optical density (OD) value in macrophages and ABCA1-positive hepatocyte number.ResultsCompared with model group 1 at week 6, Chinese herb group 1 and statin group 1 displayed significant reductions in total cholesterol (TC) (P = 0.027, 0.012) and low-density lipoprotein cholesterol (LDL-C) (P = 0.039, 0.028) levels, as well as marked increases in ABCA1-positive hepatocyte numbers (P all <0.001), and only statin group 1 displayed a markedly reduced maximal intimal thickness percentage in the CCA (P = 0.018). Compared with model group 2 at week 12, Chinese herb group 2 and statin group 2 all presented significant reductions in TC (P = 0.011, 0.003), LDL-C (P = 0.017, 0.010) and thickened intimal area percentage in the CCA (P = 0.001, 0.022), as well as prominent increases in the ABCA1 OD value of both the CCA (P = 0.001, 0.039) and TA (P = 0.001, 0.025) and positive hepatocyte number (P all <0.001). Chinese herb group 2 had a markedly reduced maximal intimal thickness percentage compared with model group 2 (P = 0.006) and a higher positive hepatocytes number than statin group 2 (P = 0.001).ConclusionsTiaozhi Tongmai Granules appear to have an anti-atherogenic effect that is most likely mediated by simultaneously upregulating the protein expression of ABCA1 in rabbit atherosclerotic plaque macrophages and in the liver.     

Alleviative effects of Cannabis flower on migraine and headache

ObjectiveFew studies to date have measured the real-time effects of consumption of common and commercially available Cannabis products for the treatment of headache and migraine under naturalistic conditions. This study examines, for the first time, the effectiveness of using dried Cannabis flower, the most widely used type of Cannabis product in the United States, in actual time for treatment of headache- and migraine-related pain and the associations between different product characteristics and changes in symptom intensity following Cannabis use.MethodsBetween 06/10/2016 and 02/12/2019, 699 people used the Releaf Application to record real-time details of their Cannabis use, including product characteristics and symptom intensity levels prior to and following self-administration; data included 1910 session-level attempts to treat headache- (1328 sessions) or migraine-related pain (582 sessions). Changes in headache- or migraine-related pain intensity were measured on a 0–10 scale prior to, and immediately, following Cannabis consumption.ResultsNinety-four percent of users experienced symptom relief within a two-hour observation window. The average symptom intensity reduction was 3.3 points on a 0–10 scale (standard deviation = 2.28, Cohen’s d = 1.58), with males experiencing greater relief than females (P < 0.001) and a trend that younger users (< 35 years) experience greater relief than older users (P = 0.08). Mixed effects regression models showed that, among the known (i.e., labeled) product characteristics, tetrahydrocannabinol levels 10% and higher are the strongest independent predictors of symptom relief, and this effect is particularly prominent in headache rather than migraine sufferers (P < 0.05), females (P < 0.05) and younger users (P < 0.001). Females and younger users also appear to gain greater symptom relief from flower labeled as “C. indica” rather than “C. sativa” or other hybrid strains.ConclusionThese results suggest that whole dried Cannabis flower may be an effective medication for treatment of migraine- and headache-related pain, but the effectiveness differs according to characteristics of the Cannabis plant, the combustion methods, and the age and gender of the patient.     

Knowledge about,attitude and acceptance towards,and predictors of intention to receive the COVID-19 vaccine among cancer patients in Eastern China: A cross-sectional survey

Objective: The coronavirus disease 2019(COVID-19) pandemic has had a serious impact on health all over the world. Cancer patient, whose immunity is often compromised, faces a huge challenge.Currently, some COVID-19 vaccines are being developed and applied on general population;however,whether cancer patients should take COVID-19 vaccine remains unknown. Our study aimed to explore the knowledge, attitude, acceptance, and predictors of intention to receive the COVID-19 vaccine among cancer patients in Eastern China.Methods: A cross-sectional study was conducted in Eastern China from June 17 th to September 3 rd, 2021.Patients were selected using a convenience sampling method. A self-report questionnaire was developed to assess knowledge about the COVID-19 vaccine, attitude towards the vaccine and acceptance of the vaccine;following a review of similar studies previously published in the scientific literature, multivariate logistic regression analysis was used to determine the predictors associated with COVID-19 vaccine acceptance.Results: A total of 2158 cancer patients were enrolled in this study. The rate of vaccine hesitancy was 24.05%(519/2158);further, among the participants of vaccine acceptance, 767 had taken COVID-19 vaccine(35.54%), and 872 were willing to get vaccinated(40.01%). A total of 24 variables including demographic characteristics, clinical status of cancer, impact of COVID-19 pandemic on study participants,patients’ knowledge about the COVID-19 vaccine, and attitude towards the vaccine, had significant differences between the ‘‘vaccine hesitancy" population and ‘‘vaccine acceptance" population.Multivariate logistic regression analysis indicated that parameters including alcohol consumption(odds ratio [OR] = 1.849;95% confidence interval [CI]: 1.375–2.488;P-reference [P-Ref] < 0.001 vs nondrinkers), income impacted by COVID-19 pandemic(OR = 1.930, 2.037 and 2.688 for mild, moderate,and severe impact, respectively;all P-Ref < 0.01 vs no impact), knowledge of how the vaccine was developed(OR = 1.616;95% CI: 1.126–2.318;P-Ref = 0.009 vs unknown), believing in the safety of the vaccine(OR = 1.502;95% CI: 1.024–2.203;P-Ref = 0.038 vs denying the safety of vaccine), willingness to pay for the vaccine(OR = 3.042;95% CI: 2.376–3.894;P-Ref < 0.001 vs unwilling), and willingness to recommend families and friends to get vaccinated(OR = 2.744;95% CI: 1.759–4.280;P-Ref < 0.001 vs do not recommend) were contributors to vaccine acceptance. While such as being retired(OR = 0.586;95% CI: 0.438–0.784;P-Ref < 0.001 vs unemployed), undergoing multiple therapies of cancer(OR = 0.408;95% CI: 0.221–0.753;P-Ref = 0.004 vs no ongoing treatment), and worrying that the vaccine might deteriorate the prognosis of cancer(OR = 0.393;95% CI: 0.307–0.504;P-Ref < 0.001 vs might not) were contributors to vaccine hesitancy.Conclusion: This study provided preliminary estimates of the rates of vaccine acceptance and vaccine hesitancy among cancer patients in Eastern China. The intention to receive the COVID-19 vaccine was impacted by factors such as patient occupation, alcohol consumption, and some parts of knowledge about and attitude towards COVID-19 vaccine. It is recommended to develop individualized vaccination plans that meet the healthcare needs of cancer patients.     

Does pomegranate consumption affect weight and body composition? A systematic review and meta‐analysis of randomized controlled clinical trials

Pomegranate is rich in tannins, polyphenols, flavonoids, and several other types of antioxidant compounds whose role in weight loss has been shown in previous studies. However, the results have been mixed regarding the effects of pomegranate consumption on weight loss. Electronic databases such as PubMed, Scopus, ISI Web of Science, and Google Scholar were systematically searched up to May 2018 for controlled clinical trials assessing the effect of pomegranate consumption on weight loss. A random effects model was used to calculate the weighted mean difference (WMD) and 95% confidence interval (CI) as the difference between the mean for the intervention and control groups. Thirteen randomized controlled trials (including 513 participants) were included in the present meta‐analysis. Compared with the control groups, there was no significant reduction in bodyweight, body mass index, waist circumference, and body fat percentage after pomegranate consumption (WMD = ?0.23 kg, 95% CI: ?0.94, 0.47, P = 0.515; WMD = ?0.12 kg/m², 95% CI: ?0.29, 0.03, P = 0.132; WMD = ?0.08 cm, 95% CI: ?0.33, 0.17, P = 0.534; WMD = ?0.05, 95% CI: ?1.66, 1.55, P = 0.947, respectively). According to the results of the present systematic review and meta‐analysis, there was no significant effect of pomegranate consumption on weight and body composition indices.     

手捻针干预重症抑郁障碍共病失眠:证据来自多导睡眠图及血清生物标志物

ObjectiveThis study is conducted to determine effects of manual acupuncture (MA) in patients with a diagnosis of major depressive disorder (MDD) and comorbid insomnia.MethodsA 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 Sìshéncōng (四神聪 EX-HN 1), Shéntíng (神庭 GV 24), Shéndào (神道 GV 11), bilateral Běnshén (本神 GB 13), and bilateral Shénmén (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.ResultsAfter eight-week treatment, the global scores of PSQI and global scores of HAMD17 declined significantly (both P < 0.05) in the real-MA group but not in the sham-MA group (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) but not in the sham-MA group (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) while those indicators only slightly fluctuated in the sham-MA group (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.     

针刺应答是否随针刺剂量增加而增大:一项基于睡眠剥夺大鼠的临床前研究

BackgroundThe 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.ObjectiveThis 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.MethodsForty-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), and no statistical differences was found between these two EA groups (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) but lower than that of either the control group (P<0.05) or the EA-5 Ts/w group (P<0.05). (3) OF test: the difference of horizontal movements between the EA-3 Ts/w group and the EA-5 Ts/w group was not significant (P>0.05), although both of them were lower than that of the control group (both P<0.05) but higher than that of the model group (P<0.05). (4) EPM test: no significant decline of open-arm total time (OT) was found in EA-3Ts/w group (P>0.05) but was found in both the model group (P<0.05) and the EA-5Ts/w group (P<0.05) compared to the control group.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.     

Effects of Tai Chi on health outcomes in patients with type 2 diabetes mellitus: A systematic review and meta-analysis

ObjectiveTo explore the effects and dose–response relationship of Tai Chi for type 2 diabetes mellitus (T2DM) and to evaluate the methodological quality of the included trials and evidence quality of the outcomes.MethodsNine major English and Chinese databases were searched for randomized controlled trials of Tai Chi for T2DM from inception to December 2021. The effects and dose–response relationships were assessed with a meta-analysis and meta-regression using Stata.16. The methodological quality of the included studies was assessed using the risk of bias tool. The evidence quality of the outcomes was assessed using the GRADE tool.ResultsA total of 24 studies with 1314 patients were included. Compared with the usual care, Tai Chi improved HbA1c (MD = ?0.80%, 95% CI [?1.05, ?0.54], P < .001, I² = 18.29%, very low–quality evidence), FBG (SMD = ?0.58, 95% CI [?0.86, ?0.31], P < .001, I² = 53.2%, low-quality evidence), fasting insulin (FIN), diastolic blood pressure, BMI, and the outcomes of quality of life (QoL) in patients with T2DM. However, when Tai Chi was compared with other exercise, there was no between-group difference in the HbA1c, FBG, TC, TG, HDL, LDL, BMI, and waist circumference (WC). Furthermore, the findings showed that an increase at every 18 weeks in length or an 823-h increase in the total time of Tai Chi intervention resulted in approximately a one unit reduction in the SMD of FBG.ConclusionCompared with usual care, Tai Chi may improve HbA1c (with clinical significance), FBG, FIN, BMI, diastolic blood pressure, and outcomes of QoL in T2DM patients. The effects of Tai Chi were similar to those of other exercises on the HbA1c, FBG, TC, TG, HDL, LDL, BMI, and WC. Given the overall poor methodological quality and evidence quality, these findings should be treated cautiously.     

Effects of Acupressure and Acupuncture-Like Transcutaneous Electrical Nerve Stimulation on Sleep Quality Among Pregnant Women

BackgroundDespite the adverse consequences of poor sleep during pregnancy, relatively few safe interventions exist for improving sleep among pregnant women. Nonpharmacological interventions are increasingly gaining acceptance. However, the effects of acupressure and acupuncture-like transcutaneous electrical nerve stimulation (ACUTENS) have not been widely reported.ObjectivesThe purpose of this study is to investigate the effects of low-frequency transcutaneous electrical nerve stimulation, otherwise known as ACUTENS, and acupressure on sleep quality among pregnant women.MethodsPurposive sampling of 42 pregnant women with sleep disorders was conducted, and the participants were randomized into 3 groups, i.e., acupressure, ACUTENS, and usual care. interventions, which were carried out twice weekly for six weeks. The Pittsburgh Sleep Quality index was used to determine the overall sleep quality.ResultsThe preintervention scores of sleep quality were 12.5 (3.75), 12.5 (4.0), and 13.0 (3.5) in the ACUTENS, acupressure, and usual care groups, respectively. The Kruskal–Wallis test did not show any significant difference in the preintervention sleep quality scores (H = 0.379, p = 0.827). Participants in the usual care group recorded the least improvement, with a score of 5.0 (2.25), the ACUTENS group recorded a score of 4.5 (3.0), and the greatest improvement was recorded in the acupressure group, with a score of 4.0 (2.2) after 6 weeks of intervention. The Kruskal–Wallis test did not show any significant difference in the postintervention sleep quality scores among the 3 groups (H = 0.666, p = 0.717).ConclusionThis study showed that ACUTENS and acupressure as an adjunct to usual care are not more effective than usual care alone in improving sleep quality among pregnant women.     

Seasonal photoperiodic influence of pineal melatonin on hypothalamic-pituitary-adrenal axis-hippocampal-receptor in male rats

BackgroundBased on the effect of seasonal changes on human visceral function, this study investigated the impact of seasonal photoperiod of the pineal body on hypothalamic-pituitary-adrenal axis-hippocampal-receptor in rats, aiming to reveal the mechanism by which pineal gland melatonin regulates the seasonal secretion of hippocampal neurotransmitters.MethodsVernal equinox, summer solstice, autumn equinox, and winter solstice were selected as four experimental time points, and rats were randomly divided into normal control group, sham operation group, and pinealectomized group. The seasonal changes in corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH), corticosterone, hypothalamic melatonin receptor (MTR), and hippocampal corticosterone receptor (CORTR) were examined by enzyme-linked immunosorbent assay.ResultsComparing the same group between different seasons, we showed that in the normal control group, CRH, ACTH, corticosterone, and MTR were higher, while CORTR was lower in autumn and winter than in spring (all P < .05). Compared with the normal control group, the pinealectomized group showed higher levels of corticosterone (P = .01), MTR (P = .01), and CORTR (P = .03) during spring; reduced levels of MTR and CORTR (both P < .001) during summer; higher levels of ACTH (P = .001) and MTR (P < .001), and lower levels of CRH (P = .001), corticosterone (P < .001), and CORTR (P = .003) during autumn; and lower levels of CRH (P < .001) and MTR (P = .004), and higher level of ACTH (P < .001) in winter.ConclusionsSeasonal photoperiod acts on the pineal gland to secrete different levels of melatonin, resulting in seasonal changes in the hypothalamic-pituitary-adrenal axis-hippocampal-receptor, which may be the pathophysiological basis for the onset of seasonal affective disorder.     

针刺督脉背段治疗伴有睡眠障碍的胃食管反流病:病例系列研究

ObjectiveTo observe the clinical therapeutic effect of acupuncture at the dorsal section of the governor vessel in the patients with gastroesophageal reflux disease (GERD) combined with sleep disorder.MethodsA total of 30 patients with GERD combined with sleep disorder were included. Acupuncture was applied to the dorsal section of the governor vessel, inferior to the spinous process from T3 to T12, once every two days, 3 times a week, totally for 8 weeks. Before and after treatment, the scores of the reflux disease questionnaire (RDQ) and the Pittsburgh sleep quality index (PSQI) were evaluated. After treatment, the clinical effect was evaluated in the patients.ResultsThe mean score of RDQ was 21.57 ± 5.91 before treatment and was 3.75 ± 4.92 after treatment, indicating the statistical significance (P < 0.05). After treatment, the score of every dimension of PSQI was lower than that before treatment, indicating the statistical significance (P < 0.05). Of 30 patients, 23 cases were effective and the total effective rate was 76.7%.ConclusionAcupuncture at the inferior of the spinous process from T3 to T12, on the dorsal section of the governor vessel, achieves the significant clinical effect on GERD combined with sleep disorder and this therapy deserves to be promoted in clinic.     

Efficacy of the herbal formula of Foeniculum vulgare and Rosa damascena on elderly patients with functional constipation: A double-blind randomized controlled trial

BackgroundConstipation is a common chronic bowel disorder with an incidence of more than 50% in the elderly population. Complementary and alternative medicine is a cost-effective and satisfactory treatment for constipation used widely by the elderly.ObjectiveThis study evaluates the efficacy of an herbal formula made from Foeniculum vulgare Mill. and Rosa damascena for the treatment of constipation in an elderly population and consequent changes to their quality of life.Design, setting, participants and interventionThis double-blind randomized active controlled clinical trial, with parallel group allocation ratio of 1:1, was conducted in a referral clinic in Afzalipour Hospital, affiliated to Kerman University of Medical Sciences in Kerman, Southeastern Iran. Individuals over 60 years of age, diagnosed with functional constipation (based on the Rome IV criteria), were included in this study. Participants received a sachet of 10 g F. vulgare and R. damascena (herbal formula group) or polyethylene glycol 4000 (PEG 4000 group) with a glass of warm water two times a day for 4 weeks and were followed up for 4 additional weeks.Main outcome measuresConstipation severity, stool consistency, and the quality of life were used as the primary outcomes. Drug side effects were used as a secondary outcome. The outcomes were assessed using the Constipation Assessment Scale, the Bristol Stool Form Scale, and the Patient Assessment of Constipation Quality of Life questionnaire.ResultsA total of 25 participants in each group completed the four-week treatment cycle and the eight-week follow-up. At the end of the four-week treatment cycle, all clinical outcomes had significant improvements in both groups (P < 0.05). The analysis of constipation severity (P < 0.001), stool consistency (P < 0.001), and the quality of life (P < 0.001) showed significant improvements with fewer side effects (mild diarrhea) and a longer duration of symptom relief in the herbal formula group compared to the PEG 4000 group.ConclusionAlthough both interventions significantly improved the treatment outcomes, constipation severity, stool consistency and the quality of life were improved more effectively by the herbal formula than by PEG 4000; however, the mechanism of action is not yet understood.Trial registrationThis trial was registered in the Iranian Registry of Clinical Trials (IRCTID: IRCT20200108046056N1).     

Core muscle functional strength training for reducing the risk of low back pain in military recruits: An open-label randomized controlled trial

BackgroundCore muscle functional strength training (CMFST) has been reported to reduce injuries to the lower extremity. However, no study has confirmed whether CMFST can reduce the risk of low back pain (LBP).ObjectiveThis study identified the effects of CMFST on the incidence of LBP in military recruits.Design, setting, participants and interventionWe performed a prospective, open-label, randomized, controlled study in a population of young healthy male naval recruits from a Chinese basic combat training program. Participants were randomly assigned to either the core group or the control group. In additional to normal basic combat training, recruits in the core group underwent a CMFST program for 12 weeks, while recruits in the control group received no extra training.Main outcome measuresAt the beginning of the study and at the 12th week, the number of participants with LBP was counted, and lumbar muscle endurance was measured. In addition, when participants complained of LBP, they were assessed using the visual analog scale (VAS) and Roland Morris Disability Questionnaire (RMDQ).ResultsA total of 588 participants were included in the final analysis (295 in the core group and 293 in the control group). The incidence of LBP in the control group was about twice that of the core group over the 12-week study (20.8% vs 10.8%, odds ratio: 2.161–2.159, P < 0.001). The core group had better lumbar muscle endurance at 12 weeks than the control group ([200.80 ± 92.98] s vs [147.00 ± 84.51] s, P < 0.01). There was no significant difference in VAS score between groups, but the core group had a significantly lower RMDQ score at week 12 than the control group (3.33 ± 0.58 vs 5.47 ± 4.41, P < 0.05).ConclusionThis study demonstrated that the CMFST effectively reduced the incidence of LBP, improved lumbar muscle endurance, and relieved the dysfunction of LBP during basic military training.