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To analyze the effect of acupuncture versus hormone replacement therapy (HRT) for premature ovarian insufficiency (POI). China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang), Chongqing VIP Database (CQVIP), China Biology Medicine Disc (CBM), Web of Science, Cochrane Library, PubMed, and Excerpta Medica Database (EMBASE) were searched up to January 31st, 2019 to identify randomized controlled trials (RCTs) evaluating the effect of acupuncture for POI. The primary outcome was the level of basal serum follicle-stimulating hormone (FSH). Secondary outcomes included serum levels of luteinizing hormone (LH), estradiol (E2) and anti-Mullerian hormone (AMH). Two authors extracted data independently and assessed the risk of bias and the methodological quality using the Cochrane’s tool. Meta-analysis was conducted by RevMan version 5.3. Eight eligible RCTs with a total of 496 POI patients were included in the meta-analysis. The pooled results showed that there was a significant reduction in the basal serum FSH level (MD=−5.82, 95%CI: −9.76 to −1.87, I2=82%, P=0.004) and a remarkable elevation in the basal E2 level (SMD=0.93, 95%CI: 0.34 to 1.52, I2=88%, P=0.002) in the acupuncture group when compared with the control. Subgroup analysis showed that compared with HRT, a significant decrease in the FSH level was observed in both acupuncture alone (MD=−4.53, 95%CI: −8.96 to −0.10, I2=73%, P=0.04) and acupuncture plus HRT (MD=−9.60, 95%CI: −17.60 to −1.61, I2=50%, P=0.02), while a remarkable elevation of E2 was only found in acupuncture plus HRT (SMD=1.43, 95%CI: 1.03 to 1.82, I2=0%, P

Background: Premature ovarian insufficiency (POI) results in the loss of ovarian function and reproductive impairment. The cause of most cases of POI is unclear, although genetic factors are thought to be involved. This study aimed to identify novel pathogenic genes and variants in a Chinese family with POI.Results: An assessment of the family pedigree suggested that POI was inherited in an autosomal dominant manner in this family. Whole-exome sequencing of the proband and her affected mother identified a novel heterozygous missense variant in the laminin subunit gamma-1 gene (LAMC1; NM_002293.4:c.A3281T:p.D1094V). This variant was not found in any public databases, and was highly conserved among mammals. Online software predicted it to be deleterious with respect to protein function. Its presence in the POI family was confirmed by Sanger sequencing.Conclusions: We report a novel heterozygous missense variant in LAMC1 in a Chinese POI family, which was inherited in an autosomal dominant manner. This variant may result in the development of POI. Our results provide supporting evidence for a causative role for LAMC1 variants in POI.

Stereoselective β-mannosylation has been recognized as one of the greatest challenges of carbohydrate chemistry. Herein, we described a practical method for stereoselective construction of β-mannosides by using a 2,6-lactone-bridged thiomannosyl donor through the remote acyl-group participation as well as the steric effect of O-4 substituent. The two effects are enabled through the conversion of a regular mannopyranosyl 4 C1 conformation into a 2,6-lactone bridged conformation. The lactone donor could be readily prepared in three steps on a gram scale and the β-mannosylation proceeded smoothly with high stereoselectivity for primary, secondary and tertiary alcohol acceptors. In addition, this strategy was successfully applied to the synthesis of a naturally occurring trisaccharide.

Background The prevalence of aortic stenosis (AS) steadily increases with age. There is a consensus that intervention should be advised in patients with symptomatic severe AS. However, decision to operate raises complex issues in the elderly due to the increasing operative comorbidity and mortality. There is limited information regarding the characteristics and outcome of elderly patients with symptomatic severe AS who were denied intervention and the reasons leading to the denial. Purpose To analyze the decision-making and the prognosis in elderly patients with symptomatic severe AS. Methods In a cohort of 8929 patients aged ≥60 years with significant valvular heart disease, we divided patients with severe (valve area ≤1 cm2 or peak velocity ≥4.0 m/s or mean gradient ≥40 mmHg), symptomatic (angina or NYHA II-IV or syncope) AS into three groups by final treatment decision: intervention group, doctor-deny group, patient-deny group. The impact of characteristics on decision-making was evaluated and 1-year mortality among three groups were compared. Results Among 546 patients with severe symptomatic AS, the interventional decision was taken in 338 patients (61.9%), 134 patients (24.5%) were denied intervention by doctor after evaluation and 74 patients (13.5%) refused intervention due to personal preference. In multivariable analysis, age [OR=1.104, 95% CI (1.068–1.142)], multi-comorbidities [OR=4.706, 95% CI (2.355–9.403)] and left ventricular end-diastolic diameter (LVEDD) [OR=1.021, 95% CI (1.001–1.042)] were markedly associated with the conservative decision made by doctor, while LVEF >50% [OR=0.260, 95% CI (0.082–0.823)] was significantly linked with the interventional decision. Lower mortality was observed in intervention group during 1-year follow-up compared with either doctor-deny group or patient-deny group (both P50% [HR=0.960, 95% CI (0.938–0.984)] were related to lower mortality. Conclusions Intervention was denied in about forty percent of elderly patients with symptomatic severe AS. Patients with advanced age, multi-comorbidities and increased LVEDD tended to be denied intervention by doctors, whereas interventions were more likely to be performed on patients with normal LVEF. Diabetes, syncope, AF, stroke and multi-comorbidities were the predictive factors of 1-year mortality. Elderly patients with symptomatic severe AS could benefit from intervention. Patient education needs to be strengthened, to encourage more patients accept the appropriate intervention. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Twelfth Five-year Science and Technology Support Projects by Ministry of Science and Technology of China

Background There is ongoing controversy and limited data about the optimal timing to perform delayed percutaneous coronary intervention (PCI) in stable ST-segment elevation myocardial infarction (STEMI) patients who have missed opportunities for acute reperfusion therapy and are in absence of ongoing ischemia. Purpose To evaluate the effects of timing of delayed PCI on short- and long-term safety outcomes in stable STEMI patients. Methods A cohort of 3,048 stable STEMI patients without acute reperfusion therapy who underwent delayed PCI were included in the study. Procedural timing was stratified into three groups: 7d. Primary outcomes were 30-day and 12-month major adverse cardiac events (MACE), a composite of death and reinfarction. Multivariate logistic and Cox regression models were performed. Results After multivariate adjustment, restricted cubic splines revealed a monotonic decrease in the risk of MACE with prolonged procedural timing (Figure-1). Delayed PCI on 3–7d and >7d were strongly associated with lower risks of MACE at 30 days (3–7d: Hazard ratio (HR) 0.43 [95% Confidence interval (CI) 0.18–0.99], P=0.046; >7d: HR 0.40 [95% CI 0.19–0.87], P=0.020) and 12 months (3–7d: HR 0.49 [95% CI 0.25–0.95], P=0.036; >7d: HR 0.42 [95% CI 0.22–0.77], P=0.006) compared with that on 7d also showed improvement in 12-month mortality (HR 0.45 [95% CI 0.22–0.91], P=0.026) over that on Conclusion Delayed PCI over a week after symptom onset had significant improvement in short- and long-term safety in stable STEMI patients especially with anterior MI or cardiac insufficiency. Decision-making on optimal timing should identify the high-risk individuals and balance between ischemic benefits and safety. Figure 1 Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Twelfth Five-year Science and Technology Support Projects by Ministry of Science and Technology of China.

Background: Poor ovarian response (POR), a manifestation of low ovarian reserve and ovarian aging, leads to a significant reduction in the pregnancy rate after in vitro fertilization-embryo transfer. Acupuncture has increasingly been used to improve the ovarian reserve. The purpose of this study will be to evaluate the effect of acupuncture on increasing the number of retrieved oocytes after controlled ovarian hyperstimulation in women with POR.Methods: This will be a multicenter randomized controlled trial. A total of 140 women with POR will be randomly assigned to receive acupuncture or nontreatment for 12 weeks before controlled ovarian hyperstimulation. The primary outcome will be the number of retrieved oocytes. The secondary outcomes will be antral follicle counts, serum levels of anti-Müllerian hormone, basal serum levels of follicle stimulating hormone, luteinizing hormone and estradiol levels, scores from the self-rating anxiety scale, fertilization rates, cleavage rates, available embryo rates and high-quality embryo rates. The safety of acupuncture will also be assessed.Discussion: The results of this trial will help to determine the effectiveness of acupuncture in the treatment of POR. This may provide a new treatment option for patients with POR and their physicians.Trial registration: AMCTR-IPR-18000198. Registered on 10 August 2018, http://www.acmctr.org/showproj.aspx?proj=289

Background and purpose Limited data is available on the situation of cardiogenic shock (CS) complicating ST-elevated myocardial infarction (STEMI) in China. This study aims to disclose the incidence, management and in-hospital mortality (IHM) of patients with STEMI complicated by CS (STEMICS) in China and at different levels of hospitals. Methods We queried the 2013–2016 China Acute Myocardial Infarction (CAMI) registry databases to identify patients with STEMI and/or CS (developing before or during hospitalization). The overall and different hospital-level incidence of STEMICS and IHM were analyzed. Results Of 28230 STEMI patients, 2273 patients (8.05%) had CS. The incidence of STEMICS in provincial, prefectural and county-level hospitals were 5.23%, 8.46% and 13.76% (p Table 1. Differences in IHM of prehospital STEMICS between county-level hospitals and other two levels of hospitals before or after adjustment Provincial hospitals/ County-level hospitals Prefectural hospitals/ County-level hospitals Unadjusted OR (95% CI) 0.54 (0.36, 0.80); P=0.0019 0.68 (0.49, 0.94); P=0.0193 Adjusted OR* (95% CI) 0.63 (0.34, 1.17); P=0.1455 0.64 (0.38, 1.08); P=0.0962 Adjusted OR† (95% CI) 0.49 (0.27, 0.90); P=0.0214 0.54 (0.32, 0.91); P=0.0198 IHM: in-hospital mortality; OR: odd ratio; CI: confidence interval. *Adjusted for baseline characteristics, in-hospital medications and primary PCI; †adjusted for baseline characteristics and in-hospital medications. Figure 1. Flowchart Conclusion The overall incidence and IHM rate of STEMICS in China are still high. Especially, higher IHM rate of prehospital STEMICS is observed in county-level hospitals, which may be attributed to the lower implementation rate of PPCI. Acknowledgement/Funding CAMS Innovation Fund for Medical Sciences (CIFMS) (2016-I2M-1-009)

In recent years, acupuncture has been used widely as an adjuvant treatment for the in vitro fertilization (IVF). "

Background According to the traditional Chinese medicine theory, moxa floss is the best material for moxibustion; the effect of moxibustion is closely related to the habitats of moxa floss, among which Qichun County, Hubei Province, China, is considered as the genuine origin. However, this view has not been validated by clinical studies. Moxibustion has been proven effective in alleviating pain and improving physical function and quality of life for patients with knee osteoarthritis (KOA). This trial aims to determine whether the habitat of moxa floss contributes to the effect of moxibustion and to validate the effectiveness of moxibustion for KOA. Methods This is a three-armed, randomized, double-blinded, sham-controlled trial. A total of 350 patients with moderate to severe primary KOA will be randomly allocated to groups A, B, or C with a 2:2:1 ratio. Moxa stick moxibustion using moxa floss from different habitats will be applied in two experimental groups: group A, moxa floss from the habitat of Qichun County, Hubei Province, China; and group B, moxa floss from the habitat of Nanyang County, Henan Province. Group C will use non-moxa floss for sham moxibustion as control. Patients will be treated for 20 min per session, for three sessions per week for 2 weeks, and followed up for 4 weeks. The primary outcome will be the change from baseline in the pain score of the Western Ontario and McMaster Osteoarthritis Index (WOMAC) at week 2. Secondary outcomes will include a change in the WOMAC pain score at week 6; the visual analogue scale for knee pain, the total WOMAC score, the WOMAC stiffness score, the WOMAC function score, the patient global assessment, and the responder criteria at weeks 2 and 6. Adverse events will be assessed throughout the study. Discussion This trial will help to identify the effectiveness of moxibustion for KOA and whether the habitat of moxa floss contributes to the effect of moxibustion. Trial registration Acupuncture-Moxibustion Clinical Trial Registry: AMCTR-IOR-16000007. Registered on 29 February 2016. Electronic supplementary material The online version of this article (10.1186/s13063-018-2794-1) contains supplementary material, which is available to authorized users.

To investigate the effect and safety of acupuncture with regulating menstruation to promote pregnancy for diminished ovarian reverse (DOR).According to prospective case series, 46 patients were observed and finally 40 cases were included. The acupoints were ① Baihui (GV 20), Shenting (GV 24), Guanyuan (CV 4) and bilateral Benshen (GB 13), Huangshu (KI 16), Dahe (KI 12), Luanchao (Extra), Zusanli (ST 36), Sanyinjiao (SP 6), Taixi (KI 3), Taichong (LR 3) and ② bilateral Shenshu (BL 23) and Ciliao (BL 32). The points in the two groups were used alternately. Acupuncture was given for 3 courses, 12 times as a course and 3 times a week. Before and after treatment, and 3 months after treatment, follicle-stimulating hormone (FSH), follicle-stimulating hormone/luteinizing hormone (FSH/LH), estradiol (ECompared with before treatment, the levels of FSH, FSH/LH decreased, and the levels of EAcupuncture with regulating menstruation to promote pregnancy can safely improve the ovarian reserve of patients with DOR.

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Electroacupuncture involving the lumbosacral region may be effective for women with stress urinary incontinence (SUI), but evidence is limited.To assess the effect of electroacupuncture vs sham electroacupuncture for women with SUI.Multicenter, randomized clinical trial conducted at 12 hospitals in China and enrolling 504 women with SUI between October 2013 and May 2015, with data collection completed in December 2015.Participants were randomly assigned (1:1) to receive 18 sessions (over 6 weeks) of electroacupuncture involving the lumbosacral region (n = 252) or sham electroacupuncture (n = 252) with no skin penetration on sham acupoints.The primary outcome was change from baseline to week 6 in the amount of urine leakage, measured by the 1-hour pad test. Secondary outcomes included mean 72-hour urinary incontinence episodes measured by a 72-hour bladder diary (72-hour incontinence episodes).Among the 504 randomized participants (mean [SD] age, 55.3 [8.4] years), 482 completed the study. Mean urine leakage at baseline was 18.4 g for the electroacupuncture group and 19.1 g for the sham electroacupuncture group. Mean 72-hour incontinence episodes were 7.9 for the electroacupuncture group and 7.7 for the sham electroacupuncture group. At week 6, the electroacupuncture group had greater decrease in mean urine leakage (-9.9 g) than the sham electroacupuncture group (-2.6 g) with a mean difference of 7.4 g (95% CI, 4.8 to 10.0; P .001). During some time periods, the change in the mean 72-hour incontinence episodes from baseline was greater with electroacupuncture than sham electroacupuncture with between-group differences of 1.0 episode in weeks 1 to 6 (95% CI, 0.2-1.7; P = .01), 2.0 episodes in weeks 15 to 18 (95% CI, 1.3-2.7; P .001), and 2.1 episodes in weeks 27 to 30 (95% CI, 1.3-2.8; P .001). The incidence of treatment-related adverse events was 1.6% in the electroacupuncture group and 2.0% in the sham electroacupuncture group, and all events were classified as mild.Among women with stress urinary incontinence, treatment with electroacupuncture involving the lumbosacral region, compared with sham electroacupuncture, resulted in less urine leakage after 6 weeks. Further research is needed to understand long-term efficacy and the mechanism of action of this intervention.clinicaltrials.gov Identifier: NCT01784172.

Background Acupuncture has been used for chronic constipation, but evidence for its effectiveness remains scarce. Objective To determine the efficacy of electroacupuncture (EA) for chronic severe functional constipation (CSFC). Design Randomized, parallel, sham-controlled trial. (ClinicalTrials.gov: NCT01726504). Setting 15 hospitals in China. Participants Patients with CSFC and no serious underlying pathologic cause for constipation. Intervention 28 sessions of EA at traditional acupoints or sham EA (SA) at nonacupoints over 8 weeks. Measurements The primary outcome was the change from baseline in mean weekly complete spontaneous bowel movements (CSBMs) during weeks 1 to 8. Participants were followed until week 20. Results 1075 patients (536 and 539 in the EA and SA groups, respectively) were enrolled. The increase from baseline in mean weekly CSBMs during weeks 1 to 8 was 1.76 (95% CI, 1.61 to 1.89) in the EA group and 0.87 (CI, 0.73 to 0.97) in the SA group (between-group difference, 0.90 [CI, 0.74 to 1.10]; P < 0.001). The change from baseline in mean weekly CSBMs during weeks 9 to 20 was 1.96 (CI, 1.78 to 2.11) in the EA group and 0.89 (CI, 0.69 to 0.95) in the SA group (between-group difference, 1.09 [CI, 0.94 to 1.31]; P < 0.001). The proportion of patients having 3 or more mean weekly CSBMs in the EA group was 31.3% and 37.7% over the treatment and follow-up periods, respectively, compared with 12.1% and 14.1% in the SA group (P < 0.001). Acupuncture-related adverse events during treatment were infrequent in both groups, and all were mild or transient. Limitations Longer-term follow-up was not assessed. Acupuncturists could not be blinded. Conclusion Eight weeks of EA increases CSBMs and is safe for the treatment of CSFC. Additional study is warranted to evaluate a longer-term treatment and follow-up. Primary Funding Source Ministry of Science and Technology of the People's Republic of China through the Twelfth Five-Year National Science and Technology Pillar Program.

Acupuncture has been used for chronic constipation, but evidence for its effectiveness remains scarce.To determine the efficacy of electroacupuncture (EA) for chronic severe functional constipation (CSFC).Randomized, parallel, sham-controlled trial. (ClinicalTrials.gov: NCT01726504).15 hospitals in China.Patients with CSFC and no serious underlying pathologic cause for constipation.28 sessions of EA at traditional acupoints or sham EA (SA) at nonacupoints over 8 weeks.The primary outcome was the change from baseline in mean weekly complete spontaneous bowel movements (CSBMs) during weeks 1 to 8. Participants were followed until week 20.1075 patients (536 and 539 in the EA and SA groups, respectively) were enrolled. The increase from baseline in mean weekly CSBMs during weeks 1 to 8 was 1.76 (95% CI, 1.61 to 1.89) in the EA group and 0.87 (CI, 0.73 to 0.97) in the SA group (between-group difference, 0.90 [CI, 0.74 to 1.10]; P 0.001). The change from baseline in mean weekly CSBMs during weeks 9 to 20 was 1.96 (CI, 1.78 to 2.11) in the EA group and 0.89 (CI, 0.69 to 0.95) in the SA group (between-group difference, 1.09 [CI, 0.94 to 1.31]; P 0.001). The proportion of patients having 3 or more mean weekly CSBMs in the EA group was 31.3% and 37.7% over the treatment and follow-up periods, respectively, compared with 12.1% and 14.1% in the SA group (P 0.001). Acupuncture-related adverse events during treatment were infrequent in both groups, and all were mild or transient.Longer-term follow-up was not assessed. Acupuncturists could not be blinded.Eight weeks of EA increases CSBMs and is safe for the treatment of CSFC. Additional study is warranted to evaluate a longer-term treatment and follow-up.Ministry of Science and Technology of the People's Republic of China through the Twelfth Five-Year National Science and Technology Pillar Program.

Background Acupuncture has been used for women during menopause transition, but evidence is limited. Objective We sought to evaluate the efficacy of electroacupuncture on relieving symptoms of women during menopause transition. Study Design We conducted a prospective, multicenter, randomized, participant-blinded trial in China mainland. Subjects were randomized to receive 24 treatment sessions of electroacupuncture at traditional acupoints or sham electroacupuncture at nonacupoints over 8 weeks with 24 weeks’ follow-up. Primary outcome was the change from baseline in the total score of Menopause Rating Scale at week 8. Secondary outcomes included the changes from baseline in the average 24-hour hot flash score, the Menopause Rating Scale subscale scores, the total score of Menopause-Specific Quality of Life Questionnaire and its subscales, and serum female hormones. All analyses were performed with a 2-sided P value of Results A total of 360 women (180 in each group) with menopause-related symptoms during menopause transition were enrolled from June 9, 2013, through Dec 28, 2015. At week 8, the reduction from baseline in the Menopause Rating Scale total score was 6.3 (95% confidence interval, 5.0–7.7) in the electroacupuncture group and 4.5 (95% confidence interval, 3.2–5.8) in the sham electroacupuncture group with a between-group difference of 1.8 (95% confidence interval, 0.9–2.8; P = .0002), less than the minimal clinically important difference of 5 points’ reduction. For secondary outcomes, the between-group differences for the decrease in the mean 24-hour hot flash score were significant at weeks 8, 20, and 32, but all were less than the minimal clinically important difference in previous reports. Interestingly, the between-group differences for the Menopause-Specific Quality of Life Questionnaire total score reduction were 5.7 at week 8, 7.1 at week 20, and 8.4 at week 32, greater than the minimal clinically important difference of 4 points. Changes from baseline in follicle-stimulating hormone, luteinizing hormone, and estradiol levels at weeks 8 and 20 (P > .05 for all), with the exception of follicle-stimulating hormone/luteinizing hormone ratios (P = .0024 at week 8 and .0499 at week 20), did not differ between groups. Conclusion Among women during menopause transition, 8 weeks’ electroacupuncture treatment did not seem to relieve menopausal symptoms, even though it appeared to improve their quality of life. Generalizability of the trial results may be limited by mild baseline menopausal symptoms in the included participants.

Placebo control is a useful method for determining the efficacy of a therapy. In acupuncture researches, the preferred method for placebo control is acupuncture using a placebo needle that has a blunt tip and achieves no skin penetration. We performed a crossover study to validate the blinding effect of a new type of placebo needle. Sixty volunteers were randomized to receive acupuncture using 2 types of needles with different sequences: sequence AB, involving first the pragmatic placebo needle and then the real needle, and sequence BA, in a reverse order. Placebo acupuncture was performed by administering the placebo needle through an adhesive pad without skin penetration on the acupoints LI4, RN12, BL25, and BL36. Real acupuncture was performed by needling through the pad and penetrating the skin to 15 mm using a real needle on the same acupoints. The acupuncture was administered every other day with 3 sessions for 1 type of needle. The primary outcome was the perception of needle penetration. Besides degree of acupuncture pain, type, and degree of needle sensation, needle acceptability and factors influencing the subject blinding effect were assessed. Needle penetration was felt by 100%, 90% (54/60), 88.3% (53/60), and 95% (57/60) of volunteers receiving placebo acupuncture and 98.3% (59/60), 96.7% (58/60), 95% (57/60), and 95% (57/60) of volunteers receiving real acupuncture on LI4, RN12, BL25, and BL36, respectively. Differences of the volunteers’ perception of needle penetration between the placebo needle and real needle were not significant for the 4 acupoints (all P > 0.05). Volunteers experienced fewer distension sensations (P = 0.01), a lower degree of needle sensation (P = 0.007), and less pain (P = 0.006) during placebo acupuncture than during real acupuncture. The placebo needle was more easily accepted than the real needle (OR = 1.63, 95% CI, 1.01–2.64). The influences of age, sex, educational level, acupuncture experience, needle sensation, acupuncture pain, and needle acceptability on volunteers’ perception of needle penetration were not significant. The pragmatic placebo needle is a valid control for acupuncture research. It produces a good subject blinding effect with a similar appearance to conventional acupuncture needles and no skin penetration when applied.

Background In women with mixed urinary incontinence, pelvic floor muscle training and solifenacin is the recommended conservative treatment, while electroacupuncture is a safe, economical and effective option. Methods/Design In this prospective, multi-center, randomized controlled trial, five hundred women with mixed urinary incontinence, from 10 centers will be randomized to receive either electroacupuncture or pelvic floor muscle training plus solifenacin. Women in the acupuncture group will receive electroacupuncture for 3 sessions per week, over 12 weeks, while women in the control group will receive pelvic floor muscle training plus solifenacin (5 mg once daily) for 36 weeks. The primary outcome measure is the proportion of change in 72-hour incontinence episode frequency from baseline to week 12. The secondary outcome measures include eleven items, including proportion of participants with ≥50% decrease in average 72-h incontinence episode frequency, change from baseline in the amount of urine leakage and proportion of change from baseline in 72-h incontinence episode frequency in week 25–36, and so forth. Statistical analysis will include covariance analysis, nonparametric tests and t tests. Discussion The objective of this trial is to compare the efficacy and safety of electroacupuncture versus pelvic floor muscle training plus solifenacin in women with moderate and severe mixed urinary incontinence. Trial registration ClinicalTrials.gov Identifier: NCT02047032

Objectives. To investigate the anti-aging effects of moxa smoke on SAMP8 mice.Methods. Using2×3factorial design, exposure length (15 or 30 minutes daily), and concentration (low, 5–15 mg/m3; middle, 25–35 mg/m3; high, 85–95 mg/m3), 70 SAMP8 mice were randomly assigned,n=10/group, to a model group or one of six moxa smoke groups: L1, L2, M1, M2, H1, or H2. Ten SAMR1 mice were used as normal control. Mice in moxa smoke groups were exposed to moxa smoke at respective concentrations and exposure lengths; the model and normal control mice were not exposed. Cerebral 5-HT, DA, and NE levels were determined using ELISA.Results. Compared to normal control, the model group showed a significant decrease in 5-HT, DA, and NE. Compared to model group, 5-HT and NE were significantly higher in groups L2, M1, and M2and DA was significantly so in L2and M1. 5-HT, DA, and NE levels were the highest in group M1among moxa smoke groups. A marked exposure length × concentration interaction was observed for 5-HT, DA, and NE.Conclusion. Moxa smoke increases monoamine neurotransmitter levels, which varies according to concentration and exposure length. Our finding suggests that the middle concentration of moxa smoke for 15 minutes seems the most beneficial.

Objective. This study aims to give a profile of discomfort and acceptability of acupuncture, including the prevalence and association with demographic and acupuncture-related factors. Methods. A cross-sectional study was conducted in Beijing, China. Outpatients of acupuncture and moxibustion departments were recruited using purposive sampling. 925 subjects were interviewed with an anonymous questionnaire. Multinomial and binary logistic regression were used to analyze factors affecting discomfort and acceptability of acupuncture. Results. The average VAS value of 925 subjects’ acupuncture discomfort was 2.66 ± 2.02, within the range of mild discomfort. Acupuncture was easily accepted by 81.1% of the subjects. Results of logistic regression were as follows: (1) subjects with a better knowledge of acupuncture, or a greater fear of pain or needles, experienced more “moderate to severe discomfort” and showed a decreased acupuncture acceptance ( or ); (2) Acupuncture with less discomfort or implemented by a more qualified doctor was easy to be accepted ( ); (3) subjects aged 20–29 preferred to report “moderate to severe discomfort” while those aged 40–59 preferred to report “slight discomfort” ( ). Conclusion. Acupuncture is an acceptable therapy with less discomfort, which can be greatly affected by fear of pain or needles, age, knowledge of acupuncture, and professional title of acupuncturist.

Previous studies have shown that acupuncture can alleviate postmenopausal symptoms, such as hot flashes, but few studies have assessed symptoms during the menopausal transition (MT) period. Thus, the effect of acupuncture upon MT symptoms is unclear. We designed a large-scale trial aimed at evaluating the efficacy of electroacupuncture for MT symptoms compared with sham electroacupuncture and at observing the safety of electroacupuncture. In this multicenter randomized controlled trial, 360 women will be randomized to either an electroacupuncture group or a sham electroacupuncture group. During the 8-week-long treatment, a menopause rating scale, average 24-hour hot flash score, Menopause-Specific Quality of Life Questionnaire score, and level of female hormones will be observed. Follow-ups at the 20th and 32nd week will be made. Though there is no completely inert placebo acupuncture and blinding is difficult in acupuncture trials, the placebo effect of EA can still be partially excluded in this study. For the placebo control, we use non-points and a tailor-made sham needle. This needle is different from a retractable needle, which is usually used for sham acupuncture. The needle in this trial is more simply constructed and more acceptable to Chinese people. We expect to evaluate the efficacy of electroacupuncture for MT symptoms and clarify its effect on these symptoms. ClinicalTrials.gov Identifier: NCT01849172 (Date of registration: 05/05/2013).

Background Previous research has shown that electro-acupuncture (EA) may be effective for functional constipation. We report a protocol for a randomized controlled trial using EA to confirm the efficacy and safety for severe chronic functional constipation. Methods/design This is a randomized, controlled trial. A total of 1,034 patients will be randomly allocated into the EA group (n=517) and the sham EA group (n=517). The EA group receives needling at ST25, SP14 and ST37 and the sham EA group receives needling at sham ST25, SP14 and ST37. The primary outcome measure is the changed number of weekly average complete spontaneous bowel movements(CSBMs) during 8 weeks of treatment, compared with baseline. The secondary outcome measures are: 1) the proportion of participants having three or more CSBMs on average per week; 2) the changed number of weekly average CSBMs during weeks 9 to 20; 3) the changed number of weekly average spontaneous bowel movements during 8 weeks of treatment; 4) stool consistency; 5) degree of difficulty in defecation; 6) patient assessment of constipation quality of life questionnaire (PAC-QOL); 7) incidence of adverse events; and 8) usage of medicine for constipation. Discussion This trial will evaluate the efficacy and safety of EA for severe chronic functional constipation. Trial registration Protocol Registration System of ClinicalTrial.gov, NCT01726504