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Lu Liu,1 Qiuyi Chen,1 Jiwei Yang,2 Weijuan Gang,2 Luopeng Zhao,1 Tianli Lyu,1 Xianghong Jing,2 Claire Shuiqing Zhang,3 Bin Li1 1Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, People’s Republic of China; 2Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China; 3School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, AustraliaCorrespondence: Claire Shuiqing Zhang, School of Health and Biomedical Sciences, RMIT University, Plenty Road, Bundoora, Melbourne, VIC, Australia, Tel +61 3 9925 7002, Fax +61 3 9925 7178, Email claire.zhang@rmit.edu.au Bin Li, Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, 23, Meishuguanhou Street, Beijing, People’s Republic of China, Tel +86 18910781852, Fax +86 52176055, Email libin@bjzhongyi.comBackground: Acute herpes zoster (HZ) is characterized as a vesicular rash with unilateral distribution produced by the reactivation of varicella zoster virus. It can induce various comorbidities that can adversely influence the quality of life of patients. The purpose of this systematic review is to assess the effect and safety of fire needling acupuncture on acute HZ.Methods: Three English databases (PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials) and four Chinese Databases (China National Knowledge Infrastructure, Wanfang database, Chongqing VIP database, and China Biology Medicine database) will be searched from their inceptions to July 2022. Randomized controlled trials investigating fire needling acupuncture therapy for acute HZ will be included, regardless of publication status. Two reviewers will independently conduct the study screening, data extraction, and research quality assessments. The primary outcome measures are the Pain Visual Analogue Scale and the occurrence of postherpetic neuralgia. Secondary outcomes measures are the evaluation of skin lesions, time to resolution of pain, tolerance evaluation, total effective rate, adverse events and changes in inflammatory and immune suppression markers in peripheral plasma. All included studies will be assessed for methodological quality via the Cochrane Collaboration’s bias risk assessment tool. Meta-analyses will be undertaken using Review Manager V.5.3 software. The findings will be reported as the risk ratio of the binary data and the mean difference (MD) or standardized MD of the continuous data. Subgroup analyses and sensitivity analyses will be conducted where appropriate. The Grading of Recommendations Assessment, Development, and Evaluation will be used to assess evidence certainty.Results: From the study, we will ascertain the effects and safety of fire needling acupuncture on acute HZ.Conclusion: This study will validate the effects and safety of fire needling acupuncture in the management of acute HZ, generating new evidence to guide acupuncture interventions for acute HZ in the future.Registration Number: PROSPERO CRD42020199047.Keywords: fire needling acupuncture, herpes zoster, postherpetic neuralgia, randomized controlled trials, systematic review

BackgroundMigraine is a prevalent headache disorder with significant impacts on patients' quality of life and economic burden. Chinese herbal medicine (CHM) is commonly prescribed for migraine in China. This review aimed to provide a rigorous evaluation of evidence on the efficacy of oral CHM for migraine and explore the correlation between its effect size and treatment duration.MethodsWe searched nine digital databases (PubMed, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, AMED, BioMedical Literature, CNKI, CQVIP, and Wanfang Data) from their inceptions to May 2021, with the language being restricted to Chinese and English. Randomized, placebo-controlled trials using oral CHM to treat adult migraine were included. Data screening and extraction were conducted by two independent reviewers. The methodological quality of randomized controlled trials (RCTs) was assessed using the Cochrane Risk of Bias tool. Meta-analyses were conducted to estimate the effect size using a random effect model, and a robust variance estimation (RVE) model was constructed to explore the correlation between treatment effects and treatment duration. The certainty of the evidence was assessed with the Grading of Recommendations Assessment, Development, and Evaluation. Publication bias was tested using a funnel plot and Egger's test.ResultsA total of 18 RCTs involving 3,015 participants were included. Results of the meta-analyses showed that, at the end of the treatment phase, CHM was more efficacious than placebo in reducing migraine frequency, migraine days, and pain severity, and increasing response rate. Additionally, CHM showed superior effects to placebo in lowering migraine frequency and pain severity at the end of the 4-week follow-up. The RVE model suggested that the benefits of CHM for migraine frequency and pain intensity increased as treatment duration extended. The number of adverse events reported by the CHM and placebo groups was comparable. The certainty of the evidence was graded as “moderate.” No publication bias was detected.ConclusionOral CHM appeared to be more efficacious than placebo for reducing migraine frequency and pain severity. Greater treatment effects were associated with longer treatment duration. The oral CHM was well tolerated.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/#recordDetails, identifier: CRD42021270719.

Context People with spasticity that occurred between 30 days and one year after stroke onset with a baseline Modified Ashworth Scale (MAS) ≥1. Objectives To determine the practicality of a pragmatic parallel-group open-labeled randomized controlled trial and to collect preliminary data of effectiveness and safety of electroacupuncture (EA) for poststroke spasticity. Methods Eligible participants were randomly allocated to the intervention group (EA plus usual care) or the control group (usual care alone) at a 1:1 ratio with block sizes of six. Participants received EA three times a week for four weeks, then were followed up for another four weeks. Participants' retention and adherence in the trial were assessed to determine the practicality of trial design. Clinical outcome measures were the change scores of MAS, Fugl-Meyer Assessment of motor performance and Barthel Index, and adverse events. Results Seventy-two people were screened for eligibility, and 30 of them were recruited and randomized. At the end, 25 participants followed the trial protocol and were included in our final data analyses using an intention-to-treat approach. No significant between-group difference was detected for the change scores of MAS, Fugl-Meyer Assessment, or Barthel Index at the end of treatment or end of follow-up. Eighteen participants reported 37 adverse events, but none of the participants was deemed related to EA. Conclusion It is feasible to conduct a full-scale trial to precisely evaluate the effectiveness and safety of EA for treating poststroke spasticity; however, longer treatment and follow-up phases should be considered in the full-scale trial.

BackgroundMigraine is a chronic neurological disease causing significant socioeconomic burden and impaired quality of life. Chinese medicine is commonly used for migraine in China. Clinical trials have generated evidence of the effectiveness of Chinese medicine therapies for migraine. However, little is known about how to use these therapies to treat migraine in real-world clinical settings.MethodsIn this retrospective study, we analyzed data from the electronic medical records (EMRs) of 2,023 migraine patients who attended the Guangdong Provincial Hospital of Chinese Medicine (GPHCM) between July 2018 and July 2020.ResultsMore than three-quarters (77.21%) of the patients were female. Most (78.20%) of the patients were aged between 18 and 50 years, 18.49% were aged above 50 years, and the remaining 3.31% were under 18 years. Sleep disorders were the most documented comorbidity occurring in 27.29% of patients, and more common in females (29.77%) than male (18.87%). Fatigue was the most frequently reported trigger of migraine attacks among all patients (9.39%), while menstruation was the most common trigger for female patients (10.24%). Less than a quarter of patients (21.01%) reported a history of taking analgesic medication for their migraine. The median treatment duration reported by the patients was 10 days. Chinese herbal medicine (CHM) was the predominant treatment for migraine at the hospital (88.48%), while pharmacotherapies were prescribed to 28.97% of the patients. CHM was prescribed more often as a sole treatment (53.58% of patients) than combined with pharmacotherapies (27.39% of patients). Among patients who reported improvements after taking CHM, the most frequently used herbs were fu ling and chuan xiong, the most frequent patented CHM product was tong tian oral solution, and the main herbal formulae were chuan xiong cha tiao san and yi qi cong ming tang.ConclusionCHM formulae, such as chuan xiong cha tiao san and yi qi cong ming tang, patented CHM product tong tian oral solution, and some herbs are potentially effective treatments for migraine. As such, CHM can be used as an alternative to conventional pharmacotherapies for migraine and is worth further evaluation in randomized controlled trials.

Knee osteoarthritis (KOA) is a degenerative disease, making a unique contribution to chronic pain, edema, and limited mobility of knee joint. Traditional Chinese Medicine (TCM) is a common complementary therapy for KOA and has been found effective. The aim of this review is to consolidate the current knowledge about the mechanism of four interventions of TCM: acupuncture, moxibustion, herbs, and massage in treating KOA, and how they alleviate symptoms such as pain, swelling, and dysfunction. Furthermore, this review highlights that four therapies have different mechanisms but all of them can manage KOA through inhibiting inflammation, which indicates that alternative therapies should be considered as a viable complementary treatment for pain management in clinical practice.

Zhengyang Qu, 1 Lu Liu, 1, 2 Luopeng Zhao, 1, 3 Xiaobai Xu, 1 Zhijuan Li, 1 Yupu Zhu, 1 Chen Zhang, 4 Xianghong Jing, 2 Xiaoyu Wang, 2 Bin Li, 1 Claire Suiqing Zhang, 5 Marc Fisher, 6 Linpeng Wang 1 1Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, People’s Republic of China; 2Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China; 3Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Institute of Traditional Chinese Medicine, Beijing, People’s Republic of China; 4Acupuncture and Moxibustion Department, Beijing Massage Hospital, Beijing, People’s Republic of China; 5School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia; 6Division of Stroke and Cerebrovascular Diseases, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USACorrespondence: Linpeng WangAcupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, No. 23 Meishuguanhou Street, Dongcheng District, Beijing 100010, People’s Republic of ChinaTel +86 1052176644Email wlp5558@sina.comPurpose: This rat experiment aims to demonstrate the efficacy of electrical acupuncture in preventing migraine attacks by stimulating the acupoint GB20.Introduction: Migraine, which takes 2ed at level four causes of GBD’s disease hierarchy, becomes a public health issue. It is important for physicians to supplement their knowledge of its treatment and consider alternative methods of therapy, such as acupuncture. However, the neurobiological and pathophysiological mechanisms of this prophylactic effect were unclear. The trigeminocervical complex is thought to be an important relay station in migraine pathophysiology as the key nuclei of the trigeminovascular system and the brainstem descending pain modulation system.Methods: There were six groups involved in this study: control, model, electroacupuncture, non-acupoint electroacupuncture, saline+electroacupuncture and saline+non-acupoint electroacupuncture. We injected saline or inflammatory soup into dura mater to induce control or migraine in the rats. The mechanical pain threshold and the single-cell extraneural neurophysiology of the C1 spinal dorsal horn neurons in the trigeminocervical complex were detected.Results: Pre-electroacupuncture could significantly increase the mechanical pain threshold of the periorbital region receptive field of the trigeminal nerve and decrease the discharges of neurons in the trigeminocervical complex. Acupuncture also reversed the abnormal skin pain response of the periorbital region receptive field of the trigeminal nerve caused by low-intensity stimulation.Discussion: We believe that our study makes a significant contribution to the literature because it is the first of its kind to use GB20 to provide relief from migraine attacks and mechanical cephalic cutaneous hypersensitivity by regulating the neuronal discharge from trigeminocervical complex.Keywords: acupuncture, headache prevention, hypersensitivity, electrophysiology, the trigeminocervical complex, inflammatory soup

It is challenging for a mobile robot to avoid moving obstacles in dynamic environments. Traditional velocity obstacle methods do not fully consider the obstacles moving with the speeds larger than the maximum speed of the robot. In this article, a new obstacle avoidance method, named the maximum-speed aware velocity obstacle (MVO) algorithm, is proposed for a mobile robot to avoid one or multiple high-speed obstacles. The proposed algorithm expands the velocity obstacle region into two parts, where one of the parts foresees collisions beyond the time horizon to ensure the feasible solutions of the current and the next control step. In practical applications, the perception capability of the robot is generally limited, and a non-holonomic robot can't move into any direction due to its kinematic constraints. In this article, the limited sensing field of view and non-holonomic kinematic constraints of the mobile robot are incorporated into the proposed MVO method. Moreover, continuity, safety, and computational complexity of the MVO approach are analyzed and presented. Extensive simulations and physical experiments are conducted to verify the efficacy of the MVO method, where a quadrotor and a differential-drive robot are used to perform dynamic obstacle avoidance.

Introduction Migraine is a disabling, recurrent headache disorder with complex comorbidities. Conventional treatments for migraine are unsatisfactory, with side effects and limited effectiveness. Chinese herbal medicine (CHM) has been used as an alternative or complementary treatment option for migraine in China. Currently, the existing evidence of benefit of CHM for migraine has been generated from randomised clinical trials using standardised intervention with a focus on internal validity hence with limited external validity. Moreover, CHM individualised intervention design, patients’ preferences and concerns, and clinicians’ experience are critical to clinical decision making and therapeutic success. This real-world observational study aims to gather practice-based evidence of effects and safety of CHM for migraine in the context of integrating Chinese medicine diagnostic procedures, patients’ preferences and matters relevant to clinical decision making. Methods and analysis The study is being undertaken at the Guangdong Provincial Hospital of Chinese Medicine (GPHCM) from December 2020 to May 2022. We anticipate that approximately 400 adult migraineurs will be enrolled and observed on their migraine severity, analgesic consumption, quality of life, anxiety, depression and insomnia at baseline and then every four weeks over 12 weeks. Treatments, diagnostic information, and patient-reported most bothersome symptoms will be collected from patient clinical records. Patient’s demographic data, preferences and concerns on CHM treatments will also be gathered at baseline and be analysed. Factors related to clinical outcomes will be explored with multiple correlation and multivariable regression analyses. Effects of CHM will be evaluated using generalised estimated equation, based on clinical outcome data. Discussion This study will provide comprehensive evidence of CHM for migraine in the context of evidence-based practice. Trial registration number ChiCTR2000041003

Fertilization practices can change soil fertility and biological properties, and influence its ecological functions. We studied the change in the straw decomposition rate and microbial community composition in soils with different long-term fertilization regimes (no-fertilizer control (CK); nitrogen, phosphorus, and potassium fertilizers (NPK); and NPK plus straw (NPKS)) with addition of straw in a 75-day incubation experiment. Carbon dioxide (CO2) emission rates from the straw material were 13.9, 15.8, and 17.9 μg C g−1 soil day−1 in the CK + S, NPK + S, and NPKS + S treatments, respectively. After straw addition, the biomass of fungi and bacteria increase following the order of CK + S ≤ NPK + S

Electroacupuncture (EA) is widely used in clinical practice to relieve migraine pain. 5-HT7 receptor (5-HT7R) has been reported to play an excitatory role in neuronal systems and regulate hyperalgesic pain and neurogenic inflammation. 5-HT7R could influence phosphorylation of protein kinase A (PKA)- or extracellular signal-regulated kinase1/2 (ERK1/2)-mediated signaling pathways, which mediate sensitization of nociceptive neurons via interacting with cyclic adenosine monophosphate (cAMP). In this study, we evaluated the role of 5-HT7R in the antihyperalgesic effects of EA and the underlying mechanism through regulation of PKA and ERK1/2 in trigeminal ganglion (TG) and trigeminal nucleus caudalis (TNC). Hyperalgesia was induced in rats with dural injection of inflammatory soup (IS) to cause meningeal neurogenic inflammatory pain. Electroacupuncture was applied for 15 min every other day before IS injection. Von Frey filaments, tail-flick, hot-plate, and cold-plated tests were used to evaluate the mechanical and thermal hyperalgesia. Neuronal hyperexcitability in TNC was studied by an electrophysiological technique. The 5-HT7R antagonist (SB269970) or 5-HT7R agonist (AS19) was administered intrathecally before each IS application at 2-day intervals during the 7-day injection protocol. The changes in 5-HT7R and 5-HT7R-associated signaling pathway were examined by real-time polymerase chain reaction (RT-PCR), Western blot, immunofluorescence, and enzyme-linked immunosorbent assay (ELISA) analyses. When compared with IS group, mechanical and thermal pain thresholds of the IS + EA group were significantly increased. Furthermore, EA prevented the enhancement of both spontaneous activity and evoked responses of second-order trigeminovascular neurons in TNC. Remarkable decreases in 5-HT7R mRNA expression and protein levels were detected in the IS + EA group. More importantly, 5-HT7R agonist AS19 impaired the antihyperalgesic effects of EA on p-PKA and p-ERK1/2. Injecting 5-HT7R antagonist SB-269970 into the intrathecal space of IS rats mimicked the effects of EA antihyperalgesia and inhibited p-PKA and p-ERK1/2. Our findings indicate that 5-HT7R mediates the antihyperalgesic effects of EA on IS-induced migraine pain by regulating PKA and ERK1/2 in TG and TNC.

Background Mild‐moderate psoriasis vulgaris is a common dermatological autoimmune condition with limited conventional therapeutic options. Safe and effective adjunct therapies to topical non‐steroidal antipsoriatic therapy are needed. The oral Chinese herbal medicine (CHM) formula PSORI‐CM01 has been evidenced potential antipsoriatic pharmacological activity. This article reports a pilot study which was designed as a double‐blinded, placebo‐controlled randomized controlled trial (RCT) evaluating the effects of PSORI‐CM01 when added to topical calcipotriol cream. Methods People with moderate psoriasis vulgaris were randomized to receive oral PSORI‐CM01 or placebo administered for 12 weeks in combination with calcipotriol. The primary clinical outcome was the change of psoriasis area severity index (PASI) score at week 12 and week 24. Secondary clinical outcomes were PASI75, PASI50, relapse rate, change in body surface area, dermatology life quality index and Skindex29, and adverse events (AEs). Participants’ satisfaction and willingness to repeat were also assessed. Results The pilot study was conducted in Australia and China, 29 participants were randomized with 26 completed the treatment and follow‐up. Participants’ baseline basic characteristics were comparable. No between‐group statistical significance was found on pre‐defined clinical outcome measures, although there seemed a trend of treatment effects favoring the combination of PSORI‐CM01 with calcipotriol. Frequency and severity of AEs were similar between two groups, with no severe AEs reported. Conclusions The design and duration of the study appears feasible. A proper powered RCT with slight adjustments in the methods is needed to reveal the add‐on effects of oral CHM PSORI‐CM01. The experience and results from this pilot study will contribute to the refine of objectives and design of a future study, and assist the sample size calculation for the full‐scale RCT.

Background: Electroacupuncture (EA) is widely used in clinical practice to relieve migraine pain. 5-HT7 receptor (5-HT7R) has been reported to play an excitatory role in neuronal systems and regulate hyperalgesic pain and neurogenic inflammation. 5-HT7R could influence Phosphorylation of protein kinase A (PKA)- or Extracellular signal-regulated kinase1/2 (ERK1/2)-mediated signaling pathways, which mediate sensitization of nociceptive neurons via interacting with cyclic Adenosine monophosphate (cAMP). In this study, we evaluated the role of 5-HT7R in the antihyperalgesic effects of EA and the underlying mechanism through regulation of PKA and ERK1/2 in trigeminal ganglion (TG) and trigeminal nucleus caudalis (TNC). Methods: Hyperalgesia was induced in rats with dural injection of inflammatory soup (IS) to cause meningeal neurogenic inflammatory pain. Electroacupuncture was applied for 15 minutes every other day before IS injection. Von Frey filaments, tail-flick, hot-plate, and cold-plated tests were used to evaluate the mechanical and thermal hyperalgesia. Neuronal hyperexcitability in TNC was studied by an electrophysiological technique. The 5-HT7R antagonist (SB269970) or 5-HT7R agonist (AS19) was administered intrathecally before each IS application at 2-days intervals during the 7-days injection protocol. The changes in 5-HT7R and 5-HT7R-mediated signaling pathway were examined by real time polymerase chain reaction (RT-PCR), Western blot, immunofluorescence and enzyme-linked immunosorbent assay (ELISA) analyses.Results: When compared with IS group, mechanical and thermal pain thresholds of the IS+EA group were significantly increased. Furthermore, EA prevented the enhancement of both spontaneous activity and evoked responses of second-order trigeminovascular neurons in TNC. Remarkable decreases in 5-HT7R mRNA expression and protein levels were detected in the IS+EA group. More importantly, 5-HT7R agonist AS19 impaired the antihyperalgesic effects of EA on p-PKA and p-ERK1/2. Injecting 5-HT7R antagonist SB-269970 into the intrathecal space of IS rats mimicked the effects of EA antihyperalgesia and inhibited p-PKA and p-ERK1/2. Conclusion: Our findings indicate that 5-HT7R mediates the antihyperalgesic effects of EA on IS-induced migraine pain by regulating PKA and ERK1/2 in TG and TNC.

It is crucial to online plan a smooth, continuous and collision-free path to navigate a fixed-wing unmanned aircraft through complex environments. In a static environment, given priori knowledge of the map, the sampling-based RRT (rapidly exploring random tree) method and its variants are efficient to provide global path planning to navigate the fixed-wing aircraft through static obstacles. However, in complex and dynamic situations, the fixed-wing aircraft may encounter dynamic obstacles when following the planned global path. In the presence of dynamic obstacles within the sensing range of the fixed-wing aircraft, it is challenging to on-line generate a new collision-free and smooth path. In this paper, a real-time collision-free path planning strategy is proposed for fixed-wing aircraft in dynamic environments. Specifically, the proposed collision-free path planner named as Spline-RRT-VO is presented incorporating the spline-RRT algorithm and the velocity obstacle (VO) method to avoid a high-speed dynamic obstacle. In the proposed spline-RRT-VO approach, a random tree grows in the local area, meanwhile, the VO method is used to extend tree edges and reject unavailable nodes. It improves the tree growing in a more efficient and smooth manner. Simulation results verify the effectiveness of the spline-RRT-VO method to navigate the fixed-wing UAVs through dynamic environments.

Background. The prophylactic effects of Chinese herbal medicine (CHM) for migraine were examined in numerous clinical trials. This review aimed to analyze the effectiveness and safety of CHM as prophylactic treatment of migraine compared to flunarizine. Methods. Nine databases were searched for randomized controlled trials (RCTs) that evaluated effects of CHM for episodic migraine prophylaxis compared to flunarizine, published before March 2019. Results. Thirty-five RCTs with 2,840 participants met the inclusion criteria, and 31 of them were included in meta-analyses. The overall meta-analysis indicated that, when compared to flunarizine, CHM reduced the frequency of migraine attacks at the end of treatment (EoT) (21 studies, mean difference (MD) −1.23, 95% confidence interval (CI) (−1.69, −0.76)) and at the end of follow-up (EoFU) (five studies, MD −0.96, 95% CI (−1.70, −0.21)). Subgroup analyses based on the treatment duration, follow-up duration, and the dosage of flunarizine showed that CHM was superior to or comparable with flunarizine in reducing migraine frequency. Similar results were also found for secondary outcomes such as the pain visual analogue scale, migraine duration, responder rate, and acute medication usage. In particular, the studies that used CHM containing herb pairs (Chuan Xiong plus Bai Zhi and Chuan Xiong plus Tian Ma) showed promising results. However, the certainty of this evidence was evaluated as “low” or “very low” using the Grading of Recommendations, Assessment, Development and Evaluations approach. Conclusion. CHM appeared to be comparable with flunarizine in reducing the frequency of episodic migraine attacks in adults at EoT and EoFU and well-tolerated by participants, regardless of the treatment duration, follow-up duration, and dosage of flunarizine. Due to the low certainty of the evidence, the suggested promising prophylactic outcomes require higher quality evidence from further rigorous RCTs.

Background Electroacupuncture (EA) is a modern form of acupuncture therapy where stainless steel acupuncture needles are used as percutaneous electrodes to apply electrical stimulation. The concern about electrolytic corrosion of needles during EA has not been conclusively addressed. Aim To examine whether corrosion of stainless steel acupuncture needles occurs after EA to establish the safety profile of this therapy. Methods The study comprised four EA sessions on healthy participants mimicking a common clinical practice, with needle surface examinations conducted immediately after each session. Used acupuncture needles that did not undergo electrical stimulation and unused needles taken from the original package were also examined as control comparisons. Two commonly used types of single-use, silicone-coated, stainless steel needles were selected for the experiment. The ES-160 digital acupunctoscope (a charge-balanced electric stimulator) was used to deliver electrical stimulation, and an oscilloscope was used to record the waveforms and electric currents. All needles were sterilised before examination by a scanning electron microscope (SEM), where images of needle tips and shafts were taken for further analysis. Results and conclusions 32 needles were examined under the SEM. As the main findings, the SEM images showed the surface finish, burr attachments and surface characteristics of needle samples. No evidence of electrolytic corrosion was detected on any needle that underwent electrical stimulation for 30 min delivered by a charge-balanced acupunctoscope in healthy participants. The choice of a charge-balanced acupunctoscope is recommended to avoid any potential corrosion of needles in EA clinical practice.

Phosphorus (P) fertilizer has been widely applied to improve crop yields in the North China Plain; however, most of applied P fertilizer is disabled due to the strong sorption/fixing processes in the soil. This study evaluates the change characteristics of soil properties on different textural soils and their relationships with the P adsorption and desorption under long-term fertilization to do a favor to make strategies for improving the P availability of the soil. Five textural fluvo-aquic soils including gritty sand, silt sand, sandy loam, medium loam, and light clay were investigated in a 27-year (1990–2017) long-term fertilization experiment at Zhengzhou (Henan province) of China. Soil samples were collected in 1990, 1999, and 2017 at 0–20 cm to measure soil properties (i.e., soil mechanical composition) and P adsorption and desorption characteristics. The clay and silt contents decreased and sand content increased in the light clay soil with the cultivation years, the opposite situation for the gritty sand and silt sand soils. The contents of total P, Olsen–P, and organic matter (SOM) in the five textural soils were increased over time. There were stronger P absorption capacity and weaker desorption ability for the light clay soil relative to others, which was reflected in the largest P maximum buffer capacity (MBC) and the lowest β value; however, the P adsorption capacity tended to decrease over time for the light clay soil. Clay and silt fractions were positively correlated with MBC, while negatively correlated with β (P

Background. Dysphagia is a common complication of stroke, affecting up to 78% of stroke patients. The existence of dysphagia after stroke has been associated with an increased risk for pulmonary complications and even mortality. Previous studies have shown that acupuncture could be potential therapeutic method for treatment of dysphagia after stroke. A prospective randomized controlled pilot trial is designed to evaluate the effect of He’s Santong needling method on dysphagia after stroke. Methods and Design. Sixty eligible participants will be recruited and randomly assigned into treatment group (He’s Santong needling method and swallowing rehabilitation training) and control group (swallowing rehabilitation training) in a 1:1 ratio. All treatments will be provided everyday on weekdays with a two-day interval at the weekend, during a total treatment course of four weeks. The Penetration-Aspiration Scale with Fiberoptic Endoscopic Examination of Swallowing will be assessed at baseline and endpoint (Week 4) as primary outcomes. The Saitoh’s classification score, Swallowing-Related Quality of Life score, the Modified Mann Assessment of Swallowing Ability score, and Surface Electromyography will be evaluated at baseline and endpoint as secondary outcomes. Ethics and Dissemination. The trial protocol has been approved by the Research Ethical Committee of Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University on 9 May 2017 (ethical batch number: 2017BL-013-02). Each participant will be notified regarding the study protocol. Written informed consent will be obtained from each participant. Trial Registration. ISRCTN registry: ISRCTN68981054; Registered on 25 September 2017.

Background An ideal placebo design in clinical research should resemble the intervention under investigation to facilitate blinding, yet remain clinically inert. With regard to physical interventions such as acupuncture, a true placebo device has not been developed and validated. Since 1998, researchers have designed several placebo acupuncture devices (PADs). The three most widely used PADs are the Streitberger, the Park and the Takakura device. Aim This review focuses on evaluating studies of these devices, in the context of credibility of blinding (COB), assessment of penetrating pain or sensation, and de qi sensation. Methods Electronic database searches were conducted in four English and two Chinese databases from their inception until November 2016. All studies included in the review were conducted on healthy participants and compared verum manual acupuncture with any of the aforementioned PADs with respect to one or more of the above three outcomes related to blinding effect. Results The synthesised analyses of the 15 included studies showed that the Streitberger and Park placebo devices may not blind participants successfully when tested at a sensitive acupuncture point (LI4). In terms of penetrating sensation, there were significant differences between these two placebo devices and verum acupuncture when applied at this point. The Takakura device was the only PAD that had the potential to blind the acupuncturist. However, the blinding analyses of all outcome measures were inconsistent. Conclusion Overall, there were insufficient data to confirm the blinding effects of these skin-contact PADs as each device was associated with limitations that warrant further design improvements.

Nutrient availability and plant diversity are two important factors determining crop productivity in agricultural ecosystems, but little is known about the underlying mechanisms shaping microbial communities and their regulatory roles in soil biological activity and function. Here, we explored the impacts of fertilization regimes and crop rotations on soil physicochemical properties, crop yield and bacterial and fungal community structures in a 26-year field experiment. The critical determinants for regulating soil enzyme activity profiles involved in carbon (C), nitrogen (N) and phosphorus (P) cycling were identified by the partial least squares path model (PLS-PM). Long-term inorganic or organic fertilization significantly increased soil total N by 27%–77% and crop yield by 237%–419% and decreased soil pH by an average of 0.4 units when compared with non-fertilized control. Soil bacteria were more sensitive than fungi to the fertilization practices. Nutrient additions enriched copiotrophic taxa affiliated to the Pseudomonadaceae and Cytophagaceae bacterial families, but reduced some Acidobacteria such as subgroup 4 RB41, which was the most sensitive biomarker responding to no fertilization. Conversely, fungi were more active in response to crop conversion from wheat-maize to wheat-soybean rotation, leading to a 3-fold enhancement of an unclassified Sordariomycetes family in soybean-based rotation. PLS-PM revealed that fertilization-induced increases in soil enzyme activities were regulated by the bacterial community, while plant-driven alterations in yield, organic C input and soil aggregate-size distribution played an important role for fungal development, which, however, had no significant link to soil enzyme activity profiles. Our results suggest that different response patterns of soil bacteria and fungi to agricultural practices might have consequences for ecosystem function.

Biochar addition to soil has been proposed as a strategy to enhance soil quality and crop productivity. However, little is known about responses of soil nutrients and microbial activities to additions of chemical fertilizer and biochar with different pyrolysis temperatures. To investigate the effects of control (CK), chemical fertilizer (NPK), and NPK with maize straw biochar (MC) produced at 300, 450, and 600 °C (NPK + MC300, NPK + MC450, and NPK + MC600) on crop yield, soil nutrients, soil enzyme activities, and microbial attributes in a calcareous soil, we conducted a pot experiment. The results showed that the NPK + MC450 treatment obtained the highest wheat yield and N, P, and K uptakes. The NPK + MC300 and NPK + MC450 treatments decreased significantly the soil available K content and increased the C/N ratio, contents of soil organic carbon (SOC) and available P compared to the NPK + MC600 treatment. The NPK + MC450 treatment promoted the increases in soil C- and N-cycling enzyme activities. The total N content, soil MBC and MBN were the main driving factors affecting soil enzyme activities. All the NPK plus MC soils significantly reduced the relative abundance of soil fungi and enhanced soil nutrient contents (excluding soil inorganic nitrogen) and total phospholipid fatty acid concentrations. A redundancy analysis revealed that the changes in soil microbial community depended mainly on the contents of MBC, MBN and available K as well as the C/N ratio. This study provides clear evidence that the co-application of NPK fertilizers and MC produced at 450 °C was more efficient for improving soil quality and potential crop productivity.

Crop nitrogen nutrition is an important indicator for evaluating crop growth. Rapid and non-destructive estimation of nitrogen accumulation in wheat leaves is of great significance for crop nitrogen fertilizer management. Based on field test data from multiple wheat varieties for different locations, years, nitrogen levels, and growth periods, the relationship between 11 canopy hyperspectral parameters and nitrogen accumulation in wheat plants was studied. According to the results of correlation and regression analysis, the flowering period of wheat was selected as the most suitable growth period for crop growth evaluation (the average R2 was 0.732, and the root mean square error (RMSE) was 0.354). A new vegetation index, NDchI*DDN (referred to as the nitrogen accumulation vegetation index, abbreviated as NAVI), was constructed based on the pairwise combination of traditional vegetation index products. This parameter had a high correlation with plant nitrogen accumulation (R2 = 0.856), and the root mean square error (RMSE) was 0.296. Tested by independent experimental data, the fitting degree of the plant nitrogen accumulation inversion model established with NAVI as the variable was R2 = 0.861, the relative error RE = 9.3%, RMSE = 0.398, and the prediction accuracy was significantly higher than other models. Therefore, construction of a NAVI-based plant nitrogen accumulation monitoring model gave ideal test results, which could reduce the limitations of experimental conditions and is expected to provide new important technical support for precise fertilization.

Background: Treatment for post-stroke spasticity (PSS) remains a major challenge in clinical practice. Chinese herbal medicine (CHM) is often administered to assist in routine care (RC) in the treatment of PSS, with increasing numbers of clinical research and preclinical studies suggesting that it has potential benefits. Therefore, we conducted a systematic review and meta-analysis to evaluate the add-on effects and safety of CHM for PSS. Methods: Five English and four Chinese databases were searched from their respective inception to 28 February 2018. We included randomized controlled trials that evaluated the add-on effects of CHM for PSS, based on changes in the scores of the (Modified) Ashworth Scale (AS or MAS), Fugl-Meyer Assessment of Sensorimotor Recovery (FMA), and Barthel Index (BI). Results: Thirty-five trials involving 2,457 patients were included. For upper-limb AS or MAS, the estimated add-on effects of CHM to RC were significantly better when using oral (SMD −1.79, 95% CI: −3.00 to −0.57) or topical CHM (SMD −1.06, 95% CI: −1.40 to −0.72). For lower-limb AS or MAS, significant add-on benefits to RC were also detected (SMD −1.01, 95% CI: −1.43 to −0.59 and SMD −1.16, 95% CI: −1.83 to −0.49) using oral and topical CHM, respectively. For FMA and BI, better results were detected when adding CHM to RC, except for the subgroup of oral CHM for upper-limb FMA. Ten of the 35 included studies reported safety information, with two of them mentioning two mild adverse events. Conclusions: Noting the quality concerns of the included trials, this review suggests that CHM appears to be a well-tolerated therapy for patients with PSS, and the potential add-on effects of CHM in reducing spasticity and improving the daily activities of patients with PSS require further rigorous assessment.

Background: Shoulder-hand syndrome (SHS) is prevalent in hemiplegic patients after stroke. Potential benefits of acupuncture were shown in recent clinical trials. This systematic review aimed to comprehensively evaluate the safety and efficacy of acupuncture for SHS in stroke patients. Methods: Five English databases (PubMed, Embase, CINAHL, CENTRAL, and AMED) and four Chinese databases (CBM, CNKI, CQVIP, and Wanfang) were searched from their inceptions to January 2019. Randomized, controlled trials that evaluated the add-on effects of acupuncture to rehabilitation for post-stroke SHS were identified. Results: Thirty-eight studies involving 3,184 participants fulfilled the eligible criteria and were included in the review. The overall meta-analysis showed that acupuncture combined with rehabilitation significantly improved motor function (upper-limb Fugl-Meyer Assessment (FMA): 34 studies, mean difference (MD) 8.01, 95% confidence interval (CI) [6.69,9.33]), and reduced pain (visual analog scale (VAS): 25 studies, MD −1.59, 95%CI [−1.86,−1.32]). It also improved activities of daily living (ADL) when compared with rehabilitation alone (ADL: 11 studies, MD 9.99, 95%CI [5.91,14.06]). However, the certainty of evidence of all these outcomes was assessed as “low.” Subgroup analyses of acupuncture stimulation types and treatment duration all showed significant add-on effects comparing with rehabilitation alone. The safety of acupuncture was unclear because there is a lack of detailed reporting of adverse events in most of the included studies. Conclusions: Acupuncture therapy seems effective for motor function, pain relief and activities of daily living in stroke patients with mild SHS, when it is used in combination with rehabilitation. The low certainty of evidence downgrades our confidence in making recommendations to clinical practice.

The carbon sequestration potential is affected by cropping system and management practices, but soil organic carbon (SOC) sequestration potential under fertilizations remains unclear in north China. This study examined SOC change, total C input to soil and, via integration of these estimates over years, carbon sequestration efficiency (CSE, the ratio of SOC change over C input) under no fertilization (control), chemical nitrogen fertilizer alone (N) or combined with phosphorus and potassium fertilizers (NP, NK, PK and NPK), or chemical fertilizers combined with low or high (1.5×) manure input (NPKM and 1.5NPKM).; Results: Results showed that, as compared with the initial condition, SOC content increased by 0.03, 0.06, 0.05, 0.09, 0.16, 0.26, 0.47 and 0.68 Mg C ha-1 year-1 under control, N, NK, PK, NP, NPK, NPKM and 1.5NPKM treatments respectively. Correspondingly, the C inputs of wheat and maize were 1.24, 1.34, 1.55, 1.33, 2.72, 2.96, 2.97 and 3.15 Mg ha-1 year-1 respectively. The long-term fertilization-induced CSE showed that about 11% of the gross C input was transformed into SOC pool.; Conclusion: Overall, this study demonstrated that decade-long manure input combined with chemical fertilizers can maintain high crop yield and lead to SOC sequestration in north China. © 2016 Society of Chemical Industry.; © 2016 Society of Chemical Industry.

The roots of two peony species, Paeonia lactiflora Pallas and Paeonia veitchii Lynch are routinely referred to as either chishao () or baishao (). This paper reviews the botanical origins and traditional medicinal usage of each species, as well as pharmacological like activity of their constituents. A search of herbal pharmacological encyclopaedia, PubChem and PubMed databases identified their known constituents. The biological data for these constituents were evaluated and classified according to pharmacological-like activity, with emphasis on compounds of greatest concentration and bioavailability. It was found that P. lactiflora and P. veitchii have some common compounds; however, their phytochemical bioavailability varies. Furthermore, a larger number of compounds have been identified in P. lactiflora. These have greater potential for antiinflammatory, antiviral, antibacterial and antioxidant therapeutic activity compared with P. veitchii. However, evidence indicates both species are similarly indicated for antiviral and glycaemic activity. Major compounds of each are classified as flavonoids, hydrolysable tannins (polyphenols) and monoterpene glycosides. The evidence suggests both species, when administered in entire botanical form, have an excellent safety profile; however, constituent toxicity risk evidence is limited, requiring further investigation. Although experiments show many compounds have biological activity, further investigation of their therapeutic potential is needed. Copyright © 2016 John Wiley & Sons, Ltd.

Background Psoriasis vulgaris is a modern medical term. In the classical Chinese medicine (CM) literature, this disorder could be classified under a diversity of terms. In order to explore how psoriasis vulgaris was conceptualized and managed throughout Chinese medical history, we undertook a systematic longitudinal analysis of descriptions in the classical CM literature of skin disorders consistent with psoriasis vulgaris. Methods Candidate search terms were identified from 33 contemporary CM books as relevant to psoriasis vulgaris. Thirteen terms were used to search the Zhong Hua Yi Dian —‘Encyclopaedia of Traditional Chinese Medicine', 4th edition, a digital collection of over 1000 medical books. Search results were entered in a spreadsheet, citations that were consistent with psoriasis vulgaris were identified based on: (i) a description of the features of psoriasis vulgaris and (ii) judgment by two clinicians regarding relevance to psoriasis vulgaris. Analysis focused on the use of terms by historical period (Chinese dynasty) and whether the terms were specific for psoriasis vulgaris Results 608 citations dating from 363 to 1947AD were included. The two criteria for determining inclusion of citations were combined to select the pool of citations most relevant to psoriasis vulgaris. Sixty citations from eight search terms were found in this pool. Among the eight terms, Bai Bi , She Shi and Bi Feng consistently identified citations that were likely to be psoriasis. The earliest was from 1368AD (Ming dynasty). The remaining five terms yielded inconsistent results. Citations of disorders consistent with psoriasis vulgaris appear prior to 1368–1644AD (Ming dynasty), but the terms used were not specific for psoriasis. Conclusions Bai Bi , She Shi and Bi Feng are the terms most consistently used to refer to psoriasis vulgaris. They first appeared in 1368–1644AD (Ming dynasty) and Bai bi remains in use. Regarding the other terms, certain citations may have referred to psoriasis vulgaris, but in other cases these terms could be used for disorders whose descriptions were inconsistent with psoriasis.