INTRODUCTION:Stimulating collagen production is a key strategy for enhancing skin vitality and counteracting aging. However, current methods to boost collagen synthesis often entail pain and tissue trauma. There is a compelling need for painless, non-invasive approaches to effectively increase skin collagen. OBJECTIVES:To investigate the effects of mid-infrared modulation (MIMO) on skin collagen deposition across multiple biological scales, from human and animal models in vivo to human dermal fibroblasts in vitro. METHODS:We determined optimal MIMO irradiation parameters (energy, duration) in human and animal skin. Effects on collagen deposition were evaluated in vivo (human, mouse) and in vitro (human dermal fibroblasts). Levels of inflammatory and collagen metabolism-related proteins were measured by ELISA. RESULTS:MIMO irradiation (70 mW/cm2) significantly enhanced collagen deposition in human and mouse skin in vivo without causing excessive heating. This was associated with downregulation of the collagen-degrading enzyme MMP-1 and upregulation of collagen synthesis-promoting factors (TGF-β, HSP47, HSP70) in mouse skin. Furthermore, MIMO stimulated the secretion of multiple collagen subtypes in human dermal fibroblasts in vitro. CONCLUSIONS:MIMO represents a safe, non-invasive, and painless approach for effectively enhancing skin collagen deposition in vivo.

BACKGROUND:Methadone maintenance treatment (MMT) is effective for managing opioid use disorder, but adverse effects mean that optimal therapy occurs with the lowest dose that controls opioid craving. OBJECTIVE:To assess the efficacy of acupuncture versus sham acupuncture on methadone dose reduction. DESIGN:Multicenter, 2-group, randomized, sham-controlled trial. (Chinese Clinical Trial Registry: ChiCTR2200058123). SETTING:6 MMT clinics in China. PARTICIPANTS:Adults aged 65 years or younger with opioid use disorder who attended clinic daily and had been using MMT for at least 6 weeks. INTERVENTION:Acupuncture or sham acupuncture 3 times a week for 8 weeks. MEASUREMENTS:The 2 primary outcomes were the proportion of participants who achieved a reduction in methadone dose of 20% or more compared with baseline and opioid craving, which was measured by the change from baseline on a 100-mm visual analogue scale (VAS). RESULTS:Of 118 eligible participants, 60 were randomly assigned to acupuncture and 58 were randomly assigned to sham acupuncture (2 did not receive acupuncture). At week 8, more patients reduced their methadone dose 20% or more with acupuncture than with sham acupuncture (37 [62%] vs. 16 [29%]; risk difference, 32% [97.5% CI, 13% to 52%]; P < 0.001). In addition, acupuncture was more effective in decreasing opioid craving than sham acupuncture with a mean difference of -11.7 mm VAS (CI, -18.7 to -4.8 mm; P < 0.001). No serious adverse events occurred. There were no notable differences between study groups when participants were asked which type of acupuncture they received. LIMITATION:Fixed acupuncture protocol limited personalization and only 12 weeks of follow-up after stopping acupuncture. CONCLUSION:Eight weeks of acupuncture were superior to sham acupuncture in reducing methadone dose and decreasing opioid craving. PRIMARY FUNDING SOURCE:National Natural Science Foundation of China.

BackgroundDepression is defined by a persistent low mood and disruptions in sleep patterns, with the WHO forecasting that major depression will rank as the third most prevalent contributor to the global burden of disease by the year 2030. Sleep deprivation serves as a stressor that triggers inflammation within the central nervous system, a process known as neuroinflammation. This inflammatory response plays a crucial role in the development of depression by upregulating the expression of inflammatory mediators that contribute to symptoms such as anxiety, hopelessness, and loss of pleasure.MethodsIn this study, sleep deprivation was utilized as a method to induce anxiety and depressive-like behaviors in mice. The behavioral changes in the mice were then evaluated using the EZM, EPM, TST, FST, and SPT. H&E staining and Nissl staining was used to detect morphological changes in the medial prefrontal cortical (mPFC) regions. Elisa to assess serum CORT levels. Detection of mRNA levels and protein expression of clock genes, high mobility genome box-1 (Hmgb1), silent message regulator 6 (Sirt6), and pro-inflammatory factors by RT-qPCR, Western blotting, and immunofluorescence techniques.ResultsSleep deprivation resulted in decreased exploration of unfamiliar territory, increased time spent in a state of despair, and lower sucrose water intake in mice. Additionally, sleep deprivation led to increased secretion of serum CORT and upregulation of clock genes, IL6, IL1β, TNFα, Cox-2, iNOS, Sirt6, and Hmgb1. Sleep.ConclusionsSleep deprivation induces anxiety-depressive-like behaviors and neuroinflammation in the brain. Transcription of clock genes and activation of the Sirt6/Hmgb1 pathway may contribute to inflammatory responses in the mPFC.

Background The number of systematic reviews and meta-analyses (SRs/MAs) on acupuncture therapy for CRI is increasing; however, the credibility of the evidence remains unclear with controversial results, necessitating a comprehensive evaluation. Objective We aimed to critically assess the evidence in SRs/MAs regarding the effectiveness of acupuncture therapy for CRI from various aspects and conduct an exploratory analysis to identify potential issues. Method Two reviewers conducted comprehensive searches in eight databases. SRs/MAs of randomized controlled trials are included. After screening according to inclusion and exclusion criteria, two reviewers extracted data from eligible SRs/MAs and conducted a detailed assessment of methodological quality, risk of bias, and quality of evidence using AMSTAR-2, ROBIS, and GRADE tools. Meanwhile, we calculated the Corrected Covered Area (CCA) leveraging the GROOVE tool. After manually excluding duplicate studies, we assess the risk of bias of primary studies extracted from SRs/MAs and conducted exploratory meta-analysis. Result The comprehensive analysis included 10 SRs/MAs. The AMSRAT-2 results indicate significant methodological flaws in SRs/MAs, with the main issues focusing on the lack of provision of exclusion checklist for the studies. Furthermore, over half of the SRs/MAs have a high risk of bias due to incomplete retrieval and failure to follow the protocol. Most SRs/MAs demonstrated considerable completeness in reporting quality. Notably, the overall level of evidence is low. High overlap indicates redundant SRs/MAs. Exploratory analysis suggests that acupuncture therapy may be effective for CRI; however, with a high risk of bias, caution is needed in interpreting the results. Sensitivity analysis results are stable, and the funnel plot indicates no publication bias. Most SRs/MAs acknowledge the safety of acupuncture. Conclusion Currently, the credibility of acupuncture therapy for treating CRI is low and improvements are needed in methodology, risk of bias, and quality of reporting. Acupuncture therapy shows potential but lacks sufficient support; high-level evidence is warranted to elucidate the effectiveness of acupuncture in treating CRI.

OBJECTIVES:To observe the clinical efficacy of the spirit-regulation method of Jin's three-needle therapy on post-stroke anxiety and its effects on the hypothalamus-pituitary-adrenal (HPA) axis.METHODS:Fifty-four patients with post-stroke anxiety were divided into spirit regulation (Jin's three needle therapy) group and sham-acupuncture group according to the random number table method, 28 cases in the spirit regulation and 26 cases in the sham-acupuncture group. The patients of the two groups received the same regimen of basic medication and rehabilitation, and the same acupoint prescription was adopted, including Sishenzhen (extra points, 1.5 cun to Baihui ［GV20］ at 3, 6, 9 and 12 o'clock positions), Shenting (GV24), Yintang (EX-HN3), and bilateral Shenmen (HT7), Sanyinjiao (SP6), Hegu (LI4) and Taichong (LR3). The true acupuncture was delivered in the spirit regulation group and the sham acupuncture operated in the sham-acupuncture group. One treatment lasted for 30 min, once daily, 5 times a week. The duration of treatment was 3 weeks in the trial. Before treatment and on day 10 and day 21 of treatment, the changes in the score of Hamilton anxiety scale (HAMA) and that of National Institutes of Health Stroke Scale (NIHSS) were compared between the two groups separately. Using ELISA, the contents of adrenocorticotropin (ACTH) and cortisol (CORT) in the serum were detected, and the adverse reactions were recorded.RESULTS:In the within-group comparison before and after treatment, HAMA score and NIHSS score dropped on day 10 and day 21 after treatment in the spirit regulation group (P<0.05)；HAMA score and NIHSS score in the sham-acupuncture group were decreased on day 21 of treatment (P<0.05). After 21 days of treatment, HAMA score and NIHSS score in the spirit-regulation group were decreased significantly than those in the sham-acupuncture group (P<0.05) and the contents of ACTH and CORT in the serum decreased when compared with those before treatment and those of the sham-operation group (P<0.05). No obvious adverse events occurred in the spirit-regulation group and the sham-acupuncture group.CONCLUSIONS:Using sham acupuncture as a control, it is preliminarily confirmed that the spirit regulation method of Jin's three-needle therapy is effective on post-stroke anxiety. In association of the downtrend of serological indicators, it is speculated that the underlying mechanism of this therapy is related to HPA axis.

ImportancePoor sleep quality greatly impairs quality of life and accelerates deterioration in patients with Parkinson disease (PD), but current remedies remain limited. Acupuncture, used as an adjunctive therapy with anti-Parkinson medications, has shown positive effects in patients with PD. However, high-quality clinical evidence to support the effectiveness of acupuncture for patients with PD and poor sleep quality is lacking.ObjectiveTo assess the safety and efficacy of real acupuncture (RA) vs sham acupuncture (SA) as an adjunctive therapy for patients with PD who have poor sleep quality.Design, Setting, and ParticipantsThis single-center randomized clinical trial was performed at The First Affiliated Hospital of Guangzhou University of Chinese Medicine in China from February 18, 2022, to February 18, 2023. Patients with PD and sleep complaints were recruited and randomized (1:1) to receive RA or SA treatment for 4 weeks. Data analysis was performed from April 12 to August 17, 2023.InterventionTreatment with RA or SA for 4 weeks.Main Outcomes and MeasuresThe main outcome was the change in Parkinson Disease Sleep Scale (PDSS) scores measured at baseline, after 4 weeks of treatment, and at 8 weeks of follow-up.ResultsOf the 83 participants enrolled, 78 (94.0%) completed the intervention and were included in the analysis. Their mean (SD) age was 64.1 (7.9) years; 41 (52.6%) were men and 37 (47.4%) were women. A significant increase in PDSS scores from baseline was observed for both the RA group (29.65 [95% CI, 24.65-34.65]; P < .001) and the SA group (10.47 [95% CI, 5.35-15.60]; P < .001). Compared with the SA group, the RA group had a significant increase in PDSS scores after 4 weeks of treatment (19.75 [95% CI, 11.02-28.49]; P < .001) and at 8 weeks of follow-up (20.24 [95% CI, 11.51-28.98]; P < .001).Conclusions and RelevanceIn this randomized clinical trial, acupuncture proved beneficial in improving sleep quality and quality of life among patients with PD. These findings suggest that the therapeutic effects of acupuncture could continue for up to 4 weeks.Trial RegistrationChinese Clinical Trial Registry Identifier: ChiCTR2200060655

This study summarizes Prof. Li-xing ZHUANG's experience in treating psycho-cardiological disease, which is characterized by cardiovascular somatic symptoms and emotional abnormalities. Psycho-cardiological disease is mainly caused by disorders of the brain and heart shen-mind, and related to the dysfunction of zangfu functions. In acupuncture treatment, attention should be paid to "regulation of the heart and brain, and taking zangfu organs in to account at the same time." Sishenzhen ((sic)) of JIN's three-needle, Shenting ((sic)GV 24) and Yintang ((sic)GV29) are adopted to regulate the brain, Shenmen ((sic)HT7) or Neiguan ((sic)PC6) are used to regulate the heart shen-mind, Hegu ((sic)LI4), Taichong ((sic)LR3), and Sanyinjiao ((sic)SP6) are used to regulate zangfu, and the Daoqi Tongjing method is applied to regulate the qi and blood, achieving good effects in the clinical setting. (c) 2022 World Journal of Acupuncture Moxibustion House. Published by Elsevier B.V. All rights reserved.

Background: Acupuncture has promising effects on diabetes, but there is limited evidence on prediabetes. The purpose of this study was to evaluate the effect and safety of Zuo's warming Yang acupuncture therapy on prediabetic patients.Methods: Fifty five individuals with prediabetes were recruited for the study. Participants in the non-acupuncture group received a 12-week lifestyle intervention, while those in the acupuncture group received the same lifestyle intervention in addition to two 50-minute sessions of Zuo's warming Yang acupuncture therapy per week. The primary outcomes measure fasting plasma glucose (FPG), 2-hour postprandial glucose (2hPG), and Glycated hemoglobin determination (HbA1c) after 12 weeks of treatment.Results: Both acupuncture group and non-acupuncture group showed significant reductions in FPG and 2hPG levels after treatment, with a statistically significant difference between them (FPG:6.25 +/- 0.48 vs 5.73 +/- 0.50, P < 0.001; 6.21 +/- 0.42 vs 6.04 +/- 0.41, P = 0.035; 2hPG:8.90(8.44,9.88) vs 7.95(6.93,8.34), P < 0.001; 9.22 +/- 1.15 vs 8.70 +/- 1.34, P = 0.046; respectively). In addition, FPG and 2hPG in the acupuncture group decreased more significantly than those in the non-acupuncture group after treatment, and the difference was statistically significant (FPG:5.73 +/- 0.50 vs 6.04 +/- 0.41, P = 0.014;2hPG:7.95(6.93,8.34) vs 8.70 +/- 1.34, P = 0.015; respectively). Although both groups showed reductions in HbA1c, only the decrease in the acupuncture group was statistically significant(5.80(5.60,5.90) vs 5.60(5.40,5.80), P = 0.015). No severe adverse events were reported.Conclusions: Zuo's warming Yang acupuncture therapy conjunction with lifestyle interventions was more effective than lifestyle interventions alone in reducing FPG, 2hPG and HbA1c levels in prediabetic patients. These results suggest that Zuo's warming Yang acupuncture therapy may be a safe and effective treatment option for prediabetes.

Background In recent years, radiomics has been increasingly utilized for the differential diagnosis of Parkinson’s disease (PD). However, the application of radiomics in PD diagnosis still lacks sufficient evidence-based support. To address this gap, we carried out a systematic review and meta-analysis to evaluate the diagnostic value of radiomics-based machine learning (ML) for PD. Methods We systematically searched Embase, Cochrane, PubMed, and Web of Science databases as of November 14, 2022. The radiomics quality assessment scale (RQS) was used to evaluate the quality of the included studies. The outcome measures were the c-index, which reflects the overall accuracy of the model, as well as sensitivity and specificity. During this meta-analysis, we discussed the differential diagnostic value of radiomics-based ML for Parkinson’s disease and various atypical parkinsonism syndromes (APS). Results Twenty-eight articles with a total of 6,057 participants were included. The mean RQS score for all included articles was 10.64, with a relative score of 29.56%. The pooled c-index, sensitivity, and specificity of radiomics for predicting PD were 0.862 (95% CI: 0.833–0.891), 0.91 (95% CI: 0.86–0.94), and 0.93 (95% CI: 0.87–0.96) in the training set, and 0.871 (95% CI: 0.853–0.890), 0.86 (95% CI: 0.81–0.89), and 0.87 (95% CI: 0.83–0.91) in the validation set, respectively. Additionally, the pooled c-index, sensitivity, and specificity of radiomics for differentiating PD from APS were 0.866 (95% CI: 0.843–0.889), 0.86 (95% CI: 0.84–0.88), and 0.80 (95% CI: 0.75–0.84) in the training set, and 0.879 (95% CI: 0.854–0.903), 0.87 (95% CI: 0.85–0.89), and 0.82 (95% CI: 0.77–0.86) in the validation set, respectively. Conclusion Radiomics-based ML can serve as a potential tool for PD diagnosis. Moreover, it has an excellent performance in distinguishing Parkinson’s disease from APS. The support vector machine (SVM) model exhibits excellent robustness when the number of samples is relatively abundant. However, due to the diverse implementation process of radiomics, it is expected that more large-scale, multi-class image data can be included to develop radiomics intelligent tools with broader applicability, promoting the application and development of radiomics in the diagnosis and prediction of Parkinson’s disease and related fields. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=383197 , identifier ID: CRD42022383197.

Abstract Many depressed patients exhibit sleep disorders, which in turn are a driver of the onset of depression. There is substantial evidence that neuroinflammation plays a key role in the pathophysiology and treatment of depression. Here, we investigated the mechanisms by which sleep deprivation (SD) induced anxiety-depressive-like behaviors in mice and the role of neuroinflammation in it. Adult male C57BL/6J mice were selected for the construction of a depression model by SD instrumentation. Five behavioral tests were used to evaluate the anxiety and depressive-like behaviors of the mice. H＆E staining and Nissl staining were utilized to detect cellular morphology and neuronal changes. Real-time quantitative fluorescence PCR (RT-qPCR) was carried out to regulate the mRNA levels of the clock gene, Silent information regulators 6 (Sirt6), High mobility group box-1 (Hmgb1), and pro-inflammatory factors. Western blot and immunofluorescence proved that SD increased the levels of clock genes and Sirt6/Hmgb1 pathway proteins. Our research showed that SD can be used as a reliable mouse model of depression. The pathological mechanism may be that SD regulated the Sirt6/Hmgb1 pathway and affected the transcription of clock genes, leading to inflammatory infiltration in the mPFC region of mice.

Anxiety or depression after percutaneous coronary intervention (PCI) is one of the key clinical problems in cardiology that need to be solved urgently. Brain-derived neurotrophic factor (BDNF) may be a potential biomarker for the pathogenesis and treatment of anxiety or depression after PCI. This article reviews the correlation between BDNF and cardiovascular system and nervous system from the aspects of synthesis, release and action site of BDNF, and focuses on the latest research progress of the mechanism of BDNF in anxiety or depression after PCI. It includes the specific mechanisms by which BDNF regulates the levels of inflammatory factors, reduces oxidative stress damage, and mediates multiple signaling pathways. In addition, this review summarizes the therapeutic potential of BDNF as a potential biomarker for anxiety or depression after PCI.

Neuroinflammation is a critical feature in the pathogenesis of neurodegenerative disorders such as Alzheimer’s disease (AD). Hesperetin can exert anti-inflammatory, antioxidant and other neuroprotective effects. In this study, the scopolamine (SCOP)-induced cognitive dysfunction in mice model was used to evaluate the neuroprotective effects of hesperetin. Behavioral tests (Morris water maze, open field, and novel object recognition tests) were conducted to evaluate the effect of hesperetin on cognitive dysfunction behaviors. Nissl staining and Immunofluorescence were used to evaluate hippocampal neuronal damage and microglial activation in mice. The levels of proinflammatory factors, oxidant stress, and the cholinergic neurotransmitter were detected by real-time quantitative fluorescence PCR (RT-qPCR) or biochemical reagent kits. Western blotting was used to detect the relative protein expression of the sirtuin 6 (SIRT6) / NOD-like receptor thermal protein domain associated protein 3 (NLRP3) pathway. Results showed that hesperetin could ameliorate SCOP-induced cognitive impairment and neuronal damage, and regulate the levels of cholinergic neurotransmitters in the hippocampal of AD mice. Hesperetin could also enhance antioxidant defense by regulating the levels of reactive oxygen species (ROS), malondialdehyde (MDA), superoxide dismutase (SOD), and catalase (CAT). Hesperetin exerted anti-neuroinflammation effects through inhibiting of microglia activation and down-regulating the mRNA transcript levels of inflammatory cytokines, such as tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), interleukin-1β (IL-1β), cyclooxygenase-2 (COX-2), and inducible nitric oxide synthase (iNOS). Meanwhile, hesperetin could attenuate the expression of NLRP3, apoptosis-associated speck-like protein containing a CARD (ASC), thioredoxin-interacting protein (TXNIP), and caspase-1 p20 and upregulate the expression of SIRT6 in SCOP-induced mice. Overall, our study suggested that hesperetin might ameliorate SCOP-induced cognitive dysfunction by improving cholinergic system dysfunction and suppressing oxidative stress and attenuating neuroinflammation via SIRT6/NLRP3 pathway in mice.

OBJECTIVE:To observe the effect of standardized Jin's three-needle therapy on limb motor function and nerve function defect in stroke patients, and to evaluate the placebo control method. METHODS:A total of 66 patients with stroke were randomly divided into a Jin's three-needle group (33 cases, 3 cases dropped off) and a placebo needle group (33 cases, 4 cases dropped off). All the patients were treated with conventional medication and rehabilitation treatment. In addition, the patients in the Jin's three-needle group were treated with standardized Jin's three-needle therapy at temporal three points, spirit four points, hand three points, foot three points, upper extremity spasm three points, lower extremity spasm three points, etc.; while the patients in the placebo needle group were treated with placebo needling at identical points. All the treatments were given once a day, 5 days a week, and 3-week treatment was given with an interval of 2 days between weeks. The scores of Fugl-Meyer assessment scale (FMA) and National Institutes of Health stroke scale (NIHSS) were observed before treatment, 10 d and 21 d into treatment, and the blind evaluation was conducted after treatment. RESULTS:On the 10 d and 21 d into treatment, the FMA scores in both groups were higher than those before treatment (P<0.01), and the NIHSS scores were lower than those before treatment (P<0.01). On the 10 d and 21 d into treatment, the FMA scores in the Jin's three-needle group were higher than those in the placebo needle group (P<0.05); on the 10 d into treatment, the NIHSS score in the Jin's three-needle group was were lower than that in the placebo needle group (P<0.05). There was no significant difference between the two groups on judging the type of treatment (P>0.05), and the consistency with the real situation was poor (Cohen's kappa coefficient<0.20). CONCLUSION:The standardized Jin's three-needle therapy could effectively improve the limb motor function and nerve function defect in stroke patients. The placebo control method used in this study shows good clinical operability and masking effect.

Professor ZHUANG Li-xing's diagnosis and treatment method and manipulation key points of mind-regulation acupuncture for psychosomatic disorders are summarized. Professor ZHUANG proposes that psychosomatic disorders can be subdivided into "mind-body disorder" and "body-mind disorder". The former requires treatment aimed at regulating the mind. The main acupoints are Sishenzhen, Shenting (GV 24), Yintang (GV 24+), Shenmen (HT 7) and Sanyinjiao (SP 6). The additional acupoints are Suliao (GV 25), Shuigou (GV 26), Shenmai (BL 62), Zhaohai (KI 6), Hegu (LI 4) and Taichong (LR 3), etc. The latter requires treatment aimed at improving the original diseases, supplemented by regulating the mind (row acupuncture on the governor vessel). Acupoint selection is based on the theories of brain-mind, and the emphasis is placed on the governor vessel; in the meanwhile, regulating zangfu and qi-blood should be valued. After the arrival of qi, the Daoqi Tongjing method (the specific technique for directing qi and preserving essence) is applied, combined with auricular point sticking and fire needling at affected part to enhance the curative effect.

ObjectiveTo evaluate the efficacy of acupuncture in treating Parkinson’s disease-related constipation (PDC).Materials and methodsThis was a randomized, controlled trial in which patients, outcome assessors, and statisticians were all blinded. Seventy-eight eligible patients were randomly assigned to either the manual acupuncture (MA) or sham acupuncture (SA) groups and received 12 sessions of treatment over a 4-week period. Following treatment, patients were monitored until the eighth week. The primary outcome was the change in weekly complete spontaneous bowel movements (CSBMs) from baseline after treatment and follow-up. The Constipation Symptom and Efficacy Assessment Scale (CSEAS), the Patient-Assessment of Constipation Quality of Life questionnaire (PAC-QOL), and the Unified Parkinson’s Disease Rating Scale (UPDRS) were used as secondary outcomes.ResultsIn the intention-to-treat analysis, 78 patients with PDC were included, with 71 completing the 4-week intervention and 4-week follow-up. When compared to the SA group, weekly CSBMs were significantly increased after treatment with the MA group (P < 0.001). Weekly CSBMs in the MA group were 3.36 [standard deviation (SD) 1.44] at baseline and increased to 4.62 (SD, 1.84) after treatment (week 4). The SA group’s weekly CSBMs were 3.10 (SD, 1.45) at baseline and 3.03 (SD, 1.25) after treatment, with no significant change from baseline. The effect on weekly CSBMs improvement in the MA group lasted through the follow-up period (P < 0.001).ConclusionAcupuncture was found to be effective and safe in treating PDC in this study, and the treatment effect lasted up to 4 weeks.Clinical trial registrationhttp://www.chictr.org.cn/index.aspx, identifier ChiCTR2200059979

This device is an auxiliary device with reasonable design for placebo acupuncture research, so as to make double-blind placebo acupuncture control possible. This new auxiliary acupuncture device includes an acupuncture device and a placebo acupuncture device with exactly the same appearance. Both of them are composed of a hemispherical base and a telescopic tube. Through the rotation of the telescopic tube in the notch of the base, the insertion angle of needles can be adjusted from 15 degrees to 165 degrees. The operation of twisting and lifting and inserting can be carried out through the horizontal rotation and vertical sliding of the telescopic tube. A silicone needle pad is arranged in the base, which can simulate the blocking feeling of skin and muscle during needle insertion. The bottom of the base is attached with hydrogel, which has good fixity. The auxiliary device is applicable to multiple parts of the human body and can effectively reduce the risk of unblinding.

Parkinson’s disease anxiety (PDA) is a nonmotor symptom of Parkinson’s disease (PD) that is often neglected. PDA poses a far-reaching challenge to the treatment of PD. Acupuncture could be successful in the treatment of PDA. However, the evidence for this is still limited. We propose a two-stage clinical trial. In stage 1, a total of 70 volunteers with PDA will be randomly assigned to either acupuncture (manual acupuncture) or control group (sham acupuncture) in a 1 : 1 ratio. Treatments will be performed for four weeks. The change in the Hamilton Rating Scale for Anxiety (HAMA) score from baseline to week 4 and week 12 will be the primary outcome. The levels of adrenocorticotropic hormone (ACTH), cortisol (CORT), serotonin (5-HT), and corticotropin-releasing factor (CRH) in the patients’ serum and the scores on the Hoehn–Yahr Rating Scale and the Unified Parkinson’s Disease Rating Scale (UPDRS) will all be considered among the secondary outcomes. Participants will be followed up until week 12. In stage 2, a total of 82 volunteers with PDA will be randomly assigned to either an acupuncture (manual acupuncture) or a control group (anti-Parkinson drugs only) in a 1 : 1 ratio. HAMA score will be the primary outcome. Universality, feasibility and cost effectiveness, Hoehn–Yahr Rating Scale, UPDRS, and serological indicators will be secondary outcomes. Participants will be followed up until week 4. The statistical analysis will include all the allocated individuals. The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine’s Research Ethical Committee authorized this procedure, and the trial is registered with ChiCTR2100047253.

靳三针疗法是根据岭南著名针灸学家靳瑞教授50余年临床经验总结而成,是岭南新针灸学派.该文介绍了靳三针疗法的主要学术特色,分析了靳三针疗法的组穴规律和穴组分类主治特点,讨论了靳三针调神思想和补泻手法等学术内容,系统地对靳三针的学术特色进行了梳理和探讨.

Background A large number of clinical RCTs have verified that Jin's three-needle therapy (JTNT) has a great contribution to promoting the function of paralyzed limbs and relieving anxiety disorders for patients with post-stroke anxiety (PSA). However, there is still a lack of sham needle control, and its placebo effect cannot be ruled out. This study firstly verifies the real effectiveness of JTNT. Besides, the changes in serum indexes on the hypothalamic-pituitary-adrenal axis (HPA axis) are observed dynamically by the Enzyme-Linked ImmunoSorbent Assay (ELISA). The activation of different brain regions by JTNT is recorded using resting functional magnetic resonance imaging (rs-fMRI). Therefore, we can provide more practical and powerful evidence-based medical evidence for clinical decisions. Method This is a 16 week parallel, single-blind, random, controlled trial, including baseline, 4 weeks of treatment, and 12 weeks of follow-up. A total of 114 participants will be randomly divided into three groups in the proportion of 1:1:1. Participants will receive Jin's three-needle therapy in the active acupuncture group and accept sham needle treatment in the sham acupuncture group. In the waitlist control group, patients will not receive any acupuncture treatment. Outcomes cover three types of indicators, including scale indicators, serum indicators, and imaging indicators. The primary outcome is the change in the performance of anxiety symptoms, which is estimated by the 14-item Hamilton Anxiety Rating Scale (HAMA-14) and the 7-item Generalized Anxiety Disorder scale (GAD-7). Secondary outcomes are physical recovery and daily quality of life, which are evaluated by the National Institute of Health stroke scale (NIHSS) and the Modified Barthel Index Score (MBI Scale). Therefore, the assessment of the scale is carried out at baseline, 2nd, 4th, 8, 12, and 16 weeks. Adrenocorticotropin and cortisol will be quantitatively detected by ELISA at baseline and 4 weeks after treatment. In addition, regional homogeneity analysis (ReHo) will be used to record the activity of brain regions at baseline and 4 weeks after intervention. Discussion The study aims to provide high-quality clinical evidence on the effectiveness and safety of JTNT for patients with PSA. In addition, this trial explores a possible mechanism of JTNT for patients with PSA. Clinical trial registration Chinese Clinical Trial Registry, identifier [ChiCTR2200058992].

目的 观察督三针配合手足挛三针治疗早中期帕金森病肌强直的临床疗效和安全性,并探讨可能的效应机制.方法 将120例早中期帕金森病肌强直患者随机分为试验组和对照组各60例.试验组在维持原有抗帕金森病药物剂量的基础上用督三针(大椎、筋缩、命门),上肢肌强直者配合手挛三针(极泉、尺泽、内关),下肢肌强直者配合足挛三针(鼠鼷、阴陵泉、三阴交),进针后行提插平补平泻法.对照组在维持原有抗帕金森药物剂量的基础上给予假针刺.两组均每周治疗4次,共治疗8周.治疗前后进行帕金森病统一评分量表运动症状部分(UPDRSⅢ量表)评分、UPDRSⅢ量表中关于肌强直的评分、10米步行测试、阿什沃思(Ashworth)量表评分,检测血清α-突触核蛋白(α-syn)、脑源性神经营养因子(BDNF)含量,治疗后判定临床疗效及记录不良事件发生情况.结果 研究过程中对照组脱落6例,试验组脱落2例,最终纳入分析试验组58例,对照组54例.治疗后试验组患者UPDRSⅢ量表评分、肌强直评分、Ashworth量表评分、10米步行时间较治疗前显著降低,10米步行速度及血清BDNF含量较治疗前提高(P＜0.05或P＜0.01),而对照组治疗前后各指标差异均无统计学意义(P＞0.05);两组患者治疗前后10米步行步幅及血清α-syn含量差异无统计学意义(P＞0.05).试验组临床疗效总有效率(67％)高于对照组(26％,P＜0.05).两组在针刺过程中均未见严重不良事件.结论 督三针配合手足挛三针可改善早中期帕金森病肌强直症状和四肢痉挛程度,提高运动功能,其机制可能与促进患者产生内源性BDNF有关.