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Acupuncture Research
 

Abstract
Objective. Our aim was to assess the efficacy and safety of acupuncture for Obstructive sleep apnea (OSA) patients with various severities of the disorder.

Methods.  Eight  databases  including  PubMed,  Cochrane Library, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), Chongqing VIP (CQVIP), Wanfang Data, and Chinese Biomedical Literature Database (CBM) were comprehensively searched till July 2019. Randomized controlled trials (RCTs) testing acupuncture in the treatment of OSA were eligible  for  inclusion.  Studies  were  selected  for  inclusion,  and data were extracted by two authors independently.  The Cochrane Collaboration’s Risk of Bias Assessment Tool and RevMan software (version 5.3) were used to evaluate the quality of studies and conduct statistical analysis. 

 

Results.  Nine RCTs with 584 participants  were  included.  The  trials covered  acupuncture and electropuncture.  Acupuncture caused clinically significant reductions in apnea-hypopnea index (AHI)  (MD: -6.18;  95% CI:  -9.58  to  -2.78;  Z = 3:56,  P = 0:0004)  as  well  as  in Epworth Sleepiness Score (ESS) (MD: -2.84;  95%  CI:  -4.80  to  -0.16,  Z = 2:09,  P= 0:04).  AHI was reduced more in the subgroup analysis of moderate OSA patients (MD: -9.44; 95% CI: -12.44 to -6.45; Z = 6:18, P < 0:00001) and severe OSA patients (MD:  -10.09;  95%  CI:  -12.47  to  -7.71;  Z = 8:31,  P < 0:00001).  ESS was also reduced more in the subgroup analysis of moderate OSA patients (MD: -2.40; 95% CI: -3.63 to -1.17; Z = 3:83, P= 0:0001) and severe OSA patients (MD: -4.64; 95% CI: -5.35 to -3.92; Z = 12:72, P < 0:00001). Besides, acupuncture had a beneficial effect on lowest oxygen saturation (LSaO2) (MD: 5.29; 95% CI: 2.61 to 7.97; Z = 3:86, P = 0:0001). The outcome of AHI and LSaO2 yielded consistent results after sensitivity analysis, but the direction of the outcome of ESS was reversed. And the quality of evidence was mainly low to very low.

 

Conclusions. Acupuncture therapy is effective for OSA patients in reducing AHI and ESS and in improving the LSaO of various severities, especially in moderate and severe OSA patients. High-quality trials are urgently needed.

Abstract

Objective: This review aimed to examine the effectiveness of acupuncture for the treatment of diabetic retinopathy (DR).
 

Methods: Fourteen databases (5 English, 4 Chinese, and 5 Korean) were searched from their inception until May 20, 2020. Randomized controlled trials (RCTs) using acupuncture for DR treatment were included. The study selection and data extraction were performed by two independent reviewers. The Cochrane risk of bias tool version 2 (RoB 2.0) and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) were used to assess all the included RCTs.

 

Results: Of 864 citations, 6 RCTs met the inclusion criteria of our review. Four studies reported the beneficial  effects of acupuncture with standard medication or acupuncture alone compared with standard medication or no treatment on the effective rate. Only three studies showed that acupuncture combined with standard medications significantly improved visual acuity compared to standard medication alone. None of the studies reported on adverse events. The risk of bias of the included studies was judged to be of “some concern” and was marked with a moderate and low certainty of evidence in different outcomes.

 

Conclusion: Our results suggest the potential benefit of acupuncture in treating DR. Acupuncture in the form of combined therapy with standard medication or acupuncture alone may be more effective in the treatment of DR than standard medication alone. Further rigorous clinical trials are needed to confirm these findings.

Keywords: Acupuncture, Diabetic, Diabetic complications, Retinopathy, Review, Traditional medicine

Abstract:

Objective. The purpose of this study was to assess the effectiveness and safety of acupuncture for functional constipation (FC).

 

Methods. A rigorous literature search was performed in English (PubMed, Web of Science, the Cochrane Library, and EMBASE) and Chinese (China National Knowledge Infrastructure (CNKI), Chinese Biological Medical (CBM), Wanfang database, and China Science and Technology Journal (VIP)) electronic databases from their inception to October 2019. Included randomized controlled trials (RCTs) compared acupuncture therapy with sham acupuncture or pharmacological therapies. The outcome measures were evaluated, including the primary outcome of complete spontaneous bowel movement (CSBM) and secondary outcomes of Bristol Stool Form Scale (BSFS), constipation symptoms scores (CSS), responder rate, the Patient Assessment of Constipation Quality of Life (PAC-QOL) questionnaire, and safety evaluation. Meta-analysis was performed by using RevMan5.3.
 

Results. (e merged data of 28 RCTs with 3525 participants indicated that acupuncture may be efficient for FC by increasing CSBMs (p < 0.00001; MD� 0.84 [95% CI, 0.65 to 1.03]; I2 � 0%) and improving constipation symptoms (p � 0.03; SMD� −0.4 [95% CI, −0.78 to −0.03]; I2 � 74%), stool formation (p < 0.00001; MD� 0.24 [95% CI, 0.15 to 0.34]; I2 � 0%), quality of life (p < 0.00001; N� 1, MD� −0.33 [95% CI, −0.45 to −0.21]), and responder rates (p � 0.02; RR � 2.16; [95% CI, 1.1 to 4.24]; I2 � 69%) compared with the effects of sham treatment. No increased risk of adverse events was observed (p � 0.44; RR � 1.18; [95% CI, 0.77 to 1.81]; I2 � 0%). With regard to medication comparisons, the pooled data indicated that acupuncture was more effective in increasing CSBMs (p � 0.004; MD� 0.53 [95% CI, 0.17 to 0.88]; I2 � 88%) and improving patients’ quality of life (p < 0.00001; SMD� −0.73 [95% CI, −1.02 to −0.44]; I2 � 64%), with high heterogeneity. However, there were no significant differences in responder rate (p � 0.12; RR � 1.31; [95% CI, 0.94 to 1.82]; I2 � 53%), BSFS (p � 0.5; MD� 0.17 [95% CI, −0.33 to 0.68]; I2 � 93%), or CSS (p � 0.05; SMD� −0.62 [95% CI, −1.23 to −0.01]; I2 � 89%). Regarding safety evaluation, acupuncture was safer than medications (p < 0.0001; RR � 0.3; [95% CI, 0.18 to 0.52]; I2 � 30%).

 

Conclusions. Current evidence suggests that acupuncture is an efficient and safe treatment for FC. Acupuncture increased stool frequency, improved stool formation, alleviated constipation symptoms, and improved quality of life. However, the evidence quality was relatively low and the relationship between acupuncture and drugs is not clear. More high-quality trials are recommended in the future. PROSPERO registration number: CRD42019143347.

Abstract

Context. Non-pharmacological approaches are effective strategies for difficult to palliate breathlessness. Whilst acupuncture is effective for dyspnoea in early-stage COPD, little is known about its effects in patients with advanced (non-)malignant diseases.

 

Objectives. To identify and examine the evidence of acupuncture on breathlessness in advanced malignant and non-malignant diseases.

 

Methods. Systematic literature review of randomised controlled trials of acupuncture and acupressure searched in five databases. Included were adult participants with at least 25% having advanced diseases such as cancer or COPD with severe breathlessness. Primary outcome was severity of dyspnoea on visual analogue or Borg scale. Secondary outcomes included quality of life, function and acceptability. Data were pooled using a random effects model of standardised mean differences.
 

Results. 12 studies with 597 patients (347 COPD, 190 advanced cancer) were included. For breathlessness severity significant differences were obtained in a meta-analysis (10 studies with 480 patients; SMD= -1.77 (95% CI -3.05,-0.49; p=0.007; I²= 90%)) and in a subgroup analysis of using sham acupuncture control groups and a treatment duration of at least three weeks (6 studies with 302 patients; SMD= -2.53 (95% CI -4.07,-0.99; p=0.001; I² =91%)). Exercise tolerance (6MWT) improved significantly in the acupuncture group (6 studies with 287 patients; SMD=0.93 (95% CI 0.27,1.59; p=0.006; I²= 85%)). In four of six studies quality of life improved in the acupuncture group.

 

Conclusion. Acupuncture improved breathlessness severity in patients with advanced diseases. The methodological heterogeneity, low power and potential morphine-sparing effects of acupuncture as add-on should be further addressed in future trials.

 

Key words: dyspnoea; acupuncture; advanced disease; systematic review; meta-analysi

Key Points:

Question:  Is the use of acupuncture and acupressure associated with improved cancer pain management compared with sham intervention and/or analgesic therapy alone?
 

Findings:  In this systematic review of 17 randomized clinical trials and meta-analysis of 14 trials in the current English-language and Chinese-language literature, a significant association was found between real (compared with sham) acupuncture and reduced pain, and acupuncture combined with analgesic therapy was associated with decreased analgesic use. However, heterogeneity lowered the level of certainty of the evidence.

Meaning:  This study found a moderate level of evidence that acupuncture and/or acupressure was significantly associated with lower pain intensity in patients with cancer compared with a sham control, which suggests a potential for a combination of acupuncture and acupressure to help reduce opioid doses in patients with cancer.

Conclusions and Relevance:  This systematic review and meta-analysis found that acupuncture and/or acupressure was significantly associated with reduced cancer pain and decreased use of analgesics, although the evidence level was moderate. This finding suggests that more rigorous trials are needed to identify the association of acupuncture and acupressure with specific types of cancer pain and to integrate such evidence into clinical care to reduce opioid use.

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Qigong & Tai Chi Research
 

Purpose of Review

To investigate the effectiveness and safety of Tai Chi for essential hypertension (EH).

 

Recent Findings

A total of 9 databases were searched from inception to January 1, 2020. Randomized controlled trials (RCTs) investigating the effectiveness and safety of Tai Chi for EH were included. Study selection, data extraction, and quality assessment were performed independently by 2 reviewers. A total of 28 RCTs involving 2937 participants were ultimately included in this systematic review. Meta-analysis showed that, compared with health education/no treatment, other exercise or antihypertensive drugs (AHD), Tai Chi showed statistically significant difference in lowering systolic blood pressure (SBP) and diastolic blood pressure (DBP). The trial sequential analysis suggested that the evidence in our meta-analysis was reliable and conclusive. Subgroup analyses of Tai Chi vs. AHD demonstrated Tai Chi for hypertension patients < 50 years old showed greater reduction in SBP and DBP. Intervention of 12–24 weeks could significantly lower SBP and DBP. Among 28 included RCTs, 2 RCTs reported that no adverse events occurred. The quality of evidence for the blood pressure (BP) of Tai Chi vs. AHD was moderate, and DBP of Tai Chi vs. health education (HE)/ no treatment (NT) was high. Other outcome indicators were considered low or very low quality according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE).

 

Summary

Tai Chi could be recommended as an adjuvant treatment for hypertension, especially for patients less than 50 years old. However, due to poor methodological qualities of included RCTs and high heterogeneity, this conclusion warrants further investigation.

Highlights

  • This systematic review and meta-analysis strengthen that Tai Chi has a positive effect on improving sleep quality.

  • The 24-form and 8-form Yang style Tai Chi show significant effectiveness on improving sleep quality.

  • Our article illuminated the future systematic research needs on different duration and other styles of Tai Chi.

Background 

Exercise-based cardiac rehabilitation is safe and effective for adults with chronic heart failure (CHF), yet services are greatly underutilized. However, tai chi is a popular and safe form of exercise among older adults with chronic health conditions.

Objective 

A systematic review and meta-analysis was conducted to examine the benefits of tai chi exercise among persons with CHF.

 

Methods 

An electronic literature search of 10 databases (Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, Embase, OpenGrey, PsycARTICLES, PsycINFO, PubMed, Scopus, SPORTDiscus, and Web of Science) was conducted from January 1, 2004, to August 1, 2019. Clinical trials that examined tai chi exercise, were published in English or German languages, and conducted among participants with CHF were included. Comprehensive Meta-Analysis version 2.0 software (Biostat, Inc) was used to calculate effect sizes (ie, Hedges g) and 95% confidence intervals using random effects models.

 

Results 

A total of 6 studies met the inclusion criteria, enrolling 229 participants (mean age, 68 years; 28% women; mean ejection fraction = 37%). At least 3 studies reported outcomes for exercise capacity (n = 5 studies), quality of life (n = 5 studies), depression (n = 4 studies), and b-type natriuretic peptide (n = 4 studies), allowing for meta-analysis. Compared with controls, tai chi participants had significantly better exercise capacity (g = 0.353; P = .026, I2 = 32.72%), improved quality of life (g = 0.617; P = .000, I2 = 0%), with less depression (g = 0.627; P = .000, I2 = 0%), and decreased b-type natriuretic peptide expression (g = 0.333; P = .016, I2 = 0%).

 

Conclusion 

Tai chi can be easily integrated into existing cardiac rehabilitation programs. Further research is needed with rigorous study designs and larger samples before widespread recommendations can be made.

Highlights

 

  • Tai chi significantly improves overall quality of life at 3 months compared to conventional therapy.

  • Tai chi+conventional therapy is more effective in improving fatigue at 3 months than conventional therapy alone.

  • Tai chi+conventional therapy improves quality of life more effectively than conventional therapy alone at 3 and 6 months.

  • Future research on tai chi needs to better characterize the tai chi intervention.

Abstract

Background:

Regular exercise is beneficial for adults with cardiovascular disease to improve psychological well-being. Tai Chi is a mind–body exercise thought to promote psychological well-being.

 

Aim:

Examine the efficacy of Tai Chi in improving psychological well-being among persons with cardiovascular disease.

 

Methods:

An electronic literature search of 10 databases (AMED, CINAHL, Embase, OpenGrey, PsycARTICLES, PsycINFO, PubMed, Scopus, SPORTDiscus, and Web of Science) was conducted. Clinical trials that examined one or more aspect of psychological well-being, incorporated a Tai Chi intervention among cardiovascular disease participants, and were published in English or German languages were included. Comprehensive Meta-Analysis version 2.0 software (Biostat, Inc.) was used to calculate the effect sizes (i.e. Hedges’ g) and the 95% confidence intervals using random effects models.

 

Results:

A total of 15 studies met the inclusion criteria, enrolling 1853 participants (mean age = 66 years old, 44% women). Outcomes included: quality of life (QOL), stress, anxiety, depression, and psychological distress. When Tai Chi was compared with controls, significantly better general QOL (Hedges’ g 0.96; p=0.02, I2=94.99%), mental health QOL (Hedges’ g=0.20; p=0.01, I2=15.93) and physical health QOL (Hedges’ g=0.40; p=0.00, I2=0%); with less depression (Hedges’ g=0.69; p=0.00, I2=86.64%) and psychological distress (Hedges’ g=0.58; p=0.00, I2=0%) were found.

 

Conclusions:

Few Tai Chi studies have been conducted during the past decade examining psychological well-being among older adults with cardiovascular disease. Further research is needed with more rigorous study designs, adequate Tai Chi exercise doses, and carefully chosen outcome measures that assess the mechanisms as well as the effects of Tai Chi.

 

Keywords: Cardiovascular disease, meta-analysis, older adults, psychological well-being, quality of life, Tai Chi

Abstract

 

Objective

To evaluate the effect of Tai Chi on balance and reducing falls incidence in neurological disorders.

Data sources:

AMED, Embase, Web of Science, SCOPUS, EBSCO and Medline from inception until February 2018.

Review method:

Randomized controlled trials of Tai Chi compared with active or no treatment control, measuring balance with the Berg Balance Scale or the Timed Up and Go Test and number of falls in neurological disorders were included. Methodological quality was assessed using PEDro and quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system.

 

Results:

A total of 10 studies involving 720 participants were reviewed. Seven studies were in Parkinson’s disease and three in stroke. Seven studies were of high methodological quality and three were low. Meta-analyses of balance measured with the Timed Up and Go Test in Parkinson’s disease revealed a statistically significant effect of Tai Chi compared to no treatment (weighted mean difference (WMD), –2.13; 95% confidence interval (CI), −3.26 to −1.00; P < 0.001) and was insignificant (WMD, −0.19; 95% CI, −1.74 to 1.35; P = 0.81) when compared with active treatment. Tai Chi significantly reduced falls incidence in Parkinson’s disease (odds ratio (OR), 0.47; 95% CI, 0.29 to 0.77; P = 0.003) and stroke (OR, 0.21; 95% CI, 0.09 to 0.48; P < 0.001). Balance measured with the Timed Up and Go Test comparing Tai Chi and active treatment was insignificant (WMD, 0.45; 95% CI, –3.43 to 2.54; P = 0.77) in stroke.

 

Conclusion:

Tai Chi is effective in reducing falls incidence in Parkinson’s disease and stroke. This systematic review did not find high-quality studies among other neurological disorders.

 

Keywords: Nervous system diseasesTai JiTai Chiaccidental fallsmeta-analysis

Abstract

Purpose

This study aims to summarize and critically evaluate the effects of Tai Chi and Qigong (TCQ) mind–body exercises on symptoms and quality of life (QOL) in cancer survivors.

 

Methods

A systematic search in four electronic databases targeted randomized and non-randomized clinical studies evaluating TCQ for fatigue, sleep difficulty, depression, pain, and QOL in cancer patients, published through August 2016. Meta-analysis was used to estimate effect sizes (ES, Hedges’ g) and publication bias for randomized controlled trials (RCTs). Methodological bias in RCTs was assessed.

 

Results

Our search identified 22 studies, including 15 RCTs that evaluated 1283 participants in total, 75% women. RCTs evaluated breast (n = 7), prostate (n = 2), lymphoma (n = 1), lung (n = 1), or combined (n = 4) cancers. RCT comparison groups included active intervention (n = 7), usual care (n = 5), or both (n = 3). Duration of TCQ training ranged from 3 to 12 weeks. Methodological bias was low in 12 studies and high in 3 studies. TCQ was associated with significant improvement in fatigue (ES = − 0.53, p < 0.001), sleep difficulty (ES = − 0.49, p = 0.018), depression (ES = − 0.27, p = 0.001), and overall QOL (ES = 0.33, p = 0.004); a statistically non-significant trend was observed for pain (ES = − 0.38, p = 0.136). Random effects models were used for meta-analysis based on Q test and I 2 criteria. Funnel plots suggest some degree of publication bias. Findings in non-randomized studies largely paralleled meta-analysis results.

 

Conclusions

Larger and methodologically sound trials with longer follow-up periods and appropriate comparison groups are needed before definitive conclusions can be drawn, and cancer- and symptom-specific recommendations can be made.

 

Implications for Cancer Survivors

TCQ shows promise in addressing cancer-related symptoms and QOL in cancer survivors.

Abstract

Objective

To summarize and critically evaluate the effects of Tai Chi on lower limb proprioception in adults older than 55.

Data Sources

Seven databases (Scopus, PubMed, Web of Science, SPORTDiscus, Cochrane Library, Wanfang, CNKI) were searched from inception until April 14, 2018.

Study Selection

Eleven randomized controlled trials were included for meta-analysis.

 

Data Extraction

Two independent reviewers screened potentially relevant studies based on the inclusion criteria, extracted data, and assessed methodological quality of the eligible studies using the Physiotherapy Evidence Database (PEDro).

 

Data Synthesis

The pooled effect size (standardized mean difference [SMD]) was calculated while the random-effects model was selected. Physiotherapy Evidence Database scores ranged from 5 to 8 points (mean=6.7). The study results showed that Tai Chi had significantly positive effects on lower limb joint proprioception. Effect sizes were moderate to large, including ankle plantar flexion (SMD=−0.55; 95% confidence interval [95% CI], −0.9 to −0.2; P=.002; I2=0%; n=162), dorsiflexion (SMD=−0.75; 95% CI, −1.11 to −0.39; P<.001; I2=0%; n=162), nondominant or left knee flexion (SMD=−0.71; 95% CI, −1.10 to −0.41; P<.001; I2=25.1%; n=266), dominant or right knee flexion (SMD=−0.82; 95% CI, −1.06 to −0.58; P<.001; I2=33.8%; n=464).

 

Conclusions

There is moderate to strong evidence that suggests that Tai Chi is an effective intervention to maintain and improve lower limb proprioception in adults older than 55. More robust multicenter studies including oldest-old participants, with longer follow-ups and validated outcome measures, are needed before a definitive conclusion is drawn.

Abstract

Objectives

Conduct a systematic review to evaluate the effects of Tai Chi on physical and psychosocial function among individuals with Multiple Sclerosis.

 

Methods

An electronic literature search of 12 databases using controlled vocabulary function and keywords from inception through August 2016. All Tai Chi intervention studies assessing physical and psychosocial function among persons with Multiple Sclerosis were included. Study quality was scored using an established tool examining 16 study elements (range = 0–32).

 

Results

A total of 91 articles were retrieved, with 3 additional articles identified through reviewing bibliographies of relevant articles. A total of 8 studies (randomized controlled trials, n = 3; quasi-experimental, n = 5) enrolled 193 participants with Multiple Sclerosis. Studies were conducted in the USA (n = 3), Europe (n = 3), Iran, (n = 1), and India (n = 1). A total of 3 studies reported using the Yang style of Tai Chi (not specified, n = 5 studies). The Tai Chi intervention averaged 27 sessions over 11 weeks. Study quality scores for the randomized controlled trials had a mean score of 23 (range 19–26), while quality scores for quasi-experimental studies had a mean score of 20 (range 13–26). Overall, participants enrolled in Tai Chi had better balance, gait and flexibility, less fatigue and depression, and better quality of life after the intervention; though mixed results were reported.

 

Conclusion

The results indicate that Tai Chi is likely safe and may provide physical and psychosocial benefits in individuals with Multiple Sclerosis. Further research is needed using more rigorous study designs to assess the benefits of Tai Chi for individuals with Multiple Sclerosis.​

 

Keywords: Multiple sclerosis, Tai Ji, Postural balance, Fatigue, Depression, Review

Abstract

Objective

To qualitatively explore perceived physical and psychosocial effects and overall patient experience associated with a 12-week tai chi (TC) intervention and an education group in a clinical trial of patients with chronic heart failure (HF).

 

Subjects and Methods

We randomized 100 patients with chronic systolic HF (NYHA Class 1–3, ejection fraction≤40%) to a 12-week group TC program or an education control. At 12-weeks, semi-structured interviews were conducted on a random subset (n = 32; n = 17 in TC, n = 15 in control), audiorecorded and transcribed verbatim. Two independent reviewers extracted information using grounded-theory methods for emergent themes. We explored similarities and differences in themes/sub-themes between the groups, and examined qualitative association with changes from baseline to post-intervention in previously reported quantitative measures (e.g., Minnesota Living with HF, Cardiac Exercise Self Efficacy and Profile of Mood States).

 

Results

The mean age (±SD) of participants was 68±9 years, baseline ejection fraction 29±7%, and median New York Heart Association class 2 HF. We idenitifed themes related to the patient’s experience of illness, perceptions of self, and relationship to others. Specific psychosocial and physical benefits were described. Common themes emerged from both groups including: social support and self-efficacy related to activity/exercise and diet. The tai chi group, however, also exhibited a more global empowerment and perceived control. Additional themes in TC included mindfulness/self-awareness, decreased stress reactivity, and renewed social role. These themes mirrored improvements in previously reported quantitative measures (quality-of-life, self-efficacy, and mood) in TC compared to control. Patients in TC also reported physical benefits (e.g., decreased pain, improved energy, endurance, flexibility).

 

Conclusion

Positive themes emerged from both groups, although there were qualitative differences in concepts of self-efficacy and perceived control between groups. Those in tai chi reported not only self efficacy and social support, but overall empowerment with additional gains such as internal locus of control, self-awareness and stress management. Future studies of mind-body exercise might further examine perceived control, self-efficacy, and locus-of-control as potential mediators of effect.

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Probiotics, Herbal Medicine, and Dietary Research
 

Abstract
 

Rationale

Antibiotics are commonly prescribed for infants. In addition to increasing concern about antibiotic resistance, there is a concern about the potential negative impact of antibiotics on the gut microbiota and health and development outcomes.

 

Objective

The aim of this study was to investigate the association between early life antibiotic exposure and later neurocognitive outcomes.

Methods

Participants were infants born to mothers enrolled in the probiotics study. The initial study was designed to evaluate the effect of two different probiotics on allergy outcomes in childhood. Antibiotic exposure was based on parent report and categorised according to the following timing of the first exposure: 0–6 months, 6–12 months, 12–24 months or not at all. At 11 years of age, children’s neurocognitive outcomes were assessed using psychologist-administered, parent-report and self-report measures. The relationship between the timing of antibiotic exposure and neurocognitive outcomes was examined using regression models.

Results

Of the 474 participants initially enrolled, 342 (72%) children had a neurocognitive assessment at 11 years of age. After adjustment for mode of delivery, probiotic treatment group assignment, income and breastfeeding, children who had received antibiotics in the first 6 months of life had significantly lower overall cognitive and verbal comprehension abilities, increased risk of problems with metacognition, executive function, impulsivity, hyperactivity, attention-deficit hyperactivity disorder, anxiety and emotional problems.

 

Conclusions

These results provide further evidence that early exposure to antibiotics may be associated with detrimental neurodevelopmental outcomes.

 

Keywords

Antibiotics, Gut-brain-axis, Neurodevelopment, Behavior, Anxiety, Attention-deficit hyperactivity disorder 

Abstract

Hepatoprotective and curative activities of aqueous extract of decoction containing 10 Chinese medicinal herbs (HPE-XA-08) were evaluated in Sprague–Dawley albino rats with liver damage induced by thioacetamide (TAA).These activities were assessed by investigating the liver enzymes level and also histopathology investigation. Increases in alkaline phosphatase (ALP) and gammaglutamyl transferase (GGT) levels were observed in rats with cirrhotic liver. No significant alterations of the liver enzymes were observed following treatment with HPE-XA-08. Histopathology examination of rats treated with HPE-XA-08 at 250mg/kg body weight, however, exhibited moderate liver protective effects. Reduced extracellular matrix (ECM) proteins within the hepatocytes were noted in comparison to the cirrhotic liver. The curative effects of HPE-XA-08 were observed with marked decrease in the level of ALP (more than 3x) and level of GGT (more than 2x) in cirrhotic rat treated with 600mg/kg body weight HPE-XA-08 in comparison to cirrhotic rat treated with just water diluent. Reversion of cirrhotic liver to normal liver condition in rats treated with HPE-XA-08 was observed. Results from the present study suggest that HPE-XA-08 treatment assisted in the protection from liver cirrhosis and improved the recovery of cirrhotic liver.

Details on the herbs used in the study: Aqueous extract of HPE-XA-08 containing mixture of 10 Chinese medicinal herbs, comprising fructus Gardenia jasminoides Ellis, Var. radicans (Thunb.) Makino, Artemisia scoparia Waldst. Et Kit, radix Rheum tanguticum Maxim. Ex Balf, radix Scutellaria baicalensis Georgi, fructus Ligustrum lucidum Ait, cortex Phellodendron amurense  Rupr., Poria cocoa (Schw.) Wolf, radix Bupleurum B. scorzoneraefolium Willd, and flos Chrysanthemum mori- folium Ramat and herbs Tarxacum mongolicum Hand, Mazz

Chinese Pinyin: Zhi Zi, Yin Chen Hao, Da Huang, Huang Qin, Nu Zhen Zi, Fu Ling, Chai Hu, Gou Qi Zi, Ju Hua, Pu Gong Ying

Abstract


Statins are the most widely prescribed, cholesterol lowering drugs in the world. Despite the expiration of their patents, revenue for statins is expected to rise, with total sales on track to reach an estimated US$1 trillion by 2020. A bitter dispute has erupted among doctors over suggestions that statins should be prescribed to millions of healthy people at low risk of heart disease. There are concerns that the benefits have been exaggerated and the risks have been underplayed. Also, the raw data on the efficacy and safety of statins are being kept secret and have not been subjected to scrutiny by other scientists. This lack of transparency has led to an erosion of public confidence. Doctors and patients are being misled about the true benefits and harms of statins, and it is now a matter of urgency that the raw data from the clinical trials are released.

Abstract

Danshen was able to reduce the risk of the patients with coronary heart disease (CHD), but the mechanism is still widely unknown.  Biochemical indices (lipid profile, markers of renal and liver function, and homocysteine (Hcy)) are closely associated with CHD risk.  We aimed to investigate whether the medicine reduces CHD risk by improving these biochemical indices.  The patients received 10 Danshen pills (27mg/pill) in Dashen group, while the control patients received placebo pills, three times daily.The duration of follow-up was three months.  The serum biochemical indices were measured, including lipid profiles (LDL cholesterol (LDL-C), HDL-C, total cholesterol (TC), triglycerides (TG), apolipoprotein (Apo) A, ApoB, ApoE, and lipoprotein (a) (Lp(a))); markers of liver function (gamma-glutamyl transpeptidase (GGT), total bilirubin (TBil), indirect bilirubin (IBil), and direct bilirubin (DBil)); marker of renal function (uric acid (UA)) and Hcy.  After three-month follow-up, Danshen treatment reduced the levels of TG, TC, LDL-C, Lp(a), GGT, DBil, UA, and Hcy (𝑃 < 0.05). In contrast, the treatment increased the levels of HDL-C, ApoA, ApoB, ApoE, TBil, and IBil (𝑃 < 0.05). Conclusion. Danshen can reduce the CHD risk by improving the biochemical indices of CHD patients.

Abstract

Alzheimer's disease (AD) is reaching epidemic proportions yet treatment strategies are limited and are restricted to providing symptomatic relief for the cognitive and behavioral and psychological symptoms of dementia (BPSD). Chinese herbal medicine (CHM) has been a valuable source of medicines for centuries and research has burgeoned in recent years to understand the scientific basis for their use. Some plants have been used in CHM for AD symptoms (e.g., Polygala tenuifolia), while others are CHMs for different conditions, but they show mechanistic effects relevant to AD (e.g., Salvia miltiorrhiza). Some CHMs (e.g., Ginkgo biloba extract, and huperzine A from Huperziaserrata) show pharmacological activities relevant to AD, and promising effects on cognitive functions in clinical trials. Other CHMs show effects relevant to BPSD (e.g., Crocus sativus). This chapter discusses available scientific evidence for CHM plants and formulae that have been used both traditionally for AD, and those that have been used traditionally but not specifically for AD symptoms, and encompasses chemical, pharmacological and clinical studies. The ethnopharmacological approach to understanding the use of CHMs for AD is also discussed.

Keywords: Alzheimer's disease, Ginkgo, Ginseng, Memory, Traditional Chinese medicine

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