The effectiveness of moxibustion for the treatment of functional constipation: a randomized, sham-controlled, patient blinded, pilot clinical trial

<p>Abstract</p> <p>Background</p> <p>Moxibustion is an ancient traditional medicine using burning mugworts to stimulate acupuncture points. The aim of this study was to investigate the safety and efficacy of moxibustion for the treatment of constipation using a randomized, sham-controlled, participant-blinded, pilot trial.</p> <p>Methods</p> <p>Twenty-six participants (identified with either qi (vital energy) deficiency or qi excess syndrome) were randomly divided into either a moxibustion or sham group. Participants were treated with real or sham moxibustion at 4 acupuncture points, ST23 and ST27, bilaterally, 3 times per week for four weeks. The primary outcome was the frequency of defecations; secondary outcomes were the Bristol stool form scale (BSS) and the constipation assessment scale (CAS).</p> <p>Results</p> <p>Of the 26 participants that were randomized, 24 completed the study. Defecation frequency, BSS, and CAS showed no difference between the moxibustion and sham groups. The differences were -0.25 (95% CI: -2.08, 1.58, p = 0.78), -1.22 (95% CI: -2.7, 0.26, p = 0.1), 0.91 (95% CI: -1.46, 3.28, p = 0.44) in defecation frequency, BSS, CAS, respectively. The defecation frequency increased from an average of 3.3 to 4.6 times per week in the moxibustion group (1.5[-0.5, 2], <it>p </it>= 0.06) and from 2.7 to 3.7 stools per week in the sham group (1[-1, 2], <it>p </it>= 0.15) after four weeks of treatment. The difference between participants with a deficiency or an excess syndrome, determined based on assessment of sweat, facial features, pain, body energy, and pulse type, was significant in only defecation frequency. The difference was 3.3 (95% CI: 0.41, 6.19, <it>p </it>= 0.03).</p> <p>Conclusion</p> <p>Moxibustion treatment appears safe, but showed no positive effect on constipation. The effectiveness of moxibustion treatment may depend on the syndrome pattern, and further long-term studies with a larger number of subjects are warranted.</p> <p>Trial registration</p> <p>Clinical Research Information Service, KCT0000168</p

MERCI: Efficient embedding reduction on commodity hardware via sub-query memoization

© 2021 ACM.Deep neural networks (DNNs) with embedding layers are widely adopted to capture complex relationships among entities within a dataset. Embedding layers aggregate multiple embeddings- A dense vector used to represent the complicated nature of a data feature-into a single embedding; such operation is called embedding reduction. Embedding reduction spends a significant portion of its runtime on reading embeddings from memory and thus is known to be heavily memory-bandwidth-bound. Recent works attempt to accelerate this critical operation, but they often require either hardware modifications or emerging memory technologies, which makes it hardly deployable on commodity hardware. Thus, we propose MERCI, Memoization for Embedding Reduction with ClusterIng, a novel memoization framework for efficient embedding reduction. MERCI provides a mechanism for memoizing partial aggregation of correlated embeddings and retrieving the memoized partial result at a low cost. MERCI substantially reduces the number of memory accesses by 44% (29%), leading to 102% (74%) throughput improvement on real machines and 40.2% (28.6%) energy savings at the expense of 8×(1×) additional memory usage.N

Expression of vesicular glutamate transporters VGLUT1 and VGLUT2 in the rat dental pulp and trigeminal ganglion following inflammation.

There is increasing evidence that peripheral glutamate signaling mechanism is involved in the nociceptive transmission during pathological conditions. However, little is known about the glutamate signaling mechanism and related specific type of vesicular glutamate transporter (VGLUT) in the dental pulp following inflammation. To address this issue, we investigated expression and protein levels of VGLUT1 and VGLUT2 in the dental pulp and trigeminal ganglion (TG) following complete Freund's adjuvant (CFA) application to the rat dental pulp by light microscopic immunohistochemistry and Western blot analysis.The density of VGLUT2- immunopositive (+) axons in the dental pulp and the number of VGLUT2+ soma in the TG increased significantly in the CFA-treated group, compared to control group. The protein levels of VGLUT2 in the dental pulp and TG were also significantly higher in the CFA-treated group than control group by Western blot analysis. The density of VGLUT1+ axons in the dental pulp and soma in the TG remained unchanged in the CFA-treated group.These findings suggest that glutamate signaling that is mediated by VGLUT2 in the pulpal axons may be enhanced in the inflamed dental pulp, which may contribute to pulpal axon sensitization leading to hyperalgesia following inflammation

Gyejigachulbutang (Gui-Zhi-Jia-Shu-Fu-Tang, Keishikajutsubuto, TJ-18) in Degenerative Knee Osteoarthritis Patients: Lessons and Responders from a Multicenter Randomized Placebo-Controlled Double-Blind Clinical Trial

Background. Gyejigachulbutang (GUI-ZHI-JIA-SHU-FU-TANG, GCB) is an herbal formula widely prescribed in traditional East Asian medicine practice for arthritis and muscle pain. We evaluated the efficacy and safety of GCB for degenerative knee osteoarthritis (KOA). Methods. Eighty patients with KOA were randomly assigned to the GCB group or the placebo group in a 1 : 1 ratio in two Korean medicine hospitals. Patients took GCB or placebo three times a day for 4 weeks. Primary outcome was the change in the visual analogue scale (VAS) score for knee pain from baseline to 4th week. Secondary outcomes were the change in the VAS score from baseline to 2nd week and 8th week, Korean Western Ontario and McMaster Universities Osteoarthritis Index (K-WOMAC), European Quality of Life Five Dimensions questionnaire (EQ-5D), and safety. Results. There was no significant difference between the compared indicators of the GCB and placebo groups. However, in subgroup analysis, GCB was effective for subjects with a BMI lower than 25 kg/m2. The dose of pain medication was significantly lower in the GCB group than in the placebo group after four weeks (p=0.016). There were no serious adverse events in the GCB group. Conclusions. GCB was not effective in primary outcome analysis. In exploratory subgroup analysis, GCB might be effective for individuals with BMI lower than 25 kg/m2 for the treatment of degenerative KOA. GCB may also help reduce the consumption of pain medication. Furthermore, research is required for our hypothesis. This trial is registered with KCT0003024

Immunofluorescent staining for VGLUT1 (A–C) and VGLUT2 (D–I) in the rat dental pulp in the control (A, D, E), CFA 1-day (B, F), and CFA 3-day (C, G–I) groups. A–C:

<p>Expression of VGLUT1 in pulpal axons in control (A) and CFA 1-day (B) and CFA 3-day (C) groups. VGLUT1 is expressed in many axons in the peripheral portion of the coronal pulp. <b>D–I:</b> Expression of VGLUT2 in pulpal axons in control (D, E), CFA 1-day (F), and CFA 3-day (G–I) groups. In the control group, VGLUT2 is expressed in a small number of axons in the peripheral portion of coronal pulp (D) and few axons in the radicular pulp (E). However, it is expressed in a large number of axons in the peripheral portion (F, G), the core of the coronal pulp (H), and in radicular pulp (I) in the CFA 1-day and CFA 3-day groups. Scale bar = 20 µm.</p

Density of VGLUT1+ and VGLUT2+ axons (A, immunofluorescence assay) and protein levels of VGLUT1 and VGLUT2 (B, C, Western blot assay) in the control, CFA 1-day and 3-day pulps.

<p><b>A</b>: The density (area fraction) of VGLUT1+ pulpal axons is not significantly different between CFA 1-day or CFA 3-day groups and control, whereas the density of VGLUT2+ axons is significantly higher in the CFA 1-day, CFA 3-day groups than control. N = 3 animals in each group. *p<0.01. <b>B</b>: Representative images of the Western blot assay. <b>C</b>: Quantitative analysis of VGLUT1 and VGLUT2 protein in the dental pulp. Protein levels of VGLUT1 and VGLUT2 in the pulp are significantly higher in the CFA 1-day, CFA 3-day groups than control. This difference is bigger for VGLUT2 (3.9 and 4.3 fold higher in the CFA 1-day and CFA 3-day groups than control) than for VGLUT1 (2.9 and 3.1 fold higher in the CFA 1-day and CFA 3-day groups than control). N = 5 animals in each group. *p<0.01.</p

Immunofluorescent staining for VGLUT1 and VGLUT2 (A), density of VGLUT1+ and VGLUT2+ somata (B, immunofluorescence assay), and protein levels of VGLUT1 and VGLUT2 (C, D, Western blot assay) in the trigeminal ganglion.

<p><b>A:</b> Immunofluorescent staining for VGLUT1 (a, b) and VGLUT2 (c, d) in the rat trigeminal ganglion in the control (a, c) and CFA 1-day (b, d) groups. VGLUT1 is expressed predominantly in medium- and large-sized somata (a, b), whereas VGLUT2 is expressed predominantly in small- and medium-sized somata (c, d). The number of VGLUT1+ somata of all somata is not different between control (a) and CFA 1-day group (b), whereas that of VGLUT2+ soma is significantly higher in the CFA 1-day (d) than in the control (c) groups. Scale bar = 50 µm. <b>B:</b> The density of VGLUT2+ somata (fraction of all somata) is significantly higher for the CFA 1-day, CFA 3-day groups than control, whereas the density of VGLUT1+ soma is not significantly different between CFA 1-day or CFA 3-day groups and control. N = 3 animals in each group. *p<0.01. <b>C:</b> Representative images of the Western blot assay for VGLUT1 and VGLUT2 in the rat trigeminal ganglion. <b>D:</b> Quantitative analysis of VGLUT1 and VGLUT2 protein in the trigeminal ganglion. The VGLUT2 protein levels are significantly higher in the CFA 1-day and CFA 3-day groups than for the control, whereas the VGLUT1 protein levels are not different between CFA 1-day or CFA 3-day groups and the control group. N = 5 animals in each group. *p<0.01.</p

Double immunofluorescent staining for VGLUT1 and CD64 (A) and for VGLUT2 and CD64 (B) in the rat dental pulp in CFA 1-day group.

<p>VGLUT1 and VGLUT2 are expressed in many CD64+ cells (arrowhead) as well as in axons (arrow) in the inflamed dental pulp. Scale bar = 20 µm.</p

Efficacy and safety of gyejigachulbutang (Gui-Zhi-Jia-Shu-Fu-Tang, Keishikajutsubuto, TJ-18) for knee pain in patients with degenerative knee osteoarthritis: a randomized, placebo-controlled, patient and assessor blinded clinical trial

Abstract Background Degenerative knee osteoarthritis is a leading cause of disability in the elderly. If patients do not respond to pharmacological or nonpharmacological intervention, total knee replacement surgery is recommended. However, owing to the contraindications and adverse effects of surgery, the need for a new treatment strategy is emerging. Traditional herbal medicine is a widely used intervention in east Asia to treat knee osteoarthritis. Gyejigachulbutang is one of the frequently prescribed herbal formulae. The aim of our study is to evaluate the efficacy and safety of gyejigachulbutang for knee osteoarthritis. Methods This study is a randomized, placebo-controlled, patient and assessor blinded, superiority clinical trial. A total of 80 patients with knee osteoarthritis will be enrolled. The participants will be randomly assigned to the gyejigachulbutang or placebo group in a 1:1 ratio in two Korean medical hospitals. Every participant will take gyejigachulbutang or placebo at a dose of 2.5 g three times a day for 4 weeks. Additional follow-up will be conducted 4 weeks after treatment completion. Any concomitant treatment to relive knee pain will not be allowed except for rescue medicine (acetaminophen). The primary outcome will be a comparison of the change in the visual analogue scale score for knee pain from baseline to visit 3 (week 4) for both the treatment and placebo groups. Secondary outcomes include clinical relevance, minimal clinically important difference, disability, quality of life, and safety. Discussion This protocol presents a research methodology for clinical trials of gyejigachulbutang for knee osteoarthritis. Various secondary outcomes make this trial more informative. Our trial will provide fundamental evidence for knee osteoarthritis management via herbal medicine treatment. Trial registration Clinical Research Information Service (CRIS), KCT0003024. Registered on 25 July 2018