This randomized sham-controlled trial suggests that acupuncture treatment shows better effect on the reduction of the bothersomeness and pain intensity than sham control in participants with cLBP.

BackgroundThe identification of eligible controlled trials for systematic reviews of complementary and alternative medicine (CAM) interventions can be difficult. To increase access to these difficult to locate trials, the Cochrane Collaboration Complementary Medicine Field (CAM Field) has established a specialized register of citations of CAM controlled trials. The objective of this study is to describe the sources and characteristics of citations included in the CAM Field specialized register.MethodsBetween 2006 and 2011, regular searches for citations of CAM trials in MEDLINE and the Cochrane Central Register of Controlled Trials (CENTRAL) were supplemented with contributions of controlled trial citations from international collaborators. The specialized register was ‘frozen’ for analysis in 2011, and frequencies were calculated for publication date, language, journal, presence in MEDLINE, type of intervention, and type of medical condition.ResultsThe CAM Field specialized register increased in size from under 5,000 controlled trial citations in 2006 to 44,840 citations in 2011. Most citations (60%) were from 2000 or later, and the majority (71%) were reported in English; the next most common language was Chinese (23%). The journals with the greatest number of citations were CAM journals published in Chinese and non-CAM nutrition journals published in English. More than one-third of register citations (36%) were not indexed in MEDLINE. The most common CAM intervention type in the register was non-vitamin, non-mineral dietary supplements (e.g., glucosamine, fish oil) (34%), followed by Chinese herbal medicines (e.g., Astragalus membranaceus, Schisandra chinensis) (27%).ConclusionsThe availability of the CAM Field specialized register presents both opportunities and challenges for CAM systematic reviewers. While the register provides access to thousands of difficult to locate trial citations, many of these trials are of low quality and may overestimate treatment effects. When including these trials in systematic reviews, adequate analysis of their risk of bias is of utmost importance.

Summary Background:  Acupuncture is one of the most popular types of complementary/alternative medicine. It is sometimes used as a treatment for schizophrenia. Aims:  The objective of this review is to assess systematically the clinical evidence for or against acupuncture as a treatment for schizophrenia. Methods:  We searched 20 databases from their inception to May 2009 without language restrictions. All randomised clinical trials (RCTs) of acupuncture, with or without electrical stimulation or moxibustion for patients with schizophrenia were considered for inclusion. Results:  Thirteen RCTs, all originating from China, met the inclusion criteria. One RCT reported significant effects of electroacupuncture (EA) plus drug therapy for improving auditory hallucunations and positive symptom compared with sham EA plus drug therapy. Four RCTs showed significant effects of acupuncture for response rate compared with antipsychotic drugs [n = 360, relative risk (RR): 1.18, 95% confidence interval (CI): 1.03–1.34, p = 0.01; heterogeneity: τ2 = 0.00, χ2 = 2.98, p = 0.39, I2 = 0%]. Seven RCTs showed significant effects of acupuncture plus antipsychotic drug therapy for response rate compared with antipsychotic drug therapy (n = 457, RR: 1.15, 95% CI: 1.04–1.28, p = 0.008, heterogeneity: τ2 = 0.00, χ2 = 6.56, p = 0.36, I2 = 9%). Two RCTs tested laser acupuncture against sham laser acupuncture. One RCT found beneficial effects of laser acupuncture on hallucination and the other RCT showed significant effects of laser acupuncture on response rate, Brief Psychiatric Rating Scale and clinical global index compared with sham laser. The methodological quality was generally poor and there was not a single high quality trial. Conclusion:  These results provide limited evidence for the effectiveness of acupuncture in treating the symptoms of schizophrenia. However, the total number of RCTs, the total sample size and the methodological quality were too low to draw firm conclusions. As all studies originated from China, international studies are needed to test whether there is any effect.

Herba houttuyniae has been used as a constituent of herval medicine prescriptions for the treatment of inflammation, cancer, and other diseases. In the present study, we investigated the cellular effects of herba houttuyniae extract (HHE) and the signal pathways of HHE-induced apoptosis in HL-60 human promyelocytic leukemia cell line. HHE treatment caused apoptosis of cells as evidenced by discontinuous fragmentation of DNA, the loss of mitochondrial membrane potential, release of mitochondrial cytochrome c into the cytosol, activation of procaspase-9 and caspase-3, and proteolytic cleavage of poly(ADP-ribose) polym erase. Pretreatment of Ac-DEVD-CHO, caspase-3 specific inhibitor, or cyclosporin A, a mitochondrial permeability transition inhibitor, completely abolished HHE-induced DNA fragmentation. Together, these results suggest that HHE possibly causes mitochondrial damage leading to cytochrome c release into cytosol and activation of caspases resulting in PARP cleavage and execution of apoptotic cell death in HL-60 cells.

Radix Paeoniae Alba (RPA) is the root of Paeonia lactiflora Pallas, which belongs to the Ranunculaceae family. RPA has been commonly used in traditional medicine to tonify the blood, to alleviate pain, and to treat inflammation and cancer. A recent study reported that RPA inhibits hepatocellular carcinoma cell growth and induces their apoptosis. 1)Several constituents isolated from RPA have also been found to have immunologically active.2,3) However, details of the mechanism underlying the activity of RPA are not understood.Apoptosis is a highly regulated process that involves the activation of a series of molecular events that lead to cell death, and is characterized by morphologic changes, chromatin condensation, and apoptotic bodies, which are associated with DNA cleavage and ladder formation. 4,5) There are two major apoptotic pathways, namely, intrinsic and extrinsic apoptosis signaling, in cells responsive to apoptotic stimuli. [6][7][8][9] The intrinsic apoptosis pathway involves mitochondrial signaling, and caspase-9 has been suggested to be the predominant initiator caspase in this pathway. 7,9) In contrast, the extrinsic apoptosis pathway is mediated by death receptors, such as, Fas receptors and tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL), and the extrinsic pathway is initiated by caspase-8. 6,8) The activated initiator caspases-8 and -9 starts a proteolytic cascade by cleaving downstream effector caspases, such as, caspase-3, -6, and -7.7) Of these, caspase-3 is believed to be the main executioner caspase and its activation has been shown to be essential for both intrinsic and extrinsic apoptotic cell death. 10,11) To study the mechanism underlying the anticancer activities of RPA, we examined the antiproliferative effect of RPA extracts (RPAE) in HL-60, a human promyelocytic leukemia cell line. Our results demonstrated that RPAE induces apoptosis in a dose-dependent manner in HL-60 cells. We further demonstrate that the apoptotic effects induced by RPAE are accompanied by intrinsic pathway features, i.e., the release of cytochrome c into cytosol and the activation of procaspase-9, but not by extrinsic pathway features, and eventual caspase-3 activation. MATERIALS AND METHODS Culture ConditionsHuman leukemia HL-60 cells were purchased from the American Type Culture Collection. Cells were placed in 75 cm 2 tissue culture flasks and grown at 37°C under a humidified, 5% CO 2 atmosphere in RPMI 1640 medium (Gibco BRL) supplemented with 10% fetal bovine serum and 2 mM glutamine, 10000 units/ml of penicillin, 10 mg/ml of streptomycin, and 2.5 mg/ml of amphotericin B.Preparation of Herbal Extract Radix Paeoniae Alba was identified by Min-Kyo Shin, keeper of the herbarium at the Department of Physiology, School of Oriental Medicine, Wonkwang University (Voucher samples were preserved for reference; Ref. No. Omcphy 2001-80). To produce the extract, 200 g of RPA was added to 1800 ml of water, boiled for 2 h, filtered, and concentrated to 200 ml. The sterile extract (41.97 g) was store...