The effects of acupuncture as adjunctive treatment to antianginal therapies for patients with chronic stable angina are uncertain. OBJECTIVE To investigate the efficacy and safety of acupuncture as adjunctive therapy to antianginal therapies in reducing frequency of angina attacks in patients with chronic stable angina. DESIGN, SETTING, AND PARTICIPANTS In this 20-week randomized clinical trial conducted in outpatient and inpatient settings at 5 clinical centers in China from October 10, 2012, to September 19, 2015, 404 participants were randomly assigned to receive acupuncture on the acupoints on the disease-affected meridian (DAM), receive acupuncture on the acupoints on the nonaffected meridian (NAM), receive sham acupuncture (SA), and receive no acupuncture (wait list [WL] group). Participants were 35 to 80 years of age with chronic stable angina based on the criteria of the American College of Cardiology and the American Heart Association, with angina occurring at least twice weekly. Statistical analysis was conducted from December 1, 2015, to July 30, 2016. INTERVENTIONS All participants in the 4 groups received antianginal therapies as recommended by the guidelines. Participants in the DAM, NAM, and SA groups received acupuncture treatment 3 times weekly for 4 weeks for a total of 12 sessions. Participants in the WL group did not receive acupuncture during the 16-week study period. MAIN OUTCOMES AND MEASURES Participants used diaries to record angina attacks. The primary outcome was the change in frequency of angina attacks every 4 weeks from baseline to week 16. RESULTS A total of 398 participants (253 women and 145 men; mean [SD] age, 62.6 [9.7] years) were included in the intention-to-treat analyses. Baseline characteristics were comparable across the 4 groups. Mean changes in frequency of angina attacks differed significantly among the 4 groups at 16 weeks: a greater reduction of angina attacks was observed in the DAM group vs the NAM group (difference, 4.07; 95% CI, 2.43-5.71; P < .001), in the DAM group vs the SA group (difference, 5.18; 95% CI, 3.54-6.81; P < .001), and in the DAM group vs the WL group (difference, 5.63 attacks; 95% CI, 3.99-7.27; P < .001). CONCLUSIONS AND RELEVANCE Compared with acupuncture on the NAM, SA, or no acupuncture (WL), acupuncture on the DAM as adjunctive treatment to antianginal therapy showed superior benefits in alleviating angina. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01686230

In this paper we derive in great detail the formula for count rates of gamma-ray bursts (GRBs) in the framework of fireballs, in terms of the integral of time, where the Doppler effect of the expanding fireball surface is the key factor concerned. Effects arising from the limit on the time delay due to the limited emitting areas on the fireball surface and other factors are investigated. Our analysis shows that the formula for the count rate of fireballs can be expressed as a function of , which is the observation timescale relative to the dynamical timescale of the fireball defined by R c /c, where R c is the fireball radius measured at an associated local time. The profile of light curves of fireballs depends only on the relative timescale, entirely independent of the real timescale and the real size of the objects. It displays in detail how a cutoff tail or a turnover feature (called the cutoff tail problem) in the decay phase of a light curve can arise. This feature is a consequence of a hot spot on the fireball surface, moving toward the observer, and has been observed in a few cases previously. Local pulses suddenly dimming produce light curves bearing a certain decay form (called a standard decay form) and exhibiting a sharp feature at their peaks. Light curves arising from gradually dimming local pulses are smooth at their peaks, and their profiles in the decay phase will obviously deviate from the standard form when the width of the local pulse is large enough. It is observed that light curves arising from relatively short local pulses should be the same, entirely independent of the local pulse shape. The impact of the rest-frame radiation form and of the variance of the form on the profile of light curves is insignificant, while the impact on the magnitude of the light curves is obvious. By performing fits to the count-rate light curves of six sample sources, we show how to obtain some physical parameters from the observed profile of the count rate of GRBs and show that there do exist some GRBs for which the profiles of their count rate light curves can be described by the formula provided. In addition, the analysis reveals that the Doppler effect of fireballs could lead to a power-law relationship between the FWHM of pulses and energy, which has been observed previously by many authors.

BackgroundAcupuncture has been commonly used for preventing migraine attacks and relieving pain during a migraine, although there is limited knowledge on the physiological mechanism behind this method. The objectives of this study were to compare the differences in brain activities evoked by active acupoints and inactive acupoints and to investigate the possible correlation between clinical variables and brain responses.Methods and ResultsA randomized controlled trial and resting-state functional magnetic resonance imaging (fMRI) were conducted. A total of eighty migraineurs without aura were enrolled to receive either active acupoint acupuncture or inactive acupoint acupuncture treatment for 8 weeks, and twenty patients in each group were randomly selected for the fMRI scan at the end of baseline and at the end of treatment. The neuroimaging data indicated that long-term active acupoint therapy elicited a more extensive and remarkable cerebral response compared with acupuncture at inactive acupoints. Most of the regions were involved in the pain matrix, lateral pain system, medial pain system, default mode network, and cognitive components of pain processing. Correlation analysis showed that the decrease in the visual analogue scale (VAS) was significantly related to the increased average Regional homogeneity (ReHo) values in the anterior cingulate cortex in the two groups. Moreover, the decrease in the VAS was associated with increased average ReHo values in the insula which could be detected in the active acupoint group.ConclusionsLong-term active acupoint therapy and inactive acupoint therapy have different brain activities. We postulate that acupuncture at the active acupoint might have the potential effect of regulating some disease-affected key regions and the pain circuitry for migraine, and promote establishing psychophysical pain homeostasis.Trial RegistrationChinese Clinical Trial Registry ChiCTR-TRC-13003635

The jet breaks in the afterglow lightcurves of short gamma-ray bursts (SGRBs), rarely detected so far, are crucial for estimating the half-opening angles of the ejecta (θ j ) and hence the neutron star merger rate. In this work we report the detection of jet decline behaviors in GRB 150424A and GRB 160821B and find θ j ∼ 0.1 rad. Together with five events reported before 2015 and other three "identified" recently (GRB 050709, GRB 060614 and GRB 140903A), we have a sample consisting of nine SGRBs and one long-short GRB with reasonably estimated θ j . In particular, three Swift bursts in the sample have redshifts z ≤ 0.2, with which we estimate the local neutron star merger rate density to be ∼ 1109 +1432 −657 Gpc −3 yr −1 or 162 +140 −83 Gpc −3 yr −1 if the narrowly-beamed GRB 061201 is excluded. Inspired by the typical θ j ∼ 0.1 rad found currently, we further investigate whether the off-beam GRBs (in the uniform jet model) or the off-axis events (in the structured jet model) can significantly enhance the GRB/GW association or not. For the former the enhancement is at most moderate, while for the latter the enhancement can be much greater and a high GRB/GW association probability of ∼ 10% is possible. We also show that the data of GRB 160821B may contain a macronova/kilonova emission component with a temperature of ∼ 3100 K at ∼ 3.6 days after the burst and more data are needed to ultimately clarify.

We perform a statistical analysis of the temporal and spectral properties of the latest Fermi gamma-ray bursts (GRBs) to revisit the classification of GRBs. We find that the bimodalities of duration and the energy ratio (E peak /Fluence) and the anti-correlation between spectral hardness (hardness ratio (HR), peak energy and spectral index) and duration (T 90 ) support the long/soft − short/hard classification scheme for Fermi GRBs. The HR − T 90 anti-correlation strongly depends upon the spectral shape of GRBs and energy bands, and the bursts with the curved spectra in the typical BATSE energy bands show a tighter anti-correlation than those with the power-law spectra in the typical BAT energy bands. This might explain why the HR − T 90 correlation is not evident for those GRB samples detected by instruments like Swift with a narrower/softer energy bandpass. We also analyze the intrinsic energy correlation for the GRBs with measured redshifts and well defined peak energies. The current sample suggests E p,rest = 2455 × (E iso /10 52 ) 0.59 for short GRBs, significantly different from that for long GRBs. However, both the long and short GRBs comply with the same E p,rest −L iso correlation.