Effects of electroacupuncture at Zusanli(ST36) on inflammatory cytokines in a rat model of smokeinduced chronic obstructive pulmonary disease

OBJECTIVE： Improvement in lung function was reported after acupuncture treatment of chronic obstructive pulmonary disease （COPD）, but little is known about the underlying mechanisms. Because an immune response imbalance could be seen in COPD, we hypothesize that electroacupuncture （EA） may play a role in regulating inflammatory cytokines and contribute to lung protection in a rat model of smoke-induced COPD. METHODS： A COPD model using male Sprague-Dawley rats exposed to cigarette smoke was established. The rats were randomly divided into four groups （control, sham, COPD, and COPD plus EA）, and COPD model was evaluated by measuring pulmonary pathological changes and lung function. EA was applied to the acupuncture point Zusanli （ST36） for 30 min/d for 14 d in sham and COPD rats. Bronchoalveolar lavage fluid （BALF） was used to measure levels of tumor necrosis factor-a （TNF-a）, interleukin-113 （IL-113）, and malonaldehyde （MDA）. RESULTS： Compared with the control rats, COPD rats had significant changes in lung resistance （R,） and lung compliance （C,） （both P〈0.01）, bronchi and bronchiole airway obstruction （P〈0.01）, and levels of MDA, TNF-α, and IL-1β（P〈0.01）. There were no significant differences between the control and the sham groups. Compared with the COPD rats, the COPD plus EA rats had decreased R, and increased CL （both P〈0.05）, and reduced bronchi and bronchiole airway obstruction （P〈0.05, P〈0.01, respectively）, while levels of TNF-α, IL-1β, and MDA in BALF were lowered （P〈0.05 and P〈0.01, respectively）. However, TNF-α and IL-1β levels of the EA group rats remained higher than those of the control group （P〈0.05）. CONCLUSION： EA at ST36 can reduce lung injury in a COPD rat model, and beneficial effects may be related to down-regulation of inflammatory cytokines. The anti-inflammatory and antioxidant effects may prolong the clinical benefit of EA.

Effects of pre-moxibustion at Zusanli (ST36) on heat shock protein 70 expression in rats with gastric mucosal lesions after neurotomy

Studies have shown that pre-moxibustion protects the gastric mucosa by up-regulating the expression of heat shock protein 70. However, the signaling pathway underlying this effect remains unclear. Rats were intragastrically administered absolute alcohol, causing obvious lesion of the gastric mucosa. Following pre-moxibustion at Zusanfi （ST36） for 8 days, the ulcer index decreased to different degrees. The results of an enzyme linked immunosorbent assay and western blotting showed significant upregulation of heat shock protein 70 expression in the gastric mucosa and serum. None out of transection of the spinal cord, damage to the nucleus of the solitary tract, neurotomy of the vagal nerve and neurotomy of the common peroneal nerve affected the decrease in ulcer index or the increase in heat shock protein 70 expression in serum after pre-moxibustion at Zusanfi, and heat shock protein 70 expression was obviously decreased in the gastric mucosa. These findings suggest that pre-moxibustion at Zusanfi can protect the gastric mucosa against lesioning, and that the mechanism underlying this effect involves its induction of heat shock protein 70 expression. Neural pathways participate in the regulatory effects of moxibustion on heat shock protein 70 expression in the gastric mucosa.

Electro-acupuncture at Zusanli(ST 36) to improve lower extremity motor function in sensory disturbance patients with cerebral stroke A randomized controlled study of 240 cases

BACKGROUND： Studies have shown that sensory transduction is a way to introduce needle sensation. OBJECTIVE： To observe the influence of electro-acupuncture at the ＂Zusanll＂ （ST 36） point on lower extremity motor function in various sensory disturbance patients with cerebral stroke. DESIGN, TIME AND SETTING： A randomized, controlled, clinical study was performed at the Department of Neurological Rehabilitation, China Rehabilitation Research Centre from September 2006 to June 2008. PARTICIPANTS： Patients with first-time cerebral infarction or hemorrhage, or with a stroke history, but no neurodysfunction （single damage）, were selected for this study. The subjects were right-handed and disease state was stable. A total of 240 inpatients were randomly assigned to the following groups： electro-acupuncture （n = 124） and control （n = 116）. The two groups were further assigned into sub-groups： no sensory disturbance, superficial sensory disturbance, deep sensory disturbance, and deep and superficial sensory disturbance. METHODS： On the basis of routine limb function training, the acupoint Zusanliwas utilized in all patients from the electro-acupuncture group. Perpendicular acupuncture was 3.0-4.0 cm deep. An electric acupuncture instrument was connected when patients developed the needle sensation, deqi. A stimulation pattern consisting of distant and dense waves of 50 Hz was used to elicit slight dorsal foot extension. Acupuncture was administered 5 times per week, 30 minutes per session, for 6 weeks in total. MAIN OUTCOME MEASURES： FugI-Meyer assessment （FMA） was used to evaluate lower extremity motor function; Ver.1.0 gait analysis to estimate gait （step frequency, step speed, and step scope）; lower extremity Composite Spasticity Scale （CSS） to estimate muscle spastic degree. RESULTS： Following treatment, motor function improved in both groups. Compared with the control group, FMA score, step speed, step frequency, and step scope were increased in the electro-acupuncture group, but there was no difference in lower extremity CSS scores between the electro-acupuncture and the control groups （P 〉 0.05）. Compared with the control group, Zusanli （ST 36） electro-acupuncture improved motor function indices as follows： FMA score, step frequency, step speed, and step scope of patients with no sensory disturbance （P 〈 0.05-0.01）, step frequency of patients with superficial sensory disturbance （P 〈 0.05）, and step frequency and step speed of patients with deep sensory disturbance （P 〈 0.05）. CONCLUSION： Zusanfi （ST 36） electro-acupuncture effects on lower extremity motor function in stroke patients were improved with no muscle tone rise. Therefore, this form of treatment can be used in convalescent treatment, Moreover, effects were different according to various sensory disturbance types, which suggested that sensory input influenced acupuncture effects.

Meta-analysis of neostigmine injections given at the Zusanli （ST 36） acupoint in thetreatment of postpartum urinary retention

Objective： We aimed to determine the effect of neostigmine injections given at the Zusanli （ST 36） acupoint whentreating postpartum urinary retention. Methods： We conducted a systematic review to identify randomized controlledtrials （RCTs） involving neostigmine injections given at the Zusanli （ST 36） acupoint for treating postpartum urinaryretention. We searched the Cochrane Library, Pubmed, Web of Science, Chinese National Knowledge Infrastructure, VipDatabase, and Chinese Biomedical Literature Database from the creation of the database to December 30, 2016. Bias riskassessment was performed using Revman 5.3 software from Cochrane based on the criteria set out in the CochraneHandbook for Systematic Reviews of Interventions, version 5.1.0. Results： Thirteen studies were included with 627participants in the treatment group and 584 participants in the control group. （1） Overall response rate： neostigmineinjections given at the Zusanli （ST 36） acupoint have a better curative effect than injections given in muscle, odds ratio（OR） = 8.74, 95% confidence interval （CI） [5.83, 13.10], Z = 10.49 （P 〈 0.001）; （2） Comparison of effects at differentdosages： （i） 0.5 mg of neostigmine Zusanli （ST 36） acupoint injection group has better effect than 1 mg of neostigmineintramuscular injection group, OR = 15.84, 95% CI [5.74, 43.72],Z = 5.34 （P 〈 0.001）, （ii） 0.5 mg of neostigmineinjection given at the Zusanli acupoint has a better curative effect than 0.5 mg of neostigmine injection given in muscle ,OR = 7.30, 95% CI [3.47, 15.34], Z = 5.24 （P 〈 0.001）; （iii） 1 mg of neostigmine injection at the Zusanli （ST 36）acupoint has better efficacy than 1 mg of neostigmine injection in muscle, OR = 7.76, 95% CI [4.46, 13.52], Z = 7.25 （P〈 0.001）. Conclusion： Neostigmine injections at the Zusanli （ST 36） acupoint have beneficial effects in treatingpostpartum urinary retention. However, the low quality of the studies included in the meta-analysis raises questions overthe reliability of the results. Further studies are still needed.

EXPERIMENTAL STUDY ON MOXIBUSTION AT ZUSANLI(ST 36) AND LIANGMEN (ST 21) INDUCING HEAT SHOCK PROTEIN 70 (HSP70) EXPRESSION TO RESIST OXIDATIVE INJURY OF GASTRIC MUCOSA

To observe effect of moxibustion at Zusanli （足三里 ST 36） and Liangmen （梁门 ST 21 ） on expression of heat shock protein 70 （HSP70） in gastric mucosa of the rat of stress ulcer （SU） to explore the mechanism of moxibustion in resisting oxidative injury of the gastric mucosa. Methods： Sixty SD rats were evenly randomized into 4 groups, a blank group, a model group, an acupoint moxibustion group and a non-acupoint moxibustion group. Water restraint stress （WRS） method was used to make stress gastric ulcer rat model. The ulcerative index （Ul） of gastric mucosa was evaluated by using GUTH method, the gastric mu- cosa blood flux （GMBF） was detected by a laser Doppler bloodflow monitor, and HSP70 expression and malondialdehyde （MDA） content in the gastric mucosa were determined respectively with immunohistochemical and thiobarbiturate methods. Results： Moxibustion at Zusanli （ST 36） and Liangmen （ST 21 ） significantly de- creased Ul, up-regulated HSP70 expression, increased GMBF, and decreased MDA content in the gastric mucosa in the rat of stress gastric ulcer, with significant differences as compared with the model group and the non-acupoint moxibustion group （P 〈 0.05 or P 〈 0.01 ）. Conclusion： Moxibustion at Zusanli （ST 36） and Liangmen （ST 21 ） can induce high expression of HSP70 and decrease MDA content in the gastric mucosa, so as to resist oxidative injury, with relative acupoint specificity.

TREATMENT OF OBSTINATE PEPTIC ULCER AND CHRONIC GASTRITIS WITH A METAL RING EMBEDDED IN ZUSANLI ACUPOINT

We had treated 102 cases of obstinate peptic ulcer and chronic gastritis with ametal ring embedded in Zusanli acupoint since October 1989 to October 1992,and got satisfactorytherapeutic effects.The total effective rate is 96.08%,the cure rate of peptic ulcer is 87.32%,therecurrence rate is significantly lower than that of control group(P【0.001),and it has no side-effect.

CONSTIPATION TREATED BY AURICULAR ACUPOINT PRESSING COMBINED WITH ACUPUNCTURE AT ZUSANLI POINT

This paper reports that 65 cases with functional constipation were treated by putting one Wang Bu Liu Xing (semen vaccariae) seed on each acupoint, Intestinum crassum, Intestinum tenue,Sympathicum, Lung, Spleen, Subcortex, of auricula and pressing, associated with acupuncture at Zusanli point on both sides. The patients were instructed to press the stuck seed twice a day for 3 to 5 minutes each time. Auricular acupoints of both sides were used alternately every 2 days. The electric acupuncture was applied at Zusanli points about 30 minutes each time every other day. Ten times (i. e. 20 days) make one course of treatment and the routine treatment consists of 1 to 2 courses. The results showed that all the patients were cured, patients with Shi Mi (the constipation of excess type) were cured after one course of treatrnent while Xu Mi (the constipation of deficiency type) were cured after two courses. The study suggests that this kind of treatment is an ideal therapy for functional constipation. The pathogenesis and mechanism of treatment of auricular acupuncture pressing associated with acupuncture at Zusanli point for constipation are discussed.

A COMPARATIVE OBSERVATION ON THE EFFECTS OF ACUPUNCTURING RENZHONG AND ZUSANLI ON THE NEURONAL ACTIVITY OF LOCUS COERULEUS IN RATS

In present work,the effects of acupuncturing Renzhong（GV 26）and Zusanli（ST 36）on the neuronal activity of Locus Coeruleus（LC）in rats were observed and compared.The resultsindicated that the central mechanism of promoting blood pressure（BP）by acupuncturing Renzhongwas related to the activity of LC;the influence of acupuncturing Renzhong on neuronal activity of LC was more obvious than that of acupuncturing Zusanli;and there was relative speciality between the acupoints.

Comparison of protective effects of electroacupuncture and moxibustion at Zusanli(ST 36)on perinatal nicotine exposure-induced lung phenotype in rat offspring

Objective:To compare the effects of electroacupuncture(EA)and moxibustion at Zusanli(ST 36)on the lung phenotype of rat offspring exposed to nicotine during the perinatal period.Methods:Pregnant Sprague-Dawley rats were randomly divided into 4 groups:the control group(saline only),the model group(nicotine only),the EA group(nicotine+EA at ST 36 acupoints bilaterally),and the moxibustion group(nicotine+moxibustion at ST 36 acupoints bilaterally).n=6 rats per group.On postnatal day 21,the body weight,lung weight,and pulmonary function were determined and lung morphometry was performed.Peroxisome proliferator-activated receptor gamma andβ-catenin levels in the lung tissue of offspring were also determined.Results:Perinatal nicotine exposure(PNE)results in decreased body and lung weights of offspring rats,abnormal lung tissue morphology,and significantly altered pulmonary function,showing an increase in total airway resistance and a decrease in tidal volume,minute ventilation,total airway compliance,and peak expiratory flow.Bilateral EA at ST 36 acupoints could block all of these perinatal nicotine-induced effects.Although moxibustion also had protective effects in nicotine-induced offspring lungs,some of these effects did not reach statistical significance,e.g.,protection against the upregulation ofβ-catenin,the downregulation of PPARγsignaling,and the increase in peak expiratory flow.Conclusion:Maternal EA at ST 36 blocked the PNE-induced changes in key developmental signaling pathways,prevented the PNE-induced changes in lung morphology,and protected pulmonary function.Moxibustion at ST 36 showed similar but weaker protective effects against the PNE-induced changes in the exposed offspring.It is important to note that the mechanism underlying the protective effects of moxibustion at ST 36 may be different from those of EA at ST 36,and further research is needed to understand these differences.

Expression of ceramide galactosy transferase in sciatic nerve of rats with diabetic peripheral neuropathy after electroacupuncture at Zusanli and Shenshu points

BACKGROUND： Ceramide galactosyltransferase （CGT） protein and mRNA expression defect can cause the abnormal morphology and slowing conduction velocity of peripheral nerve. Morphologic change and functional disorder of myelin sheath and axon appear when diabetic peripheral neuropathy （DPN） occurs. Whether electroacupuncture at Zusanfi（ST 36） and Shenshu（BL 32） points can enhance the expression of CGT protein and mRNA in the DPN tissue？ OBJECTIVE： To observe the effect of electroacupuncture at Zusanfi and Shenshu points on motor, sensory conduction velocity and CGT mRNA and its protein expression of sciatic nerve in rats with DPN. DESIGN： A randomized and controlled animal experiment SETTING ： Department of Neurology and Central Laboratory, Yueyang Hospital of Traditional Chinese ＆ Western Medicine, Shanghai University of Traditional Chinese Medicine. MATERIALS ： Totally 60 healthy male Wistar rats of clean grade, aged 4 month, with body mass of 200 to 220 g, were enrolled in this study. Streptozotocin （STZ, Sigma Company of USA, Batch No. S-0130）. METHODS： This study was carried out in the Animal Experimental Center and Central Laboratory, Yueyang Hospital of Traditional Chinese ＆ Western Medicine during February 2005 to March 2006. （1） Fifteen rats were randomly chosen,serving as normal group.AU the other rats were intraperitoneally injected once with STZ to develop experimental diabetic rat models. If fasting blood glucose was ≥ 15 mmol/L,sensory nerve and motor nerve conduction velocity of sciatic nerve was obviously slowed, tail-swaying temperature threshold was increased and myelinated nerve fiber of sciatic nerve changed, DPN models were successful. The successful model rats were randomly assigned into 3 groups： model group, control group（electroacupuncture at non-meridian-non-acupoint）and electroacupuncture group [electroacupuncture at Zusan/i and Shenshu points], with 15 rats each. The rats in the normal group and model group were untouched. In the electroacupuncture group （electroacupuncture at Zusanfi and Shenshu points）, Shenshu point （double） and Zusanfi point （double） were chosen referencing to The Atlas of the Rat＇s Acupoints. G6805- Ⅱ electric acupuncture apparatus was used, and current intensity was controlled at 20 min/time, once every other day, 12 times within 24 days. In the control group, the tip of rat-tail was stimulated, and the concrete procedures were the same as in the electroacupuncture at Zusanfi and Shenshu points. （2） Motor nerve conduction velocity and sensory nerve conduction velocity of rats were detected with neuroelectrophysiology detector in the end of the treatment, and the expressions of CGT protein and mRNA of sciatic nerve were detected with immunohistochemical method and fluorescent quantitative PCR technique. MAIN OUTCOME MEASURES： （1） Motor and sensory nerve conduction velocity. （2） The expression of CGT protein and its mRNA. RESULTS： All the 60 rats entered the stage of result analysis. （1） Comparison of motor and sensory nerve conduction velocity of rats after electroacupuncture： Motor nerve conduction velocity of rats in the model group[（31.37±3.69） m/s], control group [（32.74±5.42） m/s] and electroacupuncture group [（41.30 ±1.15） m/s] was significantly lower than that in the normal group [（41.30±1.15） m/s, P 〈 0.01]; The sensory nerve conduction velocity of rats in the model group[（18.17±9.54） m/s], control group [（21.39±5.61） m/s]and electroacupuncture group [（35.81 ±4.59） m/s] was significantly lower than that in the normal group [（46.38± 6.32） m/s,P 〈 0.01]; The motor and sensory nerve conduction velocity of electroacupuncture group was significantly higher than that in the model group [（38.04±2.01） m/s vs. （32.74±5.42） m/s,（35.81±4.59） m/s vs. （21.39±5.61） m/s,P 〈 0.01]. （2） Comparison of the expression of CGT protein of sciatic nerve of rats： The number of CGT positive cells of sciatic nerve in model group, control group or electroacupuncture group was significantly smaller than that in normal group [（9 770.33±1 461.73）, （10 588.13±1119.52）, （27 518.27± 9 078.29）, （37 769.67±4 021.81）/μm^2,P 〈 0.01]; The number of CGT positive cells of the sciatic nerve in the electroacupuncture group was significantly larger than that in the model group and control group （P 〈 0.01）. The number of CGT positive cells of sciatic nerve was close between control group and electroacupuncture group （P 〉 0.05）. （3） Comparison of CGT mRNA expression of sciatic nerve of rats： Ct value of CGT mRNA of sciatic nerve of rats in the model group,control group and electroacupuncture group was significantly higher than that in the normal group （13.75±2.60,14.81±2.80,11.67±1.75,9.30±0.98, P 〈 0.01 ）; Ct value of CGT mRNA of sciatic nerve of rats in the electroacupuncture group was significantly lower than that in the model group and control group （P 〈 0.01）, and that was close between electroacupuncture group and control group （P 〉 0.05）. CONCLUSION ： Electroacupuncture at Zusanfi and Shenshu points can increase motor and sensory nerve conduction velocity of rats with DPN. It might be associated with up-regulating the expression of CGT mRNA and its protein.

Adenosine triphosphate mediates the pain tolerance effect of manual acupuncture at Zusanli(ST36) in mice

OBJECTIVE:To investigate the mechanisms behind the effects of acupuncture in Traditional Chinese Medicine,we delved into the adenosine triphosphate/peripheral purinergic P2X receptor 3(ATP/P2X3)receptor signaling system as an indicator of the body's energy state,commonly referred to as"Qi".METHODS:The tail-flick test was utilized to explore the impact of acupuncture on pain tolerance threshold(PTT)in mice,while also assessing adenosine(ADO)levels and adenylate energy charge(EC)at Zusanli(ST36).The study further investigated the dose-dependent effects of acupuncture on PTT and ADO levels at Zusanli(ST36).To shed light on the underlying mechanisms of acupuncture's effects,the study examined the impact of ATP,a P2X3 receptor antagonist,and adenosine disodium on PTT following acupuncture administration.RESULTS:Acupuncture at Zusanli(ST36)led to significant improvements in PTT in mice,with the most effective interventions being twirling for 2 min and needle retention for 28 min.These interventions also resulted in significant increases in ATP levels.The effects of acupuncture were further augmented by administration of different doses of ATP at Zusanli(ST36),and pretreatment with a P2X3 receptor antagonist decreased PTT.Adenylate EC peaked at 30 min after intraperitoneal injection of ATP,and pretreatment with various doses of i.p.ATP 30 min prior to acupuncture increased PTT in a dose-dependent manner.Additionally,pretreatment with an i.p.or intramuscular injection of adenosine disodium enhanced the effects of acupuncture.CONCLUSION:This research provides compelling evidence that ATP is involved in the regulation of PTT through acupuncture,revealing new avenues for achieving enhanced clinical outcomes.

Effects of moxibustion with wheat-grain size cone at "Zusanli"(ST 36) on vascular injury and oxidative stress in high-fat diet rats through mTOR/HIF-1α/VEGF signaling pathway

Objective To explore the effect mechanism of moxibustion with wheat-grain size cone at “Zusanli”(ST36) on vascular injury and oxidative stress in hyperlipidemia through mammalian target of rapamycin(mTOR)/hypoxia inducible factor-1α (HIF-1α)/vascular endothelial growth factor (VEGF) signaling pathway.

Effects of moxibustion at"Zusanli"(ST 36)on oxidative stress and intestinal flora in aging rats

Objective To observe the effects of moxibustion at"Zusanli"(ST 36)on oxidative stress and intestinal flora in subacute aging rats,and to explore the possible mechanism of moxibustion in delaying aging.Methods Thirty SD rats were randomly divided into a blank group,a model group and a Zusanli group,with 10 rats in each group.Subacute aging model was established by intraperitoneal injection of D-galactose at dosage of 500 mg/kg in the model group and the Zusanli group,once a day for 42 days.In the Zusanli group,moxibustion was applied at bilateral"Zusanli"(ST 36),once a day,3 moxa cones at each acupoint,for consecutive 28 days.After intervention,the serum levels of superoxide dismutase(SOD)and malondialdehyde(MDA)were detected by ELISA;the intestinal flora was detected by 16S rRNA sequencing technique in each group.

Electroacupuncture at Feishu(BL13) and Zusanli(ST36) down-regulates the expression of orexins and their receptors in rats with chronic obstructive pulmonary disease

Inflammation and lung function decline are the main pathophysiological features of chronic obstructive pulmonary disease （COPD）. Acupuncture can improve lung function in patients with COPD, but the underlying mechanisms are not well understood. Orexins （OXs）, which are found in peripheral plasma, are neuropeptides that regulate respiration and their levels are related to COPD. Therefore, we hypothesized that acupuncture might alter OXs, reduce lung inflammation and improve lung function in COPD. METHODS： COPD was induced in rats by exposure to cigarette smoke for 8 weeks and injecting with lipopolysaccharide twice. Electroacupuncture （EA） was performed at Feishu （BL13） and Zusanli （ST36） for 30 min/d for 2 weeks. Rat lung function and morphology were assessed after EA. The levels of tumor necrosis factor-α （TNF-a） and intedeukin-1β （IL-16） in bronchoalveolar lavage fluid （BALF） and orexin A and B levels in the lung tissue were detected by enzyme-linked immunosorbent assay. OX receptor mRNA levels and immunopositive cells were assessed with real-time polymerase chain reaction and immunohistochemical methods, respectively. The relationships among lung function, cell factors, and OX levels were analyzed by Pearson correlation analyses. RESULTS： Compared with the control group, lung function was significantly decreased in the rats with COPD （P〈0.05）. There were obvious increases in TNF-α and IL-1β levels in BALF （P〈0.05 and P〈0.01, respectively）, orexin A level in lung tissue （P〈0.01; but not orexin B） and mRNA expressions of OX 1 type receptor （OXR1） and OX 2 type receptor （OXR2） in lung tissue （P〈0.05 and P〈0.01, respectively）; the integrative optical densities （IODs） of both receptors were greater in the COPD group （P〈0.05）. For rats with COPD subjected to EA, lung function was improved （P〈0.05）. There were notable decreases in TNF-a and IL-1β levels （P〈0.05 and 〈0.01, respectively） in BALF. Orexin A, but not orexin B, levels in lung tissue also decreased （P〈0.01）, as did mRNA expression of OXlR and OX2R in lung tissue （P〈0.05 and P〈0.01, respectively）. Receptor IODs were also reduced after EA treatment （P〈0.05）. Furthermore, orexin A levels and ratio of forced expiratory volume in 0.3 s to forced vital capacity were strongly negatively correlated （P〈0.01）, and orexin A was positively correlated with TNF-α and IL-1β （P〈0.001 and P〈0.05, respectively）.CONCLUSION： EA at Zusanli and Feishu improved lung function of rats with COPD and had an anti-inflammatory effect, which may be related to down-regulation of OXA and its receptors.

Electroacupuncture at Zusanli(ST36) Accelerates Intracerebral Hemorrhage-Induced Angiogenesis in Rats

Objective： To investigate the effects of electro-acupuncture on intracerebral hemorrhage （ICH）- induced angiogenesis and hypoxia-inducible factor-1 a （HIF-1 a） expression in rats. Me.otis： Adult male Sprague- Dawley rats were randomly divided into 4 groups of 24 rats each. ICH was induced in 3 groups by stereotactic injection of collagenase type Ⅶ into the right globus pallidus; of these, one group was not further treated, the second group underwent Zusanli （ST36）-acupuncture, and the third group underwent non-acupoint acupuncture. ＇The fourth group underwent sham operations. Acupuncture was performed by stimulation with electrical needles at frequencies of 2-20 Hz for 30 min per day. Angiogenesis on days 3, 7 and 14 was assessed by double iimmunolabeling, and expression of HIF-1 α was evaluated by immunohistochemistry, quantitative real time reverse chain reaction and Westem blotting. Results： 5-Bromo-2-deoxyuddine （BrdU）labeled nuclei in cerebral endothelial cells （ECs） resided around the hematoma and the labeling peaked from 7 to 14 days （P〈0.01）. HIF-1 a positive microvessels with a dilated outline were detected in pedhematomal tissues after ICH, with the vessels extending into the clot from the surrounding area beginning on day 7. Following ICH, HIF-1 a protein levels increased （P〈0.05）, but HIF-1 a mRNA levels did not change. Electro-acupuncture at the Zusanli （ST36） acupoint increased BrdU-labeled nuclei in cerebral ECs （P〈0.05） and up-regulated the expression of HIF-1 a protein （P〈0.05）, but had little effect on the spatial distribution of HIF-1α or on HIF-1α mRNA levels. Conclusions： Electro-acupuncture treatment at the Zusanli （ST36） acupoint may accelerate ICH-induced angiogenesis by up-regulating HIF-1 a protein, and may enhance recovery following hemorrhagic cerebral injury.

The Expression of Calcitonin Gene-related Peptide on the Neurons Associated Zusanli(ST 36)in Rats

Objective： To investigate the biochemical characteristic of the neurons associated Zusanli （ST 36） in the rat by using Alexa Fluor 594 conjugated cholera toxin subunit B （AF594-CTB） neural tracing and calcitonin gene-related peptide （CGRP） fluorescent immunohistochemical techniques. Methods： Four male Sprague Dawley rats were injected with AF594-CTB into the corresponding area of the Zusanli in the human body. After 3 surviving days, the rat＇s spinal cord and dorsal root ganglia （DRGs） at lumbar segments were dissected following perfusion with 4% paraformaldehyde, cut into sections, and then stained with CGRP- fluorescent immunohistochemical method. Results： AF594-CTB labeled sensory neurons were detected in the L3-L6 DRGs with high concentration in L4 DRG, and the labeled motor neurons located in the dorsolateral and intermediate regions of lamina IX from L3-L5 segments with high concentration at L4. Meanwhile, CGRP- positive neural labeling distributed symmetrically on both sides of DRGs, anterior and dorsal horns of spinal cord. In the AF594-CTB labeled neurons, 37% sensory neurons and 100% motor neurons expressed CGRP- positive. Conclusion： These findings present the morphological evidence to demonstrate that the sensory and motor neurons associated Zusanli in the rat distributed with segmental and regional patterns, and contained CGRP-expression.

Therapeutic observation on electroacupuncture at Zusanli(ST 36) and Fenglong(ST 40) for senile dementia

Objective： To explore the clinical effects of electroacupuncture（EA） at Zusanli（ST 36） and Fenglong（ST 40） in treating senile dementia. Methods： A total of 74 patients were randomly divided into an EA group and a medication group based upon the random digital table, 37 cases in each group. EA at Zusanli（ST 36） and Fenglong（ST 40） was given in the EA group, once every day, for six treatments per week. Donepezil Hydrochloride Tablets were given to the medication group, 5 mg per time and once a day in the former four weeks, 10 mg per time and once a day after 4 weeks, oral administration before sleep at night. The courses of the treatment were 12 weeks in both groups. The scores of mini-mental state examination（MMSE） and Barthel index（BI） were observed before and after the treatment, for processing the comparative analysis of the clinical effects after the course of the treatment. Results： The total effective rate was 86.5% in the EA group and 70.3% in the medication group. The therapeutic effect was better in the EA group than that in the medication group, and the difference between the two groups was statistically significant（P〈0.05）. MMSE and BI scores after the treatment in the two groups were all elevated than those of the same groups before the treatment（P〈0.05, P〈0.01）. The improving situation was obviously better in the EA group than that in the medication group, and the difference between the two groups was statistically significant（P〈0.05）. Conclusion： EA at Zusanli（ST 36） and Fenglong（ST 40） is affirmative in the therapeutic effect for senile dementia and can also improve the cognitive function and enhance the patients＇ quality of life.

Overview of researches on central action mechanism of needling Zusanli(ST 36)

The contents about the central action mechanisms of needling Zusanli（ST 36） were sorted by summarizing the relevant literatures published in the past 10 years, and it was found that： by comparing acupuncture at Zusanli（ST 36）, other acupoints or sham points, most studies showed that Zusanli（ST 36） had relatively specific characteristics in the brain function response; studies on the central action mechanisms of Zusanli（ST 36） were mainly focused on sequelae of cerebral apoplexy, pain, gastrointestinal diseases, weight loss and drug addiction withdrawal and so on; acupuncture manipulations, stimulation methods, individual differences, stimulation quantity, and stimulation duration, etc. could also induce different brain function responses; acupuncture at Zusanli（ST 36） had an after-working effect, also called long-term effect, but with poor repeatability. So, it was suggested that the future studies should focus on the factors that affect the clinical efficacies and experimental results, including the compatibility effects of the acupoints, reproducibility of research results, sample size, acupuncture methods, long-term effects and disease entities.

Effect of ear acupuncture plus injection at Zusanli(ST 36) on shoulder pain and cytokines after gynecologic laparoscopic surgery

Objective： To explore the clinical efficacy of ear acupuncture plus injection at Zusanli（ST 36） in treating shoulder pain after laparoscopic gynecological surgery, and to observe its effect on cytokines.Methods： Two hundred patients with shoulder pain after laparoscopic gynecological surgery were randomized into two groups based on their visiting sequence, 100 cases each. The observation group was intervened by ear acupuncture plus injection at Zusanli（ST 36）, and the control group was intervened by oral administration of Ibuprofen, 10 d as a treatment course. The clinical efficacies of the two groups were compared after 2 treatment courses; the visual analogue scale（VAS）,present pain intensity（PPI） and 36-item short-form health survey（SF-36） were measured before and after the treatment;the changes of interleukin（IL）-6 and IL-10 after the treatment were also observed.Results： The VAS and PPI scores were significantly changed after the treatment in both groups（both P〈0.01）. After the treatment, the VAS score in the observation group was significantly different from that in the control group（P〈0.05）. The component scores of SF-36 were significantly changed after the treatment in both groups（P〈0.01）; after the treatment, the scores of physical functioning（PF）, bodily pain（BP）, social functioning（SF）, and mental health（MH） in the observation group were significantly different from those in the control group（all P〈0.05）. The contents of IL-6 and IL-10 dropped significantly after the intervention in both groups（both P〈0.01）, and the between-group differences were also statistically significant（both P〈0.01）. The total effective rate of the observation group was higher than that of the control group（P〈0.05）.Conclusion： Ear acupuncture plus injection at Zusanli（ST 36） can significantly improve the shoulder pain after laparoscopic gynecological surgery, down-regulate the expressions of IL-6 and IL-10, and boost the recovery.