Transcutaneous electrical acupoint stimulation in adult patients receiving gastrectomy/colorectal resection:A randomized controlled trial

BACKGROUND Acupuncture promotes the recovery of gastrointestinal function and provides analgesia after major abdominal surgery.The effects of transcutaneous electrical acupoint stimulation(TEAS)remain unclear.AIM To explore the potential effects of TEAS on the recovery of gastrointestinal function after gastrectomy and colorectal resection.METHODS Patients scheduled for gastrectomy or colorectal resection were randomized at a 2:3:3:2 ratio to receive:(1)TEAS at maximum tolerable current for 30 min immediately prior to anesthesia induction and for the entire duration of surgery,plus two 30-min daily sessions for 3 consecutive days after surgery(perioperative TEAS group);(2)Preoperative and intraoperative TEAS only;(3)Preoperative and postoperative TEAS only;or(4)Sham stimulation.The primary outcome was the time from the end of surgery to the first bowel sound.RESULTS In total,441 patients were randomized;405 patients(58.4±10.2 years of age;247 males)received the planned surgery.The time to the first bowel sounds did not differ among the four groups(P=0.90;log-rank test).On postoperative day 1,the rest pain scores differed significantly among the four groups(P=0.04;Kruskal–Wallis test).Post hoc comparison using the Bonferroni test showed lower pain scores in the perioperative TEAS group(1.4±1.2)than in the sham sti-mulation group(1.7±1.1;P=0.04).Surgical complications did not differ among the four groups.CONCLUSION TEAS provided analgesic effects in adult patients undergoing major abdominal surgery,and it can be added to clinical practice as a means of accelerating postoperative rehabilitation of these patients.

Silencing miRNA-324-3p protects against cerebral ischemic injury via regulation of the GATA2/A1R axis

Previous studies have suggested that miR-324-3p is related to the pathophysiology of cerebral ischemia,but the mechanism underlying this relationship is unclea r.In this study,we found that miR-324-3p expression was decreased in patients with acute ischemic stroke and in in vitro and in vivo models of ischemic stro ke.miR-324-3p agomir potentiated ischemic brain damage in rats subjected to middle cerebral artery occlusion,as indicated by increased infarct volumes and cell apoptosis rates and greater neurological deficits.In a PC12 cell oxygen-glucose deprivation/reoxygenation model,a miR-324-3 p mimic decreased cell viability and expression of the anti-apoptotic protein BCL2 and increased expression of the pro-apoptotic protein BAX and rates of cell apoptosis,whereas treatment with a miR-324-3p inhibitor had the opposite effects.Silencing miR-324-3p increased adenosine A1 receptor(A1R)expression thro ugh regulation of GATA binding protein 2(GATA2).These findings suggest that silencing miR-324-3p reduces ischemic brain damage via the GATA2/A1R axis.

Electroacupuncture-induced neuroprotection against focal cerebral ischemia in the rat is mediated by adenosine A1 receptors

The activation of adenosine A1 receptors is important for protecting against ischemic brain injury and pretreatment with electroacupuncture has been shown to mitigate ischemic brain insult. The aim of this study was to test whether the adenosine A1 receptor mediates electroacupuncture pretreatment-induced neuroprotection against ischemic brain injury. We first performed 30 minutes of electroacupuncture pretreatment at the Baihui acupoint（GV20）, delivered with a current of 1 mA, a frequency of 2/15 Hz, and a depth of 1 mm. High-performance liquid chromatography found that adenosine triphosphate and adenosine levels peaked in the cerebral cortex at 15 minutes and 120 minutes after electroacupuncture pretreatment, respectively. We further examined the effect of 15 or 120 minutes electroacupuncture treatment on ischemic brain injury in a rat middle cerebral artery-occlusion model. We found that at 24 hours reperfusion,120 minutes after electroacupuncture pretreatment, but not for 15 minutes, significantly reduced behavioral deficits and infarct volumes. Last, we demonstrated that the protective effect gained by 120 minutes after electroacupuncture treatment before ischemic injury was abolished by pretreatment with the A1-receptor antagonist 8-cyclopentyl-1,3-dipropylxanthine（1 mg/kg, intraperitoneally）. Our results suggest that pretreatment with electroacupuncture at the Baihui acupoint elicits protection against transient cerebral ischemia via action at adenosine A1 receptors.