Hippocampal gene expression in a rat model of depression after electroacupuncture at the Baihui and Yintang acupoints

Preliminary basic research and clinical findings have demonstrated that electroacupuncture ther- apy exhibits positive effects in ameliorating depression. However, most studies of the underlying mechanism are at the single gene level; there are few reports regarding the mechanism at the whole-genome level. Using a rat genomic gene-chip, we profiled hippocampal gene expression changes in rats after electroacupuncture therapy. Electroacupuncture therapy alleviated depres- sion-related manifestations in the model rats. Using gene-chip analysis, we demonstrated that electroacupuncture at Baihui （DU20） and Yintang （EX-HN3） regulates the expression of 21 genes. Real-time PCR showed that the genes Vgf, lgf2, Trnp32, Loc500373, Hifla, Folrl, Nrnb, and Rtn were upregulated or downregulated in depression and that their expression tended to nor- malize after electroacupuncture therapy. These results indicate that electroacupuncture at Baihui and Yintang modulates depression by regulating the expression of particular genes.

Acupuncture through Baihui (DU20) to Qubin (GB7) mitigates neurological impairment after intracerebral hemorrhage

Inflammation plays an important role in nerve defects caused by intracerebral hemorrhage. Repairing brain damage by inhibiting the macrophage-inducible C-type lectin/spleen tyrosine kinase （Mincle/Syk） signaling pathway is a potential new target for treating cerebral hemorrhage. In this study, we aimed to determine whether acupuncture through Baihui （DU20） to Qubin （GBT） is an effective treatment for intracerebral hemorrhage through the Mincle/Syk signaling pathway. An intracerebral hemorrhage rat model was established by autol- ogous blood infusion into the caudate nucleus. Acupuncture through Baihui to Qubin was performed for 30 minutes, once every 12 hours, for a total of three times. Piceatannol （34.62 mg/kg）, a Syk inhibitor, was intraperitoneally injected as a control. Modified neurological severity score was used to assess neurological function. Brain water content was measured. Immunohistochemistry and western blot assay were used to detect immunoreactivity and protein expression levels of Minde, Syk, and CARD9. Real-time polymerase chain reaction was used to determine interleukin-1[~ mRNA levels. Hematoxylin-eosin staining was performed to observe histopathological changes. Our re- suits showed that acupuncture through Baihui to Qubin remarkably improved neurological function and brain water content, and inhibited immunoreactivity and expression of Mincle, Syk, CARDg, and interkeukin-1β Moreover, this effect was similar to piceatannol. These find- ings suggest that acupuncture through Baihui to Qubin can improve neurological impairment after cerebral hemorrhage by inhibiting the Mincle/Syk signaling pathway.

Scalp electroacupuncture at the Baihui acupoint (DU 20) improves functional recovery in rats with cerebral ischemia Association with increased expression of vascular endothelial growth factors

In this study, we induced cerebral infarction in rats by occluding the right middle cerebral artery, and tested the effects of electroacupuncture at the Baihui acupoint （DU 20）. Motor and sensory function was tested using Garcia’s scale and motor weakness grading, and the expression of vascular endothelial growth factor in the brain was quantified using immunoblotting and immunohistochemistry. We found that scalp electroacupuncture at DU 20 significantly improved motor performance and sensory function in rats with stroke, and this was accompanied by an increased expression of vascular endothelial growth factor in the ischemic brain tissue and peri-ischemic area. In addition, Pearson correlation analysis showed that the improvements in functional recovery were correlated with the increased expression of vascular endothelial growth factor.

CLINICAL OBSERVATION ON TREATMENT OF CHILD CEREBRAL PALSY WITH PENETRATION NEEDLING FROM SISHENCONG TO BAIHUI POINT

This study is designed to observe the therapeutic effect of penetrating needling Sishencong (EX-HN1 ) through to Baihui (GV 20), etc.. A total of 100 cases of infantile cerebral palsy were divided into acupuncture group (n = 50) and control group (n = 50, oral administration of cerebrolysin). After 3-4 courses of treatment, results showed that the total effective rates of acupuncture group and control group were 84. 0% and 48. 0 % respectively. Comparison between two groups in the effective rate showed a significant difference (P < 0.05 ), suggesting that the therapeutic effect of acupuncture stimulation is superior to that of Western medicine in treatment of child cerebral palsy.

CLINICAL OBSERVATION ON 32 CASES OF FUNCTIONAL ENURESIS TREATED WITH ACUPUNCTURE AT BAIHUI(GV 20)

Acupuncture at Baihui（GV 20）was employed in treating 32 cases of functionalenuresis.As a result,the curative rate reached 81.25％,but that in control group of 32 cases withoutneedling Baihui point was 56.25％.There was a significant difference in statistics（P【0.05）.It indi- cates that Baihui can enhance the therapeutic effect of acupuncture on treating enuresis.

EXPERIENCE OF CLINICAL APPLICATION OF BAIHUI(GV 20) POINT

Baihui (GV 20) point can treat many diseases, especially, Qi deficiency and Yang insufficiency in chronic, consumptive and intractable diseases, most achieving good therapeutic effects.The authors have treated epilepsy, deafness, blepharoptosis, etc. difficult and complicated miscellaneousdiseases mainly using Baihui point combined with other adjuvant points, attaining better results. Intreatment of epilepsy with Baihui point, reinforcing method was used at the resting stage, strengthening the body resistance to consolidate the constitution, promoting Yang function and removing obstruction of the Dumai, and the reducing method was used at the stage of attack, relieving convulsion andspasm, and inducing resuscitation for treating both the principal and the secondary aspects of the disease at the same time. In acupuncture treatment of deafness with reinforcing method, regulating Qi toreach the ear, supplementing Qi and replenishing essence, nourishing the orifices and improving thefaculty of hearing. As treatment of blepharoptosis with Baihui point, it has the function of supplementing Qi to sending up. Both reinforcing and reducing methods can be used for acupuncture at Baihuipoint, but reinforcing method is more used. The authors often use needle inserting method by pinchingthe skin, with twirling manipulation, and experiencing the needling sensation by the right hand, so thatQi can rapidly reach the diseased part.

A Comparative Study on the Acupoints of Specialty of Baihui, Shuigou and Shenmen in Treating Vascular Dementia

Objective： To study the relative specialty of the acupoints of Baihui （DU20）, Shuigou （DU26） and Shenmen （HTT） in treating vascular dementia （VD）. Methods： Fifty patients suffering from VD were divided into 5 groups randomly and treated by conventional acupuncture for hemiplegia, or conventional acupuncture plus needling in DU20, DU26, HT7 respectively or simultaneously. Clinical symptoms were observed, and the scales such as Hasegawa＇s dementia scale-recension （HDS-R）, activities of daily living （ADL） and functional activities questionnaire （FAQ） were used for assessment before and after acupuncture treatment. The scores were processed statistically. Results： DU20 and HT7 could improve the abilities of memory, orientation, reaction and reduce adamancy and trance. Bedsides, DU 20 was helpful in improving the abilities of understanding, calculating and social adapting. While DU26 is helpful in treating retardation, failure in daily activities, trance and poor memory. The combination of the 3 acupoints could improve the intelligence and social adapting ability of VD patients. Conclusion： DU20, DU26 and HT7 had its own effect in treating VD, but the effect of three points used in combination was the best.

Electroacupuncture at Baihui (DU20) acupoint upregulates mRNA expression of NeuroD molecules in the brains of newborn rats suffering in utero fetal distress

Neuro D plays a key regulatory effect on differentiation of neural stem cells into mature neurons in the brain.Thus,we assumed that electroacupuncture at Baihui（DU20） acupoint in newborn rats exposed to in utero fetal distress would influence expression of Neuro D.Electroacupuncture at Baihui was performed for 20 minutes on 3-day-old（Day 3） newborn Sprague-Dawley rats exposed to in utero fetal distress;electroacupuncture parameters consisted of sparse and dense waves at a frequency of 2–10 Hz.Real-time fluorescent quantitative PCR results demonstrated that m RNA expression of Neuro D,a molecule that indicates Neuro D,increased with prolonged time in brains of newborn rats,and peaked on Day 22.The level of m RNA expression was similar between Day 16 and Day 35.These findings suggest that electro acupuncture at Baihui acupoint could effectively increase m RNA expression of molecules involved in Neuro D in the brains of newborn rats exposed to in utero fetal distress.

Clinical Application of the Point Baihui

The authors of this article have successfully treated various cases of urinary dysfunction by means of acupuncture. Some of the cases are reported in the following.

A COMPARATIVE STUDY ON THE TREATMENT OF VASCULAR DEMENTIA BY PUNCTURING BAIHUI (GV20), SHUIGOU (GV26) AND SHENMEN (HT7)

Objective: To observe the relative specialty of the therapeutic effect of acupuncture of Baihui (百会 GV 20), Shuigou (水沟 GV 26) a nd Shenmen (神门 HT 7) in the treatment of vascular dementia (VD) patients. Methods: F ifty VD patients were randomly divided into routine treatment group (control gro up), Baihui (GV 20) group (GV 20 group), Shuigou (GV 26) group (GV 26 gr oup), Shenmen (HT 7) group (HT 7 group) a nd GV 20+GV 26+HT 7 group (joint treatment group), with 10 cases in ea ch group. In control group, acupoints used were Jianyu (肩NFDA1 LI 15), Quchi (曲池 L I 11), Waiguan (外关 TE 5), etc. (which were also used in the other four groups) on the paralyzed side. The treatment was conducted once a day except weekends, 20 session s all together. Clinical Dementia Rating Scale (CDR), Mini-Mental State Examin at ion (MMSE) test, Blessed Dementia Rating Scale (BDR) and Clinical Neurological D eficit Rating (CNDR) were used to assess the patients’ intelligence state befor e and after acupuncture treatment. Results: After acupuncture tr eatment, the VD patients’ intelligence in all the five groups was improved at different degrees . Additional acupuncture of each of GV 20, GV 26 and HT 7 had a remarkable e ffec t in improving the VD patients’ fluid intelligence, and could obviously promote their abilities of temporal orientation, spatial orientation and figure drawing ; and additional joint acupuncture of the three acupoints could improve their co gnitive and non-cognitive functions, such as reducing the severity of dementia , raising the temporal orientation, spatial orientation, calculation, short-term m emory and figure drawing abilities, and improving their activities of daily livi ng and personality. Besides, acupuncture of GV 20 could improve the abilities of calculation and short term memory, and correct the personality change of VD pat ients, while acupuncture of GV 26 could improve the abilities of naming and sh or t-term memory. Conclusion: Acupuncture of GV 20, GV 26 and HT 7 all had a certai n therapeutic effect in improving VD; the therapeutic effects of acupuncture of GV 20 and GV 26 were better than that of acupuncture of HT 7; and the effica cy of the three points used in combination was the best.

Clinical Effect of Electroacupuncture Baihui and Neiguan Acupoint on Cognitive Function Recovery in Elderly Patients after General Anesthesia

Objective:To study and analyze the clinical effect of electroacupuncture at Baihui and Neiguan Points on cognitive function recovery of elderly patients after general anesthesia.Methods:The subjects were 80 elderly patients who received general anesthesia from January 2019 to February 2021.According to different anesthesia methods,they were divided into research group(electroacupuncture at Baihui and Neiguan combined with conventional drug anesthesia)and control group(simple drug anesthesia).The postoperative cognitive function recovery of the two groups was observed and compared.Results:Compared with the control group,the MMSE score and POCD incidence of research group were significantly better.There was significant difference between the two groups(P<0.05).Conclusion:Conclusion electroacupuncture at Baihui and Neiguan combined with conventional drug anesthesia can promote the recovery of cognitive function and prevent cognitive dysfunction in elderly patients under general anesthesia.

Forty Cases of Insomnia Treated by Suspended Moxibustion at Baihui (GV 20)

Objective： To observe the therapeutic effect of suspended moxibustion at Baihui （GV 20） for insomnia. Methods： 75 cases were divided randomly into two groups, with 40 cases in the treatment group treated by suspended moxibustion over Baihui （GV 20） and 35 cases in the control group treated by oral administration of Estazolam. Results： The difference in therapeutic effect between the two groups was not statistically significant （P〉0.1）. Conelusion： It was concluded that suspended moxibustion at Baihui （GV 20） is as effective as Estazolam for insomnia.

Effect of electroacupuncture at Neiguan(PC 6) and Baihui(GV 20) on CHOP and caspase-12 gene expressions in rats after ischemia-reperfusion injury

Objective： To investigate the effects of electroacupuncture （EA） at Neiguan （PC 6） and Baihui （GV 20） by observing the changes of CCAAT/enhancer-binding protein（C/EBP） homologous protein （CHOP） and caspase-12 gene expressions in rats after cerebral ischemia-reperfusion injury （IRI）, and explore whether the apoptosis pathway of endoplasmic reticulum stress （ERS） is involved in the protective mechanisms of EA. Methods： Sixty rats were randomly assigned to five groups （12 in each group）： a normal control group （group A）, a sham-operation group （group B）, an operation group （group C）, an Edaravone group （group D） and an EA group （group E）. The cerebral IRI rat model was induced by middle cerebral artery occlusion （MCAO） using intraluminal monofilament. 2,3,5-triphenyl tetrazolium chloride （TTC） staining was adopted in the measurement of cerebral infarction volume. Real-time polymerase chain reaction （RT-PCR） was used to determine the mRNA expressions of CHOP and caspase-12. Results： Compared with group A and group B, the volume of cerebral infarction and mRNA expressions of CHOP and caspase-12 in group C, group D and group E were increased, with statistical significances （P〈0.05 or P〈O.01）; compared with group C, the volume of cerebral infarction and mRNA expressions of CHOP and caspase-12 in group D and group E were decreased significantly （P〈0.05 or P〈0.01）; there were no significant differences between group D and group E in comparing the above items （P〉0.05）. Conclusion： EA at Neiguan （PC 6） and Baihui （GV 20） can effectively suppress the volume of cerebral infarction. Furthermore, the underlying mechanism of EA at Neiguan （PC 6） and Baihui （GV 20） is possibly related to the down-regulation of CHOP and caspase-12 mRNA expressions, so as to decrease cell apoptosis.

Effect of long-time needle retaining at Baihui(GV 20) on cognitive impairment in post-stroke patients

Objective： To observe the clinical efficacy of long-time needle retaining at Baihui（GV 20） in treating post-stroke cognitive impairment. Methods： A total of 60 eligible patients with post-stroke cognitive impairment were randomized into a treatment group and a control group by random digital table, 30 cases in each group. The control group was intervened by basic treatment including routine therapy in Neurology department and Western medicine rehabilitation therapy, while the treatment group was intervened by same treatment in the control group combined with long-time needle retaining at Baihui（GV 20）. Mental state of patients was evaluated by National Institute of Health stroke scale（NIHSS） and mini-mental state examination（MMSE） after 4 weeks of treatment. Results： After 4-week treatment, the NIHSS score dropped in both groups, and intra-group comparisons showed statistical significances（both P〈0.05）, and the score in the treatment group was statistically lower than that in the control group（P〈0.01）; the MMSE score in the treatment group was significantly higher than that in the control group, there was a statistical inter-group difference（P〈0.01）; the total effective rate was 93.3%, and the marked effective rate was 50.0% in the treatment group, versus 76.7% and 20.0% in the control group, there were significant differences in the total effective rate and the marked effective rate between the two groups（all P〈0.05）. Conclusion： Long-time needle retaining at Baihui（GV 20） can produce a safe valid therapeutic efficacy in treating post-stroke cognitive impairment.

Clinical Observation on Suspended Moxibustion at Baihui （GV 20） for Insomnia

Insomnia is a common disease with frequently disturbed sleep which can strongly influence the patients＇ daily life, work and study, so it should be treated as early as possible. A more effective and less harmful therapy was recently sought by the clinical researchers due to serious side-effects of drugs. The author treated insomnia with suspended moxibustion at Baihui （GV 20）, the report is as follows.

Clinical Applications of Acupoints Baihui （GV 20） and Sishencong （Ex-HN 1）

Through clinical practice over the last decade, , I have been using Baihui （GV 20） and Sishencong （Ex-HN 1） for treating various diseases or symptoms. It is now reported as follows.

Clinical observation on moxibustion at Baihui(GV20)plus Tuina for children with postnasal drip syndrome

Objective:To observe the clinical efficacy of moxibustion at Baihui(GV20)plus Tuina(Chinese therapeutic massage)for children with postnasal drip syndrome(PNDS).Methods:A total of 60 cases were divided into an observation group and a control group according to the random number table method,with 30 cases in each group.Cases in the control group received mometasone furoate nasal spray and nasal irrigation with 0.9%normal saline.Cases in the observation group received additional moxibustion at Baihui(GV20)plus Tuina at the head and face.All the cases were treated for four consecutive weeks.The clinical efficacy and traditional Chinese medicine(TCM)symptoms score were compared between the two groups.Results:The total effective rate of the observation group was 93.3%while that of the control group was 70.0%.The difference between the two groups was statistically significant(P<0.05).After treatment,the TCM symptom scores in both groups declined significantly,showing a statistical difference from that before treatment(P<0.05),and the score of the observation group was notably lower than that of the control group(P<0.05).Conclusion:The clinical efficacy of moxibustion at Baihui(GV20)plus Tuina at the head and face on the basis of nasal spray with Western medicine is more significant than that of Western medicine alone for PNDS in children.

基于功能影像学探讨百会治疗失眠的中枢机制

百会为治疗失眠的效穴,临床使用频率高。功能影像学,广义上包括多种成像技术,狭义主要指功能性磁共振成像(fMRI),数据分析方法分为功能分离和功能整合两类,试验设计方案包括任务态(Tb-fMRI)与静息态(Rs-fMRI),静息态因操作简便且能直观反映针刺持续和累积效应而被广泛应用。多项fMRI研究表明,失眠患者在视觉区、感觉运动区、情绪相关脑区等存在局部功能异常,针刺百会单穴或组穴可引起特定脑区如顶叶、额叶、颞叶等的改变,从而改善睡眠。针刺单穴百会主要集中在Rs-fMRI局部一致性(ReHo)、比率低频振幅(fALFF)研究,而针刺百会组穴研究从Rs-fMRI局部一致性(ReHo)、度中心度(DC)、种子连接(FC),以及Tb-fMRI比率低频振幅(fALFF)等方面展开,研究发现不同研究方法和穴位组合下的脑区激活改变存在差异,且针刺百会组穴所调控脑区多于单穴针刺,体现了百会对失眠、认知和情绪的调节作用以及腧穴间的协同作用。然而,针刺百会引起的中枢信号改变复杂,功能影像作为评估失眠的中枢指标虽有潜力,但仍需更规范、深入的研究。

百会穴久留针法改善缺血性脑卒中小鼠神经功能的作用及机制

目的研究百会穴久留针法通过脑源性神经营养因子(BDNF)/酪氨酸受体激酶B(TrkB)通路改善缺血性脑卒中小鼠神经功能的作用及机制。方法选择雄性C57BL/6J小鼠48只,随机分为假手术1组、模型1组、久留针1组、普通留针组,每组12只。后3组采用线栓法制备缺血性脑卒中模型,手术造模后第1天起久留针1组和普通留针组分别给予百会穴久留针和普通留针治疗,连续14 d。另选择雄性C57BL/6J小鼠40只,随机分为假手术2组、模型2组、久留针2组、久留针3组,每组10只。后3组采用线栓法制备缺血性脑卒中模型,针灸治疗前分别给予腺相关病毒100μl单次尾静脉注射。采用改良神经功能缺损评分(mNSS)及水迷宫实验的逃避潜伏期、目标象限停留时间、穿越原平台次数评价神经功能。结果与假手术1组比较,模型1组mNSS评分、目标象限停留时间、穿越原平台次数及缺血脑组织BDNF、TrkB表达明显降低,细胞凋亡率及裂解型半胱氨酸天冬氨酸蛋白酶3(Caspase-3)表达明显增加,差异有统计学意义(P<0.05);与模型1组比较,久留针1组和普通留针组mNSS评分、目标象限停留时间、穿越原平台次数及缺血脑组织BDNF、TrkB表达明显增加,细胞凋亡率及裂解型Caspase-3表达明显降低,且久留针1组上述变化较普通留针组更为显著,差异有统计学意义(P<0.05)。与久留针2组比较,久留针3组mNSS评分、目标象限停留时间、穿越原平台次数及缺血脑组织中BDNF表达明显降低(P<0.05),细胞凋亡率及裂解型Caspase-3表达明显增加[(16.41±2.25)%vs(7.59±1.09)%;1.46±0.16 vs 0.94±0.12,P<0.05]。结论百会穴久留针治疗对缺血性脑卒中小鼠神经功能的改善作用更为显著,激活BDNF/TrkB通路是其发挥神经保护作用的相关分子机制。

复健方联合泛髓组穴治疗急性缺血性脑卒中运动功能障碍患者的疗效观察

目的 系统评价复健方联合泛髓组穴对急性缺血性脑卒中患者运动功能恢复的临床疗效。方法 90例急性期缺血性脑卒中后运动功能障碍患者随机分为对照组(n=30)、复健方组(n=30)和针药益髓法组(n=30)。对照组予以常规治疗,在对照组基础上,复健方组加用中药复健方汤剂,针药益髓法组在复健方组的基础上加刺泛髓组穴。比较3组患者FMA评分、NIHSS评分、Barthel指数、中医证候评分及神经营养因子(BDNF)水平。结果 各组患者FMA评分、Barthel指数均较治疗前升高(P<0.01),FMA分值复健方组高于对照组(P<0.05),针药益髓法组高于复健方组(P<0.05)且明显高于对照组(P<0.01),Barthel指数针药益髓法组高于对照组(P<0.01),NIHSS评分、中医证候积分均较治疗前降低(P<0.01),NIHSS评分复健方组低于对照组(P<0.05),针药益髓法组低于复健方组(P<0.05)且明显低于对照组(P<0.01),中医证候积分针药益髓法组优于对照组(P<0.01),针药益髓法组总有效率为93.3%,高于对照组的76.7%(P<0.01)。血清BDNF值均较治疗前升高(P<0.05),针药益髓法组高于对照组(P<0.05)。结论 针药结合益髓法可有效促进缺血性脑卒中偏瘫患者肢体运动功能恢复。