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.

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.

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.

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。

针刺百会、曲鬓穴对急性期脑出血大鼠的影响及其作用机制研究

目的 观察针刺百会、曲鬓穴对急性期脑出血(ICH)大鼠白细胞分化抗原36(CD36)、Toll样受体4(TLR4)表达的影响,探讨针刺治疗脑出血的作用机制。方法 选择144只Wistar雄性大鼠,采用随机数字表法分为假手术组、模型组、针刺组、抑制剂组4组,每组36只,每组按1、3、7 d时间点再分为3个亚组,每组12只。采用立体定位自体血注入法建立ICH大鼠模型。模型组仅接受ICH模型制备,不进行任何治疗;假手术组接受类似模型组各项手术操作,但不进行注血制作;抑制剂组造模后6 h,腹腔注射TLR4抑制剂TAK242,3 mg/kg,1次/d,连续5 d;造模12 h后,针刺组各亚组开始接受针刺治疗,穴位选择百会穴(顶骨正中)、右侧曲鬓穴,采用透刺方法,进针深度20 mm,以100 r/min小幅度捻转,持续捻转2 min,每间隔5 min捻针1次,共留针30 min,期间捻转3次,1次/d,针刺组各亚组分别治疗1、3、7 d。分别于治疗后第1、3、7天,采用改良神经功能缺损评分(mNSS)评估大鼠神经功能;检测脑组织血肿体积;采用Western blot法检测脑组织CD36、TLR4蛋白表达水平;采用免疫荧光法观察CD36、TLR4在星形胶质细胞中的表达。结果 (1) mNSS评分:与假手术组同一时间点比较,模型组、针刺组、抑制剂组治疗后1、3、7 d mNSS评分均明显升高(P<0.05);与模型组同一时间点比较,针刺组、抑制剂组治疗后1、3、7 d mNSS评分均明显降低(P<0.05);与针刺组同一时间点比较,抑制剂组治疗后1 d mNSS评分明显降低(P<0.05)。(2)血肿体积:与模型组同一时间点比较,针刺组、抑制剂组治疗后3、7 d脑血肿体积均明显降低,抑制剂组治疗后1、3、7 d脑血肿体积明显降低(P<0.05);与针刺组同一时间点比较,抑制剂组治疗后1、3、7 d脑血肿体积明显降低(P<0.05)。(3) CD36、TLR4蛋白表达水平:与假手术组同一时间点比较,模型组、针刺组、抑制剂组治疗后1、3、7 d CD36、TLR4蛋白表达水平均明显升高(P<0.05);与模型组同一时间点比较,针刺组、抑制剂组治疗后1、3、7 d CD36蛋白表达水平均明显升高(P<0.05),针刺组、抑制剂组治疗后3、7 d TLR4蛋白表达水平均明显降低(P<0.05);与针刺组比较,抑制剂组治疗后1、3、7 d CD36蛋白表达水平均明显升高,TLR4蛋白表达水平均明显降低(P<0.05)。(4) CD36、TLR4在GFAP中的表达水平:假手术组大鼠脑组织内可见少量CD36、TLR4表达。与假手术组同一时间点比较,模型组治疗后1、3、7 d CD36、TLR4在GFAP表达均明显增加(P<0.05);与模型组同一时间点比较,抑制剂组、针刺组治疗后1、3、7 d CD36在GFAP表达明显增加,TLR4在GFAP表达明显降低(P<0.05)。结论 针刺百会、曲鬓穴可以改善急性期ICH大鼠神经功能,减轻脑出血血肿体积,可能与促进CD36蛋白表达、抑制TLR4蛋白表达有关。

电针预处理对大鼠脑缺血再灌注后小胶质细胞极化的影响

目的探讨电针预处理对大鼠脑缺血再灌注(IR)后小胶质细胞极化的影响以及与酪氨酸激酶2(JAK2)/信号传导及转录活化因子3(STAT3)通路的关系。方法选择健康清洁级雄性SD大鼠45只,随机分为假手术组、IR组和电针组,每组15只。IR组采用线栓法建立大鼠IR损伤模型,电针组造模前连续5 d行电针刺激百会穴,假手术组仅暴露颈部血管。再灌注后24 h,采用改良神经功能缺损评分(mNSS)观察各组大鼠神经功能损伤程度,氯化三苯四氮唑染色观察脑梗死体积,Western blot检测经典激活型(M1)标志物诱导型一氧化氮合酶(iNOS)和替代激活型(M2)标志物精氨酸酶1(Arg-1)、磷酸化JAK2、JAK2、磷酸化STAT3及STAT3蛋白表达,定量聚合酶链反应检测M1标志物iNOS mRNA和M2标志物Arg-1 mRNA表达,检测肿瘤坏死因子α(TNF-α)、白细胞介素10(IL-10)表达。结果与假手术组比较,IR组和电针组mNSS、脑梗死体积、磷酸化JAK2/JAK2、磷酸化STAT3/STAT3、iNOS蛋白、iNOS mRNA、Arg-1蛋白、Arg-1 mRNA、TNF-α和IL-10表达明显升高,差异有统计学意义(P<0.01)。与IR组比较,电针组mNSS、脑梗死体积、磷酸化JAK2/JAK2、磷酸化STAT3/STAT3、iNOS蛋白、iNOS mRNA、TNF-α表达明显降低(P<0.01),Arg-1蛋白、Arg-1 mRNA、IL-10表达明显升高[2.0±0.2 vs 1.5±0.1,4.2±0.8 vs 3.1±0.3,(49.1±7.1)pg/mg vs(27.9±5.9)pg/mg,P<0.01]。结论电针预处理可促进脑IR后小胶质细胞向M2极化,抑制向M1极化,其机制可能与抑制JAK2/STAT3通路有关。

针灸刺激百会、足三里穴缓解小鼠抑郁样行为与肠道菌群的关联

目的探究针灸百会、足三里穴对慢性温和刺激(chronic unpredictable mild stress,CUMS)诱发抑郁样行为小鼠的抗抑郁效应及其与肠道菌群变化的关联。方法60只小鼠随机分为:对照组、对照+针灸组、CUMS组和CUMS+针灸组。CUMS和CUMS+针灸组进行为期6周的CUMS处理,CUMS处理的后3周对对照+针灸组和CUMS+针灸组小鼠每天进行20 min的百会和足三里穴针灸;使用糖水偏爱和悬尾实验评估小鼠的抑郁样行为;行为结束后取小鼠粪便使用16S rRNA基因测序检测肠道菌群组成。结果单纯针灸对小鼠糖水偏爱和悬尾实验不动时间无影响(P>0.05);CUMS导致小鼠出现抑郁样行为,糖水偏爱率降低(P<0.001)和悬尾不动时间增长(P=0.003);针灸百会和足三里穴使得CUMS+针灸组小鼠相比于CUMS组小鼠糖水偏爱率升高(P=0.035)和悬尾不动时间减少(P=0.045);针灸和CUMS并未导致小鼠肠道菌群丰富度发生变化(P>0.05),但导致肠道菌群组成发生显著变化(P=0.002);CUMS导致肠道Patulibacter等6个菌属丰度升高,Faecalibacterium等26个菌属丰度降低(P<0.05);CUMS+针灸组相比于CUMS组Faecalibacterium等10个菌属丰度升高,Patulibacter等4个菌属丰度降低(P<0.05);四组小鼠有其各自的特征性肠道菌群;CUMS组相比于对照组视黄醇代谢、泛素系统、N-聚糖生物合成和类固醇荷尔蒙生物合成、细胞凋亡和产热作用等基因功能显著富集(P<0.05),而针灸导致CUMS+针灸组小鼠以上肠道菌群基因功能富集程度降低(P<0.05)。结论针灸百会和足三里穴具有抗抑郁效应,且可使抑郁导致的肠道菌群紊乱部分恢复;针灸百会和足三里穴可能通过影响肠道菌群组成及视黄醇、泛素、N-聚糖和类固醇等代谢功能从而发挥抗抑郁效应。

电针对术后认知功能障碍模型大鼠炎症反应和铁死亡影响的研究

背景术后认知功能障碍(POCD)是增加患者术后发病率和死亡率的重要原因之一。炎症反应和铁死亡是POCD发生的重要机制假说,而电针改善POCD患者学习和记忆功能机制尚不明确。目的观察电针对老年POCD大鼠学习记忆及炎性细胞因子和海马神经元铁死亡的影响,探讨电针改善POCD的作用机制。方法2022年1月—2023年2月选取18~20月龄SD大鼠72只,按照随机数字表法分为3组:对照组(n=24)、模型组(n=24)和电针组(n=24)。根据术后3、7 d两个观察时间点将每组大鼠分为2个亚组(对照组术后3 d亚组、对照组术后7 d亚组,模型组术后3 d亚组、模型组术后7 d亚组,电针组术后3 d亚组、电针组术后7 d亚组),每组12只。采用剖腹探查手术建立POCD模型,选取电针组大鼠百会穴和内关穴进行电针刺激。采用Morris水迷宫装置检测大鼠行为学表现,酶联免疫吸附试验检测血清、海马中白介素(IL)6、IL-10、肿瘤坏死因子α(TNF-α)的水平,海马组织脂质过氧化物(LPO)、Fe^(2+),免疫印迹法检测海马酰基辅酶A合成酶长链家族成员4(ACSL4)、铁蛋白重链1(FTH1)、血磷脂酰胆碱酰基转移酶3(LPCAT3)蛋白表达水平。采用透射电镜观察海马区神经细胞超微结构。结果术后3、7 d大鼠组别与时间对大鼠术前认知功能训练逃避潜伏期均不存在交互作用(P_(交互)>0.05),训练时间对逃避潜伏期主效应均显著(P_(时间)<0.05),组别对逃避潜伏期主效应均不显著(P_(组间)>0.05)。模型组术后3 d亚组逃避潜伏期高于对照组术后3 d亚组、电针组术后3 d亚组,穿越平台次数、目标象限停留时间低于对照组术后3 d亚组、电针组术后3 d亚组,电针组术后3 d亚组穿越平台次数低于对照组术后3 d亚组(P<0.05)。模型组术后7 d亚组逃避潜伏期高于对照组术后7 d亚组、电针组术后7 d亚组,穿越平台次数低于对照组术后7 d亚组,目标象限停留时间低于对照组术后7 d亚组、电针组术后7 d亚组(P<0.05)。模型组术后3 d亚组血清IL-6、TNF-α高于对照组术后3 d亚组、电针组术后3 d亚组,电针组术后3 d亚组TNF-α高于对照组术后3 d亚组,IL-10高于对照组术后3 d亚组、模型组术后3 d亚组(P<0.05)。模型组术后7 d亚组血清IL-6高于对照组术后7 d亚组,TNF-α高于对照组术后7 d亚组、电针组术后7 d亚组,电针组术后7 d亚组IL-10高于对照组术后7 d亚组、模型组术后7 d亚组(P<0.05)。模型组术后3 d亚组海马IL-6、TNF-α高于对照组术后3 d亚组、电针组术后3 d亚组,电针组术后3 d亚组IL-6、TNF-α高于对照组术后3 d亚组,IL-10高于对照组术后3 d亚组、模型组术后3 d亚组(P<0.05)。模型组术后7 d亚组海马IL-6、TNF-α高于对照组术后7 d亚组、电针组术后7 d亚组,电针组术后7 d亚组IL-10高于对照组术后7 d亚组、模型组术后7 d亚组(P<0.05)。模型组术后3 d亚组Fe^(2+)、LPO、ACSL4、LPCAT3高于对照组术后3 d亚组、电针组术后3 d亚组,电针组术后3 d亚组高于对照组术后3 d亚组,模型组术后3 d亚组FTH1低于对照组术后3 d亚组、电针组术后3 d亚组,电针组术后3 d亚组低于对照组术后3 d亚组(P<0.05)。模型组术后7 d亚组Fe^(2+)、LPO、ACSL4、LPCAT3高于对照组术后7 d亚组、电针组术后7 d亚组,FTH1低于术后7 d亚组、电针组术后7 d亚组(P<0.05)。模型组术后3、7 d亚组海马组织视野内细胞核双核膜结构清晰,核周隙未见明显增宽,形态不规则,表面凹凸不平;核内染色质浓缩边集;胞质内少量线粒体膜破裂,膜结构消失;部分内质网明显扩张;并可见部分髓鞘断裂,排列紊乱;电针组术后3、7 d亚组较模型组明显改善。结论炎性细胞因子失衡和神经元铁死亡可能是POCD发生的重要病因机制;电针能够改善POCD老年大鼠的学习记忆能力,其发挥脑保护作用机制可能与其调控全身和中枢炎性细胞因子水平以及神经元细胞铁死亡途径有关。

项七针针刺联合百会压灸治疗颈性眩晕的疗效观察

目的观察项七针针刺联合百会压灸治疗颈性眩晕的临床疗效。方法将90例颈性眩晕患者随机分为治疗组和对照组,每组45例。对照组采用项七针针刺治疗,治疗组在对照组基础上采用百会穴压灸治疗。两组治疗后均采用海特光照射颈枕部。观察两组治疗前后疼痛视觉模拟量表(visual analog scale,VAS)评分、颈性眩晕症状与功能评估量表(evaluation scale for cervical vertigo,ESCV)评分及颈部红外热成像温度的变化情况,比较两组临床疗效。结果两组治疗后ESCV评分及红外热成像温度均较同组治疗前显著升高,VAS评分显著降低,差异均具有统计学意义(P<0.05)。治疗组治疗后ESCV评分及红外热成像温度明显高于对照组,VAS评分明显低于对照组,差异均具有统计学意义(P<0.05)。治疗组治疗后总有效率为93.2%,明显高于对照组的77.8%,差异具有统计学意义(P<0.05)。结论项七针针刺联合百会穴压灸可明显改善颈性眩晕患者的临床症状,缓解疼痛,有助于提高患者生活质量。

针刺调理阴阳跷脉联合百会穴压灸治疗心脾两虚型失眠的效果观察

目的研究针刺调理阴阳跷脉联合百会穴压灸治疗心脾两虚型失眠的效果。方法选择黑龙江省中医药科学院2021年9月至2023年4月收治的心脾两虚型失眠患者80例作为研究对象,根据治疗方法不同分为西药组和中医组,每组40例。西药组采取常规西药治疗,中医组在西药组的基础上采取针刺调理阴阳跷脉联合百会穴压灸。比较两组的总有效率、不良反应、中医证候积分、匹兹堡睡眠质量指数(PSQI)评分、脑动脉血流速度、睡眠潜伏时长(SOL)、觉醒时长(WASO)、睡眠总时长(TST)及丙二醛(MDA)、同型半胱氨酸(Hcy)、谷胱甘肽过氧化物酶(GSH-Px)水平。结果中医组总有效率为90.00%,高于西药组的72.50%(P<0.05)。治疗前,两组心悸健忘、失眠多梦、四肢倦怠、头晕目眩、神疲食少各项中医证候积分比较,差异均无统计学意义(P>0.05);治疗后中医组心悸健忘、失眠多梦、四肢倦怠、头晕目眩、神疲食少各项中医证候积分均低于西药组(P<0.05)。治疗前,两组PSQI各项评分比较,差异均无统计学意义(P>0.05);治疗后中医组PSQI各项评分均低于西药组(P<0.05)。治疗前,两组大脑中动脉、前动脉、后动脉的血流速度比较,差异均无统计学意义(P>0.05);治疗后中医组大脑中动脉、前动脉、后动脉的血流速度均大于西药组(P<0.05)。治疗前,两组SOL、WASO、TST比较,差异均无统计学意义(P>0.05);治疗后中医组SOL、WASO均低于西药组,TST高于西药组,差异均有统计学意义(P<0.05)。中医组不良反应发生率(7.50%)与西药组(20.00%)相比,差异无统计学意义(P>0.05)。治疗前,两组MDA、Hcy、GSH-Px水平比较,差异均无统计学意义(P>0.05);治疗后中医组MDA、Hcy水平均低于西药组,GSH-Px水平高于西药组,差异均有统计学意义(P<0.05)。结论针刺调理阴阳跷脉联合百会穴压灸治疗心脾两虚型失眠的效果更为理想,可促进患者症状快速消失,并改善其睡眠情况,使其脑动脉血流速度恢复,不良反应少,同时减轻氧化应激反应,值得临床推广使用。

政策全过程治理:惠民保发展困境与优化路径探析——以“惠邕保”和“百惠保”实施试点为例

推动惠民保的发展是完善多层次医疗保障制度的应有之义。文章运用访谈法和问卷调查法,基于政策全过程治理理论比较分析全国性惠民保政策和市级“惠邕保”“百惠保”政策的发展状况。研究发现,“惠邕保”“百惠保”存在政策制定层面缺乏创新、政策执行层面理赔时效低且流程繁琐、政策目标群体层面群众保险意识不高、政策评估层面政府部门的职能未充分发挥、政策监控层面相关监管法律制度尚未出台等问题。进而剖析以上困境产生的成因,提出政策制定层面要完善优化产品设计、政策执行层面着力改善外在环境,政策目标群体层面努力提高群众对疾病的预防能力和保险意识,从政策评估层面充分发挥政府职能,政策监控层面要完善监管措施。从而对惠民保进行全过程治理,优化多层次医保体系建设的实现路径。

温针灸治疗儿童癫痫的疗效观察及对血清PSD-95水平的影响

目的观察温针灸涌泉和百会穴治疗儿童癫痫的临床疗效及对患者神经损伤状态和血清突触后致密区95(postsynaptic density-95,PSD-95)水平的影响。方法对110例癫痫儿童患者展开回顾性研究,根据治疗方法的不同将其分为对照组和观察组,每组55例。对照组采用口服拉莫三嗪治疗,观察组在对照组口服药物基础上采用温针灸涌泉和百会穴治疗。比较两组临床疗效,观察两组治疗前后韦氏儿童智力量表(Wechsler intelligence scale for children-Ⅳ,WISC-Ⅳ)和简易精神状态检查表(mini-mental state examination,MMSE)评分、癫痫发作频率、癫痫持续时间、脑电图指标以及血清S100β、胶质纤维酸性蛋白(glial fibrillary acidic protein,GFAP)和PSD-95水平的变化。结果观察组总有效率高于对照组(P<0.05)。观察组治疗后WISC-Ⅳ和MMSE评分均高于对照组(P<0.05),癫痫发作频率低于对照组(P<0.05),癫痫持续时间短于对照组(P<0.05)。观察组治疗后脑电图β功率、δ功率、θ功率和α功率均高于对照组(P<0.05)。观察组治疗后血清S100β和GFAP水平均低于对照组(P<0.05),血清PSD-95水平高于对照组(P<0.05)。结论在口服拉莫三嗪治疗基础上,采用温针灸涌泉和百会穴治疗儿童癫痫可改善神经损伤状态,改善认知功能和精神状态,减少癫痫发作次数,缩短发作持续时间,上调血清PSD-95表达量,降低血清S100β和GFAP水平,提高临床疗效。