Mechanism of acupoint penetration acupuncture therapy regulating chondrocyte autophagy via the PI3K/Akt-mTOR pathway in KOA rats

Objective:To investigate whether acupoint penetration acupuncture(APA)could regulate chondrocyte autophagy and apoptosis via the PI3K/Akt-mTOR signaling pathway to reduce cartilage degeneration in knee osteoarthritis(KOA)rats.Methods: KOA was induced in rats via intra-articular injection of sodium iodoacetate resolution.Forty male Sprague-Dawley rats were randomly assigned to blank control,model,APA,electro-acupuncture(EA),and sham model groups(n=8)and those in the APA and EA groups received their respective therapies.Following completion of the treatment course,histological examinations of cartilage and muscle were conducted.Levels of apoptosis-and autophagy-related factors,including Bax,Bcl-2,mTOR,ULK-1,and Beclin-1 protein,and mRNAs were assessed.Additionally,β-endorphin(β-EP)concentrations in the brain and serum were measured.Results: Histological analysis revealed that APA alleviated cartilage and muscle damage compared with the model group.APA inhibited cartilage degeneration by modulating the expression of apoptosis-and autophagy-related proteins and mRNA,thus preventing chondrocyte apoptosis.In the APA group,Bax and mTOR protein levels were significantly lower than those in the model group(both P=.024).Conversely,the Bcl-2 expression level was significantly higher than that in the EA group(P=.035).Additionally,ULK-1 expression was significantly lower than that in the EA group(P=.045).The mRNA level of Bax was significantly higher than that in the blank control group(P<.001).However,Beclin-1 levels were significantly higher than those in both the model and EA groups(both P<.001).ELISA results showed a significant decrease in the concentration ofβ-EP in the brains of the rats in the APA group compared with those in the model group(P=.032).Conclusions: APA reduced osteoarthritis-related pain and alleviated cartilage damage by upregulating chondrocyte autophagy and down-regulating apoptosis via signaling pathways involving PI3K/Akt-mTOR in KOA rats.

Effects of acupuncture on serotonin,histamine,substance P,and tryptase levels at sensitized points in model rats with knee osteoarthritis

Objective:To elucidate the differences in manual acupuncture effectiveness at sensitized points by investigating the mechanisms of local skin action at different sensitization points in rats with knee osteoarthritis(KOA).Methods:Forty SpragueeDawley rats were equally divided into control,model(1 mg of mono-iodoacetate into the right knee joint cavity),sham operation,manual acupuncture at right Tianjing acupoint(MAR-SJ 10),and left SJ 10 groups.Safranine-O and fast green staining were used to assess the modeling.The morphological and functional changes in mast cells(MCs)were assessed during acupoint sensitization using toluidine blue and immunofluorescence staining.The levels of serotonin,histamine,substance P(SP),and tryptase at skin acupoints and serum levels of IL-β,IL-6,and TNF-αwere detected using ELISA.Results:After 14 days of treatment,the number of MCs and their degranulation rates were statistically higher in the model group than in the control group(both P<0.001).After applying acupuncture,the levels of 5-HT,HA,and SP at skin acupoints were lower than those in the model group(all P<0.05),and tryptase level was higher(both P<0.05).Tryptase level was higher on the skin at the MAL-SJ 10 acupoint than that on the MAR-SJ 10 acupoint(P=0.004).Compared with the model group,the serum levels of IL-1β,IL-6,and TNF-αin the MAR-SJ 10 and MAL-SJ 10 groups were lower(all P<0.05).Conclusion:Acupuncture at KOA-sensitized acupoints mitigates joint injury in KOA rats and may bidi-rectionally regulate local MCs of these acupoints.This finding not only enhances the reference value of sensitizing points in clinical diagnosis and treatment,but also contributes to the understanding of the biological mechanisms underlying acupuncture intervention at sensitizing points.

Evaluating the clinical application and effect of acupuncture therapy in anal function rehabilitation after low-tension rectal cancer surgery

BACKGROUND According to the indexes of serum and anal function,acupuncture therapy was applied to patients with low rectal cancer in order to avoid the occurrence of anal incontinence and reduce complications.AIM To explore the clinical application and evaluate the effect of acupuncture therapy for anal function rehabilitation after low-tension rectal cancer surgery.METHODS From the anorectal surgery cases,we selected 120 patients who underwent colorectal cancer surgery between January 2020 and December 2022 and randomly divided them into a control group(n=60),observation group(n=60),and control group after surgery for lifestyle intervention(including smoking cessation and exercise),dietary factor adjustment,anal movement,and oral loperamide treatment.The serum levels of motilin,5-hydroxytryptamine,and vasoactive intestinal peptide(VIP),Wexner score for anal incontinence,and incidence of complications were compared between groups.RESULTS After treatment,the VIP and 5-hydroxytryptamine levels in the observation group were lower than those in the control group(P<0.05).The motilin level was higher than that in the control group(P<0.05).Postoperative anal incontinence was better in the observation group than in the control group(P<0.05).The incidence of complications in the observation group was 6.67%,which was significantly lower than that in the control group(21.67%;P<0.05).CONCLUSION Acupuncture therapy has a positive effect on the rehabilitation of anal function after low-tension rectal cancer surgery;it can effectively help to improve the serum indices of patients,avoid the occurrence of anal incontinence,and reduce the incidence of complications.Popularizing and applying it will be valuable.

Effects of Acupuncture and Tuina Combined with Rehabilitation Therapy on Oxidative Stress Response and Motor Function in Stroke Hemiplegia Patients

Objective:To explore the effects of acupuncture and tuina combined with rehabilitation therapy on oxidative stress response and motor function in stroke hemiplegia patients.Methods:Sixty stroke hemiplegia patients were randomly divided into observation and control groups,with 30 cases each.The control group received conventional rehabilitation therapy,while the observation group also underwent acupuncture and tuina.After 8 weeks of treatment,oxidative stress indicators[malondialdehyde(MDA),superoxide dismutase(SOD),glutathione peroxidase(GSH-Px)],neurological deficit scores(NIHSS),Fugl-Meyer motor function scores(FMA),and activities of daily living(Barthel Index)were compared between the two groups.Results:Before treatment,there were no significant differences in MDA,NIHSS scores,FMA scores,and Barthel Index between the two groups(P>0.05).After 8 weeks,the observation group had lower MDA and NIHSS scores,but higher SOD,GSH-Px,FMA scores,and Barthel Index compared to the control group,with statistically significant differences(P<0.05).Conclusion:Acupuncture and tuina combined with rehabilitation therapy can effectively improve oxidative stress levels,promote neurological recovery,enhance motor function,and improve daily living activities in stroke hemiplegia patients.This combined therapy is recommended for clinical application.

Systematic evaluation and Meta-analysis of acupuncture and collaterals cupping therapy for Knee Osteoarthritis

Objective:In order to obtain the best treatment program for Knee Osteoarthritis(KOA),to alleviate the pain of patients with KOA,and to systematically evaluate the efficacy of acupuncture cupping therapy for KOA.Methods:we used computer to search the databases of CNKI(1989-2018.10),Wanfang(1989-2018.10),VIP(1989-2018.10),PubMed(1966-2018.10),EMbase(1986-2018.10)and Cochrane Library(the 3rd issue of 2018).And the literature quality was evaluated by Jadad scale.Results:A total of 19 eligible RCT studies were included,and a total of 2,088 patients participated in the eligible clinical study.Meta-analysis results showed that the total effective rate OR combination=2.85[OR=3.98,95%CI(2.98,5.32),P<0.00001].The results showed that the curative effect of acupuncture and collaterals cupping in the treatment of KOA was superior to other therapies.Conclusion:Acupuncture and cupping therapy of traditional Chinese medicine is effective and safe in treating KOA.Due to the impact of the original study on Meta-analysis results,more large samples and high-quality clinical trials are still needed to verify.

IMPACTS OF PENETRATION THERAPY WITH HEAD ELECTRICAL ACUPUNCTURE ON PROLIFERATION OF NEURAL STEM CELLS IN SUBSTANTIA NIGRA OF RAT MODEL OF PARKINSON'S DISEASE

Objective To probe into the function mechanism of penetration therapy with head electrical acupuncture on Parkinson＇s disease. Methods Microinjection of 6-hydroxydopamin （6-OHDA） on the left cor- pus striatum was adopted to prepare rotation model of Parkinson^s disease in rat. Penetration therapy with head electrical acupuncture was administered in treatment. Normal group, sham-operation group, model group and penetration therapy group were set up. （1）lmmunohistochemical （IHC） method was used to test the morphology and count of positive cell of tyrosine hydroxylase （TH）. （2）RT-PCR technology was used to detect the expression of nestin mRNA of neural stem cell （NSC）. Results （1）Compared with model group, in pene- tration therapy group, the expressions of TH-positive neurons in immune response were increased in areal density （AD）, numerical density （ND） and integrating optic density （P〈0.05）. （2）Compared with model group, in penetration therapy group, the expression of nestin mRNA was increased （P〈0. 05）. Conclusion Penetration therapy with head electrical acupuncture promotes the proliferation of endogenous neural stem cells in substantia nigra of rat model of Parkinson＇s disease.

ON THE RELEVANCE OF PSYCHOTHERAPEUTIC TECHNIQUE AND ACUPUNCTURE THERAPY

The psychotherapeutic technique plays an important role in acupuncture therapy. In the present paper, the authors explain the relevance of psychotherapeutic technique and curative effect of acupuncture from （1）connection between psychologic factors and curing disease, （2）specialty of acupuncture therapy, and （3）influence of psychologic factors on acupuncture therapy, etc. Finally bring forward how to make good use of the technique during the course of acupuncture.

Study of wrist-ankle acupuncture therapy for optimizing anaesthesia scheme of painless gastroscopy and improving painless gastroscopy related complications

BACKGROUND Painless gastroscopy is a widely used diagnostic and therapeutic technology in clinical practice.Propofol combined with opioids is a common drug for painless endoscopic sedation and anaesthesia.In clinical work,adverse drug reactions of anaesthesia schemes are often one of the important areas of concern for doctors and patients.With the increase in propofol dosage,the risk of serious adverse drug reactions,such as respiratory depression and hypotension,increases significantly;the use of opioids often causes gastrointestinal reactions in patients after examination,such as nausea,vomiting,delayed recovery of gastrointestinal function and other complications,which seriously affect their quality of life.AIM To observe the effect of wrist-ankle acupuncture therapy on the anaesthesia regimen and anaesthesia-related complications during and after painless gastroscopy examination.METHODS Two hundred patients were selected and randomly divided into a treatment group(n=100)and a control group(n=100).Both groups were routinely anaesthetized with the nalbuphine and propofol regimen,gastroscopy began after the patient lost consciousness,and given supportive treatment and vital sign monitoring.If the patient interrupted the surgery due to intraoperative torsion,intravenous propofol was used to relieve his or her discomfort.The treatment group received wrist-ankle acupuncture on this basis.RESULTS The general data before treatment,American Society of Anesthesiologist(ASA)grade and operation time between the two groups was no significant difference.The Wakeup time,and the Selfambulation time in the treatment group was significantly faster than that in the control group(P<0.05).The total dose of propofol in the treatment group was 109±8.17 mg,significantly lower than that in the control group(P<0.05).The incidence of respiratory depression and hypotension was not significantly different,but the incidence of hiccups was significantly lower than that in the control group(P<0.05).After the examination,the incidence of nausea,vomiting,abdominal distension,and abdominal pain was 11%,8%,6%,and 5%,respectively,which was significantly lower than that in the control group(P<0.05).In addition,both the operators and the patients were more satisfied with this examination,with no significant difference between the groups(P>0.05).CONCLUSION Wrist-ankle acupuncture treatment can optimize the painless gastroscopy and anaesthesia scheme,reduces propofol total dose;shortens patient Wakeup time and Self-ambulation time,improves patient compliance and tolerance,is beneficial to clinical application.

Combined treatment using acupuncture and music therapy on children with cerebral palsy Gross motor function measure comparison in 60 cases

BACKGROUND： The use of acupuncture has received recognition to effectively treat cerebral palsy. Moreover, music therapy can be used to modify treatment of cerebral palsy. OBJECTIVE： To study the effects of combined treatment using acupuncture and music therapy on gross motor function measure （GMFM） of children with cerebral palsy, compared with acupuncture treatment alone. DESIGN, TIME AND SETTING： Randomized, controlled, clinical study. The experiment was conducted in Shenzhen Hospital of Traditional Chinese Medicine between January 2007 and September 2007. PARTICIPANTS： All children with cerebral palsy in the trial were from the outpatient department of Shenzhen Hospital of Traditional Chinese Medicine. The children were randomly divided into two groups： 30 children in Group B received acupuncture and music therapy, while 30 children in Group A received only acupuncture therapy. METHODS： Subjects in Groups A and B received acupuncture based on syndrome differentiation. The main acupoints were necessary for all participants. At first, flash needling was applied to the acupoints. For the remaining acupoints, the technique of transverse needling was applied to the head acupoints, and perpendicular needling was used for the other points. The inserted needles were twirled and then maintained for 30 minutes. The needle was twirled for one second every other 10 minutes, without reinforcing-reducing techniques. The therapy was performed every other day. The trial consisted of three periods each, and lasted for 84 days. Subjects in Group B received music therapy. They listened to music that they preferred while acupuncture was being performed. Following acupuncture, they were allowed to perform musical activities, such as percussion, singing, and dancing. The music therapy was scheduled for one hour, including listening to music for 30 minutes and music activities for 30 minutes. MAIN OUTCOME MEASURES： The comprehensive functional evaluation scale of cerebral palsy and the GMFM were applied to test symptoms before and after respective treatment. RESULTS： All 60 children were included in final analysis. The general function of all children with cerebral palsy improved, but the general efficiency in Group B was obviously higher than in Group A （93% and 73%, Х^2 = 4.32, P 〈 0.05）. GMFM evaluation showed that the function of crawling and kneeling, standing, and walking improved more significantly in Group B than in Group A （P 〈 0.05）, while the function of lying down, rolling, and sitting remained similar between the two groups （P 〉 0.05）. CONCLUSION： The combination of acupuncture and music therapy on the treatment of cerebral palsy is more effective than acupuncture alone. The various activities in music therapy may affect treatment of cerebral palsy.

Auricular-Plaster Therapy Plus Acupuncture at Zusanli for Postoperative Recovery of Intestinal Function

In order to relieve the abdominal distension and other discomforts due to gastrointestinal dysfunction after abdominal operations, the patients were treated by auricular-plaster therapy plus acupuncture at Zusanli (ST 36). 12 (92.4%) of the 13 cases in the treatment group showed recovery of normal peristalsis within 72 hours after operations, while that in 13 cases of the control group was 46.1%, indicating that auricular-plaster therapy plus acupuncture at Zusanli (ST 36) may promote postoperative recovery of the intestinal function.

ACUPUNCTURE FOR LEUCOPENIA INDUCED BY CHEMOTHERAPY OR RADIOTHERAPY——A Meta-analysis

In the present paper, the authors analyze the academic theses of acupuncture for treatment of leucopenia induced by chemo or radio therapy. A total of 14 theses are retrieved and all written in Chinese. Quantitative meta analysis is done for 4 studies of dichotomous data and 5 studies of continuous data. Both of them have positive results. Majority of these trials have methodological and/or reporting shortcomings. Overall, the existing evidence supports the value of acupuncture for the treatment of leucopenia induced by chemo or radio therapy. However, the evidence is still not fully convincing. There is an urgent need for well planned, large scale and multiple center studies to assess the effectiveness and cost effectiveness of acupuncture under real life conditions.

Future directions:combination of acupuncture with mesenchymal stem cells for Parkinson’s disease

Parkinson’s disease(PD)is a progressive chronic disease currently with no radical cure drugs and means due to the complex pathological mechanisms and limited regenerative capacity of neurons.Acupuncture aids in neuronal regeneration via various signaling routes like ROCK,Wnt,and Notch,safeguarding dopaminergic neurons against inflammation,oxidative stress,and cell death,which in turn enhances the progression of PD progression.Numerous research findings indicate that integrating acupuncture with mesenchymal stem cells(MSCs)transplantation is more effective than using either acupuncture or MSCs infusion alone.The combined treatment improves the survival rate of MSCs,promotes the generation of functional neural networks by stimulating the secretion of neurotrophic factors,and ultimately improves the disease microenvironment.In this review,we state the neuroprotective effects of acupuncture or MSCs treament alone in PD,then summarize the application of acupuncture combined with MSCs therapy in other diseases.Consequently,we anticipate that integrating acupuncture with MSCs transplantation may emerge as a novel and efficient approach for managing PD.This possibility needs to be verified through further basic and clinical research.

Forty-three Cases of Acute Lumbar Sprain Treated by Acupuncture Plus Kinesitherapy

Acute lumbar sprain is commonly encountered among the young and middle-aged. It often occurs at the lower part of the back, which seriously hinders the daily life and work of the patients because of the severe pain. The author has treated 43 cases of acute lumbar sprain by needling Weizhong (BL 40), Houxi (SI 3) and Yaotongdian (EX-UE7) plus kinesitherapy and obtained satisfactory therapeutic results. A report follows.

Evaluation of Clinical Efficacy of Wumen Acupuncture in the Adju-vant Treatment of Non-arteriticAnterior Ischemic Optic Neuropathy

[Objectives]To explore the clinical efficacy of Wumen acupuncture in the adjuvant treatment of non-arteritic anterior ischemic op-tic neuropathy(NAION).[Methods]From June 2023 to April 2024,40 NAION patients were randomly divided into treatment group(Wu-men acupuncture method+methylprednisolone sodium succinate+compound Danshen dripping pills orally)and control group(methylpred-nisolone sodium succinate+compound Danshen dripping pills orally).The clinical symptoms such as fundus condition and visual field were compared between the two groups before treatment,after 2 courses of treatment and 6 months after the first diagnosis.[Results](i)After 2 courses of treatment,the patients with optic disc edema in the treatment group were more than those in the control group,and the difference was significant(P<0.05).The number of patients with retinal hemorrhage in the treatment group was less than that in the control group,and the difference was significant(P<0.05).The color of the optic nerve in the treatment group was less than that in the control group,and the difference was not significant(P>0.05).(ii)Six months after the first diagnosis,the improvement of fundus in the treatment group was bet-ter than that in the control group(P<0.05).After 2 courses of treatment and 6 months after the first diagnosis,the visual evoked potential was significantly improved compared with the control group(P<0.05).After 2 courses of treatment and 6 months from the first diagnosis,the number of lines of visual acuity improvement in the treatment group was greater than that in the controlgroup(P<0.05).After 2 courses of treatment and 6 months from the first diagnosis,the average visual field defect in the treatment group was lower than that in the control group(P<0.05).[Conclusions]Wumen acupuncture method can significantly improve the symptoms of patients with non-arteritic anterior ische-mic optic neuropathy,which is worthy of clinical promotion.

Therapeutic Effect of Chinese Massage Combined with Warm Acupuncture on Knee Osteoarthritis

Objective:To investigate the effect of Chinese massage combined with warm acupuncture on knee osteoarthritis.Methods:60 patients with knee osteoarthritis who were treated in our hospital from January 2017 to October 2019 were selected as the research subjects,and they were randomly divided into 2 groups of 30 patients each.The control group was treated with oral western medicine,and the observation group was treated with massage combined with warm acupuncture.The clinical efficacy and WOMAC index were compared between the two groups.Results:The total effective rate of the observation group was higher than that of the control group,and the WOMAC score was lower than that of the control group.The difference was statistically significant(P<0.05).Conclusion:Chinese massage combined with warm acupuncture is effective in treating knee osteoarthritis It can effectively alleviate the symptoms of pain and joint stiffness in patients,and improve joint mobility,which is worth for clinical promotion.

Acupuncture, Moxibustion, and Combination Therapies for Insomnia

Insomnia, a common sleep disorder, affects general well-being, hastens the onset of other diseases, and impairs work performance. Hypnotic medications are efficacious in the short term but have obvious side effects. Acupuncture, often used to treat insomnia in traditional Chinese medicine (TCM), is considered to be beneficial in restoring the normal sleep-wake cycle by regulating and restoring the natural flow of qi (energy power). The three main TCM theories for treating insomnia by acupuncture are the tranquilization disturbance, zangfu disturbance (disequilibrium of internal organs), and imbalance of yin and yang theories. Moxibustion, another treatment for insomnia, is usually combined with acupuncture. Acupuncture and moxibustion with tuina (exercise massage), acupuncture with Chinese herbal injection, electroacupuncture, and acupuncture with medication or psychotherapy are other interventions. Some acupuncture-based methods such as needle-rolling acupuncture, auricular acupoint plaster therapy, phlebotomy, and acupoint catgut-embedding therapy are used as well. Although most clinical trials have shown that acupuncture and its combination therapies are significantly effective in insomnia, the beneficial effects may have been overvalued, because of small sample size, nonstrict inclusion and exclusion criteria, flawed methodology, short follow-up, or nonstandardized evaluation. Therefore, clinical studies of high methodological quality are needed to verify the efficacy of acupuncture, moxibustion, and other combination therapies in insomnia.

ACUPUNCTURE THERAPY AND POINT-INJECTION OF MEDICINE FOR TREATMENT OF 32 CASES OF INFANTILE CEREBRAL PALSY

In the present study, 32 cases of infantile cerebral palsy were treated with acupunc-ture and point-injection therapies. Among them, 15 cases were cured basicaly, 7 markedly efec-tive, 9 improved and 2 failed, with a total effective rate being 93. 8%. The results showed thatthe therapies both could improve the microcirculation of the brain tissues in favour of recovery ofcerebral functions.

TREATMENT OF RADICULAR CERVICAL SPONDYLOSIS WITH ACUPUNCTURE AND SHA-SCRAPPING THERAPY(刮痧疗法)

One hundred and twenty-six cases were divided at random into acupuncture plus Sha-scrapping group (or combination group), single Sha-scrapping group and single acupuncture group. The results show that there are remarkable differences in therapeutic effects among the three groups. In addition, the instant effect, frequencies of the theatment and influence factors on therapeutic effect in these groups were also compared and analyzed. It is suggested that curative effect in acupuncture, plus Sha-scrapping group was markedly superior to those in the other two groups.

TREATMENT OF 33 CASES OF APOPLETIC HEMIPLEGIA BY COMBINED ACUPUNCTURE THERAPIES

In the present study,33 cases of apopletic hemiplegia were treated with combinedtherapies of scalp-,body-acupuncture and restoring consciousness needling;besides,electroacupuncture（EA）stimulation was added.The treatment was given once daily,six days constitutea therapeutic course with an interval of 1—2 days between courses.After 5 courses of treatment,10cases（30.30％）were cured,15（45.45％）markedly effective,7（21.21％）effective and 1（3.03％）was ineffective.The total effective rate was 96.96％.

COMPARISON OF THE EFFECTS OF CATGUT EMBEDDING THERAPY AND ACUPUNCTURE ON GASTROPTOSIS

Among 78 patients with gastroptosis treated with catgut embedding therapy, 8cases were cured, 25 cases rnarkedly improved, 4z cases improved and the effective rate was 96. 2％;and among 58 patients treated with acupuncture as control, 3 cases were cured, 18 cases markedlyimproved, 28 cases improved and the effective rate was 84. 5％. The chi square test for both cure rate(X^2 = 4. 84, P【0. 05 ) and effective rate (X^2= 5. 632, P【0.02 ) showed the significant differencesbetween 2 therapeutic groups and it indicated that the cure rate and effective rate in catgut embeddinggroup were significantly higher than those in acupuncture group.