M-CHOLINOCEPTORS IN CAUDATE NUCLEUS PARTICIPATE IN SmI ORIGINATING DESCENDING MODULATION OF PARAFASCICULARNEURONS IN ACUPUNCTURE ANALGESIA

The present study was undertaken to investigate whether M-cholinoceptors in caudate nucleus (Cd) were implicated in cortical sensorimotor area I (SmI) originating descending modulation of activities in thalamic parafascicular nuclei (Pf) in acupuncture analgesia (AA). It was found that following bilateral microinjection of atropine into Cd head electroacupuncture (EA) (n=12) or glutamate (Glu) applied at SmI (n=12) did not affect the nociceptive responses of Pf neurons (P>0. 05),while in the saline control groups EA (n=11) or Glu at SmI (n=12) obviously inhibited nociceptive responses of Pf neurons (P<0. 05). There were significant differences in the effect of EA or Glu at SmI between atropine and saline groups (ANOVA, P<0. 05). Together with our previous findings demonstrating the participation of SmI originating descending modulation of Pf neurons in AA, the present investigation indicates that M-cholinoceptors are involved in mediating SmI originating descending modulation of Pf neurons in AA.

Effectiveness and safety of electroacupuncture analgesia in controlling intraoperative pain and hemodynamics during total thyroidectomy:A randomized controlled trial

Objective:To evaluate the effectiveness and safety of electroacupuncture in conjunction with additional medications in providing analgesia and stabilizing hemodynamic parameters during total thyroidectomy.Methods:This randomized controlled trial included 100 patients who underwent a total thyroidectomy between October 2022 and October 2023 at the Vietnam National Hospital of Acupuncture.The patients were randomized into two groups.The electroacupuncture analgesia(EA)group received EA stimulation at five acupuncture points:Hegu(LI 4),Neiguan(PC 6),Shuitu(ST 10),Quepen(ST 12),and Yifeng(SJ 17),while the control group received a bilateral superficial cervical plexus block.Primary outcomes included the level of analgesia and perioperative vital signs in both groups.Additionally,pain thresholds and serum b-endorphin levels were measured before and after electroacupuncture in the EA group.Results:Complete analgesia(Level A)was attained in 86%and 76%of the patients in the EA and control groups,respectively,with no significant difference between the two groups(P=1.00).In the EA group,the mean pain threshold after receiving EA doubled(648.7(77.4)g/s vs.305.3(45.3)g/s,P<.001),and the mean serum b-endorphin level increased by approximately 13.5 pg/mL(P<.001).All patients remained hemodynamically stable throughout the surgery.Conclusion:EA,in conjunction with additional medications that stimulate five acupuncture points,LI 4,PC 6,ST 10,ST 12,and SJ 17,was well tolerated and effectively maintained a suitable level of analgesia and hemodynamic stability during total thyroidectomy.

THE ULTRASTRUCTURE AND ENZYME HISTOCHEMISTRY OF THE SUBSTANTIA GELATINOSA OF RAT SPINAL CORD UNDER THE INFLUENCE OF ELECTRO-ACUPUNCTURE ANALGESIA

Histochemistry and EM were used in this experiment to study the effect of EAon the spinal dorsal horn of rat. After 30 minutes EA, the pain threshold of EA rats were elevated400%, the acid phosphatase reaction in spinal dorsal horn of EA rats increased obviously, the roundagranular vesicles of the C-terminals of EA group was more than that of control’s. The results sug-gested that the histochemical components and numbers of synaptic vesicles in SG and their functionscould be regulated by acupuncture.

EFFECT OF ACUPUNCTURE ANALGESIA ON SYNAPSFS OF NUCLEUS CENTRO—MEDIANUS OBSERVED WITH ELECTRO—MICROSCOPE

The present study was aimed at the investigation of the ultrastructuralchanges of nucleus centromedianus(CM)of nuclei intralaminares under acupuncture analge-sia.The results of the observations on 18 healthy and adult rats were as follows.1.Thesynapses of the CM belong mainly to the axodendricular synapses and also with some suc-cessive or juxtaposing synapses.2.The presynaptic sac contains a lot of round and clearvesicles,some granular vesicles also spread among clear vesicles in a few synapses.3.Theround clear synaptic vesicles of CM in the electroacupuncture analgesia(EA)group are de-creased significantly than that in the control group.It is suggested that CM plays a role inacupuncture analgesia.

Effect of Intracerebral Injection of Substance P on Pain Threshold,Electroacupuncture Analgesia and Met-enkephalin Level in Rat Brain

Radioimmunoassay was employed to dctermine the immunorcactivc met-enkephalin(ir-MEK)contents of several brain regions .The pain threshold(PT)andir-MEK content of striatum and hypothalamus increased markedly afterintraoerebroventricular injection of substance P(SP)in the dosage of lμgg/10μl ,but nosignificant change of ir-MEK content in hippocampus was observed.When theperiaqueductal gray(PAG)was destroyed with electrolysis,the increase of PT andir-MEK content in the two brain regions after SP injection was obviouslysuppressed(P【0.05-0.01).The PT and ir-MEK content of hypothalamus andstriatum would also increase after intra-PAG injection of SP(0.4μg/4μl),electroacupuncture or intraperitoneal injection of morphine.The ir-MEK content ofhippocampus could also increase after intra-PAG injection of SP or intraperitoncal injec-tion of morphine.The combination of intra-PAG injection of SP andelectroacupuncture caused a more marked elevation of PT and ir-MEK content of the 3brain regions than either of the two used singly could(P【0.01 ).The combined effect ofintra-PAG injection of SP and intraperitoneal injection of morphine was similar to thatof either of the two used singly(P】0.05).These facts indicate that thc analgesic effect ofSP activated by PAG was mediated through the increase of cerebral met-cnkcphalin con-tent,and there was a synergic effect between SP and elcctroacupuncturc.

COMBINATION OF ACUPUNCTURE ANALGESIA AND EPIDURAL BLOCK IN RENAL TRANSPLANTATION

One hundred patients undergoing renal transplantation were randomly divided into com-bined acupuncture-epidural anesthesia group (group A, points selected: Ciliao, Sanyinjiao, Taixi to-gether with Shenyu and para-incision or Zusanli; combined with small dose of epidural block) and epidural block group (group C), each 50 patients. The initial dose and total dose of local anesthetics were 5. 6 ±0. 3 ml and 13. 5±1.0ml in group A, and 14. 5±0. 4 ml and 25. 4 ±1. 2 ml in group C,respectively. There was very significant difference between the two groups (P< 0.001 ). During the operation the hemodynaminc changes were greater in group C. Ephedrine and atropine were used in 1 and 2 cases in group A, and in 9 and 5 cases in group C, respectively. The starting time of urination of the transplanted kidney was shorter in group A than in group C, being 209±25 s and 410±47 s, re-spectively (P<0.001 ). There was no significant difference in the indices of immmunologic function between the two groups. The anesthetic results in group A were evaluated according to the initial dose of epidural anesthetics. Those were excellent in 31 cases (62 % ) and good in 13 (26% ) with the ex-cellent-good rate 88 %.

Effects of injection of anti-corticotropin release hormone serum in the lateral ventricles and electroacupuncture analgesia on pain threshold in rats with adjuvant arthritis

Rat models of adjuvant arthritis were established, and anti-corticotropin release hormone serum injection in the lateral ventricles and electroacupuncture at right Jiaji （EX-B2） were performed. The pain threshold was decreased at 45 and 60 minutes after injection of the anti-corticotropin release hormone serum. Electroacupuncture at Jiaji can resist this effect. Immunohistochemical staining results showed that the expression of corticotropin release hormone in the hypothalamic paraventdcular nucleus was greater in the electroacupuncture ＋ anti-corticotropin release hormone serum group compared with the anti-corticotropin release hormone serum group. The expression of corticotropin release hormone was correlated with the pain threshold. The effect of endogenous corticotropin release hormone in pain modulation can be obstructed by anti-corticotropin release hormone serum. The analgesia of electroacupuncture can partially resist the depressed pain threshold caused by injection of anti-corticotropin release hormone serum. The analgesic effect of electroacupuncture is associated with the corticotropin release hormone content in the hypothalamus.

Modulatory effect of International standard Scalp Acupuncture on brain activation in the elderly as revealed by resting-state fMRI

The specific mechanisms by which acupuncture affects the central nervous system are unclear. In the International Standard Scalp Acupuncture system, acupuncture needles are applied at the middle line of the vertex, anterior parietal-temporal oblique line, and the posterior parietal-temporal oblique line. We conducted a single-arm prospective clinical trial in which seven healthy elderly volunteers (three men and four women;50–70 years old) received International Standard Scalp Acupuncture at MS5 (the mid-sagittal line between Baihui (DU20) and Qianding (DU21)), the left MS6 (line joining Sishencong (EX-HN1) and Xuanli (GB6)), and the left MS7 (line joining DU20 and Qubin (GB7)). After acupuncture, resting-state functional magnetic resonance imaging demonstrated changes in the fractional amplitude of low frequency fluctuations and regional homogeneity in various areas, showing remarkable enhancement of regional homogeneity in the bilateral anterior cingulate, left medial frontal gyrus, supramarginal gyrus, right middle frontal gyrus, and inferior frontal gyrus. Functional connectivity based on a seed region at the right middle frontal gyrus (42, 51, 9) decreased at the bilateral medial superior frontal gyrus. Our data preliminarily indicates that the international standard scalp acupuncture in healthy elderly participants specifcally enhances the correlation between the brain regions involved in cognition and implementation of the brain network regulation system and the surrounding adjacent brain regions. The study was approved by the Ethics Committee of the China-Japan Union Hospital at Jilin University, China, on July 18, 2016 (approval No. 2016ks043).

THE ROLE OF P_1-PURINERGIC RECEPTORS IN THE SPINAL MECHANISMS OF ACUPUNCTURE ANALGESIA

It has been extensively proved that electro-acupuncture elicit analgesia in bothextensive areas and local region via supraspinal structures and spinal cord.The present investigationwas to study the role of P1-purinergic receptors in the spinal mechanisms of weak electroacupuncture-induced analgesia.Leg withdrawal latency（LWL）to noxious radiant heat focused on the ankle regionwas used to assess the effects of acupuncture and that of P1-purinergic（adenosine）receptor antago-nists,theophylline and caffeine on the electro-acupuncture（EA）analgesia.EA prolonged the LWLby 16.7%±20.3%,with an after-effect lasting about 15 min.Both theophylline and caffeineblocked the EA-induced prolongation of LWL in a dose-dependent manner at the doses of 1.6-16 mg/kg.These results suggest that P1-purinegic receptor is involved in the spinal mechanisms of weak EAproduced analgesia in the rat.

SYMPATHETIC REGULATION AND ACUPUNCTURE ANALGESIA IN ARTHRITIC RATS

In the present study,6-hydroxydopamine(6-OHDA),a peripheral adrenergicdepleting agent,was used to investigate the role of sympathetic activity in nociception and pain modu-lation,which was reported with some contradictory.Acute arthritis were induced by an injection ofFruend’s adjuvant in thirty-two rats.They were divided into three groups.Natural recovery fromarthritis(redness,swelling,on-going pain and hyperalgesia)was delayed by pretreatment with an in-jection of 6-OHDA,and acupuncture at Huantiao and Shensu points could accelerate its recovery.It issuggested that sympathetic regulatory system might play an important role in natural normalizationaction and in the acupuncture-induced regulation effects.

What Does GABAergic Neurotransmission System Do in Acupuncture Analgesia?

As one of the essential components of traditional Chinese medicine, acupuncture has been accepted world-widely for its effectiveness in treating various disease and health conditions. Pain management is one of the least controversial therapeutic benefits of acupuncture treatment. To date, the mechanism underlying acupuncture analgesia remains poorly understood. In this review, roles of members of GABAergic neurotransmission system which has long been related to pain perception and modulation, in acupuncture analgesia are discussed.

The Alterations of Unit Discharges of Hippocampal Formation in Acupuncture Analgesia

The actions of thc hippocampal formation were studied by recording the electrical activi-tics of a single neuron of that area.Two different reactions of some neurons in CA2,CA3 and thedentate gyrus ntight occur after peripheral noxious stimulations,that is,increase of the reaction frc-qtcncy of the nociccptive cxcitcd neurons(NENs)and decrcasc of the macron frequeency of thenociocptive inhibited neurons(NENs).Flctrical acuptmcture of the“points”would result in inhib-iting cffcet on most of the NENs but disinhibiting cffcct on NENs.Identical effect to that ofacupunctre could be creatcd by injecting morphine to the expcrimental animals.Electricalstimulation of thc nucleus raphc magnus or peri-aqueduct gray mattcr could affcct the NENs andNINs in the hippocampus,and the results were similar to that of acupucture.When 5-HT was in-jccted into thc latcral ventricle or applied to thc hippocampal neurons through micro-iontophoresis,effects similar to that of acupuncture also occurred.These facts imply that the effects of peripheral“point”acupuncture on the eletrical activities of the neurons of the hippocampal formation might be rre-lated to the activities of the cndogenous serotoninergic neurons,or to the cndogenous morphine-likesubstance.The NENs would be inhibitod after large amounts of GABA were injected into the lateralventricle.The relationship between this phcnomenon and the acfivites of GABAergic intenrons inthe hippocampus awaits furthcr investigation .

Study on the mechanism of acupuncture analgesia from the perspective of psychosomatic medicine

Acupuncture is a kind of traditional Chinese therapy which has gained increased attention in recent years.It has been shown that acupuncture is effective in treating many types of pain pathologically as well as psychologically.For instance,as a promising therapy for psychiatric disorders,acupuncture is helpful to alleviate depression,reduce the adverse effects of drug treatment at the same time.It is most widely utilized for management of chronic,noncancer pain in adults.As a non-pharmaceutical measure,acupuncture has the potential to make contribution to reduction in opioid overuse.Acupuncture analgesia can be analyzed from the perspective of psychosomatic medicine,contributing to a better understanding of its mechanism and function.The mechanisms are closely related to regulation of neurotransmitters and inflammatory factors,including down-regulation of Glutamate,5-hydroxytryptamine,dopamine,Substance P,Tumor necrosis factor-α,Interleukin(IL)-1,IL-6 and up-regulation ofβ-endorphin,endogenous opioid peptide,γ-aminobutyric acid,etc.Electro-acupuncture(EA)has pain-relief effects under some specific parameter values.Low frequency EA is more commonly used in clinical practice than high frequency EA.Our study conducts a comprehensive analysis of acupuncture analgesia and discusses associated characteristics of its mechanisms.

不同脉冲波形电针对佐剂性关节炎大鼠的影响

目的 :探讨电针治疗佐剂性关节炎 (AA)最佳适宜的脉冲波形参数。方法 :将 4 0只Wistar大鼠随机分为 5组 ,电针观察组分别采用不同脉冲波形电针对AA大鼠进行治疗 ,以痛阈、关节肿胀度和炎症局部组织中 5 羟色胺 (5 HT)、β内啡肽 (β EP)、亮脑啡肽 (LEK)的含量为观察指标。结果 :治疗后不同脉冲波形电针组痛阈高于模型组 (P <0 0 5 ,P <0 0 1) ;电针组炎症局部肿胀度虽然高于正常组 (P <0 0 1) ,但较模型组为低 (P <0 0 5 ,P <0 0 1) ;电针组炎症局部组织中 5 HT含量低于模型组 (P <0 0 5 ,P <0 0 1) ;与模型组相比 ,声电波电针有升高炎症局部组织中 β EP和LEK含量的作用 (P <0 0 1,P <0 0 5 ) ,断续波电针有升高 β EP的作用 (P <0 0 5 )。结论 :电针治疗AA最佳适宜的脉冲波形为声电波。

Research progress of acupuncture analgesia based on autonomic nerve regulation pathway

The autonomic nervous system(ANS)includes the sympathetic,parasympathetic,and enteric nervous systems,and its senior regulatory center includes the brainstem,cingulate gyrus,and hypothalamus.Acupuncture can affect visceral,vascular,and glandular functions via the autonomic nervous regulatory pathway.In this paper,the relationship between pain and autonomic nervous function,the application of acupuncture guided by the autonomic nervous system,and the basis and clinical research on acupuncture analgesia are reviewed.

“Baihui”(DU20)-penetrating “Qubin”(GB7) acupuncture on blood–brain barrier integrity in rat intracerebral hemorrhage models via the RhoA/ROCK Ⅱ/MLC 2 signaling pathway

Background: Blocking the Rho A/ROCK Ⅱ/MLC 2(Ras homolog gene family member A/Rho kinase Ⅱ/myosin light chain 2) signaling pathway can initiate neuroprotective mechanisms against neurological diseases such as stroke, cerebral ischemia, and subarachnoid hemorrhage. Nevertheless, it is not clear whether and how disrupting the Rho A/ROCK Ⅱ/MLC 2 signaling pathway changes the pathogenic processes of the blood–brain barrier(BBB) after intracerebral hemorrhage(ICH). The present investigation included the injection of rat caudal vein blood into the basal ganglia area to replicate the pathophysiological conditions caused by ICH. Methods: Scalp acupuncture(SA) therapy was performed on rats with ICH at the acupuncture point “Baihui”-penetrating “Qubin,” and the ROCK selective inhibitor fasudil was used as a positive control to evaluate the inhibitory effect of acupuncture on the Rho A/ROCK Ⅱ/MLC 2 signaling pathway. Post-assessments included neurological deficits, brain edema, Evans blue extravasation, Western blot, quantitative polymerase chain reaction, and transmission electron microscope imaging. Results: We found that ROCK Ⅱ acts as a promoter of the Rho A/ROCK Ⅱ/MLC 2 signaling pathway, and its expression increased at 6 h after ICH, peaked at 3 days, and then decreased at 7 days after ICH, but was still higher than the preintervention level. According to some experimental results, although 3 days is the peak, 7 days is the best time point for acupuncture treatment. Starting from 6 h after ICH, the neurovascular structure and endothelial cell morphology around the hematoma began to change. Based on the changes in the promoter ROCK Ⅱ, a 7-day time point was selected as the breakthrough point for treating ICH model rats in the main experiment. The results of this experiment showed that both SA at “Baihui”-penetrating “Qubin” and treatment with fasudil could improve the expression of endothelial-related proteins by inhibiting the Rho A/ROCK Ⅱ/MLC 2 signaling pathway and reduce neurological dysfunction, brain edema, and BBB permeability in rats. Conclusion: This study found that these experimental data indicated that SA at “Baihui”-penetrating “Qubin” could preserve BBB integrity and neurological function recovery after ICH by inhibiting Rho A/ROCK Ⅱ/MLC 2 signaling pathway activation and by regulating endothelial cell–related proteins.

ADVANCES OF STUDIES ON MECHANISMS OF ELECTROACUPUNCTURE ANALGESIA

The relative reports on the effects of electroacupuncture （EA） on the nervous system and neuro- transmitters, tolerance of EA and so on in recent years are reviewed so as to reveal the analgesic mechanism of EA and provide reference for clinical researches and application of EA.

电针刺大鼠足三里穴对LESP血浆胃泌素和胃动素的影响

目的:观察电针刺足三里穴对大鼠下食管括约肌压力(LESP)的影响以及与血浆胃泌素(GAS)和胃动素(MTL)的关系.方法:将Wistar大鼠40只随机分成5组:对照组、非经非络穴组、足三里穴组、阿托品组和阿托品+足三里穴组.应用三通道微细注水式测压管和荷兰UPS-2020型食管测压系统测定大鼠LESP,同时放免法测定血浆GAS和MTL的水平.结果:电针刺大鼠足三里穴和非经非络穴及电针刺停止后,LESP均有明显升高[升高率:62.7±27.0%,131.0±36.4%(0-20 min),122.6±25.9%(21-40 min),P＜0.01],足三里穴组LESP升高明显大于非经非络穴组(2.34±0.69 kPa vs 1.94±0.35 kPa,3.308±0.88 kPa vs2.30±0.36 kPa,3.17±0.69 kPA vs 2.22±0.40 kPa,P＜0.01).大鼠阿托品ip后LESP明显下降(P＜0.01);在电针刺期间及电针刺后LESP升至正常,升高率明显低于足三里穴组(P＜0.01).电针刺大鼠足三里穴后血浆GAS,MTL水平与对照组相比明显升高(P＜0.01);非经非络穴组升高不明显(P1=0.492,P2=0.104);阿托品+足三里穴组GAS和MTL比阿托品组明显升高(P1＜0.01、P2＜0.05);GAS和MTL变化与LESP呈明显正相关(r1=0.664、r2=0.703,P＜0.01).结论:电针刺对LESP的调控作用具有一定的经络和穴位特异性;胆碱能M受体阻断可部分减弱电针刺足三里的作用,电针刺可以使胆碱能神经阻断大鼠降低的LESP恢复至正常;胃泌素和胃动素可能参与了电针刺对LESP的调控作用.

Innovation and Practice of Training Mode for Professional Postgraduates of Acupuncture and Tuina Based on Artificial Intelligence

In view of the common problems of integrating artificial intelligence into the training of postgraduates in Acupuncture and Tuina major,this paper reviews the related research progress both at home and abroad.It puts forward the innovative reform paths for integrating artificial intelligence into postgraduate training mode of Acupuncture and Tuina major:construct the teaching staff of artificial intelligence graduate students;innovating artificial intelligence to promote the integration of classics and scientific research;constructing the ideological and political case base of artificial intelligence courses;implementing artificial intelligence platform blended teaching;building a domestic and foreign exchange platform for artificial intelligence.Through practical research in teaching,it has achieved good teaching results and played a good demonstration,leading and radiation role in similar majors in China.

Twenty-eight Cases of Neuritis of Lateral Cutaneous Nerve of Thigh Treated by Acupuncture and Point-Injection

Neuritis of lateral cutaneous nerve of thigh, also called meralgia paresthetica, is a commonly encountered disease in clinical practice. The author has treated 28 cases of meralgia paresthetica since 1996 by acupuncture plus point-injection with satisfactory results. A report follows.Clinical Data Among the 28 cases, 13 were male and 15 female. Their age ranged from 24 to 72 years, most of the patients being 35 to 50 years; the duration of illness varied from one month to ten years and 6 cases were affected on left side, 8 cases on right side and 14 cases on both sides.