Minocycline attenuates cognitive impairment and restrains oxidative stress in the hippocampus of rats with chronic cerebral hypoperfusion

Objective Nitric oxide （NO） was speculated to play an Minocycline, a tetracycline derivative, reduced inflammation important role in the pathophysiology of cerebral ischemia. and protected against cerebral ischemia. To study the neuroprotection mechanism of minocycline for vascular dementia, the influences of minocycline on expressions of inducible nitric oxide synthase （iNOS） and endothelial nitric oxide synthase （eNOS） were observed in the brains of Wistar rats. Methods The vascular dementia rat model was established by permanent bilateral common carotid arteries occlusion （BCCAO）. Wistar rats were divideded into 3 groups randomly： sham-operation group （S group）, vascular dementia model group （M group）, and minocycline treatment group （MT group）. The behaviour was tested with Morris water maze and open-field task. Expressions of iNOS and eNOS were measured by immunohistochemistry and reverse transcriptase-polymerase chain reaction （RT-PCR）. The optical density value was measured by imaging analysis. Percentage of positive ceils with iNOS and eNOS expression was analyzed with optical microscope. Results Minocycline attenuated cognitive impairment. Inducible NOS was significantly down-regulated in MT group, compared with that in M group （P 〈 0.01）, while eNOS was significantly up-regulated, compared with that in M group （P 〈 0.01）. The expressions of iNOS and eNOS in M and MT groups were higher than those in S group （P 〈 0.01）. Conclusion Minocycline can down-regulate the expression of iNOS and up-regulate the expression of eNOS in vascular dementia, which restrains apoptosis and oxidative stress to protect neural function.

The pathogenesis of Alzheimer and pharmaceutical research on prevention

Senile Dementia is the illness with a symptom of ongoing cognitive obstacle and loss of memory function. With our population aging, dementia and depression in old age is increasing rapidly. It is estimated that by 2020, depressive disorder will become the second largest human disease leading to crippling. By 2040, globally the number of people with dementia will reach 81.1 million while the number of dementia patients in China will be the sum of that in all developed countries. Its incidence increases exponentially with age and the incidence of the elderly over 85 reach up to 8% -10%. Among all dementia patients, people with Alzheimer＇ s disease （Alzheimer＇ s disease, AD） accounted for 50 % -70%, the rest is vascular dementia （vascular dementia, VD） and mixed dementia. In the United States, Alzheimer＇ s disease has become the fourth leading cause of death followed after cardiovascular disease, cancer and stroke. Through comprehensive control strategy, we can improve the mental health level of old people, so as to protect the physical and mental health, improving the life quality of old people.

EFFECT OF AURICULAR ACUPUNCTURE ON THE LEARNING AND MEMORY AND bcl-2 EXPRESSION IN VASCULAR DEMENTIA RATS

Objective: To study the effect of auricular acupuncture on dysmnesia and the relationship between the memory improvement and bcl 2 protein expression in vascular dementia (VD) rats. Methods: Forty Wistar rats were randomized into control group, VD group, acupuncture+VD group and pseudo operation group, with 10 cases in each group. Rat VD model was established by using 4 vessel occlusion method. Otopoint "Nao" point and "Shen"(MA SC) were punctured, once daily continuously for 15 days. The rats’ memory capability was tested with Y maze method and bcl 2 expression of the brain tissues displayed by immunohistochemical method and measured using MIAS 2000 Image Analyzer. Results: Results showed that the scores of control group, VD group and acupuncture+VD group before operation were 5.68±1.29, 6.07±1.67 and 5.86±1.74 respectively, while following auricular acupuncture treatment, the scores of the 3 groups were 5.81±1.51, 18.06±2.68 and 8.31±1.85 separately, suggesting that the VD rat’s learning and memory abilities in acupuncture+VD group were raised apparently in comparison with those of VD group (P<0.01). In control, VD and acupuncture+VD group, bcl 2 immuno reaction positive neurons in CA 1 area of the hippocampus were 14.31±4.87, 28.67±5.63 and 65.74±8.19 respectively, displaying that the improvement of learning and memory abilities caused by auricular acupuncture treatment may be related to the up regulation of bcl 2 expression (an inhibitory gene of apoptosis). In comparison with control group, the loss of neurons in the pyramidal cell layer of the hippocampal CA 1 area of VD group was more severe, while that of acupuncture group was markedly lighter. Conclusion: Auricular acupuncture of otopoint "Nao" point and "Shen"(MA SC) can raise the learning and memory abilities of VD rats, which may be realized by its inhibitory effect on apoptosis and the protection action on ischemic hippocampal neurons.

CLINICAL STUDY ON TREATMENT OF VASCULAR DEMENTIA WITH ELECTROACUPUNCTURE OF "SISHENCHONG

Aim: To observe the therapeutic effect of electroacupuncture (EA) in the treatment of vascular dementia. Methods: A total of 46 cases of vascular dementia (VD) patients were divided into 3 classes according to the scores of the revised Hasegawa dementia scale (HDS), and then randomized into EA group (n=23) and medication (Nimodipine) group (n=23). The acupoints used were "Zhisanzhen" [Shenting (GV 24) and bilateral Benshen (GB 13)] and Sishenchong (EX HN 1) etc.. Scores of HDS, ability of daily life (ADL), neurofunctional defect and main symptoms were used as the indexes for assessing the therapeutic effect. Results: Following treatment, scores of HDS and ADL of two groups increased significantly, while those of neurofunctional defect and main symptoms decreased evidently (P<0.01), and the therapeutic effect of EA was obviously superior to that of medication (P<0.01). Conclusion: EA of "Zhisanzhen" and Sishenchong (EX HN 1) is a good approach for treatment of VD.

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.

EFFECT OF ELECTROACUPUNCTURE ON CEREBRAL BLOOD FLOW, VIP AND ET IN RATS WITH VASCULAR DEMENTIA

Objective: To investigate the relationship between electroacupuncture (EA)-induced improvement of regional cerebral blood flow and the alternations of vasoactive intestinal peptide (VIP) and endothelin (ET) in rats with experimental vascular dementia (VD). Methods: 40 Wistar rats were evenly randomized into sham-operation, model, medication (Nimotone) and EA groups. Vascular dementia model was established by repeated cerebral ischemia-reperfusion which was induced by occlusion and reopen of the bilateral common carotid arteries. EA (2～200 Hz, 2～3 mA) was applied to "Baihui"(GV 20), "Dazhui"(GV 14) and "Zusanli"(ST 36) for 30 min, once daily and continuously for 15 days. The regional cerebral blood flow (rCBF) in parietal lobe and hippocampus was determined with method of hydrogen clearance; a step-down avoidance test was adopted to observe the rats’ behavior change; and plasma VIP and ET contents were assayed by radioimmunoassay. Results: In comparison with sham-operation group, the correct rate of step-down avoidance test, rCBF in parietal lobe and hippocampus and plasma VIP level in VD model group lowered significantly (P<0.01) and plasma ET increased considerably (P<0.01). However, compared with model group, the correct rate of step-down avoidance test, rCBF values and plasma VIP in EA group raised obviously while plasma ET declined significantly. No significant differences were found between EA and medication groups in the 4 indexes. Conclusion: EA can raise rCBF in the parietal lobe and hippocampus, elevate plasma VIP level and reduce plasma ET in rats with VD.

Effect of moxibustion on vascular dementia and neuropeptide substance content in cerebral spinal fluid

Objective To observe the effects of moxibustion therapy on the improvements of clinical symptom scale score and neuropeptide substance in vascular dementia （VD） and investigate a mechanism of moxibustion for VD. Methods Eighty-seven cases of VD were divided randomly into a moxibustion group （43 cases） and a medication group （44 cases）. In moxibustion group, the isolated moxibustion with Typhonium Rhizome was applied to Baihui （百会 GV 20）, and suspended moxibustion was used on Shenting （神庭 GV 24） and Dazhui （大椎 GV 14）. In medication group, Piracetam tablet was taken orally. After 4-session treatment, the scores in Hasegawa＇s Dementia Scale （HDS）, Mini Mental Status Examination （MMSE） and Activity of Daily Living Scale （ADL） as well as the content of active substances, somatostatin （SS） and arginine vasopressin （AVP） in cerebral spinal fluid relevant with learning and memory were compared with those before treatment. Results The total effective rate was 81.4% （35/43） in moxibustion group, which was superior to 63.6% （28/44） in medication group （P〈0.01）. The scores in HDS, MMSE and ADL after treatment were all improved as compared with those before treatment in two groups （P〈0.05, P〈0.01）. The improvements of the scores in MMSE and ADL in moxibustion group were superior to those in medication group （both P〈0.05）. After treatment, SS and AVP content in cerebral spinal fluid increased remarkably as compared with those before treatment in two groups （both P〈0.01）, and SS and AVP levels after treatment in moxibustion group were improved significantly as compared with those in medication group （P〈0.05, P〈0.01）. Conclusion Moxibustion therapy is superior to oral administration of Piracetam tablet no matter in the improvement of symptom scores or in the regulation of neuropeptide substances relevant with learning and memory, which deserves to be promoted in application.

The clinical manifestations and pathophysiology of cerebral small vessel disease

Small vessel disease （SVD） is responsible for brain chronic circular disorder,and accounts for 20%–30%cases of ischemic stroke as well as cerebral hemorrhage,and to a great extent,encephalopathy.Binswanger’s disease and multiple small strokes,which are common in older people,are also closely associated with SVD.These disorders often cause decline in cognition,vascular dementia,impairment in gait and balance,mood depression,and urinary incontinence,and often brings great social and economic burdens.SVD-related encephalopathy increases the incidences of fall,disability and death in elderly people.With the aging of the society,more attention should be paid to the importance of early diagnosis and prophylactic treatment of SVD.Here the clinical manifestations and pathophysiology of SVD are reviewed.

Clinical Study on Treatment of Vascular Dementia with Scalp Acupuncture

Objective： To explore a treatment method for vascular dementia. Methods： Sixty patients were randomly allocated into two groups. The observation group was treated with long-term needle-retaining method of scalp acupuncture and the control group was treated by medications. Evaluation was made respectively before and after the treatment by means of Hasegawa dementia scale （HDS）, neurological function deficit （NFD） score and main symptom （MS） score. Results： There were statistically significant differences in HDS, NFD score and MS score in both groups （P〈0.01） before and after the treatment. There were statistically significant differences in HDS, NFD score and MS score between the two groups （P〈0.05） before and after the treatment. The total effective rate was 86.8% in the observation group and 80.0% in the control group. There was a statistically significant difference in the effects between the two groups （P〈0.05）. Conclusion： This long-term needle-retaining method of scalp acupuncture is precisely effective for vascular dementia.

Specific Effects of Needling Different Acupoints of Patients with Vascular Dementia

Objective： To observe the effects of needling Baihui （GV 20）, Shuigou （GV 26） and Shenmen （HT 7） on cerebral glucose metabolism in patients with vascular dementia （VD） by cerebral functional imaging technique. Methods： Twenty-five patients with VD were divided into 5 groups （Group A, B, C, D and E） randomly. Patients in the Group A were treated by needling routine acupoints for hemiplegia （Acupoints of the three yang meridians of hand and foot）, and besides the routine acupoints, patients in the Group B were treated by needling Baihui（GV 20）, the Group C by Shuigou（GV 26）, the Group D by Shenmen（HT 7）, and the Group E by Baihui（GV 20）, Shuigou（GV 26）, and Shenmen（HT 7）. All the patients were examined by Positron Emission Tomography （PET） to detect the cerebral glucose metabolism in the bilateral frontal lobes（orbital gyri）, parietal lobes, temporal lobes（hippocampus and hippocampal gyrus）, occipital lobes, thalamus, lentiform nucleus, caudate nuclei, cingulate gyrus and cerebellum before treatments and after treatments. Results： After needling the routine acupoints for hemiplegia, glucose metabolism increased in lentiform nucleus and temporal lobe; needling Baihui（GV 20）, increased in frontal lobe, temporal lobe and lentiform nucleus; needling Shuigou（GV 26）, increased in frontal lobe, thalamus and lentiform nucleus; needling Shenmen（HT 7）, increased in parietal lobe and lentiform nucleus; and needling these three acupoints, increased in frontal lobe, temporal lobe, thalamus and lentiform nucleus. Conclusion： Needling Baihui（GV 20）, Shuigou（GV 26） and Shenmen（HT 7） affect glucose metabolism in different functional regions of the brain, and Baihui（GV 20）, Shuigou（GV26） and Shenmen（HT 7） relate to different functional regions of the brain.

Clinical Research on Comprehensive Treatment of Senile Vascular Dementia

Objective:To observe the curative effect of combined Chinese medicine,acupuncture and rehabilitation therapy on vascular dementia(VD),and to compare the Western medicine piracetam.Methods:Total 134 VD patients screened in reference to the standard for VD diagnosis in DSM-IV were randomly divided into a Chinese medicine plus rehabilitation group(32 cases),a Chinese medicine plus acupuncture group(33 cases),a Chinese medicine and acupuncture plus rehabilitation group(37 cases) and a Western medicine piracetam group(32 cases).Mini Mental State Examination(MMSE) and Bless Behavior Scale(BBS) were used to assess changes in intelligence disorder before treatment and after 12-week treatment.Results:BBS score,living ability and daily habit were enhanced after treatment in all groups.Cognitive function and behavioral ability were improved with similar total curative effects in all the 4 groups.Directional ability and short-term memory ability were significantly enhanced after treatment(P<0.05) in both the Chinese medicine plus rehabilitation group and the Chinese medicine plus acupuncture group groups.Living ability was significantly improved after treatment in the Chinese medicine and acupuncture plus rehabilitation group(P<0.01).However,no obvious difference was shown before and after treatment in the piracetam group.Conclusion:The improvement of living ability in the comprehensive treatment group is better than that in the other groups.Chinese medicine and acupuncture plus rehabilitation treatment can improve intelligence and living ability of senile VD patients.

Effect of warming yang and supplementing kidney moxibustion therapy on the NF-κB signaling pathway of vascular dementia rats

Objective： To observe the effect of warming yang and supplementing kidney moxibustion therapy on the behavioristics and the expression levels of hippocampal IL-1β, TNF-α and NF-κB related genes and proteins of vascular dementia（VD） rats, and to explore the mechanism of warming yang and supplementing kidney moxibustion therapy in inhibiting VD inflammatory response. Methods Seventy-eight SD rats, except 10 rats as sham operation group（group A）, were established into VD models by applying the ischemia reperfusion method in bilateral common carotid arteries. 30 models were successful and were randomly divided into model group（group B）, moxibustion group（group C） and western medication group（group D）, with 10 rats in each group. After modeling, suspended moxibustion was conducted at ＂Dàzhuī（大椎GV 14）＂,＂Mìngmén（命门GV 4）＂ and ＂Guānyuán（关元CV 4）＂ of the rats in group C for15 min/time. The intervention was performed for once a day, and intervention for 4 consecutive weeks was needed. Intragastric administration with nimodipine（2 mgkg-1d-1） was carried out in the rats in group D for 4 consecutive weeks. Morris water maze test was adopted for behavioral test in the rats in each group. HE staining was conducted in order to observe the pathological changes. RT-qPCR method and Western blot method were used for detecting the expression levels of hippocampal IL-1β, TNF-αand NF-κB related genes and proteins.Results： After modeling, the Morris water maze escape latency of rats in operation groups was obviously longer than that in group A（P〈0.05）. According to HE staining results, the arrangement of neurons in group B was incompact, the cell membranes were undefined, the cytoplasm was heterogeneous, karyopyknosis was found, the amount of necrosis increased, and the number of inflammatory cells significantly increased. Compared with group B, the number of inflammatory cells significantly reduced in group C and group D, and the amount of neuron necrosis also reduced. After intervention, compared with group B, the expression levels of TNF-a, p-IκB and NF-κBp65 mRNA in the hippocampal of the rats in group C and group D significantly decreased（all P〈0.05）, compared with group B, the expression levels of IL-1β, TNF-α and NF-κBp65 mRNA in the hippocampal of rats in group C and group D also significantly decreased（all P〈0.05）.Conclusion： Warming yang and supplementing kidney moxibustion therapy may inhibit the NF-κB signaling pathway and reduce the inflammatory response through lowering the expression levels of IL-1β,TNF-α and NF-κB mRNA in the brain, thus achieving the purpose of treating VD.

Effect of Sancaijiangtang on plasma nitric oxide and endothelin-1 levels in patients with type 2 diabetes mellitus and vascular dementia:a single-blind randomized controlled trial

OBJECTIVE: To observe the effect of Sancaijiangtang powders on plasma nitric oxide and endothelin-1 levels. We sought to identify the common pathological link and mechanism of action for Traditional Chinese medicine in type 2 diabetes mellitus and vascular dementia,and to explicate the material basis for treating the different diseases with the same method in Traditional Chinese Medicine.METHODS: In total,168 patients with type 2 diabetes mellitus and vascular dementia were enrolled in the study,and randomly divided into two groups by simple randomization. Patients in the treatment group received oral Sancaijiangtang powders with pioglitazone hydrochloride three times daily,while patients in the control group received pioglitazone hydrochloride alone. The treatment course was for12 weeks. Mini-mental state examinations(Chinese version) and Montreal Cognitive Assessments(Beijing version) were performed,and fasting plasma glucose,fasting insulin,hemoglobin A1 c,homeostasis model assessment of insulin resistance,plasma nitric oxide and endothelin-1 levels were measured before and after the treatment.RESULTS: The post-treatment levels for all measurements in both groups were better than pre-treatment levels(P < 0.05). The post-treatment levels for all measurements in the treatment group were better than the levels measured in the control group(P < 0.05).CONCLUSION: Type 2 diabetes mellitus and vascular dementia have common pathological mechanisms for insulin resistance and endothelium dysfunction. Sancaijiangtang powders could improve the release of nitric oxide and inhibit the secretion of endothelin-1. Therefore,the material basis exists for treating the different diseases with the same method in Traditional Chinese Medicine.

Comparative Study on the Effect of Baihui （GV 20）, Shuigou （GV 26） and Shenmen （HT 7） on Cognition of Patients with Vascular Dementia

Objective： To study the relative specificity of Baihui （GV 20）, Shuigou （GV 26） and Shenmen （HT 7） in improving the cognitive function of patients with vascular dementia （VD）. Method： Fifty VD cases were randomized into 5 groups, which were treated with routine points, routine points plus Baihui （GV 20）, routine points plus Shuigou （GV 26）, routine points plus Shenmen （HT 7）, and routine points plus the above-mentioned three points together respectively. The scale of elderly cognitive function （SECF） was measured before and after the treatment for statistical management. Results： The total score of SECF was markedly increased after Baihui （GV 20）, Shuigou （GV 26） and Shenmen （HT 7） were added to the routine points, more specifically, with addition of Baihui （GV 20）, the patients with VD got increased scores in such aspects as orientation, instant memory, long-term anamnesis, animal names, cancellation and calculation, and classification and analogy; with addition of Shuigou （GV 26）, the patients with VD got increased scores in such aspects as orientation, cancellation and calculation, and classification and analogy; with addition of Shenmen （HT 7）, the patients with VD got increased scores in such aspects as digital scope, animal names, and classification and analogy. Conclusion： Baihui （GV 20）, Shuigou （GV 26） and Shenmen （HT 7） could improve the cognitive function of patients with VD, and the combination of the three points got the best result despite their respective specificity.

Electroacupuncture on the Head Points for Improving Gnosia in Patients with Vascular Dementia

Objective： To investigate the clinical effects of electroacupuncture （EA） on the head points for improving gnosia in patients with vascular dementia （VD）. Methods： 90 VD patients were randomly divided into a drug group, an EA group and an EA plus drug group. Scoring with the M/VISE scale and detecting the relevant potentials were done before treatment and after a 6-week treatment. Results： Gnosia was improved after treatment in all the three groups with no significant difference by the intergroup comparison. Conclusion： The above three therapies can all improve gnosia, reduce the psychological stress, strengthen attention and shorten the awaiting time for recognition; and EA plus Nimodipine seems to be the best in the curative effect.

Observation on efficacy of treating vascular dementia gait disorder with electro-acupuncture(EA) on Jiājǐ(夹脊 EX-B2) along lumbar vertebra combined with scalp acupuncture

Objective To observe the efficacy of treating vascular dementia gait disorder with electroacupuncture （EA） on Jiaji （夹脊EX-B2） along the lumbar vertebra combined with scalp acupuncture, in order to explore a more effective therapeutic method. Methods Forty-two patients were divided into an acupuncture group and a drug group according to the method of random number table, with 21 cases in each group. EA on EX-B2 from L2 to L5 （bilateral） and scalp acupuncture on Baihui （百会 CV 20） and Sishencong （四神聪EX-HN 1） were applied in the acupuncture group, once a day the course of treatment was 30 days; Duxil was taken orally by the drug group, one pill twice a day for 30 days as a course of treatment. After treatment was completed, the efficacy was evaluated and activities of daily living （ADL） were compared between the two groups. Results The total effectiveness rate for the acupuncture group was 90.5%, which was significantly better than that of the drug group （61.9%）, and the differences were statistically significant （P〈0.05）; ADL was compared before and after treatment, and the differences were statistically significant （the acupuncture group： 24.52±9.34 vs 32.85±13.56; the drug group： 25.47±10.04 vs 29.99±13.87, both P〈0.01）; after treatment, ADL, including gait disorders, in the acupuncture group was more significantly improved than that of the drug group, and the differences were statistically significant （32.85±13.56 vs 29.99± 13.87, P〈0.01）. Conclusion The efficacy of treating vascular dementia gait disorder with electro-acupuncture （EA） on EX-B2 along lumbar vertebra combined with scalp acupuncture was superior to orally administered Duxil.

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.

Moxibustion therapy improving delayed memory deficits via promoting neurogenesis and angiogenesis of hippocampus in a vascular dementia rat model

Objective:To investigate the alteration of delayed memory and its relationship with neurogenesis and angiogenesis in vascular dementia(VD)rats after moxibustion therapy.Methods:Two hundred adult male SPF Wistar rats were chosen for the experiment.Thirty-six rats were randomly selected as the sham operation group.Except for rats in the sham operation group(n=36),the others were made into VD models by bilateral comm on carotid arteries occlusi on(BCCAo).After modeli ng,the 108 survived rats were ran domly divided into 3 groups:a model group,a neural stem cells(NSCs)plus endothelial progenitor cells(EPCs)moxibustion group and a NSCs moxibustion group.Co-transplanted implant was transplanted into the rats in the NSCs plus EPCs moxibustion group,and the rats in the NSCs moxibustion group were transplanted by NSCs only.The NSCs plus EPCs moxibustion group and the NSCs moxibustion group received suspended moxibustion therapy at Baihui(GV 20),Dazhui(GV 14)and Shenting(GV 24),(each group was divided into 3 subgroups by the treatment course as 1,2 and 3 courses).Every group was measured by Morris water maze to evaluate its delayed memory after 3 treatment courses and the rat's brain was taken out after perfusion of 4%paraformaldehyde one day after 1,2 and 3 treatment courses,respectively.Marker protein expression was detected by laser con focal microscope to an a lyze the effect on neuroge nesis and an gioge nesis.Results:VD rats showed delayed memory in Morris water maze test 3 d after ischemic injury.After 3 courses of moxibustion therapy,VD-induced delayed memory deficits were improved in the NSCs plus EPCs moxibustion group and the NSCs moxibustion group.The expressions of nestin,doublecortin(DCX)and CD34 increased significantly in the two moxibusiton groups after every treatment course(all P<0.05),which might contribute to the neurogenesis and angiogenesis in hippocampus.In addition,compared with the rats in the NSCs moxibustion group,the expressions of nestin,DCX and CD34 increased significantly in the NSCs plus EPCs moxibustion group(P<0.05).Conclusion:Moxibustion can reverse VD-induced delayed memory deficits,which may be related to the promotion of neurogenesis and angiogenesis.

Therapeutic efficacy and mechanism of heat-sensitive moxibustion for vascular dementia

Objective:To observe the clinical efficacy of heat-sensitive moxibustion for vascular dementia and explore its mechanism.Methods:A total of 70 patients with vascular dementia were randomized into an observation group and a control group,with 35 cases in each group.The control group was treated with piracetam,and the observation group was treated with heat-sensitive moxibustion on the basis of the treatment of the control group.The treatment lasted for 8 weeks.Before and after the treatment,the mini-mental state examination(MMSE),activity of daily living(ADL)and traditional Chinese medicine(TCM)symptom scores were assessed,and the levels of acetyl choline(Ach)and homocysteine(Hcy)were measured.The efficacy was evaluated after treatment.Results:The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).After treatment,the MMSE and ADL scores in the observation group decreased significantly,and were lower than those in the control group(all P<0.05);the TCM symptom score of the observation group decreased significantly(P<0.05),while that of the control group had no significant change(P>0.05);the plasma Ach level in the observation group increased significantly(P<0.05),and the Hcy level decreased significantly(P<0.05),which were statistically different from those in the control group(both P<0.05).Conclusion:Heat-sensitive moxibustion plus piracetam is effective in treating vascular dementia.It can significantly improve dementia symptoms and ADL,which may be related to the correction of plasma Ach and Hcy levels.