A comprehensive review of heart rate variability as an indicator in the regulation of the autonomic nervous system by acupuncture:a bibliometric analysis

This study sought to conduct a bibliometric analysis of acupuncture studies focusing on heart rate variability(HRV)and to investigate the correlation between various acupoints and their effects on HRV by utilizing association rule mining and network analysis.A total of 536 publications on the topic of acupuncture studies based on HRV.The disease keyword analysis revealed that HRV-related acupuncture studies were mainly related to pain,inflammation,emotional disorders,gastrointestinal function,and hypertension.A separate analysis was conducted on acupuncture prescriptions,and Neiguan(PC6)and Zusanli(ST36)were the most frequently used acupoints.The core acupoints for HRV regulation were identified as PC6,ST36,Shenmen(HT7),Hegu(LI4),Sanyinjiao(SP6),Jianshi(PC5),Taichong(LR3),Quchi(LI11),Guanyuan(CV4),Baihui(GV20),and Taixi(KI3).Additionally,the research encompassed 46 reports on acupuncture animal experiments conducted on HRV,with ST36 being the most frequently utilized acupoint.The research presented in this study offers valuable insights into the global research trend and hotspots in acupuncture-based HRV studies,as well as identifying frequently used combinations of acupoints.The findings may be helpful for further research in this field and provide valuable information about the potential use of acupuncture for improving HRV in both humans and animals.

Automated Segmentation of the Brainstem,Cranial Nerves and Vessels for Trigeminal Neuralgia and Hemifacial Spasm

Accurate localization of cranial nerves and responsible blood vessels is important for diagnosing trigeminal neuralgia(TN)and hemifacial spasm(HFS).Manual delineation of the nerves and vessels on medical images is time-consuming and labor-intensive.Due to the development of convolutional neural networks(CNNs),the performance of medical image segmentation has been improved.In this work,we investigate the plans for automated segmentation of cranial nerves and responsible vessels for TN and HFS,which has not been comprehensively studied before.Different inputs are given to the CNN to find the best training configuration of segmenting trigeminal nerves,facial nerves,responsible vessels and brainstem,including the image modality and the number of segmentation targets.According to multiple experiments with seven training plans,we suggest training with the combination of three-dimensional fast imaging employing steady-state acquisition(3D-FIESTA)and three-dimensional time-of-flight magnetic resonance angiography(3DTOF-MRA),and separate segmentation of cranial nerves and vessels.

Various Aetiologies of Non-Traumatic Coccydynia Cause Pain in the Posterior Sacrococcygeal Leg of the Pelvic Tripod: A Burden on the Healthcare Sector

Introduction: Coccydynia, television disease, and coccygodynia are the different names given to this disabling disease, which can become chronic. It was described by Simson in 1859. Coccydynia means pain at the end of the vertebral column. Non-traumatic coccydynia is a diagnosis, which is never straightforward like traumatic coccydynia because the onset is unclear, and both the patient and the unaware clinician face many challenges in treating it on time and with accuracy. Coccyx was likened to a cuckoo bird’s beak as a curved bone of fused 3 to 5 vertebrae with remnant disc material in some rare cases, unfused segments, linear scoliosis or subluxations and deformities. Stress X-rays of the coccyx in the antero-posterior and lateral views in standing and sitting reveal the “Dynamic Instability” due to congenital coccygeal morphological, pathological and mechanical variations. Material and Methods: This is a complex study having retrograde data collected from online publications from various databases, like PubMed, Embase, and Cochrane Library and also antegrade data collected from 100 patients with their consent from patients in Adam and Eve Specialised Medical Centre-based at Abu Dhabi, UAE and data was processed in the research centre of Krushi Orthopaedic Welfare Society based in India between 2014-2024 following all guidelines of Helsinki and approved by the ethics board of Krushi Orthopaedic Welfare Society. Clinical Presentation: The coccyx is painful, with aches, spasms, and an inability to sit. This affects daily activities without any particular date of onset. The onset remains insidious for the non-traumatic variety of coccydynia. Aetiology and Patho Anatomy: Non-traumatic coccydynia can be caused by a myriad of reasons, like congenital morphological variations, acquired dynamic instabilities, and hidden trauma remaining quiescent to re-surface as a strain-induced pain. Radiological Presentations: Unless clarity is focused on these coccygeal views, the errors of the unevacuated rectum, non-dynamic standing views, improper X-ray exposure and refuge by insurance companies to approve the much needed but multiple views in radiological investigation (Stress X-ray), MRI scan, lack of awareness by the clinician, all lead to missed diagnosis with its repercussions as congenital variations in morphology, acquired changes in structure/mobility, pathologies like tumours like congenital teratoma & adult onset chordoma, Tarlov cysts, pilonidal sinus or infections—even tuberculosis, dural syndrome, stiff coccyx due to ankylosing spondylitis and many others like relation to neurosis have all been documented. Treatment options are outside the scope of this research topic, as only the differential diagnosis is being stressed here, so that the clinician and the patient do not overlook the varying aetiology, which is the first step to timely and appropriate treatment. Conclusion: Level 3 evidence is available pointing towards many aetiologies causing non-traumatic coccydynia, and in this study of 100 patients by Krushi O W S, a non-profit organisation, the results were as follows: 1) Coccydynia is more common in Type II coccyx and bony spicules. 2) Coccydynia is more prevalent when the sacrococcygeal joints are not fused. 3) Coccydynia is more prevalent when there is subluxation at the intercoccygeal joints. 4) Coccydynia is more when the sacral angle is lower. 5) Coccydynia is associated with higher sacrococcygeal curved length. 6) Coccydynia is associated with a lower sacrococcygeal curvature index. 7) Gender variations: The coccygeal curvature index was lower in females with coccydynia;the intercoccygeal angle was lower in males. 8) Both obese and thin individuals can get affected due to different weight-bearing mechanics in play.

Acupuncture in diabetic peripheral neuropathy-neurological outcomes of the randomized acupuncture in diabetic peripheral neuropathy trial

BACKGROUND Diabetic peripheral neuropathy(DPN)is a common complication of diabetes mellitus and can lead to serious complications.Therapeutic strategies for pain control are available but there are few approaches that influence neurological deficits such as numbness.AIM To investigate the effectiveness of acupuncture on improving neurological deficits in patients suffering from type 2 DPN.METHODS The acupuncture in DPN(ACUDPN)study was a two-armed,randomized,controlled,parallel group,open,multicenter clinical trial.Patients were randomized in a 1:1 ratio into two groups:The acupuncture group received 12 acupuncture treatments over 8 wk,and the control group was on a waiting list during the first 16 wk,before it received the same treatment as the other group.Both groups received routine care.Outcome parameters were evaluated after 8,16 and 24 wk and included neurological scores,such as an 11-point numeric rating scale(NRS)11 for hypesthesia,neuropathic pain symptom inventory(NPSI),neuropathy deficit score(NDS),neuropathy symptom score(NSS);nerve conduction studies(NCS)were assessed with a handheld point-of-care device.RESULTSSixty-two participants were included.The NRS for numbness showed a difference of 2.3(P<0.001)in favor of theacupuncture group,the effect persisted until week 16 with a difference of 2.2(P<0.001)between groups and 1.8points at week 24 compared to baseline.The NPSI was improved in the acupuncture group by 12.6 points(P<0.001)at week 8,the NSS score at week 8 with a difference of 1.3(P<0.001);the NDS and the TNSc score improvedfor the acupuncture group in week 8,with a difference of 2.0 points(P<0.001)compared to the control group.Effects were persistent in week 16 with a difference of 1.8 points(P<0.05).The NCS showed no meaningfulchanges.In both groups only minor side effects were reported.CONCLUSION Study results suggest that acupuncture may be beneficial in type 2 diabetic DPN and seems to lead to a reductionin neurological deficits.No serious adverse events were recorded and the adherence to treatment was high.Confirmatory randomized sham-controlled clinical studies with adequate patient numbers are needed to confirmthe results.

Acupuncture at the “Huatuojiaji” point affects nerve root regional interleukin-1 level in a rat model of lumbar nerve root compression

BACKGROUND：It has been shown that interleukin-1 （IL-1） may cause inflammatory reactions, which stimulate the nerve root of patients with lumbar intervertebral disc protrusion and leads to pain. Whether the clinical curative effects of acupuncture in the treatment of lumbar and leg pain are linked to an inhibition of local IL-1 secretion is unknown. OBJECTIVE： To assess the influence of acupuncture on IL-1, this study was designed to verify the effects of acupuncture at the ＂Huatuojiaji （Extra）＂ point on the nerve root in a rat model of lumbar nerve root compression, compared with administration of meloxicam, a non-steroidal anti-inflammatory drug. DESIGN, TIME AND SETTING： Randomized, controlled, molecular biology experiment, performed at the Experimental Center, Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University between September 2005 and April 2006. MATERIALS： Forty healthy adult Sprague Dawley rats of either gender were included in this study. The rats were randomly and evenly divided into the following four groups： normal control, model, acupuncture and meloxicam groups. Lumbar nerve root compression was induced in rats in the model, acupuncture, and meloxicam groups by inserting a specially made silicon rubber slice at the juncture of the L5 nerve root and the dural sac. The acupuncture needle （pattern number N3030, 30#, 1.5 inch） was purchased from Suzhou Medical Appliance Factory, China. IL-1 enzyme linked immunosorbent assay （ELISA） kit was purchased from Santa Cruz Biotechnology, Inc., USA. METHODS： The acupuncture group was acupunctured at the ＂Huatuojiaji＂ point, which is lateral to the compressed L5-6 nerve root, with an acupuncture depth of 0.5 cm. There were two treatment courses, each of involved seven 20-minute acupuncture sessions, one session a day. The meloxicam group was administered intragastrically 3.75 mg/kg meloxicam （5 mg meloxicam /10 mL physiological saline）. Rats in the normal control group and model group received an intragastric administration of 10 mL/kg physiological saline. All administrations were performed once a day. MAIN OUTCOME MEASURES： At day 14 post-surgery, the IL-1 level in the compressed nerve root was determined by a streptavidin-peroxidase （S-P） immunohistochemical method, and IL-1β mRNA expression in the compressed nerve root was simultaneously detected by real-time reverse transcription-polymerase chain reaction. RESULTS： The expression levels of IL-1 and IL-1β mRNA in the L5 nerve root were significantly higher in the model group than in the control group （P 〈 0.01）. However, the expression levels of IL-1 and IL-1β mRNA were significantly lower in the acupuncture and meloxicam groups than in the model group （P 〈 0.05–0.01）. Expression levels of IL-1 and IL-1β mRNA were significantly higher in the acupuncture group than in the meloxicam group （P 〈 0.01）. CONCLUSION： Acupuncture at the ＂Huatuojiaji＂ point decreases the IL-1 level by inhibiting IL-1β mRNA expression to a greater extent than meloxicam administration.

Chitosan tube bridging autologous nerve segments for the repair of long-segmental sciatic nerve defects

BACKGROUND：Previous tissue-engineered nerve studies have focused on artificial nerve and nerve cell cultures.The effects of regeneration chambers with autologous nerve bridging for the repair of nerve defects remain unclear.OBJECTIVE：To explore the feasibility and advantages of chitosan tube bridging autologous nerve segments for repairing 12-mm sciatic nerve defects in rats.DESIGN,TIME AND SETTING：A randomized,controlled,animal study using nerve tissue engineering was performed at the Animal Laboratory and Laboratory of Histology and Embryology,Liaoning Medical University from June 2008 to March 2009.MATERIALS：Chitosan powder was purchased from Jinan Haidebei Marine Bioengineering,China.METHODS：A sciatic nerve segment of approximately 8 mm was excised from the posterior margin of the piriformis muscle of Sprague Dawley rats.The two nerve ends shrank to form a 12-mm defect,and the nerve defect was repaired using a chitosan tube bridging autologous nerve segment （bridge group）,a chitosan tube-encapsulated autologous nerve segment （encapsulation group）,and a chitosan tube alone （chitosan tube alone group）,respectively.MAIN OUTCOME MEASURES：Histological and ultrastructural changes of the injured sciatic nerve;number of regenerated myelinated nerve fibers; nerve conduction velocity; leg muscle atrophy; and sciatic nerve functional index.RESULTS：At 4 months after implantation,the chitosan tube was absorbed.The tube was thin,but maintained the original shape,and vascular proliferation was observed around the tube.In the bridge group,regenerative myelinated nerve fibers were thick and orderly,with a thick myelin sheath and intact axonal structure.The number of myelinated nerve fibers and nerve conduction velocity were significantly greater compared with the other groups （P〈 0.01）.Moreover,nerve and muscle function was significantly improved following chitosan tube bridging autologous nerve segment treatment compared with the other groups （P〈 0.05 or P 〈 0.01）.CONCLUSION：Chitosan tube bridging autologous nerve segments exhibited better repair effects on nerve defects compared with chitosan tubeencapsulated autologous nerve segments and a chitosan tube alone.This method provided a simple and effective treatment for long-segmental nerve defects.

Three-dimensional visualization of the functional fascicular groups of a long-segment peripheral nerve

The three-dimensional（3D） visualization of the functional bundles in the peripheral nerve provides direct and detailed intraneural spatial information. It is useful for selecting suitable surgical methods to repair nerve defects and in optimizing the construction of tissue-engineered nerve grafts. However, there remain major technical hurdles in obtaining, registering and interpreting 2D images, as well as in establishing 3D models. Moreover, the 3D models are plagued by poor accuracy and lack of detail and cannot completely reflect the stereoscopic microstructure inside the nerve. To explore and help resolve these key technical problems of 3D reconstruction, in the present study, we designed a novel method based on re-imaging techniques and computer image layer processing technology. A 20-cm ulnar nerve segment from the upper arm of a fresh adult cadaver was used for acetylcholinesterase（ACh E） staining. Then, 2D panoramic images were obtained before and after ACh E staining under the stereomicroscope. Using layer processing techniques in Photoshop, a space transformation method was used to fulfill automatic registration. The contours were outlined, and the 3D rendering of functional fascicular groups in the long-segment ulnar nerve was performed with Amira 4.1 software. The re-imaging technique based on layer processing in Photoshop produced an image that was detailed and accurate. The merging of images was accurate, and the whole procedure was simple and fast. The least square support vector machine was accurate, with an error rate of only 8.25%. The 3D reconstruction directly revealed changes in the fusion of different nerve functional fascicular groups. In conclusion. The technique is fast with satisfactory visual reconstruction.

Autologous nerve segment-bridging regeneration chambers for the repair of sciatic nerve defects

Proximal and distal nerve defects exhibit chemotactic growth over certain distances. Our previous studies demonstrated that Schwann cells survive in autologous nerve segments that are bridged by regeneration chambers and secrete various bioactive substances. However, more data are required to determine the required length of regeneration chambers for chemotaxis and nutrition of neural regeneration, as well as the length of repaired nerve defects to replace the effect of autologous nerve grafting. In the present study, sciatic nerve defects of 12, 16, 20 mm were repaired using a regeneration chamber of 6, 8, and 10 mm in length respectively. These were bridged with autologous nerve segments. Results showed that the bridging of two 6-mm long regeneration chambers to repair a 12-mm nerve defect exhibited similar effects to autologous nerve grafting.

A randomized trial comparing the Tennant Biomodulator to transcutaneous electrical nerve stimulation and traditional Chinese acupuncture for the treatment of chronic pain in military service members

Background:The present investigation tested the efficacy of the Tennant Biomodulator,a novel pain management intervention that uses biofeedback-modulated electrical stimulation,to reduce chronic pain and its psychosocial sequelae in a sample of current and former military service members.The Tennant Biomodulator used on its most basic setting was compared to two commonly used,non-pharmacological pain treatments—traditional Chinese acupuncture and transcutaneous electrical nerve stimulation(TENS)—in a comparative efficacy,randomized,open-label trial.Methods:Participants included 100 active duty and retired service men and women with chronic pain undergoing treatment at the Brooke Army Medical Center in Texas,USA,randomly assigned to receive six,weekly sessions of either Tennant Biomodulator treatment,traditional Chinese acupuncture,or TENS,in addition to usual care.Recruitment was conducted between May 2010 to September 2013.Outcome measures were collected at intake,before and after each treatment session,and at a 1-month follow-up.Intent-to-treat analyses were used throughout,with mixed models used to investigate main effects of group,time,and group×time interactions with consideration given to quadratic effects.Outcomes measured included ratings of chronic pain,pain-related functional disability,and symptoms of post-traumatic stress disorder(PTSD)and depression.Results:On average,regardless of their treatment group,participants exhibited a 16%reduction in pain measured by the Brooke Army Medical Center’s Clinic Pain Log[F(1,335)=55.7,P<0.0001]and an 11%reduction in pain-related disability measured by the Million Visual Analog Scale[MVAS:F(1,84)=28.3,P<0.0001]from baseline to the end of treatment,but no one treatment performed better than the other,and the reductions in pain and pain-related disability were largely lost by 1-month follow-up.Symptoms of PTSD and depression did not change significantly as a function of time or group.Conclusions:Findings build on previous work suggesting that traditional Chinese acupuncture and TENS can reduce pain and its functional sequelae without risks associated with pharmacological pain management.The Tennant Biomodulator used on its most basic setting performs as well as these other interventions.Based on the present findings,large,randomized controlled trials on the Tennant Biomodulator are indicated.Future work should test this device using its full range of settings for pain-related psychological health.Trial registration:Clincialtrials.gov(NCT01752010);registered December 14,2012.

Eighty Cases of Injury of the Superior Cluneal Nerve Treated by Electroacupuncture

Injury of the superior cluneal nerve is acommonly encountered affection in clinical practice.The author treated 80 cases of injury of the superiorcluneal nerve by electr0acupuncture from August1991 to August 1998,with other 77 cases treated byacupuncture as the controls.The result is reported asfollow.General Data157 OUtpatients were randomly diVided into thetreatment group and the control group.Among

THE STUDY ON THE RELATION BETWEEN THE LOCATION OF NERVE LESION IN PERIPHERAL FACIAL PARALYSIS AND THE THERAPEUTICAL EFFECT OF ACUPUNCTURE

Due to the difference of the plane of facial nerve lesion,facial paralysis can be classifiedinto nudear paralysis,paralysis of cerebellopontine angle,Hunt’s palsy,Bell’s palsy and simple facialneuritis.The authors treated 78 cases of the of the latter 3 types,compared the therapeutical effect after 2courses of treatment,and meanwhile made dynamic electromyographic observation between the tragusand the quadrate musde of upper lip for those with Bell’s palsy and Hunt’s palsy.The result showsthat acupuncture has a fair effect in treating peripheral facial paralysis and simple facial neuritis andthe myoelectric recovery in Bell’s palsy is quicker than that in Hunt’s palsy.It is suggested that thehfeher the pane of the facial nerve lesion is,the more unsatisfactory the effect is,and the effect ismore favorable otherwise.

Acupuncture Therapy for the Treatment of Optic Nerve Atrophy

Objective: Optical Nerve Atrophy is one of the most common causes of blindness worldwide. The condition is linked to several pathologies, which contribute to the damage of the optic nerve. The presence of a tumor on the optic nerve, improper formation of the optic nerve, glaucoma, hereditary and central nervous system diseases, and anterior ischemic optic neuropathy promote deterioration of the optic nerve. The purpose of this review is to examine the efficacy of acupuncture therapy for ONA. Method: Clinical trials (case control-trials), and randomized control trials (RCTs) were assessed to observe the efficacy of acupuncture as well as the safety of acupuncture, needling manipulation, and acupoints selection. The data collected in this research include scientific research papers from China National Knowledge Infrastructure (CNKI), PUBMED library, National Library of Medicine (NLM), EMBASE, Cochrane Library, Chinese Biomedical Literature Database, and other literature library date present. Ophthalmoscope, OCT, pupils test, ocular alignment, nystagmus, and visual acuity check were the diagnostic tools used for ONA in the included study. ONA treatment has been a challenge to ophthalmologists over the past decades. At present, western approaches have no fixed treatment mechanism for the condition. Early diagnosis, the use of magnifying lenses, and reduction of increased fluid around the spinal cord and brain are the multiple disciplinary approaches used in western medicine for ONA. On the other hand, Acupuncture, a branch of traditional Chinese medicine, which stimulates the body’s natural healing ability to promote physical and emotional well-being, has reported some significant treatment effects for ONA. Result: The overall result shows that Acupuncture greatly improved patients’ visual acuity, visual field, and visual function in the included study. Acupuncture acting alone showed significant superiority over other treatments for optical nerve atrophy. Acupuncture combined with medication could improve a patient’s condition more rapidly than medications alone. Conclusion: Optic nerve atrophy is a threatening condition to the vision, which is a leading cause of blindness worldwide. Acupuncture has improved the condition of patients with ONA more effectively than other treatment mechanisms in the included study. However, more clinical trials need to be carried out to substantiate stronger evidence of acupuncture for ONA.

Study on the therapeutic effect of external application of Shounian powder combined with acupuncture at Zhitong acupoint on intercostobrachial nerve syndrome after breast cancer operation

Background:To explore the clinical effect of external application of ShouNian Powder combined with acupuncture at Zhitong acupoint in the treatment of intercostobrachial nerve syndrome(ICBNs)after breast cancer operation.Methods:A total of 80 patients with ICBNs who underwent modified radical mastectomy in our hospital from July 2014 to July 2016 were collected and divided into control group and study group according to the different treatment methods of ICBNs.40 patients in the control group were treated with symptomatic analgesia and 40 patients in the study group were treated with external application of ShouNian Powder combined with acupuncture at Zhitong acupoint to compare and analyze the pain relief,quality of life and analgesic recurrence rate of ICBNs between the two groups.Results:Compared with the control group,the pain relief rate of ICBNs in the study group was higher.The patient satisfaction and long-term quality of life in the study group were better than those in the control group.However,there was no significant difference in postoperative pain recurrence rate.Conclusion:External application of ShouNian Powder combined with acupuncture at Zhitong acupoint can effectively relieve pain and improve quality of life for patients with ICBNs after breast cancer operation,which has a certain popularizing significance in clinical practice.

Acupuncture therapy in a patient with radial nerve injury

Objective： To analyze the cause and pathogenesis of nerve injury and find out the suitable acupuncture points. Methods： Acupuncture at the unilateral points of Hegu （LI4）, Waiguan （TB5）, Shousanli （LI10）, Quchi （LI11） and the bilateral points of Zusanli （ST36）, accompanied by method of electro-acupuncture. Results： After three courses of acupuncture treatment （30 minutes each time, 6 times each course）, the patient presented the symptoms of making a fist strongly, disappearance of wrist drop, and positive sign of lifting wrist assay in turn. Simutaneously, the grip strength of hand increased and the strength of muscle reach over level 4. Conclusion： With the help of electro-acupuncture, acupuncture therapy can relieve pain, improve the local blood supply of nerve injury and then repair the damage of the nerve.

Effect of acupuncture combined with drug therapy on the nerve cytokine secretion and oxidative stress in convalescence of cerebral infarction

Objective: To explore the effect of acupuncture combined with drug therapy on the nerve cytokine secretion and oxidative stress in convalescence of cerebral infarction. Methods: A total of 118 patients in convalescence of cerebral infarction who were treated in the affiliated hospital of our school between August 2014 and December 2016 were divided into control group (n=59) and observation group (n=59) according to the random number table method. Control group received routine drug therapy, and the observation group received acupuncture combined with drug therapy. The differences in serum levels of neurotrophic factors, nerve injury factors and oxidative stress indexes were compared between the two groups before and after treatment. Results: The differences in serum levels of neurotrophic factors, nerve injury factors and oxidative stress indexes were not statistically significant between the two groups before treatment. After treatment, serum neurotrophic factors IGF-1, BDNF and NGF levels of observation group were higher than those of control group;nerve injury factors S-100β, NSE, GFAP and UCH-L1 levels were lower than those of control group;oxidative stress indexes MDA, AOPPs and LHP levels were lower than those of control group while SOD and GSH-Px levels were higher than those of control group. Conclusion: Acupuncture combined with drug therapy can effectively optimize the nerve function, reduce the nerve injury and suppress the systemic oxidative stress response of patients in convalescence of cerebral infarction.

Effects of scalp acupuncture intervention combined with rehabilitation training on the neurotrophy status and nerve injury in patients with convalescent period of cerebral hemorrhage

Objective: To investigate the effects of scalp acupuncture intervention combined with rehabilitation training on the neurotrophy status and nerve injury in patients with convalescent period of cerebral hemorrhage. Methods: A total of 78 patients with convalescent period of cerebral hemorrhage who were treated in West China Hospital between January 2016 and March 2017 were divided into the control group and the experimental group by random number table, each with 39 cases. Control group received the routine rehabilitation training, and the experimental group received scalp acupuncture intervention combined with rehabilitation training. The differences in neurotrophy status and nerve injury were compared between the two groups before and after intervention. Results: Before intervention, there was no statistically significant difference in neurotrophy status and nerve injury between the two groups. After 1 week of intervention and after 2 weeks of intervention, serum neurotrophy indexes NGF and BDNF contents of experimental group were higher than those of control group;serum nerve injury indexes GFAP, NSE and S100B contents were lower than those of control group;serum inflammatory mediators IL-18, HMGB1 and IFN-γ contents were lower than those of control group. Conclusion: scalp acupuncture intervention combined with rehabilitation training can effectively improve the neurotrophy state and reduce the nerve injury in patients with convalescent period of cerebral hemorrhage.

Electroacupuncture and moxibustion promote regeneration of injured sciatic nerve through Schwann cell proliferation and nerve growth factor secretion

Using electroacupuncture and moxibustion to treat peripheral nerve injury is highly efficient with low side effects. However, the electroacupuncture-and moxibustion-based mechanisms underlying nerve repair are still unclear. Here, in vivo and in vitro experiments uncovered one mechanism through which electroacupuncture and moxibustion affect regeneration after peripheral nerve injury. We first established rat models of sciatic nerve injury using neurotomy. Rats were treated with electroacupuncture or moxibustion at acupoints Huantiao （GB30） and Zusanli （ST36）. Each treatment lasted 15 minutes, and treatments were given six times a week for 4 consecutive weeks. Behavioral testing was used to determine the sciatic functional index. We used electrophysiological detection to measure sciatic nerve conduction velocity and performed hematoxylin-eosin staining to determine any changes in the gastrocnemius muscle. We used immunohistochemistry to observe changes in the expression of S100—a specific marker for Schwann cells—and an enzyme-linked immunosorbent assay to detect serum level of nerve growth factor. Results showed that compared with the model-only group, sciatic functional index, recovery rate of conduction velocity, diameter recovery of the gastrocnemius muscle fibers, number of S100-immunoreactive cells,and level of nerve growth factor were greater in the electroacupuncture and moxibustion groups. The efficacy did not differ between treatment groups. The serum from treated rats was collected and used to stimulate Schwann cells cultured in vitro. Results showed that the viability of Schwann cells was much higher in the treatment groups than in the model group at 3 and 5 days after treatment. These findings indicate that electroacupuncture and moxibustion promoted nerve regeneration and functional recovery; its mechanism might be associated with the enhancement of Schwann cell proliferation and upregulation of nerve growth factor.

Improvement in acupoint selection for acupuncture of nerves surrounding the injury site: electro-acupuncture with Governor vessel with local meridian acupoints

Peripheral nerve injury not only affects the site of the injury, but can also induce neuronal apop- tosis at the spinal cord. However, many acupuncture clinicians still focus only on the injury site, selecting acupoints entirely along the injured nerve trunk and neglecting other regions; this may delay onset of treatment efficacy and rehabilitation. Therefore, in the present study, we compared the clinical efficacy of acupuncture at Governor vessel and local meridian acupoints combined （GV/LM group） with acupuncture at local meridian acupoints alone （LM group） in the treatment of patients with peripheral nerve injury. In the GV/LM group （n = 15）, in addition to meridian acupoints at the injury site, the following acupoints on the Governor vessel were stimulated： Baihui （GV20）, Fengfu （GV16）, Dazhui （GV14）, and Shenzhu （GV12）, selected to treat nerve injury of the upper limb, and Jizhong （GV6）, Mingmen （GV4）, Yaoyangguan （GV3）, and Yaoshu （GV2） to treat nerve injury of the lower limb. In the LM group （n = 15）, only me- ridian acupoints along the injured nerve were selected. Both groups had electroacupuncture treatment for 30 minutes, once a day, 5 times per week, for 6 weeks. Two cases dropped out of the LM group. A good or excellent clinical response was obtained in 80% of the patients in the GV/ LM group and 38.5% of the LM group. In a second study, an additional 20 patients underwent acupuncture with the same prescription as the GV/LM group. Electomyographic nerve conduc- tion tests were performed before and after acupuncture to explore the mechanism of action of the treatment. An effective response was observed in 80.0% of the patients, with greater motor nerve conduction velocity and amplitude after treatment, indicating that electroacupuncture on specific Governor vessel acupoints promotes functional motor nerve repair after peripheral nerve injury. In addition, electromyography was performed before, during and after electroacu- puncture in one patient with radial nerve injury. After a single session, the patient＇s motor nerve conduction velocity increased by 23.2%, indicating that electroacupuncture at Governor vessel acupoints has an immediate therapeutic effect on peripheral nerve injury. Our results indicate that Governor vessel and local meridian acupoints used simultaneously promote functional repair after peripheral nerve injury. The mechanism of action may arise from an improvement of the local microenvironment in injured nervous tissue, as well as immediate effects of Governor vessel and local meridian acupoint stimulation to ensure the continuity between the peripheral and central nervous systems.

Acupuncture inhibits Notch1 and Hes1 protein expression in the basal ganglia of rats with cerebral hemorrhage

Notch pathway activation maintains neural stem cells in a proliferating state and increases nerve repair capacity. To date, studies have rarely focused on changes or damage to signal transduc- tion pathways during cerebral hemorrhage. Here, we examined the effect of acupuncture in a rat model of cerebral hemorrhage. We examined four groups： in the control group, rats received no treatment. In the model group, cerebral hemorrhage models were established by infusing non-hep-arinized blood into the Brain. In the acupuncture group, modeled rats had Baihui （DU20） and Qubin （GBT） acupoints treated once a day for 30 minutes. In the DAPT group, modeled rats had 0.15 μg/mL DAPT solution （10 mL） infused into the brain. Immunohistochemistry and western blot results showed that acupuncture effectively inhibits Notch 1 and Hesl protein expression in rat basal ganglia. These inhibitory effects were identical to DAPT, a Notch signaling pathway inhibitor. Our results suggest that acupuncture has a neuroprotective effect on cerebral hemorrhage by in- hibiting Notch-Hes signaling pathway transduction in rat basal ganglia after cerebral hemorrhage.

Acupuncture at the Taixi(KI3) acupoint activates cerebral neurons in elderly patients with mild cognitive impairment

Our previous ifndings have demonstrated that acupuncture at the Taixi （KI3） acupoint in healthy youths can activate neurons in cognitive-related cerebral cortex. Here, we investigated whether acupuncture at this acupoint in elderly patients with mild cognitive impairment can also activate neurons in these regions. Resting state and task-related functional magnetic resonance imaging showed that the pinprick senstation of acupuncture at the Taixi acupoint differed signiifcantly between elderly patients with mild cognitive impairment and healthy elderly controls. Results showed that 20 brain regions were activated in both groups of participants, including the bi-lateral anterior cingulate gyrus （Brodmann areas [BA] 32, 24）, left medial frontal cortex （BA 9, 10, 11）, left cuneus （BA 19）, left middle frontal gyrus （BA 11）, left lingual gyrus （BA 18）, right medial frontal gyrus （BA 11）, bilateral inferior frontal gyrus （BA 47）, left superior frontal gyrus （BA11）, right cuneus （BA 19, 18）, right superior temporal gyrus （BA 38）, left subcallosal gyrus （BA 47）, bilateral precuneus （BA 19）, right medial frontal gyrus （BA 10）, right superior frontal （BA 11）, left cingulate gyrus （BA 32）, left precentral gyrus （BA 6）, and right fusiform gyrus （BA 19）. These results suggest that acupuncture at the Taixi acupoint in elderly patients with mild cogni-tive impairment can also activate some brain regions.