CLINICAL REPORT ON MULTI-CENTER RANDOMIZED CONTROLLED TRIAL OF TREATMENT OF MIGRAINE BY ELECTRO-ACUPUNCTURE AT QI■X■(丘墟GB40)

Objective To observe the therapeutic effect of electro acupuncture at QIǖXǖ（丘墟GB40） for treating migraine and provide clinical study for Acupoints Dictionary of People＇s Republic of China. Methods Multi-center （3 First-Class hospitals） study was adopted, and the involved 3 hospitals did clinical observation according to the requirements of the project. The methods are as follows. All cases were randomized into treatment group and control group according to their sequence. QIǖXǖ（丘墟GB40） was selected in treatment group, while Tiānshū （天枢 ST25） was selected in control group. Both groups were performed electro acupuncture, and syndromes indexes of migraine and 5-HT were observed before and after treatment. All data were analyzed by statistic software SPSS11.5. Results There was significant difference of VAS margin between two groups in each center and the combined center （u= -3. 362, P=0. 001 ）. There was significant difference of therapeutic effect of 4-week treatment between two groups in each clinical center and the combined center. The therapeutic effect of 3-month treatment between two groups in No. 1 and No. 3 hospitals, showed significant difference, the treatment group was better; while that of No. 2 hospital had no obvious difference. The therapeutic effect of 6-month treatment between two groups in each center and the combined center had significant difference, the treatment group was better. Conclusion The therapy of electro acupuncture at QIǖXǖ（丘墟GB40） is effective for migraine.

Effect of Electro-acupuncture Stimulation of Ximen(PC4) and Neiguan(PC6) on Remifentanil-induced Breakthrough Pain Following Thoracal Esophagectomy

The clinical analgesic effect of electro-acupuncture（EA） stimulation（EAS） on breakthrough pain induced by remifentanil in patients undergoing radical thoracic esophagectomy, and the mechanisms were assessed. Sixty patients（ASAⅢ） scheduled for elective radical esophagectomy were randomized into three groups： group A（control） receiving a general anesthesia only; group B（sham） given EA needles at PC4（Ximen） and PC6（Neiguan） but no stimulation; and group C（EAS） electrically given EAS of the ipsilateral PC4 and PC6 throughout the surgery. The EAS consisting of a disperse-dense wave with a low frequency of 2 Hz and a high frequency of 20 Hz, was performed 30 min prior to induction of general anesthesia and continued through the surgery. At the emergence, sufentanil infusion was given for postoperative analgesia with loading dose of 7.5 μg, followed by a continuous infusion of 2.25 μg/h. The patient self-administration of sufentanil was 0.75 μg with a lockout of 15 min as needed. Additional breakthrough pain was treated with dezocine（5 mg） intravenously at the patient＇s request. Blood samples were collected before（T1）, 2 h（T2）, 24 h（T3）, and 48 h（T4） after operation to measure the plasma β-EP, PGE2, and 5-HT. The operative time, the total dose of sufentanil and the dose of self-administration, and the rescue doses of dezocine were recorded. Visual Analogue Scale（VAS） scores at 2, 12, 24 and 48 h postoperatively and the incidence of apnea and severe hypotension were recorded. The results showed that the gender, age, weight, operative time and remifentanil consumption were comparable among 3 groups. Patients in EAS group had the lowest VAS scores postoperatively among the three groups（P〈0.05）. The total dose of sufentanil was 115±6.0 μg in EAS group, significantly lower than that in control（134.3±5.9 μg） and sham（133.5±7.0 μg） groups. Similarly, the rescue dose of dezocine was the least in EAS group（P〈0.05） among the three groups. Plasma β-EP levels in EAS group at T3（176.90±45.73） and T4（162.96±35.00 pg/mL） were significantly higher than those in control（132.33±36.75 and 128.79±41.24 pg/mL） and sham（136.56±45.80 and 129.85±36.14 pg/mL） groups, P〈0.05 for all. EAS could decrease the release of PGE2. Plasma PGE2 levels in EAS group at T2 and T3（41±5 and 40±5 pg/mL respectively） were significantly lower than those in control（64±5 and 62±7 pg/mL） and sham（66±6 and 62±6 pg/mL） groups. Plasma 5-HT levels in EAS group at T2（133.66±40.85） and T3（154.66±52.49 ng/mL） were significantly lower than those in control（168.33±56.94 and 225.28±82.03） and sham（164.54±47.53 and 217.74±76.45 ng/mL） groups. For intra-group comparison, plasma 5-HT and PGE2 levels in control and sham groups at T2 and T3, and β-EP in EAS group at T3 and T4 were significantly higher than those at T1（P〈0.05）; PGE2 and 5-HT levels in EAS group showed no significant difference among the different time points（P〉0.05）. No apnea or severe hypotension was observed in any group. It was concluded that intraoperative ipsilateral EAS at PC4 and PC6 provides effective postoperative analgesia for patients undergoing radical esophagectomy with remifentanil anesthesia and significantly decrease requirement for parental narcotics. The underlying mechanism may be related to stimulation of the release of endogenous β-EP and inhibition of inflammatory mediators（5-HT and PGE2）.

Comparison of the analgesic effects between electro-acupuncture and moxibustion with visceral hypersensitivity rats in irritable bowel syndrome

AIM To observe whether there are differences in the effects of electro-acupuncture(EA) and moxibustion(Mox) in rats with visceral hypersensitivity. METHODS EA at 1 m A and 3 m A and Mox at 43?℃ and 46?℃ were applied to the Shangjuxu(ST37, bilateral) acupoints in model rats with visceral hypersensitivity. Responses of wide dynamic range neurons in dorsal horns of the spinal cord were observed through the extracellular recordings. Mast cells(MC) activity in the colons of rats were assessed, and 5-hydroxytryptamine(5-HT), 5-hydroxytryptamine 3 receptor(5-HT3R) and 5-HT4Rexpressions in the colons were measured.RESULTS Compared with normal control group, responses of wide dynamic range neurons in the dorsal horn of the spinal cord were increased in the EA at 1 m A and 3 m A groups(1 m A: 0.84 ± 0.74 vs 2.73 ± 0.65, P < 0.001; 3 m A: 1.91 ± 1.48 vs 6.44 ± 1.26, P < 0.001) and Mox at 43?℃ and 46?℃ groups(43?℃: 1.76 ± 0.81 vs 4.14 ± 1.83, P = 0.001; 46?℃: 5.19 ± 2.03 vs 7.91 ± 2.27, P = 0.01). MC degranulation rates and the expression of 5-HT, 5-HT3 R and 5-HT4 R in the colon of Mox 46?℃ group were decreased compared with model group(MC degranulation rates: 0.47 ± 0.56 vs 0.28 ± 0.78, P < 0.001; 5-HT: 1.42 ± 0.65 vs 7.38 ± 1.12, P < 0.001; 5-HT3R: 6.62 ± 0.77 vs 2.86 ± 0.88, P < 0.001; 5-HT4R: 4.62 ± 0.65 vs 2.22 ± 0.97, P < 0.001). CONCLUSION The analgesic effects of Mox at 46?℃ are greater than those of Mox at 43?℃, EA 1 m A and EA 3 m A.

Electro-acupuncture Combined with Transcranial Magnetic Stimulation Improves Learning and Memory Function of Rats with Cerebral Infarction by Inhibiting Neuron Cell Apoptosis

This study examined the effect of electro-acupuncture (EA) combined with transcranial magnetic stimulation (TMS) therapy at different time windows on learning and memory ability of rats with cerebral infarction and the underlying mechanism.Two hundred SD rats were randomly divided into four groups:normal group,sham-operated group,model group and EA+TMS group,and each group was then divided into five sub-groups in terms of the different time to start treatment post operation:6,12,24,48 and 72 h.Cerebral infarction models were established in the model and the EA+TMS groups by left middle cerebral artery occlusion/reperfusion (MCAO/R).After treatment for 14 d,the Morris water maze test was applied to examine the spatial learning and memory abilities of rats.In infarcted area,the expression of caspase-3 was immunohistochemically detected,and real-time fluorescent quantitative PCR was used to measure the expression of Bcl-2 mRNA.The results showed that in EA+TMS group compared with model group at the same treatment time windows,the escape latency was substantially shortened,the expression of caspase-3 was considerably decreased and the expression level of Bcl-2 mRNA significantly increased (P<0.05).In the EA+TMS sub-groups,the escape latency was shortest,the expression level of caspase-3 lowest,and the expression level of Bcl-2 mRNA highest at the treatment time window of 24 h.It was concluded that EA combined with TMS can promote neurological function of rats with cerebral infarction by increasing the expression level of Bcl-2 mRNA and decreasing the expression of caspase-3.The best time window is 24 h after perfusion treatment to ischemia.

Clinical Study of Electro-acupuncture Treatment with Different Intensities for Functional Constipation Patients

Functional constipation （FC） is a common functional bowel disorder disease that affects life quality of a large number of people. This study aimed to explore the impact of different intensities of electro-acupuncture （EA） treatment for FC patients. Totally, 111 patients with FC meeting the Rome III criteria were randomly assigned to different intensities of EA groups （low and high intensity of EA groups） and medicine-controlled （MC） group. In EA groups, patients were treated with EA at quchi （Llll） and shangjuxu （ST37） bilaterally for 4 weeks, 5 times/week in the first 2 weeks, and 3 times/week in the last 2 weeks. In MC group, 5 mg mosapride citrate was administered orally 3 times/day for 4 weeks. Spontaneous bowel movement frequency each day was recorded using a consti- pation diary. Self-rating anxiety scale （SAS） and self-rating depression scale （SDS） were used to assess the patients＇ psychological state. Cortisol （CORT）, substance P （SP）, and vasoactive intestinal polypep- tide （VIP） were evaluated at baseline and at the end of 4 weeks after treatment. As compared with the baseline, there was statistically significant increase in stool frequency every week （P〈0.01）, but there was no statistically significant difference among the three groups. As compared with the baseline, after 4 weeks of EA therapy, the scores of SDS and serum levels of CORT were decreased significantly in low intensity of EA group （P〈0.01）, and the serum levels of SP and VIP were increased significantly （P〈0.05）; the scores of SAS and SDS and serum levels of CORT were decreased significantly in high intensity of EA group （P〈0.05）, and the serum levels of SP and VIP were increased significantly （P〈0.05）; the serum levels of CORT and VIP were increased significantly in MC group （P〈0.05）. As compared with MC group, after 4 weeks of treatment, the serum levels of SP were signifcicantly in- creased in low intensity of EA group （P〈0.01）. Low and high intensities of EA could increase the stool frequency, improve the FC patient＇s anxiety and depression, reduce the serum levels of CORT, and in- crease the serum levels of SP and VIP effectively. It is concluded that both low and high intensities of EA are effective for FC patients, but there is no significant difference between the low and high intensi- ties of EA.

Effect of Electro-acupuncture in Treating Patients with Lingual Hemangioma

Objective： To explore the clinical effect of electro-acupuncture （EA） in treating patients with lingual hemangioma （LHG）. Methods： EA therapy was applied on 36 patients by directly inserting the platinum needles into LHG through a trocar with plastic insulating cannula to protect the normal tissues and connecting the needles with the electro-chemical therapeutic apparatus of model ZAY-B. Then electricity was given until the tumor body got contracted and rigid. The result was assessed 6 months after EA was started. Results： All patients were treated effectively, namely, the effective rate was 100%, with the therapeutic effect reaching grade Ⅰ in 29 patients （80.6%）, grade Ⅱ in 7 （19.4%）, and all having the function of tongue recovered to normal. Conclusion： EA shows special superiorities in treating LHG, proved to bring a- bout less injury and quick recovery and being simple in operation. Especially when applied on huge LHG, it could not only remove the tumor, but also preserve the function of the tongue, so it is a brand-new approach that is likely to be accepted by patients.

THE INFLUENCE OF ELECTRO-ACUPUNCTURE AT NEIGUAN AND FIVE SHU POINTS OF TWELVE REGULAR MERIDIANS AT DIFFERENT TIME ON SYSTOLIC TIME INTERVAL OF NORMAL YOUNG ADULTS

The influence of electro-acupuncture at Neiguan (PC 6)and five shu points of twelve regular meridians at different time on systolic time interval (ST I) of normal young adultswere studied with 6×6 Latin square design in this work.In 12 groups according to 12 regular merldlans,the STIs were measured respectively just before and after electro-acupuncture on Neiguan andfive shu points at 00:00,04:00,08:00,12:00,16:00 and 20:00 of a day.It was found thatexcept the PEPI and PEPI/LVETI ratio among Shenmen(HT 7),Shaochong(HT 9)and Neiguan,Guanchong(TE)and Yemen(TE 2)points,the effects of electro-acupuncture at Neiguan pointand five shu points of twelve regular meridians on the indices of STI of normal young adults wereshowing no slgnificant differences.There also was no difference in different sex.But the indices ofSTI were changed when electroacupuncture on the different points of different meridians at differenttime.

Electro-acupuncture at Zusanli(ST 36) to improve lower extremity motor function in sensory disturbance patients with cerebral stroke A randomized controlled study of 240 cases

BACKGROUND： Studies have shown that sensory transduction is a way to introduce needle sensation. OBJECTIVE： To observe the influence of electro-acupuncture at the ＂Zusanll＂ （ST 36） point on lower extremity motor function in various sensory disturbance patients with cerebral stroke. DESIGN, TIME AND SETTING： A randomized, controlled, clinical study was performed at the Department of Neurological Rehabilitation, China Rehabilitation Research Centre from September 2006 to June 2008. PARTICIPANTS： Patients with first-time cerebral infarction or hemorrhage, or with a stroke history, but no neurodysfunction （single damage）, were selected for this study. The subjects were right-handed and disease state was stable. A total of 240 inpatients were randomly assigned to the following groups： electro-acupuncture （n = 124） and control （n = 116）. The two groups were further assigned into sub-groups： no sensory disturbance, superficial sensory disturbance, deep sensory disturbance, and deep and superficial sensory disturbance. METHODS： On the basis of routine limb function training, the acupoint Zusanliwas utilized in all patients from the electro-acupuncture group. Perpendicular acupuncture was 3.0-4.0 cm deep. An electric acupuncture instrument was connected when patients developed the needle sensation, deqi. A stimulation pattern consisting of distant and dense waves of 50 Hz was used to elicit slight dorsal foot extension. Acupuncture was administered 5 times per week, 30 minutes per session, for 6 weeks in total. MAIN OUTCOME MEASURES： FugI-Meyer assessment （FMA） was used to evaluate lower extremity motor function; Ver.1.0 gait analysis to estimate gait （step frequency, step speed, and step scope）; lower extremity Composite Spasticity Scale （CSS） to estimate muscle spastic degree. RESULTS： Following treatment, motor function improved in both groups. Compared with the control group, FMA score, step speed, step frequency, and step scope were increased in the electro-acupuncture group, but there was no difference in lower extremity CSS scores between the electro-acupuncture and the control groups （P 〉 0.05）. Compared with the control group, Zusanli （ST 36） electro-acupuncture improved motor function indices as follows： FMA score, step frequency, step speed, and step scope of patients with no sensory disturbance （P 〈 0.05-0.01）, step frequency of patients with superficial sensory disturbance （P 〈 0.05）, and step frequency and step speed of patients with deep sensory disturbance （P 〈 0.05）. CONCLUSION： Zusanfi （ST 36） electro-acupuncture effects on lower extremity motor function in stroke patients were improved with no muscle tone rise. Therefore, this form of treatment can be used in convalescent treatment, Moreover, effects were different according to various sensory disturbance types, which suggested that sensory input influenced acupuncture effects.

CLINICAL OBSERVATION ON THE TREATMENT OF LUMBAR VERTEBRA HYPEROSTEOGENY WITH ELECTRO- AND HYDRO-ACUPUNCTURE

In the present study, 121 patients with lumbar vertebra hyperosteogeny were dividedinto following four groups for treatment and comparison: intense electro-acupuncture group (Group1), hydro-acupuncture group (Group 2), electro-acupuncture plus hydro-acupuncture group (Group3) and analgesic liquid for spur group (Group 4). It is indicated that the effect of electro-acupunctureplus hydro-acupuncture is the best in the treatment of lumbar vertebra hyperosteogeny.

Effects of electro-acupuncture on Noxa and caspase-3 expression in hippocampal CA1 region of a vascular dementia rat model

BACKGROUND：Noxa, a pro-apoptotic member of the Bcl-2 protein family, has been shown to induce the mitochondrial pathway of apoptosis and to mediate hypoxic cell death in a rat model of cerebral ischemia. This suggests that Noxa could participate in apoptosis during vascular dementia （VD）. OBJECTIVE： To detect Noxa and caspase-3 expression after electro-acupuncture in VD rats to further validate the mechanism of electro-acupuncture-induced effects in the treatment of VD. DESIGN, TIME AND SETTING： A randomized, controlled study was performed at the Center for the Neurobiology of Fujian Medical University between January 2006 and March 2007. MATERIALS： A total of forty adult, male, Sprague Dawley rats were included in this study. The following equipment was used： confocal laser scanning microscope （Sp5, Leica, Germany）, water maze （Bejing Suntendy Science and Technology Co., Ltd., China）, and SDZ-II electronic acupuncture treatment instruments （Suzhou Medical Appliance Factory, China）. METHODS： Thirty-eight rats with sufficient learning and memory abilities were selected by Morris water maze criteria. Twelve rats received sham-surgery; the remaining 26 rats were used to establish a VD model by bilateral occlusion of the common carotid arteries. The rats that survived the occlusion procedure were randomly assigned into an electro-acupuncture group （n = 11） and a VD model group （n = 12）. MAIN OUTCOME MEASURES： Neuropathological changes were observed with hematoxylin-eosin staining of the hippocampus and expression of Noxa and caspase-3 in the hippocampal CA1 region was analyzed by confocal laser scanning microscope following immunofluorescence staining. RESULTS： Expressions of Noxa and caspase-3 in the electro-acupuncture group and sham-operated group were less than in the VD model group （P 〈 0.01）. Electro-acupuncture reduced the amount of apoptotic neurons in hippocampal CA1 area of rats with VD. The average latency in the Morris water maze test was significantly shorter, and escape strategies improved from edge and random searches to more linear swim pathways in the electro-acupuncture group compared with the VD model group （P 〈 0.01）. CONCLUSION： Electro-acupuncture can improve learning and memory ability and inhibit the occurrence of apoptosis by blocking expression of Noxa and caspase-3 in the hippocampal CA1 region of VD rats.

Regulatory effects of electro-acupuncture at Zusanfi on ir-SP content in rat pituitary gland and peripheral blood and their immunity

INTRODUCTIONIt has been reported in many studies that electro-acupuncture(EA)can positively regulate erythrocyticimmunity and T-lymphocytic subgroups.Nevertheless,its mechanism remains to be explored.In thepresent study,a multi-group,multi-stepped and multi-indexed observation was conducted on the effects of EA

Effect of Electro-acupuncture on Rat Joint Pathomorpnology of Chronic Adjuvant Arthritis Model

Objective:To study the effect of electro-acupuncture (EA) on pathomorphological changes of joints in rat model of chronic adjuvant arthritis. Methods: The rat chronic adjuvant arthritis model was established by subcutaneous injection of 0.1 ml of complete Freund’s adjuvant to the left hind sole. Forty Wistar rats were randomly divided into the model group, the low frequency (2 Hz) EA group, the high frequency EA (100 Hz) group and the body acupuncture group. After being modeled except the model group, the other three groups were treated with EA or body acupuncture in Yanglingquan points (bilateral) for 3 weeks, the left ankle joints and metatarsal joints of rats were taken for pathological examination by fixing with 10% formalin and embedding in paraffin, sectioning and staining with HE. Results: Obvious inflammatory cell infiltration, loosened synovial tissue, damage of articular cartilage and proliferation of synovial cells and granulation tissue were observed in the sections of joints in model rats.

Optimal stimulation parameters for Renzhong (DU 26) electro-acupuncture for improving motor function in a rat model of middle cerebral artery occlusion

The selection of electro-acupuncture parameters remains poorly unified between clinical studies. The present study observed the effects of electro-acupuncturing Renzhong （DU 26） with different stimulation parameters on motor function recovery following middle artery occlusion injury in rats. Results showed an optimal stimulation parameter for Renzhong electro-acupuncture that was low frequency and mild current （2 Hz, 1 mA） significantly improved cortical excitability and conductive function, and promoted recovery in a rat model of motor function in middle artery occlusion. Frequency had a greater impact than current or interaction, and played a critical role in electro-acupuncture therapy.

Pre-ischemia electro-acupuncture potentiates the expression of Bcl-2 and transforming growth factor-beta 1 in rat brains

The expression of the anti-apoptotic molecules Bcl-2 and transforming growth factor-beta 1 is known to confer protective effects on the cerebral ischemia-reperfusion injury.The current study investigated the expression levels of Bcl-2 and transforming growth factor-beta 1 in response to multiple pre-ischemia electro-acupuncture at acupoints Zusanli（ST36）and Fengchi（GB20） stimulation.Rats were divided into five groups：uninjured,control,non-acupoint,GB20 and ST36. Rats in the non-acupoint,GB20 and ST36 groups received 30 minutes（3 times or 18 times）of electro-acupuncture stimulation before experimental cerebral ischemia was induced.Bcl-2 and transforming growth factor-beta 1 were found to be significantly increased in the ST36 groups with either 3 or 18 electro-acupuncture treatments（P〈0.05）.The production was higher with 18 electro-acupuncture treatments in the ST36 groups（P〈0.05）.In the GB20 groups,significant increase was only observed in transforming growth factor-beta 1 with 18 electro-acupuncture treatments（P〈0.05）.No significant elevation of the level of transforming growth factor-beta 1 was observed in the non-acupoint groups.However,the production of Bcl-2 increased with 18 treatments in the non-acupoint groups（P〈0.05）.The data suggest that multiple pre-ischemia electro-acupuncture at ST36 was effective in conferring neuroprotective effect on the brain by means of upregulation of Bcl-2 and transforming growth factor-beta 1 and the effect was increase with the number of treatment.

Effect of electro-acupuncture on basic fibroblast growth factor protein and mRNA expression in hippocampal dentate gyrus of spleen deficiency rats

BACKGROUND： Spleen deficiency in traditional Chinese medicine refers to the functional disorder of spleen, pancreas, intestines, and nervous system in modern medicine. OBJECTIVE; To test whether electro-acupuncture could alter basic fibroblast growth factor （bFGF） protein and mRNA expression in the hippocampal dentate gyrus of spleen deficiency rats. DESIGN, TIME AND SETTING： The randomized, controlled, in vivo animal experiment was performed at the National LeveI-B Laboratory of Clinical Cell Molecule and Biology in Shenzhen Hospital of Traditional Chinese Medicine, between March and November in 2008. MATERIALS： Reserpine injection was produced by Guangdong Bangmin Pharmaceutical Co. Rhubarb extract granule preparation was produced by Guangdong Yifang Pharmaceutical. Huanqiu Brand sterile acupuncture pin was provided by Suzhou Acupuncture Supplies, China. Huatuo Brand electroacupuncture instrument （type SDZ-II） was purchased from Suzhou Medical Appliance Factory, China. METHODS： A total of 96 male Sprague Dawley rats were randomly assigned to control （n = 32） and induction （n = 64） groups. Spleen deficiency was induced via intraperitoneal injection of reserpine and intragastric administration of rhubarb. The successful models were randomized into two groups： model and electro-acupuncture, with 32 rats in each group. Electro-acupuncture was administered at Zusanfi （ST 36） and Sanyinjiao （SP 6） acupoints using a condensation wave and rarefaction （condensation wave 15 Hz） at a strength of 6-15 V for 20 minutes, once per day. The appearance of a slight shiver in the corresponding locus was taken as the standard. According to electro- acupuncture time points, each group was assigned to four subgroups at 7, 14, 28, and 49 days, respectively, with eight rats in each subgroup. Immunohistochemical staining, image analysis, and reverse-transcription polymerase chain reaction were performed at different time points. MAIN OUTCOME MEASURES： bFGF protein and mRNA expression in the hippocampal dentate gyrus of spleen deficiency rats. RESULTS： After 7 days of electro-acupuncture therapy, bFGF protein and mRNA expression significantly increased compared with the model and control groups （P 〈 0.05）. After 14 days, bFGF protein and mRNA expression decreased until 28 days, where levels were then equal to the model group and greater than the control group （P 〈 0.05）. After 49 days, the above indices remained increased in the electro-acupuncture group compared to the model and control groups （P 〈 0.05）. CONCLUSION： Continuous electro-acupuncture maintained a high level of bFGF protein and mRNA expression in the hippocampal dentate gyrus of spleen deficiency rats.

Effect of electro-acupuncture on the expression of heat shock protein-70 gene in rat spinal cords following spinal cord injury

BACKGROUND： It is generally believed that the mechanism by which heat shock protein-70 （HSP70） protects cells is related to its effectiveness in maintaining the normal stereochemical structure of intracellular proteins, and in participating in the process of cell apoptosis. Whether electro-acupuncture participates in HSP70 expression and produces neuroprotective effects remain unclear. OBJECTIVE： This study aimed at detecting HSP70 expression after electro-acupuncture in rats with transected spinal cord, in order to further validate the mechanism of electro-acupuncture-induced effects in the treatment of spinal cord injury. DESIGN： A controlled observational experiment. SETTING： Shanghai University of Traditional Chinese Medicine and Toho University, School of Medicine. MATERIALS： Seventy adult male Sprague-Dawley rats of SPF grade, weighing 200± 20 g, were provided by the Laboratory Animal Center of Shanghai University of Traditional Chinese Medicine, with permission No. SYXK （hu） 2004 - 2005. The animals were handled in accordance with the requests from Animal Ethics Committees for guidance. A G6805-2 multiple purpose treatment machine was used （Shanghai Medical Instruments High-Tech Co.,Ltd., Shanghai, China）. METHODS： This study was carried out in the state level laboratories of Shanghai University of Traditional Chinese Medicine and Toho University, School of Medicine between January 2005 and July 2007. The rats were randomly divided into the electro-acupuncture treated group, which received electro-acupuncture treatment in addition to spinal cord surgery and the control group, which received only spinal cord surgery, with 35 rats in each group. All the rats underwent the same surgery consisting of spinal cord transection at the T10 level. If the spinal cord was completely transected and the two posterior limbs were completely paralyzed, then the surgery was considered successful and the animal was kept for further analysis and testing. After surgery, rats in the experimental group were electro-acupunctured with a G6805-2 multiple purpose treatment machine. Two needle electrodes were inserted under the T7 and T10 spinal processes, The treatment was administered once a day for 20 minutes. Rats in the control group were not given any treatment after surgery. Five rats were sacrificed separately in each group on days 1, 2, 3, 7, 14, 21 and 28 after surgery. HSP70 gene expression at the site of lesion was located and quantitatively analyzed by immunohistochemistry and real-time PCR methods. Simultaneously, the spinal cord injury region and neurons were observed by HE and Klüver-Barrera stainings. MAIN OUTCOME MEASURES： （1）HSP70 gene expression in the spinal cord injury region. （2） The number of neurons in the spinal cord injury region. RESULTS： Seventy rats were involved in the final analysis. （1）At the end of each pre-determined block of time, HSP70 mRNA level in the spinal cord injury region of rats in the electro-acupuncture treated group was significantly higher than that in the control group （P 〈 0.05）. HSP70 gene expression in the two groups reached peak levels on day 2 after surgery. （2） On days 7, 14, 21 and 28 after surgery, the number of neurons in the spinal cord injury region in the electro-acupuncture treated group was significantly higher than that in the control group （P 〈 0.05）. CONCLUSION： Electro-acupuncture can effectively enhance HSP70 expression in the spinal cord injury region. HSP70 may participate in this apparent neuroprotective effect.

The neuroprotection of electro-acupuncture via the PGC-1α/TFAM pathway in transient focal cerebral ischemia rats

ATP depletion is one of the pathological bases in cerebral ischemia.Electro-acupuncture(EA)is widely used in clinical practice for ischemia.However,the mechanism of EA remains unclear.The purpose of this study was to investigate whether EA could activate the AMPK/PGC-1α/TFAM signaling pathway and,consequently,increase the preservation of ATP in rats with ischemia.In this study,48 rats were randomly divided into four groups as a sham-operation control group(sham group),a middle cerebral artery occlusion group(MCAO group),an EA group,and an EA group blocked by the AMPK inhibitor compound C(EA+CC group)(N=12/group).The rats of the EA group and EA+CC group received the EA treatment for 7 days.The rats that belonged in the two remaining groups were only grasped in the same condition.Then,their brain tissues were collected for further detection.When compared with other groups,EA significantly reduced neurological deficits score and increased motor function.The cerebral infarction volume was significantly reduced in the EA group according to TTC staining.With western blot,we found that EA improved the ratio of p-AMPKα/AMPKα(P<0.05),however,there is no difference between the MCAO group and sham group(P>0.05).In addition,EA also increased the expression of PGC-1αand TFAM(all P<0.05).By Elisa,we observed that EA increased the preservation of ATP(P<0.05)and mitochondrial respiratory enzymes,including Complex I(P<0.05),Complex IV(P<0.05),but not Complex III(P>0.05).In summary,we conclude that EA may protect against ischemic damage in MCAO rats,improve the preservation of ATP and mitochondrial respiratory enzymes.This effect may be positively regulated by the activation of the PGC-1α/TFAM signaling pathway.

Influence of Ren and Du meridian electro-acupuncture on neural stem cell proliferation and extracellular signal-regulated kinase pathway in a rat model of focal cerebral ischemia injury

BACKGROUND： Studies have shown that electro-acupuncture at the Ren meridian could improve proliferation of subventricular zone neural stem cells in cerebral-ischemic rats. However, there are few reports on the influence of electro-acupuncture at the Du meridian on neural stem cell proliferation. OBJECTIVE： To observe the influence of electro-acupuncture at Ren and Du meridians on neural stem cell proliferation in the subventricular zone and altered signal transduction in cerebral ischemia rats. DESIGN, TIME AND SETTING： A randomized, controlled, animal experiment was performed at the Laboratory of Human Anatomy, Medical College of Sun Yat-sen University from May 2006 to February 2008. MATERIALS： Mouse anti-rat bromodeoxyuridine （BrdU） monoclonal antibody was provided by Sigma, USA; mouse anti-rat nestin monoclonal antibody and extracellular signal-regulated protein kinase （ERK） specific inhibitor PD98059 were provided by Calbiochem, Germany; acupuncture needle was provided by Suzhou Acupuncture Supplies, China. METHODS： A total of 126 rats were randomly assigned to four groups： model （n = 36）, Du meridian （n = 36）, Ren/Du meridian （n = 36）, and Ren/Du meridian ＋ PD98059 （n = 18）. Rats in the Ren/Du meridian ＋ PD98059 group were observed on days 7 （n = 6） and 14 （n = 12） after cerebral ischemia injury. Rats in the model, Du meridian, and Ren/Du meridian groups were observed on days 7, 14, and 28 after cerebral ischemia injury, with 12 rats per group at each time point. Thread occlusion was used to establish middle cerebral artery occlusion models. Electro-acupuncture was performed at Renzhong （DU 26） and Baihui （DU 20） acupoints in the Du meridian group, as well as Chengjiang （RN 24）, Guanyuan （RN 4）, Renzhong, and Baihuiacupoints in the Ren/Du meridian and Ren/Du meridian ＋ PD98059 groups 2 days after model establishment. In addition, electro-acupuncture stimulation with disperse-dense waves was performed, with 30 Hz disperse wave, 100 Hz dense wave, and 5 V intensity for 20 minutes. Rats in the Ren/Du meridian ＋ PD98059 group were treated with 0.2 pg PD98059 injection into the subventricular zone, 2 pL per rat. Rats in the model group were not treated with electro-acupuncture. MAIN OUTCOME MEASURES： BrdU/nestin immunofluorescent staining was used to detect proliferating neural stem cells in the subventricular zone of cerebral ischemia rats; Western blot was used to determine phosphorylated ERK1 and 2 （pERK1/2） expression in the subventricular zone. RESULTS： On days 14 and 28 after cerebral ischemia, there were significantly more BrdU-positive and BrdU/nestin-positive cells in the Ren/Du meridian group compared with the Du meridian group （P 〈 0.05）. PD98059 decreased the number of BrdU-positive and BrdU/nestin-positive cells induced by electro-acupuncture at the/：ten and Du meridians （P 〈 0.05）. On days 7, 14, and 28 after treatment, pERK1/2 expression was significantly greater in the Du meridian and Ren/Du meridian groups compared with the model group （P 〈 0.05）. The promoting effect of electro-acupuncture at Ren and Du meridians on ERK1/2 phosphorylation was superior to electro-acupuncture at the Du meridian alone on day 14 after model induction （P 〈 0.05）. However, PD98059 completely abolished the promoting effect of electro-acupuncture at Ren/Du meridians on pERK1/2 expression （P 〈 0.05）. CONCLUSION： Electro-acupuncture at Ren and Du meridians increased proliferation of subventricular zone neural stem cells, which was related to activation of the ERK pathway in a rat model of cerebral ischemia injury.

Evaluation of Efficacy and Safety of Electro-acupuncture Precondition on Postoperative Cognitive Dysfunction (POCD) Following Knee Replacement in Elderly: A Randomized Controlled Trial

OBJECTIVE: To investigate that whether electro-acupuncture(EA) precondition can reduce the incidence of postoperative cognitive dysfunction(POCD) following knee replacement and its safety in elderly. METHODS: A total of 60 participants met the inclusion criteria were enrolled in a randomized controlled trial with the ratio of 1:1, with 30 cases in the treatment group and 30 cases in the control group. The participants in the treatment group were provided with realEA therapy whereas participants in control group were provided with placebo-EA therapy. Interventions were offered 5 days prior to the surgery, once daily, and for a total of 5 days. The scores of Mini-Mental State Examination(MMSE), and contents of serumal inflammatory cytokines including interleukin 1β(IL-1β) and tumor necrosis factor-α(TNF-α) were observed at 24 hours prior-and posterior-to the surgery respectively for assessing the incidence of POCD among patients. Meanwhile, adverse effects were monitored and recorded. RESULTS:(1) After surgery, both treatment group and control group showed a significant decrease in MMSE global scores(P < 0.001, < 0.001, respectively), and the score in control group decreased more significantly than that in treatment group(P < 0.05);(2) Contents of serumal IL-1β and TNF-α were significantly increased in both groups after 24 hours posterior to the surgery(P < 0.001), and the contents in control group increased more significantly than that in treatment group(P < 0.001);(3) After surgery, the incidence of POCD was 20% in treatment group versus 36.67% in control group. There was no statistical difference between 2 groups(P > 0.05);(4) No serious adverse events were reported in this trial, except 1 patient from treatment group had a slight hematoma after receiving acupuncture. CONCLUSION: EA precondition might reduce cognitive impairments after 24 hours posterior to knee replacement surgery in elderly through inhibiting expression of inflammatory cytokines, including both IL-1β and TNF-α. However, there is insufficient evidence to support that EA precondition could reduce incidence of POCD.

OBSERVATION ON 291 CASES OF INSOMNIA TREATED WITH ELECTRO-ACUPUNCTURE

291 cases of insomnia were treated with electro-acupuncture (EA). Among them, 139 cases were male and 152 female, aged between 16 - 60 years old. Selected acupoints were Taiyang (EX-HN 5), Neiguan (PC 6), Baihui (GV 20), Touwei (ST 8), Yintang (EX-HN 3) and were modified according to symptoms. Fengchi (GB 20) and Dazhui (GV 14) were added for the patient with indisposition or pain in nuchal region, Hegu (LI 4) for headache, and Shenmen (HT 7) for amnesia and dreaminess. EA was given with G6805 - Z Therapeutic Instrument, at continuous wave type, for 30 min, once a day. One therapeutic course consisted of 10 sessions. Any medicine was not administrated during the treatment. Results indicated that 216 cases (74. 2% ) were cured, 62 cases (21. 3 % ) were markedly effective. The total effective rate was 95. 5 %.