Acupuncture for postoperative ileus:Advancement and underlying mechanisms

Postoperative ileus(POI)remains a prevalent and significant challenge following abdominal surgeries,precipitating patient distress,prolonged hospital stays,and escalated medical expenditures.Conventionally addressed via pharmacological interventions,POI is increasingly being explored through adjunctive therapeutic strategies,with acupuncture gaining recognition as a promising option.Acupuncture has demonstrated encouraging potential in promoting gastrointestinal motility in patients with POI.Moreover,recent research has shed light on the therapeutic mechanisms underlying its efficacy.This article aims to present a comprehensive overview of acupuncture as a treatment for POI,highlighting advancements in clinical research and recent elucidations of its mechanistic underpinnings.It aspires to contribute a pivotal reference point for scholars and enthusiasts keen on garnering a deeper understanding of acupuncture’s role in managing POI.

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

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

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

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

Mechanism of acupuncture for limb spasm of post-stroke spasticity based on GABA and BDNF/Trkb-KCC2 signaling pathway

Background:To investigate the effects of acupuncture on post-stroke limb spasm model rats and the underlying mechanism.Methods:A total of 50 Sprague-Dawley rats were randomly divided into three groups,Control group(10),Model group(20)and Zhishen Tiaoxing(ZSTX)acupuncture group(20).Middle cerebral artery occlusion was conducted in SD rats to establish post-stroke limb spasm rats,which were treated with ZSTX acupuncture.Behavioral assays were determined by the Narrow ally test,the limb muscle tension was detected by the BL-420S test system,and infarct volume was assessed after the cerebral infarction by 2,3,5-triphenyltetrazolium chloride staining.Heterogeneous neurotransmitterγ-aminobutyric acid(GABA)and its receptors GABAA and GABAB in the cerebral cortex of the infarct area were determined by immunofluorescence assay.The release of Trkb and K-Cl cotransporter isoform 2 was detected by an immunofluorescence double labeling study.Western Blot was utilized to measure the expression of BDNF and Trkb.Results:The results showed that the behavioral assays in post-stroke limb spasm rats were significantly improved by the treatment of ZSTX acupuncture.14 days of ZSTX acupuncture can effectively inhibit muscle tone and decrease Infarct volume,which was measured with BL-420S biological function experiment system and triphenyltetrazolium chloride.Meanwhile,the results of Double-Label Immunofluorescence Assays showed that ZSTX acupuncture improved the expression of GABA,GABAA,GABAB,BDNF,and K-Cl cotransporter isoform 2.Double-Label Immunofluorescence Assays and WB results showed that 14 days ZSTX acupuncture declined the expression of Trkb.Conclusions:Our results suggest that 14 days of ZSTX acupuncture can significantly improve post-stroke limb spasm.Meanwhile,the pathogenesis of post-stroke limb spasm and the efficacy of ZSTX acupuncture involve metabolic pathways of neurotransmitters,and electro-acupuncture can treat post-stroke limb spasm by regulating BDNF/Trkb-KCC2 signaling pathway.

INFLUENCE OF LOCAL INFILITRATION ANESTHESIA OF SCALP-POINT ON ACUPUNCTURE INDUCED CHANGES OF CEREBRAL BLOOD PERFUSION DETECTED BY SPECT

Objective: To observe the influence of local infiltration anesthesia at the scalp point on acupuncture stimulation induced changes of cerebral blood perfusion in the brain. Methods: Experiments were conducted in 10 healthy volunteer subjects (8 males and 2 females) who were ordered to take a lying position on a specific bed with their heads keeping in a fixed position. Scalp point used was Motor Area (MS 6). The first syringe needle (gauge 5) was inserted into the scalp from the upper 1/5 of MS 6 and the second syringe needle inserted into the scalp from the middle 2/5 of MS 6 and advanced downward, with the two needles connected to a HAN’s Therapeutic Apparatus. Images of the brain were then taken before and after electroacupuncture (EA) stimulation, and after local injection of 1% lidocaine [mixed with epinephrine (1∶200,000, 3 mL)] plus EA by using Siemens ECAM/ICON Single Photo Emission Computed Tomography (SPECT). Intravenous injection of Ethyl cysteinate dimmer 555 MBq was performed before displaying cerebral images. Data of blood functional changing rat (BFCR%) were analyzed quantitatively using a mathematic model. Results: Before EA stimulation, the blood perfusion and function of cerebral cortex, thalamus, basal ganglion and cerebellum on both sides of the brain were basically symmetry. Following EA of MS 6, BFCR% of the contralateral thalamus, parietal lobe and the frontal lobe increased significantly. Following local infiltration anesthesia, BFCR% of the contralatral thalamus declined markedly (P<0.05). The results of quantitative analysis were in agreement with those of visual observation. Conclusion: Local infiltration anesthesia of the scalp point can significantly weaken or block EA stimulation induced changes of BFCR%.

Research progress on insomnia treated by traditional Chinese medicine and acupuncture based on microbial-gut-brain axis theory

Insomnia,as one of the emotional diseases,has been increasing in recent years,which has a great impact on people's life and work.Therefore,researchers are eager to find a more perfect treatment.The microbiome-gut-brain axis is a new theory that has gradually become popular abroad in recent years and has a profound impact in the field of insomnia.In recent years,traditional Chinese medicine(TCM)has played an increasingly important role in the treatment of insomnia,especially acupuncture and Chinese herbal medicine.It is the main method of TCM in the treatment of insomnia.This paper mainly reviews the combination degree of"microorganism-gut-brain axis"theory with TCM and acupuncture under the system of TCM.To explore the mechanism of TCM and acupuncture in the treatment of insomnia under the guidance of"microorganismgut-brain axis"theory,in order to provide a new idea for the diagnosis and treatment of insomnia.

PRACTICE AND DEVELOPMENT ON ZHU'S AND CHAU'S SCALP ACUPUNCTURE

Zhu’s and Chau’s Scalp Acupuncture is one of the newly developed needling meth-ods which follows the "penetrating head acu-point needling" method. Through many years ofclinical experience, exploration and research in conjunction with the various advantages of differ-ent styles and sects of scalp acupuncture needling methods, a unique method of scalp acupuncturehas been developed. This method combines the modern medical theory and the traditional Chinesemedical theory. The region of head is divided into seven treatment areas: Shenting region (GV24), Touwei region (ST 8), Shuaigu region (GB 8), Baihui region (GV 2O), Qiangjian region(GV 18), Xinhui region (GV 22), Wangu region (GB 12). The manipulation is developed andcreated according to the Collection of Acupuncture and Moxibustion, Chouqi and Jinqi methods.In the process of the insertion of the needles, this method requires the cooperation of rapid andslow breathing by lifting, following and opposing the meridian course, including active and pas-sive

A CONTROL STUDY OF SCALP ACUPUNCTURE IN TREATING APHASIA AFTER ACUTE CEREBROVASCULAR DISEASES

A control study of clinical therapeutic effects of scalp acupuncture was made onforty-four Patients suffering from aphasia caused by acute cerebrovascular diseases,and was observedfor 4 weeks.The results revealed that the therapeutic effect in the scalp acupuncture group was betterthan that in the controlgroup.Aphasia was cured more rapidly in the scalpacupuncturegroug than inhe control group.The difference was of significance statistically.

Immediate effects of scalp acupuncture with twirling reinforcing manipulation on hemiplegia following acute ischemic stroke: a hidden association study

Data mining has the potential to provide information for improving clinical acupuncture strategies by uncovering hidden rules between acupuncture manipulation and therapeutic effects in a data set. In this study, we performed acupuncture on 30 patients with hemiplegia due to acute ischemic stroke. All participants were pre-screened to ensure that they exhibited immediate responses to acupuncture. We used a twirling reinforcing acupuncture manipulation at the specific lines between the bilateral Baihui（GV20） and Taiyang（EX-HN5）. We collected neurologic deficit score, simplified Fugl-Meyer assessment score, muscle strength of the proximal and distal hemiplegic limbs, ratio of the maximal H-reflex to the maximal M-wave（Hmax/Mmax）, muscle tension at baseline and immediately after treatment, and the syndromes of traditional Chinese medicine at baseline. We then conducted data mining using an association algorithm and an artificial neural network backpropagation algorithm. We found that the twirling reinforcing manipulation had no obvious therapeutic difference in traditional Chinese medicine syndromes of ＂Deficiency and Excess＂. The change in the muscle strength of the upper distal and lower proximal limbs was one of the main factors affecting the immediate change in Fugl-Meyer scores. Additionally, we found a positive correlation between the muscle tension change of the upper limb and Hmax/Mmax immediate change, and both positive and negative correlations existed between the muscle tension change of the lower limb and immediate Hmax/Mmax change. Additionally, when the difference value of muscle tension for the upper and lower limbs was 〉 0 or 〈 0, the difference value of Hmax/Mmax was correspondingly positive or negative, indicating the scalp acupuncture has a bidirectional effect on muscle tension in hemiplegic limbs. Therefore, acupuncture with twirling reinforcing manipulation has distinct effects on acute ischemic stroke patients with different symptoms or stages of disease. Improved muscle tension in the upper and lower limbs, reflected by the variation in the Hmax/Mmax ratio, is crucial for recovery of motor function from hemiplegia.

OBSERVATION ON CLINICAL THERAPEUTIC EFFECTS OF SCALP ACUPUNCTURE FOR FACIAL SPASM

Objective; To observe clinical therapeutic effect of scalp acupuncture in the treatment of facial spasm. Methods： Sixty-five cases of facial spasm were randomly divided into control group （n = 31 ） and treatment group（n = 34）. Patients of the treatment group were treated with penetrative acupuncture from Qienshencong（前神聪 Extra） to Xuanli（悬厘 GB 6）, Baihui（百会 GV 20） to Qubin（曲鬓 GB 7）, etc., and those of control group treated with acupuncture of Taiyang（太阳 EX-HN 5）, Yengbai（阳白 GB 14）, Quanliao（颧髎 SI 18） and Xiaguan（下关 ST 7）, etc. once daily, 20 sessions altogether. Results. After treatment, of the 31 cases and 34 cases in control and treatment groups, 5 and 12 were cured, 8 and 13 had remarkable improvement, 11 and 8 had improvement, 7 and 1 failed, with the total effective rates being 77.42% and 97.06% respectively; and the therapeutic elfact of treatment group was significantly superior to that of control group（P〈0.01）. Conclusion; Scalp acupurcture has an obvious therapeutic effect for facial spasm.

STUDY ON SCALP ELECTROACUPUNCTURE TREATMENT OF APOPLEXY AND ITS INFLUENCE ON HEMORHEOLOGY IN ISCHEMIC APOPLEXY PATIENTS

Objectives: To compare the therapeutic effect of scalp electroacupuncture with that of conventional body acupuncture for apoplexy (wind stroke) and to observe the influence of both acupuncture therapies on hemorheology of ischemic apoplexy.Methods: 183 patients, whose diseases are attributed to apoplexy according to the diagnostic criteria, are randomly divided into treatment group (93 cases) and control group (90 cases) and treated respectively with scalp electroacupuncture and conventional body acupuncture. 11 items of hemorheology of patients’ blood samples are tested with NXE-1 Viscometer which are taken in the early morning before and after treatment under fasting condition. Results: Both scalp electroacupuncture and conventional body acupuncture exert therapeutic effect for apoplexy, but the effect of scalp electroacupuncture is obviously better than that of conventional acupuncture (P< 0.05 ); both treatment group and control group are statistically significant in reducing plasma viscosity, high shear reduced viscosity, low shear reduced viscosity, erythrocyte sedimentation rate, hematocrit and fibrinogen, (P<0.01 and 0.05); while the treatment group is statistically significant in reducing whole blood viscosity, ratio of whole blood viscosity, erythrocyte index of rigidity and electrophoresis time of erythrocyte (P<0.01～ 0.05), but the control group is not significant statistically in influencing these indexes (P>0.05).

Treating acute low back pain with acupuncture:A randomized controlled study protocol to compare the effectiveness between distal and local acupoints

Objective:To compare the efficacy of using“distal acupoints only”vs.“local acupoints mainly combined with distal acupoints”in cases of acute low back pain(ALBP).Methods: A total of 102 eligible patients aged 18–65 years with ALBP lasting less than 6 weeks will be randomized in a 1:1 ratio to the distal acupoints only group(DPOG)and the local acupoints mainly combined with the distal acupoints group(LPMG).During a 4-week treatment period,patients in the DPOG will receive acupuncture at distal acupoints only(Houxi[SI 3]and Yaotongxue[EX-UE 7])twice a week,while those in the LPMG group will receive acupuncture at local acupoints(mainly Shenshu[BL 23]and Dachangshu[BL 25])combined with distal points(Weizhong[BL 40]).The patients in both groups will be evaluated at every session of treatment,and the follow-up will be performed for 3 months.The primary outcome measure will be the change in ALBP intensity,assessed using visual analogue scale scores before and after treatment.The secondary outcome measure will be the evaluation of functional disability using the Oswestry Disability Index.Discussion: This study compares the DPOG and LPMG to explore the feasibility of the DPOG in the treatment of ALBP.

Acupuncture Legislation in the United States: Minnesota as a Case Study

2023 marks the 50th anniversary of legal regulation of acupuncture in the United States,as the first acupuncture law was enacted in Nevada.Acupuncture,like any other medical modality,is regulated at the state level,with each state formulating and enforcing its own laws and statutes over time.This article narrates the legislative process and major developments of the acupuncture profession in Minnesota,in the context of legislative developments across the country.It tells how this midsize,Midwest state’s acupuncture profession became regulated,and examines the challenges faced by the profession before and after state statutes were enacted.Minnesota stands as a representative example of the legislative process in other states.

Clinical research progress on acupuncture for the treatment of otogenic vertigo

Otogenic vertigo is a common disorder that affects the vestibular system,which often results in considerable discomfort and impaired daily functioning.Traditional Chinese medicine(TCM),including acupuncture and moxibustion,has been historically utilized to manage the symptoms of vertigo.However,the effectiveness and methodology of these treatments have rarely been investigated in the medical literature.This study reviews the existing literature on the point selection,method,and therapeutic effect of acupuncture and moxibustion to provide a reference for the TCM treatment of otogenic vertigo.A literature search was performed using the PubMed search engine.The terms used included otogenic vertigo,acupuncture treatment,and acupuncture point selection.A total of 34 relevant articles were retrieved from PubMed.These suggest that the clinical treatment of otogenic vertigo should consider the functions of zang-fu organs and meridians and select different acupuncture treatment methods according to syndrome differentiation based on the difference between deficiency and excess.Acupuncture and moxibustion therapy should be based on acupoint selection,considering the syndrome differentiation,supplemented with experience.The treatment of otogenic vertigo with acupuncture and moxibustion refers to the selection of appropriate acupuncture methods under the guidance of TCM theory and following the principles of syndrome,disease,and meridian differentiation.Common acupuncture methods include body acupuncture,auricular acupuncture,scalp acupuncture,acupoint injection,electroacupuncture,and moxibustion.There are many acupuncture and moxibustion acupoints selected for the treatment of otogenic vertigo.Individualized treatment according to the patient’s specific condition is effective and safe,which can help to improve the patient’s vertigo symptoms and cerebral blood perfusion.

A RESEARCH ON SCALP ACUPUNCTURE FOR CEREBRAL INFARCTION

In order to evaluate the clinical value of the lines described in the Standard Nomenclature of Scalp Acupuncture Lines, 105 patients suffering from cerebral infarction have been treated by needling along the anterior and posterior oblique lines of vertex-temple, and the line 1 and line 2 lateral to vertex. The markedly effective rate was 71.43%, and the total effective rate 88.57%. After treatment, such symptoms as hemiplegia, lingual dysfunction, facial and tongue paralysis, and the laboratory indexes of blood fat, fibrinogen and hemorrheology were obviously unproved (P【0.01 or 0.05). The therapeutic effect of scalp acupuncture was obviously better than that of Western medicine (P【0.01).

An Interview with Peter Deadman—Acupuncture Pioneer and Founder of The Journal of Chinese Medicine

This interview was conducted on August 21st, 2022 by Charles Buck and Ioannis Solos. Peter Deadman has worked in the field of health promotion for 50 years. He co-founded Infinity Foods(an organic and natural foods workers co-op) in 1971, followed by the Brighton Natural Health Centre-a charity dedicated to teaching ways to improve personal, community and planetary health and wellbeing. He qualified as an acupuncturist in 1978 and in Chinese herbal medicine in 1990. He founded The Journal of Chinese Medicine(UK) in 1979(Fig. 1), and co-authored A Manual of Acupuncture(published in 1998). He is the author of Live Well Live Long: Teachings from the Chinese Nourishment of Life Tradition. He has taught Chinese medicine and health promotion internationally for decades and is a dedicated practitioner and teacher of Qi Gong(气功).

Study on the Regulation of ROS by Acupuncture and Moxibustion to Relieve Inflammation in the Treatment of Sciatica

Objective: To observe the analgesic effect of acupuncture and moxibustion on chronic constriction injury (CCI) pain model rats, and to investigate the mechanism of constriction constriction injury. Methods: 32 SPF SD rats were divided into Control Group, Sham Surgery Group, Model Group and Acupuncture and moxibustion Group, with 8 rats in each group. The Model Group, Acupuncture and moxibustion Group and sciatic nerve ligation were used to establish the CCI pain rat model. The sham operation group only separated the nerve, and the control group did not do any treatment. After modeling, the Acupuncture and moxibustion Group was given acupuncture treatment, while the control group and the Model Group did not do any intervention. 7 days for 1 course of treatment, continuous treatment for 3 courses of sampling and detection. Paw withdrawal mechanical threshold (PWMT) and Paw withdrawal thermal latency (PWTL) were observed. Biochemical detection of reactive oxygen species (ROS), malondialdehyde (MDA), Super Oxide Dismutase (SOD), glutathione (GSH);Serum, tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6) levels were detected by ELISA. Results: Compared with the control group, PWMT and PWTL in the Model Group were decreased (P α, IL-1β and IL-6 levels or contents were increased (P α, IL-1β and IL-6 levels or contents were decreased (P Conclusion: Acupuncture and moxibustion can reduce the ROS level, enhance the antioxidant capacity of the body, reduce the damage of sciatic nerve caused by inflammation, and relieve sciatic pain.

TREATMENT OF APOPLECTIC HEMIPLEGIA WITH SCALP ACUPUNCTURE IN RELATION TO CT FINDINGS

Acupuncture is useful in the treatmentof apoplectic hemiplegia,and the use ofscalp acupuncture for this disease has a longhistory.Since the early’70s,the functionalareas of the cerebral cortex have been usedas the theoretical basis for selection of

Acupuncture for ischemic stroke:where are we now?

Acupuncture is an effective treatment for ischemic stroke(IS)and plays a key role in neurological rehabilitation after IS.Acupuncture can improve the clinical symptoms of various complications after IS,including motor dysfunction,swallowing disorders,speech disorders,cognitive impairment,depression,insomnia,and fatigue.However,the mechanisms underlying the effects of acupuncture in IS remain unclear.Available evidence suggests that acupuncture may exert neuroprotective effects through neuroplasticity(neurogenesis and synaptogenesis),angiogenesis,cell proliferation and apoptosis,and regulation of oxidative stress,inflammation,and immunity.Further studies should be conducted to improve the high-quality evidence-based system of acupuncture intervention for IS,by focusing on the clinical and basic research design,increasing the sample size,standardizing and quantifying the standards of acupuncture operations,using multidisciplinary techniques and methods to systematically explore the key targets of acupuncture intervention for IS,and reveal the efficacy and mechanism of acupuncture in the treatment of IS.

Acupuncture:Effective and Recommended but More Implementation Needed

Acupuncture enjoys a robust evidence base for dozens of clinical conditions and decades of research exploring its mechanisms of action. It has over 9,000 positive recommendations from official government and clinical guidelines. However, it still remains relatively inaccessible in the United States, Europe and elsewhere, especially compared to the strength of evidence-based recommendations for its use. Acupuncture would benefit from robust implementation strategies, utilizing insights and approaches from implementation science. The clinical use of Botox for migraine suffered from weaker evidence of effectiveness and greater evidence of harm, but using a streamlined and robust implementation strategy, Allergan was able to achieve widespread implementation from when it began its efforts around 2010. Such a systematic approach that identifies and overcomes barriers to implementation for acupuncture would benefit millions of people who currently are offered less effective and more invasive treatments, contrary to the recommendations of clinical guidelines.