Effects of “Nourishing Liver and Kidney” Acupuncture Therapy on Expression of Brain Derived Neurotrophic Factor and Synaptophysin after Cerebral Ischemia Reperfusion in Rats

The aim of the present study was to investigate the effect of ＂nourishing liver and kidney＂ acupuncture therapy on motor and cognitive deficits,and the underlying mechanism following cerebral ischemia-reperfusion（I/R） via increasing the expression of brain derived neurotrophic factor（BDNF） and synaptophysin（SYN） in the hippocampus.Healthy adult male SD rats were randomly divided into sham operation group（n=51）,model group（n=51）,acupuncture group（n=51） and acupuncture control group（n=51）.The middle cerebral I/R model was established.Acupunctures were performed in the acupuncture group and acupuncture control group at acupoints of Taixi（K103）,Taichong（ST09） of both sides,for 30 min once daily every morning.The animals in the sham operation group and model group were conventionally fed in the cage,without any intervention therapy.The rats of each group were assessed with modified neurological severity scores（m NSS）.The expression of BDNF and SYN in the hippocampus was detected by immunohistochemical SP method and the synaptic structure in hippocampus area was assessed morphologically and quantitatively at the 3rd,7th and 14 th day.The Morris water Maze（MWM） test was used to evaluate the rats＇ learning and memory abilities on the 15 th day after acupuncture.The animals in the acupuncture control group and sham operation group presented no neurological deficit.In the acupuncture group,the nerve functional recovery was significantly better than that in the model group at the 7th and 14 th day after modeling.The average MWM escape latency in the acupuncture group was shorter than that in the model group at the 3rd,4th and 5th day.The number of crossings of the platform quadrant in the acupuncture group was significantly more than that in the model group.At the each time point,the expression levels of BDNF and SYN in the hippocampal regions increased significantly in the model group as compared with the sham operation group and the acupuncture control group.In the acupuncture group,the expression levels of BDNF at the 7th and 14 th day increased more significantly than those in the model group.In the acupuncture group,the expression levels of SYN at the each time point increased more significantly than those in the model group.The post-synaptic density（PSD） was significantly increased and the synapse cleft width was narrowed in the acupuncture group as compared with other groups.The synaptic curvatures were improved obviously in the acupuncture group in contrast to the model group.It was concluded that the ＂nourishing liver and kidney＂ acupuncture therapy has positive effects on behavioral recovery,as well as learning and memory abilities,probably by promoting the expression of BDNF and SYN,and synaptic structure reconstruction in the ipsilateral hippocampus after I/R in rats.The ＂nourishing liver and kidney＂ acupuncture therapy can promote the functional recovery in rats after cerebral ischemia injury.

Optimal electroacupuncture frequency for maintaining astrocyte structural integrity in cerebral ischemia

The astrocyte is a critical regulator of neuronal survival after ischemic brain injury. Electroacupuncture may be an effective therapy for cerebral ischemia, as electroacupuncture frequency can affect the structural integdty of astrocytes. In this study, a rat model of middle cerebral artery occlusion established using the modified thread embolism method was treated with electroacupuncture of the bilateral Quchi （Llll） and Zusanfi （ST36） at 15, 30, and 100 Hz frequencies. Behavioral testing, immunohistochemistry and electron microscopy were used to explore the effect of these electroacupuncture frequencies used on maintaining the structural integrity of ischemic brain tissue. Compared with the model and 100 Hz electroacupuncture groups the 15 and 30 Hz electroacupuncture groups displayed decreased neurological deficit scores, as evaluated by the ＂Longa＂ method, significantly increased glial fibrillary acidic protein expression, and alleviated ultrastructural damage of astrocytes at the edge of the infarct. Our experimental findings indicate that 15 and 30 Hz electroacupuncture intervention can favorably maintain the structural integrity of astrocytes and play a protective role in cerebral ischemic injury. Astrocyte structural integrity may be the mechanism underlying acupuncture production of ischemic tolerance

Electro-acupuncture at Conception and Governor vessels and transplantation of umbilical cord bloodderived mesenchymal stem cells for treating cerebral ischemia/reperfusion injury

Mesenchymal stem cell transplantation is a novel means of treating cerebral ischemia/reper- fusion, and can promote angiogenesis and neurological functional recovery. Acupuncture at Conception and Governor vessels also has positive effects as a treatment for cerebral ischemia/ reperfusion. Therefore, we hypothesized that electro-acupuncture at Conception and Governor vessels plus mesenchymal stem cell transplantation may have better therapeutic effects on the promotion of angiogenesis and recovery of neurological function than either treatment alone. In the present study, human umbilical cord blood-derived mesenchymal stem cells were isolated, cultured, identified and intracranially transplanted into the striatum and subcortex of rats at 24 hours following cerebral ischemia/reperfusion. Subsequently, rats were electro-acupunctured at Conception and Governor vessels at 24 hours after transplantation. Modified neurological severity scores and immunohistochemistry findings revealed that the combined interventions of electro-acupuncture and mesenchymal stem cell transplantation clearly improved neurological impairment and up-regulated vascular endothelial growth factor expression around the isch- emic focus. The combined intervention provided a better outcome than mesenchymal stem cell transplantation alone. These findings demonstrate that electro-acupuncture at Conception and Governor vessels and mesenchymal stem cell transplantation have synergetic effects on promot- ing neurological function recovery and angiogenesis in rats after cerebral ischemia/reperfusion.

Electroacupuncture effect on synaptic ultrastructure in focal cerebral ischemia marginal zone of the rat

BACKGROUND：Synapses undergo high levels of plasticity within the nervous system, and cerebral ischemia induces synaptic plasticity changes.OBJECTIVE：To demonstrate the effects of electroacupuncture on ultrastructural synaptic changes in the focal cerebral ischemia marginal zone in rats using quantitative analysis of stereological measurement.DESIGN, TIME AND SETTING：A randomized, controlled, animal experiment was performed at the Experimental Animal Center and Laboratory of Electron Microscopy, Guangzhou University of Traditional Chinese Medicine from January 2008 to January 2009.MATERIALS：The G-6805 electric acupuncture apparatus was provided by Shanghai Huayi Instrument Factory, China.METHODS：A total of 90 male, Wistar rats were randomly assigned to sham-surgery, model, and electroacupuncture groups, with 30 animals in each group. Each group was subdivided into 1 hour, as well as 1, 3, 7, and 21 days post-surgery groups, with six animals assigned to each time point. Heat coagulation-induced occlusion of the middle cerebral artery was performed to establish a model of focal cerebral ischemia. Electroacupuncture was applied immediately following surgery to the electroacupuncture group [4/20 Hz, 2.0-3.0 V, 1-3 mA, to Baihui （GV 20） and Dazhui （GV 14）] for 30 minutes. Treatment was performed once a day, and experimental animals were sacrificed, at 1 hour, as well as 1, 3, 7 and 21 days post-surgery.MAIN OUTCOME MEASURES：At different time points after intervention, changes in synaptic ultrastructure, such as postsynaptic density thickness, synaptic cleft width, and synaptic interface curvature, were observed in the focal cerebral ischemia marginal zone in rats through the use of transmission electronic microscopy.RESULTS：Broken synapses were observed following cerebral ischemia, and the number of synapses was significantly decreased. Compared to the model group, synaptic ultrastructure was significantly improved in the electroacupuncture group. Compared to the sham-surgery group, postsynaptic density thickness was significantly decreased, as were synaptic cleft width and synaptic interface curvature in the electroacupuncture and model groups. However, compared to the model group, postsynaptic density thickness was significantly increased in the electroacupuncture group at the same time point post-surgery （P 〈 0.05 or P 〈 0.01）. In addition, synaptic cleft width and synaptic interface curvature were significantly increased with the passage of time （P〈 0.05 or P〈 0.01）.CONCLUSION：Electroacupuncture significantly ameliorated structural synapse lesion during the early stage of cerebral ischemic injury, promoted repair of synaptic structure, improved structural parameters of synapses, and increased synaptic structural plasticity, which suggested that the therapeutic effect of electroacupuncture was related to synaptic reorganization.

Acupuncture for cerebral ischemia/reperfusion injury Does it reduce the inflammatory reaction?

BACKGROUND： Nuclear factor-κB （NF-κB）, intercellular adhesion molecule-1 （ICAM-1）, and vascular cell adhesion molecule-1 （VCAM-1） in brain tissue can participate in inflammatory reactions after cerebral ischemia. Acupuncture treatment for acute cerebral ischemia produces abnormal protein expression. OBJECTIVE： To investigate the effects of acupuncture on NF-KB, ICAM-1, and VCAM-1 mRNA and protein expression in the brain tissue of rats with cerebral ischemiaJreperfUsion injury. DESIGN, TIME AND SETTING： Randomized, controlled, animal experiments were performed at the Laboratory of Department of Neurosurgery, Xiangya Hospital, Central South University, China between December 2008 and October 2009. MATERIALS： Rabbit anti-NF-KB polyclonal antibody, rabbit anti-ICAM-1 polyclonal antibody, and rabbit anti-VCAM-1 polyclonal antibody were purchased from Santa Cruz Biotechnology, USA. METHODS： A total of 46 healthy, Sprague Dawley rats were randomly assigned to sham surgery （n= 10）, model （n = 12）, acupuncture pretreatment （n = 12）, and acupuncture intervention （n = 12） groups. Models of middle cerebral artery occlusion were established by right common carotid artery ligation. In the acupuncture pretreatment group, rats received acupuncture for 3 consecutive days, and then models were established. In the acupuncture intervention group, rats received acupuncture for 3 consecutive days at Waiguan （SJ 5）, Sanyinjiao （SP 6）, and Dazhui （DU 14） acupoints following model establishment. MAIN OUTCOME MEASURES： Somatosensory asymmetry and forelimb use asymmetry were tested, as well as NF-KB, ICAM-1, and VCAM-1 mRNA and protein expression in the frontal and parietal cortex at 4, 12, 24, 48 and 72 hours following cerebral ischemia/reperfusion injury. RESULTS： Acupuncture improved neurological function and significantly decreased NF-KB, ICAM-1, and VCAM-1 mRNA and protein expression in the frontal and parietal cortex of rats with cerebral ischemia/reperfusion injury （P 〈 0.05）. CONCLUSION： Acupuncture can improve neurological function, potentially via inhibition of NF-κB, ICAM,I, and VCAM-1 mRNA and protein expression in the frontal and parietal cortex of rats with cerebral ischemia/reperfusion injury.

Combined treatment using acupuncture and music therapy on children with cerebral palsy Gross motor function measure comparison in 60 cases

BACKGROUND： The use of acupuncture has received recognition to effectively treat cerebral palsy. Moreover, music therapy can be used to modify treatment of cerebral palsy. OBJECTIVE： To study the effects of combined treatment using acupuncture and music therapy on gross motor function measure （GMFM） of children with cerebral palsy, compared with acupuncture treatment alone. DESIGN, TIME AND SETTING： Randomized, controlled, clinical study. The experiment was conducted in Shenzhen Hospital of Traditional Chinese Medicine between January 2007 and September 2007. PARTICIPANTS： All children with cerebral palsy in the trial were from the outpatient department of Shenzhen Hospital of Traditional Chinese Medicine. The children were randomly divided into two groups： 30 children in Group B received acupuncture and music therapy, while 30 children in Group A received only acupuncture therapy. METHODS： Subjects in Groups A and B received acupuncture based on syndrome differentiation. The main acupoints were necessary for all participants. At first, flash needling was applied to the acupoints. For the remaining acupoints, the technique of transverse needling was applied to the head acupoints, and perpendicular needling was used for the other points. The inserted needles were twirled and then maintained for 30 minutes. The needle was twirled for one second every other 10 minutes, without reinforcing-reducing techniques. The therapy was performed every other day. The trial consisted of three periods each, and lasted for 84 days. Subjects in Group B received music therapy. They listened to music that they preferred while acupuncture was being performed. Following acupuncture, they were allowed to perform musical activities, such as percussion, singing, and dancing. The music therapy was scheduled for one hour, including listening to music for 30 minutes and music activities for 30 minutes. MAIN OUTCOME MEASURES： The comprehensive functional evaluation scale of cerebral palsy and the GMFM were applied to test symptoms before and after respective treatment. RESULTS： All 60 children were included in final analysis. The general function of all children with cerebral palsy improved, but the general efficiency in Group B was obviously higher than in Group A （93% and 73%, Х^2 = 4.32, P 〈 0.05）. GMFM evaluation showed that the function of crawling and kneeling, standing, and walking improved more significantly in Group B than in Group A （P 〈 0.05）, while the function of lying down, rolling, and sitting remained similar between the two groups （P 〉 0.05）. CONCLUSION： The combination of acupuncture and music therapy on the treatment of cerebral palsy is more effective than acupuncture alone. The various activities in music therapy may affect treatment of cerebral palsy.

Changes in corticocerebral morphology in a rat model of focal cerebral ischemia/reperfusion injury following “Xingnao Kaiqiao” acupuncture

BACKGROUND： Cerebral ischemia/reperfusion injury has been shown to induce inflammatory reactions, including white blood cell activation and adhesion molecule expression. These reactions often lead to aggravated neuronal injury. OBJECTIVE： To observe corticocerebral pathology, as well as ultrastructural changes, in a rat model of focal cerebral ischemia/reperfusion injury through optical and electron microscopy, and to investigate interventional effects of ＂Xingnao Kaiqiao＂ acupuncture （a brain-activating and orifice-opening acupuncture method）. DESIGN, TIME AND SETTING： A randomized, controlled, neuropathology, animal experiment was performed at the Laboratory of Molecular Biology, First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine between April and June 2004. MATERIALS： A total of 50 healthy, male, Wistar rats were randomized into 5 groups, with 10 rats per group： control, sham-operated, model, non-acupoint, and ＂Xingnao Kaiqiao ＂. Transmission electron microscope （TEM 400ST） was provided by Philips, Netherlands. Electro-acupuncture treatment apparatus （KWD-8082） was provided by Changzhou Wujin Great Wall Medical Instrument, China. METHODS： Focal cerebral ischemia/reperfusion injury was induced by occlusion of the middle cerebral artery in the model, non-acupoint, and ＂Xingnao Kaiqiao＂ groups. Rats from the control group did not undergo any treatment. The sham-operated group received identical experimental procedures as the model group, except that the nylon suture was not inserted into the right internal carotid artery. At 1, 3, 6, and 12 hours following focal cerebral ischemia/reperfusion injury induction, rats from the Xingnao Kaiqiao group underwent 1-minute acupuncture at the bilateral ＂Neiguan＂ （PC 6） acupoint, using a reducing method of lifting-thrusting and twirling-rotating. Subsequently, the rats were subjected to acupuncture at the ＂Renzhong＂ （DU26） acupoint 10 times by a heavy bird-pecking method. The non-acupoint group received acupuncture administration at the bilateral costal region. MAIN OUTCOME MEASURES： After ischemia for 1 hour and reperfusion for 24 hours, corticocerebral morphology and ultrastructural changes were observed on the injured side through the use of optical and electron microscopy. RESULTS： Cerebral ischemia/reperfusion resulted in damage to neurons, glial cells, and capillary vessels in the rat brain. ＂Xingnao Kaiqiao＂ acupuncture produced superior curative effects when it was performed 3 hours after cerebral ischemia/reperfusion induction, resulting in slightly recovered neuronal structures, alleviated cellular interstitial edema, and more capillary vessels. At each corresponding time point, the ＂Xingnao Kaiqiao＂ group exhibited improved neuronal structure and cellular interstitial edema, compared with the non-acupoint group. CONCLUSION： ＂Xingnao Kaiqiao＂ acupuncture results in protective effects on corticocerebral neuronal morphology and ultrastructure in rats following focal cerebral ischemia/reperfusion.

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.

Effects of Electroacupuncture at the Conception Vessel on Proliferation and Differentiation of Nerve Stem Cells in the Inferior Zone of the Lateral Ventricle in Cerebral Ischemia Rats

Objective: To observe the effects of electroacupuncture (EA) at the Conception Vessel on proliferation and differentiation of the nerve stem cells in the inferior zone of the lateral ventricle in cerebral ischemia rats. Methods: The model rats were prepared by occlusion of the middle cerebral artery for 2 hours and then by reperfusion. They were randomly divided into two groups: a control group and an EA group. Changes in differentiation and proliferation of the nerve stem cells were observed 7, 14 and 28 days after successful modeling. Results: As compared with the 7-day control group (C-7d group), there was no significant difference (P>0.05) in the numbers of 5-bromodeoxyuridine (Brdu) positive cells, Brdu/GFAP, Brdu/Nestin and Brdu/Nse double-labeled cells in the inferior zone of the lateral ventricle in the EA group 7 days after modeling. However, in the 14-day EA group (R-14d group) and the 28-day EA group (R-28d group), the numbers of Brdu positive cells and Brdu/GFAP, Brdu/Nestin, Brdu/Nse double-labeled cells significantly increased as compared respectively with the 14-day control (C-14d group) and the 28-day control (C-28d) group (P<0.05 or P<0.01). Conclusions: EA at the Conception Vessel promotes differentiation and proliferation of the nerve stem cells in the inferior zone of the lateral ventricle in the cerebral ischemia rats, and may stimulate differentiation of the proliferous nerve stem cells towards the astrocytes.

Acupuncture effects on serum myelin basic protein and remyelination following 30 minutes and 2 hours of ischemia in a rat model of cerebral ischemia-reperfusion injury

BACKGROUND： Acupuncture treatment on injured cerebral axons has shown to provide efficacy in clinical practice. It is unknown whether acupuncture produces therapeutic effects by protecting injured cerebral myelin in ischemic stroke. OBJECTIVE： To test whether acupuncture provides protection for injured cerebral myelin, based on quantitative data from cerebral ischemia-reperfusion rats, and to compare the effects of early and late acupuncture on serum myelin basic protein （MBP） content and remyelination of the ischemic internal capsule.DESIGN, TIME AND SETTING： A randomized, controlled experiment was performed at the Neurobiological Laboratory, Sichuan University from March 2005 to March 2006. MATERIALS： ＂Hua Tuo＂ Brand filiform needles were produced by the Medical Instrument Factory of Suzhou, China.METHODS： A total of 52 adult, healthy, male, Sprague Dawley rats were randomly assigned to four groups： control （n = 4）, model （n = 16）, early acupuncture （n = 16）, and late acupuncture （n = 16）. The focal cerebral ischemia-reperfusion model was established by middle cerebral artery occlusion in the right hemisphere using the modified thread embolism method in the latter three groups. Early and late acupuncture groups underwent acupuncture after ischemia for 30 minutes and 2 hours using the Xingnaokaiqiao needling method, respectively. Acupoints were ＂Neiguarf＇ （PC 6） and ＂Sanyinjiao＂ （SP 6） on the bilateral sides, as well as ＂Shuigou＇ （DU 26） and ＂Baihui＂ （DU 20） with stimulation for 1 minute at each acupoint. Acupuncture at all acupoints was performed two or three times while the needle was retained, once per day. No special handling was administered to the control clroup.MAIN OUTCOME MEASURES： For each group, remyelination of the internal capsule was observed by Pal-Weigert＇s myelin staining and serum MBP content was detected using enzyme-linked immunosorbent assay method on days 1,3, 5, and 7 following ischemia-reperfusion injury.RESULTS： Compared with the control group, massive demyelination of the internal capsule occurred, and serum MBP content increased in the model group （P 〈 0.05）. Compared with the model group, the extent of demyelination in the internal capsule was less distinct and serum MBP content was significantly less in the early and late acupuncture group （P 〈 0.01 ）. Compared with the late acupuncture group, serum MBP content reached a peak later and the peak value was less in the early acupuncture group. CONCLUSION： Results suggest that acupuncture exerts a protective effect on injured cerebral myelin in ischemia-reperfusion rats by reducing serum MBP content and promoting remyelination. The study also suggests that the effect of early acupuncture is superior to late acupuncture.

STUDY ON THE EFFECT OF ACUPUNCTURE ON CEREBRAL ISCHEMIA IN MICE

Objective: To explore the possible mechanisms of "JIN San Zhen" (JIN’s 3 acupoints groups) in treatment of mental retardation. Methods: A total of 38 female mice were randomly divided into normal control (n=10), sham operation (n=10), model (n=8) and acupuncture (n=10) groups. "Si Shen Zhen" [4 points around "Baihui" (GV 20): 0.3 cm anterior, posterior, left and right to GV 20 respectively], and "Zhi San Zhen" ["Shenting" (GV 24) and bilateral "Benshen" (GB 13)] of "JIN San Zhen" series are used. The memory ability, AChE positive fiber density and mono amines transmitters of the brain are used as the indexes. Results: After 8 days’ treatment, cerebral ischemia induced mental retardation (decline of learning memory ability) was improved significantly shown by Y maze test (P<0.05-0.01), simultaneously, AChE positive fiber density of the frontal cerebral cortex and hippocampus, serotonie (5 HT), noradrenaline (NA) and dopamine (DA) contents of the brain increased significantly (P<0.05). Conclusion: Acupuncture induced increase of AChE, 5 HT, NA and DA in the brain may contribute to the effect of acupuncture in improving the memory capability of the RD mice.

ACUPUNCTURE THERAPY AND POINT-INJECTION OF MEDICINE FOR TREATMENT OF 32 CASES OF INFANTILE CEREBRAL PALSY

In the present study, 32 cases of infantile cerebral palsy were treated with acupunc-ture and point-injection therapies. Among them, 15 cases were cured basicaly, 7 markedly efec-tive, 9 improved and 2 failed, with a total effective rate being 93. 8%. The results showed thatthe therapies both could improve the microcirculation of the brain tissues in favour of recovery ofcerebral functions.

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.

Effects of cluster needling of scalp acupuncture on neurofilament protein 200 and signal transducer and activator of transcription 3 in rats with acute cerebral ischemia

Objective:Cluster needling at scalp acupoints has showed satisfying effects with acute cerebral ischemia in clinic whereas the mechanisms are not yet clear completely.This study investigated the influence of cluster needling at scalp acupoints on neurological function,as well as on neurofilament protein 200(NF200)and signal transducer and activator of transcription 3(STAT3)expression,in rats with acute cerebral ischemia.Methods:Fifty-four Sprague-Dawley rats were randomly assigned in equal numbers to the false operation(group F),model(group M),or cluster needling scalp acupuncture(group C)groups.Each group was divided into three subgroups,of six rats each,by acupuncture treatment time(24 h,7 days,and 14 days).The rat local cerebral ischemia model was prepared using a modified suture occlusion method.Group C rats were treated by cluster needling scalp acupuncture,while groups F and M did not receive acupuncture treatment.Neurological effects were evaluated using the Longa score.NF200 and STAT3 expression were measured by western blotting.Results:At 24 h,there were no statistical difference between group C and group M in nerve function(P>.05).On days 7 and 14,nerve function scores in group C were significantly lower than that in group M(respectively were P<.05 and P<.01).In addition,on days 14,expression of NF200 was significantly higher in group C compared with group M(P<.05).Compared with group M,STAT3 expression was also higher in group C on days 7 and 14,although these differences were not statistically significant(both P>.05).Conclusion:Cluster needling scalp acupuncture were efficient in improving nerve function scores in rats with cerebral ischemia,and promoting the recovery of motor function.These improvements were associated with increases in NF200 and STAT3 expression.

EFFECT OF ELECTRO-ACUPUNCTURE ON GLUTAMATE TRANSPORTER mRNA EXPRESSION FOLLOWING FOCAL CEREBRAL ISCHEMIA IN RATS

In this study, in situ hybridization histochemistry technique was used to observe the effect of electro-acupuncture (EA) on glutamate transporter mRNA expression following focal cerebral ischemia. We observed that glutamate transporter mRNA expression decreased significantly in the area penumbra of cerebral cortex at 12h following focal cerebral ischemia. EA did not change glutamate transporter mRNA expression in normal rat brain but prevented the decrease of glutamate transporter mRNA expression in the area penumbra of cerebral cortex following focal cerebral ischemia. The results suggest that the protective effect of EA on ischemic neuronal death may bhe related to the increase of uptake of glutamate by its transporter.

Use of acupuncture to treat cerebral infarction in the last 10 years A Scopus-based literature analysis

OBJECTIVE： To identify global research trends in the use of acupuncture to treat cerebral infarction. DATA RETRIEVAL： We performed a bibliometric analysis of studies on the use of acupuncture to treat cerebral infarction published during 2002-2011, retrieved from Scopus, using the key words of acupuncture and cerebral infarction or ischemic stroke. SELECTION CRITERIA： Inclusion criteria： peer-reviewed articles on the use of acupuncture to treat cerebral infarction indexed in Scopus and published between 2002 and 2011; types of publications were original research articles, reviews, meeting abstracts, proceedings papers, book chapters, editorial material, and news items. Exclusion criteria： articles that required manual searching or telephone access; documents that were not published in the public domain; and corrected papers. MAIN OUTCOME MEASURES： （a） Annual publication output; （b） language of publication; （c） type of publication; （d） key words of publication; （e） publication by research field; （f） publication by journal （g） publication by country and institution; （h） publication by author; （i） most-cited papers between 2002 and 2006; and （j） most-cited papers between 2007 and 2011. RESULTS： A total of 160 publications on the use of acupuncture to treat cerebral infarction from 2002-2011 were retrieved from Scopus. The number of publications increased gradually over the 10-year study period; most were written in Chinese or English. Articles and reviews constituted the major types. The most frequent key word used was acupuncture. The most prolific journals in this area were Zhongguo 7hen Jiu and the Chinese Journal of Clinical Rehabilitation. Of the 160 publications retrieved, half came from Chinese authors and institutions. Tianjin University of Traditional Chinese Medicine was the most prolific research institute. Two papers were cited 30 times; they were published in 2002 and 2009, respectively. CONCLUSION： In the field of neuroscience, there is little literature on acupuncture for cerebral infarction. The most-cited papers were cited 30 times in the past 3 years. We believe that, with advances in the study of mechanisms in neurobiology, research on acupuncture will also advance and will become the concern of more scholars.

Clinical effects of Xingnao Kaiqiao acupuncture on neurological impairment following cerebral infarction

BACKGROUND： Although the curative effects of acupuncture have been confirmed by various treatments of cerebral infarction, few studies have investigated when acupuncture can attain the best clinical effect. OBJECTIVE： Four different time points were selected for acupuncture treatment of cerebral infarction to evaluate the appropriate time course for Xingnao Kaiqiao therapy in terms of improved neurological function. DESIGN： Controlled observation. SETTING： Department of Traditional Chinese Medicine Rehabilitation and Physiotherapy of the Affiliated Hospital of Medical College of Chinese Armed Police Forces. PARTICIPANTS： A total of 120 inpatients with cerebral infarction of different stages, including 75 males and 45 females, aged 41-75 years, were selected from November 2005 to December 2006 at the Department of Traditional Chinese Medicine Rehabilitation and Physiotherapy in Affiliated Hospital of Medical College of Chinese Armed Police Forces. Diagnostic criteria： in accordance with ＂main points of diagnosis on different cerebrovascular disease＂ secondly revised in the Second Cerebrovascular Disease Academic Meeting of Chinese Medicine Association in 1986. All accepted subjects provided confirmed consent, and the experiment received ethical permission from the hospital＇s ethics committee. METHODS： ① Experiment grouping： All inpatients were divided into four groups with non-stochastic concurrent control method according to the disease course： Group Ⅰ （onset within 7 hours）, group Ⅱ （onset from 7 hours to 3 days）, group Ⅲ （onset within 4-7 days）, and group IV （onset within 21-180 days）. On the basis of symptomatic treatment with western medicine, each group received Xingnao Kaiqiao therapy after onset within 7 hours, 7 hours to 3 days, 4 to 7days, and 21 to 180 days. ① The principal acupoints were Neiguan, Renzhong, and Sanyinfiao. ② The auxiliary acupoints were Jiquan, Chize, and Weizhong. ③Acupuncture manipulations： initially, Neiguan （PC6, bilateral） was needled at 0.5-1.0 cun vertically with a reducing technique achieved by rotating-swirling and lifting-inserting for l minute. Subsequently, Renzhong （GV26） was needled at 0.3-0.5 cun obliquely towards the nasal septum, with a heavy bird-pecking method until eyeballs were moist or shed tears. Sanyinjiao （SP6, affected limb） was needled at 1.0-1.5 cun obliquely along the medial border of the tibia with a 45° angle between the needle and skin. The technique of reinforcing was achieved by a lifting-inserting method until the affected lower limb twitched three times. The auxiliary acupoint, Jiquan, was selected when the patient extended the affected upper limb abduction. Jiquan was along the downward channel, l cun from the quondam Jiquan （HT1） acupoint; the armpit hair was avoided. Jiquan （affected limb） was needled vertically at 1.0-1.5 cun. The technique of reduction was achieved by lifting-inserting until the affected upper limb twitched three times. Chize （LU5） was selected when the patient flexed the elbow at 120°. Chize was vertically needled at l cun with a lifting-inserting reducing technique until the affected forearm and fingers twitched three times. Weizhong （BL40） was selected when the patient＇s leg was raised straight in a supine position. Weizhong was vertically needled at 0.5 1.0 cun with a lifting-inserting reducing technique until the affected lower limb twitched three times. ⑤ Acupuncture manipulations were achieved by the doctor who is an associate chief physician and doctor of acupuncture and moxibustion and has aptitude for the post＇s specification. ⑥One course of treatment lasted for 10 days and each group was treated for two courses of treatment. ⑦Experiment evaluation： To apply neurological impairment scores for evaluating clinical curative effects before and after treatment with Xingnao Kaiqiao therapy on day 7, 14, and 21（range of 0 45; decreasing score indicates functional improvement）.To evaluate clinical curative effect by clinical effective power： Basic recovery： equal to or more than 81%; significant improvement： 56% to 81% （including 56%）; Improvement： between 36% to 56% （including 36%）; Slight Improvement： 11% to 36% （including 11%）; No change： less than 11%; Aggravation （including death）： negative value. Total effective rate was computed at the same time. MAIN OUTCOME MEASURES： The total effective rate and amelioration of neurological impairment of the patients after treatment. RESULTS： All 120 patients with cerebral infarction were included in the final analysis, without deletion. ① Comparison of the total effective rate： the total effective rate of group Ⅰ, group Ⅱ, group Ⅲ and group IV was 97%, 93%, 93%, and 67%, respectively. There were significant differences of interclass synthetic curative effects （x^2 = 36.351 7, P 〈 0.01）. ② Amelioration of neurological impairment： A decreased neurological impairment score was observed in group Ⅰ on day 7, 14, and 21 after Xingnao Kaiqiao therapy. The differences between group Ⅳ and the remaining three groups were significant （P 〈 0.05）. CONCLUSION： Xingnao Kaiqiao therapy is helpful for amelioration of neurological impairment in patients during the acute stage cerebral infarction.

EFFECT OF ACUPUNCTURE ON NEUROLOGICAL DEFECTS AND DAILY LIFE ABILITY IN PATIENTS WITH ACUTE CEREBRAL HEMORRHAGE

Objective: To observe the effect of acupuncture of Shuigou (GV 26), Neiguan (PC 6), Zusanli (ST 36), etc. on neurological defects and daily life ability in patients with acute cerebral hemorrhage. Methods: Fifty eight cases of acute cerebral hemorrhage patients were randomized into control group (n=28) and treatment group (n=30). Patients of two groups were both treated with intravenous infusion of Mannitol and other expectant medicines. In addition, patients of treatment group were also treated with acupuncture therapy, once daily and continuously for one month. Before and after treatment, the scores of neurological defects and daily life ability (Barthel Index) were given for assessing the therapeutic effect. Results: Following treatment, both scores of neurological defects of two groups decreased significantly (P<0.05), and the score of treatment group was strikingly lower than that of control group (P<0.05). After treatment, values of Barthel Index (BI) of two groups increased considerably in comparison with pre treatment (P<0.01), and the value of BI of treatment group was bigger than that of control group (P<0.05). Conclusion: Acupuncture can improve acute cerebral hemorrhage patients’ nervous function and daily life ability.

The Effect of Electro-Acupuncture on Motor Function Recovery in Patients with Acute Cerebral Infarction:A Randomly Controlled Trial

The aim of this study is to investigate the effect of electro-acupuncture treatment in acute phase of cerebral infarction on the motor functions. In this randomly controlled trial, 86 patients were allocated to two groups, the experimental group given clinical and electro-acupuncture treatments for a period of 4 weeks, and the control group given clinical treatment plus active and/or passive functional exercise. The result showed that the level of impairment and disability in both groups were improvement according to the Chinese Stroke Scale, Brunnstrom-Fugl-Meyer score, and Barthel Index throughout the study and 3 months after. The motor functions and the activities of daily living (ADL) were improved significantly in the electro-acupuncture group as compared with the control group (P<0.05). Also, the results showed greater reduction of neurological deficit in the electro-acupuncture group than in the control group. Conclusion: Early acupuncture treatment for acute stroke patients may improve motor functions, and consequently the activities of daily living.

APPLICATION OF SINGLE PHOTON EMMISSION COMPUTED TOMOGRAPHY TO CLINICAL STUDY ON THE THERAPEUTIC EFFECT OF ACUPUNCTURE IN TREATMENT OF CHILD CEREBRAL PARALYSIS

Subjective To identify the practicability and clinical values of acupuncture in the treatment of child cerebral paralysis, try to provide visualized evidence and mechanisms for acupuncture treatment of this disease. Meth- ods: 13 cerebral palsy children including 9 cases of spasmodic type, 2 cases of ataxia type and 2 cases of mixed type, 9 males and 4 females were subjected into this study. Acupoints used were Hegu (LI 4), Quchi (LI 11), Zusanli (ST 36) and Sanyinjiao (SP 6) that were punctured and stimulated electrically with parameters of frequency 2/15 Hz, elec- tric current 5 mA, and duration of stimulation 30 min. Under monitoring of Siemens ECAM/ICON SPECT System, blood flow volumes of different brain regions were observed before, during and after elctroacupuncture (EA) stimulation of the above-mentioned acupoints. Results: SPECT revealed that in these 13 infantile patients, 18 regions of the brain in- cluding 12 in tbe frontal lobe and 6 in the temporal lobe presented insufficiency of blood perfusion and hypofunction; during EA, these cerebral regions and parietal lobe, visual cortex, thalamus, basal ganglion and cerebellum showed improvement in blood perfusion and function in different degrees. Results of the quantitative analysis on blood flow func- tion changing rate (BFCR) % showed a significant increase in 83.3% of the focal regions during EA. Conclusion: Acupuncture therapy can effectively improve cerebral blood perfusion of the focus and is of clinical value in treatment of infantile cerebral paralysis.