Acupuncture for migraine prophylaxis: a randomized controlled trial.

BACKGROUND: Acupuncture is commonly used to treat migraine. We assessed the efficacy of acupuncture at migraine-specific acupuncture points compared with other acupuncture points and sham acupuncture. METHODS: We performed a multicentre, single-blind randomized controlled trial. In total, 480 patients with migraine were randomly assigned to one of four groups (Shaoyang-specific acupuncture, Shaoyang-nonspecific acupuncture, Yangming-specific acupuncture or sham acupuncture [control]). All groups received 20 treatments, which included electrical stimulation, over a period of four weeks. The primary outcome was the number of days with a migraine experienced during weeks 5-8 after randomization. Our secondary outcomes included the frequency of migraine attack, migraine intensity and migraine-specific quality of life. RESULTS: Compared with patients in the control group, patients in the acupuncture groups reported fewer days with a migraine during weeks 5-8, however the differences between treatments were not significant (p > 0.05). There was a significant reduction in the number of days with a migraine during weeks 13-16 in all acupuncture groups compared with control (Shaoyang-specific acupuncture v. control: difference -1.06 [95% confidence interval (CI) -1.77 to -0.5], p = 0.003; Shaoyang-nonspecific acupuncture v. control: difference -1.22 [95% CI -1.92 to -0.52], p < 0.001; Yangming-specific acupuncture v. control: difference -0.91 [95% CI -1.61 to -0.21], p = 0.011). We found that there was a significant, but not clinically relevant, benefit for almost all secondary outcomes in the three acupuncture groups compared with the control group. We found no relevant differences between the three acupuncture groups. INTERPRETATION: Acupuncture tested appeared to have a clinically minor effect on migraine prophylaxis compared with sham acupuncture. TRIAL REGISTRATION: Clinicaltrials.gov NCT00599586.

[Acupuncture plus moxibustion intervention improves learning-memory ability by suppressing hippocampal JAK2/STAT3 signaling in Alzheimer's rats].

OBJECTIVE: To investigate the effect of acupuncture plus moxibustion on learning-memory ability and expression of hippocampal Janus kinase-2 (JAK2)/signal transducer and activator of transcription-3 (STAT3)/suppressors of cytokine signaling-3 (SOCS3) signaling in Alzheimer's Disease (AD) rats, so as to reveal their mechanisms underlying improvement of AD. METHODS: A total of 60 SD rats were randomly divided into four groups：normal control, sham-operation, model and acupuncture-moxibustion (Acu-moxi, n＝15 in each group) groups. The AD model was established by microinjection of ß-amyloid 1-42(Aß1-42，5 µL)into the bilateral hippocampus. Seven days after modeling, Acu-moxi intervention was given. After insertion of acupuncture needles into "Baihui" (GV20) and bilateral "Shenshu" (BL23) and manipulating them for a while, the needles were then retained for 15 min, when, the mild moxibustion was performed at the same time. The treatment was conducted once daily, 5 times a week for consecutive 4 weeks. After the treatment, Morris water maze test was used to detect the animals' learning-memory ability. Immunohistochemistry and Western blot were respectively used to detect the number of positive cells and protein expression levels of JAK2, STAT3 and SOCS3 in the hippocampus tissue. RESULTS: Following modeling and compared with the normal control and sham-operation groups, the average escape latency was significantly prolonged (P<0.01), and the number of the original platform crossing and the residence time in the platform quadrant were significantly shortened in the model group (P<0.01). The numbers of hippocampal JAK2- and STAT3-positive cells and expression levels of hippocampal JAK2 and STAT3 proteins were significantly increased (P<0.01), and the number of hippocampal SOCS3-positive cells as well as the expression of SOCS3 protein significantly decreased in the model group relevant to the normal control and sham-operation groups (P<0.01). After the intervention, the average escape latency was significantly shortened (P< 0.01), and the number of the original platform crossing and the residence time in the platform quadrant were significantly increased in the Acu-moxi group (P<0.01), and the expression levels of JAK2 and STAT3 were significantly down-regulated and that of SOCS3 was considerably up-regulated in the Acu-moxi group relevant to the model group (P<0.01)．. CONCLUSION: Acu-moxi intervention can improve the learning-memory ability in AD rats, which is associated with its functions in inhibiting hippocampal JAK2/STAT3 signaling and up-regulating SOCS3 (a negative feedback factor) protein level.

[Acupuncture and Moxibustion Improves Learning-memory Ability of Alzheimer's Disease Rats Possibly by Up-regulating Serum Aß Internalization Enzyme Contents].

OBJECTIVE: To observe the effect of acupuncture and moxibustion (AM) on learning-memory ability and expression of amyloid beta (Aß) in the hippocampal dentate gyrus (DG) of Alzheimer's disease (AD) rats, so as to explore its mechanism underlying improvement of AD. METHODS: Forty male Wistar rats were randomly divided into normal, sham operation, model and AM groups (n＝10 in each). The AD model was established by bilateral hippocampal injection of Aß1-42(5 µL). The AM was applied at "Baihui" (GV 20) and "Shenshu" (BL 23) for 15 min, once daily for 12 times. Morris water maze tests were used to assess the rats' learning-memory ability. The levels of serum Aß1-42 and Aß internalizing enzymes including transthyretin (TTR), lipoprotein lipase (LPL), alpha 2 macroglobulin (α 2M) and apolipoprotein E (ApoE) were detected by ELISA. The expression of Aß1-42 in the hippocampal DG was detected by immunohistochemistry. RESULTS: Compared with the sham operation group, the average escape latency of location navigation test was significantly prolonged in the first 5 days and the last 3 days (P<0.01), and the residence time of the target-quadrant and the platform crossing times of special probing task were significantly reduced in the model group (P<0.01). After the intervention, the average escape latency was obviously shortened in the first 5 days and the last 3 days (P<0.01), and both the residence time and the platform crossing times were significantly increased in the AM group relevant to the model group (P<0.01, P<0.05). After modeling, the contents of TTR, LPL, α 2M and ApoE in the serum were significantly lower in the model group than in the sham operation group (P<0.01, P<0.05), while the levels of serum Aß1-42 and hippocampal Aß1-42 expression were considerably increased relevant to the sham operation group (P<0.01). Following the intervention, the TTR, LPL, α2M and ApoE contents in the serum were significantly increased (P<0.01, P<0.05), and both serum Aß1-42 and hippocampal Aß1-42 expression were notably down-regulated in comparison with the model group (P<0.05). No significant differences were found between the normal and sham operation groups in the levels of all the above-mentioned indexes (P>0.05). CONCLUSION: AM can improve the learning-memory ability of AD rats, which may be related to its effects in up-regulating the contents of serum Aß internalizing enzymes and promoting the clearance of hippocampal Aß. It suggests a protective role of AM on hippocampal neurons.

High-frequency electroacupuncture evidently reinforces hippocampal synaptic transmission in Alzheimer's disease rats.

The frequency range of electroacupuncture in treatment of Alzheimer's disease in rats is commonly 2-5 Hz (low frequency) and 50-100 Hz (high frequency). We established a rat model of Alzheimer's disease by injecting ß-amyloid 1-42 (Aß1-42) into the bilateral hippocampal dentate gyrus to verify which frequency may be better suited in treatment. Electroacupuncture at 2 Hz or 50 Hz was used to stimulate Baihui (DU20) and Shenshu (BL23) acupoints. The water maze test and electrophysiological studies demonstrated that spatial memory ability was apparently improved, and the ranges of long-term potentiation and long-term depression were increased in Alzheimer's disease rats after electroacupuncture treatment. Moreover, the effects of electroacupuncture at 50 Hz were better than that at 2 Hz. These findings suggest that high-frequency electroacupuncture may enhance hippocampal synaptic transmission and potentially improve memory disorders in Alzheimer's disease rats.

[Effect of "Kidney-reinforcing and Govenor Vessel-regulating" of Acupuncture plus Moxibustion on Mitochondrial Dynamics-related Proteins in Hippocampal Neurons of Rats with Alzheimer's Disease].

OBJECTIVE: To observe the effect of acupuncture plus moxibustion on mitochondrial dynamics-related proteins (OPA 1, Fis 1) of hippocampal neurons in rat with Alzheimer's disease (AD) , and to explore the potential mechanism underlying acupuncture for the protection of hippocampal neuronal mitochondria. METHODS: Eighty male Wistar rats were randomly divided into normal, sham-operation, model and acu-moxibustion groups. AD model was made by injecting Aß1-42 into the hippocampus. "Baihui" (GV 20) and "Shenshu" (BL 23) acupoints were stimulated by manual acupuncture (15 min) in combination with moxibustion (15 min) for two sessions of treatment, with seven consecutive treatments for one session and one day break between the two sessions. The expression of hippocampal OPA 1 and Fis 1 was assessed by means of Western blot and immunofluorescence technique. RESULTS: The expression level of OPA 1 and Fis 1 of rats in the model group was significantly lower and higher, respectively, than those of the normal and sham-operation groups (P < 0.01). Acupuncture plus moxibustion intervention notably increased OPA 1 and decreased Fis 1 expression levels in the acu-moxibustion group compared to those of the model group (P < 0.01). CONCLUSION: Acupuncture combined with moxibustion produce benefit to hippocampal neurons in AD rats probably via the regulation of the mitochondrial dynamics (imbalance between fission and fusion proteins) and improvement of the mitochondrial damage of hippocampus.

[Protective mechanism of acupuncture-moxibustion on hippocampal neuron mitochondria in rats with Alzheimer's disease].

OBJECTIVE: To observe effects of acupuncture and moxibustion on ultrastructure and silent information regulator 1 (SIR1) in hippocampal neuron mitochondria in rats with Alzheimer's disease (AD) in order to explore its possible effective mechanism during the process of protecting mitochondria. METHODS: Eighty Wistar rats were randomly divided into a normal group, a sham operation group, a model group and an acupuncture group, 20 rats in each one. The AD model was established in the model group and acupuncture group with injection of Amyloid beta Protein Fragment1-14 (Abeta1-42) into the hippocampus. Acupuncture and moxibustion was applied at "Baihui" (GV 20) and "Shenshu" (BL 23) in the acupuncture group, once a day, seven days as a treatment course and totally two course were required. The rest groups were all fed with normal diet, without any treatment. The transmission electron microscopy, immunohistochemistry and immunoblotting technique were respectively adapted to measure ultrastructure and level of STR1 in hippocampal neuron mitochondria in AD rats. RESULTS: Compared with the model group, the ultrastructure in hippocampal neuron mitochondria in the acupuncture group was effectively improved. The average optical density of SIR1 in hippocampus was 0.21 +/- 0.10 and the gray value was 136.82 +/- 47.42 in the model group, which were obviously lower than 0.47 +/- 0.09 and 281.44 +/- 57.98 in the normal group (both P < 0.01). However, levels of SIR1 in the acupuncture group, they were 0.32 +/- 0.11 and 199.52 +/- 58.12, which were significantly increased compared with those in the model group (both P < 0.05). CONCLUSION: The reinforcing-kidney and regulating-Governor Vessel method of acupuncture and moxibustion for AD could improve ultrastructure of mitochondria and increase levels of SIR1 to achieve the aim of recovering injury of mitochondria and protecting function of mitochondria.

[Effect of electroacupuncture intervention on ERK 1/2 signaling and TNF-α and IL-1ß protein levels in the substantia Nigra in rats with Parkinson's Disease].

OBJECTIVE: To observe the effect of electroacupuncture(EA) on phosphalized extracellular regulated protein kinases(p-ERK) 1/2 signaling pathway and tumor necrosis factor (TNF)-α and IL-1ß protein levels in the substantia nigra (SN) in rats with Parkinson's disease (PD), so as to explore its mechanism underlying improvement of PD. METHODS: 32 male SD rats were randomly and averagely divided into normal control group, sham-operation group, model group and EA group. PD model was established by intra-dermal-injection of rotenone(1 mg/kg, dissolved in DMSO and saline, concentration: 0. 25 mg/mL) at the nape, once daily for 14 days. EA (2 Hz, 2 mA) was applied to "Fengfu"(GV 16)and "Taichong"(LR 3) for 20 min, once daily for 14 days. For sham-operation group, subcutaneous injection of the same dose of DMSO and saline was given in the same way. The expression levels of tyrosine hydroxylase (TH), p-ERK 1/2, inflammatory cytokines TNF-α and IL-1P proteins of the SN tissue were detected using Western blot. The rat's horizontal and vertical movement ability was assessed using open-field tests. RESULTS: The horizontal and vertical movement scores were significantly lower in the model group than in the normal control group, and markedly higher in the EA group than in the model group (P<0. 05). Compared with the normal control group, the expression level of TH protein in the SN was significantly reduced in the model group( P<0. 05 ),while the expression levels of p-ERK 1/2, TNF-α and IL-1ß proteins were significantly increased in the model group(P<0. 05). After EA intervention, the expression level of TH protein was significantly increased(P<0.05),and those of p-ERK 1/2, TNF-α and IL-1ß proteins were significantly down-regulated(P<0. 05) in the EA group compared to the model group. CONCLUSION: EA therapy may improve PD rats' movement ability, which may be associated with its effects in down-regulating the expression levels of p-ERK 1/2, TNF-α and IL-1ß proteins and up-regulating the expression of TH protein in the SN.

[Effects of acupuncture and moxibustion on energy metabolism-related protein of hippocampal neuron mitochondria in Alzheimer's disease rats].

OBJECTIVE: To explore action mechanism of acupuncture and moxibustion for Alzheimer's disease (AD) to provide evidence for prevention and treatment with acupuncture and moxibustion on AD in clinic. METHODS: Eighty SPF-grade male Wistar rats, (200 +/- 20) g, were randomly divided into a normal group, a sham-operation group, a model group and a treatment group, 20 cases in each one. The model was duplicated with injection of Abeta1-42 in rats' hippocampus. Expect the treatment group, the rest groups were treated with regular feeding after respective intervention. The treatment group was treated with acupuncture and moxibustion at "Baihui" (GV 20) and "Shenshu" (BL 23), once a day, seven days as a treatment course and totally for two courses. There was one day of interval between the courses. The immunohistochemistry and quantitative RT-PCR methods were applied to test level of Abeta-binding alcohol dehydrogense (ABAD) and cytochrome oxidase IV (COX IV) in hippocampal neurons mitochondria. RESULTS: Acupuncture and moxibustion could reduce effectively level of ABAD and improve activity of COX IV in hippocampal neurons mitochondria in the treatment group, which has statistical significance compared with that in the model group (P < 0.01) and no statistical significance compared with that in the normal group and sham-operation group (P > 0.05). This indicated that acupuncture and moxibustion could effectively suppress overexpression of ABAD, improve activity of COX IV and reduce leak of reactive oxygen species, which could improve metabolic disturbance of mitochondria energy to achieve the goal of prevention and treatment of AD. CONCLUSION: The prevention and treatment of AD with acupuncture and moxibustion could be related with suppressing overexpression of ABAD and improving activity of COX IV in hippocampal neurons mitochondria to improve mitochondria energy metabolism.

[Effect of electroacupuncture stimulation of "Fengfu" (GV 16) and "Taichong" (LR 3) on expression of COX-2 and tyrosine hydroxylase in Substantia Nigra in rats with Parkinson's disease].

OBJECTIVE: To observe the influence of electroacupuncture (EA) therapy on the expression of tyrosine hydroxylase (TH) and cyclooxygenase-2 (COX-2) proteins of Substantia Nigra cells(SNc) in the rotenone-induced Parkinson's disease(PD) rats, so as to explore the mechanism of EA underlying improvement of PD. METHODS: Forty rats were randomly divided into normal, sham-operation (sham), model and EA groups (n = 10/group). The PD model was established by successive subcutaneous injection of rotenone (highly selective lesions of nigrostriatal dopaminergic neurons) for 28 days. EA (2 Hz, 1 mA) was applied to bilateral "Fengfu" (GV 16) and "Taichong" (LR 3) for 20 min, once daily for 14 days. The expression levels of TH and COX-2 proteins in the Substantia Nigra of midbrain were detected with Western blotting. RESULTS: Compared with the normal group, the expression level of TH protein in the model group was significantly decreased (P < 0.01), and that of COX-2 protein in the model group was significantly increased (P < 0.01). After the EA treatment, the expression level of TH in the EA group was obviously upregulated (P < 0.01), and that of COX-2 protein in the EA group was considerably down-regulated (P < 0.01). No significant differences were found between the normal and sham groups in the expression levels of TH and COX-2 proteins (P > 0.05). CONCLUSION: EA therapy can decrease inflammation mediator COX-2 protein expression and upregulate TH protein expression in the Substantia Nigra of midbrain in PD rats, which may contribute to its effect in relieving PD in clinic.

[Influence of electroacupuncture on p38-mitogen activated protein kinase in substantia nigra cells of rats with Parkinson disease model].

OBJECTIVE: To explore the role of inflammatory reaction mediated by p38-mitogen activated protein kinase (p38-MAPK) signal path on prevention and treatment of Parkinson disease (PD) model rats by electroacupuncture (EA). METHODS: Thirty-two healthy male SD rats were randomly divided into a normal group, a sham operation group, a model group and an EA group, eight rats in each one. The PD model was established in the model group and EA group by subcutaneous injection of rotenone in skin-back area (2 mg/kg, dissolved in sunflower oil, 2 mg/mL in density), while the injection of sunflower oil emulsion without rotenone at the same point and quantity as the model group was applied in the sham operation group. The normal group was not given any intervention. The EA treatment (continuous wave, 2 Hz in frequency, 1 mA in intensity, 20 min) was applied at "Fengfu" (GV 16) and "Taichong" (LR 3) in the EA group, once a day for continuously 14 days. No treatment was given in the other groups. The expression of tyrosine hydroxylase (TH), phosphorylated p38-MAPK, cyclooxygenase-2 (COX-2) in the substantia nigra were detected with immunohistochemical method. RESULTS: There was typical PD ethology change in the model group. Compared with the normal group and sham operation group, the expression of TH positive neuron in the substantia nigra in the model group was significantly decreased, while the expression of phosphorylated p38-MAPK and COX-2 were significantly increased (all P < 0.01). Compared with the model group, the expression of TH positive neuron in the EA group was apparently increased, while the expression of phosphorylated p38-MAPK and COX-2 were significantly decreased (all P < 0.01). CONCLUSION: The EA therapy could obviously reduce the expression of inflammation mediator COX-2, inhibit the phosphorylation of p38-MAPK, reduce the damage of dopaminergic neurons in the rats with PD, and this effect may be related with the impact of p38-MAPK signal path

[Effects of electroacupuncture stimulation of scalp-point on cardiac sympathetic discharges, myocardial beta1-adrenoceptor protein expression and plasma norepinephrine concentration in myocardial ischemia-reperfusion injury rats].

OBJECTIVE: To explore the mechanism of electroacupuncture (EA) of scalp-point in the management of myocardial ischemia-reperfusion injury (MI/RI) by examining its effects on left cardiac sympathetic nerve activity, myocardial beta1-adrenaline receptor (AR) protein expression and plasma norepinephrine (NE) concentration in MI/RI rats. METHODS: Eighteen Wistar rats were randomly divided into sham, model and EA groups (n = 6). MI/RI model was induced by ligation of the left anterior descending coronary artery for 30 min, followed by release of the ligation for 15 min. EA was applied to bilateral Epangxian I (MS 2) for 15 min. The left cardiac sympathetic nerve activity was recorded with BL-420 E+ biological signal acquisition system. Myocardial beta1-AR protein expression was examined by western blot and plasma NE level detected by enzyme-labeled immunosorbent assay. RESULTS: Compared with the sham group, the left cardiac sympathetic discharges and plasma NE levels and myocardial beta1-AR protein expression were markedly increased in the model group (P < 0.01), whereas in comparison with the model group, the sympathetic discharges, plasma NE level and myocardial beta1-AR protein expression in the EA group were down-regulated significantly (P < 0.05). CONCLUSION: Scalp-point EA intervention can suppress MI/RI induced increase of sympathetic nerve activity and plasma NE level, and beta1-AR protein expression, which may contribute to its effect in relieving myocardial ischemia.

[Analysis on acupoint prescription for acupoint sticking therapy of treating winter diseases in summer for preventing and curing chronic cough and asthma].

Based on ZhangShi YiTong written by ZHANG Lu of Qing dynasty, and the record that external application of Baijiezi (seeds of Brassica Alba) for treating asthma of cold syndrome, retrospective study is conducted to modern literature of treating winter diseases in summer with acupoint sticking therapy for preventing and treating chronic cough and asthma. Learning from thoughts and methods of evidence-based medicine, and according to subject characteristics of TCM and acupuncture, acupoints and point-selecting discipline of prescription for preventing and treating chronic cough and asthma in summer with acupoint sticking are analyzed. The results show that the top ten common acupoints used for acupoint sticking therapy of treating winter diseases in summer are Feishu (BL 13), Dingchuan (EX-B 1), Xinshu (BL 15), Geshu (BL 17), Danzhong (CV 17), Shenshu (BL 23), Gaohuang (BL 43), Dazhui (GV 14), Pishu (BL 20), Tiantu (CV 22), most of which belong to the Bladder Meridian of Foot-Taiyang, Conception Vessel and Governor Vessel or extra-meridian points. It refers that the core acupoints of acupoint sticking therapy are Feishu (BL 13), Dingchuan (EX-B 1), Xinshu (BL 15), Geshu (BL 17), Danzhong (CV 17), and adjunct points can be selected by syndrome, disease different stage, disease or symptoms.

[Effects of electroacupuncture on learning and memory ability and glial cells of the hippocampus in the rat of Alzheimer disease].

OBJECTIVE: To study on the mechanism of electroacupuncture for treatment of Alzheimer disease (AD). METHODS: SD rats were randomly divided into a normal group, a sham operation group, a model group and an electroacupuncture group, 12 rats in each group. The AD rat model was prepared by microinjection of amyloid-beta protein (Abeta1-40) into the Meynert nucleus. In the electroacupuncture group, electroacupuncture was given at "Baihui" (GV 20), "Taixi" (KI 3), "Zusanli" (ST 36). The learning and memory ability was assessed by Morris water maze and the glial cell activity in the hippocampus was determined by immunohistochemistry. RESULTS: Compared with the normal group, the glial cell in the hippocampus was activated with increase of the number, and the learning and memory ability reduced in the model group (P < 0.01). After treatment, as compared with the model group, the number of the activated glial cells was reduced and the learning and memory ability was improved in the electroacupuncture group (P < 0.01). CONCLUSION: Electroacupuncture treatment can decrease the number of activated glial cells so as to protect the neurons, improving the learning and memory ability in the AD rat.

[Influence of electroacupuncture of "Shuigou" (GV 26) on hippocampal CGRP and NPY contents in cerebral ischemia rats].

OBJECTIVE: To observe the effect of electroacupuncture (EA) on the contents of hippocampal calcitonin gene-related peptide (CGRP) and neuropeptide Y (NPY) in cerebral ischemia (CI) rats. METHODS: Forty SD rats were randomly divided into normal control, sham operation (sham), model and EA groups with 10 cases in each. CI model was duplicated by middle cerebral artery occlusion. EA (2 Hz, 1 mA, continuous waves) was applied to "Shuigou" (GV 26) for 30 min, once daily for 5 days. Hippocampal tissue was taken for assaying the contents of CGRP and NPY with radioimmunoassay. RESULTS: Compared with sham group and normal control group, hippocampal CGRP content in model group decreased apparently (P<0.01), while NPY content of model group increased significantly (P<0.01). Compared with model group, hippocampal CGRP in EA group increased considerably (P<0.01) and NPY content decreased obviously (P<0.01). CONCLUSION: Electroacupuncture of GV26 can effectively adjust hippocampal CGRP and NPY contents in CI rats, which may contribute to its effect in improving cerebral ischemia.

Translation and validation of the Nepean Dyspepsia Index for functional dyspepsia in China.

AIM: To assess the reliability and validity of the translated version of Nepean Dyspepsia Index (NDI) in Chinese patients with documented functional dyspepsia (FD). METHODS: The translation process included forward translation, back translation, pretest and cross-cultural adaptation. Reliability and validity of the translated version were examined by asking 300 subjects to complete the Chinese version of the NDI. The mean age of subjects was 39.24 years and 68.7% of the subjects were women. Internal consistency analysis with Cronbach's alpha was performed to test the reliability. Correlation analysis was used to assess the content validity. Factor analysis and structural equation models were used to assess the construct validity. RESULTS: The Cronbach's alpha coefficients ranged 0.833-0.960, well above the acceptable level of 0.70. Correlation analysis showed that each item had a strong correlation with the corresponding domain, but a weak correlation with other domains. Confirmatory factor analysis indicated that the comparative fit index was 0.94, higher than the acceptable level of 0.90. CONCLUSION: The Chinese version of the NDI is a reliable and valid scale for measuring health-related quality of life and disease severity in Chinese patients with FD.

Acupuncture as a treatment for functional dyspepsia: design and methods of a randomized controlled trial.

BACKGROUND: Acupuncture is widely used in China to treat functional dyspepsia (FD). However, its effectiveness in the treatment of FD, and whether FD-specific acupoints exist, are controversial. So this study aims to determine if acupuncture is an effective treatment for FD and if acupoint specificity exists according to traditional acupuncture meridians and acupoint theories. DESIGN: This multicenter randomized controlled trial will include four acupoint treatment groups, one non-acupoint control group and one drug (positive control) group. The four acupoint treatment groups will focus on: (1) specific acupoints of the stomach meridian; (2) non-specific acupoints of the stomach meridian; (3) specific acupoints of alarm and transport points; and (4) acupoints of the gallbladder meridian. These four groups of acupoints are thought to differ in terms of clinical efficacy, according to traditional acupuncture meridians and acupoint theories. A total of 120 FD patients will be included in each group. Each patient will receive 20 sessions of acupuncture treatment over 4 weeks. The trial will be conducted in eight hospitals located in three centers of China. The primary outcomes in this trial will include differences in Nepean Dyspepsia Index scores and differences in the Symptom Index of Dyspepsia before randomization, 2 weeks and 4 weeks after randomization, and 1 month and 3 months after completing treatment. DISCUSSION: The important features of this trial include the randomization procedures (controlled by a central randomization system), a standardized protocol of acupuncture manipulation, and the fact that this is the first multicenter randomized trial of FD and acupuncture to be performed in China. The results of this trial will determine whether acupuncture is an effective treatment for FD and whether using different acupoints or different meridians leads to differences in clinical efficacy. TRIAL REGISTRATION NUMBER: Clinical Trials.gov Identifier: NCT00599677.

[Effect of electroacupuncture pretreatment on glutamate-NMDAR signal pathway in hippocampal neurons of vascular dementia rats].

OBJECTIVE: To observe the effect of electroacupuncture (EA) pretreatment on hippocampal glutamate (Glu) content and N-methyl-D-aspartate receptor (NMDAR)1 mRNA expression in rats with vascular dementia (VD) so as to explore its underlying mechanism in improving VD. METHODS: A total of 72 SD rats were randomized into control (n=16), sham-operation (n=16), model (n=20) and EA pretreatment (n=20) groups. VD model was established by modified middle cerebral artery occlusion. EA (1 mA, 1.7 Hz) was applied to "Baihui" (GV 20), "Shenshu"(BL 23) and "Zusanli" (ST 36), once daily for 10 days. Glu content of right hippocampus tissue was detected with chromatometry. NMDAR 1 mRNA expression of hippocampus was detected by in situ hybridization histochemistry. RESULTS: In comparison with sham operation group, Glu content and NMDAR 1 mRNA expression of hippocampus in model group increased significantly (P<0.01). Compared with model group, Glu content and NMDAR 1 mRNA expression of hippocampus in EA pretreatment group decreased significantly (P<0.01, 0.05). CONCLUSION: EA pretreatment can suppress the increase of Glu content, down-regulate NMDAR 1 mRNA expression in VD rats, which may contribute to its effect in relieving VD via reducing apoptosis and protecting cerebral neurons.

[Effects of acupoint-embedding of medicinal thread and electroacupuncture on contents of TNF-alpha and IL-6 of hippocampus tissue in rats with focal cerebral ischemia-reperfusion injury].

OBJECTIVE: To observe the effects of acupoint-embedding (AE) of collagen plus Tetramethylpyrazine and electroacupuncture (EA) on the contents of TNF-alpha and IL-6 in hippocampus tissue in rats with focal cerebral ischemia-reperfusion (CI-R) injury. METHODS: A total of 120 SD rats were randomly divided into normal control (n=8), sham operation (n=24), model (CI-R, n=24), EA (n=24) and AE (n=24) groups, and the later 4 groups were further divided into 24 h, 72 h and 120 h subgroups (time-points) separately, with 8 cases in each. CI-R model was established by middle cerebral artery occlusion (MCAO) and reperfusion. For animals of AE group, the medicinal thread consisting of collagen and Tetramethylpyrazine was implanted into "Dazhui" (GV14) and bilateral "Neiguan" (PC6), once daily. For rats of EA group, EA (120 cycles/min, 1 mA) was applied to GV14 and PC6 for 30 min, once daily. The contents of TNF-alpha and IL-6 in the hippocampus were detected by using radio-immunoassay after processing the tissue samples (homogenate, centrifuge). RESULTS: The contents of TNF-alpha and IL-6 in hippocampus tissue of model group at 24 h, 72 h and 120 h time-points were significantly higher than those of normal control and sham operation groups (P<0.05), while after EA and AE, the contents of TNF-alpha at the 3 time-points decreased significantly (P<0.05), and IL-6 contents at the same 3 time-points increased further and significantly (P<0.05). Comparison between EA and AE groups showed that the contents of TNF-alpha of the later group at 72 h and 120 h were significantly lower than those of EA group (P<0.05), while IL-6 contents of AE group were significantly higher than those of EA group at the same time-points (P<0.05). CONCLUSION: Both EA and AE of collagen and Tetramethylpyrazine can evidently lower TNF-alpha content and significantly raise IL-6 level in hippocampus in rats with cerebral ischemia/reperfusion injury and the effect of AE is significantly superior to that of EA, which may contribute to their protective effects on ischemic cerebral neurons.

[Study on dual-directional regulation induced by acupuncture at different acupoints in the rat with motility abnormality of the stomach].

OBJECTIVE: To probe into the bidirectional regulation of acupuncture in the rat with motility abnormality of the stomach and the nerve mechanism. METHODS: Adopting electrophysiological methods, the extracellular discharge signals of neuronic action in NTS were recorded with glass microelectrodes. The effects of acupuncture at "Zusanli" (ST 36), "Neiguan" (PC 6), "Zhongwan" (CV 12), "Qihai" (CV 6) on discharges of NTS neurons and intra-gastric pressure were observed in the rat at normal physiological state, and increase or reduction of gastric motility. RESULTS: Acupuncture at "Zusanli" (ST 36), "Neiguan" (PC 6) could significantly promote gastric motility of the rat at normal status, increase or reduction of gastric motion, while acupuncture at "Zhongwan" (CV 12), "Qihai" (CV 6) could significantly inhibit gastric motion. And acupuncture at all the above acupoints could activate discharges of NTS neurons. CONCLUSION: The bidirectional regulation effect of an acupoint does not certainly indicate that the same point has bidirectional regulation effect on an internal organs at different pathological states, while this may show synthetic action of different points which is a good regulation towards normal states and homeostasis.

In vitro developmental competence of pig nuclear transferred embryos: effects of GFP transfection, refrigeration, cell cycle synchronization and shapes of donor cells.

The present study was designed to evaluate the feasibility of producing pig transgenic blastocysts expressing enhanced green fluorescent protein (GFP) and to examine the effects of shape and preparation methods of donor cells on in vitro developmental ability of pig nuclear transferred embryos (NTEs). In experiment 1, the effect of GFP transfection on development of pig NTEs was evaluated. The cleavage and blastocyst rates showed no significant difference between NTEs derived from transfected and non-transfected donors. In experiment 2, the effect of different nuclear donor preparation methods on in vitro development of NTEs was examined. The cleavage rate showed no statistically significant differences among three preparation methods. The blastocyst rates of donor cells treated once at -4 degrees C and those of freshly digested cells were similar to each other (26.3% vs 17.9%). The lowest blastocyst rates (5.88%) were observed when cells cryopreserved at -196 degrees C were used as donors. In experiment 3, the effect of different cell cycle synchronization methods on the in vitro development potential of pig NTEs was evaluated. The cleavage rate of NTEs derived from cycling cells was much better than that of NTEs derived from serum-starved cells (64.4% vs 50.5%, p < 0.05), but no significant difference was observed between the the blastocyst rates of the two groups. In experiment 4, the effect of different shapes of cultured fibroblast cells on the in vitro development of pig NTEs was examined. The fusion rate for couplets derived from rough cells was poorer than that observed in couplets derived from round smooth cells (47.8% vs 76.8%, p < 0.05). However, there were no significant differences observed in the cleavage rate and blastocyst rate. In conclusion, the present study indicated that (i) refrigerated pig GFP-transfected cells could be used as donors in nuclear transfer and these NTEs could be effectively developed to blastocyst stage; (ii) serum starvation of GFP-transfected cells is not required for preimplantation development of pig NTEs; and (iii) a rough surface of GFP-transfected donor cells affects fusion rate negatively but has no influence on the cleavage rate or blastocyst rate of pig NTEs.