Acupuncture for chronic pain: an update and critical overview.

PURPOSE OF REVIEW: Acupuncture is now recommended for several chronic pain conditions. Despite supportive evidence of its effectiveness, this ancient approach is often misunderstood, and may still be underused in mainstream practice. A critical review on its effectiveness and practice integration, and mechanisms of action is essential to the medical community that is continuing to seek nonopioid therapies for chronic pain. RECENT FINDINGS: Mounting evidence supports the effectiveness of acupuncture to treat chronic low back, neck, shoulder, and knee pain, as well as headaches. Additional data are emerging that support the use of acupuncture as an adjunct or alternative to opioids, and in perioperative settings. Findings related to its mechanisms of action include transient receptor potential cation channel vanilloid 1 activation in the periphery, microglial suppression in the cerebral cortex and spinal cord, and regulation of cytokines and other key inflammatory factors in the spinal cord. Incremental integration of acupuncture into pain medicine practices and training programmes continues to grow. SUMMARY: Acupuncture is effective, safe, and cost-effective for treating several chronic pain conditions when performed by well-trained healthcare professionals. Further studies on its use as an adjunct or alternative to opioids, and in perioperative settings are needed.

Nocardioides albidus sp. nov., an actinobacterium isolated from garden soil.

A novel bacterial strain, designated THG-S11.7T, was isolated from garden soil in Incheon, South Korea. Cells of the strain were Gram-stain-positive, aerobic, non-motile cocci, and were catalase- and oxidase-positive. Colonies of the strain were white. Strain THG-S11.7T grew optimally at 28 °C, at pH 7.0 and in the presence of 2.0 % NaCl. 16S rRNA gene sequence analysis indicated that the strain was a member of the genus Nocardioides. Strain THG-S11.7T showed a 16S rRNA gene sequence similarity of 98.2 % to Nocardioides kongjuensis KCTC 19054T, 98.0 % to Nocardioides caeni KCTC 19600T, 97.9 % to Nocardioides daeguensis KCTC 19799T, 97.8 % to Nocardioides nitrophenolicus KCTC 047BPT, 97.6 % to Nocardioides aromaticivorans KACC 20613T, 97.5 % to Nocardioides simplex KACC 20620T and 97.0 % to Nocardioides ginsengisoli KCTC 19135T. DNA-DNA relatedness values between strain THG-S11.7T and the closest phylogenetic neighbours were below 45.0 % and the DNA G+C content of strain THG-S11.7T was 72.2 mol%. Strain THG-S11.7T was characterized chemotaxonomically as having ll-diaminopimelic acid in the cell-wall peptidoglycan and menaquinone MK-8(H4) as the predominant isoprenoid quinone. The major phospholipid was determined to be diphosphatidylglycerol. The major cellular fatty acids of strain THG-S11.7T were iso-C15 : 0, C16 : 0 and iso-C16 : 0. Based on the phenotypic, genotypic and phylogenetic analyses, it is proposed that the isolate represents a novel species of the genus Nocardioides, for which the name Nocardioides albidus sp. nov. is proposed. The type strain is THG-S11.7T ( = KCTC 39607T = CCTCC AB 2015297T).

Massilia arvi sp. nov., isolated from fallow-land soil previously cultivated with Brassica oleracea, and emended description of the genus Massilia.

A novel bacterial strain, designated THG-RS2OT, was isolated from fallow-land soil previously cultivated with Brassica oleracea in Yongin, South Korea. Cells were Gram-stain-negative, aerobic, non-motile rods, catalase- and oxidase-positive. Strain THG-RS2OT grew optimally at 25­37 °C, at pH 7.0 and in the absence of NaCl. 16S rRNA gene sequence analysis demonstrated that strain THG-RS2OT shows highest sequence similarity with Massilia kyonggiensis KACC 17471T followed by Massilia aerilata KACC 12505T, Massilia niastensis KACC 12599T, Massilia tieshanensis KACC 14940T and Massilia haematophila KCTC 32001T. Levels of DNA­DNA relatedness between strain THG-RS2OT and the closest phylogenetic neighbours were below 55.0 % and the DNA G+C content of strain THG-RS2OT was 63.2 mol%. Major fatty acids were C16 : 0, cyclo-C17 : 0 and summed feature 3 (C16 : 1ω6c and/or C16 : 1ω7c). The major respiratory quinone was identified as ubiquonone-8 and predominant polar lipids were determined to be diphosphatidylglycerol, phosphatidylethanolamine and phosphatidylglycerol. Characterization by 16S rRNA gene sequence analysis, DNA­DNA hybridization, ubiquinone, polar lipid, fatty acid composition, and physiological and biochemical parameters revealed that strain THG-RS2OT represents a novel species of the genus Massilia. Hence, the present study describes a novel species for which the name Massilia arvi sp. nov. is proposed. The type strain is THG-RS2OT ( = KCTC 42609T = CCTCC AB 2015115T).

Novosphingobium aquaticum sp. nov., isolated from lake water in Suwon, Republic of Korea.

A novel Gram-stain negative, yellow coloured, strictly aerobic, rod-shaped, non-motile bacterium designated as THW-SA1(T), was isolated from lake water near Samsung apartment, Suwon, Republic of Korea. The phylogenetic analysis based on 16S rRNA gene sequences showed that strain THW-SA1(T) belongs to the genus Novosphingobium and is closely related to Novosphingobium taihuense (97.8 %) and Novosphingobium subterraneum (97.1 %). The DNA-DNA relatedness values between strain THW-SA1(T) and the most closely related type strains were found to be less than 30.0 %. The DNA G+C content was determined to be 67.5 mol%. The strain grows optimally at 25-28 °C, at pH 7.0, and in the presence of 0.5 % NaCl. The predominant isoprenoid quinone was identified as ubiquinone Q-10. The polar lipid profile comprises diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine, phosphatidyldimethylethanolamine, sphingoglycolipid, phosphatidylcholine, some unidentified phospholipids and some unidentified polar lipids. Fatty acids characteristic for this genus, such as C16:1, C14:0 2-OH, C16:1 ω6c and/or C16:1 ω7c (summed feature 3) and C18:1 ω6c and/or C18:1 ω7c (summed feature 8) were also detected. On the basis of the phenotypic and genotypic analysis, the strain THW-SA1(T) is considered to represent a novel species of the genus Novosphingobium, for which the name Novosphingobium aquaticum sp. nov. is proposed. The type strain is THW-SA1(T) (=KCTC 42608(T)=CCTCC AB 2015114(T)).

Taibaiella yonginensis sp. nov., a bacterium isolated from soil of Yongin city.

A novel bacterial strain, designated as THG-SC4(T), was isolated from a soil sample collected from Yongin city in South Korea. Cells of the strain were Gram-negative, aerobic, rod-shaped and non-motile. The strain grew optimally at 28-30 °C; at pH 7.0 and in the absence of NaCl. Flexirubin-type pigments were found to be present. On the basis of 16S rRNA gene sequence similarity, strain THG-SC4(T) was shown to belong to the genus Taibaiella and shares high sequence similarity with Taibaiella smilacinae KCTC 32316(T) (95.4 %), followed by Taibaiella koreensis KACC 17171(T) (94.3 %) and Taibaiella chishuiensis JCM 19637(T) (94.2 %). The DNA G+C content of the novel isolate was determined to be 43.1 mol% and MK-7 was identified as the predominant isoprenoid quinone. The only polyamine was homospermidine. The major polar lipids were phosphatidylethanolamine, an unidentified aminophospholipid and an unidentified polar lipid. The predominant fatty acids were identified as iso-C15:0, iso-C15:1 G, C16:0 and iso-C17:03-OH. On the basis of data from this polyphasic taxonomic study, strain THG-SC4(T) is considered to represent a novel species of the genus Taibaiella, for which the name Taibaiella yonginensis sp. nov. is proposed. The type strain is THG-SC4(T) (=KACC 18372(T) = CCTCC AB 2014316(T)).

Efficacy of probiotics in hair growth and dandruff control: A systematic review and meta-analysis.

Background: Probiotics are intellectually rewarding for the discovery of their potential as a source of functional food. Investigating the economic and beauty sector dynamics, this study conducted a comprehensive review of scholarly articles to evaluate the capacity of probiotics to promote hair growth and manage dandruff. Methods: We used the PRISMA 2020 with Embase, Pubmed, ClinicalTrials.gov, Scopus, and ICTRP databases to investigate studies till May 2023. Meta-analyses utilizing the random effects model were used with odds ratios (OR) and standardized mean differences (SMD). Result: Meta-analysis comprised eight randomized clinical trials and preclinical studies. Hair growth analysis found a non-significant improvement in hair count (SMD = 0.32, 95 % CI -0.10 to 0.75) and a significant effect on thickness (SMD = 0.92, 95 % CI 0.47 to 1.36). In preclinical studies, probiotics significantly induced hair follicle count (SMD = 3.24, 95 % CI 0.65 to 5.82) and skin thickness (SMD = 2.32, 95 % CI 0.47 to 4.17). VEGF levels increased significantly (SMD = 2.97, 95 % CI 0.80 to 5.13), while IGF-1 showed a non-significant inducement (SMD = 0.53, 95 % CI -4.40 to 5.45). For dandruff control, two studies demonstrated non-significant improvement in adherent dandruff (OR = 1.31, 95 % CI 0.13-13.65) and a significant increase in free dandruff (OR = 5.39, 95 % CI 1.50-19.43). Hair follicle count, VEGF, IGF-1, and adherent dandruff parameters were recorded with high heterogeneity. For the systematic review, probiotics have shown potential in improving hair growth and controlling dandruff through modulation of the immune pathway and gut-hair axis. The Wnt/ß-catenin pathway, IGF-1 pathway, and VEGF are key molecular pathways in regulating hair follicle growth and maintenance. Conclusions: This review found significant aspects exemplified by the properties of probiotics related to promoting hair growth and anti-dandruff effect, which serve as a roadmap for further in-depth studies to make it into pilot scales.

Effectiveness of training program combining chakrayoga and meditation.

Background This study was designed to examine the effectiveness of program combining chakrayoga and meditation on the physical health and disease-related factors and psychological factors of people. Methods Ninety-seven subjects (32-83 years old) who had free from prior experiences in meditation programs or Chakrayoga training courses were assigned to either the experimental group (EXP) (45 subjects; 13 male subjects and 32 female subjects; average age of 60.67 years, SD=11.09 years) or the control group (CONT) of remaining subjects (52 subjects; 14 male subjects and 38 female subjects; average age of 61.58 years, SD=9.70 years). Subjects in the EXP participated in the Chakrayoga Meditation Program for twice a week for 2 h during 6 weeks in each session consisted of 1 h of Chakrayoga and 1 h of meditation. The measurements in this study included the mindfulness, stress response, subjective quality of life, medical symptom checklist, difficulty in emotional regulation and objective of life and sense of control. Results Results revealed that participants in the EXP reported significantly more relief of mindfulness, stress response, subjective quality of life and medical symptom checklist than those in the CONT. Conclusions These findings provide evidence that the Chakrayoga Meditation Program can help relieve the physical health and disease-related factors and psychological factors.

Acupuncture for symptom management of rheumatoid arthritis: a pilot study.

We investigated the feasibility of a future acupuncture trial in the symptom management of rheumatoid arthritis (RA). Twenty-five patients meeting the American College of Rheumatology (ACR) criteria were recruited and given 14 sessions of individualised acupuncture treatment for 6 weeks. Improvement in symptoms was assessed using ACR 20, 50 and 70; disease activity score (DAS28); tender joint count; swollen joint count; morning stiffness and health-related quality of life using the Korean Health Assessment Questionnaire and the SF-36 at baseline and after 6 weeks. Erythrocyte sedimentation rate (ESR) was also assessed. At 6 weeks, 44%, 20%, and 12% of patients achieved ACR 20, 50 and 70 responses, respectively. Acupuncture also produced statistically significant improvements in DAS28, pain and global activity, swollen joint count, health-related quality of life (SF-36) and ESR. No major acupuncture-related adverse events were reported. Acupuncture treatment as used in this pilot study was safe and well-tolerated. The use of acupuncture for symptom management in RA warrants further investigation.

Turo (Qi Dance) Program for Parkinson's Disease Patients: Randomized, Assessor Blind, Waiting-List Control, Partial Crossover Study.

CONTEXT: Qigong, Tai-chi and dancing have all been proven effective for Parkinson's disease (PD); however, no study has yet assessed the efficacy of Turo, a hybrid qigong dancing program developed to relieve symptoms in PD patients. OBJECTIVE: To determine whether Turo may provide benefit in addressing the symptoms of PD patients. DESIGN: Randomized, assessor blind, waiting-list control, partial crossover study. SETTING: Kyung Hee University Korean Medicine Hospital, Seoul, Republic of Korea. PARTICIPANTS: A total of 32 PD patients (mean age 65.7 ± 6.8). INTERVENTION: Participants were assigned to the Turo group or the waiting-list control group. The Turo group participated in an 8-week Turo training program (60-minute sessions twice a week). The waiting-list control group received no additional treatment during the same period; then underwent the same 8-week Turo training. OUTCOME MEASURES: The primary outcome was a score on the Unified Parkinson's Disease Rating Scale (UPDRS), and the secondary outcomes included the perceived health status assessed using the Parkinson's disease Quality of Life questionnaire (PDQL), balance function as assessed by the Berg Balance Scale (BBS) and the results of the Beck Depression Inventory (BDI). RESULTS: The Turo group showed statistically significant improvements in the UPDRS (P < 0.01) and PDQL (P < 0.05) as compared to the control group. The changes in BBS scores displayed a tendency toward improvement, but was not statistically significant (P = 0.051). CONCLUSION: These findings suggest that Turo PD training might improve the symptoms of PD patients.

Korean acupuncture: the individualized and practical acupuncture.

BACKGROUND: Acupuncture has long been a central part of medicine in East Asia. Recently its therapeutic effects are world-widely recognized with scientific bases being established by means of basic research and clinical studies in the biomedical sciences. Even though Korean acupuncture (KA) shares its origins with traditional Chinese medicine (TCM), it has developed into its own unique system. METHODS: We assessed the unique characteristics of KA and discussed the potential contributions of KA to modern medicine. RESULTS: Individualized approach by KA is based on constitutional energy traits which are considered as a main element in Saam, Taegeuk and eight constitution acupunctures. New practical and integrated forms of therapeutic modalities, such as herbal acupuncture or pharmacopuncture, have also been developed by KA. CONCLUSION: Given its individualized and practical characteristics, KA is expected to make significant contributions to the understanding and the treatment of neurological disorders through basic research and clinical trials.

Acupuncture, a promising adjunctive therapy for essential hypertension: a double-blind, randomized, controlled trial.

BACKGROUND: This study assessed effects of acupuncture as an add-on to conventional antihypertensive managements such as medication or lifestyle modification for hypertensive or pre-hypertensive subjects. METHODS: A randomized, double-blind, placebo-controlled trial was conducted at Kyung Hee University Hospital. Forty-one hypertensive or pre-hypertensive (systolic BP> or =120 mmHg or diastolic BP> or =80 mmHg) volunteers were recruited and randomly assigned into real or sham acupuncture groups. The hypertensive subjects on antihypertensive medication continued their medication. Acupuncture point prescriptions were partially individualized, based on the Saam acupuncture theory. Park's sham needle method was adopted for the sham procedure. Measurements were performed at baseline, weeks 4 and 8. BP, scales of overall health and pain, and anticipation or satisfaction for the treatments, were recorded. RESULTS: Thirty subjects completed the intervention, all of whom were on antihypertensive medication. The sham acupuncture group showed no significant change in mean BP, while the real acupuncture group showed a significant (p<0.01) decrease in mean BP after 8 weeks of intervention from 136.8/83.7 to 122.1/76.8 mmHg. Other factors showed no difference between the groups throughout the study. CONCLUSION: Acupuncture seems to offer an additional benefit to the treatment of hypertensive patients.

Peroxisome proliferator-activated receptor-gamma Pro12Ala polymorphism is associated with the susceptibility to ischemic stroke in Taeeumin classified by Sasang medicine.

BACKGROUND: Sasang constitutional medicine classifies mankind into four constitutional types according to individual psychologic and physical traits. We hypothesized that differences among constitutional types might be explained by genetic variations. METHODS: To evaluate the hypothesis, we determined the possible association in ischemic stroke patients (n = 134) of peroxisome proliferator-activated receptor (PPAR)-gamma with four constitutional types of Sasang medicine. The constitutional type of each patient and control subject (n = 129) was classified and genotyped for PPAR-gamma polymorphism Pro12Ala by polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) methods. RESULTS: The distribution of the Pro/Ala genotypes in the ischemic stroke patients was not significantly different from that of healthy controls [odds ratio (OR)= 0.46; p = 0.1214]. However, very interestingly, we observed that all six Pro/Ala genotypes in ischemic patients were Taeeumin, one of four constitutional types of Sasang medicine. Statistical analysis revealed that Pro/Ala genotype in Taeeumin increases almost 15-fold the susceptibility to ischemic stroke compared to other constitutional types, Taeyangin, Soyangin or Soeumin (OR= 14.72; p = 0.0110). CONCLUSION: From the results in this study, we might suggest that Pro/Ala genotype in Taeeumin is associated with the susceptibility to ischemic stroke. To the author's best knowledge, this is the first report to study on genetic level the potential relationship between ischemic stroke and Sasang constitutional medicine, one of traditional Korean medicines (TKM). Authors hope that this study could provide a new approach for the study of ischemic stroke and merit further research.

Efficacy of combined treatment by scalp and penetration acupunctures with TKM medication (tang) on stroke patients.

BACKGROUND: Traditional Korean medicine (TKM) therapy of scalp and penetration acupuncture has been used for the treatment of stroke in Korea. This study investigated the efficacy of scalp and penetration acupuncture in combination with TKM medication. METHODS: Twenty-four stroke patients were enrolled in the program. Control group (n = 12) received herbal medicines (Baepungtang, Sopungtang or Sosokmyeongtang) and conventional body acupuncture. Treatment group (n = 12) received scalp and penetration acupuncture in addition to herbal medicines and conventional body acupuncture. Improvements in the motor functions were scored by the modified Barthel index (MBI). RESULTS: After 4 weeks of treatment, statistical analysis showed significant improvement in the MBI scores for both groups. Significant difference in the MBI scores between two groups, however, was not observed. CONCLUSION: The supportive effect of scalp and penetration acupuncture in the treatment of stroke needs further investigation.

[What's the original concept of meridian and acupuncture point in oriental medicine?--A perspective of medical history].

Meridian and acupuncture point (MAP) is a core theory of acupuncture and essential building blocks of oriental medicine. There still continue theoretic or experimental arguments and controversies on the origination or original concept of MAP, without any definite approval or disapproval of a hypothesis. The theory of MAP is an historic product and has never been outside of historic influences. This study discusses the original concept of meridian and acupuncture point theory and its historical evolution, based on the review of classic literatures on meridian including the mawangdui medical texts of Han dynasty. The concept of MAP served as a empirical reference system in clinical settings irrespective of the anatomical entity of MAP.

Acupuncture enhances cell proliferation in dentate gyrus of maternally-separated rats.

Maternal separation in early life can increase vulnerability to neuropsychiatric disorders over the lifespan. To investigate the effect of acupuncture on cell proliferation in the dentate gyrus (DG), 5-bromo-2'-deoxyuridine (BrdU)-immunohistochemistry was performed in maternally-separated rat pups. Maternal separation, for 7 days from postnatal day 14, induced a significant decrease of BrdU-immunoreactive cells in DG, while acupuncture treatment at acupoint Shenmen (HT7), at the end of the transverse crease of the ulnar wrist, resulted in the significant increase in the number of BrdU-positive cells in DG. However, acupuncture at acupoint ST36, near the knee joint, produced no increase in the number of BrdU-positive cells. These findings indicate that acupuncture at acupoint HT7 appears to stimulate cell proliferation, and we suggested that acupuncture may be useful in the treatment of diseases related to maternal separation.

Bee venom protects SH-SY5Y human neuroblastoma cells from 1-methyl-4-phenylpyridinium-induced apoptotic cell death.

Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by progressive selective loss of dopaminergic neurons in the substantia nigra. Recently, bee venom was reported to protect dopaminergic neurons in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine induced mice PD model, however, the underlying mechanism is not fully understood. The objective of the present study is to investigate the neuroprotective mechanism of bee venom against Parkinsonian toxin, 1-methyl-4-phenylpyridine (MPP(+)), in SH-SY5Y human neuroblastoma cells. Our results revealed that bee venom pretreatment (1-100 ng/ml) increased the cell viability and decreased apoptosis assessed by DNA fragmentation and caspase-3 activity assays in MPP(+)-induced cytotoxicity in SH-SY5Y cells. Bee venom increased the anti-apoptotic Bcl-2 expression and decreased the pro-apoptotic Bax, cleaved PARP expressions. In addition, bee venom prevented the MPP(+)-induced suppression of Akt phosphorylation, and the neuroprotective effect of bee venom against MPP(+)-induced cytotoxicity was inhibited by a phosphatidylinositol 3-kinase (PI3K) inhibitor, LY294002. These results suggest that the anti-apoptotic effect of bee venom is mediated by the cell survival signaling, the PI3K/Akt pathway. These results provide new evidence for elucidating the mechanism of neuroprotection of bee venom against PD.

Heat stimulation on the skin for medical treatment: can it be controlled?

OBJECTIVES: It has become increasingly important for evidence-based medicine to have a proper control for randomized-controlled trials. However, appropriately controlling manual therapies such as moxibustion has proved challenging. Our team designed a novel device based on sensory illusion, and tested its feasibility. DESIGN AND RESULTS: A sham moxibustion device was constructed to allow participants to feel moxibustion treatment without actually stimulating the corresponding acupoint. The device consisted of two pieces of aluminum, each shaped like a horseshoe, so that the center of the device would not touch the skin. Participants perceived two heat stimuli as one when the distances of two heat sources were within 15 mm on the forearm. The thermal stimulation of the sham device was adjusted to the lowest possible temperature, but enough to elicit a heat sensation (39°C), while that of verum was set at around 44°C. The subject blinding, tested in 30 healthy volunteers, was successful. With the exception of 1 subject, subjects in the sham group described the sensation as a warm solid circle, unable to differentiate between two-pieced sham moxibustion and verum moxibustion. CONCLUSIONS: This preliminary study indicates that this device may serve as an appropriate control for clinical studies of moxibustion, but more research is clearly needed. A validated sham moxibustion device based on sensory illusion may contribute in expanding knowledge of somatosensory studies.

Acupuncture attenuates autonomic responses to smoking-related visual cues.

OBJECTIVES: In smokers, smoking-associated cues produce smoking urges and cravings, which are accompanied by autonomic dysfunction in response to these cues. We investigated whether or not acupuncture ameliorated cigarette withdrawal symptoms, as well as attenuated the autonomic responses to smoking-related visual cues in smokers using a power spectrum analysis of heart rate variability (HRV). INTERVENTIONS: Fifteen subjects were treated with real acupuncture (RA) at HT7 and 14 subjects received sham acupuncture (SA) at LI10 using the Park Sham Device. MAIN OUTCOME MEASURE: The cigarette withdrawal scale (CWS) was measured on the third day after the subjects had quit smoking. We compared the low-frequency/high-frequency (HF/LF) ratio in the HRV of the RA and SA groups during a distraction task using neutral and smoking visual cues. RESULTS: The CWS of the RA group was significantly lower than that of the SA group. The increase in the LF/HF ratio of HRV induced by the smoking-related visual cues was also significantly lower in the RA group when compared with the SA group. Acupuncture not only ameliorated cigarette withdrawal, but also weakened the autonomic responses to smoking cues during withdrawal. CONCLUSIONS: These findings suggest that acupuncture might help in smoking cessation by attenuating withdrawal symptoms and smoking cues-induced autonomic responses.

Potential neuroprotective effects of acupuncture stimulation on diabetes mellitus in a global ischemic rat model.

Acupuncture (ACU) is known to be effective in ischemia treatment, and glutamate (GLU) excitotoxicity is an important factor in neuronal cell death. We observed the effect of ACU on cerebral blood flow (%CBF) and DeltaGLU (the changes in GLU release) in the ischemic stroke rat model of diabetic mellitus (DM). A global ischemia was induced using the eleven-vessel occlusion (11-VO) method in 14 Sprague-Dawley rats (DM), which were randomly divided into two groups: the control group and the ACU-treatment group. Extracellular DeltaGLU was assessed using an intra-cerebral biosensor system measuring 256 samples per second, simultaneously with %CBF and electroencephalogram. ACU stimulation was applied to ACU points GB34 and GB39 during the ischemic period. Twenty-three diagnostic parameters were proposed first for a detailed analysis of changes in %CBF and GLU release during ischemia/reperfusion. ACU rats showed a significant decrease in ischemic (p < 0.05) and reperfusion %CBF (p < 0.0001) than control rats, and a significantly larger decrease in ischemic DeltaGLU (p < 0.05) and peak level of reperfusion DeltaGLU (p < 0.005) than control rats. From these results, we suggest that ACU stimulation is responsible for the potential protection of neurons through suppression of %CBF response in the increased plasma osmolality and extracellular DeltaGLU in diabetic rats under ischemic conditions.