[Effects of Tongnao Huoluo acupuncture therapy on Caspase-3 and Bcl-2 of rats with acute cerebral infarction].

OBJECTIVE: To evaluate effects of Tongnao Huoluo acupuncture therapy (THAT) on Bcl-2 and Caspase-3 rats with acute cerebral infarction (ACI). METHODS: Totally 264 SD rats were randomly divided into 5 groups, i.e. the THAT group (n =72), the thrombolysis group (n =72), the body acupuncture group (n =72), the ischemia control group (n =24), and the sham-operation group (n =24). Successfully modeled rats were recruited in all groups except the sham-operation group. Rats in the THAT group, the thrombolysis group, and the body acupuncture group were divided into 3 subgroups according to the disease occurrence time, i.e., < or = 1.5 h THAT group, 1.5+ -2 h THAT group, and 2+ -3 h THAT group. The neuroethological scores were assessed at 6, 24, and 72 h after treatment. The expressions of Bcl-2 and Caspase-3 were detected using immunohistochemical staining at 24 and 72 h respectively. RESULTS: In aspect of improving scores of neurological functions: At 6 h after treatment within 2 h after the disease occurrence, the neuroethological scores were lowered more obviously in the thrombolysis group than in the THAT group (P <0.05). There was statistical difference at 24 and 72 h within 2 - 3 h after the,disease occurrence between the THAT group and the thrombolysis group (P <0.05). Compared with before treatment, there was statistical difference at 24 and 72 h within 3 h after the disease occurrence (P <0. 05, P <0.01). In aspect of lowering the expression of Caspase-3 and elevating the expression of Bcl-2: There was statistical difference in lowering the expression of Caspase-3 and elevating the expression of Bcl-2 between the THAT group and the thrombolysis group at 72 h within 2 -3 after the disease occurrence (P <0.05, P < 0.01). CONCLUSION: THAT showed favorable effects in lowering neuroethological scores, lowering expression of Caspase-3, and elevating the expression of Bcl-2 of ACI rats.

[Relationship between the inserting sites of Fu's subcutaneous needling and traditional acupoints: revelation to acupuncture and moxibustion].

Focusing on the phenomenon of "de-acupoints" of the needle insertion sites in Fu's subcutaneous needling (FSN), the authors allocated the evolution and characteristics of the needle insertion sites of FSN. From six aspects, named morphology and structure, location, nomenclature, numbers and meridian tropism, indications and acupuncture manipulations, the comparison was made between the insertion sites of FSN and traditional acupoints. It is believed: ①The needle insertion sites of FSN has the basic attributes of acupoint, which not only refers to the operation site, but also indicates the reaction of disease; moreover, it is the treatment site with significant therapeutic effect. ②The optimized sites of insertion in FSN should be named differently and their locations and numbers should be specified relatively. ③The insertion sites of FSN should be further intersected and integrated with traditional acupoints, and a part of traditional acupoints should become the insertion sites of FSN. ④Accepting and integrating the insertion sites of FSN, and expanding the scope of traditional acupoints may be the new project in the research of traditional acupoints.

miR-222 regulates cell growth, apoptosis, and autophagy of interstitial cells of Cajal isolated from slow transit constipation rats by targeting c-kit.

BACKGROUND: Excessive autophagy and apoptosis of the interstitial cells of Cajal (ICC) have been identified in gastrointestinal (GI) motility disorders including slow transit constipation (STC). MicroRNA 222 (miR-222) has been shown to affect GI motility. This study aimed to explore whether miR-222 influences apoptosis and excessive autophagy of isolated ICC. METHODS: miR-222, c-kit, and stem cell factor (SCF) were evaluated in colon tissues in STC rats compared with normal control by qRT-PCR and western blot analysis. The condition of autophagy of colon tissue was observed by transmission electron microscope. ICC were isolated from the colon of STC rats. Cell Counting Kit-8 (CCK-8) assay and wound healing assay were carried out to examine the cell viability and migration rate. Cell apoptosis was detected by terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) and Annexin V-Flourescein Isothiocyanate/Propidine Iodide (FITC/PI) apoptosis detection kit. Western blot analysis was performed to detect the c-kit and SCF expression; apoptosis-related proteins Bcl-2, Bax, caspase-3, and pro-caspase-3; and autophagy-related proteins LC3B and Beclin-1. The connection between miR-222 and c-kit was detected by bioinformatics and luciferase activity analysis. RESULTS: miR-222 expression was significantly higher, whereas c-kit and SCF expressions were markedly lower in STC rats' colon tissue compared with normal control. Meanwhile, STC rats exhibited excessive autophagy in colon tissue than normal control. Inhibition of miR-222 expression promoted cell proliferation as well as migration and inhibited autophagy, whereas upregulation of miR-222 had the opposite effect. In addition, miR-222 upregulation induced apoptosis and excessive autophagy compared with normal controls (NC). Western blot analysis showed that miR-222 overexpression caused decreased c-kit and SCF protein levels compared with NC. Bioinformatics and luciferase activity analysis revealed that miR-222 could be a predictive regulator of c-kit. CONCLUSION: miR-222 induces apoptosis and excessive autophagy of ICC and may serve as potential biomarker for ICC loss in STC.

[Clinical observation on horizontal penetration needling combined with rizatriptan monobenzoate tablets for migraine without aura in acute stage].

OBJECTIVE: To observe the therapeutic effect of horizontal penetration needling combined with rizatriptan monobenzoate tablets, simple horizontal penetration needling and simple rizatriptan monobenzoate tablets for migraine without aura in acute stage. METHODS: A total of 99 patients with migraine without aura in acute stage were randomized into an acupuncture plus medication group, an acupuncture group and a western medication group, 33 cases in each one. In the acupuncture group, horizontal penetration needling was applied once at Hanyan (GB 4) to Xuanli(GB 6), Shenting (GV 24) to Yintang (GV 29), Baihui (GV 20) to Qianding (GV 21), etc. for 2 h. In the western medication group, oral rizatriptan monobenzoate tablets for 10 mg were given once. In the acupuncture plus medication group, treatment of acupuncture combined with rizatriptan monobenzoate tablets were given, the application was the same as the acupuncture group and the western medication group. Before treatment and 0.5, 2, 24 h after treatment, the visual analogue scale (VAS) score was observed, the remission rate and the disappearance rate of migraine of 2, 24 h after treatment were compared in the 3 groups. RESULTS: Compared before treatment, the VAS scores of each time point after treatment were decreased in the 3 groups (P<0.05), and the changes in the acupuncture plus medication group were greater than those in the acupuncture group and the western medication group (P<0.05). The remission rates of 24 h after treatment and the disappearance rates of migraine of 2, 24 h after treatment in the acupuncture plus medication group were higher than those in the acupuncture group and the western medication group (P<0.05). CONCLUSION: Horizontal penetration needling combined with rizatriptan monobenzoate tablets have significant therapeutic effect on rapid analgesia and continuous analgesia for migraine without aura in acute stage, its effect is superior to simple horizontal penetration needling and simple rizatriptan monobenzoate tablets.

[Therapeutic observation on horizontal penetration needling for residual dizziness after repositioning maneuver in patients with benign paroxysmal positional vertigo].

OBJECTIVE: To observe the effect of horizontal penetration needling at vertigo auditory area and balance area on residual dizziness after successful repositioning maneuver in patients with benign paroxysmal positional vertigo (BPPV). METHODS: Sixty-six patients with residual dizziness after successful repositioning maneuver for BPPV were randomly divided into an observation group (34 cases, 1 case dropped off) and a control group (32 cases, 2 cases dropped off). The patients in the observation group were treated with horizontal penetration needling at vertigo auditory area and balance area, once every other day; three times were taken as a course of treatment, and two courses of treatment were given. The patients in the control group received no acupuncture and medication. The dizziness handicap inventory (DHI) and visual analogue scale (VAS) scores were observed before treatment and after 1 and 2 courses of treatment. RESULTS: Except for the emotional score of DHI in the control group after 1 course of treatment, the sub item scores and total scores of DHI and VAS scores in the two groups after treatment were lower than those before treatment (P<0.01, P<0.05). After 1 and 2 courses of treatment, the function scores, emotion scores, total scores of DHI and VAS scores in the observation group were lower than those in the control group (P<0.01). CONCLUSION: Whether acupuncture or not, residual dizziness after repositioning maneuver for BPPV can be relieved within 2 weeks; horizontal penetration needling at vertigo auditory area and balance area could improve dizziness symptoms and shorten the course of disease.

[Revelation of Fu's subcutaneous needling therapy on the development of acupuncture and moxibustion].

By analyzing Fu 's subcutaneous needling phenomenon, the attribute of Fu 's subcutaneous needling therapy in traditional acupuncture, the innovation and the role in the development of traditional acupuncture were demonstrated. The authors believe that the de-meridian in Fu 's subcutaneous needling therapy is similar to the connotation of meridian before the Han dynasty, the de-acupoint phenomenon in Fu 's subcutaneous needling therapy reproduces the acupoint evolution, and the sites of needle insertion of this therapy are partially overlapped with the location of traditional acupoints. In manipulation, the technique of Fu 's subcutaneous needling therapy is derived from the traditional acupuncture technique and it is also in reference to the theory and the method of modern medicine, such as muscle energy technology and fasciology. The needle device and the sweeping technique are the most essential innovation of Fu 's subcutaneous needling therapy. Fu 's subcutaneous needling therapy has the distinct attribute of traditional acupuncture.

[Analysis on relationship between syndrome differentiation of migraine and acupuncture effect].

The problems of the syndrome differentiation of migraine in acupuncture treatment were collected, e.g. inconsistency of syndrome differentiation, unclear staging of syndrome differentiation, lack of standardization in comparison between syndrome differentiation and non-differentiation, insufficient research on the factors of syndrome differentiation. In view of the exiting problems, focusing on two aspects of migraine, namely syndrome differentiation and acupuncture effect, the clinical treatment and research are conducted in migraine treated with acupuncture based on syndrome differentiation. It is believed that the comprehensive observation of the relationship between syndrome differentiation and acupuncture effect, as well as the analysis of the relevant factors of syndrome differentiation of migraine should be the focus in future research.

[Horizontal penetration needling method for headache].

The manipulation and key points of professor FAN Gang-qi 's horizontal penetration needling method for headache were introduced. This acupuncture method selects local acupoints of head, including occipital acupoint group, temporal acupoint group, frontal acupoint group and vertex acupoint group. The needles are shallowly and horizontally inserted at acupoints, with needle end towards the focus or headache site. The needle retaining time is long (6 h). This method is commonly used in the treatment of migraine, cervicogenic headache and tension-type headache. The manipulation is standard with better repeatability.

[Status quo and thinking of acupoint optimization for preventive treatment of migraine].

To summarize the status quo of acupoint optimization for prophylactic treatment of migraine from acupoint selection based on traditional Chinese medicine theory, acupoints selection based on modern medical theory, and the relative specificity of acupoints. It is found that at present, there are many gaps in the research of preventive treatment of migraine, while the initial optimization scheme of acupoints is formed, and there is controversy in the relative specificity of acupoints. It is believed that through the systematic analysis of the disease characteristics of acupuncture, manipulation, acupuncture tools and other factors that affect the selection of acupoints, the relative specificity of acupoints can be further clarified, and the advantages of acupoint selection based on traditional Chinese medicine theory and modern medical theory can be further optimized for the preventive treatment of migraine and improve the curative effect.

[Status que of acupuncture for strephenopodia after stroke].

In order to optimize acupuncture protocol for stephenipodia after stroke, related papers of the recent 20 years are retrieved. Interrelated factors which may influence the therapeutic effect of acupuncture are analyzed through the aspects such as acupoints, needling methods and opportunities of acupuncture. It is held that importance should be attached on relation between acupoints and anatomy during acupoint selection. Different acupuncture protocol can be adopted in different phases of stephenipodia according to its time of occurrence. And it is found that the combination of acupuncture and rehabilitation can reinforce the therapeutic effect. Relationship between effect of acupuncture and patient's condition, acupoint selection and prescription, acupuncture manipulations (including directions, angles, reinforcing and reducing, quantity of stimulus) are worth to be further studied. On the base of the above all mentioned studies, optimization can be carried out on selection of acupoints and acupuncture manipulations. And therapeutic effect can be enhanced when the optimized acupuncture protocol is combined with rehabilitation therapies.

[The role of acupuncture and moxibustion in organized medicine of pain].

The literature on acupuncture-moxibustion and acupuncture-moxibustion combined with other therapies for all kinds of pain as well as organized medicine of pain in recent ten years are analyzed. It is found out that application of single acupuncture-moxibustion has positive effect on most of pain, while acupuncture-moxibustion combined with other therapies could improve the efficacy in a certain extent. The organized medical model of pain, by integration of clinical paths and optimization of medical methods, could achieve best effect on pain. With acupuncture-moxibustion joining in the organized medical model of pain, the analgesia effect could be enhanced, medical cost decreased and patient's life quality improved. The suitable disease, clinical path, action function and mechanism need further evidence-based research.

[Research progression of the opportunity of acupuncture-moxibustion therapy for post-stroke dysphagia].

Through the collection of the literatures published in recent years on the opportunity of acupuncture therapy for post-stroke dysphagia, the therapy of acupuncture-moxibustion combined with the rehabilitation training is regardes as the optimal program in the paper. In this program, the timing of acupuncture intervention is a key factor to impact the efficacy on post-stroke dysphagia. It is vitally significant to grasp the intervention timing of acupuncture-moxibustion in the recovery of swallowing function as well as articulation function with dysphagia involved.

[Primary optimization of acupuncture program for dysphagia after cerebral infarction].

OBJECTIVE: To optimize primarily acupuncture program for dysphagia after cerebral infarction. METHODS: Sixty-three patients with pseudobulbar palsy dysphasia after cerebral infarction were selected as the subjects. Water swallow test was adopted for observation index. Orthogonal design was used to study the different combinations of treatment programs among four factors and three levels, named acupuncture opportunity (factor A: A1: 1-10 d, A2: 11-20 d, A3: 21-40 d), point combination (factor B: B1: points in the neck, B2: points in the neck + points in the glossopharyngeal part, B3: points in the neck + points in the glossopharyngeal part + differentiating point), needling depth (factor C: C1: shallow puncture, C2: moderate puncture, C3: deep puncture), and treatment session (factor D: D1: 2 sessions, D2: 4 sessions, D3: 6 sessions); as well as the influences on pseudobulbar palsy dysphagia after cerebral infarction so as to determine primarily the optimized acupuncture program for dysphagia after cerebral infarction. RESULTS: The direct analysis of orthogonal design indicated that the best level and the combination of four factors and three levels were A1 (or A2), B3, C3 and D3. It meant that for the patients less than 20 days for sickness, the points in the neck, points in the glossopharyngeal part and points selected according to syndrome differentiation were selected for deep puncture and the treatment lasted for 6 sessions. This program achieved the best improvement in water swallow test. The comparison between the primary effect and secondary effect among four factors (variance analysis) showed that factor A and C were the significant factors (P < 0.05), factor B and D were not significant (P > 0.05). It was suggested that acupuncture opportunity and needling depth played the significant roles in clinical efficacy. The comparison among different levels in terms of the significant factors A and C (multiple comparison) presented that A1 and A2 were superiorly significant than A3 (P < 0.001), A1 was not different in significance from A2 (P > 0.05). C3 was superiorly significant than C2 and C1 (P < 0.001, P < 0.01) and C2 was superiorly significant than C1 (P < 0.05). CONCLUSION: By the comprehensive summarization of direct analysis, variance analysis and multiple comparison combined with actual clinical situation, the optimal program of acupuncture treatment for pseudobulbar palsy dysphasia after cerebral infarction is that in terms of the four factors and three levels, for the patients within 1 to 20 days for sickness, acupuncture is applied to the points in the neck or combined with points in the glossopbaryngeal part or the points se-i lected according to syndrome differentiation, with deep puncture, for 4 to 6 sessions of treatment.

[Acupuncture analgesia and the direction, angle and depth of needle insertion].

Literatures on acupuncture analgesia of the recent 30 years are analyzed through the target pain syndromes, points and tools selected for needling as well as the chosen direction, angle and depth of insertion. The relationship between effect of acupuncture analgesia and needling direction, angle as well as depth is initially optimized to enhance the analgesic effect. The result shows that the 3 factors are the key influences. However, studies on the above mentioned relation are still far from enough. Aiming at enhancing the effect of acupuncture analgesia and exploring the relative mechanism, it is held that multivariate analysis should be adopted to do systematic analysis on relationship between effect and mechanism of acupuncture analgesia and direction, angle and depth of the needle insertion.

[Systemic analysis on the studies of combined treatment of cerebrovascular diseases with acupuncture and herbal medicines].

[In the present paper, the authors make a systemic analysis on the combined treatment of cerebrovascular diseases with acu-moxibustion and herbal medicines from 1) background, 2) objective, 3) methods and contents, and 4) the underlying mechanism. It is thought of that optimizing the therapeutic program of acu-moxibustion and herbal medicines, and then optimizing their combined ways, time, quantity, etc. may improve clinical curative effect further. Concerning the study on the combined treatment of cerebrovascular diseases with acu-moxibustion and Chinese herbal medicines, the emphasis should be laid on the research on their pathways to pass through or pass by the blood-brain barrier and their protection action on the brain neurons which is the combining point for revealing the underlying mechanisms of the joint application of acu-moxibustion and herbal medicines.

[Superficial needle therapy and development of acup-moxibustion sciences].

Superficial needle is a new type of needling tools. Superficial needling therapy is adopted mainly monouse superficial needle as treatment tools, with local disease as basic marker and needling the surroundings of the disease, with the needle tip towards the focus, and the needle body inserted along the superficial fascial layer, making a sweeping motion and then it was retained. The superficial needling therapy has wide indications, particularly, rapid and lasting analgesic effect for injury and pain of soft tissue.