ABSTRACT
As a common clinical disease, neuropathic pain is difficult to be cured with drugs. The occurrence and progression of pain is closely related to the response of spinal microglia. Aspartof the regulation of microglialactivity,PD-L1 playsacriticalrole. Loss of PD-L1 promoted the polarization of M1-like microglia. Increased expression of PD-L1 promoted M2-like polarization. Electroacupuncture has a significant analgesic effect in clinical practice, but its specific mechanism remains to be further explored. In this study, we verified the role of PD-L1 in EA analgesia and the underlying molecular mechanism through spinal nerve ligation (SNL) in rats and lipopolysaccharide (LPS)-treated BV2 microglial cells. Forbehavioralstudiesofrats,mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL) were measured, and spinal cord neuros were examined under transmission electron microscopyto determine changes to their myelin structure. The expression levels of PD-L1 and M1/M2-specific markers in rat spinal cord and BV2 microglial cells were measured by enzyme-linked immunosorbent assay, flow cytometry, immunofluorescence staining and Western blot analysis. Our study showed that EA increased the pain threshold, reduced the destruction of myelin structure, promoted the expression of PD-L1 and PD-1, inhibited the MAPK signaling pathway, and promoted the conversion of microglial polarization from the M1 phenotype to the M2 phenotype in SNL rats. PD-L1 knockdown reversed these effects of EA. In addition, PD-L1 knockdown activated the MAPK signaling pathway, promoted microglial polarization to the M1 phenotype, decreased the expression of anti-inflammatory mediators and increased the expression of proinflammatory factors in LPS-stimulated BV2 microglial cells. Our results showed that EA may regulate the excitability of primary afferent neurons through PD-L1 and then inhibit the MAPK signaling pathway to promote the transformation of activated M1 microglia into M2 microglia, reduce inflammatory reactions, and finally achieve analgesic effects. A therapy targeting PD-L1 may be an effective strategy for treating neuropathic pain.
Subject(s)
Electroacupuncture , Neuralgia , Rats , Animals , Microglia , Lipopolysaccharides/pharmacology , B7-H1 Antigen/metabolism , Spinal Nerves , Neuralgia/therapy , Neuralgia/metabolism , Analgesics/pharmacologyABSTRACT
Previous studies have shown that peripheral nerve injury can lead to abnormal dendritic spine remodeling in spinal dorsal horn neurons. Inhibition of abnormal dendritic spine remodeling can relieve neuropathic pain. Electroacupuncture (EA) has a beneficial effect on the treatment of neuropathic pain, but the specific mechanism remains unclear. Evidence has shown that slit-robo GTPase activating protein 3 (srGAP3) and Rho GTPase (Rac1) play very important roles in dendritic spine remodeling. Here, we used srGAP3 siRNA and Rac1 activator CN04 to confirm the relationship between SrGAP3 and Rac1 and their roles in improving neuropathic pain with EA. Spinal nerve ligation (SNL) was used as the experimental model, and thermal withdrawal latency (TWL), mechanical withdrawal threshold (MWT), Western blotting, immunohistochemistry and Golgi-Cox staining were used to examine changes in behavioral performance, protein expression and dendritic spines. More dendritic spines and higher expression levels of srGAP3 were found in the initial phase of neuropathic pain. During the maintenance phase, dendritic spines were more mature, which was consistent with lower expression levels of srGAP3 and higher expression levels of Rac1-GTP. EA during the maintenance phase reduced the density and maturity of dendritic spines of rats with SNL, increased the levels of srGAP3 and reduced the levels of Rac1-GTP, while srGAP3 siRNA and CN04 reversed the therapeutic effects of EA. These results suggest that dendritic spines have different manifestations in different stages of neuropathic pain and that EA may inhibit the abnormal dendritic spine remodeling by regulating the srGAP3/Rac1 signaling pathway to alleviate neuropathic pain.
Subject(s)
Electroacupuncture , Neuralgia , Animals , Rats , Dendritic Spines/metabolism , GTP Phosphohydrolases/metabolism , Guanosine Triphosphate/metabolism , Neuralgia/metabolism , Neuralgia/therapy , rac1 GTP-Binding Protein/metabolism , Rats, Sprague-Dawley , Signal Transduction , Spinal Nerves/metabolismABSTRACT
Previous studies have shown that peripheral nerve injury can lead to abnormal dendritic spine remodeling in spinal dorsal horn neurons. Inhibition of abnormal dendritic spine remodeling can relieve neuropathic pain. Electroacupuncture (EA) has a beneficial effect on the treatment of neuropathic pain, but the specific mechanism remains unclear. Evidence has shown that slit-robo GTPase activating protein 3 (srGAP3) and Rho GTPase (Rac1) play very important roles in dendritic spine remodeling. Here, we used srGAP3 siRNA and Rac1 activator CN04 to confirm the relationship between SrGAP3 and Rac1 and their roles in improving neuropathic pain with EA. Spinal nerve ligation (SNL) was used as the experimental model, and thermal withdrawal latency (TWL), mechanical withdrawal threshold (MWT), Western blotting, immunohistochemistry and Golgi-Cox staining were used to examine changes in behavioral performance, protein expression and dendritic spines. More dendritic spines and higher expression levels of srGAP3 were found in the initial phase of neuropathic pain. During the maintenance phase, dendritic spines were more mature, which was consistent with lower expression levels of srGAP3 and higher expression levels of Rac1-GTP. EA during the maintenance phase reduced the density and maturity of dendritic spines of rats with SNL, increased the levels of srGAP3 and reduced the levels of Rac1-GTP, while srGAP3 siRNA and CN04 reversed the therapeutic effects of EA. These results suggest that dendritic spines have different manifestations in different stages of neuropathic pain and that EA may inhibit the abnormal dendritic spine remodeling by regulating the srGAP3/Rac1 signaling pathway to alleviate neuropathic pain.
Subject(s)
Animals , Rats , Electroacupuncture , Neuralgia/metabolism , Neuralgia/therapy , Spinal Nerves/metabolism , Signal Transduction , Rats, Sprague-Dawley , rac1 GTP-Binding Protein/metabolism , Dendritic Spines/metabolism , GTP Phosphohydrolases/metabolism , Guanosine Triphosphate/metabolismABSTRACT
Neuropathic pain is a severe problem that is difficult to treat clinically. Reducing abnormal remodeling of dendritic spines/synapses and increasing the anti-inflammatory effects in the spinal cord dorsal horn are potential methods to treat this disease. Previous studies have reported that electroacupuncture (EA) could increase the pain threshold after peripheral nerve injury. However, the underlying mechanism is unclear. P2X7 receptors (P2X7R) mediate the activation of microglia and participate in the occurrence and development of neuropathic pain. We hypothesized that the effects of EA on relieving pain may be related to the downregulation of the P2X7R. Spinal nerve ligation (SNL) rats were used as a model in this experiment, and 2'(3')-O-(4-benzoyl)benzoyl ATP (BzATP) was used as a P2X7R agonist. We found that EA treatment decreased dendritic spine density, inhibited synaptic reconstruction and reduced inflammatory response, which is consistent with the decrease in P2X7R expression as well as the improved neurobehavioral performance. In contrast to the beneficial effects of EA, BzATP enhanced abnormal remodeling of dendritic spines/synapses and inflammation. Furthermore, the EA-mediated positive effects were reversed by BzATP, which is consistent with the increased P2X7R expression. These findings indicated that EA improves neuropathic pain by reducing abnormal dendritic spine/synaptic reconstruction and inflammation via suppressing P2X7R expression.
Subject(s)
Electroacupuncture , Neuralgia/metabolism , Neuralgia/therapy , Receptors, Purinergic P2X7/metabolism , Adenosine Triphosphate/analogs & derivatives , Adenosine Triphosphate/pharmacology , Animals , Dendritic Spines/drug effects , Inflammation Mediators/metabolism , Ligation , Male , Models, Biological , Nerve Tissue Proteins/metabolism , Neuralgia/physiopathology , Neuronal Plasticity/drug effects , Neurons/drug effects , Neurons/pathology , Pain Threshold/drug effects , Rats, Sprague-Dawley , Spinal Cord Dorsal Horn/drug effects , Spinal Cord Dorsal Horn/pathology , Spinal Nerves/drug effects , Spinal Nerves/pathology , Spinal Nerves/physiopathologyABSTRACT
Improvements in neuronal plasticity are considered to be conducive to recovery from neuropathic pain. Electroacupuncture (EA) is regarded as an effective rehabilitation method for neuropathic pain. However, the effects and potential mechanism associated with EA-induced repair of hyperesthesia are not fully understood. Evidence has suggested that the adenosine A2A receptor (A2AR) and the cyclic adenosine monophosphate (cAMP)/protein kinase A (PKA) pathway play an important role in improving neuropathic pain. Here, we examined the function of EA in promoting neuronal plasticity in spinal nerve ligation (SNL) rats. The A2AR antagonist SCH58261, A2AR agonist 2-p-(2-carboxyethyl)phenethylamino-50-N-ethylcarboxamido adenosine HCl (CGS21680) and A2AR siRNA were used to confirm the relationship between A2AR and the cAMP/PKA pathway as well as the effects of A2AR on EA-induced improvements in neurobehavioral state and neuronal plasticity. Mechanical withdrawal threshold (MWT), thermal withdrawal latency (TWL), HE staining, Western blotting, RT-PCR, immunofluorescence, enzyme-linked immunosorbent assay, Nissl staining, silver staining, Golgi-Cox staining and transmission electron microscopy were used to evaluate the changes in neurobehavioral performance, protein expression, neuronal structure and dendrites/synapses. The results showed that EA and CGS21680 improved the behavioral performance, neuronal structure and dendritic/synaptic morphology of SNL rats, consistent with higher expression levels of A2AR, cAMP and PKA. In contrast to the positive effects of EA, SCH58261 inhibited dendritic growth and promoted dendritic spine/synaptic remodeling. In addition, the EA-induced improvement in neuronal plasticity was inhibited by SCH58261 and A2AR siRNA, consistent with lower expression levels of A2AR, cAMP and PKA, and worse behavioral performance. These results indicate that EA suppresses SNL-induced neuropathic pain by improving neuronal plasticity via upregulating the A2AR/cAMP/PKA signaling pathway.
Subject(s)
Cyclic AMP-Dependent Protein Kinases/biosynthesis , Cyclic AMP/biosynthesis , Electroacupuncture/methods , Neuralgia/metabolism , Neuronal Plasticity/physiology , Receptor, Adenosine A2A/biosynthesis , Adenosine A2 Receptor Agonists/pharmacology , Adenosine A2 Receptor Antagonists/pharmacology , Animals , Ligation/adverse effects , Male , Neuralgia/therapy , Neuronal Plasticity/drug effects , Pain Measurement/methods , Rats , Rats, Sprague-Dawley , Signal Transduction/drug effects , Signal Transduction/physiology , Spinal Nerves/injuriesABSTRACT
Traditional Chinese medicine has usually been recognized to be efficacious to treat chronic diseases from the western point-of-view. However, there is a long history in China of applying traditional Chinese medicine in many acute and urgent medical conditions. In this review, selected methods documented in traditional Chinese medicine including blowing air to ear, nose insufflating therapy, acupuncture and moxibustion were presented as the common practices to promote consciousness recovery from coma. We aimed to explore the mechanism of these four methods with current scientific evidence, further discuss the potential of traditional Chinese medicine to be applied in emergency medicine and provide a path forward to more rigorously validate these procedures. The development of the integrated traditional Chinese medicine and western medicines provides a new therapeutic direction for the new first-aid treatment.
ABSTRACT
OBJECTIVE: To observe the impacts of electroacupuncture (EA) stimulation at "Zusanli and Kunlun Points" on spinal dorsal horn microglia activation in L5 spinal nerve ligation (SNL) rats and BNDF, P2 × 4 and GABAAγ2, and the changes in spinal dorsal horn synaptic plasticity in model rats. METHODS: Adult male SD rats (180-220 g) were selected and randomly divided into 6 groups, including the sham group, the SNL group, the SNL + EA group, the SNL+5-BDBD group, the SNL + EA + 5-BDBD group and the SNL + FEA group. The changes in the Iba-1, BDNF, P2 × 4 and GABAAγ2 in the spinal cord of rats were observed by Western blotting, immunofluorescence, RT-PCR and other techniques; the long-term changes in the potential after the excitatory synapse of the spinal dorsal horn in rats were observed by in vivo electrophysiological technique. RESULTS: After 7 days of intervention, the fluorescence intensity (FI) of P2 × 4 and Iba-1 in the SNL + EA group was lower than that in the SNL group and higher than that in the sham group(P < 0.01), but the FI of GABAAγ2 was higher than that in the SNL group(P < 0.01); the expression of Iba-1, BDNF and P2 × 4 proteins in the SNL + EA group, the SNL+5-BDBD group and the SNL + EA + 5-BDBD group was significantly lower than that in the SNL + FEA group(P < 0.05), but the expression of GABAAγ2 protein was higher (P < 0.05); after treatment with EA, the expression levels of Iba-1 mRNA and P2 × 4 mRNA in the SNL + EA group were lower than those in the SNL group(P < 0.01), but the expression levels of GABAAγ2 mRNA were higher (P < 0.01). Meanwhile, long-term potentiation changes could not be induced in the SNL + EA group. CONCLUSION: The EA stimulation at "Zusanli" and "Kunlun" points can improve the pain threshold of rats with neuropathic pain (NP), inhibit the excitatory postsynaptic potential (EPSP), and weaken the excitatory transmission efficiency between synapses during NP.
Subject(s)
Electroacupuncture/methods , Long-Term Potentiation/physiology , Neuralgia/metabolism , Receptors, GABA-A/biosynthesis , Receptors, Purinergic P2X4/biosynthesis , Spinal Cord/metabolism , Animals , Gene Expression , Male , Neuralgia/genetics , Neuralgia/therapy , Rats , Rats, Sprague-Dawley , Receptors, GABA-A/genetics , Receptors, Purinergic P2X4/genetics , Treatment OutcomeABSTRACT
OBJECTIVE: To investigate the effect of electroacupuncture stimulation at "Zusanli"(ST36) and "Kunlun"(BL60) on the morphological changes of the spinal dorsal horn and the expression of p38 mitogen-activated protein kinase (p38MAPK) in the injured spinal cord of rats with neuropathic pain. METHODS: Male Sprague-Dawley rats were randomly divided into sham model group, model group, electroacupuncture group, and medication group, with 10 rats in each group. Spinal nerve ligation of the L5 lumbar vertebra was performed to establish a rat model of neuropathic pain. The rats in the electroacupuncture group were given electroacupuncture at ST36 and BL60 of the operation side with dilatational wave at a frequency of 2 Hz/100 Hz and an intensity of 1.5 mA once a day, 30 minutes each time, and those in the medication group were given intraperitoneal injection of 100 mg/mL Gabapentin solution (100 mg/kg) once a day; the one-week intervention was started at one week after surgery. Mechanical withdraw threshold (MWT) and thermal withdrawal latency (TWL) were observed and recorded before modeling and on days 1,3,5,7,10,12 and 14 after modeling, and the motor function of the affected hindlimb was scored. Methenamine silver stain was used to observe the morphological changes of the spinal dorsal horn, and Western blot was used to measure the relative protein expression of p38MAPK and phospho-p38MAPK(p-p38MAPK) in L4-L6 spinal segments. RESULTS: Compared with the sham model group, the model group had significant reductions in MWT and TWL at each time point (P<0.001) and a significant increase in motor function score (P<0.001); compared with the model group, the electroacupuncture group and the medication group had significant increases in MWT and TWL and a significant reduction in motor function score after treatment (P<0.05). The model group had obvious neuronal fibrillary tangles, particle vacuolar degeneration, and vacuoles containing argyrophilic grains in the cytoplasm of neural cells under a light microscope, while there were fewer neuronal fibrillary tangles in the electroacupuncture group and reduced vacuolar degeneration in the medication group. Compared with the sham model group, the model group had significant increases in the protein expression of p-p38MAPK in the spinal dorsal horn (P<0.001), and compared with the model group, the electroacupuncture group and the medication group had significant reductions in the protein expression of p-p38MAPK in the spinal dorsal horn(P<0.05). CONCLUSION: Electroacupuncture stimulation at ST36 and BL60 can increase pain threshold, improve the motor function of the affected hindlimb, and improve the necrosis of neurofibrils in the spinal dorsal horn in rats with neuropathic pain, possibly by regulating the expression of p-p38MAPK in the spinal dorsal horn.
Subject(s)
Electroacupuncture , Neuralgia , Animals , Male , Rats , Rats, Sprague-Dawley , Spinal Cord Dorsal Horn , p38 Mitogen-Activated Protein KinasesABSTRACT
OBJECTIVE: Gua Sha and Blood-letting at the acupoints were Chinese traditional therapies for heatstroke. The purpose of present study was to assess the therapeutic effect of Gua Sha on the DU Meridian and Bladder Meridian combined with Blood-letting acupoints at Shixuan (EX-UE 11) and Weizhong (BL 40) on heatstroke. METHODS: Anesthetized rats, immediately after the onset of heatstroke, were divided into four major groups: Gua Sha group, Blood-letting group, Gua Sha combined with Blood-letting group and model group. They were exposed to ambient temperature of 43 °C to induce heatstroke. Another group of rats were exposed to room temperature (26 °C) and used as normal control group. Their survival times were measured. In addition, their physiological and biochemical parameters were continuously monitored. RESULTS: When rats underwent heatstroke, their survival time values were found to be 21-25 min. Treatment of Gua Sha combined with Bloodletting greatly improved the survival time (230±22 min) during heatstroke. All heatstoke animals displayed and activated coagulation evidenced by increased prothrombin time (PT), activated partial thromboplastin time (aPTT), D-dimer, and decreased platelet count, protein C. Furthermore, the animals displayed systemic inflammation evidenced by increased the serum levels of cytokines interleukin-1ß (IL-1ß), tumor necrosis factor α (TNF-α) and malondialdehyde (MDA). Biochemical markers evidenced by cellular ischemia and injury/dysfunction included increased plasma levels of blood urea nitrogen (BUN), creatinine, serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), and alkaline phosphatase (ALP) were all elevated during heatstroke. Core temperatures (Tco) were also increased during heatstroke. In contrast, the values of mean arterial pressure were signifificantly lower during heatstroke. These heatstroke reactions were all signifificantly suppressed by treatment of Gua Sha and Blood-letting, especially the combination therapy. CONCLUSION: Gua Sha combined with Blood-letting after heatstroke may improve survival by ameliorating systemic inflflammation, hypercoagulable state, and tissue ischemia and injury in multiple organs.
Subject(s)
Blood Coagulation Disorders/therapy , Bloodletting , Complementary Therapies/methods , Heat Stroke/physiopathology , Inflammation/therapy , Ischemia/therapy , Animals , Blood Coagulation Disorders/drug therapy , Combined Modality Therapy , Cytokines/blood , Inflammation/drug therapy , Ischemia/drug therapy , Male , Malondialdehyde/metabolism , Random Allocation , Rats , Rats, Sprague-Dawley , Survival RateABSTRACT
OBJECTIVE: To explore the essence of acupoints by studying its anatomical characteristics and classification. METHODS: Based on numerous previous anatomic researches of acupoints, an adult male and a female corpses infused with red rubber at the location of acupoints were selected in order to observe the level and sectional anatomy of the acupoints, especially the specificity of the known structural distribution of acupoints. RESULTS: (1) The distribution of acupoints has two primary elements. Firstly, it is neurovascular bundles or connective tissue containing abundant nerves and blood vessels, which has the function of qi and blood infusion. It is considered as the acupoint kernel. Secondly, it is the cleft or the tunnel that formed by bones, muscles or fascia, which is also held as the acupoint shell. Different conditions of the human body can influence the opening and closing of the shell, control as well as regulate the function of the kernel so as to regulate the qi and blood circulation. (2) Based on anatomical characteristics, acupoints can be classified into 3 types: the type of cleft, the type of tunnel, and the terminal type. Points of the cleft and tunnel types can be mainly found in the twelve regular meridians which are composed of the kernel and the shell. The points of terminal type are on the Conception Vessel, the Governor Vessel and auricular point, the superficial fascia is the confluence of cerebro-spinal nerve terminal ramus and its concomitant vessels, and it is the site where the qi and blood of meridians distribute to the body surface. CONCLUSION: Acupoints is the pore formed by bone, muscle or fascia where neurovascular bundles or connective tissue containing abundant nerves and blood vessels pass through and the position where the terminal branch of cranial and spinal nerves and their accompanying by blood vessels emerge and converge at the supiyeficial layer of central body axis. Acupoints are the nodes and terminal point where the zang-fu organs and meridians and qi and blood infused to body surface.
Subject(s)
Acupuncture Points , Adult , Connective Tissue/anatomy & histology , Female , Humans , Male , Meridians , Muscles/anatomy & histology , Skin/anatomy & histology , Skull/anatomy & histologyABSTRACT
OBJECTIVE: To observe the anatomical structure of Jiaji (EX-B 2) points at the level of lower lumbar region so as to provide evidence for the insertion angle and depth. METHODS: Thirty spine samples of male adults were adopted, and perpendicular insertion of the needle was applied at 3 locations including 1 cun, 0.5 cun and 0.3 cun lateral to the lower border of the spinous process of the lumbar vertebra. The needles were fixed at the local region. Structures and the adjacent major blood vessels and nerves were observed during the anatomy. RESULTS: When the needle was inserted perpendicularly at the point 1 cun lateral to the lower border of the spinous process of the lumber vertebra with the insertion depth of (35.77 +/- 5.86) mm, the zygapophyseal joints, the adjacent osteo-fibrous canal and osteo-fibrous aperture were touched by the tip of the needle, and the medial ramus of dorsal primary ramus of spinal nerve and concomitant vessels were stimulated. Then, needles were inserted perpendicularly 0.5 cun and 0.3 cun lateral to the lower border of the spinous process of the lumber vertebra with the insertion depth of (32.89 +/- 4.79)mm for both. When needle was inserted 0.5 cun lateral, the medial ramus of dorsal primary ramus of spinal nerve and the concomitant vessels were touched by the tip of the needle at where they across the lamina periosteum and erector spinae. When needle was inserted 0.3 cun lateral, the body of the needle reached the terminal branches of the medial ramus of dorsal primary ramus of spinal nerve and the concomitant vessels through the deep paraspinal muscles and the thoracolumbar fascia. CONCLUSION: The medial ramus of dorsal primary ramus of lumbar spinal nerve and concomitant vessels distributed at the region 1 cun, 0.5 cun and 0.3 cun beside the lower border of each lumbar spinous process. Therefore, the location of Jiaji (EX-B 2) points can be considered in the region from 0.3 cun to 1 cun beside the lower border of each spinous process.
Subject(s)
Acupuncture Points , Lumbosacral Region/anatomy & histology , Humans , Male , Spine/anatomy & histologyABSTRACT
OBJECTIVE: To provide appropriate needling angle and depth for the acupuncture and acupoint injection at Neiguan (PC 6), and to avoid damaging nerves and vessels so as to produce its maximum effect. METHODS: Thirty adults' upper-limb samples were used to dissect and observe the referred hierarchical structure and adjoining crucially nerves and vessels in needling Neiguan (PC 6) according to the national standard Acupoint Location (GB 12346-90). RESULTS: In this punctuation region, there are three parts rich in connective tissues containing the nerves and blood vessels. The surface part is between the skin and the musculus flexor digitorum superficialis and it is the tissue which contains medial and lateral antebrachial cutaneous nerve and its nutrient artery. The middle part is between the musculus flexor digitorum superficialis and the flexor digitorum profundus muscle and contains the median nerve, its palmar branch of and artery. The deep part is between the pronator quadratus muscle and the interosseous membrane and contains the anterior interosseous nerve. When perpendicular needling, the depth of needling the body from skin to the superficial surface of the musculus flexor digitorum superficialis and to the superficial surface of the flexor digitorum profundus muscle is (6.68 +/- 0.64) mm and (12.37 +/- 0.87) mm respectively. The depth of needling the body from skin to the superficial surface of the pronator quadratus muscle and to the superficial surface of the anterior interosseous terminal branch of the nerves is (17.83 +/- 1.00) mm and (30.87 +/- 1.85) mm respectively, and the proportional cun is (2.20 +/- 0.14) cm. The ulnaris cord of median nerves are located at the radial of the needle. The deep layers could touch the anterior interosseous nerve ending. CONCLUSION: Perpendicularly needling Neiguan (PC 6) for 3 fen (6.68 mm), 5 fen (12.37 mm) and 1.4 cun (30.87 mm) will stimulate the nervus vascularis of the rich part of surface, middle and deep connective tissues respectively and produce the acupuncture effect. During the acupoint injection, perforating the needle perpendicularly at the middle point of the two tendons or deviating slightly to the direction of tendon of palmaris longus can avoid the damage of the median nerve cord.
Subject(s)
Acupuncture Points , Acupuncture Therapy , Adult , Blood Vessels/anatomy & histology , Humans , Male , Muscle, Skeletal/anatomy & histology , Muscle, Skeletal/blood supply , Muscle, Skeletal/innervation , Nerve Tissue/anatomy & histologyABSTRACT
The effect of Rhizoma curcumae oil on the learning and memory in rats exposed to chronic hypoxia and the possible mechanisms were investigated. The rats were divided randomly into 5 groups (14 animals in each group): control, chronic hypoxia, chronic hypoxia with low (5 mg/kg body weight), middle (10 mg/kg body weight) and high (20 mg/kg body weight) concentrations of Rhizoma curcumae oil injection. The animals undergoing chronic hypoxia were exposed to hypoxia in a hypoxic chamber containing 10% O(2) and 5% CO(2) for 10 h/d, lasting 28 d. Morris water maze (MWM) test was used to obtain the scores of leaning and memory. The superoxide dismutase (SOD) activity and malonaldehyde (MDA) content were determined in the serum and hippocampus as well as [Ca(2+)](i) in the hippocampus. The expression of phosphorylated Ca(2+)/calmodulin-dependent protein kinase II (p-CaMKII) in the hippocampus was evaluated by using immunohistochemistry and Western blot. Compared with the control group, the chronic hypoxia group showed the following changes: (1) The escape latency to the hidden platform was remarkably prolonged (P<0.05); (2) The content of MDA and [Ca(2+)](i) were obviously higher, but the activity of SOD and the expression of p-CaMKII were significantly lower (P<0.05, P<0.01). Compared with the chronic hypoxia group, groups with Rhizoma curcumae oil injection had the following changes: (1) The escape latency to the hidden platform was remarkably shorter in 10, 20 mg/kg body weight groups (P<0.05); (2) The content of MDA and [Ca(2+)](i) were markedly decreased in 5, 10, 20 mg/kg body weight groups (P<0.05, P<0.01), but the activity of SOD in the serum and the expression of p-CaMKII were significantly higher in 10, 20 mg/kg body weight groups (P<0.05, P<0.01). The results showed that the capacity of learning and memory was degraded following chronic hypoxia. The decrease in MDA content and [Ca(2+)](i) and (or) the increase in SOD activity and p-CaMKII expression might participate in the enhancing effect on learning and memory induced by Rhizoma curcumae oil.
Subject(s)
Curcuma/chemistry , Hypoxia/physiopathology , Learning/drug effects , Memory/drug effects , Plant Oils/pharmacology , Animals , Calcium/metabolism , Calcium-Calmodulin-Dependent Protein Kinase Type 2/metabolism , Hippocampus/metabolism , Malondialdehyde/metabolism , Rats , Rhizome/chemistry , Superoxide Dismutase/metabolismABSTRACT
OBJECTIVE: To observe the effect of electroacupuncture (EA) of local plus distal acupoints on spinal substance P expression in chronic radicular pain (CRP) rats so as to investigate its underlying mechanism in the treatment of chronic radical pain. METHODS: Twenty-five Wistar rats were randomized into control, model, local acupoints [LA, bilateral "Jiaji" (EX-B 2)], distal acupoints [DA, bilateral "Yanglingquan" (GB 34)], and LA+ DA groups, with 5 cases in each. CRP model was duplicated by implanting a gel-silicon wrapping the nerve root of L4 under anesthesia. EA (2 Hz, < or =2 mA) was applied to EX-B2 and GB34 for 30 min for 8 days. Pathological changes of the local focus tissue were observed by HE dyeing, and the animals' motor state was also observed. The pain threshold was detected by using tail-flick method. Substance P immunoreactive (IR) positive product of the spinal dorsal horn (L3-L5) was detected by immunohistochemical method and expressed as integrated optical density (IOD). RESULTS: The motor scores on day 35 after modeling and pain threshold values on day 4 and 8 after treatment in EX-B2 group, GB34 group and EX-B2 + GB34 group were significantly higher than those in model group (P < 0.05, 0.01). Compared with model group, IOD values of SP in the spinal dorsal horn in EX-B2 , GB34 and EX-B2 + GB34 groups were significantly lower (P < 0.05). There were no significant differences among the 3 EA groups in the expression of SP in the spinal dorsal horn. CONCLUSION: EA of EX-B2, GB34 and EX-B2 + GB34 all has a good analgesic effect in CRP rats, which may be realized partially by suppressing the release of SP in the spinal cord. No significant differences were found among local acupoint, distal acupoint and local plus distal acupoint groups in relieving CRP, improving motor and decreasing SP expression.
Subject(s)
Acupuncture Points , Chronic Disease/therapy , Electroacupuncture/methods , Pain Management , Spinal Cord/physiopathology , Substance P/metabolism , Animals , Motor Activity , Pain Threshold , Random Allocation , Rats , Rats, WistarABSTRACT
In the present article, the authors, in the light of their research in recent a decade of years, make an overall summary on the regularities of clinical acupuncture from the stimulated points, the superficial and deep layers, the literature basis and the innovation points. These basic regularities include symmetry or corresponding, segmental innervation, center or central axis, superiority of distal limbs, ending-stimulation accelerating analgesia, periphery-stimulation accelerating easiness and smooth, local feed back, specific feed back, selection of the stimulated points, acupuncture of different layers, etc.. They also discuss the possibility of integration of traditional Chinese and Western medicine from the view-points of neuroanatomy, neurophysiology and rehabilitation medicine. Systematic analysis on the regularities of clinical acupuncture makes the ancient meridian-collateral theory and abundant clinical experience summed up in definite concepts, simplifies the complicated theory system of acupuncture learning, and favors the communication about the terminology of Chinese medicine and Western medicine.
Subject(s)
Acupuncture Therapy , Medicine, Chinese Traditional , Acupuncture Points , Humans , ResearchABSTRACT
OBJECTIVE: To observe the distribution of the blood vessels in the integument tissue of the channel area of legs. METHODS: The integument tissue of the lower limbs in the 12 cadavers were dissected with macro-and micro-dissection, radiographical technique of systemic artery and technique of image pattern analysis to observe and analyze the origins, branches and anastomoses in the integument tissues along the channels of legs. RESULTS: The distributional density of the blood vessels in the integument tissues of legs along the channel area of the three-yin meridians of the foot, the Gallbladder Meridian, and the Urinary Bladder Meridian was higher than that in the other parts. They formed an obvious nutrient vascular chain on the arteriogram. The distributional density in the channel area of the Stomach Meridian was not obviously increased and the obvious nutrient vascular chain could not be seen. CONCLUSION: An obvious nutrient vascular chain is formed in the integument tissue along the channel area of legs except the Stomach Meridian.
Subject(s)
Blood Vessels/anatomy & histology , Leg/blood supply , Meridians , HumansABSTRACT
OBJECTIVE: To provide an appropriate angle and depth of needle insertion in acupuncture at Zusanli (ST 36) and avoid injuring the nerve and blood vessel and exert the most effect. METHODS: Eighty adult lower-limb samples were used to dissect and observe the relative layered structures and adjoining important nerves and blood vessels in needling Zusanli (ST 36) according to the national standard. RESULTS: The needling depth from the skin to the interosseous membrane and from the skin to posterior border of tibialis posterior is (2.22 +/- 0.31) cm and (4.42 +/- 0.53) cm, respectively. There are flabellate branches of anterior tibial arteries and deep peroneal nerves around the needle in the superficial layer of interosseous membrane. The vessel and nerve bundles containing tibial nerve and posterior tibial vessels can be touched when the needle body past through tibialis posterior. CONCLUSION: It is recommended that ideal average depth of acupuncture is 2.22 cm and the maximum depth is 4.42 cm for oblique needling Zusanli (ST 36). When it is injected, the needle should be perpendicularly inserted or deviated slightly to the direction of tibia and paralleled to medial surface of tibia. And the safe needling depth is generally less than 5 cm. The point of the body surface between tibialis anterior and extensor digitorum longus at 3 cun below Dubi (ST 35) is also an effectively stimulating point.
Subject(s)
Acupuncture Points , Female , Humans , Male , Needles , Tibia/anatomy & histologyABSTRACT
OBJECTIVE: To explore the anatomical structures, and depth and direction of needling at Jingming (BL 1), so as to provide anatomical basis for its clinical application. METHODS: Forty-eight adult orbital specimens were observed by dissection. RESULTS: When a needle was vertically inserted into Jingming (BL 1), the needle tip will past through the skin, subcutaneous tissue, medial palpebral ligament, medialis rectus and orbital adipose body. Above the body of the needle, there are ophthalmic artery, anterior ethmoidal artery and nasociliary nerve. The average distance between the skin at the punctured point and the anterior ethmoidal artery is (18.25 +/- 4.45) mm, with an angle of (12.5 +/- 5.5) degrees, and the average distance between the skin at the punctured point and the optic nerve tunnel frontal point is (43.37 +/- 7.84) mm. CONCLUSION: To avoid bleeding caused by injuring the anterior ethmoidal artery, acupuncture at Jingming (BL 1) should avoid deeply inserting needled back-upwards and upwards, and the needling depth should not exceed 30.36 mm to avoid injury of the optic nerve tunnel frontal point.
Subject(s)
Acupuncture Points , Female , Humans , Male , Orbit/anatomy & histologyABSTRACT
OBJECTIVE: To explore effective ways of integrated clinical and basic studies. METHODS: Try to sum up clinically basic laws of acupuncture from the study thinking of clinical and basic integration. RESULTS: Some laws of clinical acupuncture were raised based on classical theories of the channel and a great of clinical experiences, in combination with basic studies of modern neuroanatomy and physiology. CONCLUSION: The clinical symmetry-corresponding law, the segmental innervation law, the central-axial law, the distal limb dominance law, the law of sallow-deep correlation and the law of local feedback confirm with classical theories of the channels and clinical experiences.