A Preliminary Study of Adjunctive Nonconvulsive Electrotherapy for Treatment-Refractory Depression.

Nonconvulsive electrotherapy (NET) defined as electrical brain stimulation administered like standard electroconvulsive therapy (ECT), but below seizure threshold, could be effective for patients with treatment-refractory depression (TRD) with fewer adverse neurocognitive outcomes. However, there is a lack of studies in Chinese patients with TRD. Thus, this study was conducted to examine the efficacy and safety of adjunctive NET for Chinese patients with TRD. Twenty TRD patients were enrolled and underwent six NET treatments. Depressive symptoms, response, and remission were assessed with the 17-item Hamilton Depression Rating Scale (HAMD-17) at baseline and after 1, 3, and 6 NET treatments. Neurocognitive function was assessed by the Wisconsin Card Sorting Test (WCST) at baseline and after the completion of six NET treatments. Mean HAMD-17 scores declined significantly from 26.2 to 10.4 (p < 0.001) after post-NET. The rates of response and remission were 60.0% (95% CI: 36.5-83.5) and 10.0% (95% CI: 0-24.4), respectively. Neurocognitive performance improved following a course of NET. No significant association was found between changes in depressive symptoms and baseline neurocognitive function. Adjunctive NET appeared to be effective for patients with TRD, without adverse neurocognitive effects. Randomized controlled studies were warranted to confirm these findings.

Serum BDNF Levels are Not Associated with the Antidepressant Effects of Nonconvulsive Electrotherapy.

OBJECTIVE: Brain-derived neurotrophic factor (BDNF) has been implicated in the pathophysiology of depression and in the antidepressant response. This study examined whether changes in serum BDNF levels are associated with the antidepressant effects of nonconvulsive electrotherapy (NET). METHODS: For BDNF analyses, serum samples were collected from 20 patients with treatment-refractory depression (TRD) and from 20 healthy controls. Serum samples were also collected from patients following a course of NET. RESULTS: Although significantly lower baseline serum BDNF levels were observed in TRD patients than in healthy controls, no changes in serum BDNF levels were found in TRD patients after a course of NET compared to baseline. No significant association was found between serum BDNF levels and depression severity. CONCLUSION: Serum BDNF levels appear to have no clinical utility in the prediction of the antidepressant effects of NET in patients with TRD. Future studies of higher quality and with larger sample sizes are needed to confirm these findings.

[Influence of acupuncture and moxibustion on defecation in postoperative patients of anal fissure: a randomized controlled trial].

OBJECTIVE: To verify the clinical efficacy of acupuncture and moxibustion on defecating and pain symptoms in postoperative patient of anal fissure. METHODS: Two hundred cases of postoperation of anal fissure were randomly divided into an acupuncture-moxibustion group and a medication group, 100 cases in each one. The basic treatment after the surgery was the same in two groups, besides, acupuncture was applied at Zhongliao (BL 33) and Xialiao (BL 34) in the morning of first 5 days of postoperative 24 h in the acupuncture-moxibustion group, and suspended moxibusiton was applied at Changqiang (GV 1) within 5 to 10 min after defecation; while two bags of forlax was orally administrated in the morning of first 5 days of postoperative 24 h in the medication group. The pain intensity, defecation willingness, defecation difficulty and stool texture during postoperative defecation were observed. RESULTS: The defecation pain on the first two days after the treatment was not statistically significant between two groups (both P > 0.05). From the third day of treatment, the improvements of defecation pain in acupuncture-moxibustion group were more obvious than those in the medication group (all P < 0.05). The patients in the acupuncture-moxibustion group had more positive defecation willingness than those in the medication group (all P < 0.05). The differences of defecation difficulty and stool properties in two groups had no statistical significance (both P > 0.05). CONCLUSION: The intervention treatment of acupuncture and moxibustion has clinical significance on relieving pain symptoms and improving defecation willingness in postoperative patient of anal fissure.

[Effect of electroacupuncture on serum proinflammatory cytokine levels and pancreatic nuclear factor kappa-b expression in acute pancreatitis rats].

OBJECTIVE: To observe the effects of electroacupuncture (EA) of "Zusanli" (ST 36) on serum TNF-alpha and IL-6 contents and pancreatic nuclear factor kappa-B (NF-kappaB) expression in acute pancreatitis rats. METHODS: Sixty-six male SD rats were randomly divided into sham operation (sham), model and EA groups (n=22). Acute pancreatitis model was established by intra-pancreatic duct injection of 3.5% sodium taurocholate (0.1 mL/100 g). EA (2 Hz /100 Hz, 2 mA) was applied to bilateral ST 36 for 30 min after modeling and at the end of the experiment. The animals were killed at 3 h (n=7), 6 h (n=7) and 12 h (n=8) after modeling. The expression of pancreatic NF-,cB P65 was detected by immunohistochemical staining, and serum TNF-alpha and IL-6 contentswere determined by ELISA. The pathological changes of pancreatic tissue were displayed by H. E. staining and the quantity of ascite was measured by electronic balance. RESULTS: The pathologic score, ascite quantity, serum TNFalpha and IL-6 contents, and pancreatic NF-kappaB P 65 expression levels at 3 h, 6 h and 12 h after modeling were significantly higher in the model group than in the sham group (P < 0.05). Compared with the model group, the pathologic score, ascite quantity, serum TNF-alpha and IL-6 contents, and pancreatic NF-kappaB P 65 expression levels at 3 h, 6 h and 12 h were significantly decreased in the EA group (P < 0.05). Microscopic observation displayed that the necrosis of the pancreatic acinar cells and infiltration of inflammatory cells were lighter in the EA group than in the model group. CONCLUSION: EA at ST 36 is able to down-regulate sodium taurocholate injection incduced increase of serum TNF-alpha and IL-6 contents, and pancreatic NF-kappaB P65 expression level in acute pancreatitis rats, which may contribute to its effect in relieving necrosis of the pancreatic acinar cells and infiltration of pancreatic inflammatory cells.

[Observation on therapeutic effect of electroacupuncture at Tianshu (ST 25) with deep needling technique on functional constipation].

OBJECTIVE: To probe into a better therapeutic method for functional constipation. METHODS: Ninety-five cases of functional constipation were randomly divided into deep puncture at ST 25 group (48 cases), shallow puncture at ST 25 group (24 cases) and medication group (23 cases). In deep puncture at ST 25 group, Tianshu (ST 25) was punctured deeply to the peritoneum, with electric stimulation. In shallow puncture at ST 25 group, Tianshu (ST 25) was punctured shallowly, 5 mm beneath the skin, with electric stimulation. In medication group, Duphalac was administered orally. These cases were treated continuously for 4 weeks in 3 groups and followed up for 6 months. It was to observe the numbers of person who had defecation 4 times a week, difference in weekly defecation frequency and the difference in the Cleveland Clinic Score (CCS). RESULTS: In deep puncture at ST 25 group, the frequency of weekly defecation and the numbers of person who had defecation 4 times a week increased and CCS decreased, which were similar to the efficacy in shallow puncture at ST 25 group (all P > 0.05). But the efficacy of both ST 25 groups was superior to that in medication group (both P < 0.05). In comparison, the deep puncture at ST 25 group acted more quickly than either shallow puncture at ST 25 group or medication group and its efficacy remained much longer. CONCLUSION: The deep puncture at ST 25 with electric stimulation presents similar efficacy on functional constipation as shallow puncture at ST 25, but it acts more quickly than shallow puncture at ST 25, both of them are more advantageous than medication and the long-term efficacy is better.

[Clinical observation of urinary retention after hemorrhoid and fistula operation treated with suspen-ding moxibustion].

OBJECTIVE: To compare the therapeutic effects among moxibustion, local hot compress and infrared irradiation on urinary retention after hemorrhoid and fistula operation so as to provide the clinical evidences for the promotion and application of moxibustion. METHODS: The randomized controlled trial method was adopted to divide 60 cases of post-operative urinary retention into moxibustion group, hot compress group and infrared irradiation group, 20 cases in each group. In moxibustion group, suspending moxibustion was applied on Qihai (CV 6) and Zhongji (CV 3). In hot compress group, hot compress was applied on the bladder region above the symphysis pubis of the lower abdomen. In infrared irradiation group, MF-C701 multi-source infrared apparatus was used on the bladder region above the symphysis pubis of the lower abdomen. One intervention therapy was administered for the cases of post-operative urinary retention. The efficacy was assessed based on the numbers of urethral catheterization indwelled in 24 h after treatment. RESULTS: There were 2 cases (10.0%) with urethral catheterization in moxibustion group, 10 cases (50.0%) in hot compress group and 9 cases (45.0%) in infrared irradiation group. The urethral catheterization rate in moxibustion group was lower than that of the other two treatment programs (both P < 0.05). CONCLUSION: Moxibustion can reduce much effectively the rate of urethral catheterization indwelled for urinary retention after hemorrhoid and fistula operation as compared with local hot compress therapy and infrared irradiation on the lower abdomen.

[Effect of electroacupuncture of Tianshu (ST 25) on the rational symptoms of functional constipation patients and evaluation on its efficacy satisfaction: a single-center, prospective, practical and randomized control trial].

OBJECTIVE: To observe the effects of electroacupuncture (EA) of Tianshu (ST 25) and medication on the subjective symptoms and the satisfactory degree of functional constipation (FO) patients, and to evaluate the efficacy of different depth-needling. METHODS: Single-blind, randomized and parallel-controlled methods were adopted in the present study and a total of 95 FC patients were randomly divided into medication group (Lactulose, 20-30 mL/d, n = 24), deep needling (DN, about 45 mm beneath the skin) of ST 25 group (n = 48), and shallow needling (SN, about 5 mm beneath the skin) of ST 25 group (n = 23). The treatment was given once daily (except weekends) for 4 weeks. The actual number of patients whose defecation frequency was up to 4 times per week, the integrative score of defecation symptoms (defecation exertion degree, abdominal pain, etc.), and the patients' satisfaction degree after the treatment were recorded and evaluated. RESULTS: One, 2, 3 and 4 weeks after the treatment, of the 48, 23 and 24 cases in DN, SN and medication groups, the numbers of FC patients whose defecation was up to 4 times per week were 31 (64.58%), 32 (66.67%), 34 (70.83%) and 37 (77.08%), 9 (39.13%), 16 (69.57%), 15 (65.22%) and 14 (60.87%), and 8 (33.33%), 7 (29.17%), 5 (20.83%) and 4 (16.67%), respectively. The effects of DN and SN groups were significantly superior to those of medication group in increasing the number of FC patients whose defecation was up to 4 times per week, improving constipation symptom integrative score (defecation exertion degree, survival desire for defecation, abdominal distension, etc.) and patients' satisfaction degree (P < 0.05). Comparison between DN and SN groups showed that the effects of the former group in accelerating the improvement of survival desire for defecation, patients' satisfaction degree were markedly superior to those of the latter group (P < 0.05). CONCLUSION: Deep needling-EA of ST 25 has a positive effect in improving functional constipation, being faster in the onset of action and stable efficacy in comparison with shallow needling.

[Observation on therapeutic effect of electroacupuncture at Chengshan (BL 57) and Changqiang (GV 1) on hemorrhoidal pain].

OBJECTIVE: To assess the clinical effect of combination of far with near acupoints, Chengshan (BL 57) and Changqiang (GV 1), for acupuncture treatment of hemorrhoidal pain. METHODS: One hundred and twenty cases of hemorrhoids with pain were randomly divided into 2 groups, an electroacupuncture group and a medication group, 60 cases in each group. The electroacupuncture group were treated by electroacupuncture at Changqiang (GV 1) and Chengshan (BL 57) with sparse-dense wave, frequency 2/100 Hz; and the medication group with oral administration of Tramadol and rectal application of Mayinglong Shexiang Zhichuang Suppository. The two group were treated for five days. Changes of pain were assessed by Visual Analogue Scale (VAS) scores at the defecation each day. RESULTS: In the electroacupuncture group, VAS score was 6.64 +/- 3.66 before treatment and 5.65 +/- 2.21 on the second day of treatment with a significant decrease (P < 0.05), and 1.85 +/- 1.24 on the fifth day after treatment end. In the medication group, VAS score was 6.58 +/- 3.18 before treatment and 4.86 +/- 2.04 on the third day after treatment with significant decrease compared with that before treatment, and 2.24 +/- 1.46 on the fifth day. There was no significant difference between the two groups in the pain score on the fifth day after the treatment end. CONCLUSION: Combination of Chengshan (BL 57) with Changqiang (GV 1) is effective for improvement of hemorrhoidal pain in defecation.