Safety and efficacy of onradivir in adults with acute uncomplicated influenza A infection: a multicentre, double-blind, randomised, placebo-controlled, phase 2 trial.

BACKGROUND: Onradivir (ZSP1273) is a novel anti-influenza A virus inhibitor. Preclinical studies show that onradivir can inhibit influenza A H1N1 and H3N2 replication and increase the survival rate of infected animals. In this study, we aimed to evaluate the safety and efficacy of three onradivir dosing regimens versus placebo in outpatients with acute uncomplicated influenza A virus infection. METHODS: We did a multicentre, double-blind, randomised, placebo-controlled, phase 2 trial at 20 clinical sites in China. Eligible participants were adults (18-65 years) with an influenza-like illness screened by rapid antigen testing at the first clinical visit, had the presence of a fever (axillary temperature ≥38·0°C), and had the presence of at least one moderate systemic and one respiratory symptom within 48 h of symptom onset. Patients were excluded if they were pregnant, allergic to onradivir, or had received any influenza antiviral medication within 7 days before enrolment. Participants were randomly assigned (1:1:1:1) into four groups by an interactive web response system: onradivir 200 mg twice per day group, onradivir 400 mg twice per day group, onradivir 600 mg once per day group, and a matching placebo group. A 5-day oral treatment course was initiated within 48 h after symptoms onset. The primary outcome was the time to alleviate influenza symptoms in the modified intention-to-treat population. Safety was a secondary outcome. We evaluated the patients' self-assessed severity of seven influenza symptoms on a 4-point ordinal scale, and the treatment-emergent adverse events in all patients. This trial is registered with ClinicalTrials.gov, number NCT04024137. FINDINGS: Between Dec 7, 2019, and May 18, 2020, a total of 205 patients were screened; of whom, 172 (84%) were randomly assigned to receive onradivir (n=43 in the 200 mg twice per day group; n=43 in the 400 mg twice per day group; and n=43 in the 600 mg once per day group), or placebo (n=42). Median age was 22 years (IQR 20-26). All three onradivir groups showed decreased median time to alleviate influenza symptoms (46·92 h [IQR 24·00-81·38] in the 200 mg twice per day group, 54·87 h [23·67-110·62] in the 400 mg twice per day group, and 40·05 h [17·70-65·82] in the 600 mg once per day) compared with the placebo group (62·87 h [36·40-113·25]). The median difference between the onradivir 600 mg once per day group and the placebo group was -22·82 h (p=0·0330). The most frequently reported treatment-emergent adverse event was diarrhoea (71 [42%] of 171), ranging from 33-65% of the patients in onradivir-treated groups compared with 10% in the placebo group; no serious adverse events were observed. INTERPRETATION: Onradivir showed a safety profile comparable to placebo, as well as higher efficacy than placebo in ameliorating influenza symptoms and lowering the viral load in adult patients with uncomplicated influenza infection, especially the onradivir 600 mg once per day regimen. FUNDING: National Multidisciplinary Innovation Team Project of Traditional Chinese Medicine, National Natural Science Foundation of China, Guangdong Science and Technology Foundation, Guangzhou Science and Technology Planning Project, Emergency Key Program of Guangzhou Laboratory, Macao Science and Technology Development Fund, and Guangdong Raynovent Biotech.

Discussion on Efficacy of intensive acupuncture versus sham acupuncture in knee osteoarthritis: a randomized controlled trial published in Arthritis & Rheumatology. / 对Arthritis & Rheumatology"å¼ºåŒ–é’ˆåˆºå¯¹æ¯”å‡é’ˆæ²»ç–—è†éª¨å ³èŠ‚ç‚Žéšæœºå¯¹ç §è¯•éªŒ"一文的讨论.

Professor LIU Cunzhi's team from Beijing University of Chinese Medicine published Efficacy of intensive acupuncture versus sham acupuncture in knee osteoarthritis: a randomized controlled trial in Arthritis & Rheumatology on November 10th, 2021, which demonstrates that three-session per week acupuncture is safe and effective for knee osteoarthritis patients. Experts from home and abroad discussed in depth the study design, acupuncture protocol, and interpretation of the results of the trial, emphasizing the importance of pretrial implementation, acupuncture dosage, reasonable setting of control group and assessing the efficacy of acupuncture, and pointed out that the mechanism of acupuncture for knee osteoarthritis still needs further study, and how to promote acupuncture for knee osteoarthritis according to the clinical practice abroad while ensuring the efficacy of acupuncture is worthwhile to explore.

Study on the Intervention Mechanism of Cryptotanshinone on Human A2780 Ovarian Cancer Cell Line Using GC-MS-Based Cellular Metabolomics.

Cryptotanshinone (CT), an active component of the traditional Chinese medicine Salvia miltiorrhiza Bunge, exhibits a wide range of biological and pharmacological activities. Although the anticancer activity of CT is well known, the knowledge of its effect on the regulation of cancer cell metabolism is relatively new. The present study investigated the anticancer mechanism of CT in ovarian cancer with a focus on cancer metabolism. CCK8 assays, apoptosis assays, and cell cycle assays were conducted to reveal the growth-suppressive effect of CT on ovarian cancer A2780 cells. To explore the potential underlying mechanisms of CT, the changes in endogenous metabolites in A2780 cells before and after CT intervention were investigated using the gas chromatography-mass spectrometry (GC-MS) approach. A total of 28 important potential biomarkers underwent significant changes, mainly involving aminoacyl-tRNA biosynthesis, energy metabolism, and other pathways. Changes in the ATP and amino acid contents were verified with in vitro and in vivo experiments. Our results indicate that CT may exert an anti-ovarian cancer effect by inhibiting ATP production, promoting the protein catabolic process, and inhibiting protein synthesis, which may lead to cell cycle arrest and apoptosis.

[Discussion on "sugar needle - comfortable acupuncture and moxibustion"].

The cases of feeling comfort during acupuncture and moxibustion treatment in literature were summarized and its biological basis was explored. A simple classification of comfort was made, and the importance of obtaining comfort in acupuncture treatment was pointed out. Considering the pursuit of less pain and harmlessness in modern clinical treatment, sugar needle should be advocated and popularized in current clinical practice of acupuncture and moxibustion.

[Challenges and choices: translational acupuncture research spectrum-a proposal].

For more than half a century，the modern bioresearch in acupuncture has made remarkable advancements, proving scientific basis underlying the traditional, intuitive treatment, as well as leading to some new discoveries with the potential to enhance the effectiveness of acupuncture as we know it. Meanwhile, the clinical researches have started to shift its paradigm from traditional individual observation to modern evidence-based medicine. However, there is little interaction between basic and clinic researches, which are like two separate worlds, not benefiting each other. Also the education and training of acupuncture are still traditional style, little combining with modern studies. To bridging the large gap, we need translational science involving in. In this article, with a critical reviews of the limitations of the traditional methods of acupuncture, the challenges faced by clinic practices and placebo-control studies, and the advantages and disadvantages of basic research, we propose a methodological paradigm of the translational research, Translational Acupuncture Research Spectrum, that meets the current situation of acupuncture researches, hoping to give insights into this field and to promote modern acupuncture to move towards a new stage.

[The path of translational medicine for neuroimmunological anti-inflammation and its enlightenment to acupuncture].

Neuroimmunological anti-inflammation is one of the most successful areas of translational medicine in the past 50 years, leading directly to the success of anti-TNF biologics and vagal nerve stimulation therapy for anti-inflammation. The latter has many similarities with traditional acupuncture therapy and further research may reveal more intertwining and enlightenment to acupuncture. This paper briefly reviews the discovery and translational process of Cachectin/TNF, anti-TNF therapy, neural inflammatory reflex arc, vagus nerve stimulation therapy, and Stimulating Peripheral Activity to Relieve Condition (SPARC) project, and also summarizes the experience and lessons learned from the path of translational medicine in this field. The two key steps in the translational process are discussed in details. The purpose is to provide reference for the development of translational medicine in acupuncture. "Minimal injury with significant healing" should be considered as the principal hypothesis to further study the biological mechanism of acupuncture and it may result in more clinical translation in the future.

Alpinetin: a Dietary Flavonoid with Diverse Anticancer Effects.

Cancer is a global burden and mechanistically complex disease with a plethora of genetic, physiological, metabolic, and environmental alterations. The development of dietary nutraceuticals into cancer chemotherapeutics has emerged as a new paradigm in cancer treatment. Alpinetin (ALPI) is a novel flavonoid component of multiple edible and medicinal plants and possesses a wide range of biological and pharmacological activities including antibacterial, anti-hemostatic, anti-oxidative, anti-hepatotoxic, stomachic, immunosuppressive, and anti-inflammatory. Recently, ALPI has been reported as a bioactive dietary nutraceutical with promising anticancer activity in various human cancers through multiple mechanisms. The purpose of this review is to compile the data on natural sources of ALPI, and its anticancer activity including cellular targets and anticancer mechanism in various human cancers. Moreover, this review will set the stage for further design and conduct pre-clinical and clinical trials to develop ALPI into a lead structure for oncological therapy.

Metal-Organic Framework-Based Nanoheater with Photo-Triggered Cascade Effects for On-Demand Suppression of Cellular Thermoresistance and Synergistic Cancer Therapy.

Nanomedicine with stable light-heat conversion and spatiotemporally controllable drug activation is crucial for the success of photothermal therapy (PTT). Herein, a metal-organic framework (MOF)-based nanoheater with light-triggered multi-responsiveness is engineered to in-situ and on-demand sensitize cancer cells to local hyperthermia. Well-dispersed platinum nanoparticles synthesized inside nanospaces of the MOF are employed as the near-infrared (NIR)-harvesting unit with stable and high light-heat conversion performance. A conformation switchable polymer shell is constructed as a secondary light-responding unit to gate the targeted activation of a molecular inhibitor against thermoresistance. By cascade transformation of light stimuli to downstream signals, the nanoheater enables inhibitor release to go with local heating at the same time restricted in lesion sites to maximize efficacy and minimize systemic toxicity. The efficient photothermal conversion and the blockage of cellular heat-protective pathways provide a dual-mode of action which selectively sensitizes cancer cells to hyperthermia in a spatiotemporally controlled manner. With NIR as the remote switch, the MOF-based nanosystem demonstrates localized and boosted PTT efficacy against cancer both in vitro and in vivo. These results present nanosized MOFs as tailorable and versatile platforms for synergistic and precise cancer therapy.

[The significance of "A neuroanatomical basis for electroacupuncture to drive the vagal-adrenal axis" published in Nature for acupuncture research].

October 2021, Nature published an original research article entitled A neuroanatomical basis for electroacupuncture to drive the vagal-adrenal axis, which draws great attention and arouses extensive discussion in the acupuncture field. Based on previous findings, this study demonstrates that the abundant innervation of PROKR2-Cre neurons in deep fascia tissues mediates the anti-inflammatory effect induced by low-intensity electroacupuncture stimulation at "Zusanli"（ST36） or "Shousanli"(LI10) via the "vagal-adrenal axis". This study is one of milestones in the field of acupuncture basic research and represents a great achievement generated by multi-discipline integration of acupuncture and neuro-immunology. It reveals partial contributing factors involved in acupuncture's effect and the relative specificity of the neuroanatomical basis of acupoints in the context of immune modulation. This study is both very informative and instructive for the innovation and clinical translation of future acupuncture research. Acupuncture researchers are recommended to attach great importance to this study in terms of its research strategy,methods and findings.

[Anatomical basis of transition from eleven to twelve meridians in Han dynasty].

The discovery of modern evolutionary anatomy shows that the persistent median artery in the upper arm is a common variant with an increasing trend. This phenomenon can explain well the transition from the eleven meridians described in the Han silk and bamboo slips to the twelve meridians finalized in Neijing and the addition of the hand- jueyin meridian in Han dynasty. After systematic analysis and comparison, the author proposes the hypothesis that "yin meridians are arteries, and yang meridians are nerve-like structures" to explain the meridian theory prior to acupuncture and acupoints in the Qin and Han dynasties. It is clear that over two thousand years ago, Chinese physicians already described the distribution, physiology, and pathology of the six main arteries and six important nerves in the human extremities. The finding suggests that it was the addition of acupuncture and acupoints that had changed the direction of TCM development in Neijing or later and promoted the maturation of qi and blood, meridians, and zangfu theories.

[In the search of mobile target for acupuncture: why is mast cell?]

Both clinical practice and basic research of acupuncture have pointed out that acupuncture treatment has specific tissue and cellular targets. In addition to the known fixed tissue targets such as nerves and blood vessels, the author analyzes the biological characteristics of other skin resident cells in the skin and concludes that cutaneous mast cells are the most suitable candidate for the cellular target of acupuncture. A hypothesis of the bionic acupuncture is proposed to explain the biological principles by which the innate immunity and healing system respond to acupuncture. The distribution of mast cells in the human skin is characterized by "approaching to the terminals and gathering at the orifices", and the cell density is highly correlated with the density of acupoints and the micro-acupuncture systems. These evidences all support that mast cells are the mobile target cells for acupuncture, which can explain some clinical phenomena and principles of acupuncture, and suggest mast cells as one of the tissue markers for acupoints.

HDC-Net: A hierarchical dilation convolutional network for retinal vessel segmentation.

The cardinal symptoms of some ophthalmic diseases observed through exceptional retinal blood vessels, such as retinal vein occlusion, diabetic retinopathy, etc. The advanced deep learning models used to obtain morphological and structural information of blood vessels automatically are conducive to the early treatment and initiative prevention of ophthalmic diseases. In our work, we propose a hierarchical dilation convolutional network (HDC-Net) to extract retinal vessels in a pixel-to-pixel manner. It utilizes the hierarchical dilation convolution (HDC) module to capture the fragile retinal blood vessels usually neglected by other methods. An improved residual dual efficient channel attention (RDECA) module can infer more delicate channel information to reinforce the discriminative capability of the model. The structured Dropblock can help our HDC-Net model to solve the network overfitting effectively. From a holistic perspective, the segmentation results obtained by HDC-Net are superior to other deep learning methods on three acknowledged datasets (DRIVE, CHASE-DB1, STARE), the sensitivity, specificity, accuracy, f1-score and AUC score are {0.8252, 0.9829, 0.9692, 0.8239, 0.9871}, {0.8227, 0.9853, 0.9745, 0.8113, 0.9884}, and {0.8369, 0.9866, 0.9751, 0.8385, 0.9913}, respectively. It surpasses most other advanced retinal vessel segmentation models. Qualitative and quantitative analysis demonstrates that HDC-Net can fulfill the task of retinal vessel segmentation efficiently and accurately.

Adjuvant surgical decision-making system for lumbar intervertebral disc herniation after percutaneous endoscopic lumber discectomy: a retrospective nonlinear multiple logistic regression prediction model based on a large sample.

BACKGROUND CONTEXT: Lumbar disc herniation (LDH) is a common condition that can affects an individual' quality of life. In patients for whom conservative treatment is ineffective after 3 months, surgical treatment, such as percutaneous endoscopic lumbar discectomy (PELD), is recommended. Because PELD is minimally invasive and produces thorough nerve root decompression, both surgeons and patients often prefer it to other techniques. PURPOSE: Surgeons find it challenging to prevent postoperative recurrent LDH (rLDH) when they use PELD. We created and verified a model for evaluating patients' recurrence risk factors before surgery so that surgeons can choose other surgical techniques when necessary. STUDY DESIGN: Retrospective study. PATIENT SAMPLE: One thousand eight hundred seven patients who underwent PELD at our hospital between 2012 and 2015 were enrolled. OUTCOME MEASURE: The main outcome measure was rLDH at any follow-up time point. METHODS: Data were retrospectively analyzed for 1807 patients who underwent PELD at our hospital at some point between 2012 and 2015; all patients had been monitored for at least 5 years after surgery. They were divided into a recurrence group and a nonrecurrence group. Clinical and radiological risk factors were assessed over time to determine their correlations with recurrence and to exclude less important factors. A nonlinear multivariate logistic regression model was established to predict the recurrence rate before surgery. RESULTS: A total of 1706 patients were monitored after PELD; data were missing for 101 additional patients. The total recurrence rate was 10.38%, and the most common time from surgery to recurrence was 1 year. Ten risk factors were assessed and included in the analysis. Regarding clinical risk factors, patients with hypertension (p < .001; correlation coefficient R [R] = 0.235; odds ratio [OR] = 4.749), diabetes (p < .001; R = 0.381; OR = 16.797), a history of smoking (p < .001; R = 0.347; OR = 9.012), and a history of performing intense physical labor (p < .001; R = 0.409; OR = 19.592) had a higher recurrence rate. Regarding radiological risk factors, patients with disc degeneration (Pfirrmann grade III) (p < .001; R = 0.228; OR = 4.919), Modic changes (level 2) (p < .001; R = 0.309; OR = 7.934), herniation in the form of extrusion (p < .001; R = 0.365; OR = 12.228), a higher disc height index (DHI) (p < .001; R = 0.336), and a larger segmental range of motion (p < .001; R = 0.243) had a higher recurrence rate. When the lumbar motion angle was negative (p < .001; R = 0.318; OR = 13.680), the recurrence rate was high. The overall accuracy of the final model was 97.6% (1665 of 1706). The recognition rate for non-rLDH cases was 99.0% (1514 of 1529), and the rate for rLDH cases was 85.3% (151 of 177); the AUC was 0.9315. A simple model was used. For those patients with postoperative trauma (p < .001; R = 0.382; OR = 13.680), a comparison model was established, and the corresponding recurrence rate was 23.0% ± 25.0% (0-76%). CONCLUSIONS: A large cohort of patients underwent long-term monitoring, and 11 risk factors were verified for assessing each patient's risks before surgery to predict the postoperative recurrence of LDH following PELD. The risk of recurrence may be effectively reduced with the use of alternative surgical techniques in high risk cases.

[Discussion on Acupuncture as adjunctive therapy for chronic stable angina: a randomized clinical trial published in JAMA Internal Medicine].

Professor LIANG Fan-rong's team from Chengdu University of TCM published Acupuncture as adjunctive therapy for chronic stable angina: a randomized clinical trial in JAMA Internal Medicine on July 29, 2019, which demonstrates that acupuncture as an adjunctive therapy is safety and effective for mild and moderate chronic stable angina. Sixteen experts at home and abroad conducted serious discussions on the research design, evaluation methods, principles and mechanisms, clinical significance and enlightenment of future acupuncture research, and provided practical suggestions for acupuncture and moxibustion to go global and gain international recognition.

Hispidulin: A novel natural compound with therapeutic potential against human cancers.

Cancer is one of the most devastating disease and leading cause of death worldwide. The conventional anticancer drugs are monotarget, toxic, expensive and suffer from drug resistance. Development of multi-targeted drugs from natural products has emerged as a new paradigm to overcome aforementioned conventionally encountered obstacles. Hispidulin (HIS), is a biologically active natural flavone with versatile biological and pharmacological activities. The anticancer, antimutagenic, antioxidative and anti-inflammatory properties of HIS have been reported. The aim of this review is to summarize the findings of several studies over the last few decades on the anticancer activity of HIS published in various databases including PubMed, Google Scholar, and Scopus. HIS has been shown to reduce the growth of cancer cells by inducing apoptosis, arresting cell cycle, inhibiting angiogenesis, invasion and metastasis via modulating multiple signaling pathways implicated in cancer initiation and progression. Multitargeted anticancer activity of HIS remains the strongest point for developing it into potential anticancer drug. We also highlighted the natural sources, anticancer mechanism, cellular targets, and chemo-sensitizing potential of HIS. This review will provide bases for design and conduct of further pre-clinical and clinical trials to develop HIS into a lead structure for future anticancer therapy.

Dry Needling: Is It Derived From Acupuncture? How Did Nonacupuncturists Start Using It?

CONTEXT: In the United States. and other Western countries, dry needling (DN) has been a disputed topic in both the academic and legal fields. OBJECTIVE: The research team intended to examine whether DN is a technique independent from acupuncture and also how nonacupuncturists, such as physical therapists (PTs), started practicing DN. DESIGN: The research team completed research, examined critical issues related to DN, and published a white paper in 2017 that discussed evidence and expert opinions from academic scholars, for health care professionals, administrators, policy makers, and the general public that demonstrate that DN is acupuncture. This article continues that endeavor. RESULTS: DN is not merely a technique but a medical therapy that is a simplified form of acupuncture practice. To promote DN theory and business, some commercial DN educators have recruited a large number of nonacupuncturists, including PTs, athletic trainers, and nurse practitioners, in recent years. PTs did not initiate the practice of DN and DN does not fit into the practice scope for PTs because it is an invasive practice. The national organizations of the PT profession, such as the American Physical Therapy Association and the Federation of State Boards of Physical Therapy, began to support the practice of DN by PTs in approximately 2010. Currently, more PTs are involved in DN practice and are teaching than any other specialty. CONCLUSIONS: Acupuncturists and physicians must complete extensive acupuncture training in accredited programs and pass national examinations to become licensed or certified to practice acupuncture. However, a typical DN course runs only 20-30 h, often in the course of 1 weekend, and the participants may receive a DN certificate without any national examination being required. For the safety of patients and professional integrity, the research team strongly suggests that all DN practitioners and educators should have to meet the same basic standards as those required for licensed acupuncturists or physicians.

Alterations in patients with major depressive disorder before and after electroconvulsive therapy measured by fractional amplitude of low-frequency fluctuations (fALFF).

BACKGROUND: Electroconvulsive therapy (ECT) is an important treatment option for patients with major depressive disorder (MDD). However, the mechanisms of ECT in MDD are still unclear. METHODS: Twenty-four patients with severe MDD and 14 healthy controls were enrolled in this study. Eight ECT sessions were conducted for MDD patients using brief-pulse square-wave signal at bitemporal locations. To investigate the regional cerebral blood flow in MDD patients before and after ECT treatments by resting-state functional magnetic resonance imaging (rs-fMRI), the patients were scanned twice (before the first ECT and after the eighth ECT) for data acquisition. Afterward, we adopted fractional amplitude of low-frequency fluctuations (fALFF) to assess the alterations of regional brain activity. RESULTS: Compared with healthy controls, the fALFF in the cerebellum lobe, parahippocampal gyrus, fusiform gyrus, anterior cingulate gyrus, and thalamus in MDD patients before ECT (pre-ECT) was significantly increased. In another comparison, the fALFF in the cerebellum anterior lobe, fusiform gyrus, insula, parahippocampal gyrus, middle frontal gyrus, and inferior frontal gyrus in pre-ECT patients was significantly greater than the post-ECT fALFF. LIMITATIONS: Only two rs-fMRI scans were conducted at predefined times: before the first and after the eighth ECT treatment. More scans during the ECT sessions would yield more information. In addition, the sample size in this study was limited. The number of control subjects was relatively small. A larger number of subjects would produce more robust findings. CONCLUSIONS: The fALFF of both healthy controls and post-ECT patients in cerebellum anterior lobe, fusiform gyrus, and parahippocampal gyrus is significantly lower than the fALFF of pre-ECT patients. This finding demonstrates that ECT treatment is effective on these brain areas in MDD patients.

The Most Commonly Treated Acupuncture Indications in the United States: A Cross-Sectional Study.

Acupuncture has been a popular alternative medicine in the United States for several decades. Its therapeutic effects on pain have been validated by both basic and clinical researches, and it is currently emerging as a unique non-pharmaceutical choice for pain against opioid crisis. However, the full spectrum of acupuncture indications remains unexplored. In this study, we conducted a cross-sectional survey among 419 acupuncturists nation-wide to investigate the top 10 and top 99 acupuncture indications in private clinics in the United States. We found the top 10 indications to be: lower back pain, depression, anxiety, headache, arthritis, allergies, general pain, female infertility, insomnia, neck pain and frozen shoulder. Among the top 99 indications, pain represents the largest category; and mental health management, especially for mood disorders, is in greatest demand. The following popular groups are: immune system dysfunctions, gastrointestinal diseases, gynecology and neurology. In addition, specialty index, commonality index, and the potential to become medical specialties were estimated for each indication. Demographic analysis suggests that China trained acupuncturists tend to have broader indication spectrums, but the top conditions treated are primarily decided by local needs. Also, gender, resident states, age and clinical experience all affect indication distributions. Our data for the first time outlines the profile of acupuncture treatable conditions in the US and is valuable for strategic planning in acupuncture training, healthcare administration and public education.

[The Incorrect Translation, Misinterpretation and Misunderstanding of "Superficial Fascia" in Acupuncture].

The "superficial fascia" is often interpreted as "tendon-membrane like structure" in acupuncture field and it is speculated that acupuncture stimulation-induced structural alteration of the superficial fascia may contribute to the alleviation of many medical conditions. The fact is that the superficial fascia mainly consists of subcutaneous adipose tissue and fibrotic network (which function in storing, supporting and buffering external pressure and are not responsible for producing "Deqi" or "needling sensations"), and has no typical tendon or membrane structure in hypodermis. In the present paper, the author tries to clarify its incorrect translation, misinterpretation, and misunderstanding in acupuncture and propose that the target of acupuncture stimulation is probably not only the subcutaneous soft tissue per se, but also the contents in subcutaneous soft tissue network as the nerves, blood vessels, lymph-vessels, cutaneous accessory structures, mast cells, multiple movable cells, related receptors, etc.