[Effect and mechanism of Zuogui Pills on neural function recovery in ischemic stroke mice based on OPN/IGF-1/mTOR].

To explore the effect and mechanism of Zuogui Pills in promoting neural tissue recovery and functional recovery in mice with ischemic stroke. Male C57BL/6J mice were randomly divided into a sham group, a model group, and low-, medium, and high-dose Zuogui Pills groups(3.5, 7, and 14 g·kg~(-1)), with 15 mice in each group. The ischemic stroke model was established using photochemical embolization. Stiker remove and irregular ladder walking behavioral tests were conducted before modeling and on days 7, 14, 21, and 28 after medication. Triphenyl tetrazolium chloride(TTC) staining was performed on day 3 after modeling, and T2-weighted imaging(T2WI) and diffusion-weighted imaging(DWI) were performed on day 28 after medication to evaluate the extent of brain injury. Hematoxylin-eosin(HE) staining was performed to observe the histology of the cerebral cortex. Axonal marker proteins myelin basic protein(MBP), growth-associated protein 43(GAP43), mammalian target of rapamycin(mTOR), and its downstream phosphorylated s6 ribosomal protein(p-S6), as well as mechanism-related proteins osteopontin(OPN) and insulin-like growth factor 1(IGF-1), were detected using immunofluorescence and Western blot. Zuogui Pills had a certain restorative effect on the neural function impairment caused by ischemic stroke in mice. TTC staining showed white infarct foci in the sensory-motor cortex area, and T2WI imaging revealed cystic necrosis in the sensory-motor cortex area. The Zuogui Pills groups showed less brain tissue damage, fewer scars, and more capillaries. The number of neuronal axons in those groups was higher than that in the model group, and neuronal activity was stronger. The expression of GAP43, OPN, IGF-1, and mTOR proteins in the Zuogui Pills groups was higher than that in the model group. In summary, Zuogui Pills can promote the recovery of neural function and axonal growth in mice with ischemic stroke, and its mechanism may be related to the activation of the OPN/IGF-1/mTOR signaling pathway.

[Effects of electroacupuncture on neurological function and expressions of p-JNK and Beclin-1 in traumatic brain injury rats].

OBJECTIVE: To observe the effect of electroacupuncture (EA) on neurological function, the expressions of phosphorylated c-Jun amino terminal kinase (p-JNK) and Beclin-1 in rats with traumatic brain injury (TBI), so as to explore the underlying mechanism of EA in the treatment of TBI. METHODS: A total of 64 SD rats were randomly divided into blank, sham, modeling groups, with 8 rats in the blank group and the sham group and 48 rats in the modeling group. The modified Feeney free-fall impact method was used to establish the TBI rat model. After modeling, rats of the modeling group were randomly divided into model and EA groups, which were further divided into 3 d, 7 d and 14 d subgroups with 8 rats in each group. Rats in the EA group were treated with acupuncture at "Baihui" (GV20, retained for 15 min), "Shuigou" (GV26, stabbed for 20 s), "Neiguan" (PC6) and "Zusanli" (ST36) of the right side. EA (2 Hz, 1 mA) was applied to PC6 and ST36 for 15 min. The above treatments were performed once a day, and different subgroups were continuously stimulated for 3, 7 and 14 days, respectively. The neurological impairment was evaluated by modified neurological severity score(mNSS). The pathological morphological changes and the protein expressions of p-JNK and Beclin-1 in the injured area of the brain were detected by Nissl staining and immunohistochemistry, separately. RESULTS: After modeling, the mNSS and the protein expressions of p-JNK and Beclin-1 were increased (P< 0.05) on day 3, 7 and 14 in the model group relative to the sham group. The Nissl bodies were reduced or even dissolved and neurons were seriously damaged in the model group on the 3rd day, which were mildly repaired on day 7 and 14. Following acupuncture interventions, compared with the model group, the mNSS on day 7 and 14 and the protein expressions of p-JNK and Beclin-1 on day 3, 7 and 14 were decreased (P< 0.05)in the EA group. The status of Nissl bodies and neurons in the EA group was better at all time points than that in the model group. There were no significant differences in the above indicators between the blank group and the sham group. CONCLUSION: EA can significantly improve the neurological function of TBI model rats, which may be related to its effects in down-regulating the protein expressions of p-JNK and Beclin-1 in the injured area of the brain.

The curative effect of Tongdu Tiaoshen acupuncture on hemiplegia after stroke and its influence on nerve function and limb function / 国际中医中药杂志

Objective:To explore the application of Tongdu Tiaoshen acupuncture in patients with hemiplegia after stroke.Methods:Randomized controlled trial. A total of 70 patients who met the inclusion criteria for post-stroke hemiplegia in our hospital from January 2020 to December 2021 were divided into two groups, with 35 cases in each group, according to the random number table. The control group was given conventional treatment combined with rehabilitation exercise therapy, and the observation group was given Tongdu Tiaoshen acupuncture on the basis of the above, and both groups were treated continuously for 1 month. Compare of the two groups Fugl-Meyer Assessment (FMA), Modified Ashworth Scale (MAS), National Institutes of Health Stroke Scale (NIHSS), Activity of Daily Living (ADL) score; Brunnstrom stage method was used to assess the patient's motor ability, and Holden walking function grade was used to assess the patient's walking ability. The activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time(TT), and serum fibrinogen (FIB), D-dimer (D-D), plasminogen activator inhibitor 1 (PAI-1) levels were observed by ELISA. Adverse events were recorded and clinical efficacy was evaluated.Results:The total effective rates of the observation group and the control group were 97.14% (34/35) and 77.14% (27/35), respectively, and the difference between the two groups was statistically significant ( χ2=6.25, P=0.012). After treatment, the scores of FMA and ADL in the observation group were significantly higher than those in the control group ( t values were 9.23 and 9.54, respectively, P<0.01), the MAS and NIHSS scores were significantly lower than those in the control group ( t values were 10.23 and 11.97, respectively, P<0.01). After treatment, the distribution of patients in Brunnstrom stage Ⅴ and Ⅵand Holden functional walking stage Ⅳ and Ⅴ in the observation group was significantly higher than those in the control group ( χ2 values were 11.96 and 11.27, respectively, P<0.05). After treatment, APTT, PT and TT in the observation group were significantly longer than those in the control group ( t values were 10.37, 13.57 and 6.54, respectively, P<0.01); serum FIB, D-D and PAI-1 levels were significantly lower than those in the control group ( t values were 12.85, 11.94 and 27.39, respectively, P<0.01). No adverse reactions occurred in both groups. Conclusion:The treatment of post-stroke hemiplegia with Tongdu Tiaoshen acupuncture can improve the effect of clinical treatment and the ability of daily life, neurological function, limb function, movement and walking ability, and stabilize the clotting state.

Effect of Jiajian Fuyuan Huoxuetang Combined with Electroacupuncture on Neurological Rehabilitation After Spinal Cord Injury / 中国实验方剂学杂志

Objective:To observe the effect of Jiajian Fuyuan Huoxuetang combined with electroacupuncture on neurological rehabilitation of patients with spinal cord injury, and to investigate its effect on neurotrophic and inflammatory factors. Method:One hundred and twenty patients were randomly divided into control group (59 cases) and observation group (61 cases) by random number table. Both groups’ patients got monosialotetrahexosylganglioside by intravenous drip for 6 weeks, 200-400 mg/time, 1 time/day.Rat nerve growth factor for injection by intramuscular injection for 4 weeks, 20 μg/time, 1 time/day. Patients in control group additionally got electroacupuncture treatment,and tongluo huatan capsule,3 caps/time,3 time/days. The patients in observation group additionally got Jiajian Fuyuan Huoxuetang combined with electroacupuncture, 1 dose/day. The courses of treatment were 12 weeks in two groups. Scores of degree of spinal cord neurological impairment were graded by using impairment score of American Spinal Injury Association (ASIA). Lower extremity motor ability was discussed by using the walking index of spinal cord injuryⅡ (WISCⅠ Ⅱ) and 10 minutes’ walking time (10 MWT). Before and after treatment, functions of daily life were evaluated by using Barthel index (MBI). Bladder function was also discussed, and levels of brain-derived nerve growth factor in peripheral blood (BDNF), nerve growth factor (NGF), astrogenic calcium binding protein S-100 β (S-100 β), tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) were also detected. Result:After the treatment, scores of sensory and motor in ASIA scale in observation group were all higher than those in control group (P<0.01). Score of WISCⅠ Ⅱ in observation group was higher than that in control group, and 10 MWT was shorter than that in control group (P<0.01). Times of leakage of urine, urinary incontinence volume and residual urine volume were all less than those in control group, and bladder volume was more than that in control group (P<0.01). Functions of daily life in observation group were better than those in control group (Z=1.967, P<0.05), and the levels of BDNF and NGF were higher than those in control group, while levels of S-100 β, TNF-α and IL-1β were lower than those in control group (P<0.01). Conclusion:On the basis of routine comprehensive rehabilitation therapy of western medicine, Jiajian Fuyuan Huoxuetang combined with electroacupuncture can promote the recovery of nervous function, improve sensory and motor function, improve bladder function and daily living ability, and promote the expression of neurotrophic factors and inhibit inflammatory reaction in neurological rehabilitation for the patients with spinal cord injury.

A statement of possibility of acupuncturing Shuigou improves neural function prognosis in patients after cardiac arrest / 中国中西医结合急救杂志

This paper focuses on the total cerebral ischemic injury after cardiac arrest (CA), the authors analyze how acupuncture improves neurological impairment and the prognosis after CA from the perspectives of traditional Chinese medicine theory and modern research achievements of acupuncture on Shuigou. It should take into consideration of three factors in both basic and clinical study: the time and link of intervention, mechanism, optimization of stimulating parameters in order to clear the direction of acupuncturing Shuigou improves the neural functional recovery after CA.

Effects of Three-in-one Acupuncture on Hemiplegia after Ischemic Stroke / 中国康复理论与实践

@#Objective To observe the effects of Three-in-one Acupuncture on hemiplegia after ischemic stroke. Methods 146 patients with hemiplegia after ischemic stroke were randomly allocated into trial group (n=73) and control group (n=73). The trial group accepted Three-in-one Acupuncture, while the control group accepted rehabilitation, for 4 weeks. They were assessed with Neurological Deficit Score (NDS), Functional Comprehensive Assessment (FCA) and Barthel Index (BI) before and 7, 14, 21 and 28 days after treatment. They were followed up for a year. Results The NDS decreased since 7 days after treatment in the trial group (P<0.05), while it decreased since 21 days in the control group (P<0.05). The NDS was less in the trial group than in the control group 7 and 14 days after treatment (P<0.05). The FCA score increased since 21 days after treatment in both groups, and the BI score increased since 14 days after treatment in both groups (P< 0.05). There was no significant difference between the trial group and the control group (P>0.05). The rate of improvement was 87.9% in the trial group, similar with 84.1% in the control group (P>0.05). The recurrence rate was 11.54% in the trial group, less than 25.49% in the control group in a year (P<0.05). Conclusion Three-in-one Acupuncture is as effective as rehabilitation on hemiplegia after ischemic stroke, more quickly and with less recurrence.

Effects of Three-in-one Acupuncture on Hemiplegia after Ischemic Stroke / 中国康复理论与实践

Objective To observe the effects of Three-in-one Acupuncture on hemiplegia after ischemic stroke. Methods 146 patients with hemiplegia after ischemic stroke were randomly allocated into trial group (n=73) and control group (n=73). The trial group accepted Three-in-one Acupuncture, while the control group accepted rehabilitation, for 4 weeks. They were assessed with Neurological Deficit Score (NDS), Functional Comprehensive Assessment (FCA) and Barthel Index (BI) before and 7, 14, 21 and 28 days after treatment. They were followed up for a year. Results The NDS decreased since 7 days after treatment in the trial group (P0.05). The rate of improvement was 87.9%in the trial group, similar with 84.1%in the control group (P>0.05). The recurrence rate was 11.54%in the trial group, less than 25.49%in the control group in a year (P<0.05). Conclusion Three-in-one Acupuncture is as effective as rehabilitation on hemiplegia after ischemic stroke, more quickly and with less recurrence.

Effects of the Staging Acupuncture Combined with Physical Therapy on Stroke / 中国康复理论与实践

@#Objective To study the effects of the staging acupuncture combined with physical therapy on the neural function, motor function and activities of daily living in stroke patients. Methods 166 cases were divided into two groups: 83 cases in the treatment group were treated with staging acupuncture combined with physical therapy; 83 cases in the control group were treated with traditional acupuncture combined with physical therapy. They were evaluated with modified Edinburgh-Scandinavia Stroke Scale (MESSS)，Fugl-Meyer Assessment (FMA), and Bathel Index (BI) before and 2 months after treatment. Results There was no significant difference between these 2 groups before treatment (P>0.05), but were significant differences in MESSS, FMA and BI (P<0.05) after treatment. The incidence of recovery after treatment was 90.36% in treatment group, significantly better than that of the control group (74.49%, P<0.05). Conclusion In comparison with the traditional acupuncture, the staging acupuncture can significantly improve the effect on stroke based on the physical therapy.