NGF/PI3K/TRPV1 pathway mediates the regulation of visceral pain by acupuncture at "Shangjuxu" (ST37) in irritable bowel syndrome rats with chronic visceral hyperalgesia. / NGF/PI3K/TRPV1通路介导针刺"上巨虚"è°ƒèŠ‚è‚ æ˜“æ¿€ç»¼åˆå¾æ ¢æ€§å† è„ç—›æ•æ¨¡åž‹å¤§é¼ å† è„ç—›.

OBJECTIVES: To investigate the effect of manual acupuncture at "Shangjuxu"(ST37) on nerve growth factor(NGF)/phosphatidylinositol 3-kinase(PI3K)/transient receptor potential vanilloid 1(TRPV1) signaling pathway in rats with chronic visceral hyperalgesia of irritable bowel syndrome (IBS), so as to explore its underlying mechanism in treating IBS chronic visceral hyperalgesia. METHODS: IBS chronic visceral hyperalgesia model was established by colorectal dilation stimulation for 2 weeks for SD pups at 8 d after birth, which were fed until 8-week age after the stimulation. Then the verified successfully modeled adult rats were randomly divided into model, Shangjuxu, and non-acupoint groups, with 6 rats in each group, and 6 unmodeled rats were selected as normal group. On the next day of model evaluation, rats in the Shangjuxu group received acupuncture at right ST37 while rats in the non-acupoint group received acupuncture at the non-meridian and non-acupoint point in the right hypochondrium, both for 15 min, with manual twisting of mild reinforcing and reducing performed for 30 s at an interval of 5 min, once a day, for a total of 7 d. Abdominal withdrawal reflex(AWR) score was used to evaluate the degree of chronic visceral pain in rats. Western blot and real-time fluorescence quantitative PCR were used to detect the colonic protein and mRNA expressions of NGF, tropomyosin receptor kinase A (TrkA), PI3K and TRPV1. The positive expressions of PI3K and TRPV1 proteins in the colon of rats were detected by immunohistochemistry method. RESULTS: Compared with the normal group, AWR scores corresponding to 4 pressure levels of 20, 40, 60 and 80 mm Hg, mRNA and protein expressions of NGF, TrkA, PI3K and TRPV1 in colon tissue, and positive expressions of PI3K and TRPV1 in colon tissue were significantly increased(P<0.05) in the model group. After intervention, compared with the model group, rats in the Shangjuxu group had reduced AWR scores corresponding to 4 pressure levels of 20, 40, 60 and 80 mm Hg, lower colonic mRNA and protein expressions of NGF, TrkA, PI3K and TRPV1, and decreased positive expressions of PI3K and TRPV1 in colon tissue(P<0.05), while there were no significant differences in the above indexes of the non-acupoint group. CONCLUSIONS: Manual acupuncture at ST37 can alleviate IBS chronic visceral hyperalgesia in rat and its analgesic effect may be related to regulating NGF/PI3K/TRPV1 signaling pathway.

[Discussion on methods for locating Xuehai (SP10) acupoint].

The position of Xuehai (SP10) is clear, but its locating method is vague, resulting in the disunity of clinical application and even possibly affecting the curative effect. Also, when learning the meridians and acupoints, the beginners are often confused by this issue possibly due to: ① when the bone-length proportional measurement combined with anatomic symbol (combination method) was adopted, it is not clear that the patient should take a posture of knee extension or knee flexion; ② when the combination method used, it is difficult to find the highest point of muscle eminence in the case of patient with thin vastus medialis muscle and fuzzy body surface projection; ③the simple method for locating SP10 is widely used at present, can it replace the combination method to locate this acupoint accurately？Guided by these questions, we, in the present paper, reviewed the rela-ted textbooks, works and other literature to explore the standard position of SP10, and the standard and simple methods for locating this acupoint. Comprehending various opinions, we hold that SP10 should be positioned under the extended knee posture, then, the acupoint's horizontal ordinate "2 cun superior to the medial end of the base of the patella" is determined by using bone-length proportional measurement to measure 2 cun from the bottom to the tip of the patella. Then, the body surface anatomic symbol method is used, when, the patient is asked to stretch the leg and contract the vastus medialis muscle, the highest spot of muscular eminence is the SP10. If the patient's muscular protuberance is not obvious, the middle line between the medial and lateral margins of the vastus medialis muscle is used as the vertical ordinate, and its intersection with the abscissa is SP10. The simple method is easy in operation and has a reference value, but may frequently produce errors, hence, it is not a substitution for the combination method.

[Analysis on the distribution of pressure- and heat-sensitive acupoints in patients with allergic rhinitis].

OBJECTIVE: To explore the distribution of pressure- and heat-sensitive acupoints of the Large Intestine of Hand-Yangming, Stomach Meridian of Foot-Yangming and the Lung Meridian of Hand-Taiyin below the elbow and knee joints in patients with allergic rhinitis, so as to explore the positive reaction points at the body surface of allergic rhinitis. METHODS: Thirty variant rhinitis volunteer subjects and 30 healthy subjects were recruited in the present study. The subcutaneous induration, reaction points of emptiness-like feeling or pressing pain below the elbow- and knee-joints along the Large Intestine Meridian, Stomach Meridian and the Lung Meridian were inspected first, then re-examined by using heat-sensitized moxibustion method and a hand-held pain threshold tester (mechanical pressure), respectively. The frequency and coincidence rate of pressing-pain sensitive and heat-sensitive points were analyzed. RESULTS: In the 30 patients with allergic rhinitis, 10 positive reaction points as Kongzui (LU6), Chize (LU5), Hegu (LI4), Quchi (LI11), Shousanli(LI10), Zusanli (ST36), Shangjuxu (ST37), Fenglong (ST40), Xiajuxu (ST39), and non-acupoint of the Lung Meridian were found. Among them, the duration of heat-sensitive reaction in the LU6, LI10, ST37, ST40, and ST39 regions was obviously shorter in patients than in healthy subjects (P<0.01,P<0.005). The heat-sensitive forms of the positive reaction points were mainly heat transmission, heat-penetration and local reaction. The mechanical pain thresholds of the positive reaction points (LI4, LU6, LI10, LI11 and non-acupoint of the Lung Meridian) at the upper limbs and those (ST36, ST37 and ST40) at the lower limbs were evidently lower in patients than in healthy volunteer subjects (P<0.05). The pressure- and heat-sensitive acupoints were basically coincide in the patients, but being higher in patients than in healthy subjects in the frequency of occurrence. The mechanical pain threshold of the pressure-sensitive acupoints in patients was remarkably lower on the left side than on the right side of the upper limb, and obviously higher on the left side than on the right side of the lower limb (P<0.05). No significant differences were found between the right and left sides in the pain threshold in healthy subjects (P>0.05). CONCLUSION: There is a high overlap in the distribution of pressure- and heat-sensitive acupoints of the Lung, Large Intestine and Stomach meridians below the elbow and knee joints in patients with allergic rhinitis, and there is an imbalance between the left and right limbs in the mechanical pain threshold of the pressure- and heat-sensitive acupoints, but needing being further confirmed.

[Effects of electroacupuncture on the function of respiration chain in hippocampal mitochondria of SAMP8 mice ].

OBJECTIVE: from the perspective of mitochondria. METHODS: Tweleve SAMP8 mice aged 8 months were randomly divided into a model group (n = 6) and an electroacupuncture group (n = 6), and six SAMR1 mice aged 8 months were selected as a control group. The electroacupuncture group was treated with electroacupuncture at "Baihui" (GV 20), "Dazhui" (GV 14), "Shenshu" (BL 23) and "Taixi" (KI 3) for 20 min, once each day, 10 days for a course, and lasted for 3 courses. The other two groups were grasped and fixed in the same way at the same time without the other treatment. After the end of treatment, the learning and memory abilities of the mice were measured by Morris water maze, the activity of hippocampal mitochondrid respiratory chain enzyme complex was performed by spectrophotometry, and the levels of adenosine triphosphate (ATP) were detected by a reverse-phase high performance liquid chromatography (HPLC) method. RESULTS: Compared with the control group, the average escape latency significantly lengthened, the residence time on the plateau phase shortened, the activity of respiratory chain enzyme complexe I, II, III, and IV was decreased, and ATP concentration was decreased in the model group. Compared with the model group, the average escape latency significantly shortened, the residence time on the plateau phase lengthened, the activity of hippocampal mitochondrid respiratory chain complexes I, II, III, and IV was significantly increased, and ATP concentration was increased in the electroacupuncture group. CONCLUSION: Electroacupuncture can increase the activity of hippocampal mitochondrid respiratory chain enzyme complexe and ATP concentration and improve mitochondrial function, which may be one of underlying mechanisms of electroacupuncture in treatment of AD.

[Relationship between efficacy of electroacupuncture and electroacupuncture stimulation of different acupoints and different tissue layers of acupoint area in hypotension plus bradycardia rats].

OBJECTIVE: To explore the relationship between the effect of electroacupuncture (EA) and EA of different layer tissues of the acupoint area and different acupoints in upregulating mean arterial pressure (MAP) and heart rate (HR) in hypotension plus bradycardia rats. METHODS: A total of 200 SD rats were used in the present study. Bradycardia plus hypotension model was established by intravenous injection of 0.4% propranolol (0.4 mg/100 g, maintaining dosage 0.025 mg/100 g per minute). EA (2 Hz/15 Hz, 5 mA) was applied to (1) right "Daling" (PC7) and "Jiexi" (ST 41), "Ximen" (PC 4) and "Housanli" (ST 36), "Quze" (PC 3) and "Dubi" (ST 35) which have a similar tissue structure, and are located in the upper and lower limbs and different meridians, and non-acupoint [3 mm left-superior to the "Tianshu" (ST 25)], (2) skin, muscle layer and periosteum part of "Ximen" (PC4), (3) skin, muscle layer and periosteum of "Housanli" (ST36) for 15 min. The HR and MAP were recorded by using a multi-channel physiological signal sampling-processing system. RESULTS: (1) In comparison with the model group, the percentages of the increased HR and MAP in the "Ximen" (PC4), "Quze" (PC3), "Housanli" (ST 36) and "Jiexi" (ST41) groups, PC 4-skin, PC 4-muscle, PC 4-periosteum, ST 36-skin, ST 36-muscle and ST 36 periosteum groups, and the increased HR in the "Dubi" (ST 35) group were upregulated significantly (P < 0.05, P < 0.01). The percentages of the increased HR and MAP were significantly higher in the "Quze" (PC3) and "Ximen" (PC4) groups than in the "Daling" (PC7) group (P < 0.01), and the increased HR evidently higher in the "Housanli" (ST36) and "Jiexi" (ST41) groups than in the "Dubi" (ST35) group (P < 0.01), suggesting different effects of EA stimulation of different acupoints in the same one meridian. No significant differences were found among the "Ximen" (PC4), "Quze" (PC3), "Housanli" (ST36) and "Jiexi" (ST 41) groups, and between the "Daling" (PC7) and model groups, and between the non-acupoint and model groups in the rising rates of both HR and MAP (P > 0.05). (2) Regarding the effects of EA of different tissue layers in "Ximen" (PC4) and "Housanli" (ST36) areas, the rising rates of HR were markedly higher in the PC 4-skin group than in the "Ximen" (PC4), PC4-muscle and PC 4-periosteum groups (P < 0.01), and considerably higher in the "Housanli" (ST36), ST 36-skin, and ST 36-muscle groups than in ST 36-periosteum group (P < 0.05). The rising rates of MAP were significantly higher in the PC 4-skin and PC 4-muscle groups than in the "Ximen" (PC4) and PC4-periosteum groups (P < 0.01), and considerably higher in the ST36-skin group than in the "Housanli" (ST36), ST36-muscle and ST36-periosteum groups (P < 0.01), suggesting different effects of EA stimulation of different tissue layers in the same one acupoint. No significant differences were found between the "Ximen" (PC 4) and PC 4-muscle groups, among the "Housanli" (ST36), ST36-skin and ST 36-muscle groups in the rising rates of HR, between the "Ximen" (PC 4) and PC4-periosteum groups, and among the "Housanli" (ST36), ST 36-muscle and ST36-periosteum groups in the rising rates of MAP (P > 0.05). (3) The effect of the PC 4-skin group was significantly superior to that of the ST 36-skin group in increasing HR (P < 0.01), and the effect of the PC 4-muscle group was obviously stronger than that of the ST 36-muscle group in raising MAP (P < 0.01), suggesting different therapeutic effects of EA stimulation of the similar tissue in different meridian-acupoints. The effects of the "Ximen"(PC4) and "Housanli" (ST36) groups in raising both HR and MAP, and that of the PC 4-muscle and ST 36-muscle groups in upregulating HR, and that of the PC 4-periosteum and ST 36-periosteum groups in raising MAP were comparable (P > 0.05). CONCLUSION: EA of different acupoints of the same one meridian, the similar structure of different meridian acupoints and different tissue layers of the same one acupoint have their own relatively specific effects in upregulating HR and MAP in hypotension plus bradycardia rats.