Analysis of mechanism of core points in acupuncture and moxibustion treatment for epilepsy based on data mining. / åŸºäºŽæ•°æ®æŒ–æŽ˜æŽ¢è®¨é’ˆç¸æ²»ç–—ç™«ç—«æ ¸å¿ƒç©´ä½çš„ä½œç”¨æœºåˆ¶.

OBJECTIVES: To explore the mechanism of core points in acupuncture and moxibustion treatment for epilepsy by using data mining technique, so as to provide a reference for clinical practice and experimental research. METHODS: The data comes from relevant documents collected from CNKI, Wanfang, SinoMed, VIP, PubMed, Embase, Cochrane Library, EBSCO, Web of Science databases. The selected acupoints were analyzed in descriptive statistics, high-frequency acupoints group and core acupoint prescription. Further, potential target mining, "core acupoint prescription-target-epilepsy" network construction, protein-protein interactions (PPI) network establishment and core target extraction, gene ontology (GO) and KEGG gene enrichment analysis of the core acupoint prescription were carried out to predict its anti-epileptic potential mechanism. RESULTS: A total of 122 acupoint prescriptions were included. The core acupoint prescriptions were Baihui (GV20), Hegu (LI4), Neiguan (PC6), Shuigou (GV26) and Taichong (LR3). 277 potential targets were identified, among which 134 were shared with epilepsy. The core targets were extracted by PPI network topology analysis, including signal transducer and activator of transcription 3, tumor necrosis factor (TNF), interleukin (IL)-6, protein kinase B1, c-Jun N-terminal kinase, brain-derived neurotrophic factor, tumor protein 53, vascular endothelial growth factor A, Caspase-3, epidermal growth factor receptor, etc. The main anti-epileptic pathways of the core acupoints were predicted by KEGG enrichment, including lipid and atherosclerosis, neurodegeneration, phosphatidylinositol-3-kinase/protein B kinase signaling pathway, mitogen-activated protein kinase signaling pathway, cyclic adenosine monophosphate signaling pathway, TNF signaling pathway, IL-17 signaling pathway, hypoxia-inducible factor-1 signaling pathway, apoptosis, etc., involving neuronal death, synaptic plasticity, oxidative stress, inflammation and other related biological process. CONCLUSIONS: The core acupoint prescription of acupuncture and moxibustion intervention for epilepsy can act on multiple targets and multiple pathways to exert anti-epileptic effects, which can provide a theoretical basis for further clinical application and mechanism research.

Effectiveness of Mobile Health Platform-Based Continuity of Care in Osteoporosis Prevention and Treatment.

Objective: To assess the effectiveness of using mobile health platforms for continuous care in preventing and treating osteoporosis. Methods: 114 patients with osteoporosis admitted to Nantong First People's Hospital from March 2021 to June 2022 were recruited and assigned equally via random number table method to receive either routine care (namely education on osteoporosis disease, dietary guidance, exercise guidance, activity guidance, medication supervision, fall prevention, psychological care, and secondary health education at the time of discharge) (routine group) or mobile health platform-based continuity of care (continuity group), with 57 patients in each group. Outcome measures included treatment compliance, disease knowledge of osteoporosis (diet, exercise, risk factors), quality of life level, and care satisfaction. Results: All eligible patients were followed up for one year after discharge from the hospital. Patients with continuity of care showed higher treatment compliance and disease knowledge of diet, exercise, and risk factors than those with routine care (P = .004). Continuity of care was associated with significantly higher MOS 36-item short-form health survey (SF-36) scores (The SF-36 is a self-administered questionnaire containing 36 items that survey overall health status) and nursing satisfaction in patients versus routine care (P = .004). Conclusion: Mobile health platform-based continuity of care effectively enhances post-discharge compliance and knowledge of osteoporosis in patients with osteoporosis, thereby improving post-discharge quality of life and satisfaction with care. Multi-center studies involving diverse healthcare settings and patient populations would provide more robust evidence. Moreover, these findings highlight the potential benefits of incorporating mobile health platforms into the care continuum for osteoporosis patients. Also, by utilizing mobile health platforms, healthcare providers can extend their reach beyond hospital settings and provide continuous care and support to patients, potentially reducing the burden on healthcare systems and improving overall population health outcomes.

Exploring the central mechanism of mind-regulation electroacupuncture in treatment of chronic fatigue syndrome with anxiety and depression comorbidity based on functional magnetic resonance imaging. / åŸºäºŽåŠŸèƒ½ç£å ±æŒ¯æŽ¢è®¨è°ƒç¥žæ³•ç”µé’ˆæ²»ç–—æ ¢æ€§ç–²åŠ³ç»¼åˆå¾ä¼´ç„¦è™‘æŠ‘éƒå ±ç— çš„ä¸­æž¢æœºåˆ¶.

OBJECTIVES: To observe the changes in the regional homogeneity (ReHo) and functional brain network in treatment of chronic fatigue syndrome (CFS) with anxiety and depression comorbidity with the mind-regulation electroacupuncture (EA), using resting-state functional magnetic resonance imaging (rs-fMRI). METHODS: Thirty CFS patients with anxiety and depression comorbidity were enrolled from medical staffs as the observation group. The other 30 healthy subjects were recruited from medical university students as the control group, matching gender, age and education years with the observation group. No any acupuncture intervention was delivered in the control group, and EA for regulating the mind was operated in the observation group. Main points were the emotional area of Sun's scalp acupuncture, the regions 1 and 8 of Sun's abdominal acupuncture. Supplementary acupoints included Baihui (GV 20), Guanyuan (CV 4) and bilateral. RESULTS: The scores of the five domains in MFI-20 (i.e. general fatigue, physical fatigue, mental fatigue, reduced motivation and reduced activity), the total score of MFI-20, and the scores of SDS, SAS and PSQI in the observation group before treatment were higher than those of the control group (P<0.05). Except the score of reduced motivation in MFI-20, the scores of the other domains and the total score of MFI-20, as well as the scores of SDS, SAS and PSQI after treatment were lower than those before treatment in the observation group (P<0.05). Compared with the values before treatment, ReHo value was increased in the the right precuneus and decreased in the left inferior temporal gyrus and the left angular gyrus of the brain in the observation group after treatment. In the observation group, when compared with the control group, ReHo values were increased in the left inferior cerebral lobe, the interhemispheric region, the right occipital lobe and the thalamus; and it was reduced in the left middle temporal gyrus, the right posterior central gyrus, the right middle temporal gyrus, the right orbital middle frontal gyrus, the paracentral lobule and the right fusiform gyrus before treatment. In the observation group, the functional connectivity was decreased between the right thalamus and the left posterior central gyrus, the right hippocampus and the right fusiform gyrus before treatment, respectively; it was re-constructed after treatment between the right thalamus and the left posterior central gyrus, and the right fusiform gyrus. Compared with the control group, the functional connectivity between the right thalamus and the left posterior central gyrus, the right hippocampus, and the right fusiform gyrus was reduced before treatment; while after treatment, the functional connectivity was reduced between the right thalamus and the hippocampus in the observation group. With Spearman correlation analysis between the differential brain regions and the scores of MFI-20, SAS, SDS and PSQI, it was found that the left middle temporal gyrus, the paracentral lobule, the right precuneus, and the left inferior temporal gyrus had a partial positive correlation with the above clinical scales; and the interhemispheric region, the thalamus, the right fusiform gyrus, and the right middle temporal gyrus showed a partial negative correlation. CONCLUSIONS: There is the decrease of ReHo in many brain regions and the numbers of the local brain functional network connectivity in CFS patients with anxiety and depression comorbidity. The mind-regulation electroacupuncture therapy may relieve the clinical symptoms of the patients through adjusting the abnormal brain regions and activating emotion-related brain regions.

Natural products for the treatment of depression: Insights into signal pathways influencing the hypothalamic-pituitary-adrenal axis.

Depression, a prevalent psychiatric malady, afflicts a substantial global demographic, engendering considerable disease burden due to its elevated morbidity and mortality rates. Contemporary therapeutic approaches for depression encompass the administration of serotonin reuptake inhibitors, monoamine oxidase inhibitors, and tricyclic antidepressants, albeit these pharmaceuticals potentially induce adverse neurological and gastrointestinal effects. Traditional Chinese Medicine (TCM) natural products proffer the benefits of multi-target, multi-level, and multi-channel depression treatment modalities. In this investigation, we conducted a comprehensive literature review of the past 5 years in PubMed and other databases utilizing the search terms "Depression," "Natural medicines," "Traditional Chinese Medicine," and "hypothalamic-pituitary-adrenal axis." We delineated the 5 most recent and pertinent signaling pathways associated with depression and hypothalamic-pituitary-adrenal (HPA) axis dysregulation: nuclear factor kappa light-chain-enhancer of activated B cell, brain-derived neurotrophic factor, mitogen-activated protein kinase, cyclic AMP/protein kinase A, and phosphoinositide 3-kinase/protein kinase B. Additionally, we deliberated the antidepressant mechanisms of natural medicines comprising alkaloids, flavonoids, polyphenols, saponins, and quinones via diverse pathways. This research endeavor endeavored to encapsulate and synthesize the progression of TCMs in modulating HPA axis-associated signaling pathways to mitigate depression, thereby furnishing robust evidence for ensuing research in this domain.

Deciphering the biological effects of acupuncture treatment modulating multiple metabolism pathways.

Acupuncture is an alternative therapy that is widely used to treat various diseases. However, detailed biological interpretation of the acupuncture stimulations is limited. We here used metabolomics and proteomics technology, thereby identifying the serum small molecular metabolites into the effect and mechanism pathways of standardized acupuncture treatments at 'Zusanli' acupoint which was the most often used acupoint in previous reports. Comprehensive overview of serum metabolic profiles during acupuncture stimulation was investigated. Thirty-four differential metabolites were identified in serum metabolome and associated with ten metabolism pathways. Importantly, we have found that high impact glycerophospholipid metabolism, fatty acid metabolism, ether lipid metabolism were acutely perturbed by acupuncture stimulation. As such, these alterations may be useful to clarify the biological mechanism of acupuncture stimulation. A series of differentially expressed proteins were identified and such effects of acupuncture stimulation were found to play a role in transport, enzymatic activity, signaling pathway or receptor interaction. Pathway analysis further revealed that most of these proteins were found to play a pivotal role in the regulation of multiple metabolism pathways. It demonstrated that the metabolomics coupled with proteomics as a powerful approach for potential applications in understanding the biological effects of acupuncture stimulation.

Acupuncture Point Laterality: Investigation of Acute Effects of Quchi (LI11) in Patients with Hypertension Using Heart Rate Variability.

Hypertension is one of the major risk factors for cardiovascular disease worldwide. Over 70% of the patients use antihypertensive drugs, so nonpharmacological treatments in addition to the medication are important. Our goal was to investigate acupuncture treatment on the Quchi acupoint using heart rate (HR) and heart rate variability (HRV) and to find out whether there is a laterality in acute effects. Sixty hypertensive patients (36 female, 24 male; mean age ± SD 55.8 ± 9.7 years) were randomly assigned to two manual needle acupuncture groups (group A: left Quchi (LI11) acupoint, group B: right Quchi acupoint). There was a significant (P < 0.05) decrease in HR immediately after inserting and stimulating the needle at the left and the right Quchi acupuncture point. In contrast, total HRV increased immediately after inserting the needle, but this increase was significant only towards the end of the stimulation phase and after removing the needle. There were some differences between stimulation of the left and right Quchi acupoint, but they remained insignificant. This study provides evidence that there is a beneficial effect on heart rate variability in patients with hypertension and that there are some effects of laterality of the acupoint Quchi.

High-throughput metabolomic approach revealed the acupuncture exerting intervention effects by perturbed signatures and pathways.

Metabolomics can capture global changes and the overall physiological status in biochemical networks and pathways in order to elucidate sites of perturbations. High-throughput metabolomics and acupuncturology have similar characteristics such as entirety, comprehensiveness and dynamic changes, and can identify potential candidates for acupuncture effects and provide valuable information towards understanding therapy mechanisms. Saliva has recently gained popularity as a potential tool for biomarker monitoring, as its composition may potentially reflect plasma metabolite levels and, therefore, may be used as an indicator of the physiological state. However, the underlying mechanism of acupuncture, remains largely unknown, which hinders its widespread use. Acupuncture would produce unique characterization of metabolic perturbations. In this study, UPLC/ESI-HDMS in high-accuracy mode coupled with pattern recognition analysis was carried out to investigate the mechanism and saliva metabolite biomarkers for acupuncture treatment at 'Zusanli' acupoint (ST-36) as a case study. Putative metabolite identifications for these ions were obtained through a mass-based database search. As a result, the top canonical pathways including phenylalanine metabolism, alanine, aspartate and glutamate metabolism, d-glutamine and d-glutamate metabolism, and steroid hormone biosynthesis pathways were acutely perturbed. 26 differential metabolites were identified by chemical profiling, and may be useful to clarify the physiological basis and mechanism of ST-36. More importantly, network construction has led to the integration of metabolites associated with the multiple perturbation pathways. These results provide useful insights into biomarker discovery utilizing metabolomics as an efficient and cost effective platform. This study opens new possibilities for the selection of saliva as a source of metabolite biomarkers representative of specific disorders.

Dissection of Biological Property of Chinese Acupuncture Point Zusanli Based on Long-Term Treatment via Modulating Multiple Metabolic Pathways.

Acupuncture has a history of over 3000 years and is a traditional Chinese medical therapy that uses hair-thin metal needles to puncture the skin at specific points on the body to promote wellbeing, while its molecular mechanism and ideal biological pathways are still not clear. High-throughput metabolomics is the global assessment of endogenous metabolites within a biologic system and can potentially provide a more accurate snap shot of the actual physiological state. We hypothesize that acupuncture-treated human would produce unique characterization of metabolic phenotypes. In this study, UPLC/ESI-HDMS coupled with pattern recognition methods and system analysis were carried out to investigate the mechanism and metabolite biomarkers for acupuncture treatment at "Zusanli" acupoint (ST-36) as a case study. The top 5 canonical pathways including alpha-linolenic acid metabolism, d-glutamine and d-glutamate metabolism, citrate cycle, alanine, aspartate, and glutamate metabolism, and vitamin B6 metabolism pathways were acutely perturbed, and 53 differential metabolites were identified by chemical profiling and may be useful to clarify the physiological basis and mechanism of ST-36. More importantly, network construction has led to the integration of metabolites associated with the multiple perturbation pathways. Urine metabolic profiling might be a promising method to investigate the molecular mechanism of acupuncture.

Systems biology approach opens door to essence of acupuncture.

For World Health Organization proposed 'Health for All', we should be to promote the use of traditional medicine. Traditional Chinese acupuncture has a history over 3000 years and is effective in the treatment of many conditions with few side effects. Acupuncture, an intrinsic part of traditional Chinese medicine (TCM), which utilizes fine needles to pierce through specific anatomical points (called "acupoints"), has been extensively used and has emerged as an important modality of complementary and alternative therapy to Western medicine. It is vital and necessary to explore the underlying biological mechanisms of acupuncture. Systems biology has become practically available and resembles acupuncture in many aspects and is current key technology that serves as the major driving force for translation of acupuncture medicine revolution into practice, will advance acupuncture therapy into healthcare for individuals. High-throughput genomics, proteomics and metabolomics in the context of systems biology have been able to identify potential candidates for the effects of acupuncture and provide valuable information toward understanding mechanisms of the therapy. To realize the full potential of TCM acupuncture, we describe the current status of principles and practice of acupuncture integrated with systems biology platform in the post-genomic era. Some characteristic examples are presented to highlight the application of this platform in omics and systems biology approaches to acupuncture research and some of the necessary milestones for moving acupuncture into mainstream health care.

Ear acupressure, heart rate, and heart rate variability in patients with insomnia.

This high-tech "teleacupuncture study" describes a neurovegetative ear acupressure effect in patients with chronic insomnia by using heart rate variability analysis. Heart rate (HR) and heart rate variability (HRV) measurements in 31 patients (mean age ± SD: 54.3 ± 10.6 years) were performed under standardized conditions in Harbin, China, and the data analysis was performed in Graz, Austria. Similar to our previous clinical and basic teleacupuncture research works, the electrocardiograms (ECGs) were recorded by an HRV Medilog AR12 system during ear acupressure of the Shenmen point on the left ear. HR decreased significantly (P < 0.05) during and after acupressure stimulation. The effect was not visible after the first stimulation, rather it appeared in the phase following the second acupressure stimulation (10 min after the first stimulation). Total HRV showed significant stimulation-dependent increases (P < 0.05), immediately after each acupressure stimulation with a maximum after the third stimulation (20 min after the first stimulation), but there was no long-lasting effect. The present results can serve as a solid basis for the further investigations of auricular point stimulation for noninvasive complementary use in treating insomnia.

[Discussion on the safe angle and depth of acupuncture at Jiuwei (CV 15)].

OBJECTIVE: To observe the safe angle and depth of acupuncture at Jiuwei (CV 15) so that the reference data can be provided for the clinical safe acupuncture at the point. METHODS: Ten healthy adults of either sex were selected. MRI was applied to scan Jiuwei (CV 15) and obtain the images. The safe angle and depth were collected for the correlative analysis with the body height, body mass, body mass index (BMI), nipple distance and the finger measurement considered. RESULTS: There was no difference in the minimal dangerous angle of the horizontal needling to the right and the left between the male and the female. There was no difference in the dangerous depth of needling under the designed angle of needling between the male and the female. The safe depth of needling to the different directions: (16.99 +/- 2.86) mm for perpendicular needling, (22.72 +/- 5.35) mm for 45 degrees downward needling, (24.61 +/- 2.92) mm for 45 degrees upward needling, (53.47 +/- 5.72) mm for 15 degrees downward needling, (25.76 +/- 2.61) mm for 15 degrees upward needling, (24.89 +/- 4.34) mm for 45 degrees needling to the right, (21.79 +/- 3.84) mm for 45 degrees needling to the left, (51.19 +/- 2.69) mm for the needling at the minimal dangerous angle to the right, (51.86 +/- 2.59) mm for the needling at the minimal dangerous angle to the left. BMI was correlated to the minimal dangerous angle of the horizontal needling to either the right or the left, perpendicular needling, 45 degrees downward needling, 45 degrees needling to the right and 45 degrees needling to the left, as well as to the dangerous depth of needling at the minimal dangerous angle to either the right or the left. The body mass was relevant with the dangerous depth of perpendicular needling, 45 degrees downward needling and 15 degrees downward needling. CONCLUSION: For the horizontal needling to the right or the left, the minimal dangerous angle should be determined in reference to BMI. For the angle of needling measured in advance, the needling depth is not required to be identified in light of the sex. For the perpendicular needling, 45 degrees downward needling and 15 degrees downward needling, the needling depth should be optioned in accordance with the body mass. For the perpendicular needling, 45 degrees downward needling, 45 degrees needling to the right or to the left, as well as the needling at the minimal dangerous angle to either the right or the left, the needling depth should be determined in terms of BMI.

Biomedical Teleacupuncture between China and Austria Using Heart Rate Variability-Part 2: Patients with Depression.

It has been shown in previous studies that the autonomic nervous system can be affected by acupuncture. Within this study, teleacupuncture between China and Austria is used for quantifying the effects of heart rate (HR) and heart rate variability (HRV) in 33 Chinese patients (27 females, 6 males; mean age ± SD 49.5 ± 13.1 years; range 22-72 years) suffering from depression. Electrocardiographic signals before, during, and after acupuncture at the acupoint Baihui (GV20) were recorded in Harbin and analyzed in Graz using teleacupuncture. HRV data were analyzed in the time and frequency domain. Mean HR decreased significantly (P < 0.05) during and after acupuncture, whereas total HRV increased significantly after the third acupuncture stimulation period (P < 0.05) and also 5-10 minutes after (P < 0.05) acupuncture. The study shows that HRV could be a useful parameter for quantifying clinical effects of acupuncture on the autonomic nervous system.

Sino-European transcontinental basic and clinical high-tech acupuncture studies-part 2: acute stimulation effects on heart rate and its variability in patients with insomnia.

This second part of a series of Sino-European high-tech acupuncture studies describes the first clinical transcontinental teleacupuncture measurements in patients with insomnia. Heart rate (HR) and heart rate variability (HRV) measurements in 28 patients (mean age ± SD: 41.9 ± 14.6 years) were performed under standardized conditions in Harbin, China, and the data analysis was performed in Graz, Austria. Similar to the first part of the series, the electrocardiograms (ECGs) were recorded by an HRV Medilog AR12 system during acupuncture of the Shenmen point (HT7) on the left hand. HR decreased significantly (P < 0.001) during and after acupuncture stimulation of the HT7 acupuncture point. Total HRV increased significantly (P < 0.05) immediately after acupuncture stimulation, but there was no long-lasting effect. The values of the low-frequency (LF) and high-frequency (HF) band increased significantly after the stimulation compared to baseline values; however, the LF/HF ratio showed no significant changes. Together with the results of previous studies, the present results can serve as a solid basis for further development of acupressure or acupuncture stimulation equipment for complementary use in treating insomnia.

Biomedical Teleacupuncture between China and Austria Using Heart Rate Variability, Part 1: Poststroke Patients.

Background. Acupuncture has been reported to affect the human autonomic system. Within this pilot study, teleacupuncture between China and Austria is used for the first time for quantifying the effects of heart rate variability (HRV) in poststroke rehabilitation. Methods. In 29 Chinese post-stroke patients (15 f, 14 m; mean age ± SD 64.7 ± 11.3 years; range 40-80 years) electrocardiographic signals before, during, and after acupuncture at the acupoint Tongli (HT 5) were recorded in Harbin and analyzed in Graz using teleacupuncture via internet. HRV data were analyzed in the time and frequency domain, and a protocol from Austria was sent to the team in China immediately after the treatment and recording session. Results. Acupuncture does not change heart rate in the post-stroke patients; however, total HRV increased significantly (P < .05) during and 5-10 minutes after acupuncture. In addition, balance between sympathetic and parasympathetic activity (low frequency/high frequency HRV ratio) changes markedly during treatment. Conclusions. Based on innovative HRV analysis, it could be demonstrated that teleacupuncture between China/Harbin and Austria/Graz over a distance of about 8,500 km is no longer a future vision; it has become reality.

Effect of Haimiding on the functioning of red cell membrane of FC and H22 tumor-bearing mice.

AIM: To study the effect of Haimiding on the functioning of red cell membrane of FC and H(22) tumor-bearing mice. METHODS: The membrane fluidity of red cells is measured with DPH fluorescence probe as a marker; the amount of red cell membrane proteins is measured using polyacrylamide gel electrophoresis; the amount of sialic acid (SA) on the surface of red cell membrane and the sealability of these cells are measured using colorimetric analysis. RESULTS: Haimiding can lower the membrane fluidity of red cells in tumor-bearing mice and the amount of their membrane proteins, while increasing the amount of sialic acid in the membrane of red cells in these mice and enhancing the ability of the membrane of their red cells to reseal. CONCLUSION: The anti-tumor effect of Haimiding on tumor-bearing mice is due to its ability to improve and restore the functions of the membrane of their red cell and to enhance the immune effect of the organisms.