Phytochemistry and Antioxidant Activities of the Rhizome and Radix of Millettia speciosa Based on UHPLC-Q-Exactive Orbitrap-MS.

The root of Millettia speciosa Champ. (MSCP) is used in folk medicine and is popular as a soup ingredient. The root is composed of the rhizome and radix, but only the radix has been used as a food. Thus, it is very important to compare the chemical components and antioxidant activities between the rhizome and radix. The extracts were analyzed by UHPLC-Q-Exactive Orbitrap-MS and multivariate analysis, and the antioxidant activities were evaluated by 2,20-azinobis (3-ethylbenzothiazo-line-6-sulfonic acid) diammonium salt (ABTS) and 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging assays. Ninety-one compounds were detected simultaneously and temporarily identified. Ten compounds were identified as chemical markers to distinguish the rhizome from the radix. The antioxidant activities of the radix were higher than the rhizome. Correlation analysis showed that uvaol-3-caffeate, 3-O-caffeoyloleanolic acid, and khrinone E were the main active markers for antioxidant activity, which allowed for the rapid differentiation of rhizomes and the radix. Therefore, it could be helpful for future exploration of its material base and bioactive mechanism. In addition, it would be considered to be used as a new method for the quality control of M. speciosa.

Combination of stem cell therapy and acupuncture to treat ischemic stroke: a prospective review.

Stroke is the second leading cause globally that leads to severe disability and death. Stem cell therapy has been developed over the recent years to treat stroke and diminish the mortality and disability rate of brain injuries. Acupuncture, which can activate endogenous recovery via physical stimuli, has been applied to enhance the recovery and rehabilitation of stroke patients. Attempts have been made to combine stem cell therapy and acupuncture to treat stroke patients and have shown the promising results. This prospective review will look into the possible mechanisms of stem cell therapy and acupuncture and intend to undercover the potential benefit of the combined therapy. It intends to bridge the modern emerging stem cell therapy and traditional acupuncture at cellular and molecular levels and to demonstrate the potential benefit to improve clinical outcomes.

HyperCKemia associated with acupuncture: a case report and review of the literature.

BACKGROUND: Acupuncture therapy has been widely used as an alternative therapy to treat multiple diseases, such as sequelae of stroke, pain, facial paralysis and so on. In recent years, few adverse events related to acupuncture treatment have been reported, among which hematoma, bleeding and dizziness are the main manifestations. However, to date, there have been no existing cases reported the association between acupuncture therapy and asymptomatic/pauci-symptomatic hyperCKemia. CASE PRESENTATION: We report a patient who developed hyperCKemia during 5 sessions of acupuncture at different frequencies. After stopping acupuncture treatment for 1 month, follow-up showed a significant downward trend in serum creatine kinase (sCK). However, after that this patient started to get acupuncture treatment again in order to improve the sequelae of stroke. Meantime, the sCK rose again. CONCLUSION: HyperCKemia may associated with acupuncture therapy. All kinds of adverse events of acupuncture should be recorded comprehensively and objectively so as to improve the safety standard system of acupuncture therapy.

Evaluating the Effects of Acupuncture Using a Dental Pain Model in Healthy Subjects - A Randomized, Cross-Over Trial.

Acupuncture is a complementary and nonpharmacological intervention that can be effective for the management of chronic pain in addition to or instead of medication. Various animal models for neuropathic pain, inflammatory pain, cancer-related pain, and visceral pain already exist in acupuncture research. We used a newly validated human pain model and examined whether acupuncture can influence experimentally induced dental pain. For this study, we compared the impact of manual acupuncture (real acupuncture), manual stimulation of a needle inserted at nonacupuncture points (sham acupuncture) and no acupuncture on experimentally induced dental pain in 35 healthy men who were randomized to different sequences of all 3 interventions in a within-subject design. BORG CR10 pain ratings and autonomic responses (electrodermal activity and heart rate variability) were investigated. An initial mixed model with repeated measures included preintervention pain ratings and the trial sequence as covariates. The results showed that acupuncture was effective in reducing pain intensity when compared to no acupuncture (ß = -.708, P = .002), corresponding to a medium Cohen's d effect size of .56. The comparison to the sham acupuncture revealed no statistically significant difference. No differences in autonomic responses between real and sham acupuncture were found during the intervention procedures. PERSPECTIVE: This study established a dental pain model for acupuncture research and provided evidence that experimentally induced dental pain can be influenced by either real acupuncture or manual stimulation of needles at nonacupuncture points. The data do not support that acupoint specificity is a significant factor in reducing experimental pain.

[Effect of acupuncture at Renying (ST 9) on blood pressure in patients with ischemic stroke complicated with essential hypertension].

OBJECTIVE: To observe the effect of acupuncture at Renying (ST 9) on morning blood pressure, daytime peak blood pressure and 24-hour blood pressure load in patients with ischemic stroke complicated with essential hypertension. METHODS: A total of 80 patients (3 cases dropped off) were randomized into an observation group (39 cases) and a control group (38 cases). Xingnao Kaiqiao acupuncture and nifedipine were given in the control group. On the basis of treatment in the control group, acupuncture at Renying (ST 9) was applied in the observation group, once a day, 6 times a week for 4 weeks. The changes of morning blood pressure, daytime peak blood pressure and blood pressure load were observed before and after treatment in the two groups. RESULTS: Compared before treatment, morning blood pressure, daytime peak blood pressure and blood pressure load after treatment were reduced in the two groups (all P<0.05). The change of morning systolic pressure in the observation group was not significant as compared with that in the control group (P>0.05); the changes of morning diastolic pressure, daytime peak blood pressure and blood pressure load in the observation group were larger than those in the control group (all P<0.05). CONCLUSION: On the basis of Xingnao Kaiqiao acupuncture and nifedipine, acupuncture at Renying (ST 9) can effectively reduce morning blood pressure, daytime peak blood pressure and blood pressure load in patients with ischemic stroke complicated with essential hypertension.

[Effect of " Huoxue Sanfeng acupuncture" auxiliary therapy on morning blood pressure and blood pressure load in elderly patients with stroke complicated with hypertension].

OBJECTIVE: To observe the effects of "Huoxue Sanfeng acupuncture" auxiliary therapy on neurological function, blood pressure load and morning blood pressure in elderly patients with stroke complicated with hypertension, on the basis of "Xingnao Kaiqiao acupuncture" combined with nifedipine. METHODS: Seventy patients with stroke complicated with hypertension were randomly divided into an observation group and a control group, 35 cases in each group. "Xingnao Kaiqiao acupuncture" and conventional nifedipine controlled release tablets were given in the control group. Regarding regaining consciousness with acupuncture, the main acupoint is Shuigou (GV 26), combined with Neiguan (PC 6) and Sanyinjiao (SP 6), retaining needle for 20 min, additionally, the quick needling technique was applied to Shangjiquan (Extra), Chize (LU 5) and Weizhong (BL 40) of the affected side, nifedipine controlled release tablets were orally administered 30 mg once a day for a total of 6 weeks. The "Huoxue Sanfeng acupuncture" was added on the basis treatment in the observation group, the acupuncture was applied at Renying (ST 9) as the main acupoint, combined with Quchi (LI 11), Hegu (LI 4), Zusanli (ST 36) and Taichong (LR 3). The strict manipulation quantitative acupuncture was used and the needle was retained for 20 min. Both acupuncture methods were performed once a day, 5 times a week, and continued treatment at intervals of 2 days, 10 times for one course, and a total of 3 courses were needed. The morning blood pressure and 24 h blood pressure load were measured before and after treatment. The National Institute of Health stroke scale (NIHSS) score and the Barthel index (BI) classification were observed before and after treatment. RESULTS: The systolic and diastolic blood pressures were significantly lower than those before treatment in the two groups (all P<0.01), and the systolic and diastolic blood pressures in the observation group were lower than those in the control group (both P<0.01). There was no significant difference between the difference of systolic blood pressure before and after treatment in the two groups (P>0.05), and the difference of the diastolic blood pressure before and after treatment in the observation group was higher than that in the control group (P<0.01). The systolic and diastolic pressures load in the two groups were lower than those before treatment (all P<0.01), and the systolic and diastolic pressures load in the observation group were lower than those in the control group (both P<0.05), the difference of systolic and diastolic pressure load before and after treatment in the observation group were higher than those in the control group (both P<0.05). After treatment, the NIHSS scores in the two groups were lower than those before treatment (both P<0.01). The NIHSS scores in the observation group were lower than those in the control group (P<0.05). The difference of NIHSS scores before and after treatment in the observation group was higher than that in the control group (P<0.01). After treatment, the BI grading was better than that before treatment in the two groups (both P<0.05), and the BI grading in the observation group was superior to that in the control group (P<0.05). CONCLUSION: On the basis of "Xingnao Kaiqiao acupuncture" combined with nifedipine controlled release tablets in the treatment of elderly patients with stroke complicated with hypertension, "Huoxue Sanfeng acupuncture" can further improve the function of nerve and limbs, effectively reduce the morning blood pressure level of elderly patients, especially diastolic blood pressure, and significantly improve systolic blood pressure and diastolic blood pressure load.

Somatosensory Stimulation With XNKQ Acupuncture Modulates Functional Connectivity of Motor Areas.

Xingnao Kaiqiao (XNKQ) acupuncture is an acupuncture technique used for stroke patients. In 24 healthy volunteers, we applied this complex acupuncture intervention, which consists of a manual needle-stimulation on five acupuncture points (DU26 unilaterally, PC6, and SP6 bilaterally). XNKQ was compared to three control conditions: (1) insertion of needles on the XNKQ acupuncture points without stimulation, (2) manual needle-stimulation on five nearby non-acupuncture points, and (3) insertion of needles on the non-acupuncture points without stimulation. In a within-subject design, we investigated functional connectivity changes in resting-state functional magnetic resonance imaging (fMRI) by means of the data-driven eigenvector centrality (EC) approach. With a 2 × 2 factorial within-subjects design with two-factor stimulation (stimulation vs. non-stimulation) and location (acupuncture points vs. non-acupuncture points), we found decreased EC in the precuneus after needle-stimulation (stimulation

[Effect of Acupuncture Plus Moxibustion on Immune Function in Patients with Bra-chiocephalic Takayasu Arteritis].

OBJECTIVE: To observe the influence of acupuncture and moxibustion on humoral immunity and cellular immunity related indexes in patients with bra-chiocephalic Takayasu arteritis (BCTA), so as to explore its underlying mechanisms in the treatment of Takayasu arteritis (TA). METHODS: A total of 31 BCTA patients (9 men and 22 women at age of 16-70 years) were treated by manual acupuncture stimulation of main acupoint Renying(ST 9)and auxillary acupoints as Jiquan (HT 1), Chize (LU 5), Fengchi (GB 20), bilateral Xinshu (BL15), Feishu (BL 13) and Geshu (BL 17), Jingming (BL 1), etc. according to clinical symptoms, with the needles retained for 20 min. Additionally, moxibustion was applied to Taiyuan (LU 9), BL 15, BL 13 and BL 17. The treatment was conducted twice daily for 4 weeks. Serum IgG, IgA, IgM, IgE, C3 , C4 contents, and CD 3＋， CD 4＋， CD 8＋ T lymphocytes contents were assayed by using immue turbidimetry and cell counting. RESULTS: Before the treatment and in these 31 BCTA patients, an abnormal increase was found in serum IgG content in 10 cases, IgM in 3 cases, IgE in 3 cases, C3 in 11 cases, CD 4＋ in 6 cases, and CD 8＋ in 9 cases, and an abnormal decrease was found in serum CD 3＋ level in 11 cases, CD 4＋ in 7 cases, as well as CD 8＋ in 4 cases. After the treatment, the increased levels of IgG, IgM, C3, CD 4＋ and CD 8＋ in patients with abnormally higher values were considerably down-regulated (P<0.05), the decreased levels of CD 3＋， CD 4＋ and CD 8＋ in patients with abnormally lower values were evidently up-regulated (P<0.05). No significant changes were found in IgG, IgA, IgM, IgE, C3 and C4, CD 3＋ and CD 8＋ in patients with normal values of these indexes after the treatment (P>0.05). The CD 4＋ level in patients with normal value was significantly deun-regulated after the treatment (P<0.05), but still in the range of normal value. CONCLUSION: Acupuncture plus moxibustion can regulate some of the abnormally elevated and lowered humoral immunity and cellular immunity related indexes in BCTA patients, possibly having a favorable role in the treatment of BCTA.

Regulation of Hypertension for Secondary Prevention of Stroke: The Possible 'Bridging Function' of Acupuncture.

Worldwide, stroke is the leading cause of mortality and disability, with hypertension being an independent risk factor for a secondary stroke. Acupuncture for the treatment of hypertension gains more attention in alternative and complementary medicine, but the results are inconsistent. Few studies regarding the secondary prevention of stroke by managing hypertension with acupuncture have been carried out as there are some problems regarding the antihypertensive drug status in the secondary prevention of stroke. Still, the potential of acupuncture in regulating the blood pressure for secondary stroke prevention deserves our focus. This review is based on papers recorded in the PubMed, Embase, and Web of Science databases, from their inception until March 28, 2017, and retrieved with the following search terms: hypertension and acupuncture, limited in spontaneously hypertensive rats (SHRs), stress-induced (or cold-induced) hypertensive or pre-hypertensive models. We find that, in these hypertensive animals, acupuncture could mainly influence factors related to the nervous system, oxidative stress, the endocrine system, cardiovascular function, and hemorheology, which are closely associated with the stroke outcome. This trend may give us a hint that acupuncture might well participate in the secondary prevention of stroke through these pathways when used in the management of hypertension.

[Resuscitation acupuncture for thalamic pain:a randomized controlled trial].

OBJECTIVE: To compare the effects between resuscitation acupuncture and pregabalin for thalamic pain and their impacts on plasma P substance (SP) and ß-endorphin (ß-EP). METHODS: Sixty-four patients were randomly assigned into an acupuncture group and a western medication group, 32 cases in each one. Based on conventional western methods, pregabalin capsule was used orally in the western medication group, 75 mg a time,twice a day; resuscitation acupuncture was applied in the acupuncture group. The main acupoints were Shuigou (GV 26), Neiguan (PC 6), Sanyinjiao (SP 6). Patients with upper limb pain were attached affected Jiquan (HT 1), Chize (LU 5), and Hegu (LI 4); lower limb pain, affected Weizhong (BL 40), Zusanli (ST 36); hea-dache, bilateral Fengchi (GB 20), Wangu (GB 12), and Yifeng (TE 17), twice a day. Treatment was given 6 d a week for 8 weeks in the two groups. The changes of simplified McGill pain questionnaire (SF-MPQ), plasma SP and ß-EP were observed before and after 4-week, 8-week treatment, as well as at follow-up, namely, 3 months after treatment. Also, clinical effects were evaluated. RESULTS: The total effective rate of the acupuncture group was 50.0% (16/32) after 4-week treatment, which was similar to 46.9% (15/32) in the western medication group (P>0.05). While after 8-week treatment and at follow-up, the total effective rates of the acupuncture group were 90.6% (29/32) and 84.4% (27/32), which were better than 65.6% (21/32) and 40.6% (13/32) of the western medication group correspondingly (both P<0.05). After 4-week, 8-week treatment and at follow-up, the pain scores of the acupuncture group were lower than that before treatment (all P<0.05). After 4-week and 8-week treatment, the pain scores of the western medication group were lower than that before treatment (both P<0.05). After 8-week treatment and at follow-up, the pain scores of the acupuncture group were superior to thoseof the western medication group (both P<0.05). After 4-week and 8-week treatment,the contents of plasma SP reduced compared with those before treatment in the two groups (all P<0.05), and plasma ß-EP increased (all P<0.05). After 8-week treatment, SP content of the acupuncture group was apparently lower than that of the western medication group (P<0.05), and ß-EP increased more obviously (P<0.05). CONCLUSIONS: Resuscitation acupuncture can effectively relieve the symptoms of thalamic pain with stable and long-term effect, and it is better than pregabalin. Meanwhile, the acupuncture can increase ß-EP and reduce SP.

[A new textual criticism on block-printed edition of Zhenjiu Dacheng in the Ming dynasty].

It has always been considered that Zhenjiu Dacheng (Compendium of Acupuncture and Moxibustion) printed by ZHAO Wenbing is the earliest version. In comparative study, it is found that there are two versions in the Ming dynasty, one is the original, stored in the Library of China Academy of Sciences and another one is the revision, stored in the Library of Tianjin University of TCM, Zhejiang Provincial Library and the Library of China Academy of Chinese Medical Sciences. The last item, Chengjiang (CV 24) in the Acupoint Indication of Conception Vessel in volume 7 is included in the revised edition, but not covered in the original one, which is the difference between the two versions. Both of the versions were in the Ming dynasty, rather than the block-printed one in the Qing dynasty.

Efficacy and safety of the "Xingnao Kaiqiao" acupuncture technique via intradermal needling to treat postoperative gastrointestinal dysfunction of laparoscopic surgery: study protocol for a randomized controlled trial.

BACKGROUND: Xingnao Kaiqiao acupuncture involves needling of the Neiguan (PC6), Renzhong (DU26), and Sanyinjiao (SP6) acupoints. The technique has a significant clinical effect in many neurological diseases. In the present report, we have developed a protocol for a scientific trial to analyze whether Xingnao Kaiqiao can be used to treat gastrointestinal dysfunction after laparoscopic surgery. In this context, we intend to execute a double-blind, randomized controlled trial to assess the efficacy and safety of Xingnao Kaiqiao acupuncture via intradermal needling. METHODS/DESIGN: This will be a single-center, double-blind, randomized controlled clinical trial. It has been designed on the basis of the Consolidated Standards of Reporting Trials (CONSORT 2010) guidelines and the Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA). The subjects will be recruited from among inpatients scheduled for laparoscopic surgery at the Department of Minimally Invasive Surgery, Tianjin Nankai Hospital, Tianjin, China. Using random numbers generated in SPSS 19.0, the recruited subjects will be allocated to either the "Xingnao Kaiqiao" group or the sham stimulation group. A specially appointed investigator will be in charge of the randomization. Xingnao Kaiqiao via intradermal needling (or sham needling) will be administered 6 h after laparoscopic surgery, and then every 12 h for a total of six sessions, each of which will last 3 min. The subjects will undergo their first evaluation shortly before the first treatment (6 h after laparoscopic surgery); evaluations will be repeated every 12 h until a total of seven evaluations have been completed. The primary outcome will be the time until the first postoperative flatus. The secondary outcomes will be: the time until the first postoperative defecation; levels of abdominal pain, abdominal distension, and nausea; blood ghrelin level; occurrence of vomiting; psychological status; and quality of life. DISCUSSION: This upcoming randomized clinical trial was designed as a standardized method to assess the efficacy and safety of Xingnao Kaiqiao acupuncture using intradermal needles on PC6, DU26, and SP6 in the treatment of gastrointestinal dysfunction after laparoscopic surgery. We aim to provide evidence and thus improve the clinical application of this technique. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR-IOR-17010763 . Registered on 2 March 2017.

Acupuncture lowering blood pressure for secondary prevention of stroke: a study protocol for a multicenter randomized controlled trial.

BACKGROUND: Stroke is the prime cause of morbidity and mortality in the general population, and hypertension will increase the recurrence and mortality of stroke. We report a protocol of a pragmatic randomized controlled trial (RCT) using blood pressure (BP)-lowering acupuncture add-on treatment to treat patients with hypertension and stroke. METHODS: This is a large-scale, multicenter, subject-, assessor- and analyst-blinded, pragmatic RCT. A total of 480 patients with hypertension and ischemic stroke will be randomly assigned to two groups: an experimental group and a control group. The experimental group will receive "HuoXueSanFeng" acupuncture combined with one antihypertensive medication in addition to routine ischemic stroke treatment. The control group will only receive one antihypertensive medication and basic treatments for ischemic stroke. HuoXueSanFeng acupuncture will be given for six sessions weekly for the first 6 weeks and three times weekly for the next 6 weeks. A 9-month follow-up will, thereafter, be conducted. Antihypertensive medication will be adjusted based on BP levels. The primary outcome will be the recurrence of stroke. The secondary outcomes including 24-h ambulatory BP, the TCM syndrome score, the Short Form 36-item Health Survey (SF-36), the National Institute of Health Stroke Scale (NIHSS), as well as the Barthel Index (BI) scale will be assessed at baseline, 6 weeks and 12 weeks post initiating treatments; cardiac ultrasound, carotid artery ultrasound, transcranial Doppler, and lower extremity ultrasound will be evaluated at baseline and 12 weeks after treatment. The safety of acupuncture will also be assessed. DISCUSSION: We aim to determine the clinical effects of controlling BP for secondary prevention of stroke with acupuncture add-on treatment. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT02967484 . Registered on 13 February 2017; last updated on 27 June 2017.

Correction: Acupuncture with reinforcing and reducing twirling manipulation inhibits hippocampal neuronal apoptosis in spontaneously hypertensive rats.

[This corrects the article on p. 770 in vol. 12, PMID: 28616034.].

Acupuncture with reinforcing and reducing twirling manipulation inhibits hippocampal neuronal apoptosis in spontaneously hypertensive rats.

To observe the effects of different acupuncture manipulations on blood pressure and target organ damage in spontaneously hypertensive rats (SHRs), this study used the reinforcing twirling method (1.5-2-mm depth; rotating needle clockwise for 360° and then counter clockwise for 360°, with the thumb moving heavily forward and gently backward, 60 times per minute for 1 minute, and retaining needle for 9 minutes), the reducing twirling method (1.5-2-mm depth; rotating needle counter clockwise for 360° and then clockwise for 360°, with the thumb moving heavily backward and gently forward, 60 times per minute for 1 minute, and retaining needle for 9 minutes), and the needle retaining method (1.5-2-mm depth and retaining the needle for 10 minutes). Bilateral Taichong (LR3) was treated by acupuncture using different manipulations and manual stimulation. Reinforcing twirling, reducing twirling, and needle retaining resulted in a decreased number of apoptotic cells, reduced Bax mRNA and protein expression, and an increased Bcl-2/Bax ratio in the hippocampus compared with the SHR group. Among these groups, the Bcl-2/Bax protein ratio was highest in the reducing twirling group, and the Bcl-2/Bax mRNA ratio was highest in the needle retaining group. These results suggest that reinforcing twirling, reducing twirling, and needle retaining methods all improve blood pressure and prevent target organ damage by increasing the hippocampal Bcl-2/Bax ratio and inhibiting cell apoptosis in the hippocampus in SHR.

Acupuncture for Blood Pressure Control in Stroke Patients: Case Reports.

BACKGROUND: Effective control of hypertension is deeply associated with the secondary prevention of stroke. The blood pressure-lowering effect of acupuncture alone is controversial but worthy of exploration, considering the side effects of and the problems of low adherence to drugs. CASE REPORTS: One male patient experienced severe dizziness after overuse of valsartan, which decreased his blood pressure to 110/70 mm Hg. Our acupuncture treatment of 40 sessions alone regulated his blood pressure to about 110/70-130/80 mm Hg, with disappearance of the dizziness after 3 sessions. The second male patient with a suboptimal blood pressure during treatment with 50 mg/day of irbesartan received sole acupuncture treatment of 41 sessions, which decreased his blood pressure to about 120/70-130/80 mm Hg after 6 sessions. The third patient, who refused to take antihypertensive drugs because of their side effects, received acupuncture treatment of 46 sessions over 2 months, which reduced his blood pressure from 150/90 to 120/80 mm Hg. The efficacy continued for 3 months (cases 1 and 3) or 2 months (case 2) post treatment end. CONCLUSION: Our cases suggest the potential of acupuncture alone to favorably control high blood pressure or regulate low blood pressure in stroke individuals, as a means of secondary prevention of stroke.

[Discussion on different methods of painless needle insertion based on positions].

Based on multiple painless needle insertion skills in clinic combined with own experience, the authors propose the opinion that different painless needle insertion methods need to be used according to the positions where acupoints are. The appropriate needle insertion mean must be selected in accord with the anatomical characteristic of acupoint position, namely, tapping insertion is applied in scalp part, skin-pinching up needle insertion is used in forehead and superficial nerve trunk, fingernail-pressure needle insertion in ocular region and positions where large blood vessels distribute, flying acupuncture insertion in face and finger tip, vibrating needle in occipitonuchal region, quivering insertion in abdomen, quick pricking by single hand in the four limbs and back, and chop acupuncture in palm and pelma. The insertion methods are systematically discussed in terms of preparation, acupoint position, manipulation and attention, etc, so that to provide the reference for painless needle insertion.

Tongguan Liqiao acupuncture therapy improves dysphagia after brainstem stroke.

Tongguan Liqiao acupuncture therapy has been shown to effectively treat dysphagia after stroke-based pseudobulbar paralysis. We presumed that this therapy would be effective for dysphagia after bulbar paralysis in patients with brainstem infarction. Sixty-four patients with dysphagia following brainstem infarction were recruited and divided into a medulla oblongata infarction group (n = 22), a midbrain and pons infarction group (n = 16), and a multiple cerebral infarction group (n = 26) according to their magnetic resonance imaging results. All patients received Tongguan Liqiao acupuncture for 28 days. The main acupoints were Neiguan (PC6), Renzhong (DU26), Sanyinjiao (SP6), Fengchi (GB20), Wangu (GB12), and Yifeng (SJ17). Furthermore, the posterior pharyngeal wall was pricked. Before and after treatment, patient swallowing functions were evaluated with the Kubota Water Test, Fujishima Ichiro Rating Scale, and the Standard Swallowing Assessment. The Barthel Index was also used to evaluate their quality of life. Results showed that after 28 days of treatment, scores on the Kubota Water Test and Standard Swallowing Assessment had decreased, but scores on the Fujishima Ichiro Rating Scale and Barthel Index had increased in each group. The total efficacy rate was 92.2% after treatment, and was most obvious in patients with medulla oblongata infarction (95.9%). These findings suggest that Tongguan Liqiao acupuncture therapy can repair the connection of upper motor neurons to the medulla oblongata motor nucleus, promote the recovery of brainstem infarction, and improve patient's swallowing ability and quality of life.

Electroacupuncture induces acute changes in cerebral cortical miRNA profile, improves cerebral blood flow and alleviates neurological deficits in a rat model of stroke.

Electroacupuncture has been shown to improve cerebral blood flow in animal models of stroke. However, it is unclear whether electroacupuncture alters miRNA expression in the cortex. In this study, we examined changes in the cerebral cortical miRNA profile, cerebral blood flow and neurological function induced by electroacupuncture in a rat model of stroke. Electroacupuncture was performed at Renzhong (GV26) and Neiguan (PC6), with a frequency of 2 Hz, continuous wave, current intensity of 3.0 mA, and stimulation time of 1 minute. Electroacupuncture increased cerebral blood flow and alleviated neurological impairment in the rats. miRNA microarray profiling revealed that the vascular endothelial growth factor signaling pathway, which links cell proliferation with stroke, was most significantly affected by electroacupuncture. Electroacupuncture induced changes in expression of rno-miR-206-3p, rno-miR-3473, rno-miR-6216 and rno-miR-494-3p, and these changes were confirmed by quantitative real-time polymerase chain reaction. Our findings suggest that changes in cell proliferation-associated miRNA expression induced by electroacupuncture might be associated with the improved cerebral blood supply and functional recovery following stroke.

Is acupuncture no more than a placebo? Extensive discussion required about possible bias.

Numerous randomized controlled trials (RCTs) of acupuncture have been conducted in recent years. The results of several studies implied that acupuncture was only a powerful placebo; however, certain studies demonstrated that verum acupuncture had a greater effect than placebo and the mechanisms between a verum acupuncture group and a placebo/sham group were different. Researchers attempted to investigate the inherent factors that may potentially influence the results of trials. Certain problems observed in acupuncture RCTs also occurred in RCTs in other fields, including insufficient sample size, high dropout rates, inadequate follow-up and randomization. The study of acupuncture is so complex that specific methodological challenges are raised, which are frequently overlooked, including sham interventions, blinding, powerful placebo effects (even stronger than an inert pill) and variations in acupuncture administration. The aforementioned problems may contribute to bias, and researchers systematically attempt to solve these problems. The present review aimed to suggest techniques to design high-quality studies, minimize the placebo effect and optimize acupuncture administration in acupuncture studies. If these problems are addressed, then the results of acupuncture studies may be different.