Efficacy of electroacupuncture pretreatment for myocardial injury in patients undergoing percutaneous coronary intervention: A randomized clinical trial with a 2-year follow-up.

Electroacupuncture pretreatment (EAP) safely protects the heart from ischemic injury, however, the efficacy of EAP for periprocedural myocardial injury after percutaneous coronary intervention (PCI) remains unclear. Our aim was to investigate whether EAP prior to PCI reduces post-PCI myocardial injury in patients with coronary artery disease (CAD). 388 patients (≥ 18 years old) with CAD, undergoing elective PCI were enrolled and randomized, out of those 204 went through the whole trial. EAP was conducted by 30-minute electrical stimulation through 4 electrodes attached to the Antiguan (PC6) and Ximen (PC4) acupoints in the forearm bilaterally 1-2h prior to PCI. The control group had sham electrodes but no electrical stimulation. The primary end point was the incidence of myocardial infarction type 4a (MI4a) based on serum cTnI values at 24h after PCI. The secondary end points included post-procedural cardiac function and the major adverse cardiac/cerebrovascular event (MACCE) rate. EAP prior to PCI significantly reduced the incidence of MI4a (serum cTnI≥0.20 ng/mL) 24h post-PCI compared to the control group (P=0.004). The echocardiography at 6 months after PCI revealed significant improvement in cardiac function in the EAP group compared with the control group. The MACCE rate was significantly decreased in the EAP group at 24 month follow-up compared to the control group (P=0.0157). Moreover, multivariate logistic regression analysis showed that EAP was associated with decreased likelihood of MACCE (odds ratio 0.327, 95% CI 0.140-0.767, P=0.010). EAP prior to PCI significantly reduced cTnI release and protected patients with CAD from subsequent myocardial injury after PCI procedure.

Combination of HBO and Memantine in Focal Cerebral Ischemia: Is There a Synergistic Effect?

Hyperbaric oxygen (HBO) therapy and memantine, a non-competitive NMDA antagonist, are both promising treatment strategies for improving stroke prognosis. However, HBO's narrow therapeutic time window (<6 h post-stroke) and the adverse effect of high-dose MEM administration limits the use of these therapeutic interventions. In this study, we investigated whether or not MEM could prolong the narrow therapeutic window of HBO treatment. Transient focal cerebral ischemia was induced in male Sprague-Dawley rats by middle cerebral artery occlusion (MCAO) for 120 min. MCAO produced neurobehavioral deficits, increased infarction volume, increased Evans blue (EB) content and levels of pro-inflammatory factors, as well as depleted glutathione (GSH), and reduced catalase (CAT) and superoxide dismutase (SOD) activity in the ischemic ipsilateral hemisphere. The combination of 5 mg/kg MEM treatment 15 min after the onset of ischemic event and HBO therapy 12 h post-reperfusion significantly restored neurologic scores, EB concentration and IL-10 levels, as well as significantly decreased infarct volume and increased antioxidant activity. These results imply that the combination of MEM and HBO therapy not only prolongs the therapeutic window of HBO treatment, but also lowers the dosage requirement of MEM. The mechanism underlying the neuroprotective effects of the combined treatment may lie in alleviated blood-brain barrier (BBB) permeability, inhibited inflammatory response, and up-regulation of the antioxidant enzyme activity.

Cardioprotective effect of transcutaneous electric acupoint stimulation in the pediatric cardiac patients: a randomized controlled clinical trial.

BACKGROUND: Acupuncture pretreatment exerts neuroprotective and cardioprotective effects in animal models and in adult patients underwent cardiac surgery; however, data in pediatric patient are unavailable. OBJECTIVE/AIM: To investigate the effects of transcutaneous electric acupoint stimulation (TEAS) on acute myocardial injury from pediatric open-heart surgery. METHODS: Children, aged 2-12 years, with congenital heart defects scheduled for surgical repair were enrolled. They were randomized to TEAS (administrated at bilateral P6 acupoint for 30 min after basal anesthesia) and control (an electrode was placed on the arm without stimulus) groups. The primary end point was serum cardiac troponin I (cTnI) over 24 h after aortic unclamping. Furthermore, clinical outcome and serum cytokine and C-reactive protein concentrations were evaluated. RESULTS: Seventy eligible children were analyzed, 36 in controls and 34 in TEAS group. Compared with controls, the mean cTnI levels were significantly lower in TEAS group at 8 h (P = 0.043) and 24 h (P = 0.046) after aortic unclamping. The duration of ventilation (P = 0.004) and length of ICU stay (P = 0.032) was significantly longer in controls than in TEAS group. There was a significant difference in the release of C-reactive protein at 8 h (P = 0.039) between two groups, whereas the values for cytokines were not significant. CONCLUSION: Transcutaneous electric acupoint stimulation on the bilateral P6 acupoint is effective for attenuation myocardial injury in children undergoing cardiac surgery. The beneficial effects may be partially associated with reduction in cTnI and C-reactive protein level in the early postoperative period.

[Involvement of cerebral neuroglobin in electroacupuncture preconditioning-induced protection effect in cerebral ischemia-reperfusion rats].

OBJECTIVE: To observe the effect of electroacupuncture (EA) preconditioning on cerebral ischemia and the role of cerebral neuroglobin (NgB) in EA-induced brain protection in focal cerebral ischemia and reperfusion injury (CI/RI) rats. METHODS: Male SD rats were randomly assigned to sham control, CI/RI 6 h, CI/RI 24 h and CI/RI 72 h groups (n = 6) for observing changes of NgB at different time-points. Additional SD rats were randomly assigned to sham, model, and EA preconditioning (EA-PC) groups (n = 16) for observing changes of cerebral NgB positive cell counts in the ischemic penumbra region 24 h after reperfusion. EA pre-conditioning was applied to "Baihui" (GV 20) for 30 min, once daily for 5 days before CI/RI. CI/RI model was established by occlusion of the right middle cerebral artery and reperfusion for 6 h, 24 h and 72 h respectively. The neurological behavior scores (NBS) of all the rats were evaluated according to Garcia's methods. The cerebral infarct volume was determined by 2,3,5-triphenyltetrazolium chloride (TTC) staining. The number of cerebral NgB positive cells was detected by immunofluorescent staining. RESULTS: No infarct loci were found in the sham group. The cerebral infarction volume percentage was significantly higher in the model group than in the EA-PC group (P < 0.01), while the NBS was significantly lower in the model group than in the EA-PC group (P < 0.01). The number of cerebral NgB positive cells in the ischemic penumbra was up-regulated 6 h after CI/RI injury, peaked at 24 h and continued at 72 h. Compared with the sham group, the number of cerebral NgB positive cells of the model group was increased significantly, whereas that of the EA-PC group up-regulated further obviously in comparison with the model group (P < 0.01). CONCLUSION: EA pretreatment has a significant neuroprotective effect on cerebral ischemia-reperfusion, which is closely related to its effect in up-regulating NgB protein expression.

Hydrotalcite-derived MnxMg3-xAlO catalysts used for soot combustion, NOx storage and simultaneous soot-NOx removal.

The hydrotalcite-based Mn(x)Mg(3-x)AlO catalysts with different Mn:Mg atomic ratios were synthesized by coprecipitation, and employed for soot combustion, NOx storage and simultaneous soot-NO(x) removal. It is shown that with the increase of Mn content in the hydrotalcite-based Mn(x)Mg(3-x)AlO catalysts the major Mn-related species vary from MnAl(2)O(4) and Mg(2)MnO(4) to Mn(3)O(4) and Mn(2)O(3). The catalyst Mn(1.5)Mg(1.5)AlO displays the highest soot combustion activity with the temperature for maximal soot combustion rate decreased by 210 degrees C, as compared with the Mn-free catalyst. The highly reducible Mn(4+) ions in Mg(2)MnO(4) are identified as the most active species for soot combustion. For NO(x) storage, introduction of Mn greatly influences bulk NO(x) storage, with the adsorbed NO(x) species varying from linear nitrites to ionic and chelating bidentate nitrates gradually. The coexistence of highly oxidative Mn(4+) and highly reductive Mn(2+) in Mn(1.0)Mg(2.0)AlO is favorable to the simultaneous soot-NO(x) removal, giving a NO(x) reduction percentage of 24%. In situ DRIFTS reveals that the ionic nitrate species are more reactive with soot than nitrites and chelating bidentate nitrates, showing higher NO(x) reduction efficiency.

[Effect of scalp acupuncture on glucose metabolism in brain of patients with depression].

OBJECTIVE: To observe the effect of scalp acupuncture (SA) on the glucose metabolism in different regions of brain in patients with depression by positron emission computed tomography (PET). METHODS: Twelve depressive patients were treated by scalp acupuncture on middle line of vertex (MS5), middle line of forehead (MS1) and bilateral lateral line 1 of forehead (MS2), once a day for six days per week, and received PET detection on different region of brain before and after 6 weeks acupuncture treatment. Semiquantitative analysis was used to compare the average values of radioactive count gotten from various brain regions before and after treatment, which could reflect the condition of glucose metabolism at the brain region detected. RESULTS: SA could increase the glucose metabolism at bilateral frontal lobes, bilateral parietal lobes, right occipital lobe, right caudate nucleus, right cingulated gyrus and left cerebellum and decrease that at right temporal lobe and bilateral thalamus. CONCLUSION: SA on MS5, MS1 and MS2 in depressive patients could influence the glucose metabolism in various brain regions. It primarily illustrated that the mechanism of SA in treating depression is related with its regulation on cortex-limbic circuitry dysfunction and increase the glucose metabolism in various brain regions.