[Effect of deep needling "Tianshu" (ST25) on colonic motility in rats with slow transit constipation].

OBJECTIVE: To observe the effect of acupuncture of "Tianshu"(ST25) at different depths on colonic transportation function, expressions of colonic substance P (SP) and interstitial cells of Cajal (ICC) in rats with slow transit constipation (STC), so as to explore its mechanisms underlying improvement of STC．. METHODS: Fifty male Wistar rats were selected and randomly divided into control，STC model，conventional acupuncture，deep needling group 1 and deep needling group 2 groups，with 10 rats in each group．The STC model was established by gavage of 1 mg/mL compound diphenoxylate suspension (10 mg/kg), once every other day for 21 days, and rats of the control group were given the same dose of distilled water by gavage．EA (2 Hz, 2 mA) was applied to "Tianshu"(ST25), with the acupuncture needle inserted to a depth of 3 mm for rats of the conventional acupuncture group, 4.5 mm for those of deep needling group 1, and 10 mm for those of the deep needling group 2. The acupuncture needle was twirled for 1 min, then retained for 15 min each time, once a day for 15 consecutive days．Following modeling, rats of the 4 groups and the control group received gavage of active carbon 2 mL (100 g/L) for observing the excretion time of the first black stool grain to assess the intestinal transit function. The colonic myoelectric activities (frequency and amplitude) were recorded by using BIOPAC multichannel physiograph. The immunoactivity of SP and c-kit (a transmembrane protein kinase for identification of ICC) of colonic musculature was detected by immunohistochemistry. RESULTS: Compared with the control group，the time of excretion of the first black stool grain, and the amplitude of colonic electromyogram (EMG) were significantly increased (P<0.01), while the frequency of EMG, expressions of SP and c-kit (ICC) were significantly decreased in the model group (P<0.01). In contrast to the model group, both deep needling group 1 and 2 had a decrease in the time of excretion of the first black stool grain, and amplitude of intestinal EMG, and an increase of frequency of intestinal EMG, and immunoactivity of SP and c-kit (P<0.01). The effect of deep needling 2 is superior to that of deep needling 1 in reducing the time of excretion of the first black stool grain (P<0.05), lowering the amplitude of EMG of the gut smooth muscle (P<0.05) and in increasing the frequency of EMG (P<0.05) and the expressions of SP and c-kit (P<0.05). No significant changes were found in the levels of frequency and amplitude of EMG, and expressions of SP and c-kit after routine needling in comparison with the model group (P>0.05), except the excretion time of the first black stool grain (P<0.05). CONCLUSION: Deep needling at ST25 at depth of 4.5 mm and 10 mm，especially at depth of 10 mm，has a significant effect in promoting gut motility to ameliorate constipation in rats with STC, which may be related to its function in up-regulating the expressions of SP and ICC activity.

[Effect of electroacupuncture of "Tianshu"(ST25) at different frequencies on electromyography and immunoactivity of SP and VIP of colon in rats with slow transit constipation].

OBJECTIVE: To observe the effect of electroacupuncture (EA) of bilateral "Tianshu"(ST25) at different frequencies on the first black stool discharge time, colonic electromyography (EMG) and immunoactivity of vasoactive intestinal peptide (VIP) and substance P (SP) in the colon tissue in rats with slow transit constipation (STC), so as to choose a better stimulating frequency in the treatment of STC. METHODS: A total of 50 male Wistar rats were randomized into control, model, 2 Hz-EA, 100 Hz- EA, and 2 Hz/100 Hz-EA groups, with 10 rats in each group. The STC model was established by intraperitoneal injection of compound diphenoxylate suspension fluid (10 mg/kg). EA was applied to bilateral ST25 for 30 min, once a day for 14 consecutive days. The discharge time for the first black stool was recorded after gavage of mixed suspension fluid of active carbon (2 mL) for assessing the gastrointestinal motility. The colonic EMG was recorded by using a pair of silver electrodes and bioelectric amplifier. The expression of SP and VIP in the colonic tissue was detected by immunohistochemistry. RESULTS: Following mode-ling, the colonic EMG amplitude, the discharge time for the first black stool and VIP immunoactivity were significantly increased (P<0.01), and the EMG frequency and SP immunoactivity were significantly decreased （P<0.01） in the model group compared with the control group. Compared with the model group, the increase of the discharge time for the first black stool, EMG amplitude and VIP immunoactivity, the decrease of EMG frequency and SP immunoactivity were reversed in the 3 EA groups (P<0.01, P<0.05). The therapeutic effect of 100 Hz-EA was notably weaker than that of both 2 Hz-EA and 2 Hz/100 Hz-EA in up-regulating EMG frequency and SP immunoactivity and in down-regulating the discharge time for the first black stool, EMG amplitude and VIP immunoactivity (P<0.05, P<0.01). There was no significant difference between the 2 Hz/100 Hz-EA and 2 Hz-EA groups (P>0.05). CONCLUSION: EA can accelerate colonic EMG activities, which may be associated with its functions in down-regulating VIP immunoactivity and up-regulating SP immunoactivity in the colonic tissues. The therapeutic effects of 2 Hz/100 Hz-EA and 2 Hz-EA are better than that of 100 Hz-EA.

Safety of Thread Embedding Acupuncture Therapy: A Systematic Review.

OBJECTIVE: To evaluate the safety of thread embedding acupuncture therapy (TEAT) and discuss the prevention and treatment of some adverse events (AEs). METHODS: Review of databases, including China National Knowledge Infrastructure (CNKI), CBMdisc, Wanfang, VIP databases and English literature published in PubMed, MEDLINE, EMBASE and Web of Science, were searched from their inception to January 2020, randomized controlled trials (RCTs) and case reports in which AEs with TEAT were included. Cochrane Collaboration's tool and RevMan V.5.3.3 software were used to evaluate the quality of the studies. RESULTS: A total of 61 studies (45 RCTs and 16 case reports) with 620 cases of AEs were included in this review. These studies were published in two countries: China and South Korea. Twenty eight kinds of AEs were summarized. The most common AEs were induration, bleeding and ecchymosis, redness and swelling, fever, and pain. They were accounted for 75.35% (425/564) in the review, and most of them were mild. The rarest AEs were epilepsy, irregular menstruation, skin ulcer, thread malabsorption, and fat liquefaction, with 1 case each. But not all of them had clear causal relationship with TEAT. Most of the AEs were local reactions [with incidence of 9.83% (480/4,882)] and systemic reactions accounted for only 1.27% (62/4,882). Although the included studies showed that AEs were very commonly encountered (11.09%), only 5 cases of severe AEs reported from 2013 to 2017 (0.1%) by using catgut thread, which are rarely seen nowdays with the wide use of new absorbable surgical suture. All of the severe AEs were recovered after symptomatic treatment with no sequelae. CONCLUSIONS: The evidence showed that TEAT is a relatively safe and convenient therapy especially since application of new absorbable surgical suture. Improving practitioner skills, regulating operations, and paying attention to the patients' conditions may reduce the incidence of AEs and improve safety of TEAT.

[Influence of Electroacupuncture Intervention on Glutamic Acid and Ca2+ Contents and Expression of NMDA Receptor Protein in Hippocampus in Vascular Dementia Rats].

OBJECTIVE: To observe the influence of electroacupuncture (EA) intervention on hippocampal glutamate (Glu) and Ca2+ contents, and expression of Glu-N-methyl-D-aspartic acid receptor(NMDAR) and the learning-memory ability in vascular dementia (VD) rats, so as to reveal its mechanisms underlying improvement of VD. METHODS: SD rats were rando-mized into sham operation (sham) group (n=9), model group (n=11) and EA groups (n=10). The VD model was established by repeated bilateral common carotid arteries occlusion and reperfusion plus intraperitoneal injection of sodium nitroprusside. EA (2 Hz, 2 mA) was applied to "Baihui" (GV 20)-"Housanli" (ST 36) and "Geshu" (BL 17)-"Dazhui" (GV 14) for 10 min, once a day for 15 consecutive days. The neurological function was assessed by using stroke index (0-10 points) and neurological deficit scaling(0-10 points). The learning-memory ability was evaluated by using step-down tests. The contents of Glu and Ca2+ in the right hippocampal tissue were determined by using aspectrophotometer and the expression of NMDAR protein in the right hippocampus was detected by immunoblotting. RESULTS: Compared with the sham group, the stroke index and neurological deficit scores, and the reaction latency and the error times of step-down tests, as well as the contents of Glu and Ca2+ and the expression level of NMDAR in the right hippocampus were significantly increased in the model group (P<0.05, P<0.01), while the step-through latency was considerably decreased (P<0.01), suggesting a neurological disorder and a cognitive decline. After EA intervention, the reaction latency and error times of step-down tests, the contents of Glu and Ca2+ and the expression level of NMDAR in the right hippocampus were significantly down-regulated, and the step-through latency was notably increased in comparison with the model group (P<0.01). CONCLUSIONS: EA intervention is able to improve the cognitive ability of VD rats, which may be associated with its effects in reducing the excitatory neurotoxicity of hippocampal Glu-NMDAR and lowering cellular Ca2+ load to resist neuronal injury.

[Effect of electroacupuncture intervention at different time-points of post-modeling on hippocampal monoamine neurotransmitter levels in mice with vascular dementia].

OBJECTIVE: To observe the effect of electrocupuncture (EA) intervention at different time-points of post-modeling on behavior and hippocampal monoamine neurotransmitter noradrenalin (NE), dopamine (DA) and 5-hydroxytrypamine (5-HT) contents in vascular dementia (VD) mice, so as to study its mechanism underlying improvement of VD. METHODS: A total of 60 Kunming mice were randomized into sham-operation control (n = 20), VD model (n = 20), EA-day (D)-1 (EA treatment was given from the 1st day on after modeling, n = 10), EA-D-3 (EA was given from the 3rd day on after modeling, n = 10) groups. VD model was established by occlusion of the bilateral cervical common arteries and reperfusion. EA (2 Hz/80 Hz) was applied to "Baihui" (GV 20), "Dazhui" (GV 14),"Zusanli" (ST 36) and "Geshu"(BL 17) for 10 min, once daily for 15 days. Hippocampal NE, DA and 5-HT contents were assayed by fluorospectrophotometry. The mouse's learning-memory ability was assessed by step-down tests. RESULTS: In comparison with the sham-operation control group, the learning-memory ability (marked increase of reaction time and error times, decrease of step-down latency) was apparently lowered in the model group (P < 0.01). The hippocampal NE, DA and 5-HT contents were significantly lower in the model group than in the sham-operation group (P < 0.01). Compared with the model group, the mice's learning-memory ability (marked decrease of reaction time and error times, increase of step-down latency) was significantly increased in EA intervention groups (P < 0.01), and hippocampal NE, DA and 5-HT levels were significantly increased (P < 0.01), and the effect of EA-D-3 group was obviously better than that of the EA-D-1 group (P < 0.05, P < 0.01). CONCLUSION: EA can improve the VD mice's learning-memory ability, which is closely related to its effects in up-regulating hippocampal NE, DA and 5-HT contents, and the effect of later EA intervention after modeling is better.

[Acupoint catgut-embedding therapy: superiorities and principles of application].

OBJECTIVE: To analyze the superiorities of acupoint catgut-embedding therapy, discuss its law of clinical application and provide scientific decision-making for clinical treatment. METHODS: Literatures on acupoint catgut-embedding therapy in the recent 40 years were selected, input, examined and verified, picked up and analyzed by establishing database with the modern computer technology. RESULTS: (1) One thousand and seventy-five literatures were input. It shows that the acupoint catgut-embedding therapy has an extensive application in all departments, especially in the internal department, accounting for 48.54% (50/103) of the total disease category. It has the most extensive application on treatment of epigastric pain, with the frequency of 102 times, and obesity of 74 times. The next is surgery, accounting for 14.56% (15/103). The major application is on low back pain and leg pain with the frequency of 79 times. Psoriasis, with the frequency of 30 times, holds the major application in dermatological department. And blepharoplasty, with the frequency of 30 times, gains the most application in department of ophthalmology and otorhinolaryngology. (2) In the included literatures, selection of adjacent acupoints and distal acupoints are held as the major method of acupoint selection. The adjusted lumbar puncture needle is taken as the major tool for the acupoint catgut-embedding therapy. And catguts of different sizes are adopted for the operation. (3) Analysis of the therapeutic effect shows that acupoint catgut-embedding therapy has obvious effect in all departments, especially in surgery and dermatology, with the total effective rate over 90%. CONCLUSION: Epigastric pain, obesity, epilepsy, asthma, abdominal pain, facial paralysis and constipation of the internal medicine, low back pain and leg pain of the surgical department, psoriasis of the dermatological department and blepharoplasty of the department of ophthalmology and otorhinolaryngology are considered as the dominant diseases for acupoint catgut-embedding therapy.

[Analysis on characteristics and regularities of efficacies of acupoint injection by using data mining technique].

OBJECTIVE: To analyze the potential learning and regularity characters of clinical application of acupoint injection in modern literature of Chinese medicine by using data mining technique, so as to provide a reference for clinical application of this therapy. METHODS: A database was established first by computer recording of the standardized information data after collection of papers about acupoint injection therapy published in modern medical journals, collections of theses of medical academic conferences, dissertations for medical master's and doctor's degrees. Then, the data mining technique was employed to conduct cross link design about the types or categories of illnesses or clinical conditions, categories of departments, selection of Chinese materia medica, acupoint recipes, and clinical outcomes, etc. At last, the rules and characteristics of the acupoint injection were summarized and analyzed. RESULTS: The acupoint injection therapy enjoys the first rank of therapies for the treatment of diseases or clinical conditions of the internal medicine, and the second rank in the treatment of surgical problems. With respect to the types of illnesses or clinical conditions, it is used most frequently for hiccup and backlog pain. Generally, about 4 acupoints and 2 categories of medicines (Chinese herbal medicine or western medicine preparations) are selected in one session of treatment by using the acupoint injection therapy. The acupoints used are those close to and remote to the loci. The drugs predominately employed are single or compound western medicine preparations. The total effective rate is up to more than 93%. CONCLUSION: The acupoint injection therapy has some obvious advantages in the treatment of clinical conditions or illness of the internal medicine and surgical problems, especially for hiccup and backlog pain. It is simple in clinical application and has a higher therapeutic effect.

[Comparative study on therapeutic effect between SXDZ-100 and SDZ-II on chronic functional constipation].

OBJECTIVE: To compare the therapeutic effects between the Hwato neuro and muscle stimulator (SXDZ-100) and the regular electronic stimulator (SDZ-II) on chronic functional constipation. METHODS: Sixty-four cases of chronic functional constipation were randomly divided into a (SXDZ-100) observation group (n = 33) and SDZ-II control group (n = 31). For the SXDZ-100 group, under the considerations of patients' endurance, Zhigou(TE 6) and Tianshu (ST 25), Zusanli (ST 36) and Shangjuxu (ST 37) were punctured and then the courle of acupoints on the same side were connected with SXDZ-100 apparatus in reinforcing and reducing by twirling and rotating manipulation wave for 30 min, while in the control group SDZ-II apparatus was applied in the same way mentioned above with disperse-dense wave at frequency of 1Hz/20Hz for 30 min. By means of clinical therapeutic effect evaluation and clinical symptom score, the contrast between two groups can be made. RESULTS: Although the total effective rates were both 100.0%, the rate of short term effects in SXDZ-100 group (54.6%, 18/33) is significantly higher than that in SDZ-II group (29.0%, 9/31) (P < 0.05). After the treatment, the clinical symptom scores in both groups decreased significantly (both P < 0.05). And the therapeutic effective indices of the SXDZ-100 group were significantly higher than those of the SDZ- II group (P < 0.05). CONCLUSION: The therapeutic effect of Hwato neuro and muscle stimulator (SXDZ-100) on chronic functional constipation is superior to that of a regular electronic stimulator (SDZ-II).

[Basic rules and characteristics of acupoint application therapy based upon data mining].

OBJECTIVE: To analyze the basic characteristics of effects of acupoint application therapy in order to guide clinical decision better. METHODS: A database on acupoint application therapy was established first by collection, sorting, screening, recording, collation, data extraction, and statistical analyses of the related literature published in recent 60 years, and using modern computer system. Then, its predominant indications and application rules in clinical practice were analyzed using data mining techniques. RESULTS: Outcomes of data mining showed that the acupoint application therapy was extensively utilized in the treatment of a variety of diseases or clinical conditions (142 in total) in different clinical departments, particularly in the internal medicine which contains 51 types of clinical conditions or diseases (accounting for 35.92%). Among them, the top 3 are asthma, cough, and abdominal pain, with the appearance frequency being 161, 79 and 45 times (= articles) in the domestic journals, respectively. The second one is the paediatric department, containing 30 kinds of diseases or clinical conditions (accounting for 21.13%). Among them, cough (106 articles), asthma (104 articles) and diarrhoea (82 articles) are frequently seen. The surgery department takes the third place, involving 27 disorders (accounting for 19.01%), with lumbago-leg pain being the most (31 articles). In the departments of ophthalmology and otorhinolaryngology, 14 types of disorders (accounting for 9.86%) have been reported, with nasosinusitis being the most (56 papers). This therapy has also been used to treat 10 types of gynecopathy (7.04%) and 10 kinds of dermopathy (7.04%), with dysmenorrhea (37 articles) and shingles (6 articles) being the most. For acupoint application, complex prescriptions of Chinese herbal medicines in the forms of paste and cataplasm are frequently adopted, but with fewer application of enhancer of cutaneous penetration. Regarding the utilized acupoint, local points are often chosen. In the light of the collected papers, the highest effective rate is for dermopathy, followed by surgical problems, gynecopathy, paediatric conditions, and disorders of the internal medicine, ophthalmology and otorhinolaryngology. CONCLUSION: Acupoint application therapy has been used for 142 kinds of disorders of different clinical departments, with the dominant indications being asthma, cough, abdominal pain, facial paralysis and constipation in the internal medicine, cough, asthma and diarrhoea in the paediatrics, lumbago-leg pain in the surgery, nasosinusitis in the otorhinolaryngology, and dysmenorrhea of gynecopathy.

Clinical study on auricular acupoint penetration needling along the skin for treatment of a variety of pain syndrome and dysfunction.

This paper is a summary of clinical studies on auricular acupoint penetration needling along the skin for treatment of pain and dysfunction in recent 10 years. Auricular acupoint penetration needling along the skin was used to observe rapid analgesic effects and clinical efficacy on cervical spondylopathy, periarthritis of shoulder, pain in waist and lower extremities, migraine, and other peripheral neuropathic pain, and stroke sequels, soft tissue injury, and so on. Self-control method was used in the studies at the first stage, and clinically randomized control trial methodwas used for systematic comparison with other therapies at the second stage. Results indicated that the auricular acupoint penetration needling along the skin had obviously clinical effects on cervical spondylopathy, periarthritis of shoulder, pain in waist and lower extremities, migraine, soft tissue injuries and stroke sequels, with a better rapid analgesic effect as compared with ear perpendicular needling method.

[Research on characteristics of different clinical conditions treated by red-hot acupuncture needle based on data mining needle].

OBJECTIVE: To analyze the regularities and characters of clinical application of red-hot needle therapy in ancient and modern literature of Chinese medicine by using data mining techniques, so as to provide a reference for study on the specificity of efficacy of red-hot needle therapy. METHODS: Sample data was collected from some medical books, medical cases, reports of modern journals for calculating frequent item sets by using methods of association rules of data mining. Then, the collected data was extracted, sorted out, and summed up by using our newly developed literature database platform of red-hot needle therapy in order to find out the most suitable indications of this therapy in clinical practice. RESULTS: A total of 6 categories of clinical conditions treated by red-hot needle therapy were found. Among them, the frequency times (percentages) of red-hot needle application for surgical problems appeared in journals, medical cases and medical books are 287 times (49.83%), 235 times (48.96%), 154 times (41.73%), respectively. The frequency times of red-hot needle application for disorders of internal medicine and dermatology are 276 times and 360 times. Among the 115 categories of clinical conditions or diseases treated by red-hot needle appeared in journals, arthromyodynia and struma are frequently found, with the frequency being 115 and 46 times, separately. The total effective rates of the present therapy from higher to lower are 99.46% for pediatric problems, 98.65% five sensory organs department, 97.32% surgery, 96.66% dermatology, 96.34% gynecology, and 93.95% internal medicine, respectively. Among the 97 types of clinical conditions recorded in the literature on medical cases, aural verruca is more frequently seen apart from arthromyodynia and struma. In medical books, 94 types of clinical conditions treated by red-hot needle therapy are found, including 32 types of problems of internal medicine. CONCLUSION: Data mining results show that red-hot needle therapy has been widely used in different clinical departments, and more frequently used in surgery (mainly orthopedic and general surgery), internal medicine (mainly neurology and gastroenterology), dermatology.