[The objectification of ashi point diagnosis and treatment].

Ashi points play a significant role in the clinical localization and qualitative diagnosis of acupuncture, as well as in selecting acupoints along the meridians and applying tonifying or reducing techniques. This paper introduces the theoretical basis and existing technical methods of objectification of ashi point diagnosis and treatment. It proposes that using sensory quantitative testing to determine the temperature and tenderness thresholds of ashi points could help to identify the pathological characteristics of "cold" "heat" "deficiency" or "excess" of ashi points. In addition, the possibility of objectification of ashi point diagnosis-treatment plan is explored from three perspectives, precision of selection of ashi point therapy, objectification of effect evaluation of ashi point analgesia, and differentiation of the studies on ashi point analgesic mechanism, aiming to provide new research ideas for the modernization of traditional Chinese acupuncture.

Ultrasound-guided acupotomy for trigger finger: a systematic review and meta-analysis.

BACKGROUND: Trigger finger is a common condition in the hand, and ultrasound-guided acupotomy for trigger finger has been widely used in recent years. PURPOSE: This study aims to investigate the efficacy and safety of ultrasound-guided acupotomy for trigger finger. METHODS: We searched for relevant studies in the Cochrane Library, China National Knowledge Infrastructure (CNKI), Embase, PubMed, Chinese Biomedical Literature Database (CBM), Wanfang Data, and other resources from their inception to January 2023. Randomized controlled trials of ultrasound-guided acupotomy for trigger finger were included. The meta-analysis was carried out using Review Manager 5.4 and Stata 15.1. RESULTS: Overall, 15 studies with 988 patients were included. The experimental group was treated with ultrasound-guided acupotomy, and the Control group received traditional acupotomy, traditional operation or injection of medication. Meta-analysis showed that the overall clinical effectiveness (OR = 4.83; 95% CI 2.49-9.37; I2 = 73.1%; P < 0.001) in the experimental group was significantly better than that of the control group. And the Visual Analogue Scale (VAS) score (WMD = - 1; 95% CI - 1.24, - 0.76; I2 = 99%; P < 0.001), the QuinneII classification (WMD = - 0.84; 95% CI - 1.28, - 0.39; I2 = 99.1%, P < 0.001), the incidence of complications (RR = 0.26; 95% CI 0.11, 0.63; I2 = 0%, P = 0.003), and the recurrence rate (RR = 0.14; 95% CI 0.03, 0.74; I2 = 0%; P = 0.021) were significantly lower in the experimental group. CONCLUSION: Our systematic review and meta-analysis can prove the effectiveness and safety of ultrasound-guided acupotomy in the treatment of trigger finger, but this still needs to be verified by a clinical standard large sample test.

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.

[Professor CHEN Gui-zhen's experience of acupuncture for perimenopausal panic disorder].

Professor CHEN Gui-zhen's experience of acupuncture for perimenopausal panic disorder was summarized. Professor CHEN believes that the etiology and pathogenesis of perimenopausal panic disorder are the deficiency of congenital kidney essence and the injury of acquired spleen and stomach, leading to mental dysfunction. The clinical treatment should be based on the principle of "nourishing the congenital, tonifying the acquired, and regulating thoroughfare vessel and conception vessel". As for the acupoint selection, the combination of back-shu point and the front-mu point is valued; as for the acupuncture technique, quick needling and skillful application of catgut embedding are recommended. The combination of acupuncture and medicine shows synergistic effect. In addition, emotional therapy is also applied for this condition. In conclusion, it is advocated to treat perimenopausal panic disorder with the combination of acupuncture, catgut embedding, herbs and emotional therapy.

[The key issues and corresponding strategy of acupoint medicated catgut embedding therapy].

Acupoint medicated catgut embedding therapy is a new type of acupuncture combined with medicine，which has great potential in the prevention and treatment of chronic diseases. This paper describes the clinical application of acupoint medicated catgut embedding in the treatment of common disease, medicated thread productionmethods and acupoints selection.To analyze the problems of the unclear mechanism, the lack of standardization of medicated thread production, the lag of the embedding tool, and the unclear adverse reaction. It is expected to promote the further development of acupoint medicated catgut embedding therapy by strengthening the mechanism of action, optimizing medicated catgut thread, rational design experiments, standardizing medicated thread production, innovating embedding tools, rational formulation, and optimizing acupoint selection.

Ventricular hypertrophy abrogates intralipid-induced cardioprotection by alteration of reperfusion injury salvage kinase/glycogen synthase kinase 3ß signal.

Recent studies have demonstrated that intralipid (ILP) conferred myocardial protection against ischemia-reperfusion (IR) injury through activation of reperfusion injury salvage kinase (RISK) pathway. As RISK signal has been shown to be impaired in hypertrophied myocardium, we investigated whether ILP-induced cardiac protection was maintained in hypertrophied rat hearts. Transverse aortic constriction was performed on male Sprague-Dawley rats to induce left ventricular hypertrophy, then sham-operated or hypertrophied rat hearts were isolated and perfused retrogradely by the Langendorff for 30 min (equilibration) followed by 40 min of ischemia and then 120 min of reperfusion. The isolated hearts received 15-min episode of 1% ILP separated by 15 min of washout or three episodes of 5-min ischemia followed by 5-min reperfusion before ischemia. The hemodynamics, infarct size, apoptosis, phosphorylated protein kinase B (p-Akt), phosphorylated extracellular regulated protein kinase 1/2 (ERK1/2), phosphorylated glycogen synthase kinase 3ß (GSK3ß), Bcl-2, phosphorylated Bad, and Bax were determined. We found that ILP significantly improved left ventricular hemodynamics and reduced infarct size and the number of TUNEL (terminal deoxynucleotidyl transferase dUTP nick end labeling)-positive cells in the sham-operated rat hearts exposed to IR. However, such myocardial infarct-sparing effect of ILP was completely blocked by phosphatidylinositol-3-kinase inhibitor wortmannin, but only partially by mitogen-activated protein kinase kinase inhibitor PD98059 in sham-operated hearts. Intralipd upregulated the phosphorylation of Akt, extracellular regulated protein kinase 1/2 (ERK1/2), and their downstream target of GSK3ß and antiapoptotic Bcl-2 expression in healthy rat hearts. Nonetheless, ILP failed to improve left ventricular hemodynamics and reduced infarct size and apoptosis and increase the phosphorylated Akt, ERK1/2, GSK3ß, and antiapoptotic Bcl-2 in hypertrophied myocardium. In contrast, ischemic preconditioning increased the phosphorylation of Akt, ERK1/2 and GSK3ß, improved heart pump function, and reduced myocardial necrosis in sham-operated hearts, a phenomenon partially attenuated by ventricular hypertrophy. Interestingly, GSK inhibitor SB216763 conferred cardioprotection against IR injury in sham-operated hearts, but failed to exert cardioprotection in hypertrophied myocardium. Our results indicated that ventricular hypertrophy abrogated ILP-induced cardioprotection against IR injury by alteration of RISK/GSK3ß signal.

Study strategies for bloodletting therapy in treatment of acute soft tissue injuries.

Bloodletting therapy is one of the typical treatment modes of traditional Chinese medicine, and acute soft tissue injury (ASTI) is one of the most common indications for acupuncture therapeutics. In this paper, the current situation of treatments and pathological mechanisms of ASTIs, the existing problems of bloodletting therapy in the treatment of ASTIs and the study strategies are systematically analyzed, indicating that bloodletting therapy is significantly effective in the treatment of ASTIs. Breakthroughs in the treatment of ASTIs will be achieved with the application of bloodletting therapy both in clinical practice and experimental research.

Effects of laser irradiation of acupuncture points Shenshu on ovariectomized rats.

BACKGROUND AND OBJECTIVE: The effect of laser acupuncture on obesity in postmenopausal women remains unknown. The aim of this study was to investigate the effects of this form of treatment using an animal model. MATERIALS AND METHODS: Seventy-seven female Sprague-Dawley rats were assigned into seven groups: normal control (Normal), sham-operation control (Sham), ovariectomized (OVX) control rats (OVX), OVX rats treated with estrogen (OVX + E), and three groups of ovariectomized rats treated with laser acupuncture (OVX + L). Bilateral ovaries were removed to decrease estrogen levels. After 2 wk, semiconductor laser irradiation was administered to bilateral Shenshu (BL 23) acupoints of rats in the three OVX + L groups at 12, 30, and 60 J/cm(2), respectively. Changes in body weight and pituitary estrogen receptor (ER) mRNA expression were analyzed. Morphological differences in the uterus and pituitary glands were also observed. RESULTS: The OVX group exhibited marked weight gain and a significant decrease in pituitary ERα mRNA expression. Semiconductor laser irradiation at 30 J/cm(2) reduced body weight and increased ERα expression compared with the control, whereas irradiation at 12 or 60 J/cm(2) presented slightly weaker effects. Significant differences in pituitary ERß mRNA were not observed due to lack of optical density data. CONCLUSIONS: The semiconductor laser irradiation of bilateral Shenshu (BL 23) acupoints can exert beneficial effects on OVX rats through reducing body weight and increasing pituitary ERα expression, and 30 J/cm(2) was the most effective dose among those used.

Effect of acupoint catgut-embedding on the quality of life, reproductive endocrine and bone metabolism of postmenopausal women.

OBJECTIVE: To observe the influence of acupoint catgut-embedding therapy on the quality of life (QOL), the reproductive endocrine and bone metabolism of postmenopausal women. METHODS: A total A total of 65 women with climacteric syndrome were enrolled and randomly assigned to two groups, thirty-three in the treatment group on whom acupoint catgut-embedding was performed with Shenshu (BL23), Sanyinjiao (SP6) and Guanyuan (CV4) as main acupoints, and thirty-two in the control group who were only medicated with Fufuchun Capsule (妇复春胶囊). The treatment course for both groups was 3 months. Before and after Before and after treatment, the clinical symptoms, the QOL score, serum follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E(2)), testosterone (T), osteocalcin (BGP), parathyroid hormone (PTH), calcitonin (CT) and alkaline phosphatase (AKP) were measured. In addition, another 28 women with childbearing potential and normal regular menstrual cycle were selected and the reproductive endocrine hormone were tested in the ovulatory period as controls. RESULTS: The levels of serum FSH and LH of postmenopausal women were higher, and serum E(2) and T were lower than those of normal women (P<0.01). After treatment, the levels of serum E(2) In both groups and T in the treatment group were increased, while in the control group the serum E(2) increase was more significant than that in the treatment group (P<0.05), and serum T showed no statistical difference. The levels of serum FSH, LH, BGP, CT, PTH and AKP were reduced significantly in both groups after treatment (P<0.05). The QOL scores were Increased remarkably in both groups on physiological functioning, bodily pain, general health, vitality, and mental health after treatment (P<0.05),but the improvement of bodily pain and mental health in the treatment group were better than those in the control group (P<0.01). There was no significant difference in the therapeutic effect between the two groups after treatment (P>0.05). CONCLUSIONS: Acupoint catgut-embedding showed an obvious effect on climacteric syndrome, and enhanced the QOL in postmenopausal women. The therapy could regulate the hypothalamic-pituitary-ovarian axis to raise the serum E(2) level which may be significant in preventing and curing the osteoporosis in postmenopausal women.

[Effect and safety evaluation of catgut implantation at acupoint for levels of bone metabolism and free radicals in postmenopausal women].

OBJECTIVE: To compare the effect and safety evaluation of catgut implantation at acupoint and drugs for levels of bone metabolism and free radicals in postmenopausal women. METHODS: Sixty-five postmenopausal women were randomly divided into an acupoint catgut implantation group (33 cases) and a medication group (32 cases). Sanyinjiao (SP 6), Shenshu (BL 23) and Guanyuan (CV 4) were used as main points combined with adjunct points according to syndrome differentiation in the acupoint catgut implantation group, once two weeks. The medication group was treated with oral administration of 2 pills of Fu fuchun capsule, once a day. Three months constitute one course in the both groups. The scores of the symptoms and signs were evaluated, and elbow vein blood was drawn to detect the correlative index on the beginning and the ending day of the treatment respectively. The safety of catgut implantation at acupoint was evaluated after one course of treatment. Besides, the sex hormone test in ovulatory period was detected in twenty-eight normal women in reproductive age with regular menstrual cycle. RESULTS: 1) The total effective rate of the acupoint catgut implantation group was 93.9% (31/33), and that of the medication group was 96.9% (31/32), there was no significant difference between the two groups (P>0.05). The contents of bone gla protein (BGP), calcitonin (CT), parathyroid hormone (PTH) and alkaline phosphatase (AKP) in the both groups had significant differences after treatment (P<0.05, P<0.01); 2) The content of estradiol (E2) in serum in the both groups was decreased more obviously than those of normal women in reproductive age (both P<0.001). The content of E2 in the both groups was obviously increased after treatment (P<0.05, P<0.01), this function in the acupoint catgut implantation group was weaker than that of the medication group (P<0.05), while the incidence rate of adverse effect in the acupoint catgut implantation group was lower than that of the medication group (P<0.05); 3) There were significant differences of the level of superoxide dismutase (SOD) and malondialdehyde (MDA) before and after treatment in the acupoint catgut implantation group, the level of SOD was obviously increased after treatment (P<0.01), while the level of MDA decreased obviously (P<0.001). CONCLUSION: Catgut implantation at acupoint can improve the low level of estrogen of postmenopausal women, with good safety. It can regulate the levels of bone metabolism and free radicals of postmenopausal women, so it is very meaningful to prevent and treat postmenopausal degenerative diseases including the osteoporosis and to delay the process of apolexis.

[Summarization of professor Zhang Jia-wei's experiences in treatment of female climacteric syndrome].

Professor ZHANG Jia-wei's unique experiences in treatment of women's climacteric syndrome are introduced. According to physio-pathologic characteristics of the women in climacteric, in acupuncture and moxibustion treatment, he puts forward the therapeutic principles of reinforcing the spleen and replenishing the kidney, harmonizing yin and yang, and pays attention to application of the needling method, flying needling manipulation with stable, accurate, light and quick characteristics, which are summarized by professor Zhang according to his clinical experience of many years, and catgut embedding at back-shu points; in addition, he advocates selection of treatment methods according to climatic and seasonal condition, geographical location and individual condition, puncturing followed by moxibustion, combining acupuncture with medicine.

[Exploration and reflection on bilingual teaching of acupuncture and moxibustion].

OBJECTIVE: To explore bilingual teaching of acupuncture and moxibustion for cultivating compound senior acupuncture persons. METHODS: Beginning with the concept of bilingual teaching in conjunction with acupuncture own characteristics, the problems involved in the practice of bilingual teaching of acupuncture and moxibustion were analyzed and explored. RESULTS: Unifying opinion and correct localizing position should be started for acupuncture and moxibustion bilingual teaching, and choice of teachers, subjects, models, materials, examination of bilingual teaching should be focused on, and appropriate means should be applied in practice to test, consolidate and distillate the effect of bilingual teaching. CONCLUSION: Bilingual teaching of acupuncture and moxibustion is an important measure of economic globalization and knowledge economy. Only if various teaches involved in its practice were properly dealt with could better teaching results be obtained.