Notoginsenoside R1 improves intestinal microvascular functioning in sepsis by targeting Drp1-mediated mitochondrial quality imbalance.

CONTEXT: Sepsis can result in critical organ failure, and notoginsenoside R1 (NGR1) offers mitochondrial protection. OBJECTIVE: To determine whether NGR1 improves organ function and prognosis after sepsis by protecting mitochondrial quality. MATERIALS AND METHODS: A sepsis model was established in C57BL/6 mice using cecum ligation puncture (CLP) and an in vitro model with lipopolysaccharide (LPS, 10 µg/mL)-stimulated primary intestinal microvascular endothelial cells (IMVECs) and then determine NGR1's safe dosage. Groups for each model were: in vivo-a control group, a CLP-induced sepsis group, and a CLP + NGR1 treatment group (30 mg/kg/d for 3 d); in vitro-a control group, a LPS-induced sepsis group, and a LPS + NGR1 treatment group (4 µM for 30 min). NGR1's effects on survival, intestinal function, mitochondrial quality, and mitochondrial dynamic-related protein (Drp1) were evaluated. RESULTS: Sepsis resulted in approximately 60% mortality within 7 days post-CLP, with significant reductions in intestinal microvascular perfusion and increases in vascular leakage. Severe mitochondrial quality imbalance was observed in IMVECs. NGR1 (IC50 is 854.1 µM at 30 min) targeted Drp1, inhibiting mitochondrial translocation, preventing mitochondrial fragmentation and restoring IMVEC morphology and function, thus protecting against intestinal barrier dysfunction, vascular permeability, microcirculatory flow, and improving sepsis prognosis. DISCUSSION AND CONCLUSIONS: Drp1-mediated mitochondrial quality imbalance is a potential therapeutic target for sepsis. Small molecule natural drugs like NGR1 targeting Drp1 may offer new directions for organ protection following sepsis. Future research should focus on clinical trials to evaluate NGR1's efficacy across various patient populations, potentially leading to novel treatments for sepsis.

Comparative efficacy of acupuncture-related therapy for postmenopausal osteoporosis: protocol for Bayesian network meta-analysis.

INTRODUCTION: The review aims to conduct the first network meta-analysis to comprehensively evaluate the application of multiple acupuncture techniques in patients with postmenopausal osteoporosis, ranking the best acupuncture treatment and providing a reference for clinical treatment extensively. METHODS AND ANALYSIS: Randomised controlled trials of different acupuncture-related therapies for postmenopausal osteoporosis will be searched in the following databases from 1 January 2002 to 31 December 2022, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, VIP Database, Wanfang Database and China Biomedical Literature Database. Overall, clinical efficacy rate, bone mineral density and a Visual Analogue Scale score are used as the primary outcome indicators. In addition, the secondary outcome indicator is adverse reactions. The entire screening process will be conducted by two independent investigators; meanwhile, Stata (V.14.0) and RevMan (V.5.4) will be used to conduct the network meta-analysis. If the data are permissible and feasible, we will also perform meta-regression and subgroup analyses to address the underlying causes of data inconsistency and heterogeneity in the statistical analyses. Besides, to improve the credibility of this network meta-analysis, we will evaluate the quality of evidence in this research according to the GRADE assessment. ETHICS AND DISSEMINATION: Ethics approval is not required for network meta-analyses, which do not involve animals' or people's welfare. The results of this network meta-analysis will be submitted to a recognised journal for publication. PROSPERO REGISTRATION NUMBER: CRD42023401003.

[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.

The efficacy and safety of acupoint catgut embedding for peripheral facial paralysis: A protocol for systematic review and meta analysis.

BACKGROUND: Peripheral facial paralysis (PFP) is a consequence of the peripheral neuronal lesion of the facial nerve. It can be either primary (Bell palsy) or secondary. The incidence of PFP is 11.5 to 40.2 per 100,000 people a year. Nearly 70% of patients with PFP recover completely, but almost 30% of patients leave multiple sequelae which caused impacts on the patient's quality of life, both physically and psychologically. The conventional treatments of PFP are limited for some person because of side-effects. Previous studies have suggested that using acupoint catgut embedding (ACE) alone or combined with other therapeutic methods is effective for PFP. However, whether ACE is effective for PFP is still unknown. The purpose of this systematic review (SR) and meta-analysis will summarize the present evidence of ACE used as an intervention for PFP. METHOD/DESIGN: Randomized controlled clinical trials that use ACE for PFP will be searched from four international electronic databases (PubMed, Cochrane Library, EMBASE, and Web of Science) and 4 Chinese electronic databases (China National Knowledge Infrastructure, VIP, Wanfang, and China Biology Medicine) to search for relevant literature. We only include studies that were published from the initiation to May 2021. The primary outcomes include effectiveness rate based on House-Brackmann Facial Nerve Grading System. Secondary outcomes will include Sunnybrook facial nerve grading system, Portmann score, facial nerve conduction velocity, Facial Disability Index Scale, adverse events. Two reviewers will perform study selection, data extraction, data synthesis, and quality assessment independently. Assessment of risk of bias and data synthesis will be conducted by using Review Manager 5.3 software. Grade system will be used to evaluate the quality of evidence. DISCUSSION: This systematic review will help establish clinical evidence regarding the efficacy and safety of acupoint catgut embedding for peripheral facial paralysis. TRIAL REGISTRATION NUMBER: CRD42021243212 (PROSPERO).

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 effectiveness and safety of acupoint catgut embedding for the treatment of primary dysmenorrhea: A protocol for systematic review and meta-analysis.

BACKGROUND: Primary dysmenorrhea (PD), also regarded as functional dysmenorrhea, refers to dysmenorrhea without obvious organic lesions in the reproductive system. It accounts for more than 90% of dysmenorrhea and seriously affects womens life and work. Previous studies have proved that acupoint catgut embedding therapy is effective and safe for PD patients. It could relieve the pain rapidly and work for a long time in multiple mechanisms. This protocol aims to evaluate the effectiveness and safety of acupoint catgut embedding therapy on PD systematically. With the latest published evidence, a systematic review and meta-analysis of catgut embedding for patients with PD would be carried out in this study. METHODS: All randomized controlled trials (RCTs) related to acupoint catgut embedding therapy on PD will be searched in the following electronic databases: PubMed, Cochrane Library, EMBASE, Wed of Science, Chinese National Knowledge Infrastructure (CNKI), Chongqing VIP Database, Wanfang Database, and Chinese Biomedical Literatures Database (CBM), from inception to September 2020. The primary outcomes contain visual analog scale (VAS), dysmenorrhea symptom score, and clinical effectiveness rate, while the secondary outcomes consist of adverse events and the recurrence rate. Two reviewers will independently perform data selection, data synthesis, and quality assessment. Assessment of risk of bias and data synthesis would be performed with Review Manager 5.3 software. RESULT: This systematic review will summarize the current and high-quality evidence of acupoint catgut embedding therapy on PD. CONCLUSION: This systematic review aims to offer the latest persuasive evidence for clinical practitioners that using acupoint catgut embedding therapy on PD is effective and safe. PROSPERO REGISTRATION NUMBER: CRD42020156362.

The Efficacy and Safety of Traditional Chinese Medicine Tonifying-Shen (Kidney) Principle for Primary Osteoporosis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

OBJECTIVE: This study aimed to appraise the efficacy and safety of the tonifying-Shen (kidney) principle (TS (TK) principle) for primary osteoporosis (POP). METHODS: Randomized controlled clinical trials (RCTs) using the TS (TK) principle for POP were searched from eight electronic databases to search for relevant literature that was published from the initiation to September 2019. Two reviewers performed study selection, data extraction, data synthesis, and quality assessment independently. Review Manager 5.3 software was used to assess the risk of bias and conduct the data synthesis. We assessed the quality of evidence for outcomes by using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. RESULTS: Thirty-six studies with 3617 participants were included. Meta-analysis showed a consistently superior effect of the TS (TK) principle combined with conventional Western medicine (CWM) in terms of total effectiveness rates (RR = 1.28; 95% CI (1.23, 1.33); P < 0.00001), BMD of the lumbar spine (SMD = 0.71; 95% CI (0.47, 0.95); P < 0.00001) and proximal femur (SMD = 0.94; 95% CI (0.49, 1.38); P < 0.00001), TCM symptom integral (SMD = -1.23; 95% CI (-1.43, -1.02); P < 0.00001), and VAS scores (SMD = -3.88; 95% CI (-5.29, -2.46); P < 0.00001), when compared to using CWM alone and with significant differences. Besides, in respect of adverse effects, it showed no significant statistical difference between the experimental and control groups, RR = 0.99 and 95% CI (0.65, 1.51), P=0.97. CONCLUSION: Our meta-analysis provides promising evidence to suggest that using the TS (TK) principle combined with CWM for POP is more effective than using CWM alone. Also, both of them are safe and reliable for POP.

Biomarkers of postmenopausal osteoporosis and interventive mechanism of catgut embedding in acupoints.

INTRODUCTION: Postmenopausal osteoporosis (PMOP), which is a common and frequently occurring age-related metabolic bone disease in perimenopausal women, severely affects patients living quality. Modern medicine therapies for PMOP have several problems such as side reactions, low compliance, and high costs. Thus, nonpharmacological modality is urgently needed. Although acupoint thread embedding treatment is widely used in clinical practice, there is no persuasive evidence of its effect on increasing bone mass for PMOP. This experiment aims to investigate the efficacy and safety of acupoint thread embedding on PMOP and elucidate the correlations among brain neural activation, bone mineral density (BMD), and clinical outcomes with magnetic resonance evidence, thus to explore its neural mechanism. METHODS: This parallel designed, exploratory randomized, controlled, assessor-statistician-blinded, positive medicine clinical trial will include 70 participants with PMOP recruited from 2 traditional Chinese Medicine hospitals. These participants will be randomly allocated to a treatment group (Group Embedding) and a control group (Group Medication) in a 1:1 ratio. Participants in the treatment group will receive acupoint thread embedding treatment once 2 weeks in the following predefined acupoints: Shenshu (BL23), Sanyinjiao (SP6), Guanyuan (RN4), Ganshu (BL18), Dazhu (BL11), Xuanzhong (GB39), Zusanli (ST36), and Pishu (BL20). Meanwhile, the participants in the control group will take 0.3 mg Climen tablet orally, 1 tablet/day; every month has a schedule of the 21-day-continuous-taking-medicine period, and 7-day tablet-free period. There is a study period of 3 months and a follow-up period of 1 month for each group. The primary outcomes will be the following therapeutic indexed: Short-Form of McGill Pain Questionnaire (SF-MPQ), Osteoporosis Symptom Score during the observation period and follow-up period. The secondary outcomes will be Osteoporosis Quality of Life Scale (OQOLS), 16-item Assessment of Health-Related Quality of Life in Osteoporosis. In addition, functional magnetic resonance imaging (fMRI) scans and bone density test will be done before and after the observation period to show cranial neuroimaging changes. All the outcomes will be evaluated before and after treatment. The safety of interventions will be assessed at every visit. DISCUSSION: We present study design and rationale to explore the effectiveness and neural mechanism of acupoint thread embedding for PMOP through these outcomes. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR-INR-17011491.

In vivo investigation on bio-markers of perimenopausal panic disorder and catgut embedding acupoints mechanism.

BACKGROUND: Panic disorder (PD), defined by repeated and unexpected panic attacks, severely affects patients' living quality and social function. Perimenopausal women are high-risk group of PD and suffer greatly from it. Modern medicine therapies for this disorder have many side reactions and poor effects, so nonpharmacological modality is an urgent need. Although acupoint catgut embedding is widely used in clinical practice, there is no persuasive evidence of its effect for perimenopausal PD. The aim of this study is to investigate the effectiveness and safety of acupoint catgut embedding for perimenopausal PD and to elucidate the correlations among brain neural activation, bio-markers (amino acids) and clinical outcomes with radiographic evidence, thus to explore its neural mechanism. METHODS: The parallel designed, exploratory randomized controlled trial will include 70 outpatients with perimenopausal PD recruited from two hospitals of Chinese Medicine. These subjects will be randomly allocated to an intervention group (Group Embedding) and a control group (Group Medication) in a 1:1 ratio. The subjects in the intervention group will receive acupoint catgut embedding treatment two weeks a time in the following predefined acupuncture points: Shenshu (BL23), Sanyinjiao (SP6), Guanyuan (RN4), Ganshu (BL18), Zusanli (ST36) and Pishu (BL20). The included women of the control group will take 0.4 mg Alprazolam tablet orally, 1 tablet a time, 3 times a day. There is a study period of 3 months and a follow-up period of 1 month for each group. The primary outcomes will be the following therapeutic indexes: the frequency of panic attack, Panic Disorder Severity Score (PDSS), and Panic-associated Symptoms Score (PASS) during the observation period and follow-up period. The changes in Hamilton Anxiety Scale (HAMA) Score and Symptom Checklist 90 (SCL-90) Score will also be compared between these two groups. Additionally, functional magnetic resonance imaging (fMRI) and proton magnetic resonance spectroscopy (1H-MRS) scans will be done before and after the observation period to show cranial neuroimaging changes. DISCUSSION: We present a study design and rationale to explore the effectiveness and neural mechanism of acupoint catgut embedding for perimenopausal PD. There are still several factors restrict our research such as no unified standard of diagnostic criteria and curative effect evaluation. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR-INR-16009724, registered in November 2016.

The Effectiveness and Safety of Acupoint Catgut Embedding for the Treatment of Postmenopausal Osteoporosis: A Systematic Review and Meta-Analysis.

PURPOSE: To evaluate the effectiveness and safety of acupoint catgut embedding therapy (ACET) in postmenopausal osteoporosis (PMOP). METHODS: Review of some databases from their inception to June 2018 and randomized controlled trials (RCTs) in which ACET with PMOP were included. Two researchers extracted and evaluated the information independently. Cochrane Collaboration's tool and Jadad scale were used to evaluate the quality of the studies. RevMan V.5.3.3 software was used to carry out the meta-analysis while trial sequential analysis (TSA) performed with TSA 0.9 software. RESULTS: 12 RCTs with 876 participants were included in this review. Meta-analysis showed that ACET alone was not superior to medication in effectiveness rate (RR= 1.11; 95% CI (0.89, 1.40); P=0.35) and E2 (SMD= 0.20; 95% CI (-0.17, 0.57); P=0.28; I 2 =20%) while ACET combining medication was more effective on the effectiveness rate (RR= 1.32; 95% CI (1.20, 1.46); P<0.000 01) and E2 (SMD= 1.24; 95% CI (0.63, 1.84); P<0.0001). Additionally, ACET combining calcium could increase the bone mineral density (BMD) of the L2~4 vertebrae and femur-neck [WMDL2~4 = 0.03; 95% CI (0.01, 0.05); P=0.003; and WMDFemur-neck = 0.07; 95% CI (0.03, 0.10); P = 0.0006], reduce TCM syndrome score [WMD = -1.85; 95% CI (-2.13, -1.57); P<0.000 01], improve patient's quality of life [WMDthree months = 6.90; 95% CI (3.90, 9.89); P<0.000 01; and WMDsix months = 12.34; 95% CI (5.09, 19.60); P=0.0009], and relieve pain [WMDVAS = -1.26; 95% CI (-1.66, -0.85); P<0.000 01; and WMDPain score = -2.59; 95% CI (-4.76, -0.43); P= 0.02]. The TSA showed that the effectiveness of ACET for PMOP was demonstrated accurately. CONCLUSIONS: ACET combining medication but not ACET alone is more effective than medication as comparison in the treatment of PMOP. As a novel treatment, ACET shows the potential of effectiveness and deserves further high quality of well-designed study.

Acupuncture for primary osteoporosis: A network meta-analysis of randomized controlled trials protocol.

BACKGROUND: A large number of randomized controlled trials (RCTs) have shown that acupuncture (ACU) has certain advantages over pharmacotherapies in the treatment of primary osteoporosis (POP). However, due to the diversity of ACU treatments, its relative effectiveness have not yet been studied and explained. Therefore, based on the network meta-analysis (NMA), this study will compare the differences in the efficacy of multiacupuncture in the treatment of POP, to provide a reference for clinical treatment. METHODS: We will search PubMed, MEDLINE, Embase, the Cochrane Library, China National Knowledge Infrastructure (CHKD-CNKI), WANFANG database (Chinese Medicine Premier), Chinese Biomedical Literature database (CBM), and VIP for relevant RCTs of ACU treatments for POP, from their inceptions to January 2019. STATA 15.0 and GEMTC software will be used to perform a NMA. The evidence will be evaluated by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach and the type 1 error rate will be assessed by trial sequential analysis (TSA). RESULTS: The results of this review will be submitted to a recognized journal for publication. CONCLUSION: This proposed systematic review will evaluate the different advantages of various types of ACU in the treatment of POP. REGISTRATION: PROSPERO (registration number CRD42019122724).

[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.

Brain neural effects of the 'tonifying kidney and benefiting marrow' method in the treatment of osteoporosis.

In Traditional Chinese Medicine (TCM), the 'tonifying kidney and benefiting marrow' (TKBM) method is based on the theory that kidney controls bones, while marrow moistens bones. There have been aboundant theoretical studies on kidney controlling bones since Huangdi's Internal Classics. However, there are too few ones about the marrow moistening the bones. Researchers generally use the tonifying kidney method instead of the TKBM method, which causes lack of a unified standard and theoretical basis in evaluating the TKBM method. Herein, we first proposed the hypothesis that deficiency of marrow sea causes osteoporosis. Next, we prove the scientific validity of this hypothesis from the side of the TCM theory on the relationship among kidney, bone and marrow sea physiologically and pathologically. Based on this, we find that the TCM theory provides theoretical basis for deficiency of marrow sea causing osteoporosis. On the other side, Western Medicine theory holds that (a) physiologically, the brain regulates the bone mass via three pathways: the neuro-osteogenic network, neuro-endocrine-bone network, and neuropeptide-bone network; (b) pathologically, brain impacts bone mass via three major passways including the regulation of the sympathetic nervous system, secreting hormones that directly act on bone cells and regulating the synthesis and secretion of hormones in the intermediary organs, and neuropeptides such as neuropeptide Y (NPY), substance P (SP), and calcitonin gene-related peptide (CGRP). Evidences involving estrogen deficiency, sympatheticotonia, or neuropeptides imbalance prove that brain-bone mass regulation plays an important role in the pathogenesis of osteoporosis. Finally, we find that kidney invigoration method can change the concentrations of central neurotransmitters of norepinephrine and glutamate to regulate neuro-osteogenic network, and promote the recovery of ovarian function and have an estrogen-like effect by regulating the hypothalamus-pituitary-ovarian axis, which thus influences bone metabolism without clinically significant estrogen-like side effects, and regulate NPY, CGRP and SP involved in the bone metabolism. These further support our hypothesis by revealing the brain neural mechanism of the TCM kidney invigoration method for preventing and treating osteoporosis. In the future, neuroimaging techniques may be useful in exploring its neural effects and also aid in developing new strategies for treating osteoporosis.

Metabonomic analysis reveals efficient ameliorating effects of acupoint stimulations on the menopause-caused alterations in mammalian metabolism.

Acupoint stimulations are effective in ameliorating symptoms of menopause which is an unavoidable ageing consequence for women. To understand the mechanistic aspects of such treatments, we systematically analyzed the effects of acupoint laser-irradiation and catgut-embedding on the ovariectomy-induced rat metabolic changes using NMR and GC-FID/MS methods. Results showed that ovariectomization (OVX) caused comprehensive metabolic changes in lipid peroxidation, glycolysis, TCA cycle, choline and amino acid metabolisms. Both acupoint laser-irradiation and catgut-embedding ameliorated the OVX-caused metabonomic changes more effectively than hormone replacement therapy (HRT) with nilestriol. Such effects of acupoint stimulations were highlighted in alleviating lipid peroxidation, restoring glucose homeostasis and partial reversion of the OVX-altered amino acid metabolism. These findings provided new insights into the menopause effects on mammalian biochemistry and beneficial effects of acupoint stimulations in comparison with HRT, demonstrating metabonomics as a powerful approach for potential applications in disease prognosis and developments of effective therapies.

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.