Fungi Fibrinolytic Compound 1 Plays a Core Role in Modulating Fibrinolysis, Altering Plasma Clot Structure, and Promoting Susceptibility to Lysis.

Fibrin clot structure and function are major determinants of venous and arterial thromboembolic diseases, as well as the key determinants of the efficiency of clot lysis. Studies have revealed that fungi fibrinolytic compound 1 (FGFC1) is a novel marine pyranisoindolone natural product with fibrinolytic activity. Here, we explore the impacts of FGFC1 on clot structure, lysis, and plasminogen activation in vitro using turbidimetric, enzyme-linked immunosorbent assay, confocal and electron microscopy, urokinase, or plasmin chromogenic substrate. Clots formed in the presence of FGFC1 expressed reduced fibrin polymerization rate and maximum turbidity; however, they did not influence the lag phase of fibrin polymerization. In the absence of scu-PA (single-chain urokinase plasminogen activator), microscopy revealed that FGFC1 increased the number of protofibrils within fibrin fiber and the pore diameter between protofibrils, inducing clots to form a region of thinner and looser networks separated by large pores. The effects of FGFC1 on scu-PA-mediated plasma clot structure were similar to those in the absence of scu-PA. In addition, FGFC1 promoted the lysis of clots and increased the D-dimer concentration in lysate. FGFC1 increased the generation rate of p-nitroaniline in plasma. These results show that FGFC1 has fibrinolytic activity in plasma, leading to interference with the release of fibrinopeptide B to affect lateral aggregation of protofibrils and increase clot susceptibility to fibrinolysis by altering its structure.

Collagen from Iris squid grafted with polyethylene glycol and collagen peptides promote the proliferation of fibroblast through PI3K/AKT and Ras/RAF/MAPK signaling pathways.

Collagens from marine sources have been used widely in food, cosmetics and tissue engineering application due to their excellent functional and biological properties. In the present study, a novel protein, collagen from iris squid skin (SSC) was characterized, grafted with polyethylene-glycol (PEG) and Acid-Green 20 (AG) and was investigated the molecular signaling pathways in L-929 fibroblast cells along with their structural peptide analogs. SDS-PAGE and IR spectrum of SSC analysis showed the typical structure of type I collagen. The fibroblast proliferation was evaluated for SSC, SSC grafted PEG (SSC-PEG) and their structural analogs including Gly-Pro-Leu-Gly-Leu-Leu (PEP1), Gly-Pro-Leu-Gly-Leu-Leu-Gly-Phe-Leu (PEP2), Gly-Pro-Leu-Gly-Leu-Leu-Gly-Phe-Leu-Gly-Pro-Leu (PEP3) and Gly-Pro-Leu-Gly-Leu-Leu-Gly-Phe-Leu-Gly-Pro-Leu-Gly-Leu-Ser (PEP4). The optimal concentration of SSC and its derivative was 0.07 µ mol/L. The fibroblast growth-promoting factors were promoted by all the treatment groups by accelerating the PI3K/AKT and Ras/RAF/MAPK signaling pathways in L-929 cells, and inhibiting the secretion of apoptotic factors. Compared to the control group, mRNA and protein expression of AKT in the PI3K/AKT and Ras in Ras/RAF/MAPK signaling pathway were accelerated significantly by PEP4, respectively, while the Bax value was significantly lower (P < 0.01). The promoting effect of PEP1, PEP2, PEP3 and PEP4 on L-929 cells was closely related to the length of the peptides. Therefore, this study disclosed that PEP1, PEP2, PEP3 and PEP4 were novel analogs that greatly promote the proliferation of L-929 cells through PI3K/AKT and Ras/RAF/MAPK signaling pathways.

Safe and Durable Treatment of Dentin Hypersensitivity via Nourishing and Remineralizing Dentin Based on ß-Chitooligosaccharide Graft Derivative.

Dentin hypersensitivity (DH) is a common symptom of various dental diseases that usually produces abnormal pain with external stimuli. Various desensitizers are developed to treat DH by occluding dentine tubules (DTs) or blocking intersynaptic connections of dental sensory nerve cells. However, the main limitations of currently available techniques are the chronic toxic effects of chemically active ingredients and their insufficiently durable efficacy. Herein, a novel DH therapy with remarkable biosafety and durable therapeutic value based on ß-chitooligosaccharide graft derivative (CAD) is presented. Particularly, CAD indicates the most energetic results, restoring the amino polysaccharide protective membrane in DTs, significantly promoting calcium and phosphorus ion deposition and bone anabolism, and regulating the levels of immunoglobulin in saliva and cellular inflammatory factors in plasma. Exposed DTs are occluded by remineralized hydroxyapatite with a depth of over 70 µm, as shown in in vitro tests. The bone mineral density of Sprague-Dawley rats' molar dentin increases by 10.96%, and the trabecular thickness of bone improves to about 0.03 µm in 2 weeks in the CAD group compared to the blank group. Overall, the ingenious concept that modified marine biomaterial can be a safe and durable therapy for DH is demonstrated by nourishing and remineralizing dentin.

Assessment of the Iodine Status of Lactating Women and Infants in Shanghai, China.

There is a risk of iodine deficiency among pregnant women in China. However, research on the iodine status of lactating women and infants is scarce. In this study, we aimed to evaluate the iodine status of lactating women and their infants and explore the relationship between breast milk iodine concentrations (BMICs) and urinary iodine concentrations (UICs). In total, 257 lactating women and their infants were recruited from the Shanghai Sixth People's Hospital East campus between May 2018 and May 2019. The BMIC and UIC were measured by inductively coupled plasma‒mass spectrometry (ICP‒MS). One-day 24-h dietary recall was used to determine the dietary intake of iodine. The mean dietary intake of iodine among the lactating women was 145.1 µg/day, and 97.83% (n = 225) of the lactating women had a dietary iodine intake below 240 µg/day. The median BMIC and UIC of the lactating women was 150.7 µg/L (interquartile range, IQR 102.9, 205.5) and 110.0 µg/L (IQR 65.8, 171.4), respectively, and the median UIC of the infants was 212.7 µg/L (IQR 142.1, 320.6). The BMIC of lactating women who consumed iodized salt was significantly higher than that of lactating women who did not consume iodized salt (p = 0.015). The infants' UIC values were significantly correlated with the BMIC values (r = 0.597**, p < 0.001). The iodine nutritional status of lactating women and infants in Shanghai was generally sufficient according to the WHO's iodine nutritional status recommendation. The use of iodized salt was related to increasing dietary iodine intake and the BMIC. Improvements in BMICs have positive effects on the nutritional levels of iodine in infants.

Paradoxical Duel Role of Collagen in Rheumatoid Arthritis: Cause of Inflammation and Treatment.

In biology, collagen-biomaterial regulates several signaling mechanisms of bone and immune cells involved in tissue repair and any imbalance in collagen turnover may affect the homeostasis of cells, becoming a major cause of several complications. In this case, the administration of oral collagen may play a potential role in returning cells to their normal function. For several decades, the beneficial effects of collagen have been explored widely, and thus many commercial products are available in cosmetics, food, and biomedical fields. For instance, collagen-based-products have been widely used to treat the complications of cartilage-related-disorders. Many researchers are reporting the anti-arthritogenic properties of collagen-based materials. In contrast, collagen, especially type-II collagen (CII), has been widely used to induce arthritis by immunization in an animal-model with or without adjuvants, and the potentially immunogenic-properties of collagen have been continuously reported for a long time. Additionally, the immune tolerance of collagen is mainly regulated by the T-lymphocytes and B-cells. This controversial hypothesis is getting more and more evidence nowadays from both sides to support its mechanism. Therefore, this review links the gap between the arthritogenic and anti-arthritogenic effects of collagen and explored the actual mechanism to understand the fundamental concept of collagen in arthritis. Accordingly, this review opens-up several unrevealed scientific knots of collagen and arthritis and helps the researchers understand the potential use of collagen in therapeutic applications.

Natural Triterpenoids Isolated from Akebia trifoliata Stem Explants Exert a Hypoglycemic Effect via α-Glucosidase Inhibition and Glucose Uptake Stimulation in Insulin-Resistant HepG2 Cells.

The inhibition of α-glucosidase activity is a prospective approach to attenuate postprandial hyperglycemia in the treatment of type 2 diabetes mellitus (T2DM). Herein, the inhibition of α-glucosidase by three compounds T1 -T3 of Akebia trifoliata stem, namely hederagenin (T1 ), 3-epiakebonoic acid (T2 ), and arjunolic acid (T3 ) were investigated using enzyme kinetics and molecular docking analysis. The three triterpenoids exhibited excellent inhibitory activities against α-glucosidase. T1 -T3 showed the strongest inhibition with IC50 values of 42.1±5.4, 19.6±3.2, and 11.2±2.3 µM, respectively, compared to the acarbose positive control (IC50 =106.3±8.2). Enzyme inhibition kinetics showed that triterpenoids T1 -T3 demonstrated competitive, mixed, and noncompetitive-type inhibition against α-glucosidase, respectively. The inhibition constant (Ki ) values were 21.21, 7.70, and 3.18 µM, respectively. Docking analysis determined that the interaction of ligands T1 -T3 and α-glucosidase was mainly forced by hydrogen bonds and hydrophobic interactions, which could result in improved binding to the active site of the target enzyme. The insulin resistant (IR)-HepG2 cell model used in this study (HepG2 cells exposed to 10-7  M insulin for 24 h) and glucose uptake assays showed that compounds T1 -T3 had no cytotoxicity with concentrations ranging from 6.25 to 25 µM and displayed significant stimulation of glucose uptake in IR-HepG2 cells. Thus, triterpenoids T1 -T3 showed dual therapeutic effects of α-glucosidase inhibition and glucose uptake stimulation and could be used as potential medicinal resources to investigate new antidiabetic agents for the prevention or treatment of diabetes.

[Effect of electroacupuncture on mitochondrial function in mice with Parkinson's disease].

OBJECTIVE: To observe the effect of electroacupuncture (EA) on behavior, tyrosine hydroxylase (TH), mitochondrial complexes Ⅰ-Ⅳ, mitochondrial membrane potential and mitochondrial ultrastructure of Parkinson's disease (PD) mice, so as to explore its mechanism underlying improvement of PD. METHODS: C57BL/6 mice were randomly divided into normal, model, medication (Madopar) and EA groups (n=11 in each group). PD model was duplicated by intraperitoneal injection of 1-methyl-4-phenyl-1, 2, 3, 6-tetrahydropyridine (MPTP, 30 mg·kg-1·d-1) for consecutively 5 d. EA was performed on the chorea tremor areas on both sides of the head of mice for 15 min, once a day for 14 d. The behavioral changes of mice were observed. The expression of TH in substantia nigra compacta of midbrain was detected by immunohistochemistry. The activities of mitochondrial complexes Ⅰ-Ⅳ were measured. The changes of mitochondrial membrane potential were detected by JC-1 staining method. The ultrastructural changes of striatum mitochondria were observed by transmission electron microscope. RESULTS: After modeling, the mice showed obvious behavioral abnormalities such as tremor, vertical hair and tail warping, and the pole test time in the model group was significantly longer than that in the normal group (P<0.01). After 7 and 14 days of the treatment, the pole test time in the EA and medication groups was shorter than that in the model group (P<0.05，P<0.01). Compared with the normal group, the number of TH positive cells of the substantia nigra, the mitochondrial membrane potential and the activity of mitochondrial complex I were decreased significantly in the model group (P<0.01), and EA and medication intervention reversed these changes (P<0.01). The mitochondrial structure of mice in the model group was obviously damaged, and the damage of mitochondrial structure was alleviated and the number of damaged mitochondria was decreased in the EA and medication groups. CONCLUSION: EA can protect and promote the recovery of mitochondrial structure and function in MPTP-induced PD mice, which may play a neuroprotective effect on PD mice by improving mitochondrial dysfunction, balancing cell homeostasis and reducing dopaminergic neuron damage.

Resveratrol and Celastrol Loaded Collagen Dental Implants Regulate Periodontal Ligament Fibroblast Growth and Osteoclastogenesis of Bone Marrow Macrophages.

Collagen is widely used for dental therapy in several ways such as films, 3D matrix, and composites, besides traditional Chinese medicine (TCM), has been used in tissue regeneration and wound healing application for centuries. Hence, the present study was targeted for the first time to fabricate collagen film with TCM such as resveratrol and celastrol in order to investigate the human periodontal ligament fibroblasts (HPLF) growth and bone marrow macrophages (BMM) derived osteoclastogenesis. Further, the physicochemical, mechanical and biological activities of collagen-TCM films crosslinked by glycerol and EDC-NHS (1-ethyl-3-(3-dimethylaminopropyl)carbodiimide-N-hydroxysulfosuccinimide) were investigated. Collagen film characterization was significantly regulated by the nature of plasticizers like hydrophobic and degree of polarity. Interestingly, the collagen film's denaturation temperature was increased by EDC-NHS than glycerol. FT-IR data confirmed the functional group changes due to chemical interaction of collagen with TCM. Morphological changes of HPLF cells cultured in control and collagen films were observed by SEM. Importantly, the addition of resveratrol upregulated the proliferation of HPLF cells, while osteoclastogenesis of BMM cells treated with mCSF-RANKL was significantly downregulated by celastrol. Accordingly, the collagen-TCM film could be an interesting material for dental regeneration, and especially it is a therapeutic target to restrain the elevated bone resorption during osteoporosis.

Effects of acupuncture treatment on motor function in patients with subacute hemorrhagic stroke: A randomized controlled study.

OBJECTIVE: The aim of this study was to evaluate the additional effects of acupuncture treatment on motor function in patients with subacute hemorrhagic stroke. DESIGN: One hundred and thirty-four patients with subacute hemorrhagic stroke were randomized to receive acupuncture treatment plus conventional treatment (treatment group) or conventional treatment only (control group). Acupuncture treatments were given in 24 sessions over 4 weeks, with 3-month follow-up period. Blinded evaluation was based on Fugl-Meyer Assessment, Barthel Index with an intention-to-treat analysis. For those patients who were able to walk, a three-dimensional gait analysis system was employed to objectively record spatiotemporal and kinematic parameters. RESULTS: Compared with control group, the treatment group showed a significantly greater over-time improvement in total Fugl-Meyer, lower-limb Fugl-Meyer, but not in upper-limb Fugl-Meyer and Barthel Index. The spatiotemporal parameters of velocity, step length, cadence, step width all showed significant difference between the 2 groups. The velocity in treatment group decreased unexpectedly at day 14, then increased sharply and overcame control group at day 28. The treatment group also showed a significantly greater increase in peak circumduction, peak hip hiking, hip range of motion, knee range of motion and a tendency for the ankle range of motion. CONCLUSIONS: Acupuncture may promote the motor function recovery of hemorrhagic stroke patients in subacute phase mainly by enhancing the lower limb ability. It probably diminishes the compensation strategies earlier to correct the abnormal gait pattern. Although this adjustment may result in a compromise in the improvement of gait velocity temporarily, patients would benefit from it in a long run.

Effects of Acupuncture Treatment on Lower Limb Spasticity in Patients Following Hemorrhagic Stroke: A Pilot Study.

BACKGROUND AND PURPOSE: Lower limb spasticity is often a significant problem in stoke rehabilitation. The purpose of this study was to investigate the effects of acupuncture treatment on lower limb spasticity in patients following hemorrhagic stroke. METHODS: Fifty-nine patients following hemorrhagic stroke were randomized to receive acupuncture treatment combined with conventional treatment (treatment group [TG]) or conventional treatment only (control group [CG]). Acupuncture treatments were given in 24 sessions over 4 weeks. Blinded evaluation was based on Modified Ashworth Scale (MAS), short intracortical inhibition (SICI), and Hmax/Mmax ratio as the primary outcomes. In addition, Fugl-Meyer Assessment (FMA), Barthel Index (BI), motor evoked potential (MEP) and surface integrated electromyogram (IEMG) were employed as the secondary outcomes. All the evaluations were performed at 14 and 28 days after the start of the treatment. RESULTS: Compared with the CG, the TG showed a significantly greater over-time decrease in MAS for knee (p = 0.022) and ankle (p = 0.017), SICI (p = 0.000) and Hmax/Mmax ratio (p = 0.000). In all patients of TG, we found a greater improvement in lower-limb FMA and MEP but not in BI. IEMG show that TG obtained a greater reduction in spastic agonist muscles and a greater enhancement in spastic antagonist muscles. A significant correlation between a greater decrease in ankle MAS and a greater increase in SICI for spastic muscles was found (r = 0.390, p = 0.002). CONCLUSIONS: Acupuncture could improve the lower limb spasticity and motor function, thus providing a safe and economical approach for treating stroke patients. The potential mechanism underpinning the greater improvement may be attributed to a reshape of corticospinal plasticity induced by acupuncture.

Immediate effect of scalp acupuncture on the gait of patients with subacute intracerebral haemorrhage analysed by three-dimensional motion: secondary analysis of a randomised controlled trial.

OBJECTIVE: To investigate the immediate effect of scalp acupuncture on walking pattern, using three-dimensional gait analysis (3D-GA), among patients in the subacute stage of intracerebral haemorrhage (ICH). METHODS: A subset of 30 patients with subacute ICH participating in a recently published randomised controlled trial who were able to walk independently were assessed by 3D-GA before and immediately after scalp acupuncture treatment (treatment group) or no intervention (control group) and the results presented here as a secondary analysis. The acupuncture manipulation was repeated three times with an interval of 5 min. Spatiotemporal and kinematic parameters during walking were collected and analysed using a 3D motion analysis system. RESULTS: After treatment, there were significant differences between the treatment and control groups in the spatiotemporal parameters of step length, velocity and cadence (p<0.05) and double-limb support. No significant difference was found in step width. When kinematic parameters were evaluated, the treatment group showed a significantly decreased peak pelvic anterior tilt angle and an increased hip extension angle after scalp acupuncture treatment, whereas the control group demonstrated no temporal changes. There were no significant changes in any other kinematic parameters in either group. CONCLUSIONS: As the first exploratory study to investigate the effect of the scalp acupuncture on gait performance in patients with subacute ICH, this secondary analysis of a recent randomised trial suggested an immediate effect of treatment on spatiotemporal parameters. Improvement in gait pattern may be associated with a decreased anterior tilt of the pelvis and augmented hip joint motion during walking. TRIAL REGISTRATION NUMBER: ChiCTR-TRC-08000225; Post-results.

Efficacy and safety of penetration acupuncture on head for acute intracerebral hemorrhage: A randomized controlled study.

BACKGROUND: Acupuncture, especially acupuncture treatment on head for acute intracerebral hemorrhage (ICH), has long been disputable. The aim of this study was to evaluate the efficacy and safety of penetration acupuncture on head in patients with acute ICH. METHODS: Eighty-two patients with acute ICH were randomized to receive penetration acupuncture treatment on head combined with conventional treatment (treatment group [TG]) or conventional treatment only (control group [CG]). Acupuncture treatments were given in 24 sessions over 4 weeks, with 3-month follow-up period. Measures included Clinical Neurological Function Deficit Scale (CNFDS), Barthel Index (BI), vital signs (respiration, heart rate, blood pressure, and oxygen saturation), and hematoma absorption ratio. RESULTS: Both groups showed a progressively improvement in CNFDS and BI scores from day 7 to 90. The TG showed a significantly greater improvement in CNFDS than CG over time (P < 0.05). However, BI failed to show significant difference between the 2 groups (P > 0.05). The vital signs were stable and no expansion of hematoma occurred over the course of acupuncture treatment. CONCLUSION: Penetration acupuncture treatment on head appeared to be safe over the course of treatment on acute ICH and may result in additional functional improvements detected in the CNFDS but not reflected in the BI. A larger-scale clinical trial with longer follow-up assessments is required to confirm these findings.

Immediate effects of scalp acupuncture with twirling reinforcing manipulation on hemiplegia following acute ischemic stroke: a hidden association study.

Data mining has the potential to provide information for improving clinical acupuncture strategies by uncovering hidden rules between acupuncture manipulation and therapeutic effects in a data set. In this study, we performed acupuncture on 30 patients with hemiplegia due to acute ischemic stroke. All participants were pre-screened to ensure that they exhibited immediate responses to acupuncture. We used a twirling reinforcing acupuncture manipulation at the specific lines between the bilateral Baihui (GV20) and Taiyang (EX-HN5). We collected neurologic deficit score, simplified Fugl-Meyer assessment score, muscle strength of the proximal and distal hemiplegic limbs, ratio of the maximal H-reflex to the maximal M-wave (Hmax/Mmax), muscle tension at baseline and immediately after treatment, and the syndromes of traditional Chinese medicine at baseline. We then conducted data mining using an association algorithm and an artificial neural network backpropagation algorithm. We found that the twirling reinforcing manipulation had no obvious therapeutic difference in traditional Chinese medicine syndromes of "Deficiency and Excess". The change in the muscle strength of the upper distal and lower proximal limbs was one of the main factors affecting the immediate change in Fugl-Meyer scores. Additionally, we found a positive correlation between the muscle tension change of the upper limb and Hmax/Mmax immediate change, and both positive and negative correlations existed between the muscle tension change of the lower limb and immediate Hmax/Mmax change. Additionally, when the difference value of muscle tension for the upper and lower limbs was > 0 or < 0, the difference value of Hmax/Mmax was correspondingly positive or negative, indicating the scalp acupuncture has a bidirectional effect on muscle tension in hemiplegic limbs. Therefore, acupuncture with twirling reinforcing manipulation has distinct effects on acute ischemic stroke patients with different symptoms or stages of disease. Improved muscle tension in the upper and lower limbs, reflected by the variation in the Hmax/Mmax ratio, is crucial for recovery of motor function from hemiplegia.

[Immediate effects of twirling reinforcing-reducing manipulation at head acupoints on muscle force in patients with acute ischemic stroke: a randomized controlled trial].

OBJECTIVE: To observe differences of immediate effect of twirling reinforcing-reducing manipulation at head acupoints on muscle force in patients with acute ischemic stroke. METHODS: A total of 126 patients who met the inclusive criteria were randomly divided into a twirling reinforcing group, a mild reinforcing-reducing group and a twirling reducing group, 42 cases in each one. The lines between Baihui (GV 20) and bilateral Taiyang (EX-HN 5) were selected and treated with successive insertion of three needles. The twirling reinforcing method was used in the twirling reinforcing group, and mild reinforcing-reducing method was used in the mild reinforcing- reducing group, and twirling reducing method was used in the twirling reducing group. Each needle was manipulated for 1 min, which was repeated once every 10 min. The needles were retained for 30 min. Muscle force was evaluated immediately after treatment. RESULTS: (1) Muscle force of upper limb: after acupuncture, the muscle force of proximal and remote ends were all improved significantly in three groups (all P < 0.05), which was more obvious in proximal end (all P < 0.05). The improvement of the muscle force of proximal end in the twirling reinforcing group was superior to those in the mild reinforcing-reducing group and twirling reducing group (both P < 0.05); the differences of the muscle force of remote end were not significant among three groups (all P > 0.05). (2) Muscle force of lower limb: after acupuncture, the muscle force of proximal and remote ends was all improved significantly in the three groups (all P < 0.05). The improvement of the muscle force of proximal end was superior to that of remote end in the twirling reinforcing group and mild reinforcing-reducing group (both P < 0.05). CONCLUSION: The twirling reinforcing manipulation at head acupoints is superior to mild reinforcing-reducing and twirling reducing manipulation for muscle force in patients with acute ischemic stroke, which is more significant in proximal end of limbs.

[Effect of Scalp Penetration Acupuncture on the Expression of NGF in Brain Tissue around Hematoma of Intracerebral Hemorrhage Rats].

Objective To observe the effects of scalp penetration acupuncture on the expression of nerve growth factor (NGF) in brain tissue around hematoma of intracerebral hemorrhage rats. Methods To- tally 120 healthy male Wistar rats were divided into the sham-operation group, the model group, the acupunc- ture group by random digit table, 40 in each group. Rats in each group were further randomly divided into 4 time points, i.e., 6 h, 24 h, day 3, day 7. The intracerebral hemorrhage rat model was prepared by modified autologous arterial blood method, intervened by electroacupuncture (EA) at Baihui (DU20) through Taiyang (EX- HN5). Neuroethological assessment was conducted by Longa score. The expression of NGF positive cells in brain tissue around hematoma was detected using immunohistochemical method. The amount of NGF mRNA expression was measured by q-PCR. Results Compared with the sham-operation group, neurobehavioral scores increased, NGF positive cells increased, NGF mRNA expression increased in the model group at each time point, with statistical difference shown (P <0.05). Compared with the model group, 6 h neurobehavioral scores,NGF positive cells, mRNA expression of NGF did not change significantly in the acupuncture group, with no statistical difference shown (P > 0. 05). Neuroethological scores decreased, NGF positive cells increased, mRNA expression of NGF was up-regulated in the acupuncture group at 24 h, day 3 and 7, respec- tively, with statistical difference shown (P <0. 05). Conclusion scalp penetration acupuncture could up-regulate gene and protein expressions of NGF, and promote recovery of nerve function, showing favorable neuro-protective effects.

[Impacts on fine movement of upper extremity with flaccid paralysis in stroke treated with acupuncture combined with motor imagery].

OBJECTIVE: To explore the impacts on the fine movement of upper extremity with flaccid paralysis in stroke treated with acupuncture and motor imagery. METHODS: Sixty-two cases of flaccid paralysis of upper extremity in stroke were randomized into an observation group (30 cases) and a control group (32 cases). In the control group, the conventional western medication and the passive movement of the extremity were applied. Additionally, the penetrating needling technique was used at the head points [penetrating needling from Baihui (GV 20) to Taiyang (EX-HN 5)] and the local affected extremity [penetrating needling from Jianyu (LI 15) to Binao (LI1 14), from Quchi (LI 11) to Shaohai (HT 3), from Waiguan (TE 5) to Neiguan (PC 6), etc]. The needles were retained for 30 min. In the observation group, on the basic treatment as the control group, during the needle retaining, the motor imagery therapy was supplemented. The treatment was given once a day, 5 treatments a week, for 4 weeks totally in the either group. The scores in the action research arm test (ARAT) and the modified Fugl-Meyer assessment (FMA) were recorded at the moment of enrollment, in 2 and 4 weeks of treatment, in the 6th and 8th weeks, as well as after 90 days separately. RESULTS: (1) ARAT score: since the 2nd week, ARAT scores in the observation group were all improved significantly as compared with those in the control group at the each time points (all P<0. 05). In the observation group, the scores were improved significantly in the pair comparison at the time points (all P<0. 05). In the control group, the score in the 2nd week was not different significantly as compared with that before treatment (P>0. 05), but the scores at the rest time points were improved significantly in the pair comparison (all P<0. 05); (2) FMA score: in the 2nd week and on the 90th day, FMA score in the observation group was higher significantly than those in the control group (both P < 0. 05). In the observation group, the scores were all improved significantly in the pair comparison at the time points (all P<0. 05). In the control group, except that in comparison between the 90th day and the 8th week (P>0. 05), the results were all P<0. 05 at the rest time points. CONCLUSION: The early intervention of the combined therapy of acupuncture and motor imagery effectively promotes the recovery of the coordination function and the fine movement of upper extremity, especially the improvements of the fine movement in stroke at flaccid paralysis stage. The efficacy is better than the single acupuncture treatment.

[Professor Dong Gui-rong's experiences in treatment of child cerebral palsy].

According to the characteristics of the etiology and pathogenesis of child cerebral palsy, on the basis of "regulating the mind in treatment of all kinds of diseases" and "regulating the functions of five zang organs with back-shu points", Professor DONG Gui-rong applied the penetrating needling technique on the scalp points and acupuncture at back-shu points of five zang organs in the treatment of child cerebral palsy. The valuable clinical experiences have been summarized as "regulating the mind with scalp needling technique, benefiting the brain and opening the orifice", "regulating five zang organs with back-shu points" and "integration of acupuncture and rehabilitation, and function reconstruction". Two effective cases were introduced.

Using acupoint-to-acupoint penetrative needling to treat post-stroke spastic paralysis: a clinical progress review.

OBJECTIVE: To determine the characteristics and advantages of acupoint-to-acupoint penetrative needling (AAPN) treatment for post-stroke spastic paralysis (PSSP) to improve the clinical outcomes of this disease in the future. METHODS: Randomized, controlled trials of PSSP patients receiving AAPN treatment were searched from MEDLINE, EMBASE, and China National Knowledge Infrastructure Database between January 2006 and June 2013. Key words included: clinic or clinical, acupuncture, needling, acupoint-to-acupoint, penetrative or penetration or penetrating, stroke or apoplexy or cerebral infarction or cerebral hemorrhage, spastic paralysis or spasticity or palsy, and hypermyotonia. Language was limited to English and Chinese. Case series reports, review articles, and, animal studies were excluded. RESULTS: AAPN showed better clinical results on PSSP than other acupuncture treatments, especially when combined with adjunct therapies such as electroacupuncture, bloodletting, and rehabilitation. The greatest benefit was achieved with rehabilitation combined with penetration from Yang-channel acupoints to Yin-channel acupoints in the upper limbs, and from Yin-channel acupoints to Yang-channel acupoints in the lower limbs with a reinforcing maneuver. CONCLUSION: AAPN is an effective treatment for PSSP, and it can accelerate and enhance functional repair of PSSP patients.

[Clinical safety research of penetrating acupuncture at the head points for cerebral hemorrhage at the acute stage].

OBJECTIVE: To verify the safety of penetrating acupuncture at the head points for cerebral hemorrhage at the acute stage. METHODS: Sixty cases of cerebral hemorrhage at the acute stage were selected and randomized into a western medication group and a head-point group, 30 cases in each one. In the western medication group, the anti-cranial pressure and anti-blood pressure program was administered with the conventional intravenous infusion of Sodium Nitroprusside, Mannite, etc. In the head-point group, on the basis of the treatment as the western medication group, the penetrating acupuncture at the head points was supplemented. For consciousness disturbance, Taiyang (EX-HN 5), Benshen (GB 13) and penetrating needling from Shenting (GV 24) to Shangxing (GV 23) were selected. For headache, the penetrating needling was adopted from Shangxing (GV 23) to Yintang (EX-HN 3) and from Fengchi (GB 20) to Fengchi (GB 20). For disturbance of urination and defecation, the penetrating needling was adopted from Baihui (GV 20) to Sishencong (EX-HN 1). For aphasia, the penetrating needling was adopted from Fengfu (GV 16) to Yamen (GV 15), etc. For facial paralysis, the penetrating needling from Dicang (ST 4) to Jiache (ST 6) and Xiaguan (ST 7) were selected. For paralysis, the penetrating needling was adopted from Baihui (GV 20) to Taiyang (EX-HN 5), etc. Before and after treatment, the changes in cerebral hemorrhagic volume, the results of blood, urine and stool routine examination, the situations of the life indices such as heart, liver and kidney functions, blood pressure, respiration and heart rate were observed, as well as the impacts on ECG. RESULTS: The cranial CT sania cn indicated that the rate of the basic and significant absorption of hematoma was 80.0% (24/30) in the head-point group, which was superior to 56.7% (17/30) in the western medication group (P < 0.05). Before and after treatment, the results of blood, urine and stool routine examination and the life indices such as blood pressure, respiration and heart rate were all in the normal scope for the patients in the head-point group (all P > 0.05). There were no any abnormal changes in liver and kidney functions. In the head-point group, the abnormality rate of ECG was lower obviously than that in the western medication group [16.7% (5/30) vs 43.3% (13/30), P < 0.05]. CONCLUSION: The penetrating acupuncture at the head points is safe in the treatment of cerebral hemorrhage at the acute stage.

[Observation on therapeutic effect of Tongluo Guben needling method for lumbar disc herniation].

OBJECT: To explore the better treatment of lumbar intervertebral disc herniation. METHODS: One hundred and thirty-two cases of lumbar intervertebral disc herniation were randomly divided into an observation group and a control group, sixty-six cases in each group. In observation group, Baihui (GV 20) penetrating to Taiyang (EX-HN 5), Jiaji (EX-B 2), Huantiao (GB 30) and Chengfu (BL 36) etc. on affect side were applied; in control group, Shenshu (BL 23), Dachangshu (BL 25), Huantiao (GB 30) and Chengfu (BL 36) etc. on affect side were applied. Once a day, 6 treatments made one session and one day break between courses. The curative effects after 4 and 8 courses and the recurrence rate that 6 months after treatment were observed; the pain scale evaluated by Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI) were observed. RESULTS: The cured rate and total effective rate were 44.3% (27/61) and 100.0% (61/61) in observation group, 26.7% (16/60) and 93.3% (56/60) in control group after 4 courses; there were significant differences between two groups (all P < 0.05). After 8 courses, the cured rate and total effective rate were no significant differences between two groups (all P > 0.05). In observation group, the recurrence rate was 9.4% (5/53) 6 months after treatment, which was lower than that (24.1%,13/54) in control group (P < 0.05). The VAS and ODI scale were significantly reduced (all P < 0.05) after treatment, and which in observation group were inferior to those in control group (all P < 0.01). CONCLUSION: The lumbar intervertebral disc herniation treated with puncture by opening meridian and consolidating origin is rapidly effected with low recurrence rate.