Warm acupuncture therapy alleviates neuronal apoptosis after spinal cord injury via inhibition of the ERK signaling pathway.

PURPOSE: Warm acupuncture (WA) therapy has been applied to treat spinal cord injury (SCI), but the underlying mechanism is unclear. The current study attempted to explore the WA therapy on neuronal apoptosis of SCI and the relationship with the extracellular signal-regulated kinase (ERK) signaling pathway. METHODS: The rat SCI models were established by the impact method. SCI rat models were subjected to WA treatment at Dazhui (GV14) and Jiaji points (T10), Yaoyangguan (GV3), Zusanli (ST36), and Ciliao (BL32). The rat SCI models were established by the impact method. WA and U0126 treatments were performed on the SCI rats. Motor function and neuronal apoptosis were detected. The relative mRNA of tumor necrosis factor-α (TNF-α), interleukin-1ß (IL-1ß), and interleukin-6 (IL-6), the phosphorylation level of ERK 1/2 and levels of B-cell lymphoma-2 (Bcl-2), BCL2-Associated X (Bax), and caspase-3 in spinal cord tissue were tested. RESULTS: After WA treatment, the Basso, Beattie & Bresnahan locomotor rating scale (BBB scale) of SCI rats in the WA treatment was significantly raised from 7 to 14 days after SCI. WA and U0126 treatment significantly diminished apoptotic cells and preserved the neurons in the injured spinal cord. WA and U0126 treatment alleviated the production of inflammatory cytokines in the spinal cord. The distinct increase of p-ERK 1/2 induced by SCI was reversed in WA and U0126 treatment groups. WA and U0126 treatment augmented the level of Bcl-2 and reversed the elevated cleaved caspase-3 protein level after SCI. CONCLUSION: Our study demonstrated that WA might be associated with the downregulation of the ERK signaling pathway. In summary, our findings indicated that WA promotes the recovery of SCI via the protection of nerve cells and the prevention of apoptosis. Meanwhile, the anti-apoptotic effect of WA might be associated with the downregulation of the ERK signaling pathway, which could be one of the mechanisms of WA in the treatment of SCI.

Relationship between Coronary Artery Tortuosity and Cardiorespiratory Fitness in Patients without Obstructed Coronaries.

OBJECTIVE: This study aimed to analyze the relationship between cardiorespiratory fitness (CRF) and the increasing severity of coronary artery tortuosity (CAT) in patients with non-stenosed coronaries. METHODS: A total of 396 patients who underwent coronary angiography and cardiopulmonary exercise testing (CPET) between August 2020 and July 2021 were included in this single-center retrospective study after excluding patients with significant coronary artery disease (≥50% stenosis). Patients were divided into two groups: no or mild coronary artery tortuosity (N/M-CAT) and moderate to severe coronary artery tortuosity (M/S-CAT) and laboratory electrocardiographic, echocardiographic, and CPET parameters were compared between two groups. RESULTS: M/S-CAT was found in 46.9% of the study participants, with 66.7% being women. M/S-CAT was significantly associated with advanced age (P=0.014) and females (P=0.001). Diastolic dysfunction parameters, E velocity (P=0.011), and E/A ratio (P=0.004) also revealed significant differences between the M/S-CAT group and N/M-CAT group. VO2@peak (1.22±0.39 vs. 1.07±0.39, P<0.01) and VO2@AT (0.77±0.22 vs. 0.71±0.21, P=0.017) were significantly lower in the M/S-CAT group than in the N/M-CAT group. Multivariate logistic regression analysis identified females (OR=0.448; 95% CI, 0.296-0.676; P=0.000) and E/A ratio (OR=0.307; 95% CI, 0.139-0.680; P=0.004) to be independent risk factors of M/S-CAT and showed no association of CPET parameters to M/S-CAT. CONCLUSION: The results indicate that increasing severity of CAT is strongly associated with female gender and E/A ratio and is not directly correlated with decreasing CRF. Further research with a larger patient population and a longer follow-up time is required to fully comprehend the impact of CAT on CRF.

Acupuncture combined with moxibustion promote the recovery of spinal cord injury in correlation with Shh/Gli-1 signaling pathway.

Objective: Acupuncture combined with moxibustion (AM) therapy has been applied to treat spinal cord injury (SCI), but the underlying mechanism is unclear. The present study aimed to confirm the effect and mechanism of AM treatment on the recovery of SCI.Design: Male Sprague-Dawley rats were used to establish the SCI model by impact method. SCI rat models were subjected to AM treatment at Dazhui (GV14) and Jiaji points (T7-T12), Yaoyangguan (GV3), Zusanli (ST36) and Ciliao (BL32).Outcome measures: Motor function and cell apoptosis in rats after SCI. The mRNA and protein expression levels of Shh and Gli-1 were determined by real-time quantitative polymerase chain reaction, western blot and immunohistochemistry.Results: After AM treatment, the hindlimb motor function of SCI rats was significantly increased than the SCI group at 7, 9, 11, 14 days (P < 0.05). AM treatment 7 d and 14 d significantly preserved the nissl-stained positive neurons and significantly decreased number of apoptotic cells, compared to that of SCI 7 and 14 d groups (P < 0.05). AM treatment improved the mRNA protein levels of Shh and Gli-1 after 7 and 14 days treatment compared to the SCI group (P < 0.05).Conclusion: AM could improve the expression of Shh and Gli-1 in injured spinal cord of rats. That could be part of underlying mechanisms of AM treatment including recover motor function and preserve the neuron cells and alleviate the apoptosis of nerve cells in rats after SCI.

Effect of electroacupuncture on the mRNA and protein expression of Rho-A and Rho-associated kinase II in spinal cord injury rats.

Electroacupuncture is beneficial for the recovery of spinal cord injury, but the underlying mechanism is unclear. The Rho/Rho-associated kinase (ROCK) signaling pathway regulates the actin cytoskeleton by controlling the adhesive and migratory behaviors of cells that could inhibit neurite regrowth after neural injury and consequently hinder the recovery from spinal cord injury. Therefore, we hypothesized electroacupuncture could affect the Rho/ROCK signaling pathway to promote the recovery of spinal cord injury. In our experiments, the spinal cord injury in adult Sprague-Dawley rats was caused by an impact device. Those rats were subjected to electroacupuncture at Yaoyangguan (GV3), Dazhui (GV14), Zusanli (ST36) and Ciliao (BL32) and/or monosialoganglioside treatment. Behavioral scores revealed that the hindlimb motor functions improved with those treatments. Real-time quantitative polymerase chain reaction, fluorescence in situ hybridization and western blot assay showed that electroacupuncture suppressed the mRNA and protein expression of Rho-A and Rho-associated kinase II (ROCKII) of injured spinal cord. Although monosialoganglioside promoted the recovery of hindlimb motor function, monosialoganglioside did not affect the expression of Rho-A and ROCKII. However, electroacupuncture combined with monosialoganglioside did not further improve the motor function or suppress the expression of Rho-A and ROCKII. Our data suggested that the electroacupuncture could specifically inhibit the activation of the Rho/ROCK signaling pathway thus partially contributing to the repair of injured spinal cord. Monosialoganglioside could promote the motor function but did not suppress expression of RhoA and ROCKII. There was no synergistic effect of electroacupuncture combined with monosialoganglioside.

High-density lipoprotein cholesterol and in-hospital mortality in patients with acute aortic dissection.

The association between high-density lipoprotein cholesterol (HDL-C) and mortality in patients with acute aortic dissection (AAD) is unclear. From January 2007 to January 2014, a total of 928 consecutive AAD patients who were admitted within 48 h after the onset of symptoms were enrolled in the study. Patients were divided into two groups according to whether serum HDL-C level was below the normal lower limit or not. The Cox proportional hazard regression model was used to identify the predictive value of HDL-C for in-hospital mortality in patients with AAD. As compared with normal HDL-C group (n=585), low HDL-C group (n=343) had lower levels of systolic blood pressure and hemoglobin and higher levels of leukocyte, alanine aminotransferase, blood glucose, blood urea nitrogen, creatinine and urea acid. Low HDL-C group had significantly higher in-hospital mortality than normal HDL-C group (21.6% vs. 12.6%, log-rank=10.869, P=0.001). After adjustment for baseline variables including demographics and biologic data, the increased risk of in-hospital mortality in low HDL-C group was substantially attenuated and showed no significant difference (adjusted hazard ratio, 1.23; 95% confidence interval, 0.86-1.77; P=0.259). Low HDL-C is strongly but not independently associated with in-hospital mortality in patients with AAD.

CYP2C8-derived epoxyeicosatrienoic acids decrease oxidative stress-induced endothelial apoptosis in development of atherosclerosis: Role of Nrf2 activation.

The aim of the present study is to investigate how cytochrome P450 enzymes (CYP) 2C8-derived epoxyeicosatrienoic acids (EETs) regulate the nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway and protect against oxidative stress-induced endothelial injuries in the development and progression of atherosclerosis. In this study, cultured human umbilical vein endothelial cells (HUVECs) were transfected with CYP2C8 or pretreated with exogenous EETs (1 µmol/L) before TNF-α (20 ng/mL) stimulation. Apoptosis and intracellular ROS production were determined by flow cytometry. The expression levels of ROS-associated NAD(P)H subunits gp91 and p47, the anti-oxidative enzyme catalase (CAT), Nrf2, heme oxygenase-1 (HO-1) and endothelial nitric oxide synthase (eNOS) were detected by Western blotting. The results showed that CYP2C8-derived EETs decreased apoptosis of HUVECs treated with TNF-α. Pretreatment with 11, 12-EET also significantly blocked TNF-α-induced ROS production. In addition, 11, 12-EET decreased oxidative stress-induced apoptosis. Furthermore, the ability of 11, 12-EET to protect cells against TNF-α-induced apoptosis via oxidative stress was abrogated by transient transfection with Nrf2-specific small interfering RNA (siRNA). In conclusion, CYP2C8-derived EETs prevented TNF-α-induced HUVECs apoptosis via inhibition of oxidative stress associated with the Nrf2 signaling.

[Study on needling Ying method for treatment of sore throat].

To explore the mechanism of needling Ying method for treatment of sore throat. By the analysis of pathogenesis of sore throat, the authors think the key of its pathogenesis is stagnation of pathogenic factors such as hotness and phlegm accumulating, and meridian-vessel obstruction in the throat is its meridian foundation. There are several meridians passing through the throat, so the throat is closely related to viscera and meridians, and stagnation of pathogenic factors such as hotness and phlegm accumulating in the throat lead to sore throat when exogenous pathogenic factors invading or dysfunction of viscera and meridians. The treatment of needling Ying at local throat or combined with corresponding meridian point selection can dredge collaterals, dispel pathogenic factors, remove pathogenic factors to dispel swelling, resolve phlegm and dissipate stagnation and harmonize yin and yang, so as to relieve sore throat. In conclusion, needling Ying method is an important method in the treatment of sore throat.

[Study on treatment of flaccidity from the Governor Vessel].

The relationship of affected regions, cause of disease, pathogenesis of flaccidity with physiological functions of the Governor Vessel is expounded, indicating that "skin, muscle, tendon, vessel and joint" are basic structures of performing motor function of the organism, which depend on nourishing of qi, blood, body fluid, essence and marrow; "insufficiency of essence and marrow" and "deficiency of qi and blood" are keys of pathogenensis of flaccidity; "deficiency or obstruction of the Governor Vessel" and "yang of the Governor Vessel unable to function" are the basis of channels and collaterals for flaccidity attack. Clinically, regulation of the Governor Vessel can promote repair of morphosis and functions of the Governor Vessel (brain and spinal cord), and rebuilding of the regulative system of the brain-the Governor Vessel (spinal cord)-viscera-channels, qi and blood functional activities, so as to restore the normal distribution and transduction of qi, blood, body liquid, essence and marrow to nourish skin, muscle, tendon, vessel and joint.

[Brief analysis on scientifity of the international scalp acupuncture].

By comparing and analyzing the similarity among the international scalp acupuncture, JIAO's scalp acupuncture and ZHU's scalp acupuncture, it is believed that the international scalp acupuncture is a combination of traditional acupuncture and other scalp acupuncture on the basis of channel theory of TCM, and this combination is worthy of discussion. However JIAO's scalp acupuncture lacks scientific evidence. So, the international scalp acupuncture following most contents of JIAO's scalp acupuncture is worthy of discussion.

[Observation on the therapeutic effect of warming needle moxibustion on prolapse of lumbar intervertebral disc].

OBJECTIVE: To observe the therapeutic effect of warming needle moxibustion on prolapse of lumbar intervertebral disc. METHODS: Seventy-eight cases were randomly divided into a test group and a control group, 39 cases in each group. The control group were treated with acupuncture at Shenshu (BIL 23), Mingmen (GV 4), Yaoyangguan (GV 3) and Weizhong (BL, 40), etc. , and the test group with acupuncture at the same acupoints as in the control group plus warming needle moxibustion at Mingmen (GV 4), Yaoyangguan (GV 3) and Weizhong (BL 40). RESULTS: The total effective rate of 94.9% in the test group was significantly better than 71.8% in the control group (P < 0.01). The incidence rate of needling sensation propagating along the channel (84.6%) in the test group was significantly higher than 56.4% in the control group (P < 0.01). CONCLUSION: The warming needle moxibustion stimulating the needling sensation propagating along the channel has a better therapeutic effect on prolapse of lumbar intervertebral disc.

[Clinical observation on moxibustion and acupuncture at Zusanli (ST 36) for treatment of refractory facial paralysis].

OBJECTIVE: To observe clinical therapeutic effect of moxibustion and acupuncture at Zusanli (ST 36) on refractory facial paralysis. METHODS: Sixty cases were randomly divided into a test group and a control group, 30 cases in each group. The control group were treated with acupuncture at Hegu (LI 4), Taichong (LR 3), Touwei (ST 8), etc. , and the test group with acupuncture at the same points as those in the control group plus moxibustion and acupuncture at Zusanli (ST 36) with a warm-heat sense transmitting into the depth of the point along the needle body for the patient. RESULTS: The total effective rate of 93.3% in the test group was significantly better than 76.7 in the control group (P < 0.05); in the test group, the total effective rate for the patients with needling sensation propagating along the channel was 100%, which was significantly superior to 80.00% in the patients with no needling sensation propagating along the channel (P < 0.05). CONCLUSION: Moxibustion and acupuncture at Zusanli (ST 36) activating sensation propagating along channel as main way has a better therapeutic effect on refractory facial paralysis.