[Effect of electroacupuncture at "Zusanli" (ST36) and "Tianshu" (ST25) on intestinal function and autonomic nerve balance in rats with irritable bowel syndrome].

OBJECTIVE: To study whether electroacupuncture (EA) of "Zusanli" (ST36) combined with "Tianshu" (ST25) has a synergistic effect in regulating the colonic function and autonomic nerve balance in rats with irritable bowel syndrome (IBS). METHODS: Male Wistar rats were randomly divided into control, model, EA-ST36, and EA-ST36+ST25 groups, with 14 rats in each group. The IBS model was established by using water avoidance stress method. The visceral hypersensitivity was measured using the abdominal wall retraction reflex (AWR). The rectus abdominis electromyogram (EMG), intestinal electrical activity, and electrocardiogram (ECG) were recorded using a PowerLab data acquisition and analysis system. The contents of serum cAMP and cGMP were determined by ELISA, the expression levels of colonic tyrosine hydroxylase (TH) and choline acetyl-transferase (ChAT) proteins were determined by immunofluorescence staining and Western blot, respectively. RESULTS: Compared with the control group, the model group had an evident increase in the levels of AWR, LF, LF/HF, ChAT protein expression, cAMP and cGMP contents and cAMP/cGMP ratio (P<0.001, P<0.05), and a marked decrease in the levels of HF, frequency of slow waves of intestinal EMG, visceral pain threshold (PT), immunoactivity and expression of TH protein (P<0.05, P<0.001). In contrast to the model group, the levels of AWR, LF, LF/HF, ChAT protein expression and immunoactivity, cAMP and cGMP contents and ratio of cAMP/cGMP were significantly reduced (P<0.001, P<0.05, P<0.01), whereas the levels of frequency of slow waves of intestinal EMG, PT, and the immunoactivity and expression of TH were considerably increased (P<0.001, P<0.05) in both EA-ST36 and EA-ST36+ST25 groups. CONCLUSION: EA of both ST36 and ST36+ST25 can relieve visceral pain, and reduce sympathetic activity to improve autonomic nerve balance, but without apparent synergistic effect between EA-ST36 and EA-ST25 in rats with IBS.

[Challenges and choices: translational acupuncture research spectrum-a proposal].

For more than half a century，the modern bioresearch in acupuncture has made remarkable advancements, proving scientific basis underlying the traditional, intuitive treatment, as well as leading to some new discoveries with the potential to enhance the effectiveness of acupuncture as we know it. Meanwhile, the clinical researches have started to shift its paradigm from traditional individual observation to modern evidence-based medicine. However, there is little interaction between basic and clinic researches, which are like two separate worlds, not benefiting each other. Also the education and training of acupuncture are still traditional style, little combining with modern studies. To bridging the large gap, we need translational science involving in. In this article, with a critical reviews of the limitations of the traditional methods of acupuncture, the challenges faced by clinic practices and placebo-control studies, and the advantages and disadvantages of basic research, we propose a methodological paradigm of the translational research, Translational Acupuncture Research Spectrum, that meets the current situation of acupuncture researches, hoping to give insights into this field and to promote modern acupuncture to move towards a new stage.

[Dose-effect relationship and precise treatment of acupuncture：viewing from translational medicine].

The acupuncture treatment scheme contains several key elements including acupoint selection and prescription, duration of needle retention, treatment frequency, needling manipulation technique, etc. which have, in precision degree, an important influence on the clinical efficacy, and their precise determination needs the guidance of the dose-effect relationship of acupuncture stimulation. In the present article, we discuss the basic concept and content of the dose-effect relationship of acupuncture and analyze its relationship with the precise treatment scheme. The precision and standardization of clinical treatment scheme of acupuncture are definitely not the negation of rich clinical experience, but rather, they are the transcendence of rich clinical experience. The dose-effect relationship of acupuncture is the rule that the acupuncture effect changes with the quantitative change of each key element, and its main contents include: the dose-effect relationship of acupoint prescription, the dose-effect relationship of needling manipulation, and the time-effect relationship of acupuncture.

[Re-thinking the acupoint-visceral correlation: evidence from clinical literature and its biological mechanism].

The regularity of acupoint-viscera correlation is a basic problem in the study of acupuncture and moxibustion. At present, there are two main theories of the regularities: (1) the law of acupoint effect determined by meridian circulation; (2) segmental dominance of acupoint effect. These two regularities belong to different paradigm systems, they are not complementary relations within the same conceptual system. Based on the evidence of clinical practice of acupuncture and moxibustion, combined with the research on biological mechanisms, this paper analyzed the objectivity and universality of the regularities of acupoint-visceral correlation. The law determined by meridian of acupoint effect does not manifests the universality guiding role in the clinical practice of modern acupuncture and moxibustion, which is obviously divorced from the needs of modern clinical practice. The segmental dominance of acupoint effect has been strongly supported by the clinical practice of modern acupuncture and moxibustion, which is highly consistent with the clinical practice. The regularity of acupoint effect needs to be tested and re-identified in practice.

[Dilemma and breakthrough of acupuncture-moxibustion department under the situation of rapid expansion of hospital].

Under the situation of the rapid expansion of hospital, the dilemma of acupuncture-moxibustion department, as well as the relevant solutions are explored. The main reasons for the shrinking situation of the service in acupuncture-moxibustion department include: the disease-based department division trends to divert many diseases suitably treated in acupuncture-moxibustion department; the environment pursuing economic benefits restricts the development of acupuncture-moxibustion therapy characterized by "simple and low-cost operation". There are three important approaches for breaking through the dilemma of acupuncture and moxibustion therapy. First, modifying the traditional service mode as waiting for patients in acupuncture-moxibustion department and promoting acupuncture and moxibustion technology to be adopted in other departments rather than limited only in acupuncture-moxibustion department. Second, increasing the charges of acupuncture and moxibustion technology rationally. Third, positioning accurately the role of acupuncture and moxibustion technology in health services based on its own characteristics and advantages and promoting it in community medical institutions. All of these solutions require the guidance of supporting policies.

[Trajectory of the internationalization of acupuncture at different times: thoughts on post-internationalization of acupuncture].

The process of acupuncture internationalization includes two basic stages: pre-internationalization period and post-internationalization period. The former is mainly characterized by unidirectional export led by China, while other countries and regions are mainly learning and absorbing. The latter is manifested by the localization transformation and development of acupuncture in foreign countries, which brings severe challenges to traditional Chinese acupuncture. It is helpful to grasp the international trend of acupuncture development by actively understanding the trajectory of acupuncture internationalization. To effectively cope with the challenges brought by the post-internationalization period, modern acupuncture is needed to be developed proactively. Only by establishing a modern acupuncture system compatible with modern science, can China continue to lead the international acupuncture academic development.

[Research progress and problems of neurobiological mechanisms of acupuncture underlying improvement of irritable bowel syndrome].

In recent years, many studies have confirmed the positive effect of acupuncture and moxibustion in the treatment of irritable bowel syndrome (IBS), and a lot of researches have been made to explore its neurobiological mechanisms. The neurobiological mechanisms include two aspects 1) remission of visceral hypersensitivity via peripheral and central pathways (spinal cord and brain), and 2) improvement of intestinal motility via vagus nerve and enteric nervous system (ENS)- interstitial cells of Cajal (ICC)-smooth muscle cells (ENS-ICC-SMC) network, and 5-HT, vasoactive intestinal peptide (VIP), neuropeptide Y, etc.. At the same time, we also discussed the existing problems in the research of the underlying neurobiological mechanisms of acupuncture and moxibustion for IBS. The existing problems in this field mainly include 1) fragmentization or lack of integrity in researches, and 2) limitation of the reductionism method. For this reason, we should draw lessons from the research methods of systematic science to study the neurobiological mechanisms of acupuncture and moxibustion in the treatment of IBS, including the detailed links of peripheral and central nervous transmission of acupoint stimulation signals, and the interactive action modes (two-way benign regulation, multi-target regulation, saturation regulation, etc.).

[Internationalized background of developing modern acupuncture and moxibustion-on the reform of teaching material of Acupuncture and Moxibustion].

This paper analyzes the severe challenges posed by the localization process in the internationalization of Chinese acupuncture and moxibustion to Chinese traditional acupuncture and moxibustion, and the ways to deal with the challenges. It is believed that the lack of deep understanding of the challenges in the process of internationalization of acupuncture and moxibustion is mainly due to the lack of knowledge structure of acupuncture and moxibustion, and the innovation of acupuncture and moxibustion teaching materials is the basis of effectively adjusting the knowledge structure. The direction of the reform of acupuncture and moxibustion teaching materials should separate the modern version of acupuncture and moxibustion that conforms to the nature of science and teach it in parallel with the traditional version of acupuncture and moxibustion. The development of modern acupuncture and moxibustion in line with the nature of science is not only an urgent need to meet the challenges of western acupuncture and moxibustion, but also an internal requirement for the development of acupuncture and moxibustion itself.

[Localization of Chinese acupuncture-moxibustion in the United States: the openness of modern acupuncture-moxibustion system].

The internationalization of Chinese acupuncture-moxibustion is inevitably accompanied by the localization of acupuncture-moxibustion. The localization of acupuncture-moxibustion will inevitably promote the diversified development of acupuncture-moxibustion technique and theory, which fully demonstrates the openness of modern acupuncture-moxibustion. In this study, the characteristics of localization of Chinese acupuncture-moxibustion in the United States are explored and studied from the following aspects: legal adjustment, technical adjustment, educational adjustment, service adjustment and theoretical adjustment.

[An analysis on correlation between acupoint and target organs of acupuncture-moxibustion from the perspective of modern medical sciences].

The segmental neuronal connection plays an important role in acupoint-target organ specific correlation. The acupoint-target organ correlation includes acupoint-visceral correlation and acupoint-somatic correlation. The acupoint-viscera correlation involves both the primary central (spinal cord) mechanism and the peripheral (dorsal root ganglion, DRG) mechanism implemented by segmental nerve reflex via the spinal cord and axonal reflex via DRG respectively, while the acupoint-somatic correlation mainly involves the axonal reflex.

[Inclusivity and innovation in modern acupuncture and moxibustion: breakthroughs of Introduction to Acupuncture and Moxibustion Medicine].

As a work of modern acupuncture and moxibustion, the Introduction to Acupuncture and Moxibustion Medicine discusses various key issues in the field of acupuncture and moxibustion, such as the existing problems of acupuncture and moxibustion, the deconstruction of traditional acupuncture and moxibustion, the cultural problems of acupuncture and moxibustion, the construction of modern acupuncture and moxibustion system, the significance of western acupuncture and moxibustion, the value of ZHU Lian's acupuncture and moxibustion, the problems of systematic acupuncture and moxibustion, which has showed inclusivity and innovation of modern acupuncture and moxibustion.

The roles of autophagy and apoptosis in burn wound progression in rats.

Understanding the role of cell death in burn wound progression is crucial for giving appropriate diagnoses and designing therapy regimens for burn patients. A well-described and reliable "comb burns model" was employed to evaluate the roles of autophagy and apoptosis in burn wound progression at 2 h, 6 h, 12 h, 24 h, and 48 h post-burn in a rat model. Immunohistochemistry (IHC) results showed that autophagy was detectable in hair follicle epithelium at 2 h post-burn, peaked at 12 h post-burn, then declined. Conversely, apoptosis was mainly located in the stratum epidermis and took place at low levels until 6 h post-burn, at which point it slowly increased. Bcl-2 and Bax, which are regulators of both processes, showed protein expression level patterns that were consistent with the IHC results. This study of autophagy in burn wound tissue progression represents a conceptual expansion of cell death in burn wounds. Based on these results, we suggest that different treatments should be performed on a specific post-burn time course depending on the most prevalent type of cell death occurring at that time.

A clinical trial of acupuncture about time-varying treatment and points selection in primary dysmenorrhea.

OBJECTIVE: To observe the clinical therapeutic effects of acupuncture at single point Shiqizhui (EX-B8) and multi-points in time-varying treatment for primary dysmenorrhea. METHODS: 600 patients with primary dysmenorrhea were randomly assigned to the single point group (n=200) including group A (treating before the menstruation, n=100) and group B (immediately treating as soon as pain occurrence, n=100), the multi-points group (n=200) including group C (treating before the menstruation, n=100) and group D (immediately treating as soon as pain occurrence, n=100), or the control group, group E (n=200, no treatment). The therapeutic effects were analyzed after treatment for three menstrual cycles and interviewed for three follow-up periods. RESULTS: Acupuncture could effectively relieve menstrual pain for primary dysmenorrhea compared with the control group (P<0.05, P<0.01). Immediate pain relief occurred following acupuncture within 5 min in group B (P<0.01) and group D (P<0.01), and the two groups obviously relieved menstrual pain for VAS scores. Both group A and group C obviously relieved menstrual pain (P<0.01), and group C was better than group A (P<0.05). Compared with group D, Group C was much better for CMSS scores in cycle 1. CONCLUSION: Treating before the menstruation is better than immediately treating as soon as pain occurrence at the improvement in symptoms of dysmenorrheal at multi-points. And single point is better than multi-points when immediately treating as soon as pain occurrence. The present trial suggest Shiqizhui (EX-B8) should be chosen as a convenient point.

Zeolite-based hemostat QuikClot releases calcium into blood and promotes blood coagulation in vitro.

AIM: To examine the changes in electrolyte concentrations after addition of zeolite-based hemostat QuikClot in blood and the effects of zeolite on blood coagulation in vitro. METHODS: Fresh blood was taken from healthy adult volunteers and sheep, and the electrolyte concentrations in blood were measured using a blood electrolyte analyzer. Zeolite Saline Solution (ZSS) was prepared by addition of 2 g zeolite to 0.9% NaCl solution (4, 8, or 16 mL). The electrolytes in ZSS were measured using inductively coupled plasma atomic emission spectroscopy. The prothrombin time (PT) and activated partial thromboplastin time (APTT) of blood were measured using the test tube method. The activated clotting time (ACT) and clotting rate (CR) of blood were measured with Sonoclot Coagulation and Platelet Function Analyzer. RESULTS: Addition of zeolite (50 and 100 mg) in 2 mL human blood significantly increased Ca(2+) concentration, while Na(+) and K(+) concentrations were significantly decreased. Addition of zeolite (50 and 100 mg) in 0.9% NaCl solution (2 mL) caused similar changes in Ca(2+) and Na(+) concentrations. Si(4+) (0.2434 g/L) and Al(3+) (0.2575 g/L) were detected in ZSS (2 g/8 mL). Addition of ZSS in sheep blood shortened APTT in a concentration dependent manner, without changing PT. ZSS or aqueous solution of CaCl2 that contained Ca(2+) concentration identical to that of ZSS significantly shortened ACT in human blood without significantly changing CR, and the effect of ZSS on ACT was not significantly different from that of CaCl2. CONCLUSION: Zeolite releases Ca(2+) into blood, thus accelerating the intrinsic pathway of blood coagulation and shortening the clot formation time.

Epidemiological studies of electrical injuries in Shaanxi province of China: a retrospective report of 383 cases.

A statistical survey was conducted at the Burn Unit of the Tangdu Hospital, Shaanxi, China, during the 10-year period from January 2000 to December 2009. In this retrospective study, 383 patients who admitted to our burn unit because of electrical trauma were included. Data including the patient's general condition, clinical presentation, complications and operation times was collected retrospectively and analyzed with epidemiological methods. Subjects in our collective were predominantly male (90.3%, n=346/383) and were composed by those who injured in work-related incidents (78.3%, n=300/383), rural individuals (58.2%, n=223/383) and students (9.4%, n=36/383). High voltage was directly correlated to severity clinical complications, and amputation. The percentage of myocardial impairment was 79.3% (n=92/116) among patients who suffered with electrical current through heart tissue. Along with the more developed east area of China, electrical injuries are becoming a growing concern of the developing West part in China as well. Electrical injuries induce serious tissue damage, need long hospital stay, and result in high rate of permanent disability and economic hardship for the afflicted families. A competent prevention program needs to be developed to address this problem.

[Observation on immediate analgesic effect of acupuncture at Shiqizhui (EX-B 8) only or multi-acupoints in patients with dysmenorrhea: a randomized controlled trial].

OBJECTIVE: To compare the different therapeutic effect between acupuncture at Shiqizhui (EX-B 8) only and multi acupoints on dysmenorrhea. METHODS: Thirty eight cases were randomly divided into a single acupoint group and a multi-acupoints group, 19 cases in each group. The single acupoint group was treated by acupuncture at Shiqizhui (EX-B 8) only, and the multi-acupoints group by acupuncture at Shiqizhui (EX-B 8), Sanyinjiao (SP 6), Diji (SP 8), Ciliao (BL 32). They were all treated from the first day when sudden intense pain occurs, one time each day, for 3 days in each menstrual cycle, the treatment of three menstrual cycles. The therapeutic effect and Visual Analogue Scale (VAS) were compared and the score of general frequency and severity of dysmenorrhea by using Cox Menstrual Symptom Scale (CMSS) were evaluated. RESULTS: The cured rate was 68.4% (13/19) and the effective rate was 31.6% (6/19) in the single acupoint group, being similar to 78.9% (15/19) and 21.1% (4/19) in the multi-acupoints group (P > 0.05). VAS and the scores of general frequency and severity of dysmenorrhea were all significantly decreased after treatment in both groups (all P < 0.001), with no significant difference between the two groups (all P > 0.05). CONCLUSION: Acupuncture at Shiqizhui (EX-B 8) only can be as effective as selecting multi-acupoints to cure essential dysmenorrhea.

[Preliminary comparison on the time-effect rule of pain-relieving in the treatment of moderate dysmenorrhea between acupuncture on single-point and acupuncture on multi-point].

OBJECTIVE: To compare the time-effect rule of pain-relieving in moderate dysmenorrhea in the treatment between acupuncture on single-point and acupuncture on multi-point so as to determine the best time of needle retaining on single-point and multi-point as well as provide the reference evidences of acupuncture frequency in the treatment. METHODS: Sixty-three cases of moderate dysmenorrhea were randomized into a single-point group (31 cases) and a multi-point group (32 cases). During the attack of dysmenorrhea, in single-point group, Shiqizhui (EX-B 8) was punctured; in multi-point group, Shiqizhui (EX-B 8), Diji (SP 8), Ciliao (BL 32) and Sanyinjiao (SP 6) were punctured and the needles were retained for 30 min. Visual Analogue Scale (VAS) values were recorded in the immediate time before acupuncture, in 5 min, 10 min, 20 min and 30 min after needle insertion, as well as in 30 min, 60 min and 120 min after needle withdrawal separately. RESULTS: After needling, analgesia was generated rapidly in either group. During 30 min of needle retaining, analgesia was enhanced persistently till needle withdrawal in either group. In 10 min after needle insertion, the immediate analgesia in multi-point group was superior obviously to single-point group (P < 0.05) and this effect was maintained in 2 h after needle withdrawal. In 30 min after needle withdrawal, acupuncture analgesia was declined to the maximum. CONCLUSION: Either single-point acupuncture at Shiqizhui (EX-B 8) or multi-point acupuncture at Shiqizhui (EX-B 8) and other acupoints has apparent immediate analgesia on primary dysmenorrhea of moderate degree, but the effect of multi-point acupuncture is better than that of acupuncture at Shiqizhui (EX-B 8). No matter with acupuncture at Shiqizhui (EX-B 8) or at multi-point, the time of needle retaining should not be shorten than 30 min. It is suitable to give acupuncture, twice per day for the patients with moderate and persistent pain.

Clinical study on the treatment of primary dysmenorrhea with preconditioning acupuncture.

OBJECTIVE: To observe the therapeutic effect of preconditioning acupuncture (PA) on the treatment of primary dysmenorrhea. METHODS: Eighty patients suffered from primary dysmenorrhea were randomly assigned on the ratio of 1:1:2 into three groups, 20 in Group A, 20 in Group B, and 40 in Group C. Group A and B were treated with PA and immediate acupuncture (IA), respectively, while Group C received no acupuncture treatment and be taken as a blank control. The treatment was lasted for three menstrual cycles. The therapeutic effects were observed and compared. RESULTS: Comparing the scores of the symptoms in the different groups, the therapeutic effect in different groups showed that the symptom scores in Group A at the second and third cycle of treatment, as well as at the first and third cycle of follow-up, were significantly lower than the scores in Group B, respectively (P<0.05 or P<0.01), and the duration of symptoms was shorter in Group A than in Group B at the third cycle of treatment and the first and third cycle of follow-up (P<0.05). Symptom scores in Groups A and B in the treatment and follow-up periods were all lowered as compared to those before treatment (P<0.01), and the scores were also lower than those in Group C measured at corresponding times (P<0.01). CONCLUSION: The therapeutic effect of PA, either the short-term or the long-term effect, was superior to that of IA in treating dysmenorrhea.

Electrical injury alters ion channel expression levels and electrophysiological properties in rabbit dorsal root ganglia neurons.

The electrophysiological and morphological changes of nerve fibers induced by electrical injury have been widely addressed. However, the changes of ion channels in neurons after electrical shocks have not been systematically investigated yet. In this study, the sciatic nerves of rabbit were injured by 50 V 50 Hz, 110 V 50 Hz, and 220 V 50 Hz alternating current, respectively. One week later, the expression levels and electrophysiological changes of voltage-gated potassium (Kv) and sodium (Nav) channels in dorsal root ganglia (DRG) neurons were evaluated by RT-PCR, immunofluorescence staining and patch clamp technique. The Nav1.1 expression was decreased by 50V injury. The Kv1.2, Kv1.4, Nav1.1 and Nav1.7 expression levels and Kv current densities were reduced after 110 V injury. Under the 220 V injury circumstance, Kv1.2, Nav1.1, Nav1.7 expression levels, Kv current densities and TTX-R Na(+) current densities were significantly decreased, while TTX-S Na(+) current densities increased. These findings suggest that the expression levels, subunit compositions, and electrophysiological properties of Kv and Nav channels are altered after electrical injury, and the severity of injury gets worse as injury voltage increases.

[Observation on the fluid resuscitation and the change in blood sodium of severely burned patients in the early stage].

OBJECTIVE: To study the necessary amount of fluid consisting of electrolyte and colloid, the ratio of electrolyte and colloid used, and the change of blood sodium during early resuscitation in severely burned patients. METHODS: Sixty-seven patients with total burn surface area (TBSA) equal to or over 70% and full-thickness area equal to or over 50%TBSA, hospitalized from March 2004 to March 2009, were resuscitated with fluid. The infusion amount of electrolyte, colloid, and water, and urinary output of patients at post injury hour (PIH) 24, 48, and 72 were analyzed retrospectively. The variation in blood sodium and fluid infusion at different time points was recorded. Data were processed with SPSS 13.0 software. RESULTS: Among the 67 patients, hyponatremia occurred in 9 cases, hypernatremia occurred in 5 cases, and 53 patients had normal blood sodium level. The urinary output of patients within PIH 72 was above 70 mL/h. K value was calculated through the formula: actual total infusion amount of electrolyte and colloid (mL) = burn area (%TBSA) x body weight (kg) x K. In the first 24 PIH, K value was about 1.7, and the ratio of electrolyte and colloid was 1.4. In the second 24 PIH, K value was about 1.3 with electrolyte and colloid ratio 1.6. K value in the third 24 PIH was about 0.9 with electrolyte and colloid ratio 2.0. CONCLUSIONS: The actual amount of resuscitation fluid is slightly larger than that calculated from traditional formula during the early stage in severely burned patients. The amount of electrolytes and the proportion of electrolyte and colloid will influence blood sodium level of patients.