[Effects of moxibustion at "Tianshu"（ST25） and "Shangjuxu" （ST37） on colonic metabolites and inflammatory factors in rats with Crohn's disease].

OBJECTIVE: To observe the effects of moxibustion at "Tianshu"（ST25） and "Shangjuxu"（ST37） on the colonic metabolites and inflammatory factors in rats with Crohn's disease（CD）, so as to explore the mechanisms of moxibustion in protecting colon of CD rats based on metabolomics. METHODS: Twelve rats were first randomly selected from 36 male SD rats as a normal group（NG）. The CD model was induced by 2, 4, 6 trinitrobenzene sulfonic acid（TNBS） enema on the rest 24 rats. After successful modeling, rats were randomly divided into model（TNBS） and moxibustion（TNBS+MOX） groups（n=10 rats/group）. Moxibustion was applied at bilateral ST25 and ST37 for 30 min, once daily for 7 consecutive days in the TNBS+MOX group, while rats in the NG and TNBS groups did not receive any interventions. Body weight of rats was recorded and disease activity index（DAI） was assessed during the experiment. After interventions, HE staining was performed to observe pathological damage of colon. Serum levels of inflammatory factors were measured by ELISA. NMR hydrogen spectroscopy was used to detect colonic metabolites of each group, and orthogonal partial least squares discriminant analysis（OPLS-DA） was used to screen differential colonic metabolites between groups, followed by pathway analysis using MetaboAnalyst 5.0 platform. RESULTS: After modeling, compared with the NG group, the body weight of the rats in the TNBS group was significantly decreased（P<0.05）, the DAI score was increased （P<0.05）, the colon had obvious inflammatory damage and the pathological injury index was increased（P<0.05）, and levels of serum tumor necrosis factor-α（TNF-α）, interleukin（IL）-1ß and interferon-γ（IFN-γ） were significantly increased（P<0.05）. After moxibustion intervention, compared with the TNBS group, the body weight was significantly increased（P<0.05）, while the levels of serum TNF-α, IL-1ß, IFN-γ, and DAI score of the rats in the TNBS+MOX group were significantly decreased（P<0.05）, with alleviated colonic inflammatory injury detected by HE staining. Compared with the NG group, the relative expressions of colonic hypoxanthine, betaine, creatine, inositol, taurine, uracil, and methanol of the TNBS group were decreased（P<0.05）, while the relative expressions of histidine, leucine, proline, lysine, isoleucine, phenylalanine, tyrosine, propionic acid, and valine were increased（P<0.05） in the TNBS group, among which, relative expressions of hypoxanthine, leucine, lysine, isoleucine, betaine, tyrosine, and taurine were reversed in the TNBS+MOX group relevant to the TNBS group, mainly involving phenylalanine, tyrosine and tryptophan biosynthesis, and taurine and subtaurine metabolism pathway. CONCLUSION: The mechanism of moxibustion at ST25 and ST37 for CD may be related to improving colon metabolic disorder state by regulating multiple metabolic metabolites and metabolic pathways, and reducing the level of inflammatory factors, so as to maintain intestinal immune homeostasis.

[Comparison of stimulation-induced local changes of expression of local Meckel cell-related proteins and neuropeptides and number of mast cells among acupuncture and moxibustion alone or in combination in chronic atrophic gastritis rats].

OBJECTIVE: To compare the effects of acupuncture and moxibustion alone or in combination on the number of mast cells and expression levels of cytoketatin 18 (CK18) and CK19 (marker of Meckel cells), and calcitonin gene-related peptide (CGRP), neuropeptide-Y (NPY) and bradykinin (BK) in the local acupoint area of rats with chronic atrophic gastritis (CAG). METHODS: Fifty male SD rats were randomly divided into normal, CAG model, moxibustion, acupuncture and acupuncture+moxi-bustion groups (10 rats in each group). The CAG model was established by gavage of 1-methyl-3-nitro-1-nitrosoguanidine (170 µg/mL,1 mL/100 g, once a week) and 40% ethanol solution (twice a week) for 12 consecutive weeks. After successful establishment of CAG model, moxibustion, manual acupuncture or acupuncture+moxibustion was applied to bilateral "Zusanli" (ST36) and "Zhongwan"(CV12) for 15 min, once daily for 14 consecutive days. At the end of the experiment, the gastric mucosal tissues were collected for observing histopathological changes of gastric mucosa after H.E. staining, and the tissues of the stimulated ST36 region collected for detecting the expression levels of CK18, CK19, CGRP, NPY and BK and the number of mast cells in the local ST36 region by immunohistochemistry. RESULTS: Compared with the normal group, the number of mast cells, the expression levels of CK19, NPY and BK in the ST36 area were significantly increased (P<0.05), and the expression level of CGRP was apparently decreased (P<0.05) in the model group. In comparison with the model group, the number of mast cells and the expression levels of CGRP and NPY in the moxibustion group, the expression of CGRP in the acupuncture group, and the number of mast cells, as well as the expression levels of CK18, CK19 and CGRP in the acupuncture+moxibustion group were significantly up-re-gulated (P<0.05). The effect of acupuncture combined with moxibustion was obviously superior to that of moxibustion or acupuncture in up-regulating the expression of CK18 and CK19 (P<0.05) and superior to that of moxibustion in down-regulating BK expressio level (P<0.05). No significant changes were found in the expression of CK18 after modeling (vs the normal group), in the expression levels of CK18, CK19 and BK after moxibustion and acupuncture (vs the model group), in the number of mast cells and expression of NPY after acupuncture (vs the model group), and in the expression levels of NPY and BK after acupuncture+moxibustion (vs the model group) (P>0.05). H.E. staining showed infiltration of many lymphocytes in the gastric mucosa and submucosal layers, atrophy and necrosis of lots of main cells with vacuole-like changes, and disordered arrangement of the atrophic glands in the model group, which was milder particularly in the acupuncture + moxibustion group. CONCLUSION: Acupuncture combined with moxibustion of ST36 can up-regulate the levels of local CK18, CK19 and CGRP proteins and number of mast cells, moxibustion may up-regulate the levels of CGRP and NPY and number of mast cells, while acupuncture may up-regulate the expression of CGRP in the local stimulated area in CAG rats.

[Revealing characteristics and rules of acupoint sensitization phenomena: based on knee osteoarthritis].

OBJECTIVE: To explore the characteristics and rules of acupoint sensitization phenomena based on knee osteoarthritis (KOA), one of the clinical dominant diseases of acupuncture-moxibustion. METHODS: In combination with literature and expert experiences, the acupoints with the highest use frequency in treatment of KOA were screened, e.g. Heding (EX-LE 2), Liangqiu (ST 34), Mingmen (GV 4), Neixiyan (EX-LE 4), Ququan (LR 8) and Dubi (ST 35). In 814 patients with KOA and 217 healthy subjects, the acupoint temperature, mechanic pain threshold and pressure pain threshold were detected separately. Using machine learning method, the sensitization was judged at each acupoint. RESULTS: Compared with healthy subjects, the acupoint temperature was increased and the mechanic pain threshold and pressure pain threshold were reduced in KOA patients (P<0.05). Besides, the cut-off value was presented to distinguish whether the acupoint was sensitized or not. The results of machine learning showed that the highest prediction accuracy of acupoint sensitization was 86.7% (Shenshu [BL 23]) and the lowest one was 73.9% (Heding [EX LE 2]). The prediction accuracy at the third clinical stage trial was higher, the highest was 93.3% (Ququan [LR 8]) in KOA patients. CONCLUSION: It is confirmed that the acupoint sensitization reflects the characteristics of disease and is correlative with the conditions of illness, which may provide the reference for the auxiliary diagnosis and condition assessment of KOA.

[Moxibustion on mental disorder in close contacts of coronavirus disease 2019: a randomized controlled trial].

OBJECTIVE: To observe the effect of moxibustion combined with Daiwenjiu plaster on mental disorder and self rating symptoms in close contacts of coronavirus disease 2019 (COVID-19) during quarantine. METHODS: A total of 240 close contacts of COVID-19 were randomized into an observation group (120 cases, 18 cases dropped off) and a control group (120 cases, 58 cases dropped off). Conventional observation was adopted in the control group. Moxibustion combined with Daiwenjiu plaster was given in the observation group, moxibustion was applied at Zusanli (ST 36), Hegu (LI 4) and Shenque (CV 8), 10 min each acupoint, once a day; Daiwenjiu plaster was applied at Dazhui (GV 14) and Feishu (BL 13) for 3 to 6 h each time, once every 2 days, the treatment was required for 2 weeks. Before and after treatment and in the follow-up of 2 weeks after treatment, self-reporting questionnaire 20 (SRQ-20), self-rating anxiety scale (SAS) scores and self rating symptoms were evaluated in the two groups. RESULTS: In the follow-up, SRQ-20 score was decreased compared before treatment (P<0.01), SAS score was decreased compared before and after treatment (P<0.01, P<0.05) in the observation group. After treatment and in the follow-up, SRQ-20 scores in the observation group were lower than those in the control group (P<0.05, P<0.01). After treatment, the case proportion of fatigue in the observation group was higher than that in the control group (P<0.05). In the follow-up, the case proportion of tension was lower than that in the control group (P<0.05). CONCLUSION: Moxibustion combined with Daiwenjiu plaster can effectively improve the mental disorder in close contacts of COVID-19.

[Effect of moxibustion and acupuncture on gastric mucosal cell apoptosis and expression of NF-κB, Bcl-2 in chronic atrophic gastritis rats].

OBJECTIVE: To observe the effect of moxibustion and acupuncture on apoptosis in gastric mucosal cell and expression of NF-κB, Bcl-2 in chronic atrophic gastritis (CAG) rats, so as to explore its mechanisms underlying improvement of CAG. METHODS: Forty-eight male SD rats were randomly divided into normal, model, moxibustion and acupuncture groups, with 12 rats in each group. The CAG model was established by gavage of N-methyl-N'-nitro-N-nitroso-guanidine (MNNG) solution and irregular diet for 12 weeks. Moxibustion or acupuncture was applied to "Zusanli" (ST36) and "Zhongwan" (CV12) for 15 min, once daily for two weeks in the moxibustion or acupuncture group. The histopathological changes of the gastric mucosa were observed by HE staining. The apoptosis index of gastric mucosa was measured by TUNEL method. The gene expression levels of NF-κB and Bcl-2 were detected by real-time PCR. RESULTS: After modeling, the color of gastric mucosa was pale and dark, with low folds and significant bleeding points. The glands in lamina propria were atrophied, arranged disorderly, and the numbers were significantly reduced, with inflammatory cells infiltrated. Those histopathological changes were evidently milder in the moxibustion and acupuncture groups. Compared with the normal group, the apoptosis index, NF-κB and Bcl-2 gene expression of the model group were significantly increased (P<0.01). After the treatment, the apoptosis index, NF-κB and Bcl-2 gene expression were significantly reduced in the moxibustion and acupuncture groups (P<0.05，P<0.01). The NF-κB expression was lower in the acupuncture group than that of moxibustion group (P<0.01). CONCLUSION: Moxibustion and acupuncture therapy can improve the injury of gastric mucosa in CAG rats, which may be associated with its function in down-regulating the expression of NF-κB and Bcl-2 genes in the gastric mucosa.

Effects of moxibustion and acupuncture at Zusanli (ST 36) and Zhongwan (CV 12) on chronic atrophic gastritis in rats.

OBJECTIVE: To evaluate the effects of moxibustion and acupuncture of Zusanli (ST 36) and Zhongwan (CV 12) acupoints on chronic atrophic gastritis (CAG) in rats, and to study the mechanisms behind their actions. METHODS: Forty-four male Sprague-Dawley rats were induced with CAG by intragastric administration of 40% ethanol combined with free drinking of N-methyl-N'nitro-N-nitrosoguanidine and irregular feeding for 12 weeks, followed by daily treatment with moxibustion or acupuncture for 2 weeks. Histopathologic examination, Western blotting of cytokines [epidermal growth factor (EGF), EGF receptor (EGFR), extracellular signal-regulated kinase (ERK), phosphorylated ERK (p-ERK)], and 1H NMR-based metabolic profiling of gastric tissues were used to measure changes related to CAG modeling and treatment. RESULTS: Moxibustion and acupuncture at Zusanli (ST 36) and Zhongwan (CV 12) each relieved CAG-induced abnormalities in histopathology and cytokine expression of ERK and p-ERK. Only moxibustion treatment regulated the expression of EGF and EGFR. Metabolites that were increased in gastric tissue by CAG induction (alanine, nicotinamide adenine dinucleotide phosphate, uracil DNA glycosylase, lactate, glycerol and adenosine) were restored to normal levels after moxibustion treatment; acupuncture treatment only normalized the levels of adenosine monophosphate and glycerol. CONCLUSION: Our findings suggest that moxibustion or acupuncture at Zusanli (ST 36) and Zhongwan (CV 12) can significantly improve the condition of CAG in rats. These treatments exert their effects on CAG through different mechanisms.

[Effect of autologous concentrated growth factor fibrin solution combined with Bio-Oss bone powder on mucosal healing and bone regeneration after oral implanted guided bone regeneration].

PURPOSE: To investigate the effect of autologous concentrated growth factor fibrin solution combined with Bio-Oss bone powder on mucosal healing and bone regeneration after oral implanted guided bone regeneration. METHODS: From October 2016 to December 2018, 83 patients with maxillary single anterior tooth loss and labial bone defect were treated, they were divided into two groups. Patients in the experimental group (42 cases) received autologous concentrated growth factor fibrin solution + Bio-Oss bone powder, while patients in the control group (41 cases) received Bio-Oss bone powder alone. The degree of mucosal healing, implant success, bone defect regeneration, pain and other complications were followed up 7 days, 6 weeks and 1 year after operation. The success rate and complications of the two groups were observed, as well as the differences of mucosal color, swelling degree, bleeding index, depth of probing, attachment loss, height of bone graft and thickness of bone formation were measured and recorded. Statistical analysis was performed using SPSS 25.0 software package. RESULTS: There was no significant difference in the success rate of implants between the two groups (95.24% vs 97.56%, P>0.05). The complication rate of the experimental group was significantly lower than that of the control group (2.38% vs 14.63%, P<0.05). The mucosal color and swelling degree scores of the experimental group were significantly lower than those of the control group [(0.65±0.03) points vs (2.01±0.15) points, (1.10±0.37) points vs (2.69±0.54) points, P<0.05], and the bleeding index, probing depth, and attachment loss were significantly lower than the control group [(0.35±0.05) vs (0.49±0.09), (3.39±0.62) mm vs (4.41±0.95) mm, (3.02±0.66) mm vs (5.31±0.91) mm, P<0.05], bone graft height and osteogenesis height were significantly higher than the control group [(2.61±0.50) mm vs (2.20±0.31) mm, (2.53±0.34) mm vs (2.02±0.27) mm, P<0.05]. The degree of postoperative pain in the experimental group was significantly lower than that in the control group(P<0.05). CONCLUSIONS: Rich self-concentrating growth factor fibrin solution combined with Bio-Oss bone powder can effectively promote mucosal healing and bone regeneration after oral implant-guided bone regeneration, and reduce postoperative pain and complications.

[Analysis of theoretical basis and clinical application of dog-days moxibustion].

The present situation of the clinical application of dog-days moxibustion (moxibustion applied in the three periods of the hot season) is summarized so as to provide the guide for the theoretic study and clinical application of dog-days moxibustion. The intervention time of dog-days moxibustion is on the 1st day of each of the three periods of the hot season. Simultaneously, the geographic factors are considered. The disorders of lung system are mostly dominant among the indications of dog-days moxibustion, complicated with spleen and stomach disorders as well as cold and deficiency syndromes/patterns. The acupoints are mainly selected from the front-mu points on the chest and the back-shu points on the back, in combination with the differentiation of diseases, symptoms/patterns and the disorder stages. The duration of treatment is ranged from 1 to 3 years. The clinical therapeutic effect is improved constantly along with the increase of treatment periods by years.

[Analysis on the theory and clinical ideas of acupuncture and moxibustion for the prevention and treatment of coronavirus disease 2019].

Acupuncture and moxibustion has a wealth of experience in the prevention and control of epidemic disease since ancient times, which was used for all kinds of acute infectious diseases in modern times and its efficacy has been clearly and reliably reported. This article proposes the theoretical feasibility and reliability of acupuncture and moxibustion interventional prevention and treatment by discussing the recognition of coronavirus disease 2019 (COVID-19) from the perspective of acupuncture and moxibustion. The unique "acupuncture and moxibustion program" for COVID-19 is presented including treatment in different stages, selecting acupoints by distinguishing meridians, applying needle technique by various methods. The article also proposes a new understanding of acupuncture and moxibustion at related acupoints on the surface of the body that can directly affect the "moyuan" to treat the disease.

Acupuncture and moxibustion for pain relief and quality of life improvement in patients with knee osteoarthritis: A protocol for systematic review and meta-analysis.

OBJECTIVE: The aim of this systematic review and meta-analysis is to assess the efficacy of acupuncture and moxibustion in pain relief and quality of life improvement of knee osteoarthritis (KOA) patients. METHODS: The following databases will be searched: MEDLINE, EMBASE, the Cochrane Library, Web of Science, Chinese Biomedical Literature Database, Chinese Nation Knowledge Infrastructure, Wanfang Database, the Chongqing VIP from inception to May 1, 2020. All randomized controlled trials (RCTs) used acupuncture or moxibustion to relieve pain and improve quality of life (QoL) among KOA patients will be included. Study selection, data extraction, quality assessment and assessment of risk bias will be performed by 2 reviewers independently. Data synthesis will be performed using Review Manager V5.3 software. A meta-analysis will be performed when there is sufficient available data. PROSPERO REGISTRATION NUMBER: CRD42020169724.

[Significance and operation mode of moxibustion intervention for the group under quarantine after close contact with COVID-19].

On the base of the idea of traditional Chinese medicine as "disease prevention", the mode and the protocol of the moxibustion intervention for the group under quarantine after close contact with coronavirus disease 2019 (COVID-19) were explored. The group under quarantine after close contact with COVID-19 was taken as the subjects. By the non-contact physician-patient communication network platform co-developed by China Association of Acupuncture-Moxibustion, Hunan Provincial Association of Acupuncture-Moxibustion, Data Center of China Academy of Chinese Medical Sciences and Yuge Medicine Company, an exploratory randomized controlled trial was designed. A total of 100 cases were included and randomized into a moxibustion group and a conventional intervention group, 50 cases in each one. In the moxibustion group, moxibustion intervention was used. In the conventional intervention group, the conventional observation was adopted without moxibusiton intervention applied. The outcomes included the symptoms changes, e.g. anxiety, emotional disturbance, fatigue, headache and diarrhea, as well as whether quarantine release and the case confirmed or not, etc. The results were evaluated before intervention, in 14 days of intervention and 2 weeks after intervention separately. In this research, on the base of internet plus technology and with the internet communication platform adopted, through mobile phone WeChat App, it was to implement the subject screen, the random allocation and the instruction of moxibustion intervention as well as the quality control of patient's diary and data collection. It is anticipated that the significance and the implementation mode of moxibustion intervention can be assessed preliminarily for the group under quarantine after close contact with COVID-19.

Impact of local thermal stimulation on the correlation between oxygen saturation and speed-resolved blood perfusion.

The physiologically important relationship between oxygen saturation and blood flow is not entirely understood, particularly with regard to the multiple velocity components of flow and temperature. While our previous studies used classic laser Doppler flowmetry combined with an enhanced perfusion probe to assess local blood flow following thermal stimulation, oxygen saturation signals were not assessed. Thus, the current study used multiscale entropy (MSE) and multiscale fuzzy entropy (MFE) to measure the complexity of oxygen saturation signals following thermal stimulation in healthy subjects. The results indicate that thermal stimulation increases oxygen saturation and affects the measured signal complexity in a temperature-dependent fashion. Furthermore, stimulus temperature not only affects the correlation between speed-resolved blood perfusion and oxygen saturation, but also the correlation between the complexity area indices (CAI) of the two signals. These results reflect the complexity of local regulation and adaptation processes in response to stimuli at different temperatures.

[Clinical observation on distribution characteristics and rules of pain sensitivity points on body surface in patients with knee osteoarthritis].

OBJECTIVE: To observe the distribution characteristics and rules of pain sensitivity points on body surface in patients with knee osteoarthritis (KOA). METHODS: A total of 916 patients with KOA were selected in this study, the pain sensitivity points of local site of knee joint were probed by thumb palpation. Tape was used to measure the distance between the pain sensitivity points and the most nearby acupoints. The Wagner tenderness measuring instrument was used to measure the tenderness threshold of pain sensitivity points. RESULTS: A total of 3618 pain sensitivity points were probed, among them, 3338 pain sensitivity points were sensitized. The minimum sensitization degree was 1.00, the maximum sensitization degree was 3.39, while the average sensitization degree was (2.16±0.60). Pain sensitivity points were distributed 0.37-1.73 cun around the acupoints, the average distance was (1.26±0.20) cun. Most of the pain sensitivity points (48.7%) were around Yingu (KI 10), Ququan (LR 8) and Xuehai (SP 10). The number and sensitization degree of pain sensitivity points were associated with McGill pain questionnaire score of patients with KOA (P<0.001). CONCLUSION: The pain sensitivity points of patients with KOA may be the expansion effect of acupoint areas in the disease states, pain sensitivity points are more likely to appear on the medial side of knee joint.

Acupuncture as Adjunctive Therapy for Chronic Stable Angina: A Randomized Clinical Trial.

IMPORTANCE: The effects of acupuncture as adjunctive treatment to antianginal therapies for patients with chronic stable angina are uncertain. OBJECTIVE: To investigate the efficacy and safety of acupuncture as adjunctive therapy to antianginal therapies in reducing frequency of angina attacks in patients with chronic stable angina. DESIGN, SETTING, AND PARTICIPANTS: In this 20-week randomized clinical trial conducted in outpatient and inpatient settings at 5 clinical centers in China from October 10, 2012, to September 19, 2015, 404 participants were randomly assigned to receive acupuncture on the acupoints on the disease-affected meridian (DAM), receive acupuncture on the acupoints on the nonaffected meridian (NAM), receive sham acupuncture (SA), and receive no acupuncture (wait list [WL] group). Participants were 35 to 80 years of age with chronic stable angina based on the criteria of the American College of Cardiology and the American Heart Association, with angina occurring at least twice weekly. Statistical analysis was conducted from December 1, 2015, to July 30, 2016. INTERVENTIONS: All participants in the 4 groups received antianginal therapies as recommended by the guidelines. Participants in the DAM, NAM, and SA groups received acupuncture treatment 3 times weekly for 4 weeks for a total of 12 sessions. Participants in the WL group did not receive acupuncture during the 16-week study period. MAIN OUTCOMES AND MEASURES: Participants used diaries to record angina attacks. The primary outcome was the change in frequency of angina attacks every 4 weeks from baseline to week 16. RESULTS: A total of 398 participants (253 women and 145 men; mean [SD] age, 62.6 [9.7] years) were included in the intention-to-treat analyses. Baseline characteristics were comparable across the 4 groups. Mean changes in frequency of angina attacks differed significantly among the 4 groups at 16 weeks: a greater reduction of angina attacks was observed in the DAM group vs the NAM group (difference, 4.07; 95% CI, 2.43-5.71; P < .001), in the DAM group vs the SA group (difference, 5.18; 95% CI, 3.54-6.81; P < .001), and in the DAM group vs the WL group (difference, 5.63 attacks; 95% CI, 3.99-7.27; P < .001). CONCLUSIONS AND RELEVANCE: Compared with acupuncture on the NAM, SA, or no acupuncture (WL), acupuncture on the DAM as adjunctive treatment to antianginal therapy showed superior benefits in alleviating angina. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01686230.

Metabolomics analysis of herb-partitioned moxibustion treatment on rats with diarrhea-predominant irritable bowel syndrome.

BACKGROUND: Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder, which is commonly treated with antidiarrhoeal, antispasmodics, serotonergic agents or laxative agents. These treatments provide relief for IBS symptoms but may also lead to undesired side effects. Previously, herb-partitioned moxibustion (HPM) treatment has been demonstrated to be effective in ameliorating symptoms of IBS. However, the underlying mechanism of this beneficial treatment is yet to be established. The aim of the current study was to systematically assess the metabolic alterations in response to diarrhea-predominant IBS (IBS-D) and therapeutic effect of HPM. METHODS: Proton nuclear magnetic resonance spectroscopy (1H NMR)-based metabolomics approach was used to investigate fecal and serum metabolome of rat model of IBS-D with and without HPM treatment. RESULTS: The current results showed that IBS-induced metabolic alterations in fecal and serum sample include higher level of threonine and UDP-glucose together with lower levels of aspartate, ornithine, leucine, isoleucine, proline, 2-hydroxy butyrate, valine, lactate, ethanol, arginine, 2-oxoisovalerate and bile acids. These altered metabolites potentially involve in impaired gut secretory immune system and intestinal inflammation, malabsorption of nutrients, and disordered metabolism of bile acids. Notably, the HPM treatment was found able to normalize the Bristol stool forms scale scores, fecal water content, plasma endotoxin level, and a number of IBS-induced metabolic changes. CONCLUSIONS: These findings may provide useful insight into the molecular basis of IBS and mechanism of the HPM intervention.

[Observation of electroacupuncture intervention on cell apoptosis and Bax and Bcl-2 expression in cerebral and myocardial tissues in cerebral ischemia rats based on "heart-brain correlation" theory].

OBJECTIVE: To compare the effect of electroacupuncture (EA) of "Neiguan" (PC6) of the Pericardium Meridian, "Shenmen" (HT7) of the Heart Meridian，"Shuigou" (GV26) of the Governor Vessel and "Zhaohai" (KI6) of the Kidney Meridian on myocardial and cerebral cell apoptosis in cerebral ischemia (CI) rats, so as to explore its mechanism underlying improvement of CI based on the theory of "Heart-brain Correlation". METHODS: Forty-eight SD rats (half male and half female) were randomly divided into normal control, model, PC6, HT7, GV26 and KI6 groups (n＝8 in each one). The CI model was established by occlusion of the middle cerebral artery (MCAO). EA (4 Hz/20 Hz, 1.5 mA) was applied to the right PC6, HT7, GV26 or KI6 respectively for 30 min, once every 12 h for 5 times. The cell apoptosis of the ischemic myocardial and cerebral tissues was detected by TUNEL method, and the expression of cerebral and myocardial Bax and Bcl-2 was determined by using immunohistochemistry. RESULTS: Following modeling, the cell apoptosis percentages and Bax-positive cells of both myocardial and cerebral tissues were significantly increased in the model group in comparison with the control group (P<0.01). After EA intervention, the cerebral apoptotic percentage and cerebral Bax-positive cells in the cerebral tissue of the PC6, HT7 and GV26 groups, and the myocardial apoptosis percentage in the PC6 and HT7 groups, as well as the myocardial Bax-positive cells in the PC6 group were obviously decreased (P<0.05, P<0.01), while the cerebral Bcl-2 positive cells in the PC6, HT7 and GV26 groups, and the myocardial Bcl-2 positive cells in the PC6 and HT7 groups were significantly increased relevant to the model group (P<0.01, P<0.05). No significant changes were found in the KI 6 group in the cell apoptosis index and percentages and Bax- and Bcl-2-positive cells of both myocardium and cerebral cortex tissues compared with the model group (P>0.05)．. CONCLUSION: EA stimulation of PC6 and HT7 can inhibit CI injury induced cell apoptosis of cerebral and myocardial tissues in CI rats, which is possibly associated with its effects in down-regulating Bax expression and up-regulating Bcl-2 expression of both myocardial and cerebral tissues.

[Effect of moxibustion at "Zusanli"(ST36) on metabolites of gastric tissue in rats with chronic atrophic gastritis based on metabonomics].

OBJECTIVE: To observe the effect of moxibustion at "Zusanli" (ST36) on metabolites of gastric tissue in chronic atrophic gastritis (CAG) rats, so as to explore the correlation between Yangming Meridian and stomach based on metabolomics. METHODS: Fifty-six SD rats were randomly divided into normal, normal ＋ moxibustion, model and model ＋ moxibustion groups (n＝14 rats/group). The CAG model was established by gavage of N-methyl-N'-nitro-N-nitroso-guanidine (MNNG) solution and irregular diet for 12 weeks. Moxibustion was applied to ST36 and "Zhongwan" (CV12) for 15 min, once daily for two weeks in the normal＋ moxibustion group and model＋moxibustion group. The histopathological changes of the gastric tissue were observed by H．E. staining. 1H nuclear magnetic resonance (1H NMR) spectroscopy was used to detect gastric tissue metabolites and the data were analyzed using the Chenomx NMR Suite software. RESULTS: After modeling, the regional gastric tissue showed pale thinner gastric wall, and reduction of regional glands with necrosis and disordered arrangement, epithelial cell exfoliation, lymphocyte infiltration as well as scattered punctate hemorrhage, which was evidently milder in the model ＋ moxibustion group. The metabolites of lactic acid, glutathione, N-acetylaspartate, uridine diphosphate glucose and muscle sugar in the gastric tissue in the model group were increased compared with those in the normal group (P<0.05), and the metabolites of leucine, betaine, phosphorylcholine, and uracil were decreased (P<0.05). The glutathione, N-acetylaspartate, phosphorylcholine and uracil in the model＋moxibustion group were significantly reversed relevant to the model group (P<0.05). The inositol in gastric tissue were significantly increased (P<0.05), 3-hydroxybutyric acid, serine and uridine diphosphate glucose were significantly decreased (P<0.05) in the normal ＋ moxibustion group than in the normal group. CONCLUSION: Moxibustion has a good efficacy in regulating some metabolic substances such as glutathione, N-acetylaspartic acid, choline phosphate and uracil of CAG rats, suggesting a specific relationship between the Stomach Meridian and the stomach.

[Effects of herbal-cake-separated moxibustion on the repair of vascular endothelial and SDF-1 in rabbits with atherosclerosis].

OBJECTIVE: To observe the effects of herbal-cake-separated moxibustion on the repair of damaged vascular endothelium structure and the content of stromal cells derived factor 1 (SDF-1) in rabbits with atherosclerosis. METHODS: A total of 75 rabbits were randomly divided into a normal group, a model group, a direct moxibustion group, an atorvastatin calcium group and a herbal-cake-separated moxibustion group, 15 rabbits in each one. The rabbits in the normal group were fed with normal diet, and the remaining rabbits were fed with high-cholesterol diet for 12 weeks to prepare atherosclerotic model. Two groups of acupoints, one was "Juque" (CV 14), "Tianshu" (ST 25) and "Fenglong" (ST 40), the other one was "Xinshu" (BL 15), "Ganshu" (BL 18) and "Pishu" (BL 20), were applied in the direct moxibustion group and herbal-cake-separated moxibustion group; the two groups of acupoints were selected alternatively every other day. The moxibustion was given for 30 min per treatment, once a day for 4 weeks. The rabbits in the atorvastatin calcium group were treated with atorvastatin calcium tablets (1.96 mg•kg-1•d-1) which were crushed into powder and mixed into breakfast. After modeling, the rabbits in the normal group and model group received no treatment, and immobilized at the time when moxibustion was applied in other three groups. The levels of total cholesterol (TC) and triglyceride (TG) were measured by enzymic method; the low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were measured by colorimetric method; the morphological structure of aortic wall was observed under optical microscope; the serum level of SDF-1 was determined by enzyme-linked immunosorbent assay (ELISA). RESULTS: After treatment, compared with the normal group, the levels of TC, TG and LDL-C were significantly increased in the model group (all P<0.01), and the level of HDL-C was decreased (P<0.01). Compared with the model group, the levels of TC, TG and LDL-C were significantly decreased (all P<0.01), and the level of HDL-C was significantly increased in the direct moxibustion group, atorvastatin calcium group and herbal-cake-separated moxibustion group (P<0.01, P<0.05). Compared with the normal group, the morphological structure of aortic wall was significantly damaged in the model group. Compared with the model group, the vascular endothelial structure was improved in the atorvastatin calcium group and herbal-cake-separated moxibustion group, and the pathological change of aorta endothelial in the direct moxibustion group was relieved. After treatment, compared with the model group, the level of SDF-1 was increased in the direct moxibustion group, atorvastatin calcium group and herbal-cake-separated moxibustion group (P<0.05, P<0.01); the level of SDF-1 in the herbal-cake- separated moxibustion group was higher than that in the direct moxibustion group (P<0.05). CONCLUSION: The herbal- cake-separated moxibustion can promote the expression of SDF-1 in serum and repair the damaged aortic endothelial structure.

Acupuncture for patients with mild hypertension: A randomized controlled trial.

Acupuncture may be beneficial for patients with mild hypertension, but the evidence is not convincing. We aimed to examine the effect of acupuncture on blood pressure (BP) reduction in patients with mild hypertension. We conducted a multicenter, single-blind, sham-controlled, randomized trial in eleven hospitals in China. The trial included 428 patients with systolic blood pressure (SBP) from 140 to 159 mm Hg and/or with diastolic blood pressure (DBP) from 90 to 99 mm Hg. The patients were randomly assigned to receive 18 sessions of affected meridian acupuncture (n = 107) or non-affected meridian acupuncture (n = 107) or sham acupuncture (n = 107) during 6 weeks, or to stay in a waiting-list control (n = 107). All patients received 24-hour ambulatory blood pressure monitoring at weeks 6, 9, and 12. We included 415 participants in the intention-to-treat analysis. The two acupuncture groups were pooled in the analysis, since they had no difference in all outcomes. SBP decreased at week 6 in acupuncture group vs sham acupuncture vs waiting-list group (7.2 ± 11.0 mm Hg vs 4.1 ± 11.5 mm Hg vs 4.1 ± 13.2 mm Hg); acupuncture was not superior to sham acupuncture (mean difference 2.7 mm Hg, 95% CI 0.4 to 5.9, adjusted P = 0.103) or waiting-list control (2.9 mm Hg, 95% CI -0.2 to 6.0, adjusted P = 0.078). However, acupuncture was superior to sham acupuncture (3.3 mm Hg, 95% CI 0.2 to 6.3, adjusted P = 0.035) and waiting-list control (4.8 mm Hg, 95% CI 1.8 to 7.8, P < 0.001) at week 9. Acupuncture had a small effect size on the reduction of BP in patients with mild hypertension.