Impact factors of Blastocystis hominis infection in persons living with human immunodeficiency virus: a large-scale, multi-center observational study from China.

BACKGROUND: Blastocystis hominis (Bh) is zoonotic parasitic pathogen with a high prevalent globally, causing opportunistic infections and diarrhea disease. Human immunodeficiency virus (HIV) infection disrupts the immune system by depleting CD4+ T lymphocyte (CD4+ T) cell counts, thereby increasing Bh infection risk among persons living with HIV (PLWH). However, the precise association between Bh infection risk and HIV-related biological markers and treatment processes remains poorly understood. Hence, the purpose of the study was to explore the association between Bh infection risk and CD4+ T cell counts, HIV viral load (VL), and duration of interruption in antiviral therapy among PLWH. METHODS: A large-scale multi-center cross-sectional study was conducted in China from June 2020 to December 2022. The genetic presence of Bh in fecal samples was detected by real-time fluorescence quantitative polymerase chain reaction, the CD4+ T cell counts in venous blood was measured using flowcytometry, and the HIV VL in serum was quantified using fluorescence-based instruments. Restricted cubic spline (RCS) was applied to assess the non-linear association between Bh infection risk and CD4+ T cell counts, HIV VL, and duration of interruption in highly active antiretroviral therapy (HARRT). RESULTS: A total of 1245 PLWH were enrolled in the study, the average age of PLWH was 43 years [interquartile range (IQR): 33, 52], with 452 (36.3%) being female, 50.4% (n = 628) had no immunosuppression (CD4+ T cell counts > 500 cells/µl), and 78.1% (n = 972) achieved full virological suppression (HIV VL < 50 copies/ml). Approximately 10.5% (n = 131) of PLWH had interruption. The prevalence of Bh was found to be 4.9% [95% confidence interval (CI): 3.8-6.4%] among PLWH. Significant nonlinear associations were observed between the Bh infection risk and CD4+ T cell counts (Pfor nonlinearity < 0.001, L-shaped), HIV VL (Pfor nonlinearity < 0.001, inverted U-shaped), and duration of interruption in HARRT (Pfor nonlinearity < 0.001, inverted U-shaped). CONCLUSIONS: The study revealed that VL was a better predictor of Bh infection than CD4+ T cell counts. It is crucial to consider the simultaneous surveillance of HIV VL and CD4+ T cell counts in PLWH in the regions with high level of socioeconomic development. The integrated approach can offer more comprehensive and accurate understanding in the aspects of Bh infection and other opportunistic infections, the efficacy of therapeutic drugs, and the assessment of preventive and control strategies.

[Effects of electroacupuncture on the secretion function of ovarian cells and kisspeptin/kiss1r system in rats with polycystic ovarian syndrome].

OBJECTIVE: To observe the effects of electroacupuncture （EA） on hormone secretion function of ovarian granulosa cells and theca cells, as well as the expression changes of kisspeptin and kiss1r in rats with polycystic ovarian syndrome （PCOS）, so as to explore the mechanism of EA for relieving ovarian dysfunction in PCOS rats. METHODS: Forty-eight SD female rats were randomly divided into control group, model group, EA group and flutamide group, with 12 rats in each group. PCOS rat model was replicated with the gavage of letrozole （0.1 mg/mL, 10 mL•kg-1•d-1）. In the EA group, EA （2 Hz, 2 mA） was used to stimulate "Guanyuan" （CV4） for 20 min each time. In the flutamide group, flutamide solution （50 mg•kg-1•d-1） was administrated by gavage. The treatments were given once daily for 14 days in each group. After the modeling and treatment, the body and ovarian weights of the rats were measured, and the ovarian index was calculated. Using HE staining, the morphological changes of ovary were observed. ELISA was adopted to detect the contents of testosterone （T）, luteinizing hormone （LH） and estradiol （E2） in serum, the contents of E2 and T in the culture medium of ovarian granulosa cells and theca cells, as well as the content of kisspeptin in the ovarian tissue. The positive expression of kisspeptin in ovary was observed by immunohistochemical method, and the protein expression of its receptor kiss1r was detected by Western blot. RESULTS: Compared with the control group, the body and ovarian weights, ovarian index, the contents of T and LH in serum and that of T in the culture medium of theca cells, as well as the content and positive expression of kisspeptin in ovary were all increased （P<0.01, P<0.05）； and the content of E2 in the culture medium of granulosa cells was decreased （P<0.01） in the model group. When compared with the model group, in the EA and flutamide groups, the body and ovarian weights, ovarian index, the contents of T and LH in serum and that of T in the culture medium of theca cells, as well as the content and expression of kisspeptin in ovary were all decreased （P<0.01, P<0.05）； and the content of E2 in the culture medium of granulosa cells was increased （P<0.05, P<0.01）. CONCLUSION: EA regulates the serum sex hormone levels, the secretion function of the ovarian granulosa cells and theca cells, and the ovarian kisspeptin/kiss1r protein expression in PCOS rats, showing the similar effect as receptor blockade intervention. It is suggested that the improvement of EA in ovarian dysfunction of PCOS rats may be related to the kisspeptin/kiss1r system.

[Immediate analgesic effect of electroacupuncture combined with diclofenac sodium on acute gouty arthritis: a randomized controlled trial].

OBJECTIVE: To observe the immediate analgesic effect of electroacupuncture (EA) combined with diclofenac sodium on acute gouty arthritis (AGA). METHODS: A total of 90 patients with AGA were randomly divided into a low-dose medication (LM) group (30 cases, 1 case was eliminated, 1 case dropped off), a conventional medication (CM) group (30 cases, 1 case dropped off) and a combination of acupuncture and medication (AM) group (30 cases ). The LM group was given oral administration of 50 mg diclofenac sodium sustained-release capsule; the CM group was given oral administration of 100 mg diclofenac sodium sustained-release capsule; on the basis of the treatment of LM group, the AM group was treated with electroacupuncture at ashi points, Dadu (SP 2), Taichong (LR 3), Taibai (SP 3), Neiting (ST 44), Sanyinjiao (SP 6), Zusanli (ST 36) and Yinlingquan (SP 9) on the affected side, and Taichong (LR 3) and Zusanli (ST 36), Sanyinjiao (SP 6) and Yinlingquan (SP 9) were connected to electroacupuncture respectively, continuous wave, 2 Hz in frequency. The visual analogue scale (VAS) scores of pain before treatment and after 10 min, 2 h, 4 h and 6 h of treatment completion, joint tenderness and swelling scores before treatment and after 10 min and 6 h of treatment completion were compared, and the rate of diclofenac sodium addition within 24 h after treatment completion was recorded among the three groups. RESULTS: After 10 min of treatment completion, the scores of VAS, joint tenderness and joint swelling in the AM group were lower than those before treatment (P<0.05), and the VAS score in the AM group was lower than that in the other two groups (P<0.05). After 2, 4 and 6 h of treatment completion, the VAS scores of the three groups were lower than those before treatment (P<0.05), and the scores in the AM group were lower than those in the LM group (P<0.05). After 6 h of treatment completion, the joint tenderness scores of the three groups and the joint swelling scores of the AM group and the CM group were lower than those before treatment (P<0.05), and the joint tenderness and swelling scores of the AM group were lower than those of the LM group (P<0.05). The rate of diclofenac sodium addition was 3.3 % (1/30) and 3.4 % (1/29) in the AM group and the CM group, respectively, which were lower than 17.9% (5/28) in the LM group (P<0.05). CONCLUSION: Electroacupuncture combined with diclofenac sodium have a good immediate analgesic effect in the treatment of AGA, and have the advantages of small dosage of analgesic drugs and less adverse reactions.

Reduced SARS-CoV-2 infection risk is associated with the use of Seven-Flavor Herb Tea: A multi-center observational study in Shanghai, China.

OBJECTIVE: Omicron, a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant, is responsible for numerous infections in China. This study investigates the association between the use of Seven-Flavor Herb Tea (SFHT) and the risk of SARS-CoV-2 infection to develop precise and differentiated strategies for control of the coronavirus disease 2019 (COVID-19). METHODS: This case-control study was conducted at shelter hospitals and quarantine hotels in China. A total of 5348 laboratory-confirmed COVID-19 patients were enrolled between April 1 and May 31, 2022, while 2190 uninfected individuals served as healthy controls. Structured questionnaires were used to collect data on demographics, underlying diseases, vaccination status, and use of SFHT. Patients were propensity-score-matched using 1:1 nearest-neighbor matching of the logit of the propensity score. Subsequently, a conditional logistic regression model was used for data analysis. RESULTS: Overall, 7538 eligible subjects were recruited, with an average age of [45.54 ± 16.94] years. The age of COVID-19 patients was significantly higher than that of uninfected individuals ([48.25 ± 17.48] years vs [38.92 ± 13.41] years; t = 22.437, P < 0.001). A total of 2190 COVID-19 cases were matched with uninfected individuals at a 1:1 ratio. The use of SFHT (odds ratio = 0.753, 95% confidence interval: 0.692, 0.820) was associated with a lower risk of SARS-CoV-2 infection compared to untreated individuals. CONCLUSION: Our findings suggest that taking SFHT reduces the risk of SARS-CoV-2 infection. This is a useful study in the larger picture of COVID-19 management, but data from large-sample multi-center, randomized clinical trial are warranted to confirm the finding. Please cite this article as: Zhang SX, Chen XX, Zheng Y, Cai BH, Shi W, Ru M, Li H, Zhang DD, Tian Y, Chen YL. Reduced SARS-CoV-2 infection risk is associated with the use of Seven-Flavor Herb Tea: A multi-center observational study in Shanghai, China. J Integr Med. 2023; 21(4):369-376.

[Effect of electroacupuncture on the morphology of prostate and degranulation of mast cells in rats with chronic nonbacterial prostatitis].

OBJECTIVE: To observe the effect of electroacupuncture (EA) on the morphology of prostate and degranulation of mast cells in prostate of rats with chronic nonbacterial prostatitis (CNP). METHODS: Male SD rats were randomly divided into sham operation group, model group and EA group, with 8 rats in each group. CNP model was established by surgical castration combined with 17-ß estradiol injection once daily for 30 days. EA was applied to "Zhongji" (CV3), "Guanyuan" (CV4) and bilateral "Dahe" (KI12) for 20 min, once daily for 8 days. The mechanical pain threshold of scrotum skin area was tested before modeling, after modeling and after intervention. The pathological morphology of the prostate was observed by HE staining. Collagenous fiber was observed by Masson staining. The infiltration of mast cells was observed by toluidine blue staining. The contents of interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) in prostate were determined by ELISA. The protein expression levels of tryptase and transforming growth factor ß1 (TGF-ß1) in prostate were detected by Western blot. RESULTS: A normal appearance with little inflammatory cell infiltration was observed in the prostate of the sham operation group. Gland atrophy, epithelial destruction, hyperemia and edema, diffuse inflammatory cell infiltration and visible collagen fiber deposition were observed in prostate of the model group. The degree of infiltration of inflammatory cells and collagen fiber deposition were reduced in the EA group. Compared with the sham operation group, mechanical pain threshold was decreased (P<0.01), while the collagen volu-me fraction (CVF) of prostate, the degranulated rate of mast cells, the protein expression levels of tryptase and TGF-ß1, and the contents of IL-6 and TNF-α were increased (P<0.01) in the model group. Following EA intervention, compared with the model group, the mechanical pain threshold was increased (P<0.01), CVF of the prostate, the degranulated rate of mast cells, the protein expression levels of tryptase and TGF-ß1, and the contents of IL-6 and TNF-α were decreased (P<0.05, P<0.01) in the EA group. CONCLUSION: EA can relieve pain and reduce inflammation and fibrosis of prostate in CNP rats, which may be related to inhibiting the degranulation of prostate mast cells and down-regulating the expression of inflammatory factors and TGF-ß1.

The rapid and efficient strategy for SARS-CoV-2 Omicron transmission control: analysis of outbreaks at the city level.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron (B.1.1.529) variant is highly transmissible with potential immune escape. Hence, control measures are continuously being optimized to guard against large-scale coronavirus disease 2019 (COVID-19) outbreaks. This study aimed to explore the relationship between the intensity of control measures in response to different SARS-CoV-2 variants and the degree of outbreak control at city level. METHODS: A retrospective study was conducted in 49 cities with COVID-19 outbreaks between January 2020 and June 2022. Epidemiological data on COVID-19 were extracted from the National Health Commission, People's Republic of China, and the population flow data were sourced from the Baidu migration data provided by the Baidu platform. Outbreak control was quantified by calculating the degree of infection growth and the time-varying reproduction number ([Formula: see text]). The intensity of the outbreak response was quantified by calculating the reduction in population mobility during the outbreak period. Correlation and regression analyses of the intensity of the control measures and the degree of outbreak control for the Omicron variant and non-Omicron mutants were conducted, respectively. RESULTS: Overall, 65 outbreaks occurred in 49 cities in China from January 2020 to June 2022. Of them, 66.2% were Omicron outbreaks and 33.8% were non-Omicron outbreaks. The intensity of the control measures was positively correlated with the degree of outbreak control (r = 0.351, P = 0.03). The degree of reduction in population mobility was negatively correlated with the Rt value (r = - 0.612, P < 0.01). Therefore, under the same control measure intensity, the number of new daily Omicron infections was 6.04 times higher than those attributed to non-Omicron variants, and the Rt value of Omicron outbreaks was 2.6 times higher than that of non-Omicron variants. In addition, the duration of non-Omicron variant outbreaks was shorter than that of the outbreaks caused by the Omicron variant (23.0 ± 10.7, 32.9 ± 16.3, t = 2.243, P = 0.031). CONCLUSIONS: Greater intensity of control measures was associated with more effective outbreak control. Thus, in response to the Omicron variant, the management to restrict population movement should be used to control its spread quickly, especially in the case of community transmission occurs widely. Faster than is needed for non-Omicron variants, and decisive control measures should be imposed and dynamically adjusted in accordance with the evolving epidemic situation.

[Role of innate immunity in the pathogenesis of chronic prostatitis/chronic pelvic pain syndrome: Advances in studies].

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common disease in men, which has a high incidence and seriously affects the quality of life of the patients. The possible pathogenic factors of the disease include urine reflux, hidden infection, central sensitization, oxidative stress, and abnormal immune response, among which abnormal immune response plays a significant role in its development and progression. Immune response involves innate immunity and adaptive immunity, and most previous studies focused on adaptive immunity. In recent years, more and more attention has been paid to the role of the innate immune system in the pathogenesis of CP/CPPS. Studies show that mast cells, macrophages, Toll-like receptors and related cytokines in the innate immune system are all involved in the development and progression of CP/CPPS. As the innate immune system is the first barrier of the immune response of the body, studies on innate immunity will provide some new ideas for the diagnosis and treatment of CP/CPPS.

[Research advances of studies on involvement of the anterior cingulate cortex involved in acupuncture-induced amelioration treatment of affective pain].

As an unpleasant subjective feeling and emotional experience, pain has a negative impact on the physical and mental health of patients. In the early years, the research concerning pain mostly focused on the sensory-discriminative component. With the development of modern medicine, people found that the generation of affective-emotional component of pain has its unique physiological mechanism, and thus carried out a lot of in-depth research. The anterior cingulate cortex (ACC) is the main brain area activated by affective pain, and the regulation of acupuncture on pain aversion is mainly related to it. The mechanism includes various signal pathways, such as extracellular regulated protein kinases-mitogen activated protein kinase-cAMP-response element binding protein pathway, adenylate cyclase 1 protein kinase Mζ- glutamate receptor 1 pathway, contains many biomolecules, such as opioid receptors, neuropeptide S and its receptor, and refers to microglia at the cellular level. This article reviewed the neural mechanism of ACC involved in affective pain and the role of acupuncture played in this process.

Immediate effects of Zhongji point acupuncture on pelvic floor structure in female patients with stress urinary incontinence: a randomized, single-blind, and sham-controlled clinical trial protocol.

BACKGROUND: Stress urinary incontinence (SUI) is defined as involuntary leakage of urine from the external urethra due to increased abdominal pressure, for example, upon sneezing, coughing, or exercise. Acupuncture is an effective therapy for patients with SUI, although objective evidence of its benefits or mechanism of action is limited. Patients with SUI often harbor structural changes of pelvic floor, the parameters of which are measurable from various perspectives and in multiple dimensions, dynamically and comprehensively, through transperineal ultrasound (TPUS). The status of such changes may then be assessed following acupuncture procedures. In the present investigation, TPUS serves to gauge the immediate effects of acupuncture on pelvic floor structures in female patients with SUI. METHODS: This protocol calls for a prospective, randomized, controlled, and single-blinded study of 72 female patients with SUI, each randomly assigned as test or control group members. The test group is subjected to one-time acupuncture at the Zhongji (RN3) acupoint for a period of 10 min, whereas the control group undergoes sham acupuncture in the same manner. In both groups, TPUS imaging of pelvic floor is performed before, during, and immediately after acupuncture procedures. Bladder neck mobility (BND), urethral rotation angle (URA), retrovesical angle (RVA), lowest point of bladder (BN-S), and presence/absence of urethral funneling or bladder bulging are then recorded as outcome measures. DISCUSSION: Above efforts are intended to assess real-time pelvic floor structural changes in women undergoing acupuncture for SUI. The subsequent findings may help objectively document the efficacy of acupuncture in this setting and clarify its mechanism of action. TRIAL REGISTRATION: Registration with the Chinese Clinical Trial Registry (ChiCTR200041559) (http://www.chictr.org.cn/edit.aspx?pid=64591&htm=4), was effective December 29, 2020. DATES OF STUDY: 12/19/2020 to 06/30/2022.

[Effect of electroacupuncture on expression of p-ERK1/2 and c-fos in spinal dorsal horn in rats with interstitial cystitis].

OBJECTIVE: To observe the effect of electroacupuncture (EA) at "Ciliao" (BL32) and "Huiyang" (BL35) on the expression of extracellular signal-regulated kinase 1/2 (p-ERK1/2) and cellular oncogene fos (c-fos) phosphorylated of spinal dorsal horn in rats with interstitial cystitis (IC). METHODS: Eighteen female Wistar rats were randomly divided into control, model and EA groups, with 6 rats in each group. The IC model was established by intraperitoneal injection of cyclophosphamide (150 mg/kg). EA (30 Hz, 1 mA) was applied to bilateral BL32 and BL35 for 20 min, once daily for 3 consecutive days. The bladder pain was measured by using a Von Frey at 48 h after modeling and 24 h after EA. The expression levels of p-ERK1/2 and c-fos protein in L6-S1 segment of spinal cord were detected by Western blot, and the expression of p-ERK1/2 and c-fos in the right spinal dorsal horn were displayed by immunofluorescence staining. RESULTS: After modeling, the bladder mechanical pain threshold (PT) was significantly decreased (P<0.05), the protein expression of p-ERK1/2 and c-fos in the spinal cord was increased (P<0.05) and the immunofluorescence surface density of p-ERK1/2 and c-fos in the right dorsal horn of spinal cord was increased (P<0.05) in the model group relevant to the control group. After EA intervention, IC-induced reduction of PT, and increases of the expression of p-ERK1/2 and c-fos as well as immunofluorescence surface density of p-ERK1/2 and c-fos were reversed in the EA group relevant to the model group (P<0.05). CONCLUSION: EA at BL 32 and BL 35 has an analgesic effect in IC rats, which may be related to its effect in down-regulating the expression of p-ERK1/2 and c-fos in spinal dorsal horn.

Electroacupuncture Alleviates Bladder Overactivity via Inhabiting Bladder P2X3 Receptor.

Electroacupuncture (EA) has been widely applied for overactive bladder, but the mechanism of its action remains to be clarified. This study was aimed to investigate EA regulating the effect of purinergic signaling in the OAB of rats. Electroacupuncture (continuous wave, 30 Hz, 1 mA) was applied to stimulate the Ciliao point (BL32) and the Huiyang point (BL35) of rats. Results showed that when the P2X3 receptor in bladder peripheral level and the spinal cord central level was involved in the bladder micturition reflex of the afferent signaling, intravenous administration P2X3 antagonist AF-353 can significantly inhibit urination in naive rats and OAB of rats and increase bladder volume and micturition pressure. EA stimulation alleviated bladder overactivity significantly and after the P2X3 receptor was blocked, the EA effect was weakened. EA stimulation can effectively reduce the P2X3 mRNA and protein expression in OAB of rats, spinal cord (L6-S1), and DRG (L6-S1) and can significantly reduce the number of positive P2X3 cells in OAB of rats, spinal cord (L6-S1), and DRG (L6-S1). These findings suggest that EA stimulation could alleviate bladder overactivity, and the function is closely related to the inhabited P2X3 receptor in the bladder.

[Effect of electroacupuncture at different acupoints on follicle development and related factors in serum and ovary tissues of PCOS rats].

OBJECTIVE: To observe the effect of electroacupuncture (EA) at different acupoints on follicle development, expression of gonadotropins and their receptors and anti-Müllerian hormone(AMH), inhibin B(INHB) in polycystic ovarian syndrome (PCOS) rats, so as to explore its mechanisms underlying improvement of PCOS. METHODS: Sixty female SD rats were randomized into six groups: control, model, Zusanli(ST36), Sanyinjiao(SP6), Guanyuan(CV4) and combination (ST36+SP6+CV4, n=10 rats/group). The PCOS model was established by gavage of Letrozole solution (1.0 mg/kg) once daily for 21 consecutive days. Rats of the control group were given 1% Carboxymethyl Cellulose (CMC, 1 mg/kg). EA (2 Hz) was applied to ST36, SP6, or/and CV4 for 20 min, once daily for 14 consecutive days. The number of follicles was counted, and the ovarian structure and follicular development were observed under light microscope after H.E. stain, and the contents of serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), AMH, and INHB were assayed by enzyme-linked immunosorbent assay, and the ratio of LH/FSH was calcula-ted. The immunoactivity of LH receptor (LHR) and FSH receptor (FSHR) proteins was detected by immunohistochemistry. RESULTS: After modeling, the number of follicles at the growth stage, contents of serum LH, AMH and INHB, and ratio of LH/FSH were significantly increased, and serum FSH level and FSHR, LHR immunoactivity were remarkably decreased in the model group relevant to the control group (P<0.05, P<0.01). Following EA intervention, the number of follicles at the growth stage in the SP6, CV4 and combination groups, LH/FSH ratio and serum AMH levels in the 4 EA groups, INHB contents in the ST36, CV4 and combination groups were significantly reduced (P<0.05, P<0.01), while serum FSH contents in the 4 EA groups, FSHR immunoactivity at the early stage in the ST36 group and LHR immunoactivity at both early and late stages in the ST36 and CV4 groups were considerably increased in comparison with those of the model group (P<0.01, P<0.05). The therapeutic effect of SP6 was significantly superior to that of CV4 in down-regulating serum LH level (P<0.01), but significantly inferior to that of CV4 in up-regulating serum FSH content and in down-regulating LH/FSH ratio and serum AMH and INHB levels (P<0.05, P<0.01). The effect of CV4 was comparable to that of ST36 in up-regulating serum FSH, and in down-regulating serum LH/FSH ratio, AMH and INHB levels (P>0.05). CONCLUSION: EA of CV4, SP6, ST36 and ST36+CV4+SP6 can reduce the number of follicles at the growth stage and regulate the expression levels of gonadotropins in PCOS rats. The effects of EA of CV4 and ST36 are evidently better than those of EA of SP6 in up-regulating serum FSH content and in down-regulating LH/FSH ratio, and serum AMH and INHB levels, and EA of SP6 is evidently superior to EA of CV4 down-regulating LH level, but without synergistic effect among the 3 acupoints.

Application of electroacupuncture for postoperative pain management after total knee arthroplasty: a study protocol for a single-blinded, randomised placebo-controlled trial.

INTRODUCTION: The purpose of this study is to assess the efficacy of electroacupuncture (EA) to relieve pain and promote functional rehabilitation after total knee surgery. METHODS AND ANALYSIS: We propose a single-blinded, randomised placebo-controlled trial to evaluate the efficacy of EA. Patients with osteoarthritis (aged 55-80 years) undergoing unilateral total knee arthroplasty (TKA) will be included in the trial. They will be randomised to receive either EA or sham-EA. A total of 110 patients will receive EA and sham-EA for 3 days after TKA. Postoperative pain will be measured using visual analogue score, and the need for an additional dose of opioid and analgesics will be recorded as the primary outcome. Secondary outcomes include knee function and swelling, postoperative anxiety, postoperative nausea and vomiting among other complications. ETHICS AND DISSEMINATION: This study has been approved by the ethics committee, and subsequent modifications of the protocol will be reported and approved by it. Written informed consent will be obtained from all of the participants or their authorised agents. TRIAL REGISTRATION NUMBER: ChiCTR1800016200; Pre-results.

[Effect of Electroacupuncture at Different Acupoints on Steroid Hormones and Ovarian Androgen Receptor Expression in Polycystic Ovary Syndrome Rats].

OBJECTIVE: To observe the effect of electroacupuncture (EA) at different acupoints on hyperandrogenism and ovarian androgen receptor (AR) expression in rats with polycystic ovary syndrome (PCOS), so as to explore its mechanisms underlying improvement of PCOS. METHODS: Sixty female SD rats were randomly divided into control, model, Zusanli (ST 36), Sanyinjiao (SP 6), Guanyuan (CV 4) and comprehensive groups (10 rats/group). The PCOS model was established by giving (gavage) the animals with Letrozole solution (1.0 mg/kg), once daily for 21 consecutive days. EA stimulation was applied to ST 36, SP 6, or CV 4 respectively, once daily for 14 days. The comprehensive group was treated by EA treatment of the abovementioned three acupoints in the meantime. Before and after the treatment, the body mass and the ovary weight were measured. The morphological structure of the ovary was observed under microscope after H．E. staining. The levels of serum hormone and sex hormone binding globulin (SHBG) were assayed by ELISA. Free androgen index (FAI) was calculated and the expression of AR in the ovary was detected by immunohistochemistry. RESULTS: After modeling, the body mass, ovary weight, serum testosterone (T) and FAI levels and the expression of AR protein in late ovarian follicles were significantly increased (P<0.01, P<0.05), and serum estradiol (E2) and SHBG contents were significantly decreased relevant to the control group (P<0.01). Following EA intervention and compared with the model group, the body weight of each EA group was significantly reduced (P<0.05), the ovarian pathological changes were improved, and serum T and FAI levels were significantly decreased (P<0.01), and serum E2 and SHBG contents significantly increased in the ST 36, CV 4 and comprehensive groups (P<0.01, P<0.05). The ovary weight of only CV 4 group was significantly lower than that of the model group (P<0.01). The expression of AR protein in late follicles of both CV 4 and SP 6 groups was markedly decreased (P<0.05, P<0.01). CONCLUSION: EA at ST 36, SP 6, and CV 4 all can improve the hyperandrogenism and ovarian polycystic morphological changes of PCOS rats, while different acupoints have different functional characteristics.

[Comparative study on effects between electroacupuncture and auricular acupuncture for methamphetamine withdrawal syndrome].

OBJECTIVE: To observe the efficacy difference of electroacupuncture and auricular acupuncture in the treatment of methamphetamine withdrawal syndrome. METHODS: Ninety male patients of methamphetamine addiction were randomized into an electroacupuncture group, an auricular acupuncture group and a control group, 30 cases in each one. In the electroacupuncture group, Neiguan (PC 6), Shenmen (HT 7), Zusanli (ST 36), Sanyinjiao (SP 6), Jiaji (EX-B 2) at T5 and L2 were selected bilaterally. In the auricular acupuncture group, jiaogan (AH(6a)), shenmen (TF4), fei (CO14) and gan (CO12) were selected unilaterally. The treatment was given 3 times a week, totally 12 treatments were required. In the control group, no any intervention was applied. Separately, before treatment and after 1, 2, 3 and 4 weeks treatment, the scores of methamphetamine withdrawal syndrome, Hamilton anxiety scale and Hamilton depression scale were observed in each group. RESULTS: The total score of methamphetamine withdrawal syndrome, anxiety score and depression score were obviously reduced in 2, 3 and 4 weeks of treatment as compared with those before treatment in the electroacupuncture group and the auricular acupuncture group (all P < 0.05), and showed a trend of gradual decline as the extension of treatment. In 1,2,3,4 weeks of treatment, the total score of withdrawal syndrome, anxiety score and depression score in the electroacupuncture group and auricular acupuncture group were lower significantly than those in the control group (all P < 0.05), in which, the total score of withdrawal syndrome in the electroacupuncture group was lower significantly than that in the auricular acupuncture group in the 4th week of treatment (3.69 +/- 2.446 vs 5.73 +/- 3.169, P < 0.05); the anxiety scores were lower significantly than those in the auricular acupuncture group in 3 and 4 weeks of treatment (8.19 +/- 4.57 vs 9.65 +/- 4.24, 5.27 +/- 2.89 vs 7.38 +/- 3.10, both P < 0.05); the depression scores were lower significantly than those in the auricular acupuncture group in 2, 3 and 4 weeks of treatment (15.35 +/- 5.64 vs 19.81 +/- 5.37, 10.96 +/- 4.52 vs 15.00 +/- 4.53, 7.96 +/- 2.69 vs 12.35 +/- 3.59, all P < 0.05). CONCLUSION: Electroacupuncture at the body points and auricular acupuncture play the therapeutic role in the treatment of methamphetamine withdrawal syndrome, anxiety and depression. The longer time the treatment is with electroacupuncture at the body points, the more obvious the efficacy will be on the above symptoms.

The effects of acupuncture on bladder interstitial cells of cajal excitability in rats with overactive bladder.

It is well known that acupuncture treatment has an effect on patients with an overactive bladder, but the mechanism of its action remains to be clarified. This study was aimed to investigate the effects of acupuncture on bladder overactivity, and the excitability of interstitial cells of Cajal of the bladder in a rat model of partial bladder outlet obstruction. Electroacupuncture (continuous wave, 30 Hz, 1 mA) was applied to stimulate the Ciliao point (BL32) and the Huiyang point (BL35) of rats for 20 min, 3 days. Results showed that acupuncture suppressed detrusor unstable contraction frequency and decreased detrusor maximum pressure in the bladder filling period. Compared with the normal control rats, HCN2 mRNA and protein expression within the bladder were upregulated and were reversed by electroacupuncture in overactive bladder rats as determined by RT-PCR, western blotting and immunohistochemistry. Moreover, in-vitro cell-cultured OAB rats bladder interstitial cells of Cajal intracellular Ca(2+) concentration were higher than normal control rats, which were lowered after acupuncture treatment. These findings suggest that acupuncture stimulation can suppress bladder overactivity, and regulate the excitability of bladder interstitial cells of Cajal in treatment of overactive bladder myogenic mechanism.

[Effects of acupuncture combined general anesthesia on endorphin and hemodynamics of laparoscopic cholecystectomy patients in the perioperative phase].

OBJECTIVE: To observe the effects of different anesthesia ways on endorphin and hemodynamics of laparoscopic cholecystectomy patients in the perioperative phase. METHODS: A total of 90 laparoscopic cholecystectomy patients, 29 to 80 years old, were randomly assigned to Group A (treated with electroacupuncture at acupoints combined general anesthesia), Group B (treated with electroacupuncture at non-acupoints combined general anesthesia), and Group C (treated with general anesthesia) according to American Society of Anesthesiologists (ASA) I-II, 30 cases in each group. All patients were induced by 3 microg/kg Fentanyl (Fen), 2 mg/kg Propofol (Pro), and 0.1 mg/kg Vecuronium (Vcr). Bispectral index (BIS), being 40 -65, indicated the state of general anesthesia. The anesthesia was maintained by intravenous injecting Pro, interruptedly intravenous injecting Fen and Vcr. Each patient received patient controlled intravenous analgesia (PCIA) after operation. On these bases, patients in Group A received electrical acupuncture at bilateral Hegu (LI4), Neiguan (PC6), Quchi (Ll11), Zusanli (ST36), and Yanglingquan (GB34). Patients in Group B received electrical acupuncture at the points beside acupoints. The electroacupuncture was lasted from 15 -30 min before anesthesia induction to the end of the operation in Group A and B. The heart rate (HR), mean arterial pressure (MAP), cardiac index (CI), cardiac output (CO), systemic vascular resistance index (SVRI), and acceleration index (ACI) were recorded before anesthesia induction, immediate before pneumoperitoneum, 5 min after pneumoperitoneum, excision of gallbladder, and at the end of operation. The time consumption from discontinuation to spontaneously breathing recovery, analeptic, and extubation were recorded. The blood samples (3 mL each time) were collected from the peripheral vein before anesthesia induction, 2 h after operation, the 1st day after operation, and the 3rd day after operation to detect the beta-endorphin (beta-EP) level. The visual analogue scale (VAS) were observed and recorded in the 3 groups at post-operative 4, 6, 8, 24, and 44 h, respectively. RESULTS: (1) Compared with before anesthesia induction in the same group, the CI, CO, ACI of all patients decreased significantly at 5 min after pneumoperitoneum and at excision of gallbladder (P < 0.01, P < 0.05). The HR, MAP, SVRI obviously increased in Group B and Group C at each time point (P < 0.05, P < 0.01). Less change happened in Group A. Compared with Group C, the increment of MAP was less in Group A at 5 min after pneumoperitoneum, showing statistical difference (P < 0.05). (2) The time consumption from discontinuation to analeptic and extubation was obviously shorter in Group A than in Group B and Group C (P < 0.05, P < 0.01). (3) The level of beta-EP on the 1st day of operation was significantly lower in Group A than in Group B (P < 0.05) and Group C (P < 0.01). (4) The VAS score at post-operative 44 h was significantly lower in Group A than in Group B and Group C (P < 0.05). CONCLUSIONS: Electroacupuncture at acupoints combined general anesthesia could maintain the stabilization of haemodynamics, and relieve the stress reaction after pneumoperitoneum and operation, and prolong it to early post-operative period, and strengthen the effects of post-operative analgesia. The post-operative recovery was fast, safe, and reliable.

[Effects of laparoscopic cholecystectomy under different anesthetic methods on T-lymphocyte immune function and postoperative analgesia].

OBJECTIVE: To compare the differences in the effect of laparoscopic cholecystectomy (LC) with different anesthetic methods on T-lymphocyte immune function and postoperative analgesia as well as validate the specificity of meridian points. METHODS: Ninety cases of LC were randomized into three groups, named group A (compound general anesthesia group with meridian points involved), group B (compound general anesthesia group with placebo points involved) and group C (general anesthesia group). In group A, electroacupuncture was applied at first for 15 to 30 min to bilateral Hegu (LI 4), Neiguan (PC 6), Zusanli (ST 36), Yanglingquan (GB 34) and Quchi (LI 11). Afterwards, the general anesthesia was conducted and electric stimulation lasted till the end of operation. In group B, the points adopted were the midpoints between the meridians in which the acupoints were selected in group A and the adjacent meridians on the lateral side, at the level of selected meridian points correspondingly. The method and time of electroacupuncture were same as those in group A. In group C, the general anesthesia was adopted simply. The changes of T-lymphocyte subgroup were detected before anesthesia, in 2 h, 1 day and 3 days after operation separately; and the dose of narcotic in operation as well as the dose of analgesia pumper in 4 h, 6 h, 8 h, 24 h and 44 h after operation separately. RESULTS: (1) In comparison between the result 2 h after operation and that before operation, the levels of CD3+, CD4+ and CD8+ in all of three groups were lower than those before operation. Except that the change in CD4+ in group A did not present significant statistical difference as compared with that before operation (P > 0.05), all of the other differences in T-lymphocyte subgroup indicated statistical significance (all P < 0.05). The ratio of CD4+/CD8+ in three groups was higher than that before operation, but the difference in group A was significant statistically (P < 0.05). In 3 days after operation, the levels of CD3+, CD4+ and CD4+/CD8+ were all higher than those before operation, indicating significant statistical differences (all P < 0.05) except CD4+/CD8+ in group B (P > 0.05). (2) In group A, during operation, the dose of narcotic reduced apparently (P < 0.05). (3) Separately, in 4, 6 and 8 h after operation, the dose of analgesia pumper reduced significantly in group A (all P < 0.05). CONCLUSION: Compound general anesthesia with meridian points involved can increase pain threshold of human body, reduce the dose of narcotic during operation, alleviate the suppression in body immune regulation due to stress reaction of general anesthesia and operation, prolong the time-effect of postoperative analgesia and explain the specificity of meridian points.

[Systematic assessment of acupuncture for treatment of herpes zoster in domestic clinical studies].

OBJECTIVE: To assess the effectiveness of acupuncture for treatment of herpes zoster. METHODS: According to the requirement of evidence-based medicine, acupuncture, body acupuncture, electroacupuncture, head acupuncture, three edged needle, plum-blossom needle, fire needle, elongated needle, encircling needling, herpes zoster, etc. were selected as subject words to retrieve the relative medical database at home, and clinically randomized controlled trials were used as enrolled criteria, the treatment group were treated with acupuncture or acupuncture plus other therapies, and the control group with medicine, the cured rate and the time of killing pain for herpes zoster were used as assessment indexes. Altogether 43 papers were enrolled. Among them 10 papers were conducted for Meta-analysis by RevMan 4.2.9. RESULTS: The total OR was 4.27 with 95% CI [2.90, 6.29] of the clinically cured rate in the 10 studies, and the total OR was -7.64 with 95% CI [-8.12, -7.15] of the time of killing pain in the 4 studies. The therapeutic effect in the treatment group on herpes zoster was superior to that of the western medicine (P < 0.01). CONCLUSION: Acupuncture therapy for herpes zoster is effective, but more high-quality studies are required to prove this view point.