Effect of electroacupuncture on glial fibrillary acidic protein and nerve growth factor in the hippocampus of rats with hyperlipidemia and middle cerebral artery thrombus.

Electroacupuncture (EA) has been shown to reduce blood lipid level and improve cerebral ischemia in rats with hyperlipemia complicated by cerebral ischemia. However, there are few studies on the results and mechanism of the effect of EA in reducing blood lipid level or promoting neural repair after stroke in hyperlipidemic subjects. In this study, EA was applied to a rat model of hyperlipidemia and middle cerebral artery thrombosis and the condition of neurons and astrocytes after hippocampal injury was assessed. Except for the normal group, rats in other groups were fed a high-fat diet throughout the whole experiment. Hyperlipidemia models were established in rats fed a high-fat diet for 6 weeks. Middle cerebral artery thrombus models were induced by pasting 50% FeCl3 filter paper on the left middle cerebral artery for 20 minutes on day 50 as the model group. EA1 group rats received EA at bilateral ST40 (Fenglong) for 7 days before the thrombosis. Rats in the EA1 and EA2 groups received EA at GV20 (Baihui) and bilateral ST40 for 14 days after model establishment. Neuronal health was assessed by hematoxylin-eosin staining in the brain. Hyperlipidemia was assessed by biochemical methods that measured total cholesterol, triglyceride, low-density lipoprotein and high-density lipoprotein in blood sera. Behavioral analysis was used to confirm the establishment of the model. Immunohistochemical methods were used to detect the expression of glial fibrillary acidic protein and nerve growth factor in the hippocampal CA1 region. The results demonstrated that, compared with the model group, blood lipid levels significantly decreased, glial fibrillary acidic protein immunoreactivity was significantly weakened and nerve growth factor immunoreactivity was significantly enhanced in the EA1 and EA2 groups. The repair effect was superior in the EA1 group than in the EA2 group. These findings confirm that EA can reduce blood lipid, inhibit glial fibrillary acidic protein expression and promote nerve growth factor expression in the hippocampal CA1 region after hyperlipidemia and middle cerebral artery thrombosis. All experimental procedures and protocols were approved by the Animal Use and Management Committee of Beijing University of Chinese Medicine, China (approval No. BUCM-3-2018022802-1002) on April 12, 2018.

[Effect of Electroacupuncture on Cerebro-cortex Caspase-3 Expression and Blood Lipid Levels in Hyperlipemia Rats with Cerebral Ischemia].

OBJECTIVE: To observe the effect of electroacupuncture (EA) stimulation of "Fenglong" (ST 40), "Sanyinjiao" (SP 6) plus manual acupuncture (MA) stimulation of "Shuigou" (GV 26) and "Baihui" (GV 20) on Caspase-3 protein expression in the cerebral cortex of rats with hyperlipemia and cerebral ischemia(HL-CI),so as to reveal its mechanisms underlying improvement of HL-CI. METHODS: Forty-five rats were randomly divided into normal control,sham operation,model,EA group I(EA+MA was given for 14 days, i.e., 7 days before CI, and 7 days more after HL-CI)and EA group Ⅱ (EA+MA was given for only 7 days after HL-CI),with 9 rats being in each group. The HL-CI model was established by feeding the animals with high fat forage for 6 weeks and then making an occlusion of the unilateral middle cerebral artery by regional application of quantitative paper adsorbing 50% FeCl3 solution (10 µL). Rats of the sham operation group were treated with the same procedures only without application of FeCl3 solution. For rats of the EA group I,EA (1-3 mA, 2 Hz/100 Hz) was applied to bilateral acupoints SP 6 and ST 40 (for 20 min),and MA stimulation applied to GV 26 and GV 20. EA was conducted once daily for 7 days after 6 weeks' high fat fo-rage feeding, and EA+MA intervention was conducted once daily for 7 days after CI modeling. For rats in the EA group Ⅱ, EA+MA was applied to the same 4 acupoints once a day for 7 days only after CI modeling. The neurological impairment was assessed by Zea Longa's scoring. The blood sample was taken from the abdominal aorta for measuring the contents of serum cholesterol (CHO),triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). Pathological changes of the cerebral cortex were observed after H.E. staining, and the expression of cerebro-cortex Caspase-3 was analyzed by immunohistochemistry. RESULTS: Following modeling,the neurological score,CHO, TG and LDL-C contents, and the number of Caspase-3 positive cells as well as Caspase-3 immunoactivity level were significantly increased in the model group(P<0.05), while serum HDL-C level was obviously decreased(P<0.05). After the treatment,the increased neurological score, CHO, TG and LDL-C contents, and the number of Caspase-3 positive cells and Caspase-3 immunoactivity level were considerably decreased in the EA group I and Ⅱ(P<0.05)while the decreased HDL-C level was notably increased relevant to the model group(P<0.05). The effects of the EA group I were notably superior to those of EA group Ⅱ in down-regulating the neurological score,CHO, TG and LDL-C levels and the expression of Caspase-3 protein(P<0.05). No significant differences were found between the normal control and sham operation groups in the neurological scores 20 min and 7 days after modeling and Caspase-3 expression levels (P>0.05). H.E. staining showed a reduction of the apoptotic cells and inflammatory cells in both EA group I and Ⅱ. CONCLUSIONS: Both EA and EA+MA interventions can improve neurological function in HL-CI rats,which may be related to their effects in adjusting the levels of serum lipids and down-regulating the expression of cell apoptosis-related Caspase-3 protein in the ischemic cortex. Moreover, the cerebral ischemia injury may be lightened by EA-lowering hyperlipemia first.

Effects of electroacupuncture intervention on expression of cyclooxygenase 2 and microglia in spinal cord in rat model of neuropathic pain.

OBJECTIVE: To investigate the effect of electroacupuncture (EA) treatment on the expression of cyclooxygenase (COX) 2 and microglia in spinal cord by using rat model of neuropathic pain, and to probe into the relationship between COX 2 and microglia. METHODS: The rats were randomly divided into 6 groups, including normal control group, model group, sham group, EA 1 group (distant acupoints + local acupoints), EA 2 group (local acupoints), and EA 3 group (distant acupoints). Thermal withdrawal latencies were evaluated at 1 day preoperatively and 3, 5 and 7 days postoperatively. At 7 days postoperatively, the spinal COX 2 mRNA was detected by reverse-transcription polymerase chain reaction. Double immunofluorescent staining technology was applied to screen and verify the relationship between altered COX 2 and microglia. RESULTS: Compared with the model group, thermal withdrawal latencies increased after EA treatment (P<0.01). The expressions of COX 2 mRNA were up-regulated in spinal cord of rat on day 7 after surgery (P<0.05). Compared with the model group, EA stimulation (EA 1 and EA 2 groups) reversed the up-regulation of COX 2 mRNA expression (P<0.05). EA 1 and EA 2 groups might have better treatment effect compared with the EA 3 group. Fluorescent images displayed COX 2 and microglia expressed at common areas. CONCLUSIONS: EA was effective in analgesic and anti-inflammatory. EA has decreased the expression of spinal COX 2 mRNA in the trend of the therapeutic effect of "distant acupoints + local acupoints", and "local acupoints" intervention may be superior to that of "distant acupoints" intervention. Microglia may be related to the formation of COX 2.

[Effect of Electroacupuncture at Distal and Proximal Acupoints on Expression of Spinal p 38 Mitogen-activated Protein Kinase and Cyclic Adenosine 3',5'-monophosphate in Rats with Lumbago].

OBJECTIVE: To observe the influence of Electroacupuncture (EA) stimulation of different distal-proximal acupoints combination groups on pain reaction, spinal p 38 mitogen-activated protein kinase (p 38 MAPK) expression and cyclic adenosine 3', 5'-monophosphate (cAMP) content in experimental lumbago rats. METHODS: Seventy-eight male SD rats were randomized into normal, model, sham operation, EX-B 2-BL 25 (proximal acupoints, PA), BL 40-BL 60 (distal acupoints, DA) and DA+PA groups. The lumbago model was established by implanting the autologous nucleus pulposus to the site close to the left L 5 dorsal root ganglion and the surface of dura mate of spinal cord. EA (2 Hz/100 HZ,1-3 mA) was applied at bilateral EX-B 2-BL 25 or BL 40-BL 60 or both for 20 minutes, once daily for 7 days. The mechanical pain threshold was measured, and the expression of p 38 MAPK in the lumbar spinal cord was detected by immunohistochemistry and Western blot, separately. The content of cAMP in spinal cord (L 4-L 6) was measured by enzyme-linked immunosorbent assay (ELISA). RESULTS: After mode-ling, the mechanical pain threshold percentages were significantly decreased on day 3, 5 and 7 (P<0.01), and after EA stimulation of DA,PA and DA+PA, the decreased pain threshold was significantly increased at the 3 time-points (P<0.01), and the effects of both PA and DA+PA were markedly superior to that of DA (P<0.05, P<0.01). Following modeling, lumbar spinal p 38 MAPK immunoactivity and protein expression, and cAMP content were obviously up-regulated (P<0.01). Compared with the model group, the levels of p 38 MAPK immunoactivity and protein expression in the 3 EA groups and the sham group, and cAMP contents in both PA and DA+PA groups (not in the DA and sham groups) were considerably down-regulated (P<0.01, P<0.05). CONCLUSIONS: EA stimulation of distal+proximal acupoints and proximal acupoints near the focus can raise pain threshold in lumbago rats, which may be associated with their effects in suppressing lumbago-induced increase of expression of spinal p 38 MAPK protein and cAMP content. The effects of EA of distal+proximal acupoints and proximal acupoints are better than those of EA of simple distal acupoints.

[Development of Researches on Mechanisms of Acupoint Combination for Some Disorders in Nerve-humoral-immunological Modulation].

Proper combination of acupoints is one of the core issues of acupuncturology, and is also one of the factors affecting clinical outcomes. In the present paper, the authors make a review on the development of researches on the underlying mechanisms of acupoint combination for some clinical disorders from nerve system, humoral factors and immunological regulation. The neural mechanism involves both the peripheral nervous system (mainly the segmental innervation) and central nervous system (spinal cord, brainstem, hypothalamus, cerebral cortex and cerebellum) , while the humoral factors chiefly contain neurotransmitters and hormones of the endocrine system. The immunological mechanisms involve immunocytes and cytokines. Generally speaking, following acupuncture stimulation of different combined-acupoints or acupoint groups, some synergistic effects may be produced. In fact, the relatively specific clinical effect may be easy to be obtained at the peripheral segmental innervations level.

Electro-acupuncture decreases postoperative pain and improves recovery in patients undergoing a supratentorial craniotomy.

We performed this study to examine the effect of electro-acupuncture (EA) on postoperative pain, postoperative nausea and vomiting (PONV) and recovery in patients after a supratentorial tumor resection. Eighty-eight patients requiring a supratentorial tumor resection were anesthetized with sevoflurane and randomly allocated to a no treatment group (Group C) or an EA group (Group A). After anesthesia induction, the patients in Group A received EA at LI4 and SJ5, at BL63 and LR3 and at ST36 and GB40 on the same side as the craniotomy. The stimulation was continued until the end of the operation. Patient-controlled intravenous analgesia (PCIA) was used for the postoperative analgesia. The postoperative pain scores, PONV, the degree of dizziness and appetite were recorded. In the first 6 hours after the operation, the mean total bolus, the effective times of PCIA bolus administrations and the VAS scores were much lower in the EA group (p < 0.05). In the EA group, the incidence of PONV and degree of dizziness and feeling of fullness in the head within the first 24 hours after the operation was much lower than in the control group (p < 0.05). In the EA group, more patients had a better appetite than did the patients in group C (51.2% vs. 27.5%) (p < 0.05). The use of EA in neurosurgery patients improves the quality of postoperative analgesia, promotes appetite recovery and decreases some uncomfortable sensations, such as dizziness and feeling of fullness in the head.

Regional homogeneity analysis on acupoint specificity with resting-state functional magnetic resonance imaging.

BACKGROUND: The mechanism of acupuncture analgesia in craniotomy has been widely studied. However, the theoretical basis for selection of acupoints has not been examined. In this study, we used the regional homogeneity method blood oxygen level-dependent (BOLD) signals to determine changes in brain activity in response to transcutaneous electrical stimulation on acupoints and non-acupoints in resting state functional magnetic resonance imaging (fMRI). METHODS: Twelve healthy volunteers were enrolled in this study. BOLD fMRI scanning of the brain was performed for 306 seconds before and 30 minutes after transcutaneous electrical stimulation on acupoints UB63 (Jinmen), LV3 (Tai chong), ST36 (Zusanli), and GB40 (Qiuxu). The procedure was repeated after one week with stimulation on non-acupoints (one was 9 above BL67, the second was 12 above BL67 (Kunlun), the third was 7 above KI3, and the fourth was 10 above KI3 (Taixi)). RESULTS: The regional homogeneity in the acupoint group was increased in the left thalamus, caudate, putamen, lentiform nucleus (BA19, 30, 39), postcentral gyrus, precentral gyrus (BA3, 4, 30, 32), calcarine fissure, middle temporal gyrus (BA30), right superior temporal gyrus, inferior temporal gyrus (BA38), cuneus, and precuneus (BA7, 19) when compared to the non-acupoint group. The regional homogeneity of the acupoint group was decreased in the left cerebellum posterior lobe, middle frontal gyrus (BA10), double-side precuneus (BA7), and the postcentral gyrus (BA40). CONCLUSIONS: The brain region activated following acupoint stimulation is the ipsilateral pain-related brain region, which may relate to the therapeutic effect of acupuncture on pain relief. Further acupoint stimulation causes different central nervous responses compared to non-acupoint stimulation.

[Effect of electroacupuncture on Sevoflurane anesthesia in patients undergoing resection of supratentorial tumor].

OBJECTIVE: To observe the supplementary analgesic effect of electroacupuncture and its influence on the maintenance of anesthesia and the speed of recovery of patients undergoing craniotomy. METHODS: Eighty cases of supratentorial tumor resection were randomly divided into group A and group S, 40 cases in each group. All the patients were anesthetized with 2% Sevoflurane. The patients in group A received electroacupuncture at Hegu (LI 4) and Waiguan (TE 5), Jinmen (BL 63) and Taichong (LR 3), Zusanli (ST 36) and Qiuxu (GB 40) from anesthesia beginning to the end of operation, and in group S without electroacupuncture. The end-tidal Sevoflurane concentration, minimum alveolar concentration (MAC), bispectral index (BIS) and the information during anesthesia recovery stage were recorded, respectively. RESULTS: The end-tidal concentration and MAC of Sevoflurane in group A at all times were significant lower than those in group S (P<0.05, P<0.01) with a Sevoflurane saving of 9.62% on average. The BIS in group A during a few phases were higher than that in group S (all P<0.05). During anesthesia recovery stage, the time of each phase in group A was significantly shorter than that in group S (all P<0.01). No dysphoria and one case with nausea and vomiting were shown in group A, but in group S, 2 patients had dysphoria and 3 patients had nausea and vomiting. CONCLUSION: Electroacupuncture combined with Sevoflurane anesthesia can decrease the dosage of Sevoflurane, shorten the recovery time of anesthesia and improve the quality of anesthesia recovery of the patients undergoing resection of supratentorial tumor.

[Effect of electroacupuncture on the proliferation of stem cells in the subependymal zone of the lateral ventricle of the brain in rats with hyperlipemia and cerebral ischemia].

OBJECTIVE: To observe the effect of electroacupuncture (EA) and acupuncture (A) on the proliferation of stem cells in the subependymal zone (SPZ) of the lateral ventricle and the frontal lobe cortex in hyperlipemia(HL) combined with cerebral ischemia (CI) rats. METHODS: A total of 72 male SD rats were randomized into control, HL, HL+EA, CI, CI+A, HL+CI, HL+CI+EA I and HL+CI+EA II groups (n=9 /group). HL model was established by feeding the animals with high fat forage for 6 weeks and CI model was established by FeCl3-induced occlusion of the unilateral middle cerebral artery. EA was applied to "Sanyinjiao" (SP 6) and "Fenglong" (ST 40) once daily for 17 days for HL+ EA group; and acupuncture to "Baihui" (GV 20) and "Shuigou" (GV 26) once daily for 7 days for CI + A group. For HL+CI+EA I group, EA was applied to SP 6 + ST 40 first before CI, once daily for 10 days, followed by EA of SP 6+ST 40 and acupuncture of GV20+GV26 for 7 days after CI. For HL+CI+EA II group, no treatment was given before CI, then, acupuncture of GV 20 + GV 26 and EA of SP 6 + ST 40 were given once daily for 7 days after CI. The immunoactivity of Nestin and proliferation cell nuclear antigen (PONA) of SPZ was detected by immunohistochemistry. RESULTS: In comparison with normal control group, the numbers of both Nestin and PCNA immunoreaction (IR) positive cells in the dorsolateral extension and the wall of the lateral ventricle of the brain increased significantly in CI and HL+CI groups (P < 0.01). Compared with CI group, the numbers of Nestin and PCNA IR positive cells in the dorsolateral extension and the wall of the lateral ventricle in CI + A group increased considerably (P < 0.01). In comparison with HL+CI group, both Nestin and PCNA IR positive cell numbers in the dorsolateral extension and the wall of the lateral ventricle of the brain in HL+CI+EA I and HL+CI+EA II groups increased significantly (P < 0.01), and the effect of HL+CI+EA I group was markedly superior to that of HL+CI+EA II group in upregulating the numbers of Nestin and PCNA IR positive cells in the aforementioned regions of the lateral ventricle (P < 0.01). No significant differences were found between HL and control groups, and between HL+EA and HL groups in the numbers of Nestin and PCNA IR positive cells in the dorsolateral extension and the wall of the lateral ventricle of the brain (P > 0.05). CONCLUSION: EA can upregulate Nestin and PCNA expression of the dorsolateral extension and the wall of the lateral ventricle of the brain on the ischemic side in rats with CI, and with HL+CI, which may contribute to its effects in promoting the proliferation and migration of neural stem cells in the brain.

[Effect of electroacupuncture on the expression of hippocampal calbindin-D 28 K in hyperlipemia rats with concurrent cerebral ischemia].

OBJECTIVE: To observe the effect of electroacupuncture (EA) on Calbindin D28 K(CB) expression and apoptosis in hippocampus in hyperlipemia rats with concomitant cerebral ischemia (CI). METHODS: Forty male SD rats were randomized into control, hyperlipemia+ CI (model), acupuncture I, and acupuncture II groups, with 10 cases in each. Hyperlipemia model was established by feeding the animals with high fat forage for 6 weeks and CI model established by occlusion of the unilateral middle cerebral artery. For rats of acupuncture I group, EA (1-3 mA, 15 Hz) was applied to bilateral "Sanyinjiao" (SP 6) and "Fenglong" (ST 40) for 20 min every time, once daily for 10 days before CI. For rats of both acupuncture I and II groups, after CI, EA was applied to SP 6, ST 40, "Baihui" (GV 20) and "Shuigou" (GV 26) were punctured with filiform needles and stimulated by twirled the needle with hand continuously for 1 min, once daily for 7 days. The apoptotic cells of hippocampal CA 3 area were displayed by TUNEL (terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling) method. CB antibody staining with immunohistochemistry was used to show CB-positive cells which were observed by optic microscope. RESULTS: In comparison with control group, the percentage of apoptotic cells of the hippocampal CA 3 area in model group increased considerably (P < 0.01), while the number of CB immunoreaction (IR)-positive cells in the same area decreased significantly (P < 0.05). Compared with model group, the percentages of apoptotic cells of CA 3 area in acupuncture I and acupuncture II groups lowered remarkably (P < 0.01), while the numbers of CB IR-positive cells in the later two groups increased significantly (P < 0.01). The therapeutic effect of acupuncture I group was apparently superior to that of acupuncture II group in lowering the percentage of apoptotic cells and upregulating CB IR-positive cell number (P < 0.05). CONCLUSION: Acupuncture can effectively lessen neuronal apoptosis of the hippocampus CA 3 area which may be closely related to its effect in upregulating the expression of CB in hyperlipemia + CI rats. Moreover, the cerebral ischemia injury degree may be lightened by acupuncture-lowering hyperlipemia first.

[Effect of electroacupuncture on proliferation and differentiation of neural stem cells in the subependymal zone of the cerebral lateral ventricle in rats with hyperlipemia and cerebral ischemia].

OBJECTIVE: To observe the effects of electroacupuncture (EA) on the expression of vimentin and beta-Tubulin (Tju-1) in the dorsolateral extension and the lateral wall of the lateral ventricle (both of which belong to the subependymal ventricular zone, SVZ) on the ischemic side of the brain in rats with hyperlipemia (HL) plus cerebral ischemia (CI) so as to study its underlying mechanism in relievting HL, CI and combined HL and CI by regulating the proliferation and differentiation of neural stem cells. METHODS: Seventy two male SD rats were randomized into control, HL, HL + EA, CI, CI + manual acupuncture (MA), HL + CI, HL + CI + EA I and HL + CI + EA II groups, with 9 cases in each. HL model was established by feeding the animals with high fat forage for 6 weeks and CI model was duplicated by occlusion of the unilateral middle cerebral artery induced by regional application of FeCl3. For rats of HL+ EA group, EA (15 Hz, 1 - 3 mA) was applied to bilateral "Sanyinjiao" (SP 6) and "Fenglong" (ST 40) for 20 min, once daily for 17 days. For rats of CI+ MA group, "Baihui" (GV 20) and "Shuigou" (GV 26) were punctured and stimulated manually for 1 min (the former with the needle retained for 20 min), once daily for 7 days. For rats of HL+ CI + EA I group, bilateral "Sanyinjiao" (SP 6) and "Fenglong"(ST 40) were stimulated electrically after needle-insertion, once daily for 10 days, followed by duplicating CI model and performing MA stimulation of GV 20 and GV 26 respectively, once daily for 7 days. For rats of HL + CI + EA II groups, EA was applied to bilateral SP 6 and ST 40, and simultaneous MA stimulation of GV 20 and GV 26, once daily for 7 days after HL + CI. The expression of vimentin and Tuj-1 in the dorsolateral extension and the lateral wall of the cerebral lateral ventricle on the ischemic side was detected by immunohistochemistry. RESULTS: Compared with the control group, the expression levels of both vimentin and Tuj-1 in the dorsolateral extension and the lateral wall of the lateral ventricle of the brain on the ischemic side were increased significantly in the CI and HL + CI groups (P < 0.01), while compared with the CI group, the expression of vimentin and Tuj-1 in the CI + MA group were increased further significantly (P < 0.01). In comparison with the HL + CI group, the expression of vimentin and Tuj-1 in the HL + CI + EA I and HL + CI + EA II groups were also upregulated considerably (P < 0.01). Comparison between the HL + CI + EA I and HL + CI + EA II groups showed that the expression levels of vimentin and Tuj-1 were significantly lower in the latter group than in the former group (P < 0.01). No significant diffrences were found between the HL and control groups, and between the HL and HL+ EA groups in the expression of vimentin and Tuj-1 (P > 0.05). CONCLUSION: Acupuncture and Acupuncture + EA can further significantly upregulate the expression levels of vimentin and Tuj-1 in both the dorsolateral extension and the lateral wall of the cerebral lateral ventricle on the ischemic side in rats with CI and CI + HL, which may contribute to their effects in improving CI and HL+CI by suppressing the reduction of proliferation and differentiation of neural stem cell in the SVZ of the ischemic brain induced by CI and HL+ CI.

[Effects of electroacupuncture of different acupoint groups on sevoflurane anesthesia in patients undergoing resection of supratentorial tumors].

OBJECTIVE: To observe the effect of electroacupuncture (EA) of different acupoint groups on the sevoflurane anesthetic requirement for resection of supratentorial tumors and the speed of post-operation recovery. METHODS: A total of 120 cases of supratentorial tumor resection patients were randomly and equally allocated into general anesthesia (GA) group, EA-proximal acupoints group (EA-PA group) and EA-distant acupoints group (EA-DA group). The supratentorial tumor patients were anesthetized with sevoflurane for surgery. Proximal acupoints used were Fengchi (GB 20), Tianzhu (BL 10), Cuanzhu (BL 2) and Yuyao (EX-HN 4) that the former 2 acupoints and the latter 2 acupoints were for penetrative needling; and distant acupoints used were Hegu (LI 4), Waiguan (TE 5), Jinmen (BL 63), Taichong (LR 3), Zusanli (ST 36) and Qiuxu (GB 40) on the craniotomy side, and stimulated with EA (2 Hz/100 Hz, a tolerable electric stimulating strength), beginning from the anesthesia induction till the end of surgical operation. All patients were anesthetized by inhalation of propofol (2 mg/kg), sufentanil (0.3 microg/kg) and vecuronium bromide (0.1 mg/kg) and maintained with sevoflurane. The end-tidal sevoflurane concentration, minimum alveolar concentration (MAC), bispectral index (BIS), and the speed of recovery were recorded. RESULTS: In comparison with the GA group, the end-tidal concentrations during anesthesia maintenance at the time-points of post skull drilling, dura incising, intracranial operation in EA-PA group, the time-points of post skull drilling, skull opening, dura incising, and intracranial operation in EA-DA group, and the MAC of sevoflurane at the time-points of skull drilling in EA-DA group, and skull opening, dura incising, intracranial operation and dura suturing in both EA-PA and EA-DA groups were significantly lower (P < 0.05, P < 0.01). Compared to the GA group, the BIS values of EA-DA group at the time-points of skull drilling and opening, and dura incising were significantly higher (P < 0.05), while during the recovery stage of anesthesia, in comparison with the GA group, the autonomous respiration recovery time, tracheo-tube removing time, eye-opening time, voluntary motion recovery time, orientation force recovery time, and operating room-departure time of both EA-PA and EA-DA groups were significantly shorter (P < 0.05, P < 0.01). No significant differences were found between the EA-PA and EA-DA groups in the aforementioned indexes (P > 0.05). CONCLUSION: EA of both proximal and distant acupoints can reduce the expired concentration and MAC of sevoflurane during anesthesia maintenance, and accelerate the recovery after cease of anesthesia in supratentorial tumor resection patients.

[Advances of studies on the underlying mechanism of acupuncture efficacies by using functional magnetic resonance imaging].

In the present paper the authors review recent progress in the study on the underlying mechanism of acupuncture effects by using functional magnetic resonance imaging (fMRI) from (1) fMRI imaging technology, (2) the meridian-collateral system of Chinese medicine, (3) the factors affecting the therapeutic effect of acupuncture, (4) the mechanism underlying the efficacy of acupuncture treatment, (5) the experimental design methods for studying acupuncture by using fMRI, and (6) the methods for analyzing fMRI data. Research results show that fMRI technology is a new and useful approach for studying the underlying mechanism of acupuncture effect.

[Effect of electroacupuncture on caspase-9 expression in hippocampus and neuroethology in hyperlipemia rats with concurrent cerebral ischemia].

OBJECTIVE: To observe the effect of electroacupuncture (EA) on hippocampal apoptosis protein caspase-9 expression and neuroethology in hyperlipemia plus cerebral ischemia (HL-CI) rats. METHODS: Seventy male SD rats were randomized into control, hyperlipemia (HL), CI, HL-CI, CI + EA, HL-CI + EA I , and HL-CI + EA II groups, with 10 cases in each. HL model was established by feeding the animals with high fat forage for 6 weeks and CI model was established by occlusion of the unilateral middle cerebral artery. EA (1-3 mA, 15 Hz) was applied to bilateral "Sanyinjiao" (SP 6) and "Fenglong" (ST 40) for 20 min every time; and "Baihui" (GV 20) and "Shuigou" (GV 26) were punctured and stimulated by twirling the acupuncture needle with hand continuously for 1 min. Acupuncture was given once daily for 17 days (beginning from the 10th day on before CI) in HL-CI + EA I group, and for 7 days (beginning after CI) in HL-CI + EA II group. The expression of hippocampal Caspase-9 was detected with immunohistochemistry. The score of neuroethology was also measured according to modified Bederson's method. RESULTS: In comparison with normal control and hyperlipemia model groups, Caspase-9 immune reaction (IR) positive cells in the hippocampus in HL-CI group increased significantly (P<0.01). After acupuncture Caspase-9 IR-positive cells decreased remarkably. In comparison with group HL-CI + EA II, Caspase-9 IR-positive cells decreased significantly in HL-CI + EA I (P<0.01). The score of neuroethology also degraded obviously. CONCLUSION: Acupuncture can improve neuroethology symptom, lessen over expression of hippocampal Caspase-9, and prevent CI injury in hyperlipemia rats with concurrent CI.

[Effect of acupuncture on serum lipid and cerebral neurogrowth factor levels in hyperlipemia rats with concurrent cerebral ischemia].

OBJECTIVE: To observe the effect of electroacupuncture (EA) on serum lipid and cerebral neurogrowth factor (NGF) in rats with hyperlipemia and cerebral ischemia (CI). METHODS: A total of 36 SD rats were evenly randomized into control, model, EA-I and EA-II groups with 9 cases in each group. Hyperlipemia plus CI model was established by feeding the rats with high-fat foodstuff (6 weeks) and FeCI3-evoked middle-cerebral-artery (MCA) occlusion method. EA (15 Hz, 1-3 mA) was applied to "Sanyinjiao" (SP 6) and "Fenglong" (ST 40) for 20 min, once daily, continuously for 7 days, additionally,"Baihui" (GV 20) and "Shuigou"(GV 26) were punctured and stimulated with hand, which was conducted first before MCA occlusion for rats of group EA-I and after MCA occlusion for rats of group EA-II separately. Fasting blood samples (2 mL/rat) were taken for detecting serum total cholesterol (TC), triglyceride (TG), low density lipid cholesterol (LDL-C) and high density lipid cholesterol (HDL-C) levels. After decapitation of the rats, cerebral tissues were taken, homogenated for detecting NGF content with ABC-ELISA (enzyme-linked immunosorbent assay) and some other cerebral tissues were cut into sections (6 microm)for observing structural changes of the brain after staining with haematoxylin and cosin (HE) method. RESULTS: Compared with control group, serum TC, TG and LDL-C contents of model, EA-I and EA-II groups increased significantly on day 42 and 59 after modeling (P < 0.01), and HDL-C content of model, EA-I and EA-II groups decreased markedly on day 42 after modeling (P < 0.01). Compared with model group, TC contents of both EA-I and EA-II groups, and TG and LDL-C of EA-I group decreased significantly on day 59 after establishing the model (P < 0.05, 0.01). No significant differences were found between EA-I and EA-II groups in the 4 indexes of blood lipid (P > 0.05). HE staining showed that in model group, neuronal ischemic injury including cellular swelling, edema and nuclear fragmentation in the striatum and the cortex of parietal lobe, widening of the cellular interspace. vacuolation, irregularity of the kytoplasm and karyolemma, etc in CA3 region of hippocampus was apparent, while the situation in EA groups was lighter. Regarding the changes of NGF, compared with control group, NGF contents of model group and EA-I group were significantly lower (P < 0.01); while compared with model group, NGF content of EA-I was significantly higher (P < 0.01); and that of EA-lI group was markedly lower than that of EA-I group (P < 0.05). CONCLUSION: EA can lower the levels of serum TC, LDL-C and TG and suppress cerebral ischemia plus hyperlipemia induced decrease of NGF level in the brain, which may contribute to its effect in relieving ischemic cerebral injury.