[Electroacupuncture improves learning-memory of rats with low estrogen-induced cognitive impairment].

The present study was aimed to investigate the effect of electroacupuncture (EA) on learning-memory of rats with low estrogen-induced cognitive impairment and the possible mechanism. The rat model was established by ovariectomy, which resulted in low estrogen-induced cognitive impairment. EA was applied continuously for 3 months 2 weeks after ovariectomy. Morris water maze was used to test the ability of spatial learning and memory. Enzyme-linked immunosorbent assay (ELISA) and real-time quantitative RT-PCR were used to detect the concentration of serum estradiol (E2) and relative expression of choline acetyltransferase (ChAT) mRNA in hippocampus, respectively. The result showed that, compared with the sham group, the ovariectomy model group exhibited longer escape latency, reduced number of platform-crossing, lower concentration of serum E2, and decreased expression of ChAT mRNA in hippocampus. EA shortened the escape latency and increased the number of platform-crossing in the ovariectomy model group. Moreover, the concentration of serum E2 and the hippocampal expression of ChAT mRNA in the ovariectomy model group were significantly elevated by EA treatment. These results suggest EA is capable of improving learning and memory in ovariectomized rats, and the mechanism involves the up-regulation of the expression of ChAT mRNA in hippocampus induced by the increase of the serum concentration of estrogen.

[Correlation between the liver meridian and the frontal lobe in depression by needling at taichong (LV3): a resting-state fMRI study].

OBJECTIVE: To explore the mechanism of depression treatment by needling at Taichong (LV3) and the correlation between the liver meridian and the frontal lobe. METHODS: Forty-two patients with moderate depression at the first attack in line with Diagnostic and Statistical Manual of Mental Disorders (4th ed) by American Psychiatric Association were assigned to the fluoxetine group, the needling + fluoxetine group, and the needling group, 14 in each. The therapeutic course for them all was one month. Resting fMRI scanning was performed before and after treatment using 3.0 T magnetic resonance. Data were analyzed using fractional amplitude of low frequency fluctuations (fALFF). Paired t-test was used for comparison. Correlation analysis was performed in the fALFF images after treatment and Hamilton's depression scale. RESULTS: Compared with before treatment, fALFF values in the left frontal lobe (BA6, BA9, BA48), the right frontal lobe (BA4, BA46), the bilateral inferior parietal lobules (BA40, BA48), the precuneus (BA7), the posterior cingutate (BA31), the left occipital lobe (BA17), and the right occipital lobe (BA18) of the needling +fluoxetine group were lowered (P<0.05). fALFF values in the right inferior parietal lobule (BA40) and the right occipital lobe (BA17) of the fluoxetine group were lowered (P<0.05). fALFF values in the left frontal lobe (BA10), the right frontal lobe (BA45), the left occipital lobe (BA19), the right occipital lobe (BA17), the left precuneus (BA7), and the posterior cingutate (BA31) were lowered in the needling group (P<0.05). Hamilton's depression scale was positively correlated with the fALFF value in the left frontal lobe of the needling +fluoxetine group and the needling group, while Hamilton's depression scale was positively correlated with the fALFF value in the left middle frontal gyrus, the left parietal lobe, and the left occipital lobe in the fluoxetine group. CONCLUSIONS: Combination of needling and antidepressive agents was superior to needling or antidepressive agents alone. Changes of the frontal lobe functions were correlated with the severity of depression. More extensive correlation existed between the liver meridian and the frontal lobe, which might be the antidepressive mechanism of needling Taichong (LV3).

The flavonoid kurarinone inhibits clinical progression of EAE through inhibiting Th1 and Th17 cell differentiation and proliferation.

INTRODUCTION: The flavonoid kurarinone suppresses CD4+ T-cell-mediated chronic inflammatory dermatitis. However, kurarinone's effects upon autoimmune central nervous system (CNS) disease remain unknown. We investigated the potential therapeutic effects and molecular mechanism(s) of kurarinone in an experimental autoimmune encephalomyelitis (EAE) murine model of multiple sclerosis (MS). MATERIALS AND METHODS: Myelin oligodendrocyte glycoprotein (MOG35-55) peptide-induced EAE was constructed in wild-type mice. Effects of kurarinone (100 mg/kg/day) upon clinical scores were assessed based on physical traits and signs. Spinal cord sections were extracted to assess inflammation, demyelination, and mRNA expression of key pro-inflammatory cytokines and chemokines. CNS-infiltrating mononuclear cells (MNCs) and splenocytes were harvested; flow cytometry was then applied to determine CD4+ and CD8+ T-cell percentages as well as Th1/Th2/Th17 subset percentages. Purified naïve CD4+ T-cells underwent in vitro T-cell polarization and proliferation to assess kurarinone's effects. RESULTS: Prophylactic and treatment regimens of kurarinone significantly improved clinical scores in the MOG35-55 peptide-induced EAE model (P < 0.05). Kurarinone significantly lowered CNS inflammation and demyelination (61% and 83% decreases, respectively; P < 0.05), significantly decreased MNC infiltration into CNS tissue (42% decrease; P < 0.05), and significantly inhibited levels of several pro-inflammatory cytokines and chemokines (P < 0.05). Kurarinone significantly lowered CD4+ and CD8+ CNS T-cell counts (51% and 80% decreases, respectively; P < 0.05) and significantly reduced CNS Th1 and Th17 cell percentages (24% and 44% decreases, respectively; P < 0.05). Kurarinone significantly inhibited in vitro Th1, Th2, and Th17 cell differentiation and proliferation (P < 0.05). CONCLUSIONS: Kurarinone significantly inhibits the clinical progression of EAE through the inhibition of Th1 and Th17 cell differentiation and proliferation. Kurarinone may show promise as an immunomodulatory therapeutic agent in treating MS.

["Xingnao Kaiqiao" Acupuncture(Acupuncture Technique for Restoring Consciousness) Combined with Hyperbaric Oxygen in Patients with Hypoxic Ischemic Encephalopathy: Clinical Observation and Its Influence on Blood Rheology].

OBJECTIVE: To observe the effect of "Xingnao Kaiqiao" acupuncture(acupuncture technique for restoring consciousness) combined with hyperbaric oxygen in patients with hypoxic ischemic encephalopathy and assess its influence on blood rheology. METHODS: Forty patients with hypoxic ischemic encephalopathy were randomly divided into treatment group and control group with 20 cases in each group. The treatment group received "Xingnao Kaiqiao" acupuncture combined with hyperbaric oxygen, and the control group received hyperbaric oxygen only. The two groups of patients were treated once per day for 6 consecutive days, which consisted of one course of treatment, and the total treatment lasted for four courses. Before and after treatment, the patients underwent the mini mental state examination (MMSE) to evaluate cognitive function and the barthel index score for activities of daily living. The changes of whole blood viscosity, plasma viscosity, and erythrocyte aggregation index were determined. RESULTS: After treatment, both the treatment and control groups showed improvements in cognitive function，activities of daily living, and blood rheology compared with those before treatment (P<0.05). However, these improvements in the treatment group were significantly greater than those in the control group (P<0.05). CONCLUSIONS: Application of "Xingnao Kaiqiao" acupuncture combined with hyperbaric oxygen in patients with hypoxic ischemic encephalopathy can result in an integrated curative effect, a significant improvement in the blood rheology indexes, and promote the recovery of brain cells.

[Observation on clinical effects of moxibustion stimulation of different sensitive status acupoints for knee osteoarthritis].

OBJECTIVE: To observe the clinical effect of moxibustion of different acupoints undergoing heat-sensitive state and resting state in the treatment of knee osteoarthritis (KOA) patients. METHODS: A total of 60 cases of KOA patients were enrolled in the present trial. They were divided into heat-sensitive moxibustion (heat-sensitive) group and non-sensitive moxibustion group (resting group). Moxibustion was applied to Neixiyan (EX-LE 4), Waixiyan (i.e. Dubi, ST 35) and Heding (EX-LE 2) for about 45 min, once daily for 20 days. The heat-sensitive state was evaluated according to the patient's feeling. After moxibustion stimulation at the acupoint area, if the patient feels the heat penetrating from the skin surface to the deep tissue, or/and extending peripherally around the moxibustion site, or/and transmitting toward a certain direction, it is considered to be heat sensitization state. The therapeutic effect was evaluated by using visual analogue scale (VAS) for pain severity changes and by Guiding Principles for Clinical Trials of New Drugs of Chinese Materia Medica for evaluating functional activity of the knee-joint. RESULTS: After 20 sessions of treatment and after a half year's follow-up, the total integrated scores of VAS in the heat-sensitive group were all lower than those of the resting group (P < 0.01). Following 20 sessions of treatment, of the two 30 KOA patients in the heat-sensitive group and resting group, 14 (46.67% )and 5 (16.67%) experienced a marked improvement, 10 (33.33%) and 9 (30.00%) were effective, 6 (20.00%) and 16 (53.33%) were invalid, with the effective rates being 80.00% and 46.67 , respectively. Half-year's follow-up showed that the effective rates of the heat-sensitive group and resting group were 79.17% (19/24) and 42.86% (6/14), respectively, suggesting a better therapeutic effect of heat-sensitive moxibustion. CONCLUSION: The clinicaln effect of heat-sensitive moxibustion is significantly superior to that of non-sensitive moxibustion in the treatment of KOA patients, being worthy of clinical application.

[Relationship between patients' sensitivity to moxibustion stimulation and clinical effect in the treatment of peripheral facial palsy].

OBJECTIVE: To compare the outcome difference between the heat-sensitive and non-sensitive moxibustion stimulation of Yifeng (TE 17) in the treatment of peripheral facial palsy. METHODS: A total of 43 patients with peripheral facial paralysis were divided into heat-sensitive moxibustion (n = 21) and non-sensitive moxibustion (n = 22) groups in accordance with their reactions to moxa-heat stimulation. Mild moxibustion was applied to bilateral Yifeng (TE 17) for 45 minutes, followed by mild acupuncture stimulation of Cuanzhu (BL 2), Yangbai (GB 14), Sibai (ST 2), Hegu (LI 4), etc. Moxibustion treatment was conducted once daily for 10 days, and acupuncture treatment given once daily for 20 days (with 2 days interval between every 10 days). Following moxibustion, if the patient felt regional heat penetrating to the deep tissue, extending peripherally, or propagating to other part of the body, or felt mild warm in the stimulated region but warmer in the slightly distant part, or felt mild warm on the skin surface but warmer in the deep tissue, it was considered to be heat-sensitivity. Patients with occurrence of heat-sensitivity being equal to and more than 3 times during the 10 sessions of treatment were assigned to heat-sensitive group, and those with occurrence of heat-sensitivity being equal to or less than 2 times assigned to non-sensitive moxibustion group. According to Portmann Scale (including movement and resting posture) for the voluntary movement state of the face, forehead, winkles eye closure, open mouth smile, snarl, and pucker; points 0, 1, 2 and 3 indicate no muscular movement, marked asynersis, asynersis and normal, respectively. In the light of resting posture of the eye, the nasolabial fold and mouth corner, 0, 1, and 2 points indicate severe, mild dissymmetry and normal, separately. In evaluation of the therapeutic effect, twenty points (at most) indicate cured, 17-19 points marked improvement; 14- 16 points improved, and < or = 13 points failure. RESULTS: Compared with pre-treatment, Portmann scores of both heat-sensitive moxibustion and non-sensitive moxibustion groups were significantly increased after the treatment (P < 0.001), and the score of the heat-sensitive moxibustion group was markedly higher than that of the non-sensitive moxibustion group (P < 0.05). Of the 21 and 22 facial palsy patients in the heat-sensitive moxibustion and non-sensitive moxibustion groups, 8 and 5 cases were cured, 10 and 7 were markedly effective, 3 and 10 were improved, with the markedly effective rates being 85.71% and 54.55%, respectively. The therapeutic effect of the heat-sensitive moxibustion group was statistically better (P < 0.05). CONCLUSION: Heat-sensitive moxibustion is significantly superior to non-sensitive moxibustion in improving symptoms of peripheral facial palsy patients, suggesting a necessity for paying attention to patients' reactions during moxibustion treatment.

[Effect of acupuncture stimulation of Zusanli (ST 36) on cerebral regional homogeneity in volunteer subjects with different constitutions: a resting-state fMRI study].

OBJECTIVE: To observe the synchronism difference of brain region activities in response to acupuncture stimulation of Zusanli (ST 36) in healthy volunteer subjects with different acupuncture analgesia sensitivity, so as to study the central factors influencing acupuncture intervention outcomes. METHODS: Forty-five healthy volunteer subjects with different constitutions (different sensitivities in response to needling stimulation) were divided into insensitive group, normal group and sensitive group (n = 15). The pressure pain threshold (PPT) of the Zusanli (ST 36) region before and after acupuncture stimulation of ST36 was assessed using visual analog scale (VAS). Two weeks later after acupuncture stimulation of ST 36, resting-state fMRI images were acquired by using a nuclear magnetic resonance imaging system and analyzed by using DPARSFV 2.1 software package, software SPM 8 and REST 1.7. The cerebral regional homogeneity (ReHo) of the subjects was then calculated by Resting-State fMRI Data Analysis Toolkit (REST). RESULTS: Compared with pre-acupuncture, PPT levels of the normal and sensitive groups were significantly increased after acupuncture of ST 36 (P < 0.05), and that of the insensitive group had no significant change (P > 0.05). Following acupuncture stimulation of ST 36, the insensitive group only showed a significant decreased ReHo in the left fusiform gyrus, left inferior temporal gyrus, bilateral postcentral gyrus, and left anterior central gyrus. In the normal group, a significantly increased ReHo was found in left brainstem, the right cerebellum posterior lobe, right parahippocampa gyrus, right fusiform gyrus, left angular gyrus, temporal lobe and the left frontal lobe; and a significantly decreased ReHo in the occipital lobes and the right superior temporal gyrus after acupuncture stimulation of ST 36. In the sensitive group, a markedly increased ReHo was found in the left brainstem, bilateral cerebellum posterior lobes, left inferior temporal gyrus, basal ganglia, the left insular lobe, anterior cingutate, frontal lobe, inferior parietal lobule, and the right supplementary motor area, and an obviously decreased ReHo found in the bilateral occipital lobes, fusiform gyrus, posterior central gyrus, the right posterior cingutate, the left temporal lobe and the left paracentral lobule, etc. after acupuncture of ST 36. CONCLUSION: Constitution-associated needling sensation may be an important influential factor for acupuncture analgesia in normal subjects. The change of ReHo in different cerebral areas is probably responsible for the difference of acupuncture analgesia in different constitution people.

[Effect of scalp acupuncture combined with body acupuncture on limb function in subacute stroke patients].

OBJECTIVE: To observe the effect of acupuncture stimulation of scalp- and body-acupoints on limb function in subacute stroke patients. METHODS: A total of 110 stroke inpatients were randomly and equally divided into acupuncture group and control group. Patients of the acupuncture group were treated by acupuncture stimulation of scalp acupoint Dingnie Qianxiexian (MS 6) and body acupoints Neiguan (PC 6), Jianyu (LI 15), Sanyinjiao (SP 6), etc. once daily for 20 days and routine neurological therapies, including drugs for controlling blood pressure, blood sugar, water-electrolyte balance, anticoagulation, encephaledema reduction, intracranial pressure reduction, anti-inflammation, neurofunction protection, etc. The stroke patients of the control group were treated with the routine neurological therapies only. The Fugl-Meyer assessment (FMA), US National Institutes of Health Stroke Scale (NIHSS) were used to assess the patients' limb function and nerve functional lesion severity before and after the treatment, and the ratio of mortality/disability and recurrence rate were used to assess the efficacy of acupuncture at the end of 3 and 6 months' follow-up. RESULTS: After the treatment, the FMA scores were increased significantly and NIHSS scores decreased considerably in both groups (P < 0.01), and the effects of acupuncture group were obviously superior to those of the control group (P < 0.05). There were no significant differences between two groups in the ratios of mortality/disability and recurrence rates at the end of 3 and 6 months' follow-up (P > 0.05). CONCLUSION: Scalp acupuncture combined with body acupuncture can evidently improve limb movement function and reduce the nerve function damage in stroke patients.

[Comparative study of heat-sensitive moxibustion in the treatment of knee osteoarthritis].

OBJECTIVE: To verify the clinical efficacy of heat-sensitive moxibustion in treatment of knee osteoarthritis (KOA). METHODS: Sixty cases of KOA were randomly divided into a heat-sensitive moxibustion group and a conventional moxibustion group, 30 cases in each one. Dubi (ST 35), Yanglingquan (GB 34), Zusanli (ST 36) and Heding (EX-LE 2) on the affected side were selected in two groups. In heat-sensitive moxibustion group, the techniques of circling moxibustion, sparrow-pecking moxibustion, moving moxibustion and mild moxibustion were applied. In conventional moxibustion group, the mild moxibustion was used, 2 to 3 cm far from the skin of the acupoints selected. Lysholm scale for the assessment of knee joint function was adopted to evaluate the efficacy. The scores of joint pain, morning stiffness, joint swelling and walking ability were compared before and after treatment in two groups. RESULTS: The scores of joint pain, morning stiffness, joint swelling and walking ability after treatment were all apparently improved as compared with those before treatment in either group (all P < 0.05). The improvement in the above-mentioned indices in heat-sensitive moxibustion group was much more apparent as compared with that in conventional moxibustion group (all P < 0.01). The effective rate was 90.0% (27/30) in heat-sensitive moxibustion group and was 73.3% (22/30) in conventional moxibustion group. The effective rate in heat-sensitive moxibustion group was obviously superior to that in conventional moxibustion group (P < 0.01). CONCLUSION: The efficacy of heat-sensitive moxibustion is superior to that of conventional moxibustion in the treatment of KOA. This therapy can more significantly improve the symptoms and physical signs of the patients with KOA.

[Observation on therapeutic effect of acupuncture of five Shu-points of the liver meridian combined with bloodletting for depression patients and concomitant changes of blood rheology].

OBJECTIVE: To observe the clinical efficacy of acupuncture of five Shu-points of the Liver Meridian plus bloodletting for depression patients and its effect on hemorheology. METHODS: Thirty depression outpatients were randomly and equally divided into medication and acupuncture + bloodletting groups. Patients of the medication group were treated with Fluoxetine (20 mg/d, PO. in the morning) and those of the acupuncture + bloodletting group treated by acupuncture of Xingjian (LR 2), Taichong (LR 3), Zhongfeng (LR 4) and Ququan (LR 5) first, followed by pricking Dadun (LR 1) to let a little bit of blood out. The treatment was given once every other day, two months altogether. The therapeutic effect was assessed by using Hamilton Depression Rating Scale (HAMD) and the Clinical Global Impression Scale for Severity of Illness (CGI-SI) before and 1, 2, 4, 6, and 8 weeks after the treatment, respectively. Changes of hemorheology were detected by using a blood rheology detector. RESULTS: Of the 15 outpatients in both medication and acupuncture + bloodletting groups, 6 (40.00%) and 6 (40.00%) were cured basically, 5 (33.34%) and 4 (26.67%) experienced marked improvement, 2 (13.33%) and 3 (20.00%) were improved, and 2 (13.33%) and 2 (13.33%) invalid, respectively. No significant difference was found between the two groups in the therapeutic effect (P > 0.05). On the 6th and 8th weeks of the treatment, the CGI-SI score of the acupuncture + bloodletting group was significantly lower than that of the medication group (P < 0.05), suggesting a better therapeutic effect of the acupuncture + bloodletting group. The low and high shear viscosity of whole blood, erythrocyte aggregation index and rigidity index, and fibrinogen levels of the two groups were decreased significantly after the treatment (P < 0.05). No significant difference was found between the two groups in the changes of hemorheology indexes following the treatment (P > 0.05). CONCLUSION: Acupuncture of the five Shu-points of the Liver Meridian combined with bloodletting is effective in relieving depression symptoms and improving blood rheology in depression patients.