Acupoint Catgut Embedding Research Articles

Adverse events/adverse reactions of acupoint catgut embedding therapy for psoriasis vulgaris: a systematic review

To systematically review the occurrence of adverse events/adverse reactions (AEs/ARs) induced by acupoint catgut embedding therapy for psoriasis vulgaris (PV) and its safety. Randomized controlled trials, controlled clinical trials, cohort studies, case-control studies, case-series, and case reports concerning the treatment of PV with acupoint catgut embedding therapy were searched from Chinese and English databases from their inception to January 7th, 2021. The AEs/ARs related to acupoint catgut embedding therapy for PV were subjected to descriptive statistics, followed by the analysis of possible reasons. Finally, 16 studies were included, involving 1 158 patients. A total of 79 cases were reported to present with mild to moderate AEs/ARs related to acupoint catgut embedding therapy for PV, and there were no serious AEs/ARs or death cases. The most common AEs/ARs were local redness, swelling, heat, and pain (31.65%,25/79), followed by low-grade fever and fatigue (29.11%,23/79), isomorphic reaction (16.46%,13/79), local induration (13.92%,11/79), and fainting (8.86%,7/79). In terms of embedding materials, catgut (93.67%,74/79) and lumbar puncture needles or other puncture needles (49.37%,39/79) were proved the most common AEs/ARs-inducing factors. The proportion of AEs/ARs resulting from treatment interval≤two weeks (67.09%,53/79) and treatment course≤eight weeks (55.70%,44/79) was relatively high. Because the incidence of AEs/ARs fails to be calcula-ted, it is not yet possible to accurately assess the risk and safety of acupoint catgut embedding therapy for PV. Available evidence suggests that in the treatment of PV, acupoint catgut embedding therapy may induce a series of mild to moderate AEs/ARs, so its clinical practice deserves attention. We should strictly grasp its indications and contraindications, and prevent the occurrence of related AEs/ARs by standardizing the operation and improving the embedding materials.

Effect of Acupoint Catgut Embedding for Middle-Aged Obesity: A Multicentre, Randomised, Sham-Controlled Trial.

Objectives This study aimed to examine the efficacy and safety of acupoint catgut embedding (ACE) for obesity over a 16-week treatment period using sham stimulation as the control. Methods A multicenter, randomised, parallel, sham-controlled trial was conducted from February 10, 2017, to May 15, 2018. Men with waistlines ≥85 cm and women with ≥80 cm at three sites were randomised to receive eight sessions (over 16 weeks) of ACE (n = 108) or sham ACE (n = 108) with skin penetration at sham acupoints. The catgut was embedded once every two weeks using two alternating sets of acupoints. The follow-up lasted for an additional 24 weeks. The primary outcome was the percentage waistline reduction from baseline to week 16. Results We included 216 individuals in the intention-to-treat analysis. At 16 weeks, the rate of waistline reduction was 8.80% (95% confidence interval (CI), 7.93% to 9.66%) in the ACE group and 4.09% (95% CI, 3.18% to 5.00%) in the sham control group, with a between-group difference of 4.71% (95% CI, 3.47% to 5.95%; P < 0.0001). This difference persisted throughout the entire follow-up period (between-group difference after 24-week additional weeks, 4.94% (95% CI, 3.58% to 6.30%); P < 0.001). The subgroup analyses of waistline by sex (male/female) revealed treatment effects of 1.93 (95% CI, −0.37 to 4.23, P = 0.1) in the male group and 3.19 (95% CI, 1.99 to 4.39, P < 0.001) in the female group. The adverse event analysis suggested that ACE and laboratory tests confirmed the safety of ACE. Discussion. ACE for 16 weeks could decrease the waistline and weight and was safe for the treatment of obesity. Further research is needed to evaluate the long-term efficacy and sex differences. This trial is registered with NCT02936973.

Meta Analysis of the Efficacy of Non-pharmaceutical Chinese Medicine Therapy in the Treatment of Obese Polycystic Ovary Syndrome

Objective: To systematically evaluate the effects of acupuncture, auricular point sticking, acupoint catgut embedding, cupping and other non-pharmaceutical Chinese medicine therapies on sex hormone as well as glucose and lipid metabolism in patients with obese polycystic ovary syndrome. Method: The databases such as China National Knowledge Infrastructure were searched by computer to collect the literature on the treatment of obese polycystic by non-pharmaceutical Chinese medicine therapy combined with western medicine or lifestyle change, and the literature quality of the included literature was evaluated, and finally the data were analyzed. A total of 15 randomized controlled trial (RCT) literature were included in this study, with a total of 1263 patients. Results: Non-pharmaceutical Chinese medicine therapy combined with metformin or lifestyle can reduce body mass index, insulin resistance index, fasting plasma insulin, fasting blood glucose, luteinizing hormone, ratio of luteinizing hormone to follicle stimulating hormone, testosterone, but it has no obvious advantage over follicle stimulating hormone (FSH). Conclusion: Compared with simple application of metformin or lifestyle change, traditional Chinese medicine non drug therapy combined with metformin or lifestyle change can better improve sex hormone and blood glucose metabolism in obese PCOS patients.

Study on intestinal flora of acupoint catgut embedding intervention in female patients with abdominal obesity: study protocol for a randomized controlled trial

Study on intestinal flora of acupoint catgut embedding intervention in female patients with abdominal obesity: study protocol for a randomized controlled trial

The efficacy and safety of acupoint catgut embedding for peripheral facial paralysis sequela: A protocol for systematic review and meta-analysis.

Background:Peripheral facial paralysis sequela (PFPS) is a group of sequence syndrome after the acute onset of peripheral facial paralysis. Nearly 70% of patients with peripheral facial paralysis recover completely, but nearly 30% of patients leave multiple sequelae, which have serious negative impacts on the physical and psychological health of patients. Without a high risk of side effect, acupoint catgut embedding (ACE), a common acupuncture therapy, is widely used to treat this disorder. And a number of studies have shown the efficacy of this therapy for PFPS. But in fact, the evidence of the overall effect of ACE in the treatment of PFPS is still insufficient. Therefore, the purpose of this study is to evaluate the efficiency and safety of ACE for PFPS.Methods:Two reviewers will collect randomized controlled trials (RCTs) on ACE for PFPS by searching the following databases, including The Cochrane Library, PubMed, Web of Science, EMBASE, China Biomedical Literature (CBM), China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP), and Wanfang database, from their initiation to May 2021. The searching of publications will include English and Chinese without any restriction of countries and regions. Besides, 2 reviewers will independently include in studies that meet the inclusion criteria and extract data we need, then use Cochrane Collaboration's Risk of Bias Tool to assess their methodological quality. The efficacy and safety of ACE as a treatment for PFPS will be assessed according to the synthetic risk ratio (RR), odds ratio (OR), or weighted mean difference (WMD), standardized mean difference (SMD) with consistent 95% confidence intervals (95% CI). And the Review Manager 5.3 software will be adopted to conduct the statistical analysis.Results:The protocol for meta-analysis will systematically evaluate the efficacy and safety of ACE for PFPS. And the final result of this search will provide sufficient evidence and an authentic assessment focusing on the problem.Conclusion:This search will explore whether ACE could be used as an effective and non-drug external therapy of TCM for PFPS and offer supports for clinical practice.PROSPERO Registration Number:CRD42021240004

The efficacy and safety of acupoint catgut embedding for peripheral facial paralysis: A protocol for systematic review and meta analysis.

Background:Peripheral facial paralysis (PFP) is a consequence of the peripheral neuronal lesion of the facial nerve. It can be either primary (Bell palsy) or secondary. The incidence of PFP is 11.5 to 40.2 per 100,000 people a year. Nearly 70% of patients with PFP recover completely, but almost 30% of patients leave multiple sequelae which caused impacts on the patient's quality of life, both physically and psychologically. The conventional treatments of PFP are limited for some person because of side-effects. Previous studies have suggested that using acupoint catgut embedding (ACE) alone or combined with other therapeutic methods is effective for PFP. However, whether ACE is effective for PFP is still unknown. The purpose of this systematic review (SR) and meta-analysis will summarize the present evidence of ACE used as an intervention for PFP.Method/Design:Randomized controlled clinical trials that use ACE for PFP will be searched from four international electronic databases (PubMed, Cochrane Library, EMBASE, and Web of Science) and 4 Chinese electronic databases (China National Knowledge Infrastructure, VIP, Wanfang, and China Biology Medicine) to search for relevant literature. We only include studies that were published from the initiation to May 2021. The primary outcomes include effectiveness rate based on House-Brackmann Facial Nerve Grading System. Secondary outcomes will include Sunnybrook facial nerve grading system, Portmann score, facial nerve conduction velocity, Facial Disability Index Scale, adverse events. Two reviewers will perform study selection, data extraction, data synthesis, and quality assessment independently. Assessment of risk of bias and data synthesis will be conducted by using Review Manager 5.3 software. Grade system will be used to evaluate the quality of evidence.Discussion:This systematic review will help establish clinical evidence regarding the efficacy and safety of acupoint catgut embedding for peripheral facial paralysis.Trial registration number:CRD42021243212 (PROSPERO)

Comparing acupoint catgut embedding and acupuncture therapies in simple obesity

Abstract Introduction: As society develops, obesity has become a growing public health issue that seriously affects people's health and quality of life. Acupoint catgut embedding therapy is a new treatment method that continuously stimulates acupoints by implanting catguts into acupoints that has been widely used in East Asian countries to treat obesity. The objective of this systematic review is to evaluate the effectiveness and safety of acupoint catgut embedding therapy alone or the combination with other acupuncture therapies compared with same acupuncture therapies for obesity. Methods: Nine electronic databases will be searched from inception to September 2021 without language limitations. Clinicaltrials.gov and the WHO International Clinical Trials Registry platform will also be searched for ongoing trials. Randomized controlled trials that evaluated the effectiveness of acupoint catgut embedding therapy alone or the combination with other acupuncture therapies compared with same acupuncture therapies for obesity will be included. Two independent reviewers will select the studies, extract the data, and assess the quality of the papers. Risk of bias assessment and meta-analysis will follow the Cochrane guideline, and meta-analysis will be conducted using the RevMan version 5.4.1 software from Cochrane Collaboration. Grading of Recommendations Assessment, Development and Evaluation will be conducted to assess the confidence in the estimates of effect. The primary outcome will be to assess body mass index, body weight, waist circumference, hip circumference, waist-hip ratio, and body fat percentage. The secondary outcome will be to evaluate metabolic markers and adverse effects. Discussion: The systematic review will provide evidence of the safety and effectiveness of acupoint catgut embedding therapy with other acupuncture therapies in clinical settings for obese patients. This systematic review will be disseminated in a peer-reviewed publication or relevant academic conference. Trial register number: INPLASY2021100014

Effect of Acupoint Catgut Embedding on Intestinal Flora in Rats with Ovariectomized Osteoporosis

Objectives: By observing the effect of acupoint catgut embedding on the intestinal flora of ovariectomized osteoporotic rats, the correlation between the regulation of intestinal flora and the prevention and treatment of osteoporosis was discussed preliminarily.Methods: By observing the effect of acupoint catgut embedding on the intestinal flora of ovariectomized osteoporotic rats, the correlation between the regulation of intestinal flora and the prevention and treatment of osteoporosis was discussed preliminarily.Result:Compared with Group A and Group B, bone mineral density (BMD) of femur and tibia in Group C decreased significantly (p&lt;0.05), indicating successful modeling. Compared with Group C, BMD of femur and tibia in Group D was significantly increased (p&lt;0.05). Compared with Group A and Group B, content of serum estrogens, calcium, and PTHrP in Group C were significantly decreased (p&lt;0.05 or p&lt;0.01). Content of serum estrogen, calcium, and PTHrP in Group D were significantly higher than those in Group C (p&lt;0.05 or p&lt;0.01). Compared with Group A and Group B, the abundance of mollicutes, actinobacteria, acidobacteria, chloroflexi and fusobacteria in group C was significantly increased. The abundance of probiotics in Group D such as lactobacillales, (lactobacillaceae, lactobacillus), bacillales, and streptococcus was significantly higher than that in Group C (p&lt;0.05). The content of SCFAs such as acetic acid, butyric acid, iso-valeric acid, valeric acid and caproic acid in Group D were significantly higher than those in Group C, with statistical significance (p&lt;0.05).Conclusions: Acupoint catgut embedding can effectively improve BMD, increase content of estrogen, calcium, PTHrP and SCFAs. Furthermore, embedding can also improve the abundance of probiotics and reduce the abundance of pathogenic bacteria. The changes of intestinal flora were correlated with the changes of estrogen and calcium, which may be one of the mechanisms of acupoint catgut embedding in the prevention and treatment of osteoporosis.

Metabolomics Analysis on Mice With Depression Ameliorated by Acupoint Catgut Embedding.

Depression is a prevalent mental disease characterized by persistent low mood, lack of pleasure, and exhaustion. Acupoint catgut embedding (ACE) is a kind of modern acupuncture treatment, which has been widely used for the treatment of a variety of neuropsychiatric diseases. To investigate the effects and underlying mechanism of ACE on depression, in this study, we applied ACE treatment at the Baihui (GV20) and Dazhui (GV14) acupoints of corticosterone (CORT)-induced depression model mice. The results showed that ACE treatment significantly attenuated the behavioral deficits of depression model mice in the open field test (OFT), elevated-plus-maze test (EPMT), tail suspension test (TST), and forced swimming test (FST). Moreover, ACE treatment reduced the serum level of adreno-cortico-tropic-hormone (ACTH), enhanced the serum levels of 5-hydroxytryptamine (5-HT), and noradrenaline (NE). Furthermore, metabolomics analysis revealed that 23 differential metabolites in the brain of depression model mice were regulated by ACE treatment for its protective effect. These findings suggested that ACE treatment ameliorated depression-related manifestations in mice with depression through the attenuation of metabolic dysfunction in brain.

The effectiveness of acupoint application of traditional Chinese medicine in treating primary dysmenorrhea: A protocol for meta-analysis and data mining.

Background:Primary dysmenorrhea (PD) is a functional disease of the female reproductive system, which has adverse effects on patients’ physical and mental health and quality of life. At present, acupoint application of traditional Chinese medicine (TCM) as adjuvant therapy is undergoing clinical trials in different medical centers. However, there is no systematic review or meta-analysis to evaluate the efficacy of acupoint application of TCM in the treatment of PD. There is also a lack of systematic evaluation and analysis of acupoints and herbs.Methods:All randomized controlled trials related to acupoint catgut embedding therapy on PD will be searched in the following electronic databases: Cochrane Central Registry of controlled trials, PubMed, Wed of Science, EMBASE, Science Net, China Biomedical Literature Database, China Science Journal Database, China National Knowledge Infrastructure and Wan-Fang Database, from inception to May, 2021 were searched without language restrictions. The primary outcomes contain visual analog score, The Cox Menstrual Symptom Scale, while the secondary outcomes consist of adverse events and the recurrence rate. Two reviewers will independently perform data selection, data synthesis, and quality assessment. Data meeting the inclusion criteria will be extracted and analyzed by Revman v.5.3 software. Two reviewers will evaluate the study using the Cochrane collaborative bias risk tool. We will use the scoring method to assess the overall quality of the evidence supporting the main results. We will also use Spass software (version 19.0) for complex network analysis to explore the potential core prescription of acupoint application of traditional Chinese medicine in the treatment of PD.Results:This study will analyze the clinical effective rate, functional outcomes, quality of life, improvement of clinical symptoms of PD, and effective prescriptions of acupoint application for patients with PD.Conclusion:Our findings will provide evidence for the effectiveness and potential treatment prescriptions of acupoint application for patients with PD.PROSPERO registration number: CRD 42021244357

Effect of acupoint catgut embedding combined with moxibustion on Notch signaling pathway in colonic mucosa of rats with active ulcerative colitis

To observe the effect of acupoint catgut embedding (ACE) combined with moxibustion on the expressions of Notch receptor 1 and target genes Hes 1 and Math 1 in colonic mucosa of ulcerative colitis (UC) rats, so as to reveal its mechanism of treating UC from the perspective of Notch signaling pathway. Thirty SD rats were randomized into normal, model, ACE combined with moxibustion (combination), ACE, and moxibustion groups (n=6 in each group). The UC model was established by intrarectal administration of 5% trinitro-benzene-sulfonic acid and 50% ethyl alcohol. Moxibustion was applied to bilateral "Shangjuxu" (ST37), "Tianshu" (ST25) and "Dachangshu" (BL25) for 10 min, once daily for 14 days, and ACE applied to the same 3 acupoints, once a week for two weeks. After the treatment, colonic mucosal pathological changes were observed after hematoxylin eosin (HE) stain. Protein and mRNA expressions of Notch 1, Hes 1 and Math 1 were detected by RT-PCR and Western blot, respectively. H.E. staining showed severe defect of the colonic mucosal epithelium with infiltration of a large number of inflammatory cells in the model group, which was milder in moxibustion, ACE and moxibustion + ACE groups. After modeling, the protein and mRNA expressions of Notch 1 and Hes 1 in the colonic mucosa were obviously increased (P<0.01), while the protein and mRNA expressions of Math 1 were significantly decreased (P<0.01) in the model group relevant to the normal group. Following the intervention, the protein and mRNA expression levels of Notch 1 and Hes 1 in the colonic mucosa were significantly lower (P<0.05, P<0.01) in moxibustion, ACE and combination groups, the mRNA expression level of Math 1 was significantly increased in both ACE and combination groups (P<0.01), and the protein expression of Math 1 was significantly higher in the three treatment groups relevant to the model group (P<0.01). The above indexes of moxibustion + ACE were considerably superior to those of simple ACE and simple moxibustion (P<0.05, P<0.01). Acupoint catgut embedding combined with moxibustion can repair the injured colonic mucosa of UC rats, which may be related with its effects in suppressing the expression of Notch 1 and Hes 1, up-regulating the expression of Math 1 in the colonic mucosa, thereby regulating the balance of differentiation between colonic epithelial secretory and absorption cell lines.

Electroacupuncture combined with acupoint catgut embedding for postoperative pain after fistulotomy

To evaluate the effect of electroacupuncture(EA) combined with acupoint catgut embedding the-rapy for postoperative pain after fistulotomy. A total of 138 patients were randomly assigned into EA, acupoint catgut embedding and combination groups, with 46 patients in each group. The interventions were performed 30 min before surgery in all the three groups. The acupoints were Changqiang(GV1) and Chengshan(BL57). The visual analogue scale (VAS) score and limb activity score of the three groups at 6, 12, 24, 48 and 72 h after surgery, as well as maximum VAS score within 24 h(T24max VAS) of 1-3 d and total amounts of oral analgesic within 72 h after surgery were observed and recorded. The VAS score and limb activity score from the 6, 12 and 24 h after surgery, and T24max VAS score on the 1st day of the EA group were lower than those of the acupoint embedding group (P<0.05). While the VAS pain score and limb activity score at the 48 h and 72 h after surgery, and T24max VAS score at the 2nd to 3rd day, and total dose of oral analgesic within 72 h in the acupoint embedding group were lower than those of the EA group (P<0.05). The combination group was superior to the EA and acupoint embedding groups in terms of VAS score and limb activity score at different postoperative time, T24max VAS score at 1-3 d after surgery, and the total amounts of analgesic used within 72 h (P<0.05). EA combined with acupoint catgut embedding is more effective than simple EA or acupoint catgut embedding for postoperative pain after fistulotomy, with significant curative effect and no adverse reactions.

Acupoint catgut embedding for the treatment of peptic ulcers: A protocol for systematic review and meta analysis.

Background:Peptic ulcer (PU) is a common clinical disease of the digestive system, which can occur in all ages, gastric and duodenal ulcers are the most commonly seen PUs in clinical practice. The main manifestations are chronic and periodic rhythmic upper abdominal pain, accompanied by indigestion symptoms such as pantothenic acid, belching, and nausea. Serious complications such as bleeding, perforation, obstruction and canceration are easy to occur, endangering the life safety of patients. There are many ways to treat PU in clinic, and acupoint catgut embedding therapy has its unique advantages. Hence, our systematic review aims to evaluate the efficacy and safety of acupoint embedding therapy in the treatment of PU and to provide a reliable basis for physician.Methods:We will search electronic databases including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database (WF), China Biomedical Literature Database (CBM), and China Scientific Journals Database (VIP) from establishment to April 2021, and will manually searched the list of medical journals as a supplement. Two authors will screen the studies independently, as well as extract data information, and assess methodological quality through the Cochrane risk of bias (ROB) tool. The Stata software (Version 16.0) software will be used for statistical analysis.Results:By evaluating the current status of acupoint catgut embedding for Peptic ulcer disease, this study would prove the effectiveness and safety of acupoint embedding therapy, and will be published in a peer-reviewed journal.Conclusion:This systematic review will provide a credible evidence-based for acupoint catgut embedding in the treatment of peptic ulcer.INPLASY Registration number:INPLASY202130097

The study on the clinical effectiveness and safety of traditional Chinese medicine acupoint catgut embedding guided by musculoskeletal ultrasound in the treatment of nerve root sciatica: A protocol for systematic review and meta-analysis of randomized controlled trials.

Background:Nerve root sciatica (NRS) is a common orthopedic disease, which usually occurs between 20 and 40 years of age, and the incidence rate is increasing year by year and is being younger. The disease has no special effect of treatment, clinically generally taking the symptomatic treatment, such as taking short-term glucocorticoids, sedatives, analgesics, and so on. Long-term use of drugs will adversely affect the patient's gastrointestinal tract, liver, and kidney function. The surgical treatment has a high risk of surgery, high cost, side effects, and other problems, so the choice of treatment method has always been a difficult problem in clinical and scientific research. The study shows that 90% of patients with sciatica can be cured by non-surgical treatment, so conservative therapy is often used in the treatment of sciatica, traditional Chinese medicine treatment methods in the treatment of NRS has been widely used, which has achieved good results, but there is no evidence of evidence-based medicine. Therefore, this study uses systematic evaluation to conduct the scientific evaluation of the clinical effectiveness and safety of traditional Chinese medicine acupoint catgut embedding guided by musculoskeletal ultrasound in the treatment of NRS, and provide evidence-based medical evidence support for the treatment of NRS.Methods:Using the computer to retrieve the PubMed, ScienceDirect, Web of Science, Embase, Cochrane Library, CNKI, VIP, WANFANG Database, and CBM. Using the subject words and terminology words to retrieve the Chinese-English database and retrieve a randomized controlled study on the clinical effectiveness and safety of traditional Chinese medicine acupoint catgut embedding guided by musculoskeletal ultrasound in the treatment of NRS, and the range of search time is January 1990 to January 2021. The searched literature is screened and evaluated by two researchers respectively according to the inclusion and exclusion criteria. If there is disagreement, discussing it with the third researcher to determine the final inclusion of the literature. Using the RevMan 5.3 software to conduct the meta-analysis.Results:This study will compare the effectiveness and safety of traditional Chinese medicine acupoint catgut embedding guided by musculoskeletal ultrasound in the treatment of NRS.Conclusion:The results of this study will be published in internationally influential academic journals to provide evidence-based medical evidence for the clinical effectiveness and safety of traditional Chinese medicine acupoint catgut embedding in the treatment of NRS.Ethics and dissemination:This study does not involve specific patients, and all research data comes from publicly available professional literature, so an ethics committee is not required to conduct an ethical review and approval of the study.OSF registration number:DOI 10.17605/OSF.IO/Q492E.

Recent Trends in Catgut Therapy Using Textile Materials

The article comprehensively reviews recent developments in textile materials used for catgut embedding therapy applications. Polyglycolic acid (PGA) monofilament has been regarded as an excellent acupoint catgut embedding therapy (ACET) material because it offers numerous advantages, including easy accessibility and good forming and degradable properties. However, the poor hydrophilicity and cytocompatibility are the main disadvantages preventing it from having wider applications. Chitosan coating on acupoint catgut embedding therapy (ACET) is a critical issue in improving the comprehensive performances of embedding materials. However, the existing coating technologies have struggled to keep pace with both the academic study and industrial production. This work proposed a novel chitosan coating system consisted of pretreatment, spray-coating and rolling and drying parts. To evaluate the feasibility of this system, four types of monofilaments, namely polypropylene (PP), polylactic acid (PLA), polydioxanone (PDO) and polyglycolide acid (PGA), were adopted and their properties, such as swelling, compression and hydrophilicity, were also measured. Surgical site infections are liable to cause significant postoperative morbidity and increase health costs. However, polylactic acid and poly (D, L-lactide-co-glycolide) acupoint catgut-embedding therapy materials used to stimulate certain points for curing diseases are typically devoid of antibacterial activity. Novel polylactic acid and poly (D, L-lactide-coglycolide) embedding materials have been developed with effective antibacterial properties via chitosan-coating treatment that retained their inherent excellent characteristics. Acupoint catgut-embedding therapy (ACET) is considered one of the most promising technologies to replace traditional acupuncture therapy in clinical settings. Polyglycolic acid (PGA) monofilament shows great potential for ACET applications due to its advantages of good formability and biodegradability. The ideal embedding materials are required to have excellent swelling, mechanical, and antibacterial properties. For this paper we prepared two types of PGA monofilaments by first using the melt-spinning method and then applying chitosan onto the PGA monofilaments at three different concentrations.

Effect of acupoint catgut embedding on intestinal mucosal epithelial barrier in ulcerative colitis rats

To observe the effect of acupoint catgut embedding on intestinal mucosal epithelial injury, and expression of epithelial tight junction proteins and mRNAs and protein kinase C(PKC) protein (intestinal mucosal epithelial barrier-related molecules) in rats with experimental ulcerative colitis (UC) of "deficiency-stasis" type, so as to explore its mechanisms underlying improvement of UC. Male SD rats were randomly divided into normal control, UC model, medication (sulfasalazine, SASP) and catgut-embedding groups. The "deficiency-stasis" type UC model was established by gavage of adenine (10 mL/kg) for 2 weeks, cold Folium Sennae (10 mL/kg) for 2 weeks, and then enema of mixture solution of 5% trinitro-benzene-sulfonic acid (100 mg/kg) + 50% ethyl alcohol. Rats of the medication group received gavage of SASP. The catgut-embedment was applied to bilateral "Tianshu"(ST23),"Zusanli"(ST36), "Geshu"(BL17), "Pishu"(BL20), "Shenshu"(BL23) and "Dachangshu"(BL25), once every two weeks, 3 times altogether. The body mass was recorded, and histopathological changes of the colon tissues were observed after H.E. staining. The contents of serum D-lactic acid (D-LA), diamine oxidase (DAO) and protein kinase C (PKC) were detected by ELISA. The expression levels of occludin, claudin-8, cingulin and zonulin mRNAs and proteins and PKC protein of the colon tissues were detected by using quantitative real-time PCR and Western blot, separately. Compared with the control group, the body mass and expression levels of colonic occludin, claudin-8 and cingulin mRNAs and proteins were significantly lower (P<0.01), and the colonic mucosa damage index (CMDI) score, contents of serum D-LA, DAO and PKC, as well as the expression levels of zonulin mRNA and protein and PKC protein were significantly higher in the model group (P<0.01). In comparison with the model group, the body mass, and the expression levels of occludin, claudin-8 and cingulin mRNAs and proteins were significantly higher (P<0.05, P<0.01), whereas the CMDI score, expression levels of zonulin mRNA and protein and PKC protein were remarkably lower in both the medication group and acupoint embedding groups (P<0.05,P<0.01). No significant differences were found between the acupoint embedding and medication groups in all the indexes mentioned above (P>0.05). H.E. staining showed markedly swollen, disordered arrangement of intestinal mucosal cells, and hemorrhage with infiltration of inflammatory cells in the colonic tissues after modeling, which was relatively milder in both medication and acupoint embedding groups. Acupoint catgut embedding can reduce colonic tissue injury in UC rats, which may be related to its functions in regulating the expression of intestinal epithelial tight junction proteins and mRNAs and in inhibiting the activation of PKC protein.

Effect of proximal and distal acupoint catgut-embedding on uterus prostaglandin, serum IL-2 and splenic NK cell activity in primary dysmenorrhea rats

To observe the effect of proximal and distal acupoint catgut-embedding on the contents of prostaglandin E2 (PGE2) and prostaglandin F2α(PGF2α) in the uterus, serum Interleukin-2 (IL-2) contents and splenic natural killer (NK) cell activity in primary dysmenorrhea (PD) rats，so as to explore the different effects of proximal and distal acupoint catgut-embedding on PD rats. Female Wistar rats were randomly divided into control, model, proximal catgut-embedding and distal catgut-embedding groups, with 8 rats in each group. The PD model was established by subcutaneous injection of estradiol ben-zoate (0.5 mg/rat on the first day and 10th day, and 0.2 mg/rat from the 2nd to the 9th day) and intraperitoneal injection of oxytocin (2 U/rat, on the 11th day). Catgut-embedding was applied at bilateral "Guanyuan"(CV4) and "Ciliao"(BL32) in the proximal catgut-embedding group, and bilateral "Sanyinjiao" (SP6) and "Diji"(SP8) in the distal catgut-embedding group. After the treatment, the body writhing times in 30 min and uterine mass were recorded, PGE2 and PGF2αin uterus and IL-2 in serum were assayed by using ELISA, the activity of NK cell in the spleen was detected using MTT colorimetry. Following modeling, the body writhing times of the model group was increased than that of the control group (P<0.01); After interventions, the body writhing times were decreased in the proximal and distal catgut-embedding groups than those of the model group (P<0.01). Compared with the control group, the uterine mass and uterus PGF2α content were increased (P<0.01), while uterus PGE2, serum IL-2 and splenic NK cell activity were decreased (P<0.01) in the model group. After interventions, the uterine mass and uterus PGF2α were down-regulated (P<0.01, P<0.05), while the contents of uterus PGE2, serum IL-2 and splenic NK cell activity up-regulated (P<0.01) in the proximal and distal catgut-embedding groups in contrast to the model group. The content of uterus PGF2α was down-regulated (P<0.05) and splenic NK cell activity was up-regulated (P<0.01) in the proximal catgut-embedding group than those of the distal catgut-embedding group. Both proximal and distal acupoint catgut-embeding can increase PGE2 and decrease PGF2α in the uterus, increase the level of serum IL-2 and the activity of NK cells in the spleen in PD model rats, thereby achieving analgesic effect. The effect of proximal catgut-embedding is better than that of distal catgut-embedding.

Acupoint catgut embedding improves senescence in a rat model of ageing by regulating mitophagy via the PINK1 pathway.

Ageing population is a tough task worldwide, and the aggravating trend of ageing population in China brings enormous pressure to healthcare system. Chinese acupuncture has shown definite anti‐ageing effect as arthralgia relief, movement improvement, energy increase and immunity enhancement; however, the mechanisms underlying are far away from illumination. Increasing literature has highlighted the role of alterations in mitochondrial function as a potential central regulator in ageing biology; mitophagy plays a critical role in mitochondrial quality control. In the present study, we demonstrated that acupoint catgut embedding treatment ameliorated ageing‐related alterations in appearance, muscle function and spatial memory in rats, reduced degenerated cells in hippocampus, and maintained relatively normal structures in the hippocampus tissue and neurons. These changes were proved to be associated with the regulation of mitochondrial function and autophagic activity. Furthermore, we investigated part of the molecular mechanisms and demonstrated that the PINK1 other than PINK1–Parkin signalling pathway involved in the effects of acupoint catgut embedding, and the imbalancement between mitochondrial fusion and fission and stimulation of mitochondrial biogenesis may aggravate or compensate for impaired mitochondria. The factors act downstream PINK, and the interaction between them for mitochondrial homeostasis in this process remains to be identified.

Plasma Modification of PLA/PGA Embedding Threads with Different Proportions: A Strategy for Developing Novel ACET Materials

Polylactic acid (PLA) and polyglycolic acid (PGA) have been widely used in the acupoint catgut embedding therapy (ACET) field. However, some defects such as hydrophobicity, poor swelling and cell adhesion properties which significantly limit their further applications. Herein, we report a strategy for developing ACET materials via 3D fabrication and plasma treatment. The results showed that modified samples showed rougher surface morphology and better hydrophilicity. Sample L4G0 (PLA strands: PGA strands=4:0) showed the largest tensile strength and elongation values at 32.15±5.26 cN/dtex and 56.37±4.38 %, respectively. Samples were proved to be non-toxicity and had better cell attachment and tissue growth ability after modification. In sum, the strategy of plasma modified PLA/PGA is deserved to be further studied with outstanding clinical efficacy.

Therapeutic effect of acupoint catgut embedding on balance function and plantar pressure in hemiplegic patients

To investigate the therapeutic effect of acupoint catgut embedding on balance function and plantar pressure in hemiplegic patients. A total of 98 hemiplegic patients were equally randomly assigned to routine treatment group and acupoint catgut embedding group. The patients in the routine treatment group were given routine medical treatment, routine acupuncture and rehabilitation training. And those in the catgut embedding group were given catgut embedment at Shenshu (BL23), Xinshu (BL15), Ganshu (BL18), Pishu (BL20), Guanyuan (CV4) and Qihai (CV6) in addition to the treatment in the routine treatment group. The course of treatment was 3 weeks for both groups. The plantar pressure as well as the Berg balance scale (BBS) score were measured before and after treatment. (1) After 3 weeks treatment, the percentage of static plantar pressure of the affected foot was significantly increased in the two groups compared with their own pre-treatment (P<0.05, P<0.01), and it was significantly higher in the catgut embedding group than in the routine treatment group after one week treatment (P<0.01). (2) After 3 weeks treatment, the peak pressures of the following parts in the catgut embedding group increased significantly in comparison to its own pre-treatment (P<0.05, P<0.01), which were 1) the first toe (affected foot), 2) the first metatarsal bone (affected foot), 3) the third metatarsal bone (affected foot), 4) the middle of foot (affected foot), 5) the medial heel (affected foot). After 3 weeks treatment, the peak pressures of the first metatarsal bone and the medial heel of the affected foot in the routine treatment group were significantly higher than those before treatment (P<0.05). After 1 week treatment, the peak pressure of the first toe of the affected foot in the embedding group was significantly higher than that in the routine treatment group (P<0.05). The peak pressures of the first metatarsal bone and the middle of the affected foot in the catgut embedding group were significantly higher than those in the routine treatment group after one and two weeks treatment (P<0.01, P<0.05). After 1, 2 and 3 weeks treatment, the peak pressure in the middle of the healthy foot in the embedding group was significantly lower than that in the routine treatment group (P<0.01). (3) After 3 weeks treatment, the BBS scores of the two groups were significantly higher than those before treatment (P<0.05), and the BBS score of the embedding group was significantly higher than that of the routine treatment group (P<0.05). Acupoint catgut embedding can effectively improve the plantar pressure and balance function of stroke patients with hemiplegia.