Acupuncture Manipulation Research Articles

The Combination of Proteolytic Enzyme Supplementation, Acupuncture, and Osseous Manipulation for the Treatment of Traumatic Peripheral Nerve Injury: A Case Report

This report describes the treatment of peripheral nerve injury in a 43-year-old woman using a combination of proteolytic enzymes, acupuncture, and osseous manipulation as alternatives to conventional care. Her presenting symptoms include complete loss of sensation in the superolateral left thigh and a mass of fibrotic scar tissue in the area of injury. A holistic treatment plan was created to address the underlying mechanisms of the injury. Plant-based proteolytic enzymes, bromelain and papain, were used to address tissue inflammation and reduce scar tissue formation around the nerve, acupuncture was used to regenerate the superficial nerves, and osseous manipulations were provided for structural re-alignment. After 8 weeks of treatment, the patient reported significant reduction in the size of the fibrotic mass and complete resolution of sensory loss. The fibrotic mass of tissue reduced from 6 cm to 1 cm during the treatment course. Proteolytic enzymes have wide-ranging indications; however, they have not been well studied for peripheral nerve injury, which makes this a novel indication for this natural health product. This case report found the use of proteolytic enzymes, and acupuncture, effective in treating peripheral nerve injury and provides grounds for research to treat nerve-related injuries.

Keratinocyte Piezo1 and CD39 initiated the acupuncture analgesic signals via Co-regulating extracellular ATP mobilization at acupoints

Acupoints are the initiation sites for acupuncture analgesic signals, where adenosine signaling plays a crucial role. A comprehensive understanding of this matter will guide clinicians to optimize acupuncture manipulations to improve acupuncture effectiveness. Recently, keratinocyte Piezo1 channels and cascade ATP release are independently unveiled to be essential for the skin tactile sensation. Thus, we aimed to investigate whether keratinocyte Piezo1-mediated ATP release, in orchestration with CD39, contributed to this initiation mechanism via producing adenosine. 20-min needling was administered at the unilateral ST36 acupoint on the acute ankle arthritis rats. The pain thresholds in the affected hindpaws were determined. Interstitial ATP and adenosine were extracted with microdialysis and assessed by luciferase-luciferin and HPLC, respectively. To simulate needling stimulation, keratinocyte HaCaT cells were subjected to hypotonic shock. ATP release and live calcium imaging were conducted. Immunofluorescence labeling showed the presence of Piezo1 and CD39 on keratinocytes. Acupuncture led to a prompt analgesic effect, as well as a temporary accumulation of ATP and adenosine. Activating adenosine A1 receptors, promoting ATP release by activating Piezo1, or facilitating ATP hydrolysis by potentiating CD39 achieved anti-nociceptive effects. Conversely, altering these modulations in the opposite direction reversed the subsequent effects of acupuncture. Needling-induced accumulation of interstitial ATP parallelly changed with these modulations. Hypotonic shock led to ATP release and [Ca2+]i rise in HaCaT, which were impeded by introducing siRNA-Piezo1, or replicated by agonism at Piezo1. These findings suggest that keratinocyte Piezo1 and CD39 co-mediated ATP mobilization at acupoints contributes to the initiation signals of acupuncture analgesia via triggering adenosine signaling. SectionPhysical/Mental practices (acupuncture) Taxonomy (classification by evise)pain and analgesia.

Thoughts and suggestions about ethical requirement in acupuncture animal experiments.

The animal experiment is an important form of acupuncture research, which is of great significance for revealing the regularities and mechanisms of acupuncture effects. The ethical principle of animal welfare is the important guarantee of animal rights and experimental scientificity in the process of research. Starting from the "3R principle" and "five welfare" rules, and the specific operation process of acupuncture animal experiments, we, in this paper, proposed the implementation methods of animal ethics in acupuncture experiments, including ethical execution before acupuncture experiments, and ethical requirements during the experimental stage (such as animal fixation method that meets the needling needs, selection of acupuncture apparatus, acupuncture manipulations, acupuncture stimulation intensity, and sampling of animal tissues). These proposed methods may provide some appropriate references for the guarantee of animal ethics in acupuncture research, and provide ideas for establishing a new paradigm of animal welfare ethics in acupuncture animal experiments, and finally promote the standardization and scientificity process of the implementation of animal welfare ethics in acupuncture animal experiments.

Survey the change of skin surface temperature at the face when using tonifying or dispersing acupuncture manipulations at dazhui acupoint in healthy volunteers

Survey the change of skin surface temperature at the face when using tonifying or dispersing acupuncture manipulations at dazhui acupoint in healthy volunteers

Manual Acupuncture Manipulation Recognition Method via Interactive Fusion of Spatial Multiscale Motion Features

Manual acupuncture manipulation (MAM) is essential in traditional Chinese medicine treatment. MAM action recognition is important for junior acupuncturists’ training and education; however, there are obvious personalized differences in hand gestures among expert acupuncturists for the same type of MAM. In addition, during the MAM operations, the magnitude and frequency of the expert acupuncturists’ hand shape and relative needle-holding finger position changes are tiny and fast, resulting in difficulties in observing MAM action details. Thus, we propose a Spatial Multiscale Interactive Fusion MAM Recognition Network to solve the difficulties in MAM recognition. First, this paper presents an optical flow-based hand motion contour global feature extraction method for acupuncture hand shape. Second, to explore the motion rule between the needle-holding fingers during the MAM operations, we design a quantitative description method of the relative motion of the needle-holding fingers: an “interactive attention module,” which achieves feature fusion and mines the correlation between different scales of MAM action features. Finally, the proposed MAM recognition method was validated by 20 acupuncturists from the Beijing University of Traditional Chinese Medicine and 10 from the Beijing Zhongguancun Hospital who participated in the MAM video signal collection. The proposed recognition method achieves the highest average validation accuracy of 95.3% and the highest test accuracy of 96.0% for four typical MAMs, proving its feasibility and effectiveness.

The Role of p38 Mitogen-Activated Protein Kinase-Mediated F-Actin in the Acupuncture-Induced Mitigation of Inflammatory Pain in Arthritic Rats.

The analgesic efficacy of acupuncture has been widely recognized. However, the mechanism by which manual acupuncture-generated mechanical stimuli translate into biological signals remains unclear. This study employed a CFA-induced inflammatory pain rat model. Acupuncture intervention was then performed following standardized procedures. Enzyme-linked immunosorbent assay (ELISA) assessed inflammatory cytokines levels, while immunofluorescence and qRT-PCR screened the level of p38 and F-actin expression in the ST36 acupoint area of rats. Results indicated increased inflammatory factors, including IL-1β and TNFα, with reduced paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency (PWTL) in CFA rats compared to unmodeled rats. After acupuncture intervention, the heightened expression level of F-actin and p38 mRNA and the phosphorylation of p38 in the acupoint area was observed alongside decreased inflammatory factors in diseased ankle joints. The application of lifting and thrusting manipulations further enhanced the effect of acupuncture, in which the molecular expression level of muscle and connective tissue increased most significantly, indicating that these two tissues play a major role in the transformation of acupuncture stimulation. Moreover, antagonizing p38 expression hindered acupuncture efficacy, supporting the hypothesis that p38 MAPK-mediated F-actin transduces mechanical signals generated by acupuncture and related manipulation into biological signals.

Development and current application status of acupuncture manipulation measuring instrument and operating instrument.

Acupuncture manipulation, a crucial component of acupuncture procedures, significantly influences the therapeutic outcomes. Acupuncture manipulation measuring instrument and operating instrument have been developed based on modern technology to objectively characterize manipulation parameters, and achieve standardized and normalized output of acupuncture manipulation. This paper systematically reviews the development and current application status of in vivo acupuncture manipulation measuring instrument, ex vivo acupuncture manipulation measuring instrument, and acupuncture manipulation operating instrument worldwide, and explores key issues that acupuncture manipulation operating instruments need to address for clinical applications, and provides insights into the future prospect of acupuncture robots.

Immediate neural effects of acupuncture manipulation time for stroke with motor dysfunction: a fMRI pilot study.

Acupuncture is widely utilized as a beneficial intervention for the treatment of motor dysfunction after stroke, and its effectiveness depends on the stimulation dose. Manipulation time is an important factor affecting the dose. This trial aimed use fMRI to explore the immediate neural effects in stroke patients with motor dysfunction by different acupuncture manipulation times, to reveal the neural mechanism of acupuncture manipulation. Thirty participants were divided into three groups according to different acupuncture times. Each group received the same acupoint prescription, although the continuous manipulation time of each acupoint in three groups was 1-min, 2-min, and 3-min, respectively. The NIHSS, FMA and fMRI-BOLD in each participant we obtained before and after acupuncture manipulation. Then, we used the regional homogeneity (ReHo) algorithm to analyze the changes of brain function and to compare the neural effects at different acupuncture manipulation times. There were no significant differences in NIHSS and FMA scores between and within groups. Longitudinal analysis of ReHo values indicated that the right inferior frontal gyrus was activated in the 1-min group, the right insula in the 2-min group, and the right inferior temporal gyrus in the 3-min group. Compared with the 1-min group, the 2-min group showed the ReHo values of the right precentral gyrus was decreased, and the 3-min group showed the left cerebellum posterior lobe was increased, the right posterior cingulate gyrus and the right anterior cingulate gyrus were decreased. Compared with the 2-min group, the 3-min group showed the ReHo values of the right cerebellum anterior lobe was increased. Our findings suggest that acupuncture at different manipulation times caused different changes of the neural effects in stroke patients, and the volume of activated voxel clusters is positively correlated with the manipulation time. Longer acupuncture manipulation could drive SMN and DMN in stroke patients, which may be the potential neurological mechanism of acupuncture manipulation affecting the recovery of motor dysfunction.

Evaluation of Acupuncture Efficacy in Modulating Brain Activity with Periodic-aperiodic EEG Measurements.

Acupuncture is an important therapeutic method of traditional Chinese medicine and can effectively modulate brain disorders. The therapeutic efficacy of acupuncture is hard to evaluate due to lacking of effective measurements of brain activity. In this work, we design an EEG-based monitoring system to evaluate therapeutic effect of acupuncture on human brain by extracting periodic-aperiodic features. Power spectral density is estimated to compute the adjusted power of periodic oscillatory rhythm in EEG under acupuncture stimulation. It is exhibited that the brain activity in alpha band (8-12 Hz) is significantly enhanced during acupuncture, especially in parietal and occipital lobe regions. To probe the modulatory effect of acupuncture on aperiodic brain activity, we calculate the aperiodic exponent based on the parameterization of EEG power spectra. The aperiodic exponent decreases along with acupuncture process, which is more significant in central and frontal lobe regions. Furthermore, sensitivity of different brain regions to acupuncture is assessed by the integration of adjusted power and aperiodic exponent. Experimental results demonstrate the effectiveness of proposed periodic-aperiodic measurements of EEG signals, by which different effects of four acupuncture manipulations are precisely evaluated and a knowledge graph is established. The monitoring system provides a new perspective to quantitatively evaluate acupuncture effect on human brain and improve its therapeutic efficacy in clinical applications for neural disorders.

Spatiotemporal Dynamics of Periodic and Aperiodic Brain Activity Under Peripheral Nerve Stimulation With Acupuncture.

Brain activities are a mixture of periodic and aperiodic components, manifesting in the power spectral density (PSD) as rhythmic oscillations with spectral peaks and broadband fluctuations. Periodic oscillatory properties of brain response to external stimulation are widely studied, while aperiodic component responses remain unclear. Here, we investigate spatiotemporal dynamics of periodic and aperiodic brain activity under peripheral nerve stimulation with acupuncture by parameterization of power spectra of EEG signals. Regarding periodic brain activity, spectral peak in delta band emerges in frontal and central brain regions indicates a typical phenomenon of neural entrainment, which is formed by coupling periodic brain activity to external rhythmic acupuncture stimulation. In addition, the statistical results show that alpha periodic power is an important indicator for characterizing the modulatory effects of acupuncture on periodic brain activity. As for aperiodic brain activity, broadband EEG spectral trend analysis demonstrates a steeper aperiodic slope in left parietal lobe and a stronger negative correlation with the aperiodic offset under acupuncture compared with resting state, with the absolute value of correlation coefficient increasing from 0.27 to 0.50. Based on the two parameters that can best characterize the acupuncture effect, alpha periodic power and aperiodic slope, the accurate decoding of acupuncture manipulation is realized with AUC = 0.87. This work shows the modulatory effect of peripheral nerve stimulation with acupuncture on the brain activity by characterizing the periodic and aperiodic spectrum features of EEG, providing new insights into the comprehensive understanding of the response processes of human brain to acupuncture stimulation.

An acupuncture manipulation classification system based on three-axis attitude sensor and computer vision.

To explore the action characteristics of acupuncture manipulations by combining visual and sensor technique, so as to improve the identification and classification accuracy of acupuncture manipulations and to quantificate the classifiations. In this paper, the time domain features of acupuncture physical parameters and dynamic gesture features in the video of acupuncture manipulations are combined together to identify and classify acupuncture techniques. The acupuncture needle manipulation processes of 2 acupuncture experts and 3 young acupuncturists were selected as the study objects. The collected data included 4 basic manipulation techniques：lifting-thrusting reinforcing, lifting- thrusting reducing, twisting reinforcing and twisting reducing methods, all of which were performed by right-handed doctors. During acupuncture manipulation, a three-axis attitude sensor was used to acquire finger moving acceleration velocity and needle-rotating angle velocity, followed by analyzing the parameters of hand-moving velocity, amplitude, strength and angle. The mapping relationship among physical parameters and different manipulating methods was formed in time domain. The computer vision technology was employed to extract the spatio-temporal features of the acupuncture manipulation video images, and a hybrid model of three-dimensional convolutional neural network (3D CNN) and long- and short-term memory (LSTM) neural network were used for the recognition and classification of dynamic gestures of hand in acupuncture manipulation videos. Then the time-domain features of physical parameters were combined with the dynamic gestures in the classification process, with the manipulation classification realized. In performing the lift-thrusting reinforcing method, the needle insertion speed was faster and the force was larger, while the needle lifting speed was slower and the force was smaller. And in performing the lift-thrusting reducing method, the needle lifting speed was faster, the force was stronger, and the needle insertion speed was slower and the force was smaller. In the performance of twisting reinforcing, the leftward twisting force was bigger and the rotation amplitude was larger, while in performing the reducing method, the rightward twisting force was larger and the rotation amplitude was larger. When using the mean value of time of acceleration, speed, and amplitude as the basis of discrimination, the accuracy rates of lifting-thrusting reinforcing and reducing were 95.56% and 93.33%, while those of the two twisting manipulations were 95.56% and 91.11%, respectively. Compared with the classification method that only uses the sensor to obtain the manipulation information, the recognition accuracy was significantly improved. The acupuncture manipulation classification system can achieve quantitative analysis of physical parameters and dynamic recognition of acupuncture techniques, providing a certain foundation for the quantification and inheritance of acupuncture techniques.

Whole-Body Vibration Prevents Neuronal, Neurochemical, and Behavioral Effects of Morphine Withdrawal in a Rat Model.

Peripheral mechanoreceptor-based treatments such as acupuncture and chiropractic manipulation have shown success in modulating the mesolimbic dopamine (DA) system originating in the ventral tegmental area (VTA) of the midbrain and projecting to the nucleus accumbens (NAc) of the striatum. We have previously shown that mechanoreceptor activation via whole-body vibration (WBV) ameliorates neuronal and behavioral effects of chronic ethanol exposure. In this study, we employ a similar paradigm to assess the efficacy of WBV as a preventative measure of neuronal and behavioral effects of morphine withdrawal in a Wistar rat model. We demonstrate that concurrent administration of WBV at 80 Hz with morphine over a 5-day period significantly reduced adaptations in VTA GABA neuronal activity and NAc DA release and modulated expression of δ-opioid receptors (DORs) on NAc cholinergic interneurons (CINs) during withdrawal. We also observed a reduction in behavior typically associated with opioid withdrawal. WBV represents a promising adjunct to current intervention for opioid use disorder (OUD) and should be examined translationally in humans.

A Preliminary Study on Warm Acupuncture and Moxibustion for Treating Chronic Obstructive Pulmonary Disease with Abdominal Distension.

Most patients with COPD have a combination of abdominal distension, which has been shown to adversely affect pulmonary symptoms, frequency of acute exacerbations, and quality of life in patients with COPD. Warm acupuncture and moxibustion have been shown to be effective in relieving symptoms in patients with COPD combined with abdominal distention. Warm acupuncture and moxibustion are highly effective, easy to perform, and inexpensive forms of traditional Chinese medicine treatments. The standardized practice of warm acupuncture and moxibustion is very important for the treatment of COPD combined with abdominal distension. The specific steps include selecting the appropriate acupoints for needling through syndrome differentiation treatment and selecting moxa sticks of appropriate length for moxibustion for about 30 min after the De-qi. The course of treatment lasts for one week. The following indicators are specifically assessed: the score of the COPD Assessment Test (CAT) and the abdominal distension visual analog scale (VAS). This article will clearly illustrate how to standardize the manipulation of warm acupuncture and moxibustion to relieve COPD combined with abdominal distention.

Acupuncture with twirling reinforcing and reducing manipulation shows a control of hypertension and regulation of blood pressure-related target brain regions in spontaneously hypertensive rat: a preliminary resting-state functional MRI study.

To observe the effects of acupuncture manipulations on blood pressure and brain function in spontaneously hypertensive rats and elucidate the anti-hypertensive effect of the manipulations' central mechanism. This study used acupuncture twirling reinforcing, acupuncture twirling reducing, and acupuncture twirling uniform reinforcing-reducing manipulations to act on the bilateral TaiChong point of rats. The depth of acupuncture was 1.5-2 mm, and twisting was performed at a frequency of 60 times/min within ±360° for 3 min, followed by the needle being retained for 17 min. Functional magnetic resonance imaging was performed at the end of the intervention. Regional homogeneity and amplitude of low-frequency fluctuations were used to assess the differences in brain regions in each group of rats, and the core brain region (left hypothalamus) among the differential brain regions was selected as the seed for functional connectivity analysis. (1) The anti-hypertensive effect was achieved by acupuncture manipulations, and the anti-hypertensive effect of twirling reducing manipulation on spontaneously hypertensive rats was better than that of twirling uniform reinforcing-reducing and twirling reinforcing manipulations. (2) After regional homogeneity and amplitude of low-frequency fluctuations analyses, the hypothalamus, the brain region related to blood pressure, was activated in the twirling uniform reinforcing-reducing manipulation group; the corpus callosum and cerebellum were activated in the twirling reinforcing manipulation group; and the hypothalamus, olfactory bulb, corpus callosum, brainstem, globus pallidum, and striatum were activated in the twirling reducing manipulation group. (3) According to the functional connectivity analysis, different acupuncture manipulations increased the functional connections between seed points and the brainstem, olfactory bulb, and cerebellum, etc. These results suggest that acupuncture manipulations achieved the hypotensive effect and the twirling reducing manipulation had a better hypotensive effect on spontaneously hypertensive rats than twirling uniform reinforcing-reducing and twirling reinforcing manipulations; the central mechanism of the anti-hypertensive effect of twirling reinforcing and reducing manipulation may be related to the activation of brain regions associated with blood pressure regulation and the functional connections between them. Furthermore, brain regions involved in motor control, cognition, and hearing were also activated. We hypothesize that activation of these brain regions may help prevent or mitigate the onset and progression of hypertensive brain damage.

Flexible needle-type Microbiosensor for real-time monitoring traditional acupuncture-mediated adenosine release In vivo

Rapid adenosine (ADO) signaling, on the time frame of seconds, regulates physiological and pathological processes, including the therapeutic efficacy of acupuncture. Nevertheless, standard monitoring strategies are limited by poor temporal resolution. Herein, an implantable needle-type microsensor capable of monitoring ADO release in vivo in response to acupuncture in real time has been developed. Electrocatalytic Prussian Blue nanoparticles, an immobilized multienzyme system, and a permselective poly-o-phenylenediamine-based membrane were used for the sequential modification of the sensing region of the electrode. The resultant sensor can perform amperometric measurements of ADO levels in response to a very low level of applied potential (−0.05 V vs Ag/AgCl). This microsensor also functioned across a broad linear range (0–50 μM) and exhibited good sensitivity (1.1 nA/μM) with a rapid response time of under 5 s. Importantly, the sensor also exhibited good reproducibility and high selectivity. For in vivo animal studies, the microsensor was employed for the continuous assessment of instantaneous ADO release at the ST36 (Zusanli) acupoint when this acupoint was subjected to twirling-rotating acupuncture manipulation. Benefiting from superior sensor in vivo performance and stability, the positive correlation between the variability in acupuncture-induced ADO release and the stimulus intensity levels that affect the clinical benefit can be demonstrated for the first time. Overall, these results highlight a powerful approach to analyzing the in vivo physiological effects of acupuncture, expanding application realm of micro-nano sensor technology on a fast time scale.

The regulations on cortical activation and functional connectivity of the dorsolateral prefrontal cortex-primary somatosensory cortex elicited by acupuncture with reinforcing-reducing manipulation.

Traditional acupuncture with reinforcing-reducing manipulation is essential for clinical effectiveness, whereas the underlying central mechanism of it remains unknown. This study with multiple-channels functional near-infrared spectroscopy (fNIRS) aims to explore cerebral-response modes during acupuncture with reinforcing-reducing manipulations. Functional near-infrared spectroscopy data were recorded from 35 healthy participants during the lifting-thrusting reinforcing manipulation, the lifting-thrusting reducing manipulation, and the even reinforcing-reducing manipulation with lifting-thrusting. The general linear model based (GLM) cortical activation analysis and the functional connectivity (FC) based on region of interest (ROI) analysis were combined to be conducted. In comparison with the baseline, the results showed that three acupuncture with reinforcing-reducing manipulations similarly induced the hemodynamic responses in the bilateral dorsolateral prefrontal cortex (DLPFC) and increased FC between the DLPFC and primary somatosensory cortex (S1). Specifically, the even reinforcing-reducing manipulation deactivated the bilateral DLPFC, the frontopolar area (FP), the right primary motor cortex (M1), the bilateral S1, and the bilateral secondary somatosensory cortex (S2); The reducing manipulation deactivated the bilateral DLPFC; The reinforcing manipulation activated the bilateral DLPFC, the left S1, and the right S2. The between-group comparisons indicated that the reinforcing-reducing manipulation induced opposite hemodynamic responses in the bilateral DLPFC and the left S1 and exhibited different FC patterns in the left DLPFC-S1, within the right DLPFC, and between the left S1 and the left orbitofrontal cortex (OFC). These findings verified the feasibility of fNIRS for investigating cerebral functional activities of acupuncture manipulations, suggesting that the regulations on the DLPFC-S1 cortex may be the potential central mechanism for the realization of acupuncture with reinforcing-reducing manipulation's effect. ClinicalTrials.gov, identifier, ChiCTR2100051893.

Constituent elements and characteristics of ancient acupuncture and moxibustion prescriptions: taking migraine and headache as an example

The basic constituent elements of ancient acupuncture prescriptions and moxibustion prescriptions for migraine and headache are extracted and summarized. The frequency and proportion of each element are counted and its characteristics are analyzed. The basic constituent elements of ancient acupuncture and moxibustion prescriptions includes five aspects: disease symptoms (main symptoms, concurrent symptoms, etiology and pathogenesis), disease type, acupuncture and moxibustion site (acupoint name, site name, meridian name), manipulation method (acupuncture method, reinforcing and reducing method, blood pricking method, moxibustion method) and curative effect. Acupuncture and moxibustion prescriptions are essential for recording the disease symptoms, while the acupuncture and moxibustion site and manipulation methods are the two core elements of ancient acupuncture and moxibustion prescriptions, which are also the premise to ensure that acupuncture and moxibustion prescriptions have good reference value.

A Miniature Multiaxis Force/Torque Sensor for Acupuncture

To realize the quantitative analysis and research of traditional Chinese medicine (TCM) acupuncture manipulations, miniaturized multidimensional force sensors are necessary to measure the lifting–thrusting force and twisting torque in the process of acupuncture, which records the manipulations of excellent physicians for relevant physicians to learn and improve their manipulations. A miniature multiaxis force/torque ( <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">${F}/{T}$ </tex-math></inline-formula> ) sensor for acupuncture is developed in this article. The elastomer of the design adopts hollow thin-wall cross beam structure with inverted <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">${T}$ </tex-math></inline-formula> floating beam, which retains the space for the strain gauge to be pasted, reduces the coupling between dimensions, and improves the sensitivity and accuracy. This design has the advantages of miniaturization, lightweight, high precision, and convenient needle substitution. The elastomer is processed with polyetheretherketone (PEEK) material to reduce the mass. First, the feasibility of the hollow thin-wall cross beam structure with inverted <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">${T}$ </tex-math></inline-formula> floating beam is verified by ANSYS finite element simulation. Then, the hardware system based on STM32 is designed to realize signal acquisition, amplification, and transmission. Next, the static calibration and decoupling of the sensor are accomplished with the calibration device. The calibration results indicate that the accuracy of the sensor is high (the coupling error is less than 2%). Finally, the acupuncture force measurement system is constructed to complete the acupuncture manipulation experiment. The experimental results demonstrate that our system can accurately obtain the needle force information and can distinguish different acupuncture manipulations, which verifies the feasibility of the sensor while realizing the quantitative characterization of acupuncture manipulations.

Mechanical effects of needle texture on acupoint tissue

ObjectiveThis study aims to clarify how the stimulation of acupuncture points is achieved by needles with different surface texture during acupuncture; it also seeks to lessen injury at the insertion site and increase the therapeutic efficacy of acupuncture, by simulating the mechanical effects of various needle surface patterns on Zusanli (ST36) without changing the radius of acupuncture needles. MethodsFive acupuncture needle models with different surface patterns, including the smooth needle, the lined needle, the ringed needle, the left-hand threaded needle and the right-hand threaded needle, and a layered model of the Zusanli acupoint were used to investigate how to reduce tissue damage and increase stimulation during acupuncture treatment. Puncturing of the skin as well as lifting-inserting and twisting needle manipulations were simulated using these models, and the degree of damage and force of stimulation caused by the acupuncture needles with different surface patterns during acupuncture were compared. ResultsThe smooth needle and the lined needle caused the least tissue damage during insertion, while the left-hand threaded and the right-hand threaded needles caused the most damage. The ringed needle, the left-hand threaded needle and the right-hand threaded needle stimulated the acupoint tissue more during lifting-inserting manipulations, while the lined needle and the smooth needle produced less stimulation. The stimulation of the lined needle on the acupoint tissue was the largest during twisting manipulation, whereas the left-hand threaded needle and the right-hand threaded needle had smaller effects. In lifting-inserting and twisting manipulations, both the left-hand threaded needle and right-hand threaded needle provided more stimulation, but the torsion direction in which they produced better stimulation was the opposite. ConclusionAccording to the simulation results, the ringed pattern enhances stimulation best in the lifting-inserting manipulation, whereas the lined pattern enhances stimulation best in the twisting manipulation. Both the right-hand and left-hand thread patterns have certain enhancing effects in these two operations. Taking the geometric properties of the pattern into account, the left-hand thread pattern and the right-hand thread pattern have the geometric characteristics of both the lined pattern and the ringed pattern. To conclude, a pattern perpendicular to the movement direction during the acupuncture manipulation creates more stimulation. These results have significance for future needle design.Please cite this article as: Sun MZ, Wang X, Li YC, Yao W, Gu W. Mechanical effects of needle texture on acupoint tissue. J Integr Med. 2023; 21(3): 254–267.

Methodological issues of the central mechanism of two classic acupuncture manipulations based on fNIRS: suggestions for a pilot study.

Background: Acupuncture reinforcing-reducing manipulation (ARRM) is a necessary procedure of traditional Chinese acupuncture and an essential factor affecting the therapeutic effect of acupuncture. Shaoshanhuo reinforcing method (SSH) and Toutianliang reducing method (TTL) are the most representative ARRMs. They integrate six single ARRMs and pose distinguished therapeutic effects of acupuncture. However, due to the complexity, diversity, and variation, investigating the mechanism of these two classic manipulations is insufficient. The neuroimaging technique is an important method to explore the central mechanism of SSH and TTL. This study attempted to design a randomized crossover trial based on functional near-infrared spectroscopy (fNIRS) to explore the mechanism of SSH and TTL, meanwhile, provide valuable methodological references for future studies. Methods: A total of 30 healthy subjects were finally included and analyzed in this study. fNIRS examination was performed to record the neural responses during the two most representative ARRMs. The cortical activation and the inter-network functional connectivity (FC) were explored. Results: The results found that SSH and TTL could elicit significant cerebral responses, respectively, but there was no difference between them. Conclusion: Neuroimaging techniques with a higher spatiotemporal resolution, combinations of therapeutic effects, and strict quality control are important to neuroimaging studies on SSH and TTL.