Sham Acupoint Research Articles

Acupuncture improves cognitive function of vascular dementia rats by regulating PI3K/Akt/mTOR pathway

To explore the mechanism of acupuncture in improving cognitive ability by regulating hippocampal phosphatidylinositol-3 kinase (PI3K)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) pathway in vascular dementia (VD) rats. A total of 80 male SD rats were randomized into sham operation, model, non-acupoint and acupoint groups (n=18 per group). The VD model was established by ligation of the bilateral common carotid arteries. For rats of the acupoint group, "Baihui" (GV20) and bilateral "Zusanli "(ST36) were needled and stimulated by twirling the needles with reinforcing method, and for rats of the non-acupoint group, the bilateral subcostal spots (about 10 mm superior to the iliac cresta) were needled and stimulated by twirling the needles with uniform reinforcing and reducing method. The treatment was conducted once daily, 6 times a week for two weeks, beginning 3 days after successful modeling. Rats of the sham operation group and model group received grasps as those in the acupoint groups. Morris water maze test was used to detect the abilities of learning and spatial memory. The contents of reactive oxygen species (ROS), malondialdehyde (MDA), superoxide dismutase (SOD) and the activities of acetylcholinesterase (AChE) and acetylcholine transferase (ChAT) in the hippocampus tissue were detected by using ELISA, changes of hippocampal mitochondrial membrane potential (MMP) detected using JC-1 fluorescence probe, and the expression levels of hippocampal phosphorylated (p)-PI3K, p-Akt and mTOR proteins measured using Western blot. Compared with the sham operation group, the escape latency, contents of ROS and MDA, and AChE activity were significantly increased (P<0.05), and the spatial memory ability, SOD activity, ChAT activity, MMP, p-PI3K, p-Akt and mTOR expression levels were significantly decreased in the model group (P<0.05). Compared with the model group, carotid artery ligature-induced increase of the escape latency, contents of ROS and MDA, and AChE activity, and decrease of the spatial memory ability, SOD activity, ChAT activity, MMP, p-PI3K, p-Akt and mTOR expression levels were significantly reversed in the acupuncture group (P< 0.05), but not in the non-acupoint group (P>0.05). The therapeutic effects of acupoint needling were obviously superior to those of non-acupoint needling in decreasing the escape latency, contents of ROS and MDA, and AChE activity (P<0.05), and in increasing the spatial memory ability, SOD activity, ChAT activity, MMP, p-PI3K, p-Akt and mTOR expre-ssion levels (P<0.05). Acupuncture can improve cognitive function of VD rats, which may be related with its functions in easing oxidative stress and MMP reduction by activating PI3K/Akt/mTOR signaling pathway in the hippocampus.

Clinical Evidence of Brain Effect Difference between True Point and False Point: A Meta-analysis Based FMRI

Imaging studies after acupuncture at acupoints and sham acupoints have shown significant changes in the function of specific parts of the brain, but these findings are not consistent. In this meta-analysis, we examined different studies to determine whether there are differences in brain function changes in the brain imaging findings of acupuncture at real and sham points. Pubmed, Embase, Cochrane, CNKI, VIP and Wanfang databases were used to search for acupuncture brain imaging literatures published by May 2020. Study selection, quality assessment and data extraction were carried out by two independent researchers. The whole brain function data of acupuncture points were analyzed by sdM-PSI. Thirteen studies met the inclusion criteria, including 266 subjects enrolled at acupoints including Taichong, Xingjian, Neiting, Guangming, Neiguan, Baihui, Fengchi, Sanyinjiao, Zusanli, Wai Guan, Feng Long, Zhongdu, Xiangu, 214 true acupoints, 186 false acupoints. Our analysis revealed that the brain region positively activated by acupuncture was Right fusiform gyrus, BA 30, Right inferior gyrus, Stationarity BA 48, and Right superior Temporal gyrus, BA 42. These findings suggest that the limbic system is the common difference in brain function after acupuncturing at different true and false acupoints.

Influence of Electroacupuncture on Acupoints of Yanglingquan (GB34) on Gallbladder Volume and Gallbladder Arterial Hemodynamics in Patients With Chronic Cholecystitis

Introduction: In China, patients with chronic cholecystitis account for approximately 10% of the total population, in which over 90% of cholecystitis is caused by cholelithiasis. This study aimed to discuss the possible mechanism of electroacupuncture on the Yanglingquan acupoint promoting gallbladder contractibility of patients with chronic cholecystitis. Methods: 60 patients were randomly divided into a trial group and a control group. Doppler ultrasound and color Doppler blood flow imaging was applied. The trial group adopted the BT701-1B electroanesthesia apparatus to perform electroacupuncture on the bilateral acupoints of Yanglingquan, while electroacupuncture was made on sham acupoints in the control group. Results: Before the electroacupuncture, gallbladder volume was 49.6 ± 5.66 ml, after 15 min and 30 min of electroacupuncture, the gallbladder volume was then 32.9 ± 5.66 ml and 23.0 ± 2.83 ml respectively. The comparison before and after electroacupuncture was obviously and statistically different (P &lt; 0.01). The comparison between after 15 min and 30 min is obviously statistically different (P &lt; 0.01). Before the electroacupuncture, the gallbladder artery Vmax, Vmin, and RI were 18.4 ± 2.69 cm/s, 9.7 ± 0.07 cm/s, and 0.47 ± 0.06, respectively; the cystic artery Vmax, Vmin, and RI after 30 min were 8.1 ± 0.92 cm/s, 3.1 ± 0.57 cm/s, and 0.61 ± 0.02. The comparison in gallbladder artery Vmax and Vmin and the drag index (RI) before and after electroacupuncture was obviously and statistically different (P &lt; 0.01). Conclusions: Electroacupuncture on the acupoints of Yanglingquan has the potential to promote the emptying of the gallbladder. The mechanism may be related to that the smooth muscle of the gallbladder contracts after electroacupuncture and the gallbladder empties.

Research on the body surface resistance imbalance degree at yuan-source points of three yin meridians of foot in the patients with primary dysmenorrhea

ObjectiveTo explore whether or not the changes in body surface resistance at yuan-source points of three yin meridians of foot can specifically responds the onset of primary dysmenorrhea (PD) in females of menstrual period and the before and after, so as to provide the evidence for acupoint selection in clinic. MethodsA total of 90 cases of PD were recruited in a PD group and 90 healthy female undergraduates were recruited in a normal group. The yuan-source of points of three yin meridians of foot were selected, i.e. Tàibái (太白SP3), Tàichōng (太冲LR3) and Tàixī (太溪KI3). The acupoints for control were Xuèhăi (血海SP10), the non-special acupoint, Xuánzhōng (悬钟GB39), the acupoint not on the relevant meridian, as well as a non-meridian point. Successively, before menstruation, on Day 1 during menstruation and on Day 3 after menstruation, the body surface resistance at the above-mentioned test sites was detected in the participants of two groups each day. The resistance imbalance degree (RID) of the bilateral acupoints was taken as the outcome indicator. The observation lasted one menstrual cycle. Results(1) Intra-group comparison: at LR3, the RID was lower on Day 1 during menstruation than that before menstruation significantly in the normal group (P ≤ 0.05). There was no significant change in RID at the same time points, but RID on Day 3 after menstruation was lower significantly than that before menstruation in the PD group (P ≤ 0.05). At SP3, KI3, SP10, GB39 and sham acupoint, there were no significant differences in RID among different time points within the same group (all P > 0.05). (2) Inter-group comparison: there were no significant differences in RID among different time points at the same point. (all P > 0.05). ConclusionRID at yuan-source points of three yin meridians of foot cannot specifically respond to PD. However, at LR3, before and after menstruation, RID changes are different between PD patients and healthy female undergraduates, which needs a further study in the future.

Evaluating the Long-Term Efficacy of Acupuncture Therapy for Subacute Poststroke Aphasia: Study Protocol for a Randomized, Blinded, Controlled, Multicentre Trial.

Background Poststroke aphasia (PSA) is a disabling condition that decreases the quality of life, and the duration of the disease harms the quality of life of PSA patients. Acupuncture has been widely employed for PSA. There is some evidence for the immediate treatment efficacy of acupuncture for PSA; however, long-term results after acupuncture may be poorer. Methods This is a multicentre, randomized, blinded, nonacupoint (NA) acupuncture controlled, multimodal neuroimaging clinical trial. A total of 48 subjects with subacute PSA will be randomly assigned to an acupoint group or an NA control group. The acupoint group will receive acupuncture with normal needling at DU20, EX-HN1, HT5, GB39, EX-HN12, EX-HN13, and CV23. The NA control group will receive acupuncture in locations not corresponding to acupuncture points as sham acupoints. Both groups will receive identical speech and language therapy thrice a week for four weeks. The primary outcome will be the change in the aphasia quotient (AQ) score measured by the Western Aphasia Battery (WAB) test during the 12th week after randomization. Participants will be blindly assessed at prerandomization (baseline) and 4 weeks, 12 weeks, and 24 weeks after randomization. The secondary outcomes include the Boston Diagnostic Aphasia Examination (BDAE) score, the Disease Prognosis Scale score for ischaemic stroke, etc. Magnetic resonance imaging (MRI) and electroencephalogram (EEG) will also be performed at 4-time intervals as secondary outcomes. All scores and image evaluations will be taken at the same point as the linguistic evaluation. The multilevel evaluation technique will be used to assess the long-term efficacy of acupuncture therapy. MRI scans and EEG will be used to assess acupuncture-related neuroplasticity changes. Discussion. The results from our trial will help to supply evidence for the long-term acupuncture effects for PSA over a long follow-up period. It will provide valuable information for future studies in the field of PSA treatment. The trial was registered at the Chinese Clinical Trial Registry on 16 March 2020 (ChiCTR2000030879).

Alternation of Resting-State Functional Connectivity Between Visual Cortex and Hypothalamus in Guinea Pigs With Experimental Glucocorticoid Enhanced Myopia After the Treatment of Electroacupuncture

Excessive glucocorticoids (GC) may lead to the aggravation of several basic diseases including myopia, due to plasma hormone imbalances associated with the hypothalamic–pituitary–adrenal axis (HPAA). Electroacupuncture (EA) is an effective therapeutic method to treat many diseases, although it remains unclear whether EA at acupoints on the foot or back would be effective in treating eye diseases. It was recently found that visual cortex activity for responses to visual stimuli with spatial frequency and resting-state functional connectivity (FC) between the supramarginal gyrus and rostrolateral prefrontal cortex was significantly reduced in patients with high myopia. The present study aims to investigate the role of the alternation of resting-state FC among the bilateral visual cortex and hypothalamus in exerting anti-myopia effects of EA in GC-enhanced lens-induced myopic (LIM) guinea pigs such that the mechanisms of EA to treat GC-enhanced myopia at Shenshu (BL23) acupoints can be probed. To confirm the effects of EA, ocular parameters including axial length and GC-associated physiological parameters such as animal appearance, behavior, bodyweight, and levels of four HPAA-associated plasma hormones [free triiodothyronine (FT3), free thyroxine (FT4), estradiol (E2), and testosterone (T)] were also collected. Increased resting-state FC between the left and right visual cortex was detected in GC-enhanced lens-induced myopic guinea pigs with EA at BL23 acupoints (LIM+GC+EA) guinea pigs compared to GC-enhanced lens-induced myopic guinea pigs with EA at sham acupoints (LIM+GC+Sham) guinea pigs, as well as suppressed myopia and recovery of symptoms initially caused by overdose of GC. Recovered symptoms included improved animal appearance, behavior, bodyweight, and HPAA-associated plasma hormone levels were observed after 4 weeks of EA treatment. In contrast, the LIM+GC+Sham group showed decreased FC with elongation of axial length for myopization as compared to the control group and LIM group and exhibited a deterioration in physiological parameters including reduced body weight and balance disruption in the four measured HPAA-associated plasma hormones. Our findings suggest that EA could effectively treat GC-enhanced myopia by increasing resting-state FC between the left and right visual cortices, which may be pivotal to further understanding the application and mechanisms of EA in treating GC-enhanced myopia.

Perioperative transcutaneous electrical acupoint stimulation for improving postoperative gastrointestinal function: A randomized controlled trial

BackgroundPostoperative gastrointestinal dysfunction (PGD) is one of the most common complications in patients undergoing major abdominal surgery. Acupuncture has been used widely in gastrointestinal diseases due to its effectiveness and minimally invasive nature. ObjectiveThis study evaluated the efficacy of using transcutaneous electrical acupoint stimulation (TEAS) during the surgery and postoperative recovery in patients with gastric and colorectal surgery for improving postoperative gastrointestinal function. Design, setting, participants and interventionsA total of 280 patients undergoing abdominal surgery were stratified by type of surgery (i.e., gastric or colorectal surgery) and randomly allocated into the TEAS group (group T) or the sham group (group S). Patients in group T received TEAS at LI4, PC6, ST36 and ST37. Patients in group S received pseudo-TEAS at sham acupoints. The stimulation was given from 30 min before anesthesia until the end of surgery. The same treatment was performed at 9 am on the 1st, 2nd and 3rd days after surgery, until the recovery of flatus in patients. Main outcome measuresThe primary outcome was the time to the first bowel motion, as detected by auscultation. The secondary outcomes included the first flatus and ambulation time, changes of perioperative substance P (SP), incidence of PGD, postoperative pain, postoperative nausea and vomiting (PONV) and some economic indicators. ResultsThe time to first bowel motion, first flatus and first ambulation in group T was much shorter than that in group S (P < 0.01). In patients undergoing colorectal surgery, the concentration of SP was lower in group T than in group S on the third day after the operation (P < 0.05). The average incidence of PGD in all patients was 25%, and the frequency of PGD was significantly lower in group T than in group S (18.6% vs. 31.4%, respectively; P < 0.05). TEAS treatment (odds ratio = 0.498; 95% confidence interval: 0.232–0.786) and type of surgery were relevant factors for the development of PGD. Postoperative pain score and PONV occurrence were significantly lower in group T (P < 0.01). Postoperative hospitalization days and the resulting cost to patients were greatly reduced in the TEAS group (P < 0.01). ConclusionPerioperative TEAS was able to promote the recovery of postoperative gastrointestinal function, reduce the incidence of PGD and PONV. The concentration of SP was decreased by TEAS treatment, which indicates that the brain-gut axis may play a role in how TEAS regulates gastrointestinal function. Trial registrationChinese Clinical Trial Registry, ChiCTR1900023263.

The fMRI study for acupuncture on shift work sleep disorder: Study protocol for a randomized controlled neuroimaging trial.

Introduction:Nearly 20% of night shift nurses will cause shift work disorder (SWD) due to the disruption of sleep-wake cycle, which not only affects the daily work efficiency, but also brings a huge burden on physical and mental health. Acupuncture is a safe and effective intervention on SWD. This trial will combine with functional magnetic resonance imaging (fMRI) to study the clinical effects and potential mechanism of acupuncture in the treatment of SWD.Methods and analysis:This is a randomized controlled neuroimaging trial, with enrolled participants, outcome assessors, and data statisticians blinded. 60 patients with SWD and 30 healthy controls who sleep regularly will be recruited and divided into divided into a control group, a true acupoints treatment group (TATG) and a sham acupoints treatment group (SATG) by the ratio of 1:1:1. The TATG and SATG will receive 8 sessions of acupuncture treatment in 4 weeks. Cognitive function scales and MRI scanning will be performed before and after 4-week acupuncture treatment. The control group will receive no intervention. Functional connectivity of intra-network and inter-network will be the primary outcome and effect indicator. The secondary outcomes included Repeatable Battery for the Assessment of Neuropsychological Status, Attentional Network Test, Pittsburgh Sleep Quality Index scale and needle sensation assessment scale. Neuroimage indicators will be correlated with clinical data and scores of cognitive function assessment to explore the possible mechanisms underlying the changes of brain activity caused by acupuncture treatment.Discussion:The results of this study will enable us to verify the therapeutic effect of acupuncture on SWD and explore the potential central mechanism of acupuncture on SWD from the change of brain activity.

Corrigendum to: Is Tapping on Acupuncture Points an Active Ingredient in Emotional Freedom Techniques: A Systematic Review and Meta-Analysis of Comparative Studies.

We published a meta-analysis of component trials of emotional freedom techniques (EFT) in this journal. EFT is an evidence-based method, validated in over 100 clinical trials, that uses fingertip tapping on acupressure points in conjunction with techniques from exposure and cognitive therapy. The meta-analysis examined six studies in which an active control, such as diaphragmatic breathing or sham acupoints, was used in place of tapping on actual acupoints. The purpose of the meta-analysis was to determine whether tapping was an inert or an active ingredient in EFTs observed treatment effects. Subsequent to publication, errors in the statistical analysis were identified, primarily incorrect standard deviation values, and our methodological approach was questioned by others. We therefore had the meta-analysis rerun by an independent senior statistician who compared pre- to follow-up results to determine the sustained effects of treatment. The cumulative fixed effects Hedge's g-value was found to be 0.73 (95% confidence interval = 0.42-1.04, p < 0.0001). The corresponding random effects Hedge's g-value is 0.74 (95% confidence interval = 0.34-1.13, p < 0.0001). We also reviewed and clarified our methodology. In conclusion, despite computational errors in our original publication, the present revised analysis supports the original conclusion that the acupressure component of the EFT protocol is an active ingredient that contributes to the method's favorable health effects.

Does the Acupoint Specificity Exist? Evidence from Functional Neuroimaging Studies.

Using functional neuroimaging techniques to explore the central mechanism of acupoint specificity, the key of acupuncture theory and clinical practice, has attracted increasing attention worldwide. This review aimed to investigate the current status of functional neuroimaging studies on acupoint specificity and explore the potential influencing factors for the expression of acupoint specificity in neuroimaging studies. PubMed database was searched from January 1st, 1995 to December 31st, 2016 with the language restriction in English. Data including basic information, methodology and study results were extracted and analyzed from the eligible records. Seventy-nine studies were finally enrolled. 65.8% of studies were performed in China, 73.4% of studies were conducted with healthy subjects, 77.2% of studies chose manual acupuncture as the intervention, 86.1% of studies focused on the instant efficacy and 89.9% of studies used functional magnetic resonance imaging as scanning technique. The average sample size was 16 per group. The comparison of verum acupoints and sham acupoints were the main body of acupoint specificity researches. 93.7% of studies obtained the positive results and favored the existence of acupoint specificity. This review affirmed the existence of acupoint specificity and deemed that the acupoint specificity was relative. Multiple factors such as participants, sample size, acupoint combinations, treatment courses, and types of acupoint could influence the expression of acupoint specificity.

Electroacupuncture improves myocardial ischemia injury via activation of adenosine receptors

Electroacupuncture (EA) can improve myocardial ischemia (MI) injury; nevertheless, the mechanism is not entirely clear. And there were disagreements about whether the effect of EA at acupoint in disease-affected meridian is better than EA at acupoint in non-affected meridian and sham acupoint. Here, we showed that the effect of EA at Neiguan (PC6) is better than EA at Hegu (LI4) and sham acupoint in affecting RPP and ECG, increasing ATP and ADO production, decreasing AMP production, and upregulating the mRNA expression levels of A1AR, A2aAR, and A2bAR; knockdown of A1AR or A2bAR reversed the effect of EA at PC6 in alleviating MI injury; knockdown of A2aAR had no influence on the cardiac protection of EA at PC6; thus, the cardioprotective effect of EA at PC6 needs A1AR and A2bAR, instead of A2aAR; considering that the cardio protection of adenosine receptor needs activation of other adenosine receptors, one of the reasons may be that after silence of A1AR or A2bAR, EA at PC6 could not impact the expression levels of the other two adenosine receptors, and after silence of A2aAR, EA at PC6 could impact the expression levels of A1AR and A2bAR. These results suggested that EA at PC6 may be a potential and effective treatment for MI by activation of A1AR and A2bAR.

Transcutaneous electrical acupuncture stimulation (TEAS) for gastrointestinal dysfunction in adults undergoing abdominal surgery: study protocol for a prospective randomized controlled trial

BackgroundPostoperative gastrointestinal (GI) dysfunction (PGD) is a common problem after abdominal surgery. PGD can increase the length of hospital stay and may lead to serious complications. Acupuncture and moxibustion are alternative therapies for PGD that have been used in some settings. However, the effect of preventive application of acupuncture or transcutaneous electrical acupuncture stimulation (TEAS) is still uncertain. The purpose of this study is to investigate the efficacy of the continuous application of TEAS on GI function recovery in adults undergoing abdominal surgery. At the same time, we will try to confirm the mechanism of TEAS through the brain–gut axis.Methods/designThis study is a prospective, single-center, two-arm, randomized controlled trial that will be performed in a general hospital. In total, 280 patients undergoing abdominal surgery were stratified by type of surgery (i.e. gastric or colorectal procedure) and randomized into two treatment groups. The experimental group will receive TEAS stimulation at L14 and PC6, ST36 and ST37. The sham group will receive pseudo-TEAS at sham acupoints. The primary outcome will be the time to the first bowel motion by auscultation. The recovery time of flatus, defecation, the changes in perioperative brain–intestinal peptides, postoperative pain, perioperative complications, and hospitalization duration will be the secondary outcomes.DiscussionThe results of this study will demonstrate that continuous preventive application of TEAS can improve the GI function recovery in patients undergoing abdominal surgery and that this effect may act through brain–gut peptides.Trial registrationChinese Clinical Trial Registry, ChiCTR1900023263. Registered on 11 May 2019.

Effectiveness of taichong (LR3) acupuncture point on blood pressure in patients with hypertension: A randomized sham control trial

BackgroundImmediate effects of acupuncture may be beneficial for reduction in blood pressure among the patients with hypertension, but the available evidence for some acupucunture points is limited. ObjectivesTo evaluate the effectiveness of acupuncture point (Taichong, Liver 3, LR3) in lowering systolic and diastolic blood pressure (BP) in patients with hypertension (HTN). MethodsNinety patients with HTN attending an outpatient department were included in this randomized clinical trial. Taichong (LR3) was applied to the experimental group (n = 45) and to the first metatarsal (sham acupoint) in the sham control group (n = 45). BP was measured by electronic monitoring before and immediately after (20th min) and 30 min after acupuncture. ResultsThe two groups were similar for demographics and antihypertensive drug use. Mean systolic and diastolic BP in the experimental group decreased at 0, immediately after (20th min), and 30 min after acupuncture (145.0/92.4, 140.4/88.4, 135.7/80.2, and 132.2/78.6 mmHg); no significant changes occurred in the control group. There was a significant difference in systolic and diastolic BP between the experimental and control groups immediately and 30 min after acupuncture (P < 0.05). ConclusionTaichong (LR3) acupuncture point lowered BP in patients with HTN in our study. Taichong(LR3) may be effectively used alongside conventional therapies in the management of HTN. Additional studies are required to validate our findings further, with respect to the optimal dosage required and the frequency of needling.

Acupuncture for poststroke hemiplegia focusing on cerebral bilateral connections: study protocol for a randomised controlled neuroimaging trial

IntroductionAcupuncture is safe and effective for improving the motor function of poststroke hemiplegic patients, but there still exists a certain gap between clinical practice and understanding its neural mechanisms. The...

Efficacy of verum and sham acupoint catgut embedding for treatment of obesity: Study protocol for a randomized controlled trial

BackgroundObesity has become a major public health hazard with epidemic proportions, affecting adults, adolescents, and children of both genders. Previous studies have suggested that acupoint catgut embedding (ACE) might be a potential therapeutic approach for obesity. The purpose of this study is to conduct a rigorous and normative trial to determine the efficacy of ACE for obesity.Methods/designA total of 99 eligible patients diagnosed with obesity will be recruited in this study. They will be randomly allocated to either the verum ACE group, sham ACE group, or waiting list (WL) group, with 33 patients in each group. Each patient in the two ACE-based groups will receive eight sessions of treatment, lasting over 8 weeks. The primary outcome is the reduction of body mass index (BMI) after treatment. Secondary outcomes will include waist circumference (WC), hip circumference (HC), waist:hip ratio, body fat percentage, blood lipid level, subcutaneous fat area, visceral fat area, and World Health Organization Quality of Life (WHOQOL). All the outcomes will be evaluated at baseline, at the end of the 8 weeks of treatments, and at 3 months of follow-up. The evaluators and data analyzers will be blinded to group allocation.DiscussionThe findings of this randomized, sham-, and WL-controlled trial will help to investigate the influence of ACE on clinical variables as well as visceral fat area of obesity, which will provide high-quality evidence on the efficacy of ACE for obesity.Trial registrationChinese Clinical Trial Registry, ChiCTR1800020248. Registered on December 21, 2018.

Electroacupuncture increases immunoexpression of CB1 and CB2 receptors in experimental model of inflammatory bone loss.

This study evaluated the participation of CB1 and CB2 receptors in the antiresorptive effect of electroacupuncture (EA) on an experimental model of inflammatory bone loss in rats. 30 rats were divided into five groups: C (control); EP (experimental periodontitis); EA (C+ EA); EP-EA (EP+ EA in the acupoints LI4, LG11, ST36, ST44); EP - EA-sham (EP+ EA in sham acupoints). For the EP groups, a ligature was placed around the right mandibular first molars at day 1. Sessions of EA or EA-sham were assigned every other day. Animals were euthanized at day 11. Histometric analysis was performed to evaluate the percentage of bone area in the furcation area. Immunolabeling patterns in the periodontal tissues and immunofluorescent staining in the trigeminal ganglia and in the trigeminal spinal tract for CB1 and CB2 receptors were performed. It was observed increased bone loss in the furcation in the EP and EP-EA-sham groups, in comparison to the other groups (p < 0.05). Enhanced CB2 immunolabeling was observed in the periodontal tissues in the EP-EA group, when compared to the EP and EP-EA-sham groups (p < 0.05). Increased CB1 immunofluorescent staining was observed in the neural tissues in the EA treated group in comparison with the other groups (p < 0.05), while no expression of CB2 was observed in those regions. Our study showed that in the presence of inflammatory bone disease, EA treatment reduced bone erosion and increased the immunoexpression of CB1 in the neural tissues and CB2 in the periodontal tissues.

The Effects of Acupressure on Physiological Indicators of Pain in Children Undergoing Tonsillectomy: A Randomized, Single-Blind, Placebo-Controlled Trial Study

Background: Tonsillectomy is regarded as one of the most commonly used pediatric surgical procedures whose anxiety-related consequences can bring about several changes in the physiological characteristics of children. Therefore, the use of low-cost anxiety-relieving techniques in this domain can be of utmost importance to stabilize vital signs in this age group. Objectives: Accordingly, the purpose of the present study was to investigate the effects of acupressure on physiological indicators of pain including respiratory rate, heart rate, and levels of arterial oxygen saturation in children undergoing tonsillectomy. Methods: This study was a three-group single-blind clinical trial conducted on 144 children aged five to 12 years undergoing a tonsillectomy. To this end, the subjects were allocated into three groups of 48 individuals including control, intervention, and placebo ones. In this respect, the intervention (experimental) group received acupressure applied to three pressure points three times a day for one hour, two to four hours, and six to eight hours following a tonsillectomy. However, in the placebo group, acupressure was applied to a false (sham) acupoint. The control group also received only routine care services. Before and after all three phases of the intervention, the physiological indicators of pain (heart and respiratory rate, blood pressure) were measured and recorded in all three study groups. The data were finally analyzed using descriptive statistics (mean and standard deviation) and inferential ones (Wilcoxon signed-rank test, chi-square test, one-way analysis of variance (ANOVA), and Kruskal-Wallis test). Results: The results of this study revealed significant differences in heart rate (P = 0.001), respiratory rate (P = 0.001), and levels of arterial oxygen saturation (P = 0.001) after three intervals of acupressure in the intervention group compared to those in other two groups. Accordingly, the means of heart rate and respiratory rate decreased and the levels of arterial oxygen saturation increased in the intervention group indicating a small number of fluctuations and much more balance in physiological indicators of pain. Conclusions: The findings of the present study showed that parasympathetic activity, following acupressure in the intervention group, could cause several changes in physiological responses, and also create a sense of relief and moderate anxiety in children. Therefore, anxiety in children undergoing a tonsillectomy could be lowered with the use of a simple, low-cost, and non-invasive technique contributing to the maintenance of physiological indicators of pain as well as decreased complications driven by vital signs, not in a normal range.

Effectiveness of acupressure on anxiety of children undergoing anesthesia.

Tonsillectomy is one of the most commonly used pediatric surgeries with high stress levels for children and their parents. The present study was designed and implemented regarding the fact that limited studies have ever been carried out about the effects of complementary therapies such as acupressure on the preoperative anxiety levels in children throughout the world. Present study was a randomized clinical trial that was done in three groups with 144 children aged 5-12 years undergoing tonsillectomy. In present study, the children were allocated in three groups: intervention, control and sham. In the intervention group, the acupressure was applied on the Yintang point and in the sham group, was applied at a sham acupoint. No intervention was performed in the control group. Before and after intervention, the pediatric anxiety levels were measured using instruments. The results were analyzed using descriptive and inferential statistics such as the Kruskal-Wallis and Wilcoxon tests, chi-square (χ2) and analysis of variance (ANOVA) test. The significance level was considered p < 0.05. The total anxiety score in children was (70.39 ± 20.93) in the control group, (67.83 ± 16.78) in the intervention group and (71.40 ± 21.82) in the sham group, not significant difference (p > 0.05). The different in the overall anxiety score among children before intervention compare to after intervention was as following: Control group (-3 ± 17.46), intervention group (8.42 ± 32.98) and sham group (-4.32 ± 24.47). Like other surgical procedures, the tonsillectomy has serious stress for children. Our study demonstrates that the acupressure has a significant effect on the level of preoperative anxiety in children undergoing surgery. Therefore, nurses can use this technique to reduce the pediatric anxiety.

Electroacupuncture reduces obesity by improving metabolism and up-regulating expression of hypothalamic Sirtuin 1 and proopiomelanocortin in obese rats

To observe the effect of electroacupuncture (EA) on expression of hypothalamic sirtuin 1(SIRT1) and proopiomelanocortin (POMC), and body weight, food-intake, blood glucose, and blood lipid levels in obese rats, so as to explore its mechanisms underlying improvement of obesity. Forty male Wistar rats were randomly divided into normal, model, EA, and sham EA groups (n＝10 rats in each group). The obesity model was established by feeding the rats with high fat diet. EA (2 Hz, 1 mA) was applied to "Zusanli" (ST36), "Zhongwan" (CV12), "Guanyuan" (CV4) and "Fenglong" (ST40) or sham acupoints (about 5 mm beside each acupoint, shallow needling) for 20 min, once every other day for 8 weeks. The rats' body weight and food-intake were recorded. The blood glucose (fasting plasma glucose: FPG, postprandial plasma glucose: PPG) and blood lipids (triglyceride: TG, total cholesterol: TC, non esterified fatty acid: NEFA) were assayed by using an automatic biochemical analyzer. The protein and mRNA expression levels of SIRT1 and POMC in the hypothalamus were detected by Western blot and quantitative real-time PCR, respectively. In comparison with the normal group, the body weight, food-intake, blood lipids, and PPG levels were significantly increased (P<0.05，P<0.01), and the expression levels of SIRT1 protein and mRNA in the hypothalamus were significantly doun-regulated in the model group (P<0.05). Following EA, the body weight, food-intake, blood lipids, and PPG levels were considerably down-regulated (P<0.01，P<0.05), and the expression levels of SIRT1 and POMC protein and mRNA in the hypothalamus were significantly up-regulated in the EA group rather than those in the sham EA and the model groups (P<0.05)．. EA can reduce the obese rats' body weight, food-intake, blood lipids and blood glucose, which may be associated with its effect in up-regulating the SIRT1 and POMC expression of hypothalamus.

Penetrative needling improves neurological function by up-regulating expression of autophagy related protein LC3 in rats with hemorrhagic stroke

To observe the effect of penetrative needling from "Baihui" (GV20) to "Qubin" (GB7) on neurological function and expression of autophagy related protein microtubule-associated protein, light chain 3 (LC3) in rats with hemorrhagic stroke, so as to explore its mechanism underlying improvement of hemorrhagic stroke. A total of 120 male SD rats were randomly divided into sham operation, model, non-acupoint, acupuncture and medication (Rapamycin) groups which were further divided into two time-point subgroups (3, 7 days after modeling, n=12/subgroup). The intracerebral hemorrhage model was established by injection of the rat's auto-blood (50 μL) into the putaman region. Penetrative needling from GV20 to GB7 or sham acupoints (about 1 cm beside GV20 and GB7) was conducted for 30 min, twice daily for 7 days. For rats of the medication group, Rapamycin solution (7 μmol/L) was injected into the right lateral ventricle. The neurological functions (locomotor and balance deficits) were evaluated according to suspended wire test (0-6 points) and horizontal board walking test (0-6 points). Immunohistochemistry and Western blot were used to detect the expression of total LC3 and expression of LC3-Ⅰ and LC3-Ⅱ proteins in the ischemic penumbra region of brain tissue, respectively. After modeling, the neurological function scores were significantly decreased on day 3 and 7, the levels of LC3-Ⅱ/Ⅰ and LC3 protein on day 3 and 7 were significantly increased in the model group relevant to the sham operation group (P<0.05). Following the interventions, the neurological function scores as well as LC3-Ⅱ/Ⅰ and LC3 protein expression were significantly increased in both acupuncture and medication groups compared with the model group (P<0.05). The effect of Rapamycin was obviously stronger than that of penetrative needling in up-regulating the expression of LC3-Ⅱ/Ⅰ and LC3 protein (P<0.05). Penetrative needling can improve neurologic function in hemorrhagic stroke rats, which is related with its effect in up-regulating the expression of autophagy-related protein LC3.