Sham Points Research Articles

Effectiveness and cerebral responses of multi-points acupuncture for primary insomnia: a preliminary randomized clinical trial and fMRI study

BackgroundPrimary insomnia (PI) is characterized by difficulties in initiating sleep or maintaining sleep, which lead to many serious diseases. Acupuncture for PI has drawn attention with its effectiveness and safety. However, the operation of choosing acupoints lacks scientific suggestion. Our trial aims to provide reference and scientific basis for the selection of acupoints and to explore its possible mechanism.MethodsA patient-assessor-blinded, randomized and sham controlled trial was designed to compare the efficacy of 5-weeks acupuncture at a single acupoint, the combination of multi-acupoints, and a sham point. The Pittsburgh sleep quality index and Athens Insomnia Scale questionnaire were used for the primary clinical outcomes, while polysomnography was performed for the secondary clinical outcomes. The resting state functional MRI was employed to detect the cerebral responses to acupuncture. The brain activity in resting state was measured by calculating the fractional amplitude of low-frequency fluctuations (fALFF), which reflected the idiopathic activity level of neurons in the resting state. These results were analyzed by two factorial ANOVA test and post-hoc t-tests.ResultsThe clinical outcomes suggest that acupuncture could improve clinical symptoms, and the combination of multi-acupoints might lead to a better clinical efficacy. The rs-fMRI results suggested that the brain activity of certain regions was related to the sleep experience, and acupuncture could regulate the activity of these regions. Furthermore, the combination of multi-acupoints could impact more regions which were influenced by the sleep experience.ConclusionsAcupuncture has been proven to be beneficial for PI patients, and the combination of multi-acupoints might improve its efficacy.Trial registrationThis trial has been registered on the U.S. National Library of Medicine (https://clinicaltrials.gov) ClinicalTrials.gov Identifier: NCT02448602. Registered date: 14/04/2015.

Efficacy of Electroacupuncture on Treating Depression-Related Insomnia: A Randomized Controlled Trial.

ObjectiveTo evaluate the efficacy of electroacupuncture (EA) on treating insomnia in patients with depression.Patients and MethodsIn a patient-assessor-blind, randomized and sham controlled trial, 90 depression patients with insomnia were assigned into three different groups, receiving EA in the treatment group, superficial acupuncture at sham points in the control group A, or Streitberger non-insertion sham acupuncture in the control group B. Treatment was applied 3 times weekly for 8 consecutive weeks. The primary outcome was measured using the Pittsburgh Sleep Quality Index (PSQI). Secondary outcomes were sleep parameters including sleep efficiency (SE), total sleep time (TST) and numbers of sleep awakenings (SA) recorded in the actigraphy, as well as applying the Hamilton Rating Scale for Depression (HAMD-17), Self-Rating Depression Scale (SDS) and Hamilton Rating Scale for Anxiety (HAMA). Assessments were performed at the baseline (week 0), week 4, week 8, and week 12. Linear mixed-effects models were used for analyses and all statistical tests were two-sided.ResultsPatients in the EA group had more significant improvement in PSQI scores than those in the control groups over time (respectively p<0.001 and p=0.04 for treatment and time interaction). At 8-week posttreatment, the EA group reported a reduction of −6.64 points in PSQI scores compared with −2.23 points in the control group A (95% CI= −5.74 to −2.39) and −2.94 points in the control group B (95% CI= −5.73 to −2.47). Compared with the two control groups, significant between-group differences were seen in SE (both p<0.01) and TST (both p<0.01) at week 8; similar results can be found in HAMD-17, SDS, and HAMA scores as well. However, there were no between-group differences in SA (respectively p=0.24 and p=0.08) after 8-weeks of treatment.ConclusionElectroacupuncture may improve the sleep quality of patients with depression.Trial RegistrationChinese Clinical Trial Registry (ChiCTR); URL: http://www.chictr.org.cn/showproj.aspx?proj=12327; Trial ID: ChiCTR-IIR-16008058.

Effects of the New Lift-Thrust Operation in Laser Acupuncture Investigated by Thermal Imaging.

Acupuncture manipulation is one of the key factors affecting the performance of acupuncture in Traditional Chinese Medicine. Lift-thrust and twirl-twist are two of the most commonly used manipulation methods for needle acupuncture. We previously have developed a novel laser acupuncture model that emulates lift-thrust operation. In this study, we intend to show the effectiveness of such a model by applying it on the Neiguan acupoint (PC6). Stimulation was reported to be beneficial for improving cardiac output and peripheral circulation. Therefore, we hypothesized that the stimulation of laser acupuncture may increase the temperature of the subjects' fingertip due to increased peripheral blood flow. A thermal imager was used to measure the temperature change of subjects' fingertips. Through regression analysis, it has been shown that while PC6 is stimulated, laser acupuncture with lift-thrust operation caused a more rapid, stable, and lasting temperature rise of fingertip than that without lift-thrust operation. On the contrary, we observe no significant temperature change when a sham point nearby PC6 (a point which is not traditionally defined as the acupoint) was stimulated. Our results suggest the emulation of manipulation methods such as the lift-thrust operation could be a potential direction for the future development of laser acupuncture.

Effect of acupuncture at ST36 on motor cortical excitation and inhibition.

BackgroundAcupuncture at Zusanli (ST36) is often used to facilitate motor recovery after stroke. However, the effect of acupuncture at ST36 on motor cortical excitation and inhibition remains unclear. This study aimed to explore the effect of acupuncture at ST36 on motor cortical excitation and inhibition.MethodsTwenty healthy volunteers were recruited to receive acupuncture treatment. We selected the acupoint ST36 and its respective sham point as the experimental acupoint. Transcranial magnetic stimulation (TMS) was used to measure motor‐evoked potentials (MEP) at 7 time points—before acupuncture (Pre), acupuncture (T0), 4 and 8 min after acupuncture (T4; T8), needle removal (T12), 4 and 8 min after needle removal (T16; T20). Simultaneously, paired TMS (pTMS) was employed to measure short‐ and long‐interval intracortical inhibition (SICI [short latency intracortical inhibition]; LICI [long latency intracortical inhibition]), respectively, at three time points—before acupuncture (Pre), acupuncture (T0), needle removal (T12). After removing the acupuncture needle, all subjects were asked to quantify their Deqi sensation using a Gas table.ResultsThe average Deqi sensation score of all subjects during acupuncture at ST36 was higher than that observed at the sham point. With acupuncture at ST36, the MEP amplitude was higher at three time points (T0, T4, T8) than at Pre, although the MEP amplitude tended toward Pre after needle removal. The MEP amplitude was also higher at the same time points (T0, T4, T8) than at the sham point. Furthermore, the Deqi sensation score was correlated with MEP amplitude. With acupuncture at ST36, SICI and LICI at T0 were higher than those at Pre, and SICI and LICI at T0 were higher than those at the sham point.ConclusionAcupuncture at ST36 increased motor cortical excitation and had an effect on the remaining needle phase. Deqi sensation was correlated with MEP amplitude. Acupuncture at ST36 also decreased motor cortical inhibition.

Analysis on regional homogeneity of resting brain during balance acupuncture-induced analgesic effect in migraine patients without aura

To observe the relationship between the analgesic effect of balance acupuncture and functional changes in brain in patients with migraine without aura. A total of 40 cases of migraine without aura were equally randomized into a headache-acupoint group and a sham-acupoint group. When acupuncture given, a filiform needle was inserted into the headache-acupoint (the midpoint of the depression region anterior to the juncture of the first and second metatarsal bones on the dorsum of the foot) or the sham point (the midpoint of the depression region anterior to the juncture site between the 3rd and 4th metatarsal joints of the dorsum of the foot) about 25-40 mm deep and manipulated for a while till the patient experienced feelings of electric shock and numbness, then withdrawn immediately. The treatment was conducted once daily for 4 weeks. The visual analogue scale (VAS) was used to evaluate the severity of pain, and the regional homogeneity (ReHo) analysis of resting state functional magnetic resonance imaging (fMRI) was used to assess changes of the spontaneous brain activity. After acupuncture, the analgesic effect of headache-acupoint was better than that of the sham-acupoint in both intervention stage and the follow-up stage (P< 0.05), and was also stronger in the intervention stage than in the follow-up stage (P<0.05). There was no significant difference in the analgesic effect between the intervention stage and the follow-up stage in the sham-acupoint group (P>0.05). Compared with pre-intervention, 4-weeks' intervention at the headache-acupoint showed an increase of ReHo values in the anterior cingulate gyrus, anterior central gyrus, superior orbital frontal gyrus, insula, inferior lobule, left anterior cingulate gyrus, ventral lateral nucleus and ventral posteromedial nucleus of the thalamus, pontine nucleus, cerebellar tonsils and orbital frontal inferior gyrus of the brain (P<0.05), and a decrease of ReHo values in the right brain bridge, central posterior gyrus, posterior cingulate gyrus, left central anterior gyrus, posterolateral nucleus of thalamus, and hippocampus (P<0.05), separately. In the sham-acupoint group, the ReHo value was increased in the right tongue gyrus, the left anterior lobe, the anterior cingulate gyrus and the lower occipital gyrus of the brain (P<0.05), and reduced in the left ventral posterolateral nucleus of the thalamus, separately (P<0.05). Balance acupuncture stimulation of headache acupoint has an analgesic effect in migraine patients without aura, which may be related to its effect in regulating resting state brain function of the limbic-system-dominated multiple brain regions.

Comparative Effects of the Stimulation of BL10, BL11, and GB34 Acupuncture Points with P6 Point using a Low-Level Laser on the Prevention of Vomiting after Strabismus Surgery: A Randomized, Double-Blind, Controlled Clinical Trial

Background: Vomiting is a common act after strabismus surgery. Three points (BL10, BL11, GB34) belong to the eye's energy channels and may be more effective in vomiting after strabismus surgery compared to P6 point. Objectives: The present study aimed to compare the effects of stimulation of BL10, BL11, and GB34 acupuncture points with point P6 via the use of a low-level laser in the prevention of vomiting after strabismus surgery. Methods: The present study used a randomized, double-blind, clinical trial design. The participating samples of this study were 63 strabismus surgery candidates with ASA I physical status, aged from 3 to 35 years who admitted to a university-affiliated hospital in Ahvaz, Iran, and were. The patients were randomly divided into three groups (21 patients in each group): Group I (laser acupuncture P6), group II (laser acupuncture BL10, BL11, GB34), and group III (control). Laser stimulation was performed on acupuncture points (P6 & BL10, BL11, GB34) for 60 seconds and 15 minutes before anesthesia induction and 15 minutes after arrival in the PACU. Group III (control) received placebo (laser off) stimulation on sham point. The number of vomits occurred 2, 6, and 24 hours after the surgery was recorded. Results: Significant statistical differences were not observed in the number of vomiting after 6 hours among the three groups (P = 0.01). On the other hand, significant statistical differences were found between P6 point and placebo groups in terms of the mean value of vomiting 2 and 24 hours after the surgery (P = 0.03). However, no significant statistical differences were observed between P6 and BL10 groups at any time of the study. Conclusions: Based on the findings, laser acupuncture of P6 point reduced the incidence of vomiting after strabismus surgery. Also, laser acupuncture of BL10, BL11, and GB34 points showed no significant differences in terms of the incidence of PONV when compared to P6 point. P6 point was the most effective point in controlling the incidence of PONV.

Effects of Acupressure on Sleep Quality and Psychological Distress in Nursing Home Residents: A Randomized Controlled Trial

ObjectiveTo compare the efficacy of acupressure with sham acupressure in older-adult nursing home residents presenting with poor sleep quality and psychological distress. DesignProspective, randomized, double-blind, sham-controlled trial. Setting and participantsSixty-two nursing home residents with poor sleep quality and psychological distress participated in this study. Participants were randomly assigned to an experimental group (n = 31) receiving acupressure at true acupoints (Baihui, Juque, Neiguan, Tianzhu, and Yongchung) or control group (n = 31) receiving acupressure at sham points. All participants received 20 minutes of acupressure before sleeping 3 times a week for 8 weeks. All participants were blinded to group allocation. MeasuresSleep quality and psychological distress were measured using the Pittsburgh Sleep Quality Index and the Kessler Psychological Distress scale, respectively. Both groups' outcomes were assessed by assessors blinded to group allocation at the baseline, the end of the intervention, and 1 month after the intervention. ResultsThe experimental group demonstrated significantly more improvement in sleep quality than did the control group at the end of the intervention (10.5 vs 13.3) and 1 month after the intervention (8.3 vs 14.2; both P ≤ .001). Moreover, the experimental group had lower psychological distress levels than did the control group at 1 month after the intervention (14.6 vs 17.9, P = .05). Furthermore, significant differences in mean sleep quality (F = 60.8, P < .001) and psychological distress (F = 24.6, P < .001) were observed in the experimental group between the measurements at baseline and after the intervention. ConclusionsAcupressure at true acupoints improves sleep quality, reduces psychological distress, and provides more clinically beneficial effects compared with that at sham points. Future studies should examine whether these effects are maintained in the long term.

EFFECTIVENESS OF AURICULAR THERAPY ON LABOR PAIN: A RANDOMIZED CLINICAL TRIAL

ABSTRACT Objective: to evaluate the effectiveness of auricular therapy on pain in the active phase of labor. Method: a randomized, parallel and triple-blind clinical trial, conducted from April 2015 to June 2016. A total of 102 pregnant women with a gestational age ≥37 weeks, cervical dilatation ≥4 cm and two or more contractions within 10 minutes, randomly divided into three groups: intervention (auricular therapy), placebo (sham points) and control (without intervention). Auricular therapy was applied with crystal microspheres in four strategic points and pain intensity evaluated by a Visual and Analog Scale. For the analyses, the following tests were used: Kruskal-Wallis and Generalized estimating equations. Results: pain intensity averages were similar at admission (intervention: 7.2±1.6 vs placebo: 6.9±2.4 vs control: 7.5±1.8; p-value=0.4475), but with 60 minutes (intervention: 6.8±1.9 vs placebo: 7.5±2.4 vs control: 8.3±1.8; p=0.0060) and 120 minutes (intervention: 7.1±1.9 vs placebo: 8.0±2.4 vs control: 8.8±1.9; p-value=0.039), there was a significant increase in pain scores between parturients of the placebo and control groups. Conclusion: parturients who received auricular therapy during labor showed a reduction in pain intensity, which may characterize the effectiveness of the therapy in this phase. Registration: No. RBR-47hhbj.

Electroacupuncture Reduces Body Fat by Down-regulating IL-6 and Vimentin in Abdominal White Adipose Tissue of Diet-induced Obesity Rats

To investigate the effect of electroacupuncture (EA) on IL-6 and vimentin protein expression in white adipose tissue (WAT) of diet-induced obesity (DIO) rats, so as to reveal its mechanism underlying losing weight. Thirty-four Wistar rats were randomly divided into normal (control, n＝10), model, sham-EA and EA groups (n＝8 in each of the latter 3 groups). The obesity model was established by feeding the rats with high fat diet. EA (2 Hz/15 Hz, 1 mA) was applied to bilate-ral "Zusanli "(ST 36) and "Tianshu "(ST 25) for 30 min, 5 times per week for a total of 8 weeks. For sham-EA group, two sham points (about 5 mm lateral to ST 36 and to ST 25) were only punctured with filiform needles but without electrical stimulation. Du-ring EA treatment, all rats were fed with normal fodder, and their body weight were measured once a week. Histopathologic changes (diameters of adipose cells) of abdominal WAT were observed under microscope after sectioning and H．E. staining, and the expression levels of IL-6 and vimentin in the WAT were detected by Western blot. Compared with the control group, the body weight, diameter of fat cells and the expression levels of IL-6 and vimentin in the WAT were significantly increased in the model group (P<0.05). Following EA, the body weight, diameter of fat cells and the expression levels of IL-6 and vimentin proteins were considerably down-regulated in the EA group (P<0.05), rather than in the sham-EA group relevant to the model group (P>0.05)．. EA intervention can effectively down-regulate the expression of IL-6 and vimentin in WAT of DIO rats, which may contribute to its action in reducing body fat by relieving chronic inflammation.

P3-198 - Efficacy and safety of megestrol acetate plus zusanli(ST 36) point injection in the prevention of CINV

Background: To explore the therapeutic effect on chemotherapy-induced nausea and vomitting and side effect with megestrol acetate plus zusanli(ST 36) point injection. Methods: 180 cases of NSCLC patient were randomly divided into four groups. Group control (group C) received placebo plus sham point injection. Group megestrol acetate (group M) recieved megestrol acetate plus sham point injection.Group zusanli(ST 36) point injection (group Z) received placebo plus zusanli(ST 36) point injection. Group megestrol acetate combined with zusanli(ST 36) point injection (group M+Z) received megestrol acetate plus zusanli(ST 36) point injection. Results: In the acute phase, group M+Z was effective as group M(92.9%vs93.0%, P = 0.976), and more effective than either group Z(92.9%vs69.8%, P = 0.006;93.0%vs69.8%, P = 0.006) or group C(92.9%vs70.5%, P = 0.008;88.01%vs80.58%, P = 0.007). There was no statistical difference between group Z and group C(69.8%vs70.5%, P = 0.944). The complete control rates were similar in the four groups with no significant difference(P = 0.950). In the delayed phase, group M+Z was more effective than group C, M, Z(85.7%vs29.5%, P = 0.000; 85.7%vs58.1%, P = 0.005; 85.7%vs58.1%, P = 0.005). Group M and Z were more effective than group C(58.1%vs29.5%, P = 0.007; 58.1%vs29.5%, P = 0.007). The complete control rates of group M+Z were higher than group C,M and Z(59.5%vs27.3, P = 0.003;59.5%vs27.9%, P = 0.003;59.5%vs30.2, P = 0.007). There was no statistical difference between group C, M and Z with similar complete control rates(P > 0.05). The adverse effects of each group were mild. Conclusions: Megestrol acetate plus zusanli(ST 36) point injection was shown to be effective and safe. This might be a new antiemetic option for chemotherapy.

Acupuncture and Acupressure Applied on the Extra-1 (Yintang) Acupoint in Healthy Volunteers Do Not Affect Regional Cerebral Blood Flow as Assessed by the Pulsatility Index: A Cohort Observational Study.

Objective: Acupressure applied on the Extra-1 (Yintang) point decreases bispectral index (BIS) values and stress in healthy volunteers. The current authors hypothesized that acupressure and/or acupuncture could alter regional cerebral oxygenation as expressed by middle cerebral-artery velocity. This study was conducted to test that hypothesis. Materials and Methods: After giving written informed consent, healthy volunteers received, randomly, (1) acupressure on the Extra-1 (Yintang) point, (2) acupressure on a sham point lying 2 cm over the lateral end of the right eyebrow, (3) no acupressure, or (4) modified manual acupuncture on the Extra-1 (Yintang) point. Each intervention lasted 10 minutes, except for acupuncture, which lasted for 20 minutes. The flow velocity of the left middle cerebral artery-as expressed by the Pulsatility Index (PI), heart rate (HR), and hemoglobin oxygen saturation (SpO2)-was recorded before each intervention, every 2 minutes during the intervention, and 10 and 70 minutes after the end of the intervention. A 2-MHz hand-held probe of a transcranial Doppler system (Companion II Micro TCD Nikolet Biomedical Inc., Madison, WI) was used to isolate the left middle cerebral artery via a transtemporal approach. Results: There was no difference among the four interventions at any timepoint in PI (P = 0.431; F = 0.929), HR (P = 0.948; F = 0.121), and SpO2 (P = 0.708; F = 0.465), as well as in systolic arterial pressure (P = 0.857; F = 0.255) or diastolic arterial pressure (P = 0.991; F = 0.036). Conclusions: There were no changes in PI measurements when acupuncture or acupressure was applied on the Extra-1 (Yintang) point once and for a limited time duration.

Experimental and placebo auriculotherapy for stressed nurses: randomized controlled trial.

To compare the efficacy of experimental auriculotherapy and placebo auriculotherapy with sham points for the treatment of stress in nurses of a charity hospital in São Paulo. Randomized, single-blind, controlled trial. The sample consisted of 168 nurses with medium and high stress levels according to the List of Stress Symptoms (LSS). The participants were randomized to three groups: Auriculotherapy (G1), Placebo (G2) and Control (G3). Groups 1 and 2 received 12 sessions, twice a week. The points used in Group 1 were: Shenmen and Brainstem; in Group 2 the points were: External Ear and Face Area. The three groups were evaluated at baseline, after eight sessions, 12 sessions and in a follow-up (after 15 days). Group 1 achieved a 43% reduction and a 1.81 Cohen d index (high effect), presenting statistical difference after eight sessions, maintained in the follow-up evaluation (p <0.001), according to Analysis of Variance. Group 2 achieved a 26% reduction, with Cohen's d index of 0.86 (great effect), achieving a difference after 12 sessions (p<0.001), maintained in the follow-up (p <0.05). The G3 did not present stress reduction. Experimental auriculotherapy achieved greater stress reduction among nurses, but there was no statistical difference between the two intervention groups. Brazilian Registry of Clinical Trials: RBR-req2792.

The Effect of Transcotaneus Electrical Acupoint Stimulation on Sleep Quality in Nurses

Background: Sleep problems are one of the most common health problems in people with shift jobs. Due to being awake during night, nurses face with sleep problems, resulting in impaired cognitive functioning and professional mistakes. One of the common treatments in complementary medicine is transcutaneous electrical acupoint stimulation (TEAS). The purpose of this study was to investigate the effect of TEAS on the sleep quality in nurses working shift in Kermanshah hospitals. Methods: This study was a single-blind clinical trial conducted in Kermanshah city in 2015. The research population included 36 shift nurses working in Kermanshah hospitals. Nurse’s sleep quality was evaluated by pittsburgh sleep quality questionnaire. We used “electrical stimulating acupuncture point’s machine”. The excitatory points included SP6, LI4 and HT7. Results: The results showed that there was no significant difference between Pittsburgh sleep quality index in three groups before the intervention (P > 0.05). After the intervention, the sleep quality index was significantly increased in the real points group and sham points (P < 0.001), (P = 0.016). Conclusions: The results of this study showed that electrical stimulation of acupuncture points can be effective in improving the overall index of sleep quality of shift work nurses. It is recommended that objective tools be used to study the effects of this method more precisely.

Migraine without aura treated with balance acupuncture therapy:a randomized controlled trial

To assess the effect of balance acupuncture for migraine without aura. Blind evaluation was conducted. Forty patients with migraine without aura were randomized into an observation group and a control group, 19 cases in each one with 1 patient dropped out respectively. In the observation group, Toutongxue, the middle point was used in the hollow before the 1, 2 metatarsal combination, and in the control group, a sham point was applied in the hollow before the 3, 4 metatarsal combination. The manipulation in the two groups was the same. The treatment was given for 4 weeks, once a day, 5 times a week. The comprehensive score and visual analogue scale (VAS) were used before and after treatment, as well as 4 weeks after treatment. The comprehensive score and VAS score after treatment in the observation group decreased after treatment (both P<0.05), of which the total headache time and attack number for one month were lower than those before treatment (both P<0.05), but at follow-up the VAS score was higher than that after treatment (P<0.05). The above indices in the control group were not significantly different from those before treatment (allP>0.05). All the indices in the observation group after treatment and at follow-up were lower than those in the control group (all P<0.05). The different values for the comprehensive score and VAS score before and after treatment, before treatment and at follow-up in the observation group were better than those in the control group (all P<0.05). The different values after treatment and at follow-up had no significant difference between the two groups (bothP>0.05). Balance acupuncture at Toutongxue achieves obvious effect for migraine without aura, which can relieve pain.

Nogo presence is inversely associated with shifts in cortical microglial morphology following experimental diffuse brain injury

Diffuse traumatic brain injury (TBI) initiates secondary pathology, including inflammation and reduced myelination. Considering these injury-related pathologies, the many states of activated microglia as demonstrated by differing morphologies would form, migrate, and function in and through fields of growth-inhibitory myelin byproduct, specifically Nogo. Here we evaluate the relationship between inflammation and reduced myelin antigenicity in the wake of diffuse TBI and present the hypothesis that the Nogo-66 receptor antagonist peptide NEP(1–40) would reverse the injury-induced shift in distribution of microglia morphologies by limiting myelin-based inhibition. Adult male rats were subjected to midline fluid percussion sham or brain injury. At 2h, 6h, 1d, 2d, 7d, and 21d post-injury, immunohistochemical staining was analyzed in sensory cortex (S1BF) for myelin antigens (myelin basic protein; MBP and CNPase), microglia morphology (ionized calcium-binding adapter protein; Iba1), Nogo receptor and Nogo. Pronounced reduction in myelin antigenicity was evident transiently at 1d post-injury, as evidenced by decreased MBP and CNPase staining, as well as loss of white matter organization, compared to sham and later injury time points. Concomitant with reduced myelin antigenicity, injury shifted microglia morphology from the predominantly ramified morphology observed in sham-injured cortex to hyper-ramified, activated, fully activated, or rod. Changes in microglial morphology were evident as early as 2h post-injury, and remained at least until day 21. Additional cohorts of uninjured and brain-injured animals received vehicle or drug (NEP(1–40), i.p., 15min and 19h post-injury) and brains were collected at 2h, 6h, 1d, 2d, or 7d post-injury. NEP(1–40) administration further shifted distributions of microglia away from an injury-induced activated morphology toward greater proportions of rod and macrophage-like morphologies compared to vehicle-treated. By 7d post-injury, no differences in the distributions of microglia were noted between vehicle and NEP(1–40). This study begins to link secondary pathologies of white matter damage and inflammation after diffuse TBI. In the injured brain, secondary pathologies co-occur and likely interact, with consequences for neuronal circuit disruption leading to neurological symptoms.

Changes in Esophageal Motility after Acupuncture

BackgroundChinese medicine is widely used in the East with good results for the treatment of many diseases. Acupuncture has been increasingly used and recognized as a complementary medical treatment. Some studies on gastrointestinal motility are available; however, acupuncture effect on esophageal motility is still elusive due to the lack of studies with adequate methodology. This study aims to evaluate acupuncture effect on esophageal motility. MethodsWe studied 16 (50% females, mean age 26 years) volunteers. No individual underwent acupuncture sessions previously. All individuals underwent high-resolution manometry. The test was performed in three phases: basal measurements, 20 min after acupuncture stimulation of the gastrointestinal point (ST36), or 20 min after acupuncture stimulation of a sham point (5 cm medial to ST36) (crossover). ST36 or sham points were alternated in order based on randomization. Lower esophageal sphincter (LES) resting and residual pressure, distal latency (DL) ,and distal contractility integral (DCI) were recorded. All tests were reviewed by two experienced investigators blinded to the acupuncture point. ResultsLES resting pressure was significantly reduced after acupuncture (p = 0.015, Wilcoxon signed-rank test). DL was significantly increased after acupuncture (either Sham or ST36) as compared to basal measurement. ConclusionOur results showed that acupuncture on the digestive point decreases LES basal pressure. Acupuncture may be an alternative treatment to spastic disorders of the LES.

Acupressure for nausea-vomiting and fatigue management in acute lymphoblastic leukemia children

Context: Chemotherapy induced nausea vomiting and fatigue are prevalent problems following chemotherapy and pharmacologic methods are moderately efficient in alleviating them. Acupressure is a substitute approach. Aims: This paper sought to determine the effectiveness of acupressure application in relieving nausea vomiting and fatigue among children with acute lymphoblastic leukemia in compression with a placebo treatment. Settings and Design: In this single blind, randomized, placebo controlled clinical trial, 120 hospitalized school age children with ALL, randomly divided into experimental and placebo groups. Subjects rated the intensity of nausea and fatigue by visual analog scales. Material and Methods: In the experimental group, finger acupressure on p6 and ST36 (true points) and in the placebo group on SI3 and LI12 (sham points) was applied. Symptoms of nausea and fatigue intensity immediately and an hour postintervention evaluated. Then variable of nausea vomiting and Fatigue was also measured 12 h postintervention by the instruments of Adapted Rhodes Index of Nausea and Vomiting for Pediatrics by Child and Fatigue Scale Child, Respectively. Statistical Analysis Used: Data were analyzed by SPSS version 16.0. Results: Significant differences were observed between two groups based on the fatigue and nausea intensity immediately and an hour postintervention with confidence interval 95% and P Conclusions: Applying one time acupressure may reduce the intensity of nausea immediately postintervention and fatigue and nausea at one hour post treatment. Hence, acupressure could be recommended as a helpful, nonpharmacologic method for some cancer related fatigue and chemotherapy induced nausea vomiting management.

Long-term acupuncture treatment has a multi-targeting regulation on multiple brain regions in rats with Alzheimer's disease: a positron emission tomography study.

The acute effect of acupuncture on Alzheimer's disease, i.e., on brain activation during treatment, has been reported. However, the effect of long-term acupuncture on brain activation in Alzheimer's disease is unclear. Therefore, in this study, we performed long-term needling at Zusanli (ST36) or a sham point (1.5 mm lateral to ST36) in a rat Alzheimer's disease model, for 30 minutes, once per day, for 30 days. The rats underwent 18F-fluorodeoxyglucose positron emission tomography scanning. Positron emission tomography images were processed with SPM2. The brain areas activated after needling at ST36 included the left hippocampus, the left orbital cortex, the left infralimbic cortex, the left olfactory cortex, the left cerebellum and the left pons. In the sham-point group, the activated regions were similar to those in the ST36 group. However, the ST36 group showed greater activation in the cerebellum and pons than the sham-point group. These findings suggest that long-term acupuncture treatment has targeted regulatory effects on multiple brain regions in rats with Alzheimer's disease.

Photoacoustic microscopy of electronic acupuncture (EA) effect in small animals.

Acupuncture has been an effective treatment for various pain in China for several thousand years. However, the mechanisms underlying this mysterious ancient healing are still largely unknown. Here we applied photoacoustic microscopy (PAM) to investigate brain hemodynamic changes in response to electronic acupuncture (EA) at ST36 (Zusanli). Due to the high optical absorption of blood at 532nm, PAM could sensitively probe changes in hemoglobin concentration (HbT, i.e., cerebral blood volume [CBV]) of cortical regions in high resolution. Six healthy mice were stimulated at the acupoint and three healthy mice were stimulated at sham points. Remarkable CBV changes in sensorimotor and retrosplenial agranular cortex were observed. Results showed the potential of PAM as a visualization tool to study the acupuncture effect on brain hemodynamics in animal models. (a) Schematic showing the stimulation points. (b) B-scan images overlaid with mouse atlas. (c) & (d) Statistical results of CBV changes from cortical regions.

Laser acupuncture reduces pain in pediatric kidney biopsies: a randomized controlled trial.

Evaluate laser acupuncture (LA) as an adjuvant therapy in pain management during percutaneous kidney biopsy procedure in children and adolescents. This prospective, double-blinded, randomized controlled trial enrolled patients aged 7 to 26 years admitted to a children's hospital for percutaneous kidney biopsy. Patients received LA to treatment points (acupuncture group) or sham points (control group) before the procedure. The laser delivered a dose of 42 J/cm over 10 acupoints. Patients and parents rated the pain during and after the biopsy, and change in pain scores were calculated for each patient. Anxiety, vital signs, sedation medication, and patient's biopsy experience were secondary outcomes. Sixty-nine treatments (33 in the acupuncture group and 36 in the control group) were eligible for analysis. Patients in the acupuncture group reported a significantly improved change in the pain score after the biopsy compared with the controls (0.8 vs -0.5, P = 0.044). Patients in the acupuncture group had a statistically significant decrease in procedure vital signs including heart rate (-1.8 vs 5.6, P = 0.043) and respiratory rate (-2.4 vs 0.4, P = 0.045) when compared with controls. Parents also perceived a correspondingly greater improvement in their child's pain for those in the acupuncture group compared with the controls (2.3 vs 0.3, P = 0.04). Adjunctive LA significantly improved pain after pediatric percutaneous kidney biopsies.