Therapeutic Effect Of Acupuncture Research Articles

The therapeutic effect of acupuncture on neurocognitive disorders under the concept of outcome based education

BackgroundThe neurocognitive disorder is a common neuropsychological disease characterized by impaired cognitive function, attention deficit, and memory loss. With the aging of the population and lifestyle changes, the prevalence of neurocognitive disorders is on the rise, seriously affecting patients’ quality of life. Acupuncture therapy, an essential part of traditional Chinese medicine, has shown potential therapeutic effects in treating neurocognitive disorders.Subjects and MethodsThe outcome based education concept was incorporated into acupuncture therapy to explore its therapeutic effect on neurocognitive disorders. The study included 50 neurocognitive-impaired patients, 25 of whom received acupuncture therapy under the outcome based education concept as an experimental group. The other 25 served as a control group and received traditional Chinese acupuncture treatment. The experiment lasted three months, and the 3-minute Delirium Diagnostic Scale (3D-CAM) was used to measure the level of consciousness, mental clarity, attention, and delirium characteristics.ResultsAfter receiving acupuncture therapy under the outcome based education concept, most of the patients in the experimental group had a lower risk of delirium, and their attention, thinking, and consciousness levels were significantly improved. Patients in the control group generally had a higher risk of delirium, difficulty concentrating, and memory loss.ConclusionsThe study proposed that the outcome based education concept in acupuncture therapy has a more noticeable effect on treating neurocognitive disorders. At the same time, this study’s results will help reveal the mechanism of acupuncture therapy in treating neurocognitive disorders and provide guidance for clinical practice.AcknowledgementThe research is supported by the Key R&D project of Hainan Province (No.zdyf2019191).

Role of Acupuncture in Oral Medicine: A Review

Acupuncture is an alternative or complementary form of treatment. Acupuncture may be used in management of temporomandibular disorders, bell palsy, dental pain, xerostomia and various other disorders. Though there are studies which prove the efficacy of acupuncture, the exact mechanism behind the therapeutic effect of acupuncture is not known. Hence it is not used very frequently in oral medicine or dental practice. Further studies with larger sample size are required to understand other areas were acupuncture can be used.

Acupuncture combined with exercise training at different time points on nerve repair of cerebral ischemia-reperfusion injury in rats and its effects on the expressions of Nestin, bFGF and EGF.

The aim of the study was to observe the neuroreparative effect of electroacupuncture in rats with cerebral ischemia-reperfusion injury, and to explore the difference in the therapeutic effect of acupuncture on different acupoint groups after cerebral ischemia-reperfusion. Experimental rats were randomly divided into: sham operation group, model group, electroacupuncture group, rehabilitation group, and Diankang group (electroacupuncture + rehabilitation training). There were 24 rats in each group, and the focal cerebral ischemia-reperfusion model was established by Zea-Longa suture method. After modeling, it took 4 hours to electroacupuncture at Baihui and Dazhui points, which was used to observe the changes of nerve function in rats with signs of keel nerve function defect. Protein expression was detected by immunohistochemistry. Compared with the model group, the EA 3d, 7d, 10d groups and the rehabilitation group had no significant difference in promoting the expression of Nestin (p>0.05). There was a significant difference (p<0.01). After cerebral ischemia-reperfusion injury, the expression of bFGF and EGF on the ischemic side was stronger. The peak of bFGF expression appeared earlier, and the peak of EGF expression appeared later. The expression of bFGF and EGF in cerebral ischemic cortex at different time points of ischemia in electroacupuncture group, rehabilitation group and Diankang group was increased, and the response was enhanced. The effect of Diankang group on the upregulation of bFGF and EGF was more significant (p<0.01, p<0.05). Under the influence of different effects, Diankang is superior to simple treatment in improving ischemic neurological dysfunction. This may be related to the fact that Diankang can promote the proliferation of neural stem cells and the expression of neurotrophic factors on the ischemic side of the rat brain.

Acupuncture Alleviates Corneal Inflammation in New Zealand White Rabbits with Dry Eye Diseases by Regulating α7nAChR and NF-κB Signaling Pathway.

The purpose of this study is to determine the mechanism of improvement in dry eye diseases (DEDs) treated by acupuncture. The inflammatory molecules and related pathways will be analyzed in our study. In order to establish the animal model for DEDs, healthy New Zealand white rabbits were treated with scopolamine (Scop) hydrobromide for 21 consecutive days. After 21 days, acupuncture, fluorometholone (Flu), and α7nAChR antagonist (α-BGT) treatments were performed, and the Scop injections were continued until day 35. The therapeutic effect of acupuncture on DED inflammation was evaluated by corneal fluorescence staining, tear film rupture time, tear flow measurement, in vivo confocal microscopy (IVCM), corneal histopathology, and cytokine protein chip technology. The influence of acupuncture on the corneal pathology and inflammatory factors ACh, α7nAChR, and NF-κB was detected by enzyme-linked immunosorbent assay (ELISA) and western blot. Compared with the group Scop, acupuncture can significantly reduce corneal staining and increase the tear film rupture time and tear flow, which are accompanied by a decrease in corneal epithelial detachment and lymphocyte infiltration. Acupuncture can relieve the inflammation of corneal stroma and mitigate the expression of proinflammatory factors and chemokines. Acupuncture can upregulate the expression of ACh and α7nAChR and downregulate the expression of NF-κB. Our findings demonstrate that acupuncture can alleviate corneal inflammation in New Zealand white rabbits with DEDs via α7nAChR and NF-κB signaling pathway regulation. The expression indicates that α7nAChR/NF-κB signaling pathway may be active and that acupuncture is a potential therapeutic target for dry eye.

Therapeutic effect of acupuncture and moxa combustion on prostate hyperplasia.

Introduction:Both acupuncture and moxibustion have been used for thousands of years in China for diverse conditions. But there are few reports on their combined effect in managing benign prostatic hyperplasia (BPH). To answer this question, we designed a prospectively study and the present protocol described details of this randomized controlled trial (RCT).Methods:In this RCT, an estimated number of 200 patients with BPH will be enrolled from Shanghai Fourth People’s Hospital, China. They will be assigned to either the combined therapy group or the conventional western medicine group in a ratio of 1:1. The International Prostate Symptom Score (IPSS) will be assessed as the primary outcome, other parameters, including the post-voiding residual urine volume, maximum flow rate (Qmax), and average flow rate (Qave), voiding time, and time to maximum flow, are secondary outcomes.Discussion:Results of this study will provide the theoretical basis for clinicians to select combined therapy or conventional western medicine treatments for BPH patients based on the efficacy of these therapies.Trial registration:chictr.org.cn, ID: ChiCTR2000030504/ChiMCTR2000003082. http://www.chictr.org.cn/edit.aspx?pid=47719&htm=4, Registered on 5th March 2020.

Potential mechanisms of acupuncture for neuropathic pain based on somatosensory system.

Neuropathic pain, caused by a lesion or disease of the somatosensory system, is common and distressing. In view of the high human and economic burden, more effective treatment strategies were urgently needed. Acupuncture has been increasingly used as an adjuvant or complementary therapy for neuropathic pain. Although the therapeutic effects of acupuncture have been demonstrated in various high-quality randomized controlled trials, there is significant heterogeneity in the underlying mechanisms. This review aimed to summarize the potential mechanisms of acupuncture on neuropathic pain based on the somatosensory system, and guided for future both foundational and clinical studies. Here, we argued that acupuncture may have the potential to inhibit neuronal activity caused by neuropathic pain, through reducing the activation of pain-related ion channels and suppressing glial cells (including microglia and astrocytes) to release inflammatory cytokines, chemokines, amongst others. Meanwhile, acupuncture as a non-pharmacologic treatment, may have potential to activate descending pain control system via increasing the level of spinal or brain 5-hydroxytryptamine (5-HT), norepinephrine (NE), and opioid peptides. And the types of endogenously opioid peptides was influenced by electroacupuncture-frequency. The cumulative evidence demonstrated that acupuncture provided an alternative or adjunctive therapy for neuropathic pain.

Electroacupuncture remodels the extracellular matrix and promotes synaptic plasticity in a mouse model of depression

Depression is a chronic and recurrent disease without satisfactory treatment strategies. The therapeutic effect of acupuncture is well known in Traditional Chinese medicine (TCM) due to its unique non-pharmacological nature. Electroacupuncture (EA) for antidepressant therapy has been widely recognized and used in clinic. In this study, the lipopolysaccharide (LPS)-induced depression mice model was used to evaluate the anti-depressant effects of EA treatment. Open Field Test (OFT), Force Swimming Test (FST), and Sucrose Preference Test (SPT) were utilized to detect the ethological alterations in mice. The transcriptology technique was used to evaluate the changes in the hippocampal transcriptome in different groups. We measured protein levels using Western blot and immunohistochemistry. Our data showed that LPS induced ethological alterations in mice and enhanced the gene expression related to gene ontology such as the banded collagen fibril, fibrillar collagen trimer, and collagen fibril organization, pathways such as collagen chain trimerization, collagen biosynthesis and modifying enzymes, and collagen formation. EA could reverse the ECM deposition by inhibiting collagen type Ⅳ trimer, extracellular matrix organization, and collagen formation. EA could enhance the MMP1 and MMP9 expression and promote synaptic plasticity. These data indicated that EA possesses an antidepressant effect, this may achieve by increasing MMPs expression and then remodeling the ECM surrounding the neurons, ultimately repairing neural circuits and promoting synaptic plasticity.

Effects of Acupuncture on Cortical Activation in Patients with Disorders of Consciousness: A Functional Near-Infrared Spectroscopy Study

Background Disorder of consciousness (DoC) is a clinical condition caused by severe brain damage. Some studies have reported that acupuncture, a traditional Chinese treatment, could facilitate the recovery of the patient's consciousness. The therapeutic effects of acupuncture may be due to its modulation of facilitating cortex (PFC) activity, but it has not been greatly demonstrated. Objectives We intended to observe the effects of acupuncture on prefrontal cortical activity, explore the potential correlation between cortical activation and the severity of DoC, and analyze the functional brain network connectivity to provide a theoretical basis for its application in clinical practice. Methods Participants diagnosed with DoC were included in the study. Before the intervention, we assessed the patient's state of consciousness using relevant scales, such as the Glasgow coma scale (GCS) and the coma recovery scale-revised (CRS-R). All patients received acupuncture manipulation with the functional near-infrared spectroscopy (fNIRS) system monitored. Result A total of 16 subjects participated in our study. We observed that the concentration of oxygenated hemoglobin (HbO) in the PFC was increased during the acupuncture manipulation and declined during the resting state. Then, the connection strength of the left cerebral cortex was generally higher than that of the right. Finally, we observed only a weak difference in hemodynamic responses of PFC between the vegetative state (VS) and minimally conscious state (MCS) groups. However, the difference was not statistically significant. Conclusion Our results indicated that acupuncture can increase the concentration of HbO in the PFC and strengthen the connection strength of the left cerebral cortex. However, our present study did not find a significant correlation between the cortical hemodynamic response and the severity of DoC.

The therapeutic effect of acupuncture combined with joint mobilization on periarthritis of the shoulder

Objective: To explore the therapeutic effect of acupuncture combined with joint mobilization in the treatment of periarthritis of the shoulder. Methods: According to the random number table method, 46 patients with periarthritis of the shoulder were randomly divided into two groups, with 23 patients in each group. Acupuncture combined with joint mobilization (combination group) and acupuncture alone (control group) were used respectively. The visual analogue scale (VAS), range of motion (ROM), and efficacy were evaluated before treatment, 4 weeks after treatment, and 8 weeks after treatment in each group. The therapeutic effect, pain, and changes in shoulder joint function were compared between the two groups. Results: After 4 weeks of treatment, the VAS scores of patients in both groups were lower than before treatment and the combination group improved better than the control group (P&lt;0.05); the ROM scores of patients in both groups were higher than before treatment and the combination group scored higher than the control group in the forward flexion, back extension and abduction directions (P&lt;0.05); after 8 weeks of treatment, the VAS scores of patients in both groups were lower than before treatment and 4 weeks of treatment and the combination group improved better than the control group (P&lt;0.05); the ROM scores of patients in both groups were higher than those before and at 4 weeks of treatment, and the scores in all directions in the combination group were higher than those in the control group (P&lt;0.05). Conclusion: Acupuncture combined with joint mobilization can better alleviate the pain of patients with periarthritis of the shoulder, and can also more effectively improve the limitation of shoulder joint activity and improve its function

Effect of Acupuncture on Oxidative Stress and Inflammation: From Mechanisms to Therapeutic Applications

Inflammation is a common feature of disorders affecting various systems in the body, and oxidative stress can lead to an imbalance in the cellular metabolism and impaired regeneration of injured tissue. The therapeutic effect of manual acupuncture and electroacupuncture has long been studied. In this study, we conducted a literature review focusing on oxidative stress and inflammation and the therapeutic effect of acupuncture on pathological pathways. Our results reveal that through a novel light therapy technique, manual acupuncture and electroacupuncture can be combined to provide an alternative method for optimizing their therapeutic effects.

Effects of acupuncture treatment on postoperative gastrointestinal dysfunction in colorectal cancer: study protocol for randomized controlled trials

BackgroundPostoperative gastrointestinal dysfunction (PGID) is a common complication arising from colorectal cancer surgery. Attributing factors, such as anesthesia, surgical retraction, and early intake of water, can inhibit gastrointestinal motility, causing constipation, reduction or absence of bowel sounds, nausea, vomiting, and other symptoms. Delayed recovery in gastrointestinal function can lead to intestinal obstructions or paralysis, anastomotic leaks, and other complications, affecting the patient’s recovery and quality of life negatively. Due to its complex pathophysiology, treatment for PGID in colorectal patients has remained a challenge. Acupuncture is an alternative therapy commonly used for postoperative recovery. This study aims to evaluate the therapeutic efficacy and safety of acupuncture on PGID. Through the complementation of acupuncture and enhanced recovery after surgery (ERAS) protocols, the advantages of acupuncture treatments could be demonstrated to promote its application in future clinical practice.MethodsThe study design is a prospective randomized controlled trial (RCT). One hundred sixty postoperative colorectal cancer patients will be recruited from Cancer Hospital Chinese Academy of Medical Sciences (CICAMS). Subjects who fulfill inclusion criteria will be randomly assigned into the acupuncture group (AG) (n = 80) or control group (CG) (n = 80). AG will receive acupuncture treatment and perioperative care guided by ERAS protocols, and CG will only receive perioperative care guided by ERAS protocols. The intervention will begin on the first day post-surgery, continuing for 4 days, with a follow-up assessment in a month. Time of first postoperative flatus would be the primary outcome measure. Secondary outcome measures include the time of first postoperative defecation, time of first fluid intake, time of first ambulation, postoperative hospital stay, gastrointestinal reaction score, acupuncture sensation evaluation scale, laboratory tests, postoperative quality of life, readmission rate, and postoperative complications. All results are evaluated from baseline, post-treatment, and upon follow-up.DiscussionThe results of the study would help elucidate evidence of the therapeutic effects of acupuncture on the recovery of postoperative gastrointestinal function. The objective of the study aims for the eventual inclusion of acupuncture in the ERAS protocol, allowing for wider application in clinical practice.Trial registrationClinicalTrials.gov ChiCTR2000036351. Registered on August 22, 2020

Potential Mechanisms of Acupuncture for Functional Dyspepsia Based on Pathophysiology.

Functional dyspepsia (FD), a common disorder of gastrointestinal function, originated from the gastroduodenum. Although the therapeutic effect of acupuncture has been investigated by various high-quality randomized controlled trials, the potential mechanisms showed obvious heterogeneity. This review summarized the potential mechanisms of acupuncture on FD in order to guide for future laboratory and clinical studies. Here, we argued that the primary cause of FD was gastroduodenal low-grade inflammation and acid exposure, which impaired mucosal integrity, caused brain-gut axis dysfunction, and impaired brain network connectivity, all of which generated various symptom patterns. Overall the clinical studies indicated that acupuncture was a promising treatment to alleviate symptoms in FD patients, whose efficacy was influenced by acupoints and individual variance. Mechanistically, studies with animal models of FD and patients have shown that acupuncture, a non-invasive strategy for nerve stimulation, may have the potential to control intestinal inflammation and suppress acid-secretion via different somatic autonomic reflex pathways, regulate the brain-gut axis through intestinal microbiota, and has the potential to ameliorate FD-symptoms. The cumulative evidence demonstrated that acupuncture is a promising treatment to alleviate symptoms of FD patients.

[Acupuncture regulates PI3K/Akt/mTOR signaling and up-regulates cell autophagy to protect sy-novial tissue of adjuvant arthritis rats].

To observe the effect of acupuncture of "Yinlingquan"(SP9) and "Sanyinjiao"(SP6) on expression of phosphatidylinositol-3 kinase/protein kinase B/mammalian target protein of rapamycin (PI3K/Akt/mTOR) signaling in adjuvant arthritis (AA) rats, so as to explore its mechanism underlying improvement of AA. Forty-eight male Wistar rats were randomly divided into normal control, AA model, acupuncture and medication (tripterygium wilfordii) groups, with 12 rats in each group. The AA model was established by putting the rats in a windy, cold and wet environment for 12 h, once every day for 21 days and injection of Freund's complete adjuvant (CFA) into the sole of the right hindlimb on the 21st day. Manual acupuncture stimulation was applied at SP9 and SP6 for 30 min/time, once a day for 21 days. Rats of the medication group received gavage of tripterygium wilfordii tablets solution (8 mg/kg), once a day for 21 days, and those of the normal control group and model group received gavage of the same amount of normal saline, once a day for 21 days. The degree of joint swelling and arthritis index (AI) were detected 1 day before modeling, 3 days after modeling, and 21 days after the treatment. Twenty-four hours after the last treatment, the contents of serum cytokines interleukin (IL)-17, IL-6 and tumor necrosis factor (TNF)-α were detected by enzyme-linked immunosorbent assay (ELISA); and changes of synovial ultrastructure were observed under electron microscope. Western blot was used to detect the expression levels of PI3K, Akt, phosphorylated protein kinase B (p-Akt), phosphorylated mammalian rapamycin target protein (p-mTOR), mTOR, microtubule associated protein 1 light chain 3B (LC3-Ⅱ) and mammalian atg6 homologous protein (Beclin-1) in the synovial membrane tissue. Compared with the normal control group, the joint swel-ling degree and AI, contents of serum TNF-α, IL-6 and IL-17, and the expression levels of PI3K, Akt, p-Akt, mTOR and p-mTOR in the synovium were increased in the model group (P<0.05), while the expression levels of LC3-Ⅱ and Beclin-1 proteins in the synovium were significantly decreased (P<0.05). Compared with the model group, the joint swelling degree and AI, contents of serum TNF-α, IL-6 and IL-17, and the expression levels of PI3K, Akt, p-Akt, mTOR and p-mTOR were significantly decreased in the acupuncture and medication groups (P<0.05), while the expresion levels of LC3-Ⅱ and Beclin-1 proteins were significantly increased （P<0.05）. Comparison between the two treatment groups showed that the therapeutic effects of acupuncture were obviously weaker than those of medication in down-regulating TNF-α and IL-6, Akt, p-Akt and mTOR levels (P<0.05) and in up-regulating Beclin-1 expression (P<0.05). Outcomes of electron microscope displayed widened nuclear membrane space, some fractured mitochondrial cristae with vacuoles, expanded rough endoplasmic reticulum, reduction of autophagosomes in the cytoplasm and ruptured synovial cell membrane in the model group, and increase of autophagosomes, deformed organelles in the acupuncture and medication groups. Acupuncture can relieve the inflammatory reactions and joint synovial injury of the affected joint in AA rats which may be associated with its effects in inhibiting PI3K/Akt/mTOR signaling and increasing the auto-phagy level of synovial cells.

Low-Dimensional Dynamics of Brain Activity Associated with Manual Acupuncture in Healthy Subjects.

Acupuncture is one of the oldest traditional medical treatments in Asian countries. However, the scientific explanation regarding the therapeutic effect of acupuncture is still unknown. The much-discussed hypothesis it that acupuncture’s effects are mediated via autonomic neural networks; nevertheless, dynamic brain activity involved in the acupuncture response has still not been elicited. In this work, we hypothesized that there exists a lower-dimensional subspace of dynamic brain activity across subjects, underpinning the brain’s response to manual acupuncture stimulation. To this end, we employed a variational auto-encoder to probe the latent variables from multichannel EEG signals associated with acupuncture stimulation at the ST36 acupoint. The experimental results demonstrate that manual acupuncture stimuli can reduce the dimensionality of brain activity, which results from the enhancement of oscillatory activity in the delta and alpha frequency bands induced by acupuncture. Moreover, it was found that large-scale brain activity could be constrained within a low-dimensional neural subspace, which is spanned by the “acupuncture mode”. In each neural subspace, the steady dynamics of the brain in response to acupuncture stimuli converge to topologically similar elliptic-shaped attractors across different subjects. The attractor morphology is closely related to the frequency of the acupuncture stimulation. These results shed light on probing the large-scale brain response to manual acupuncture stimuli.

Abstracts from Society for Acupuncture ResearchPandemics, Pain, &amp; Public Health:Roles and Relevance of Traditional East Asian MedicineJune 14–17, 2021

The Journal of Alternative and Complementary MedicineAhead of Print AbstractsFree AccessAbstracts from Society for Acupuncture ResearchPandemics, Pain, & Public Health:Roles and Relevance of Traditional East Asian MedicineJune 14–17, 2021Published Online:8 Oct 2021https://doi.org/10.1089/acm.2021.29097.abstractsAboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail Featured Poster AbstractsA.32 A SYSTEMATIC REVIEW OF ACUPUNCTURE THERAPIES FOR RECURRENT URINARY TRACT INFECTIONS IN WOMENMeaghan Coyle, RMIT University; Xindong Qin, Guangdong Provincial Hospital of Chinese Medicine; Jueyao Liang, Guangdong Provincial Hospital of Chinese Medicine; Lihong Yang, Guangdong Provincial Hospital of Chinese Medicine; Kaiyi Wang, RMIT University; Xinfeng Guo, Guangdong Provincial Hospital of Chinese Medicine; Anthony Lin Zhang, RMIT University; Wei Mao, Guangdong Provincial Hospital of Chinese Medicine; Chuanjian Lu, Guangdong Provincial Hospital of Chinese Medicine; Charlie C Xue, RMIT University; Xusheng Liu, Guangdong Provincial Hospital of Chinese MedicineIntroduction and Aims: Recurrent urinary tract infections are estimated to affect 30–44% of women. Antibiotics are effective for alleviating the symptoms of acute infections and are recommended to prevent recurrence, but antibiotic resistance remains a global challenge. Acupuncture has been suggested in clinical practice guidelines as an alternative option to prevent recurrent urinary tract infections in women based on the results of two clinical trials. This systematic review determined the efficacy and effectiveness of acupuncture therapies for recurrent urinary tract infections.Methods: Nine English and Chinese databases were searched from inceptions to February 2019. Randomised controlled trials that evaluated acupuncture‐related therapies for the management or prevention of uncomplicated UTI were included. Data were extracted, risk of bias was assessed and adherence to the Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA) guidelines was determined. The primary outcomes were composite cure (defined as a resolution of symptoms and/or negative urine culture) and recurrence. Meta‐analysis used risk ratio (RR) for dichotomous outcomes and mean difference (MD) for continuous outcomes, with 95% confidence intervals (CI).Results: Five randomised controlled trials were included; three recruited women with acute infections and two tested acupuncture as a preventative treatment. Information relating to STRICTA items ‘details of needling’, ‘treatment regimen’ and ‘control or comparator interventions’ were generally reported well. For women with acute infection, acupuncture therapies increased the chance of a composite cure more than antibiotics (RR 1.92 [95% CI 1.31, 2.81], I2 = 38%). Fewer instances of recurrence were reported with acupuncture compared to sham acupuncture (RR 0.45 [95% CI 0.22, 0.92]) and no treatment (RR 0.39 [95% CI 0.26, 0.58], I2 = 0%).Conclusions: Acupuncture may have a role to play in reducing reliance on antibiotics for women with recurrent urinary tract infections, but more research is needed to guide clinical decision‐making.A.14 ACUPUNCTURE DECREASED THE RISK OF CORONARY HEART DISEASE IN PATIENTS WITH OSTEOARTHRITIS IN TAIWAN: A NATIONWIDE MATCHED COHORT STUDYGil Ton, Graduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan.; Hung‐Rong Yen, College of Chinese Medicine, Graduate Institute of Chinese Medicine, China Medical University, Taichung, Taiwan; Yu‐Chen Lee, Graduate Institute of Acupuncture Science, China Medical University, Taichung, TaiwanObjectives: Patients with osteoarthritis (OA) are more likely to develop coronary heart disease (CHD) than the general population. Acupuncture is commonly used in OA patients however, the therapeutic effect of acupuncture on the risk of CHD in patients with OA and the association between OA patients and their risk to develop CHD in Taiwan are unknown. We investigated the risk of CHD according to acupuncture use in OA patients and compared it with the general population.Design: Records obtained from Taiwan's National Health Insurance Research Database identified 84773 patients with OA, which were compared with 727,359 patients without OA diagnosis. 5046 of whom met study inclusion criteria, had 1:1 frequency matching and were categorized as OA‐acupuncture cohort (n = 1682) OA non‐acupuncture cohort (n = 1682) and non‐OA cohort (n = 1682). Cox proportional hazards regression analysis determined the risk of CHD, which was defined as the study main outcome. Therapeutic effects of acupuncture and medical expenditure were also analyzed.Results: OA non‐acupuncture cohort had 3.04 higher risk to develop CHD compared with OA‐acupuncture cohort (95% CI 2.54‐3.63 p < 0.001) and non‐OA cohort had 1.88 higher risk to develop CHD compared with OA‐acupuncture cohort (95% CI 1.52‐2.32 p < 0.001). In subgroup analyses, OA patients treated with both acupuncture and oral steroids were at significantly lower risk of CHD compared with those who used neither (aHR; 0.34 95% CI, 0.22‐0.53), and OA patients treated with acupuncture had the lowest medical expenditure in a follow‐up time of 6 months, 3 and 5 years.Conclusion: This is the first large‐scale investigation in Taiwan that shows the association between OA and CHD and the beneficial effects of acupuncture in OA patients and their associated risk to develop CHD. Our results may provide valuable information for health policy decision making. Further randomized controlled trials are needed to confirm these observational findings.A.36 ACUPUNCTURE FOR CHEMOTHERAPY‐ASSOCIATED INSOMNIA IN BREAST CANCER PATIENTS: A PILOT RANDOMIZED CONTROLLED TRIALJialing Zhang, University of Hong Kong; Zongshi Qin, University of Hong Kong; Tsz Him So, University of Hong Kong; Haiyong Chen, University of Hong Kong; Lixing Lao, University of Hong Kong; Zhangjin Zhang, University of Hong KongObjective: Chemotherapy‐associated insomnia is a highly prevalent complaint in breast cancer patients. This study was undertaken to evaluated the feasibility, preliminary efficacy and safety of acupuncture for chemotherapy‐associated insomnia in breast cancer patients. This pilot study would provide useful information for designing a larger clinical trial.Methods: In this randomized, assessor‐blinded, wait‐list controlled trial, 30 breast cancer patients with insomnia under or post chemotherapy were randomly allocated to either the acupuncture group (n = 15) or the wait‐list control group (n = 15). Participants in the acupuncture group received acupuncture treatment (electroacupuncture plus auricular acupressure) twice a week for 6 weeks. Participants from the wait‐list control group received the same regime of acupuncture treatment after the 6‐week of waiting period. The Insomnia Severity Index (ISI) served as the primary outcome measurement. Depression, anxiety, multidimensional health‐related quality of life (QoL) were also evaluated. A linear mixed‐effects models were used for analyses.Results: Twenty‐eight participants completed study (13 in the acupuncture group versus 15 in the wait‐list control group). At week‐6 post‐intervention, ISI score change from baseline showed significant between‐group difference favoring acupuncture group of −2.9 points (95% CI: −5.2 to −0.6, P = 0.014). The acupuncture group showed greater improvements in the total sleep time (P = 0.026), scores of PSQI (P = 0.012), HADS‐depression (P = 0.020), and FACT‐B (P < 0.001) compared with the control group. Improvements were maintained at week‐10 and week‐14 follow‐ups.Conclusions: Acupuncture treatment was a feasible, acceptable, safe and effective intervention for chemotherapy‐associated insomnia in breast cancer patients under or post chemotherapy. A larger sample size randomized clinical trial is warranted to confirm the present findings.Trial registration: Clinicaltrials.gov: NCT03762694.A.51 AURICULAR ACUPRESSURE FOR PATIENTS WITH EMOTIONAL DISTRESS UNDER THE COVID‐19 PANDEMIC: A RANDOMIZED CONTROLLED TRIALPeijing Rong, Institute of Acu.‐Moxi., China Academy of Chinese Medical Sciences; Lei Wang, Institute of Acu.‐Moxi., China Academy of Chinese Medical Sciences; Lingling Yu, Tongji Hospital of Tongji Medical College; Junying Wang, Institute of Acu.‐Moxi., China Academy of Chinese Medical SciencesPurpose: To confirm whether self‐administered AVNA treatment is effective in improving emotional distress under the COVID‐19 pandemic.Methods: A smartphone‐based online, randomized, controlled trial was designed from 26 February 2020 to 28 April 2020 in four study sites, including Wuhan, Beijing, Shenyang, and Guangzhou of China. Local residents who had considerable emotional distress with a score of the Hospital Anxiety and Depression Scale (HADS) ≥9 were recruited. Participants were randomly assigned to three times of AVNA (n = 191) per day, in morning, around noon, and in evening or usual care (UC, n = 215) once daily for 14 days. The primary outcome was the response rate, which was the proportion of participants whose Hospital Anxiety and Depression Scale (HADS) score reduced from baseline by ≥50%. The assessment was conducted at baseline, 3 days, and 14 days.Results: The AVNA group had a markedly higher response rate than the UC group at 3 days (35.6% vs. 24.9%, P = 0.02) and at 14 days (70.7% vs. 60.6%, P = 0.02). The AVNA group showed significantly greater reduction in scores of HADS at the two measurement points and BAI at 3 days (P ≤ 0.03), with average respective effect size of 0.217 and 0.195. Participants with AVNA spent less time falling asleep and rated their sleep quality being remarkably higher than those with UC at endpoint.Conclusion: During COVID‐19 pandemic period, treatment with self‐administrated AVNA was more effective than UC in reducing emotional distress of isolated populations. These findings support self‐administered AVNA as a treatment option for patients with emotional distress under the COVID‐19 pandemic or other emergent events.A.56 COMPARISON BETWEEN VAGAL NERVE STIMULATION AND ELECTROACUPUNCTURE AT ST‐36 FOR TREATING OPIOID‐INDUCED CONSTIPATION IN RATSYiling Zhang, Beijing University of Chinese Medicine; Li Cui, Johns Hopkins University; Xue Lin, Johns Hopkins University; Jiande Chen, University of MichiganAims: Constipation and opioid‐induced constipation (OIC) are high prevalence with limited therapies. We investigated the effects of electroacupuncture (EA) at ST‐36 on OIC in rats and compared its performance with vagal nerve stimulation (VNS).Methods: Acute study: 8 rats implanted with electrodes at the sub‐diaphragmatic vagal nerve for VNS and another 8 rats implanted with electrodes at acupoints ST‐36 for EA. All rats were also implanted with a catheter in the proximal colon for assessing whole colon transit. Chronic study: 30 rats were treated daily with loperamide for 7 days to induce OIC then divided into three groups (N = 10 each) treated with daily EA, VNS and sham‐stimulation for a week, respectively. Feces were collected daily. Whole gut transit time (WGTT) and distal colon transit time (dCTT) were measured.Results: 1) Both VNS and EA at ST‐36 accelerated the whole colon transit (Fig.1) and no difference between the two; 2) Chronic VNS increased the number of daily fecal pellets (39 ± 5 vs. 28 ± 4, P < 0.05, VNS vs. sham‐VNS), wet weight of daily fecal pellets (6.5 ± 0.8 g vs. 4.5 ± 0.4 g, P < 0.05, VNS vs. sham‐VNS), and water content in feces (31.0 ± 2.8 % vs. 20.4 ± 3.6 %, P < 0.05, VNS vs. sham‐VNS). EA at ST‐36 showed similar effects and no difference between the two. 3) Both chronic VNS and EA at ST‐36 shortened WGTT (10.0 ± 1.1 h vs. 12.5 ± 2.3 h, P < 0.05, EA vs. sham‐VNS) and dCTT (17.7 ± 0.7 min vs. 25.0 ± 2.3 min, P < 0.05, EA vs. sham‐VNS); there was no significant difference between the two.Conclusions: EA at ST‐36 improves constipation by enhancing gastrointestinal motility and its effect is as effective as VNS in a rodent model of OIC.A.9 DEVELOPMENT OF A MODEL ACUPUNCTURE RESEARCH CURRICULUM FOR EAM SCHOOLSHeidi Most, Maryland University of Integrative Health; Lisa Conboy, New England School of Acupuncture at MCPHS; Rosaleen Ostrick, Yo San UniversityPurpose: The Society for Acupuncture Research (SAR) is an international group of researchers from major medical and research institutions dedicated to improving the quality and increasing the awareness of research in acupuncture. At the June 2019 SAR conference, a seminar was organized to advance acupuncture research education for EAM students. Out of that conference, SAR participants formed a special interest group on education (SAR SIG‐Edu). Fourteen members from EAM schools across the US and Brazil have been collaboratively contributing to a model curriculum and coordinating through bi‐monthly meetings. One of our goals is to create a model Acupuncture Research curriculum which includes: (1) existing basic science and clinical evidence, its strengths and shortcomings, (2) acupuncture research challenges, and (3) an experiential component to give students a sense of research activities.Methods: We began with a draft syllabus from Dr. Ari Ojeda Ocampo More. Across multiple Zoom meetings and with the help of our members, we iteratively expanded the curriculum and created other resources.Results: This presentation explains our collaborative process and is a venue to share the final curriculum.Conclusion: Creating a detailed curriculum and resources that are available to all EAM schools would improve students' knowledge of the evidence base that exists for acupuncture. An enhanced knowledge base enables them to be valued members of an integrative medicine team as more informed practitioners who incorporate evidence into their treatments. The affiliation with SAR lends legitimacy to the work of SAR SIG‐Edu, which enhances our ability to further develop the curriculum and encourage its adoption. It may also be of interest to international EAM schools.A.39 HERBAL MEDICINE AS A CRITICAL ELEMENT OF INTEGRATIVE CANCER CARE: A RETROSPECTIVE ANALYSIS OF THE HERBAL DISPENSARY PROGRAM AT MEMORIAL SLOAN KETTERING CANCER CENTERYen Nien Hou, MSKCC; Jun Mao, MSKCCObjective: Many cancer patients and survivors use herbs for symptom relief and to prevent disease recurrence. To integrate botanicals used in traditional Chinese medicine (TCM) with proven benefit and safety into cancer care, the Integrative Medicine Service (IMS) along with the Pharmacy division at Memorial Sloan Kettering Cancer Center (MSK) initiated an herbal dispensary. This study aims to analyze data from this program to inform integrative oncology practice and future research.Methods: Patient demographics; herbal prescriptions (type, dose and duration); patient compliance; and pharmacosurveillance data (concomitant drug use and side effects) were documented by IMS physicians and a TCM‐trained pharmacist. The outcomes included prevalence of herbal medicine use; patient characteristics (age, gender, race, cancer type and stage, purpose of use, venue, insurance coverage); the most commonly used herbal formula/single herb and its indication(s), clinical effects, side effects; and concomitant drug use/herb‐drug interactions.Results: Since the program launch in February 2019, 1,172 supplements were dispensed to 736 unique patients. The top indications and corresponding products dispensed were pain/external pain plaster; constipation/Ma Zi Ren Wan; and immunomodulation/turkey tail mushroom.Conclusions: The Integrative Medicine Service at MSK successfully launched an herbal dispensary program – the first of its kind at a National Cancer Institute‐designated cancer center – to integrate herbal therapies into cancer care. The dispensary also helped identify promising supplements for conducting future clinical trials. The data obtained will be used to educate physicians and patients about the safety and efficacy of these products. The findings will also be translated into monographs that will be published on IMS's About Herbs (www.aboutherbs.com) database.A.61 MULTI‐BRAIN FUNCTIONAL CONNECTIVITY DURING ELECTRO‐ACUPUNCTURE IN PATIENT‐CLINICIAN DYADS: AN ELECTROENCEPHALOGRAPHY (EEG) HYPERSCAN APPROACHAlessandra Anzolin, MGH/HMS Athinoula Martinos Center for Biomedical Imaging; Arvina Grahl, MGH/HMS Athinoula Martinos Center for Biomedical Imaging; Kylie Isenburg, Boston University; Jlenia Toppi, Sapienza, University of Rome; Angela Ciaramidaro, University of Modena and Reggio Emilia; Maya Barton Zuckerman, MGH/HMS Athinoula Martinos Center for Biomedical Imaging; Meryem Yucel, Boston University; Dan‐Mikael Ellingsen, University of Oslo; Laura Astolfi, Sapienza, University of Rome; Ted Kaptchuk, Harvard Medical School; Vitaly Napadow, Harvard Medical SchoolIn chronic pain management and treatment, a positive patient‐clinician relationship is associated with higher patient satisfaction and treatment efficacy. In this study, we investigated synchronization of brain activity between patients and clinicians during an experimentally controlled augmented (empathetic) compared to limited (business‐like) clinical interaction context. We recorded EEG simultaneously (hyperscanning, 16 dyads, 64 channels per subject) from low back pain patients and acupuncturists during a task with treatment trials (electro‐acupuncture) and no‐treatment trials in conjunction with evoked cuff pain. EEG data were reconstructed using the algorithm eLORETA on 17 Regions of Interest (ROIs) defined by our previous fMRI study (Ellingsen et al. 2020) and directed statistical connectivity patterns were obtained by comparing Granger Causality‐based estimates for treatment and no‐treatment trials (α = 0.05, FDR corrected). Patients in the augmented group, compared to the limited group, rated therapeutic alliance and clinician warmth significantly higher (Fig.1a, p < 0.01). Low back pain intensity decreased after acupuncture treatment, irrespective of clinical context (Fig.1b, p < 0.01). EEG analysis suggested that in Theta band (linked with empathy for pain in prior EEG studies), inter‐brain network density within social mirroring and pain/sensorimotor brain regions was altered when acupuncturists treated evoked pain. The number of significant inter‐brain clinician‐to‐patient connections was higher in the no‐treatment condition (Fig.1c), while the number of patient‐to‐clinician connections were greater during treatment trials. Also, the density of patient‐to‐clinician inter‐brain connections increased during treatment relative to no‐treatment irrespective of clinical context, yet statistical significance was noted only for the augmented group (Fig.1d, p < 0.01). Both behavioral and simultaneous brain‐to‐brain responses across the patient/clinician dyad reflect clinical interaction context. EEG hyperscanning is an ecologically valid approach to identify inter‐brain networks whose density and directionality within the dyad is altered by electro‐acupuncture and clinical context, highlighting new brain mechanisms linking therapeutic alliance and chronic pain therapy.A.63 NEURAL AND BEHAVIORAL CORRELATES OF PATIENT‐CLINICIAN THERAPEUTIC ALLIANCE IN A LONGITUDINAL ACUPUNCTURE INTERVENTION: AN FMRI HYPER‐SCANNING STUDYArvina Grahl, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States; Alessandra Anzolin, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States; Kylie Isenburg, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States; Jeungchan Lee, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States; Maya Barton‐Zuckerman, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States; Dan‐Mikael Ellingsen, Department of Psychology, University of Oslo, Oslo, Norway; Changjin Jung, KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea; Jessica Gerber, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States; John Kelley, Endicott College, Beverly, MA, United States; Irving Kirsch, Program in Placebo Studies & Therapeutic Encounter (PiPS), Harvard Medical School, Boston, MA, United States; Ted Kaptchuk, Program in Placebo Studies & Therapeutic Encounter (PiPS), Harvard Medical School, Boston, MA, United States; Vitaly Napadow, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United StatesPrevious research suggests that a warm‐empathic (Augmented) compared to a neutral business‐like (Limited) patient‐clinician relationship can improve clinical outcomes. The clinical relationship is important to acupuncture therapy, which includes multiple sessions allowing for an evolving patient‐clinician relationship. We applied fMRI hyperscanning including a video connection between two scanners and an evoked cuff pressure pain‐treatment paradigm to determine whether behavioral, neural, and clinical variables associated with therapeutic alliance influence clinical outcomes. Eleven women with fibromyalgia (mean age = 38.55, SD = 11.25), randomly assigned to either an Augmented (N = 5) or a Limited (N = 6) patient‐clinician dyad interaction style, were treated with electro‐acupuncture for 6 biweekly sessions, and scanned before and after the acupuncture intervention. Clinical outcomes and the quality of the patient‐clinician relationship were assessed (e.g. pain levels, therapeutic alliance, warmth). As rated by patients, pooled therapeutic alliance and clinicians' warmth in the Augmented group (mean_alliance = 43.17, SD = 2.84; mean_warmth = 4.00, SD = 0.0) were significantly higher than in the Limited group (mean_alliance = 28.84, SD = 9.97; mean_warmth = 3.14, SD = 0.72; t_alliance(9) = 3.04, p = 0.014; t_warmth(9) = 2.65; p = 0.027). Additionally, over all 6 acupuncture treatment sessions, most patients experienced post‐treatment clinical pain relief (p < 0.001) irrespective of group assignment. However, after the 3‐week intervention, patients in the augmented group expected a higher likelihood of fibromyalgia pain relief from future acupuncture and reported a higher probability of continuing to see their assigned acupuncturist for future treatments. Based on results of our previous hyperscan fMRI study (Ellingsen et al., 2020), brain imaging data analysis will focus on social mirroring areas such as the temporo‐parietal junction (TPJ).Our preliminary results from this longitudinal patient‐acupuncturist interaction study highlight the positive influence of the therapeutic relationship on brain processing of nociceptive signaling and clinical outcomes. Moreover, we hope that our results will inform future chronic pain treatment approaches, to harness the positive effects of the patient‐clinician relationship.A.13 SELF‐ADMINISTERED ACUPRESSURE FOR INSOMNIA DISORDER: A RANDOMIZED CONTROLLED TRIALWing Fai YEUNG, School of Nursing, The Hong Kong Polytechnic University; Ka Fai CHUNG, Department of Psychiatry, The University of Hong Kong; Zhang Jin ZHANG, School of Chinese Medicine, The University of Hong Kong; Lixing LAO, School of Chinese Medicine, The University of Hong Kong; Lorna Kwai Ping SUEN, School of Nursing, Tung Wah College; Fiona Yan Yee HO, Department of Psychology, the Chinese University of Hong Kong; Lai Ming HO, School of Public Health, The University of Hong Kong; Branda Yee‐Man YU, School of Nursing, The Hong Kong Polytechnic UniversityObjectives: To evaluate the effects of self‐administered acupressure for insomnia disorder delivered by a training course.Hypothesis: Subjects in the self‐administered acupressure group will have greater improvement in insomnia symptoms and daytime impairment than those in the sleep hygiene education (SHE) group at week4 and 8 week‐8.Design and Methods: A randomized controlled trial with 200 subjects, which were randomized into the self‐administered acupressure group or sleep hygiene education group in a 1:1 ratio. Subjects in the self‐administered acupressure group attended an acupressure training course (2 sessions, 2 hours each) to learn self‐administered acupressure, which were then performed every night for 4 weeks. Subjects in the comparison group received sleep hygiene education (2 sessions, 2 hours each) and be reminded to follow the sleep hygiene practice daily for 4 weeks. The primary outcome was the Insomnia Severity Index (ISI). Other measures included a 7‐day sleep diary and actigraphy, Hospital Anxiety and Depression Scale and Short‐form Six‐Dimension.Results: The subjects in the self‐administered acupressure group had a significantly lower ISI score than the subjects in the sleep hygiene education group at week 4 (d = 0.51, P < 0.001) and 8 (d = 0.67, P < 0.001). Subjects in self‐administered acupressure group had a higher sleep‐diary‐derived TST and SE than those in sleep hygiene education group at week 4 (Cohen's d = 0.32 and 0.32, respectively, all p = 0.03). In addition, self‐administered acupressure showed a greater improvement in HADS‐anxiety (d = 0.35, p = 0.02), HADS depression score (d = 0.28, p = 0.049) and the SF6D (d = 0.32, p = 0.02) at week 4, but not week 8.Conclusions: Self‐administered acupressure taught is a feasible and effective approach to improve sleep and related daytime impairment as well as mood problems in individuals with insomnia disorder.A.44 SHEN LING BAI ZHU SAN FOR CHRONIC DIARRHEA ‐ A SYSTEMATIC REVIEW OF RCTS AND META‐ANALYSISHui Wang, MSKCC; Guang'anmen Hospital, China Academy of Chinese Medical Sciences; Yen‐Nien Hou, MSKCC; Mingxiao Yang, MSKCC; Ye Feng, MSKCC: Peking University Cancer Hospital & Institute; Yi Lily Zhang, MSKCC; Colleen M. Smith, MSKCC; Wei Hou, Guang'anmen Hospital, China Academy of Chinese Medical Sciences; Jun J. Mao, MSKCC; Gary Deng, MSKCCObjective: Many cancer patients experience chronic diarrhea, a debilitating symptom for which effective treatment strategies are lacking. Shen Ling Bai Zhu San (SLBZS) is a botanical formulation used in traditional Chinese medicine to manage diarrhea. This systematic review was conducted to evaluate the available evidence of anti‐diarrheal efficacy of SLBZS.Methods: Both English and Chinese language databases were searched through April 20, 2020 for relevant randomized controlled trials (RCTs). Fourteen RCTs involving 1,158 participants were included. Reported outcomes included stool frequency, stool consistency, patient‐reported satisfaction of chronic diarrhea treatment, and adverse events (AEs). Controls used were prescription drugs and in one study placebo SLBZS.Results: Quality of the studies ranged from low to high risk of bias. One small study reported SLBZ's effects on objective outcomes (no significant reduction in stool frequency but a significant improvement in stool consistency in week 12, when compared to placebo). Meta‐analysis showed that SLBZS with or without conventional medicine was associated with higher patient‐reported satisfaction compared to conventional medicine (RR, 2.15; 95% CI, 1.40 to 3.29; p = 0.0004; I2 = 0%; and RR, 2.34; 95% CI, 1.84 to 2.97; p < 0.00001, I2 = 0). The risk of AEs was not greater with SLBZS (OR, 0.49; 95% CI, 0.28 to 0.84; p = 0.009; I2 = 0%).Conclusions: This systematic review found that treatment with SLBZS significantly improved patient‐reported satisfaction. Well‐designed RCTs with larger sample sizes, lower bias, and strong primary endpoints are needed to further determine the efficacy of SLBZS in reducing stool frequency, and in improving stool consistency for specific gastrointestinal disease.A.79 SPINAL ADIPONECTIN IS INVOLVED IN ELECTROACUPUNCTURE‐PRODUCED ANALGESIC EFFECTSZhipeng Ning, The University of Hong Kong; Haiyong Chen, The University of Hong Kong; Zhangjin Zhang, The University of Hong Kong; Lixing Lao, Virginia University of Integrative MedicinePurpose: To determine whether electroacupuncture (EA)‐produced analgesic effects require the involvement of adiponectin (APN) in the spinal cordMethods: Male C57BL/6J mice, and APN knockout (KO) and wild‐type (WT) mice with a C57BL/6J background were used. Inflammatory pain was induced on hand paw by subcutaneously injection of 0.02 ml complete Freund's adjuvant (CFA). EA of 10 Hz, 2.5 mA and 0.1 ms pulse‐width at acupoint GB30 bilaterally was administrated for 20 min. Sham EA was performed with no‐invasive needle taped on the skin of the point with no electrical current delivered. Recombinant mouse APN protein or vehicle was administrated intrathecally. Paw‐withdrawal latency (PWL) and paw‐withdrawal threshold (PWT) tests were used to measure pain sensitivity. Western blotting (WB) and Immunofluorescence (IF) was used to detect protein expression of spinal APN.Results: Results showed EA reduced 22.87% mechanical allodynia (79.95 ± 1.14% vs 57.08 ± 3.49%, P < 0.001) and 18.17% thermal hyperalgesia (76.00 ± 1.10% vs 57.83 ± 1.65%, P < 0.001) at 5h post‐CFA when compared with sham EA in WT mice, but EA had no significant benefits in mice lacking APN. Moreover, after treatment with 1ng, 10ng, and 100ng recombinant APN. Mechanical allodynia reduced from 82.23 ± 0.78% to 72.34 ± 2.79% (P = 0.0679), 50.69 ± 2.26% (P < 0.001), and 49.99 ± 2.99% (P < 0.001). Thermal hyperalgesia reduced from 80.25 ± 1.43% to 73.19 ± 2.34% (P = 0.3108), 58.42 ± 3.05% (P < 0.001), and 55.17 ± 1.71% (P < 0.001). Furthermore, we confirmed that APN does co‐locate with vascular endothelial marker, not neuronal, microglial, or astrocytic markers in spinal dorsal horn (SDH) and discovered that EA triggers increased APN level on the ipsilateral side of spinal cord at 5h post‐CFA when compares with sham EA group (1.13 ± 0.04 vs 1.42 ± 0.08 in WB examination, P < 0.0

Exploration of the therapeutic effect and clinical outcomes of acupuncture at pain-sensitive points to treat chronic nonspecific low back pain: Application of the acupoint sensitization theory 基于穴位敏化理论探讨针刺痛敏点对慢性非特异性腰痛患者的临床疗效

Objectives To investigate the clinical and therapeutic effects of acupuncture at the pain-sensitive points of patients with chronic nonspecific low back pain and optimize the acupuncture treatment for chronic nonspecific low back pain.Methods Using the FDK 20 pressure algometer, the pain-sensitive points were probed in 30 patients with chronic nonspecific low back pain. The top 5 points that elicited the most painful reaction were selected and stimulated with an even-needling technique after deqi. The needles were retained for 30 min. TDP irradiation was concurrently administered. The treatment was administered once daily on weekdays (Monday to Friday) and discontinued for 2 days during the weekend (Saturday and Sunday). The treatment lasted for 2 consecutive weeks. The changes in the range of motion (ROM) of the lumbar vertebrae, visual analogous scale (VAS) score, and the Oswestry disability index (ODI) score of the lumbar vertebrae were assessed before treatment and after 5 and 10 treatment sessions.Results Compared with the data before treatment, the spinal ROM increased after 5 and 10 treatment sessions in the patients with chronic nonspecific low back pain.The ROM after 10 treatment sessions was remarkably wider than that after 5 treatments, with statistical significance (all P < 0.05). Compared with that before treatment, the immediate VAS score showed statistically significant reduction after 5 treatment sessions (P < 0.05). Moreover, compared with the score after 5 treatment sessions, the immediate VAS score reduced after 10 treatment sessions, but without any statistical significance. After 5 and 10 treatment sessions, the ODI score was reduced in the patients and it was significantly different from that before treatment (both P < 0.05).Conclusion Acupuncture at the pain-sensitive points alleviates pain and improves lumbar vertebral function in patients with chronic nonspecific low back pain. Thus, further research is needed to confirm whether acupuncture can be a better intervention for chronic nonspecific low back pain.

This issue of ACTA

The cover photo shows 3D image-guided treatment planning for brachytherapy of choroidal melanomas from the paper by Espensen et al. Borgersen et al. discuss the association between C-reactive protein and polypoidal choroidal vasculopathy. Review and meta-analysis of observational studies for human papillomavirus infection in conjunctival squamous cell carcinoma come from Ramberg et al. Na et al. wrote about the therapeutic effects of acupuncture on typical dry eyes in a systematic review and meta-analysis. Zada et al. discuss the natural history and clinical biomarkers of progression in X-linked retinitis pigmentosa in a systematic review. Implantable Collamer Lens and the corresponding toric lens have similar efficacy, safety, predictability and induced acceptable levels of higher-order aberrations in correcting myopia and myopic astigmatism according to Wei et al. Näslund et al. report treatment effects with two photorefractive intrastromal cross-linking protocols in low-grade myopia through a 24-month follow-up. The occurrence of giant cell arteritis showed seasonal variation with higher occurrence in the summer months when compared to autumn in the Danish cohort reported by Kønig et al. Eymard et al. conclude that patients with Cushing’s syndrome have a higher prevalence of pachychoroid spectrum disease based on enhanced-depth imaging (EDI)-optical coherent (OCT) data. Optical coherent (OCT) as a longitudinal screening tool for preclinical Alzheimer’s disease should be carefully interpreted according to van de Kreeke et al. Subfoveal choroidal thickness was thinner in patients with carotid stenosis without an association between subfoveal choroidal thickness and the grade of stenosis according to Ala-Kauhaluoma et al. study. Smid et al. observed that the clinical, morphological and vascular features of perifoveal exudative vascular anomalous complex (PEVAC) and PEVAC-resembling lesions are similar based on multimodal imaging (OCT), OCT angiography and colour fundus photography. Leveziel et al. report inequalities in terms of the prevalence of self-reported vision problems in Europe, with higher prevalence in Eastern European countries and among women and older individuals. Oganesyan et al. show cases for a modified three-quarter Descemet’s membrane endothelial keratoplasty technique to treat pseudophakic bullous keratopathy in the presence of a glaucoma drainage device tube in the anterior chamber. Souissi et al. update on continuous-wave cyclophotocoagulation and micropulse transscleral laser treatment for adult and paediatric refractory glaucoma. 3D image-guided treatment planning for Ruthenium-106 brachytherapy of choroidal melanomas is reviewed by Espensen et al. Wang et al. conclude that retinal microvascular parameters analysed optical coherence tomographic-angiography may serve as markers for chronic kidney disease. Wang et al. suggest that longer axial length and higher axial length-to-cornea radius ratio may be protective against the occurrence and progression of diabetic retinopathy. Measured by phase-contrast magnetic resonance imaging, non-significant reduction in ophthalmic artery blood flow rate in the normal-tension glaucoma patients compared with the healthy controls was observed by Kristiansen et al. Xu et al. developed and validated a standardized prediction model aiming at 1-year axial length elongation and to guide the orthokeratology lens practice. Kristianslund et al. estimated the prevalence and incidence of keratoconus in Norway based on the nationwide register. Grinton et al. investigated the relationship between vitreomacular traction (VMT) width, foveal floor width and other anatomical characteristics between the eyes of patients with VMT. Cho et al. show that the incidence rate of massive submacular haemorrhage in eyes with polypoidal choroidal vasculopathy was about three times higher than that in eyes with typical neovascular age-related macular degeneration. In non-acute Vogt–Koyanagi–Harada disease, disrupted ellipsoid zone and reduced central retinal thickness correlated with impaired multifocal electroretinogram and standardized automated perimetry parameters, even in patients with good visual acuity according to Souto et al. report. Li et al. show results of over 10-year follow-up outcomes and failure analysis of black diaphragm intraocular lens implantation in traumatic aniridia. Holtan et al. present novel ABCA4-variants in Norwegian retinal dystrophy patients. Sorkin et al. indicated that both manual astigmatic keratotomy (AK) and femtosecond astigmatic keratotomy (FSAK) are safe and effective in reducing postkeratoplasty astigmatism. However, FSAK was superior visual and keratometric outcomes compared with manual AK Martel et al. report that phantom eye pain is a common complication of eye amputation and it is strongly associated with postoperative anxiety. The increased acute primary angle-closure admission in summer was observed in a 5-year hospital-based Chinese retrospective study by Zhong et al. Wonneberger et al. wrote about corneal perforation due to palytoxin exposure of domestic zoanthid corals. Cabrera-Aquas et al. show diagnostic data using polymerase chain reaction in herpes simplex keratitis. Hecht et al. discuss clinical outcomes and inflammatory responses after cataract surgery. Chen et al. discuss whether mitomycin C, 5-fluorouracil or no antimetabolites should be used in bleb needling. Fieß et al. show associations between central retinal arteriolar and venular equivalent with birthweight. Laban et al. report a severe outcome of idiopathic inflammatory mass lesions primarily located in the posterior orbit and orbital apex. We hope that this issue of Acta partly responds to your thirst for knowledge,

Acupuncture Treatment for Social Defeat Stress.

Depression is a mood disorder characterized by disordered affect, thoughts, cognition, and behavior. Antidepressant therapy is often the primary treatment for depression. However, antidepressant therapy may cause unwanted side effects, and its effects are slow. Therefore, some patients are seeking alternative treatments for depression, such as acupuncture. However, there are many unclear points regarding the mechanism of the effect of acupuncture on depression. In recent years, we have reported that acupuncture improves the symptoms of mild depression induced by water-immersion stress in a rat model and depression induced by forced swimming in a mouse model. In this study, we examined the effect of acupuncture on the symptoms of social defeat stress (SDS)-induced depression in mice that most closely resemble human symptoms. In this study, we investigated the preventive and therapeutic effects of acupuncture as part of GV20 “Bai-Hui” and Ex-HN3 “Yintang” on model mice with depression induced by SDS. To examine the mechanism of the preventive and therapeutic effects of acupuncture on depression model mice, we examined the expression of neurotrophic factors in the brains of SDS mice. Two weeks of simultaneous acupuncture stimulation as part of GV20 and Ex-HN3 restored SDS-reduced brain-derived neurotrophic factor (BDNF), neurotrophin (NT)-3, and NT-4/5 expression, which was not observed with antidepressants. In contrast, acupuncture stimulation suppressed nerve growth factor (NGF) expression induced by SDS. These results suggest that acupuncture treatment could be effective in correcting the imbalance in the expression of neurotrophic factors. Furthermore, the effects of acupuncture on the expression of neurotrophic factors appear earlier than those of antidepressants, suggesting that it may be a useful treatment for depression.

Therapeutic Effect of Acupuncture and Point Injection of Drugs on Lumbar Disc Herniation

Therapeutic Effect of Acupuncture and Point Injection of Drugs on Lumbar Disc Herniation

Acupuncture an alternative treatment for patients with refractory sudden sensorineural hearing loss

Objectives: This study aims to investigate the effect of acupuncture treatment on hearing and tinnitus in patients with sudden sensorineural hearing loss (SNHL) refractory to treatment. Patients and Methods: Between January 2013 and May 2015, a total of 25 patients (8 males, 17 females; median age: 43.3 years; range, 18 to 65 years) resistant to medical treatment who underwent acupuncture as salvage therapy were retrospectively analyzed. The patients were evaluated with pure-tone audiometry, Speech Discrimination Score (SDS), and Tinnitus Handicap Inventory (THI) at pre-treatment (T0), and after 10th (T1) and 20th sessions (T2) of acupuncture. Results: Hearing loss evaluated according to the four-frequency pure-tone average (PTA; 500, 1,000, 2,000, and 4,000 kHz) showed a statistically significant improvement at the end of the 10th session of acupuncture (p=0.017). There was also a significant improvement in the PTA values of the worst three consecutive frequencies at the end of the 20th session (p=0.034). A significant improvement in SDS (p=0.022) and THI (p&lt;0.001) was found at the end of the 20th session. Conclusion: Acupuncture treatment yields promising results in the improvement of PTA. The therapeutic effect of acupuncture is also evident in the treatment of tinnitus secondary to SNHL.