Effect of Electroacupuncture at Proximal and Distal Acupoints on Pain-inducing Substances， Macrophages and Related Inflammatory Factors in Myofascial Pain Syndrome Model Rats / 中医杂志

ObjectiveTo explore the possible peripheral analgesic mechanism of electroacupuncture （EA） at promimal and distal acupoints in treatment of myofascial pain syndrome （MPS）. MethodsTwenty-four SD rats were randomly divided into blank group， model group， proximal group， and distal group， with six rats in each group. MPS model was prepared by “strike combined with centrifugal exercise” in all groups except for the blank group. After modeling， the rats in the proximal group received EA at the local myofascial trigger points （MTrPs）， namely the Ashi points， with dilatational waves of frequency of 2/100 HZ and voltage of 2-4 V， current intensity depending on a slight trembling of the left lower limbs， once a day， 15min each time，for 14 days. The rats in the distal group received EA at “Yanglingquan” （GB 34） and “Yinlingquan” （SP 9）， with the same operations as the proximal group. The rats in the blank group and the model group were only grasped and hedged， without other interventions. After intervention， the paw withdrawl mechanical threshold （PWMT） was measured， and variability between the left and right hind paws was calculated. Musculoskeletal ultrasound imaging and electromyography monitoring were performed on the left lower extremity vastus medialis. The morphological changes of vastus medialis muscle of the left lower extremity were observed by HE staining. The positive expression of substance P （SP）， calcitonin gene-related peptide （CGRP）， CD68 and CD206 in muscle tissue was detected by immunohistochemistry. Abdominal aortic serum interleukin-1β （IL-1β）， interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）， interleukin-10 （IL-10）， and interleukin-8 （interleukin-8） were detected by ELISA. ResultsCompared to those in the blank group， the fibers of the vastus medial muscle of the rats in the model group were broken and distorted with thickness in variation， and the myofascia was broken， with fibrillation potential， enlarged muscle cells， inward moved nucleus， and widened muscle space； the variability of PWMT between the left and right hind paws significantly increased， as well as the levels of SP， CGRP， CD68， and CD206 in the vastus medialis muscle （P＜0.01）， and the serum IL-8 and TNF-αlevels were significantly elevated （P＜0.05 or P＜0.01）. Compared to those in the model group， the muscle fibers in the proximal and distal group were complete in shape and arranged in an orderly manner， with continued non-broken myofascia， regular shape of muscle cells， and significantly reduced level of IL-8 （P＜0.01）； the amplitude and frequency of spontaneous discharge in the proximal group significantly decreased， as well as the variability of PWMT between the left and right hind paws， and the levels of SP， CGRP， and CD68 in the vastus medialis muscle， while the CD206 level increased significantly （P＜0.05 or P＜0.01 ）； there was complex discharges in the distal group， with significantly decreased level of CD68 in the vastus medialis muscle and increased level of CD206 （P＜0.01）. Compared to the proximal group， the level of IL-8 in the distal group was significantly higher （P＜0.05）. ConclusionsEA at proximal acupoints can significantly improve the pain threshold and local muscle tissue morpho-logy in rats， and its mechanism may be related to reducing the levels of pain-causing substances and related inflammatory factors and promoting the polarization of macrophages. The analgesic effect of EA at distal acupoints is not obvious， and the mechanism is still unclear.

Moxibustion promoted wound healing in rats with full-thickness cutaneous wounds / 针刺研究

OBJECTIVE: To explore the effects of moxibustion intervention on wound healing in rats with full-thickness cutaneous wounds. METHODS: A total of 28 adult SD male rats were randomly assigned to model group and moxibustion group (n＝14 in each one). The skin wound model was established by removal of a piece of full-thickness skin from the median line of the rats' back (about 2 cm below the shoulder blade). Moxibustion intervention was applied to the surrounding area of the focus for 25 min, once daily for 6 days. The wound healing was observed and photographed after each moxibustion intervention. The wound tissues were harvested after transcardiac perfusion with 4% paraformaldehyde solution on the 2nd and 7thday after modeling, and stained with H．E. and Masson methods for displaying histopathological changes and collagen fiber growth status, respectively. RESULTS: After modeling, the cutaneous wound was healed gradually in both groups, and the wound area was significantly smaller from the 2nd day to the 5th day in the moxibustion group than in the model group (P<0.01, P<0.05). Correspondingly, the wound closure area was significantly bigger from the 2nd to the 5th day in the moxibustion group than in the model group (P<0.01). H．E. and Masson staining showed that the number of the inflammatory cells (monocytes, macrophages, neutrophile, etc.) and the collagen fiber area in the local wound tissue of the moxibustion group were significantly bigger than those of the model group on the 2nd day after intervention (P<0.01). After 6 sessions of moxibustion intervention, the number of fibroblasts and collagen fibers in the moxibustion group were obviously increased than that in the model group, characterized by closer arrangement of fibroblasts and collagen fibers, more and larger of the new-born blood vessels, and thicker of the scab in the wound area. CONCLUSION: Moxibustion can promote the wound healing by enhancing the growth of collagen fibers and cell proliferation in the traumatic cutaneous area in full-thickness cutaneous wound rats.

Moxibustion promoted transformation of inflammatory phase to facilitate wound healing in rats with full-thickness cutaneous wounds / 针刺研究

OBJECTIVE: Our previous study demonstrated that moxibustion could promote skin wound healing in rats with full-thickness cutaneous wounds. The present study was designed to observe the effect of moxibustion on the levels of pro-inflammatory and anti-inflammatory cytokines, and proliferation of vascular endothelial cells, so as to explore its mechanisms underlying facilitating wound-healing. METHODS: A total of 84 adult SD male rats were randomly assigned to normal (n＝6), model(n＝39)and moxibustion(n＝39)groups. The skin wound model was established by removal of a piece of full-thickness skin from the median line of the rats' back (about 2 cm below the shoulder blade). Moxibustion was applied to the surrounding area of the focus for 25 min, once daily for 6 days. The blood samples were collected at day 1, 2, 3 and 5 after modeling for assaying serum contents of IL-1α， IL-1β， IL-6, IL-4, IL-10, IL-13, granulocyte-colony stimulating factor (G-CSF), granulocyte macrophagecolony stimulating factor (GM-CSF, an inflammatory mediator), macrophage inhibitory protein-1α (MIP-1α) and vascular endothelial growth factor (VEGF) with liquid chip methods, and the topical wound tissues were collected after trans-cardiac perfusion with 4% paraforma-ldehyde solution for detecting the expression of CD31 proteins by using immunofluorescence staining. RESULTS: After modeling and in comparison with the model group, the contents of serum IL-1α and IL-6 at the 1st day were significantly increased (P<0.05), but notably decreased at the 3rd day after modeling in the moxibustion group (P<0.05). The contents of serum IL-1β on day 1 and 2 were significantly higher in the moxibustion group than those of the model group (P<0.05). After moxibustion, the contents of serum IL-4 and IL-10 were significantly up-regulated on day 1 after modeling (P<0.05), and obviously down-regulated from the 3rd day on (P<0.05). The contents of serum MIP-1α on the 2nd day and serum VEGF on day 1 and 2, and wound-skin VEGF on day 5 were obviously up-regulated in the moxibustion group in comparison with the model group (P<0.05, P<0.01)．. CONCLUSION: Moxibustion promotes the inflammatory response by regulating the levels of both pro-inflammatory and anti-inflammatory cytokines in the early phase of skin wounds in rats, which may be in favor of the transformation from the inflammatory phase to the proliferation phase in advance, promoting wound healing at last.

Research progress of acupuncture and the related adjuvant therapy for promoting pressure ulcer healing in recent 10 years / 中国针灸

OBJECTIVE@#To summarize the research progress of acupuncture-moxibustion and the related adjuvant therapy for promoting pressure ulcer healing in recent 10 years and explore the future research direction.@*METHODS@#By retrieving Chinese Journal Full-text Database (CNKI), VIP Database (VIP) and PubMed database, dated from January 2008 through to December 2017, the articles for the treatment of pressure ulcers with acupuncture-moxibustion and the related adjuvant therapy were collected. In terms of clinical research and experimental research, the research progress and the related effect mechanisms were analyzed and summarized.@*RESULTS@#Through screening, 78 articles for the treatment of pressure ulcer with acupuncture-moxibustion and the adjuvant therapy were collected finally, of which, 71 articles were Chinese and 7 articles were English. The therapies with the highest frequency for pressure ulcer were the simple moxibustion or moxibusiton combined with other adjuvant measures. The local surrounding needling therapy, electroacupuncture, transcutaneous electrical nerve stimulation (TENS), neuromuscular electrical stimulation (NMES) and laser therapy were followed by regarding the use frequency. All of these interventions promoted the healing of pressure ulcers to different degrees. The underlying mechanisms were related to the regulation of the local blood perfusion, differentiation and migration of vascular endothelial growth factor, angiogenesis, superoxide dismutase SOD and eNOS/NO signaling pathway so as to promote tissue migration and proliferation.@*CONCLUSION@#Acupuncture-moxibustion and the related adjuvant therapies achieve the definite therapeutic effects on pressure ulcers. The researches on the treatment of pressure ulcers at home and abroad are diversified, but it is still limited in the research on the effect mechanism.

Influence of Cordyceps sinensis on pancreatic islet beta cells in rats with experimental liver fibrogenesis / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the effect of Cordyceps sinensis (CS) on pancreatic islet B cells of experimental hepatic fibrogenesis rats.</p><p><b>METHODS</b>Rats were randomly allocated into three groups: normal group, model group and CS group. The rats in the latter two groups were administered with CCl(4) solution to induce liver fibrosis, the CS group was also treated with CS 10 days after the beginning of CCl(4) administration. Rats in normal group were sacrificed at the beginning of the experiment, while the rats in the other two groups were sacrificed randomly at the end of the third and sixth weeks. The rats' islets were isolated and cultured in vitro, then the basal insulin level of the islets and the serum level of insulin were determined by radioimmunological assay.</p><p><b>RESULTS</b>It seemed no change that the levels of serum insulin and basal insulin between the model group and the normal group at the third week. But at the sixth week, both insulin levels in the model group were higher than those in the normal group (52.6 mU/L2.5 mU/L vs 23.7 mU/L 2.3 mU/L, q=13.01, p<0.05; 52.94muU/ml 13.12muU/ml vs 35.16muU/ml 5.64muU/ml, q=10.06, p<0.01). No significant change could be seen in the serum levels of insulin between the CS group and the model group at the third and sixth weeks. But the basal insulin levels in the CS group were apparently higher than those in the model group at the third and sixth weeks (156.63muU/ml 6.57muU/ml vs 39.64muU/ml 3.95muU/ml, q=66.94, p<0.001; 140.44muU/ml 38.53muU/ml vs 52.94muU/ml 13.12muU/ml, q=12.98, p<0.01).</p><p><b>CONCLUSION</b>Cordyceps sinensis can increase the basal insulin level of the islets in CCl(4)-induced liver fibrosis rats.</p>