Effects of electroacupuncture at different time during reperfusion on the expression of Bcl-2 and Beclin1 in myocardial tissue in rats with myocardial ischemia reperfusion injury / 中国针灸

OBJECTIVE@#To compare the effects of electroacupuncture (EA) at different time during reperfusion on the expression of autophagy-related protein Bcl-2 and Beclin1 in myocardial tissue in rats with myocardial ischemia reperfusion injury (MIRI), and to explore the autophagy-related mechanism of EA on protecting MIRI.@*METHODS@#A total of 72 SD rats were randomly divided into a sham operation group, a model group, a RA group, a RB group, a RC group and a RD group, 12 rats in each group. Except the sham operation group, the rats in the remaining groups were treated with ligating the left anterior descending artery (LAD) for 30 minutes followed by reperfusion to establish the model of MIRI. The rats in the sham operation group were treated with crossing a line through the LAD. The rats in the model group did not receive treatment. The rats in the RA group, RB group, RC group and RD group were treated with EA at "Neiguan" (PC 6) for 20 min, starting at 0 h, 0.5 h, 1 h, 2 h after reperfusion. Evans Blue-TTC double-staining was employed to evaluate myocardial infarct size; the serum CK-MB was detected by ELISA and the expression of Bcl-2 and Beclin1 protein in myocardial tissue were detected by Western blot.@*RESULTS@#Compared with the model group, the percentage of myocardial infarct size in the RB group, RC group and RD group was decreased significantly (all 0.05); the increasing of Bcl-2 in the RB group was more significant than that in RC group (0.05).@*CONCLUSION@#EA at different time during reperfusion could reduce myocardial infarct size in rats with MIRI, and EA at 0.5 h after reperfusion has best efficacy; this protective effect may be achieved by increasing Bcl-2 expression and reducing Beclin1 expression to inhibit overautophagy during reperfusion.

An autophagic mechanism study on effect of electroacupuncture at different times pretreating myocardial ischemia-reperfusion injury / 中国针灸

OBJECTIVE@#To investigate the difference of protective effect of electroacupuncture (EA) at different times pretreating myocardial ischemia-reperfusion injury (MIRI) and the protein expressions of ULK1 and Beclin-1 in myocardial tissue, so as to explore the relation of the difference and autophagic mechanism.@*METHODS@#Sixty-three male SD rats were randomized into 7 groups, a sham group, a model group, an EA pretreating for 1 d (EA-1d) group, an EA pretreating for 2 d (EA-2d) group, an EA pretreating for 3 d (EA-3d) group, an EA pretreating for 4 d (EA-4d) group, an EA pretreating for 5 d (EA-5d) group, 9 rats in each group. All the rats in the pretreating groups were treated with EA 1-5 days before MIRI surgery. EA (2 Hz/100 Hz, 2 mA) was used at bilateral "Neiguan (PC 6)" for 20 min. All the rats except for those in the sham group was underwent left thoracotomy and ligation of the left anterior descending (LAD) coronary artery for 30 minutes followed by 4 hours of reperfusion to establish the MIRI model. The same operation was performed in the sham group except for the ligation of the LAD. Throughout the experiment, electrocardiogram was continuously monitored. The myocardial infarct sizes were assessed by Evans blue and triphenyltetrazolium chloride (TTC) staining. The serum concentrations of cardiac troponinⅠ(cTnⅠ) was detected by ELISA. The expressions of ULK1 and Beclin-1 in the heart tissues were analyze by Western blot.@*RESULTS@#Compared with the sham group, the concentrations of cTnⅠ and the protein expressions of ULK1 and Beclin-1 increased in the model group (all <0.05). Compared with the model group, the infarct sizes decreased in the EA-1d, EA-2d, EA-3d, EA-4d and EA-5d groups (all <0.05), with less risk sizes in the EA-3d, EA-4d and EA-5d groups (all <0.05). The levels of cTnⅠin the EA-4d and EA-5d groups decreased ( both <0.05); the expressions of ULK1 protein decreased in the EA-1d, EA-2d, EA-3d, EA-4d and EA-5d groups (all <0.05); the expressions of Beclin-1 protein decreased in the EA-2d, EA-3d, EA-4d and EA-5d groups (all <0.05). The infarct sizes in the EA-4d and EA-5d groups were lower than that in the EA-1d group (both 0.05). The cTnⅠconcentration in the EA-4d group was less than that in the EA-1d group (<0.05).@*CONCLUSION@#Pretreatment with EA for 1-5 days can improve the infarct size in MIRI, with better effect of the pretreatment for 4-5 days. The cardioprotective effect may be related to the inhibition of autophagy. But the difference of the protective effects is not related to the protein expressions of ULK1 and Beclin-1.

Acupuncture from Tiaokou (ST 38) to Chengshan (BL 57) combined with local exercise for periarthritis / 中国针灸

<p><b>OBJECTIVE</b>To compare the effect difference between acupuncture from Tiaokou (ST 38) to Chengshan (BL 57) combined with local exercise and acupuncture.</p><p><b>METHODS</b>Sixty patients with periarthritis were randomly divided into an acupuncture group and an acupuncture combined with exercise group (active acupuncture group), 30 cases in each group. Acupuncture from Tiaokou (ST 38) to Chengshan (BL 57) was given in both groups. The active shoulder joint during acupuncture was applied in the active acupuncture group. The treatment was given once every two days, 5 times as one course and a total of 2 courses were required. The activity-related pain (VAS score), shoulder joint activity (Melle score), and daily living ability (ADL score) were observed before and after treatment in the two groups.</p><p><b>RESULTS</b>The VAS score, Melle score and ADL score were significantly lower in the two groups after treatment compared with those before treatment (all <0.05); the VAS score, Melle score, and ADL score in the active acupuncture group were lower than those in the acupuncture group (all <0.05).</p><p><b>CONCLUSION</b>The curative effect of acupuncture from Tiaokou (ST 38) to Chengshan (BL 57) combined with local exercise on periarthritis is superior to that of acupuncture from Tiaokou (ST 38) to Chengshan (BL 57) alone.</p>

Effects of preventative moxibustion on AMPK and mTOR in myocardial tissue in rats with exhaustive exercise / 中国针灸

<p><b>OBJECTIVE</b>To observe the effects of preventative moxibustion on adenosine monophosphate-activated protein kinase (AMPK) and mammalian target of rapamycin (mTOR) in myocardial tissue in rats with exhaustive exercise, and to explore the action mechanism of preventative moxibustion for myocardial injury by exhaustive exercise.</p><p><b>METHODS</b>Eighteen SD male rats were randomly divided into a blank group, an exhaustive exercise group and a moxibustion group, 6 rats in each one. Rats in the blank group were treated with immobilization for 5 min per day, without any intervention. Rats in the exhaustive exercise group were treated with no intervention in the first 10 days. Rats in the moxibustion group were treated with moxibustion at "Zusanli" (ST 36) and "Guanyuan" (CV 4), 5 cones for each acupoint, for 10 days.On 11th day, rats in the exhaustive exercise group and moxibustion group were sacrificed to collect sample after exhaustive swimming, and time of exhaustive exercise was recorded. HE staining was used to observe the inflammatory changes of myocardial tissue; colorimetric method was used to measure lactic dehydrogenase (LDH), activity of superoxide dismutase (SOD) and malonaldehyde (MDA); immune suppression method was used to measure the content of creatine kinase isoenzyme (CK-MB) in serum; Elisa method was used to measure the content of troponinT (cTnT) in serum; western blot method was applied to measure the content of AMPKα2 and mTOR in myocardial tissue.</p><p><b>RESULTS</b>The time of exhaustive exercise was (4 831.17±689.88) s in the moxibustion group, which was longer than (3 509.50±1 232.49) s in the exhaustive exercise group (<0.05); HE staining indicated structure of the myocardium was clear and inflammatory cell infiltration was reduced in the moxibustion group. Compared with the blank group, the contents of serum LDH, CK-MB, cTnT were increased in the exhaustive exercise group (all<0.05); MDA content was increased and SOD activity was decreased (both<0.05); the AMPK α2 content in myocardial tissue was increased and the mTOR content was decreased (both<0.05). Compared with the exhaustive exercise group, the contents of serum LDH, CK-MB, cTnT were reduced in the moxibustion group (all<0.05); MDA content was decreased and SOD activity was increased (both<0.05); the AMPKα2 content in myocardial tissue was increased, and the mTOR content was decreased (both<0.05); AMPKα2 and mTOR were negatively correlated (=-0.764,<0.05).</p><p><b>CONCLUSIONS</b>Preventative moxibustion is likely to regulate the expression of AMPK and mTOR to induce signaling pathway to recover myocardial injury by exhaustive exercise.</p>

Effects of moxibustion with seed-sized moxa cone on apoptosis of myocardial cells after sport fatigue in mice / 中国针灸

<p><b>OBJECTIVE</b>To observe the effects of moxibustion on factors related with apoptosis of myocardial cells after sports fatigue in mice as well as the relationship among histone acetyltransferases p300 (p300), CREB binding protein (CBP) and cell apoptosis to discuss the role of p300 and CBP in moxibustion against apoptosis of myocardial cells.</p><p><b>METHODS</b>Sixty clean-grade male Kunming mice were randomly divided into a control group, a sport group and a moxibustion group, 20 cases in each one. Mice in all group received identical feeding environment. Mice in the control group did not received sport nor moxibustion; mice in the sport group and moxibustion group received non-weight swimming training which lasted from 30 min per day to 90 min per day gradually for 21 days; 1 h after swimming training, mice in the moxibustion group received moxibustion with seed-sized moxa cone at "Zusanli" (ST 36) and "Guanyuan" (CV 4), 5 cones at each acupoint, once a day for 21 days. 24 h after the final swimming training, cardiac muscle tissue was collected to test factor associated suicide (Fas), B cell lymphoma/lewkmia-2 (Bcl-2) by immunohistochemical method and expression of p300 and CBP.</p><p><b>RESULTS</b>Compared with the control group, the apoptosis rate of myocardial cells in the sport group was significantly increased (P<0.01), and apoptosis body with dense distribution and deep coloring can be seen in the field of microscope; the expression of Fas protein was significantly increased (P<0.01), and expression of Bcl-2, p300 and CBP was reduced (all P<0.01). The equally distributed apoptosis body with slight coloring was seen in the moxibustion group. Compared with the sport group, the apoptosis rate of myocardial cells in the moxibustion group was significantly reduced (P<0.05); the expression of Fas protein was significantly reduced (P<0.05), and expression of Bcl-2, p300 and CBP was increased (all P<0.05).</p><p><b>CONCLUSION</b>Moxibustion could promote the expression of p300 and CBP in myocardial cells after sports fatigue in mice to inhibit the starting of apoptotic process, therefore reducing the apoptosis of myocardial cells after heavy exercise and protecting heart function.</p>

Effect of Cathodal Transcranial Direct Current Stimulation on Upper Extremities of Patients with Stroke: A Systematic Review of Randomized Controlled Trials / 中国康复理论与实践

@#Objective To evaluate the effectiveness of cathodal transcranial direct current stimulation(c-tDCS) on the upper extremities of patients with stroke. Methods Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMbase, Web of Science, Ovid,China Biology Medicine disc (CBMdisc), China National Knowledge Infrastructure, Wanfang Data and VIP Database for Chinese Technical Periodicals were searched for the randomized controlled trials (RCTs) of c-tDCS in the treatment of the upper extremities of patients with stroke from the date of establishment of the databases to July 2013. The bibliographies of the retrieved studies were also searched. 2 independent researchers evaluated the included studies using the risk of bias provided by Cochrane Library. The extracted data were analyzed by RevMan 5.1 software. Results A total of 10 trials were discovered. Compared with the sham tDCS group, the c-tDCS group which stimulated the area of primary motor cortex (M1) did not increase the score of Fugl- Meyer Assessment (upper extremity) [WMD=0.11, 95%CI: -5.77~5.99, Z=0.04, P=0.97] and Jebsen-Taylor Test [WMD=-1.52, 95%CI: -4.94~1.90, Z=0.87, P=0.38]. According to the Jadad Score of included studies, 2 of them were of low quality and 8 of them were of high quality. Conclusion Currently, no evidence shows that c-tDCS can improve the upper extremities function of stroke patients more than sham tDCS.

Efficiency of repetitive transcranial magnetic stimulation on rehabilitation of motor function in patients with stroke:A systematic review / 中国组织工程研究

BACKGROUND:Studies have different views on the effect of repetitive transcranial magnetic stimulation applied in stroke patients for improving motor function. OBJECTIVE:To evaluate the effect of repetitive transcranial magnetic stimulation on rehabilitation of motor function in patients with stroke. METHODS:We searched Cochrane Central Register of Control ed Trials, PubMed, ISI Web of science, Medline, EMBASE, China Biology Medicine disc, China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodical, Wanfang Data (from database building to July 2013) for randomized control ed trials concerning repetitive transcranial magnetic stimulation on improving motor function in patients with stroke. The included studies were evaluated according to the method recommended by the Cochrane Col aboration. Meta analysis was performed in qualified literatures. The extracted data were analyzed by RevMan 5.1 software and GRADEprofiler 3.6 software. RESULTS AND CONCLUSION:A total of 23 trials were included (intervention group n=400, control group n=301). Quantitative analysis was conducted in seven studies, and descriptive study was performed in the remaining studies. Meta-analyses analyzed Fugl Meyer Motor Scale and Barthel index. Results showed that Fugl Meyer Motor Scale [SMD=0.48, 95%CI(0.10, 0.86)] and Barthel index [SMD=1.38, 95%CI (0.68, 2.09)] were significantly higher in the intervention group than that in the control group. In accordance with The Grading of Recommendations Assessment, Development and Evaluation, outcome indexes were evaluated, and the two indexes were graded low quality. The current evidence shows that repetitive transcranial magnetic stimulation appears to enhance motor function and activities of daily living of the patients with stroke. Considering the limitations of the included studies, more multi-central randomized control ed trials with large sample sizes and high qualities are required in future to verify the therapeutic efficacy of repetitive transcranial magnetic stimulation on motor function of stroke patients.

A pilot study of the effect of aerobic training with bicycle ergometer on hemiplegic stroke patients without ambulation ability / 中华物理医学与康复杂志

Objective To study the effectiveness and feasibility of low intensity of aerobic bicycle ergometer training on hemiplegic stroke patients unable to perform assistive or independent ambulation.Methods Thirty stroke patients unable of assistive or independent ambulation were randomly divided into a control group and a aerobic training group.Patients in the aerobic training group performed low intensity of aerobic bicycle ergometer training for 30 min,3 times a week for 6 weeks in addition to a routine rehabilitation regime.The training duration and course of routine rehabilitation training were the same in both groups.The related cardiovascular response in aerobic training and changes in motor performance as well as the risk factors for stroke were observed in both groups.Results Twenty-four patients(12 patients in each group)completed the experiment.Patients in aerobic training group performed all training regime safely without any adverse response.Their motor function(including FMA score,Rivermead index,BI ADL ability),exercise endurance duration in exercise test,glucose level at 2 h in oral glucose tolerance test,fasting insulin level and HOMA-IR index all improved greatly as compared to the control group(P ＜ 0.05).Conclusion Low intensity of aerobic bicycle ergometer training can be safely and effectively administered in hemiplegic stroke patients unable of assistive ambulation or independent ambulation.

Curriculum reformation of rehabilitation therapy with the integrative traditional and western medicine / 中华医学教育探索杂志

Rehabilitation therapy with the integrative traditional and western medicine is the devel opment trend in China,and it is also the aim of talent education of Nanjing University of Chinese Medicine.Based on the introduction of rehabilitation therapy education in our university,this article makes a discussion on the research and practice of curriculum reformation of rehabilitation therapy with the integrative traditional and western medicine.Additionally,it puts forward some implement measures.

Research in effect of hand function recovery machine on hand function rehabilitation of hemiplegia patients after stroke / 中国实用护理杂志

Objective To compare the rehabilitation effect of free rehabilitation, the needle therapy and the hand function recovery machine combined with free rehabilitation on movement function, the feeling function as well as the movement pattern of newly stroke patients with hemiplegia. Methods 49 newly stroke patients were divided into the free rehabilitation group, the acupuncture group and the hand function recovery machinegroup, each group received corresponding intervention. The movement function, the feeling function as well as the movement pattern were compared among the three groups using blind method. Results Brunnstrom evaluation for hands feeling-movement function, the Fugl- Meyer evaluation score showed obvious progress compared to before the treatment, score of fine hand - function assessment of Carrshepherd showed no change. Two weeks after treatment,Brunnstrom evaluation for hands feeling-movement function and the Fugl - Meyer evaluation score showed no difference between the free rehabilitation group and the acupuncture group, but the hand function recovery machine group showed better results than the other two groups. One months after treatment,Brunnstrom evaluation for hands feeling-movement function was different among these groups, but not the Fugl-Meyer evaluation score, the hand function recovery machine group showed better results than the other two groups, still score of fine hand-function assessment of Carrshepherd showed no change. Conclusions Acupuncture, free rehabilitation, hand function recov - ery machine all make progress in hand function recovery for newly stroke patients with hemiplegia, but hand function recovery machine combined with free rehabilitation proved to be the best method. Its effect for hand intricate function needs to be enhanced.