Effects of catgut embedding and PGLA embedding at "Zusanli" (ST 36) on skin mast cells, substance P and histamine in healthy rats / 中国针灸

OBJECTIVE@#To observe the effects of catgut embedding and polyglycolic acid/poly-lactic acid (PGLA) embedding at "Zusanli" (ST 36) on the activation of local skin mast cells (MC), and expression of substance P (SP) and histamine (HA), and to explore the mechanism of the temporal stimulation effect of acupoint catgut embedding and provide a foundation for further research on the initiation mechanism of acupoint catgut embedding.@*METHODS@#One hundred and sixty male SPF-grade SD rats were randomly divided into a blank group (10 rats), a sham-embedding group (50 rats), a catgut group (50 rats), and a PGLA group (50 rats). Each intervention group was further randomly divided into five subgroups according to the time points after intervention: 8 hours, 3 days, 7 days, 14 days, and 21 days, with 10 rats in each subgroup. One-time sham-embedding, catgut embedding and PGLA embedding was given at left "Zusanli" (ST 36) in each intervention group, respectively. The skin and subcutaneous connective tissue of the left "Zusanli" (ST 36) were collected at the corresponding time points after intervention, except for the blank group (only one day before intervention). Toluidine blue staining was used to detect MC count and degranulation, and immunohistochemical staining was used to detect the expression of SP and HA positive cells.@*RESULTS@#There was no significant difference in MC count between the subgroups of each intervention group and the blank group (P>0.05). There was no significant difference in MC count between the subgroups of the catgut group and the PGLA group (P>0.05). The MC count in the 8-hour subgroup of PGLA group was higher than that in the 8-hour subgroup of catgut group (P<0.05), while the MC count in the 21-day subgroup of PGLA group was lower than that in the 21-day subgroup of catgut group (P<0.05). Compared with the blank group, the degranulation rates of MC were increased in the 8-hour and 3-day subgroups of sham-embedding group, 8-hour, 3-day, and 7-day subgroups of catgut group, and 8-hour, 3-day, 7-day, and 14-day subgroups of PGLA group (P<0.01, P<0.05, P<0.001). There was no significant difference in the degranulation rate of MC between the subgroups of the catgut group and the PGLA group (P>0.05), and no significant difference in the degranulation rate of MC between the two embedding groups at the same time point (P>0.05). Compared with the blank group, the expression of SP positive cells was increased in the 8-hour subgroup of sham-embedding group, 8-hour, 3-day, 7-day, and 14-day subgroups of catgut group, and 3-day, 7-day, and 14-day subgroups of PGLA group (P<0.001, P<0.05). The expression of SP positive cells in the 7-day subgroup of catgut group was higher than that in the 8-hour subgroup of catgut group (P<0.05), while the expression of SP positive cells in the 14-day subgroup of catgut group was lower than that in the 7-day subgroup of catgut group (P<0.001). The expression of SP positive cells in the 7-day subgroup of PGLA group was higher than that in the 3-day subgroup of PGLA group (P<0.05), while the expression of SP positive cells in the 14-day subgroup of PGLA group was lower than that in the 7-day subgroup of PGLA group (P<0.01). There was no significant difference in the expression of SP positive cells between the subgroups of the two embedding groups at the same time point (P>0.05). Compared with the blank group, the expression of HA positive cells was increased in the 8-hour, 3-day subgroups of sham-embedding group, 8-hour, 3-day, 7-day, and 14-day subgroups of catgut group, and 8-hour, 3-day, 7-day, 14-day, and 21-day subgroups of PGLA group (P<0.001, P<0.01, P<0.05). The expression of HA positive cells in the 14-day subgroup of catgut group was lower than that in the 7-day subgroup of catgut group (P<0.05), while the expression of HA positive cells in the 3-day subgroup of PGLA group was higher than that in the 8-hour subgroup of PGLA group (P<0.05), and the expression of HA positive cells in the 14-day subgroup of PGLA group was lower than that in the 7-day subgroup of PGLA group (P<0.05). The expression of HA positive cells in the 3-day subgroup of PGLA group was higher than that in the 3-day subgroup of catgut group (P<0.05).@*CONCLUSION@#Catgut and PGLA embedding at "Zusanli" (ST 36) in healthy rats could induce changes in local skin MC, SP, and HA, which may be one of the mechanisms of the temporal stimulation effect after acupoint embedding. There are certain differences between different suture materials. A moderate inflammatory response in the acupoint area, mediated by MC and involving SP and HA, may be one of the initiating factors for the effect of acupoint catgut embedding.

Influence of acupoint catgut embedding combined with exercise therapy on the rehabilitation effect of patients with upper limb spasticity after stroke and qi deficiency and blood stasis type / 国际中医中药杂志

Objective:To explore the influence of acupoint catgut embedding combined with exercise therapy on the rehabilitation effect of patients with upper limb spasticity after stroke and qi deficiency and blood stasis type.Methods:A total of 76 patients with qi deficiency and blood stasis type of upper limb spasticity after stroke who met the inclusion criteria in the hospital were enrolled between May 2018 and May 2020, and they were divided into two groups according to the random number table method, with 38 in each group. The control group was given conventional rehabilitation treatment, while the observation group was combined with acupoint catgut embedding and exercise therapy intervention on the basis of the control group. The degree of elbow spasm was assessed by Modified Ashworth Scale and hemiplegic hand function was evaluated by Hemiplegic Hand Function Classification Scale. Simplified Fugl-Meyer Scale was used to evaluate the limb motor ability and Modified Barthel Index was used for ability of daily living, and the adverse events during treatment were recorded.Results:After treatment, the improvement degree of elbow spasm in observation group was significantly better than that in control group ( Z=2.29, P=0.022), and the hemiplegic hand function classification was significantly better than that in control group ( Z=2.08, P=0.038). After treatment, the scores of upper and lower extremities and total score of Fugl-Meyer Scale in observation group were significantly higher than those in control group ( t=7.17, 7.40, 11.39, all Ps<0.001). While the scores of hemiplegia, faintness, shortness of breath and sallow complexion in observation group were significantly lower than those in control group ( t=7.82, 12.87, 12.55, 7.95, all Ps<0.001). The Barthel index in observation group was significantly higher than that in control group at 6 and 12 months of follow-up ( t=4.82. 6.45, all Ps<0.001). Conclusion:Acupoint catgut embedding combined with exercise therapy for intervention can improve the hemiplegic hand function, and enhance the limb motor function and daily living ability of patients with qi deficiency and blood stasis type of upper limb spasticity after stroke.

Acupoint catgut embedding inhibiting neuroinflammation in vascular dementia rats / 解剖学报

Objective To observe the effect of acupoint catgut embedding on the expression of inflammatory factor mRNA in cyclooxygenase-2 (COX-2)/prostaglandin E2 (PGE2) signal pathway of vascular dementia (VD) rats, and to explore the protective mechanism of acupoint catgut embedding on the brain inflammatory response of VD rats. Methods VD model was established by the modified Pulsinelli ' s four vessel blocking method. Totally 148 male rats were randomly divided into VD model group, non acupoint catgut embedding group and acupoint catgut embedding group. On the 7th day after operation, catgut embedding at acupoints and catgut embedding at non acupoints were performed in the two treatment groups respectively, and materials were taken out 15 days later. Western blotting was used to detect the expression of COX-2 and PGE2, and real-time PCR was used to detect the mRNA expression of tumor necrosis factor α (TNF-α), intercellular cell adhesion molecule 1 (ICAM-1), interieukin(IL)-6, macrophage inflammatory protein 2 (MIP-2), IL-lβ, and monocyte chemotactic protein 1 ( MCP-1 ) in rat hippocampus. Results Compared with the sham group, the expressions of COX-2, PGE2, TNF-α, ICAM-1, IL-6, MIP-2, IL-lβ and MCP-1 in hippocampus of the other three groups were significantly higher (P<0.01). Compared with the model group, the expressions of COX-2, PGE2 protein and TNF-α, ICAM-1, IL-6, MIP-2, IL-lβ, MCP-1 mRNA in the hippocampus of the acupoint catgut embedding group and the non acupoint catgut embedding group decreased significantly (P<0.01). Conclusion Acupoint catgut embedding can protect the brain from inflammatory injury by down-regulating the expression of related inflammatory factors in COX-2/PGE2 signaling pathway and reducing the inflammatory response induced by VD rats.

Clinical Efficacy of Modified Xiao Chengqitang Combined with Acupoint Catgut Implantation in Treating Diet-induced Obesity Syndrome of Stomach Heat Dampness Obstruction / 中国实验方剂学杂志

Objective:To observe the clinical efficacy and safety of modified Xiao Chengqitang combined with acupoint catgut implantation in treating diet-induced obesity （DIO） syndrome of stomach heat dampness obstruction. Method:One hundred and seventy-two patients were randomly divided into control group（84 cases） and observation group（88 cases）. Both groups of patients received diet and exercise lifestyle adjustments， and acupoint catgut implantation was performed， 10 days for 1 time， 5 days intervals and then catgut implantation again， for a total of 6 times. Patients in observation group took modified Xiao Chengqitang granular powder， 10 g/time， with lukewarm boiled water in morning and evening. Patients in control group took modified Xiao Chengqitang granular powder simulant， 10 g/time， with lukewarm boiled water， 2 times/day. The treatment courses continued 4 months in two groups. Then the body mass index （BMI）， fat percentage （F%）， obesity， waist to hip ratio （WHR） were measured before and after treatment. Color Doppler ultrasonography was used to measure abdominal fat thickness， prehepatic fat thickness （AHF）， perirenal fat thickness （PRF）， and visceral fat index （UVI）. Fasting blood glucose （FBG）， triglyceride （TG）， total cholesterol （TC）， high-density lipoprotein-cholesterol （HDL-C）， low-density lipoprotein-cholesterol （LDL-C）， fasting insulin （FINS）， leptin （LP）， and adiponectin （APN） were detected before and after treatment， and the homeostasis model assessment of insulin resistance （HOMA-IR） index was calculated. In addition， safety evaluation was also conducted. Result:The BMI， F%， obesity degree and WHR in observation group were all lower than those in control group （<italic>P</italic><0.05 or <italic>P</italic><0.01）. Subcutaneous fat thickness， AHF， PRF and UVI in observation group were lower than those in control group （<italic>P</italic><0.01）. The TG， TC， LDL-C and FINS levels in observation group were lower than those in control group （<italic>P</italic><0.01）. The LP and HOMA-IR were also lower than those in control group （<italic>P</italic><0.01）， while the APN was higher than that in control group （<italic>P</italic><0.01）. The total effective rate in clinical application was （71/80） 88.75% in the observation group， higher than （57/75） 76.00% in the control group （<italic>χ</italic>²=4.374，<italic> P</italic><0.05）. Conclusion:Modified Xiao Chengqitang combined with acupoint catgut implantation in treating DIO syndrome of stomach heat dampness obstruction can adjust LP， APN and other factors， improve energy metabolism such as sugar and fat， and effectively control obesity with high safety， so it is worthy of clinical use.

Absorbable versus Non-Absorbable Sutures in Paediatric Facial Trauma - A Cosmetic Assessment

Paediatric age group is most vulnerable to trauma. Children often suffer facial injuries. Though many topical skin adhesives and strips are available in the market which have given excellent cosmetic results, deeper injuries especially along the lines of high tension need suturing both with buried and skin sutures. Different variety of sutures are available in the market which are used as per the choice of the surgeon. Children are more apprehensive when it comes to suture removal. So use of absorbable sutures in place of non-absorbable sutures in skin can save the children from this fear factor. MethodsA prospective study was done in the department of plastic surgery from May 2012 to Dec. 2013 with an objective of studying the outcome of plain catgut suture as skin sutures versus non-absorbable skin suture Nylon in facial trauma in the paediatric age group. Chromic catgut was used as buried suture in both groups. All the patients presenting in emergency department with facial trauma with age 10 years or less were included in the study. Skin sutures, where needed removal, were removed on 5th post-operative day followed by follow up on 7th post-operative day, 3rd month and 8th month during which cosmetic assessment of scar was done. 25 patients who presented first in emergency and fulfilled the study criteria were sutured with 5 - 0 chromic catgut buried sutures and skin suture used was 6 - 0 Nylon and this group was labelled group A. Next 25 patients who presented in emergency for suturing were sutured with 5 - 0 chromic catgut as buried and plain catgut as skin suture. This group was labelled as Group B. Cosmetic outcome was assessed on 7th post-operative day, 3rd month and 8th month by using Beusang E cosmetic scar assessment scale based on two parameters which included colour and texture of scar.1 Statistical analysis was done with continuous variables expressed as Mean ± S.D. and categorical variables were expressed as count (percentage). Chi-square was used to compare the categorical variables between groups or Fisher exact test was used. ResultsOn 7th post-operative day follow up, out of 50 patients, 25 patients (50 %) in whom nylon was used as skin suture, 4 patients (16 %) had mismatch of colour. All scars were smooth in texture. In rest 25 patients (50 %) in whom plain catgut was used as a skin suture, 1 (4 %) patient had mismatch of the colour. None of the patients had frank pus in both groups & hypertrophic scar was seen in one patient. On 3rd month follow up, Group A patients with nylon as skin suture, 1 (4 %) patient showed hypertrophic scar whereas in Group B (8 %) patients had hypertrophic scar. On 8th month follow up, both group A & B had colour mismatch of 12% with firm texture of scar in 8% patients. ConclusionsThere is no long-term differences in cosmetic outcomes and complication rates between absorbable catgut suture and commonly used nylon sutures in the repair of facial trauma in paediatric age groups. So, absorbable sutures are acceptable alternative to non-absorbable suture especially in paediatric age group, keeping in mind their apprehensive nature and fear of suture removal.

Protocolo para el manejo de la pareja infértil con implantación de catgut en puntos de acupuntura / Protocol for the management of infertile couples with catgut implantation in acupuncture points

RESUMEN Introducción: en la mujer, el hallazgo inmediato más importante en los estudios de infertilidad es la ausencia de ovulación y aunque en su tratamiento existen alternativas, aún son ineficaces debido a limitaciones diagnósticas y terapéuticas. En las causas masculinas, las alteraciones idiopáticas de la calidad del semen predominan, son más frecuentes la astenozoospermia y oligozoospermia, asociado al diagnóstico de varicocele. Las razones por las cuales el potencial de fertilidad no siempre se mejora después de tratamiento quirúrgico oportuno y adecuado del varicocele, están todavía en estudio, y los tratamientos convencionales propuestos son costosos y no siempre efectivos. Objetivo: elaborar un protocolo para el manejo de la pareja infértil con implantación de catgut en puntos de acupuntura. Desarrollo: se analizaron temáticas sobre la atención a la mujer con ciclos anovulatorios y a hombres infértiles después del tratamiento quirúrgico del varicocele y con infertilidad idiopática y los tratamientos tradicionales propuestos. Se generaron preguntas científicas para confeccionar el protocolo. Protocolo para el manejo de la pareja infértil con implantación de catgut en puntos de acupuntura que incluye: profesionales a quienes va dirigido, población diana, recursos necesarios, equipo de trabajo, papel de los miembros del equipo, secuencia de actuación, modo de realización, ventajas, desventajas y contraindicaciones de la implantación de catgut, diferenciación y tratamiento en cada caso según el diagnóstico tradicional chino e indicadores de evaluación. Conclusiones: la modalidad terapéutica propuesta, es una alternativa inocua y poco costosa que contribuye a mejorar la fecundidad y la natalidad de la pareja infértil.

ABSTRACT Introduction: in women, the most important immediate finding in infertility studies is the nonexistence of ovulation and although there are alternatives in their treatment, they are still ineffective due to diagnostic and therapeutic limitations. In male causes, idiopathic alterations in semen quality predominate, the most frequent being asthenozoospermia and oligozoospermia associated with the diagnosis of varicocele. The reasons why fertility potential is not always improved after timely and adequate surgical treatment of varicocele are still under study, and the proposed conventional treatments are expensive and not always effective. Objective: to elaborate a protocol for the management of the infertile couples with catgut implantation in acupuncture points. Development: topics regarding this protocol were analyzed on the care of women with anovulatory cycles and infertile men after surgical treatment of varicocele along with idiopathic infertility as well as the proposed traditional treatments, generating scientific questions to draw up the protocol. The protocol for the management of infertile couples with implantation of catgut in acupuncture points includes: professionals to whom it is directed, target population, necessary resources, teamwork, role of team members, sequence of action, approach for its implementation, advantages, disadvantages and contraindications concerning the implantation of catgut, differentiation and treatment in each case according to the traditional Chinese diagnosis and assessment indicators. Conclusions: the proposed therapeutic modality is an innocuous and inexpensive alternative that contributes to the improvement of fertility and birth rate in the infertile couples.

Effect of acupoint catgut embedding therapy on joint attention and social communication in children with autism spectrum disorder: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the clinical effect on the joint attention and social communication in children with autism spectrum disorder (ASD) between the combined treatment of acupoint catgut embedding therapy with rehabilitation training and the simple application of rehabilitation training.@*METHODS@#A total of 60 children with ASD were randomized into an observation group and a control group, 30 cases in each one. In the control group, the routine ASD rehabilitation training was adopted, including conductive education, speech training and music therapy, once a day. In the observation group, on the base of the treatment as the control group, the catgut embedding therapy was applied to Shenting (GV 24), Baihui (GV 20), Shenmen (HT 7) and the optic area (the point of scalp acupuncture), once a week. In the two groups, the treatment for 4 weeks was as one course, at the interval of 1 week between the courses. A total of 3 courses of treatment were required. The social domain of the autism treatment evaluation checklist (ATEC) and the autism behavior checklist (ABC) were adopted to assess the therapeutic effect of the two groups.@*RESULTS@#After treatment, the scores of each item of the social domain in ATEC and the scores of ABC (feeling, communication, physical movement, language and healthy behavior) were all lower than those before treatment in the two groups (<0.01). The scores of each item in the observation group were lower than those in the control group after treatment (<0.05).@*CONCLUSION@#The combined treatment of acupoint catgut embedding therapy with the rehabilitation training effectively improves in the joint attention and social communication. The therapeutic effect of this combined treatment is better than the simple application of rehabilitation training.

Analysis of adverse reactions of acupoint catgut embedding therapy / 中国针灸

OBJECTIVE@#To objectively evaluate the safety of acupoint catgut embedding therapy.@*METHODS@#A total of 331 patients who received acupoint catgut embedding therapy were enrolled and summarized through the inpatient medical record system, follow-up record and adverse reaction report card. The statistical analysis was performed from the aspects of patients' gender, age, marital status, history of allergy, history of diabetes and the time, symptoms, duration and prognosis of adverse reactions, etc.@*RESULTS@#Among 331 patients who received acupoint catgut embedding therapy, 70 patients had adverse reactions, which were divided into 9 types, including post-treatment discomfort, local hematoma or subcutaneous hemorrhage, local swelling, local induration, severe pain, thread-body rejection, local pruritus, post-treatment body temperature rising, local redness, swelling, fever and pain. The incidence rate of adverse events was 21.15%, and the incidence of serious adverse events was 0. Among the patients with adverse reactions, 58 patients (82.86%) relieved without treatment, and 12 patients (17.14%) received after symptomatic treatment; all patients had no sequelae.@*CONCLUSION@#The acupoint catgut embedding therapy is relatively safe and the incidence of adverse reactions is low.

Moxibustion combined with acupoint catgut embedding promotes recovery of injured colonic mucosa by suppressing inflammation in ulcerative colitis rats / 针刺研究

OBJECTIVE: To observe the effect of moxibustion and acupoint catgut embedding (ACE) at "Tianshu"(ST25) "Dachangshu"(BL25) and "Shangjuxu"(ST37) on changes of body mass, stool property, histopathological conditions and expression levels of interleukin 6 (IL-6) in colonic mucosa of ulcerative colitis (UC) rats, so as to reveal its anti-inflammatory mechanisms underlying improvement of UC. METHODS: SD rats were randomized into normal, model, moxibustion, ACE and moxibustion＋ACE groups (n＝6 in each group). The UC model was established by enema of trinitro-benzene-sulfonic acid and ethanol. Moxibustion was applied to bilateral ST25, BL25 and ST37 for 10 min, once daily for 14 days, and ACE applied to the same 3 acupoints, once a week for two weeks. After the treatment, the rats' general conditions were observed, and the severity of UC was assessed by using disease activity index (DAI) score. Colonic mucosal pathological changes were observed under microscope after hematoxylin eosin (H.E.) stain, and the expression levels of IL-6 in the colonic mucosa tissue detected by using immunohistochemical stain and Western blot, respectively. RESULTS: After modeling, the DAI score, and expression level of colonic IL-6 protein detected by immunohistochemistry and Western blot were obviously increased in the model group relevant to the normal group (P<0.01). Following the intervention, the increase of DAI score and IL-6 expression were reversed in moxibustion, ACE and moxibustion＋ACE groups (P<0.01, P<0.05). The therapeutic effects of moxibustion＋ACE were considerably superior to those of simple ACE and simple moxibustion in down-regulating the levels of DAI score and IL-6 expression (P<0.01). H．E. staining showed severe defect of the colonic mucosal epithelium with infiltration of a large number of inflammatory cells in the model group, which was milder in moxibustion, ACE and moxibustion＋ACE groups. CONCLUSION: Moxibustion combined with ACE is able to improve the inflammatory injury of colonic mucosa in UC rats, which may be related with its effect in suppressing the expression of colonic IL-6; and the efficacy of moxibustion＋ACE is apparently superior to that of moxibustion and ACE alone.

Effect of acupoint catgut embedding on levels of PG-related factors and NF-κB proteins in ute-rine tissues of rats with primary dysmenorrhea / 针刺研究

OBJECTIVE: To observe the effect of acupoint catgut embedding on levels of prostaglandin F2α(PGF2α), cyclooxygenase-2(COX-2) and nuclear factor kappa B(NF-κB) in the uteruses of rats with primary dysmenorrhea (PD), so as to explore its mechanisms underlying improvement of PD. METHODS: Forty female SD rats were randomly divided into normal, model, acupoint catgut embedment and medication groups, with 10 rats in each group. The PD model was established by subcutaneous injection of estradiol benzoate (0.5 mg on the 1st day, and 0.2 mg thereafter) once daily for 10 days, followed by i．p. of oxytocin 2 U(0.5 mg•5 U－1•mL－1) on the 11th day. Catgut embedment was applied to "Guanyuan"(CV4) and "Sanyinjiao"(SP6) on day 1 and 5 while modeling, and rats of the medication group received gavage of ibuprofen (1.25 mg/mL, 0.8 mL/rat) once daily for 10 d. The level of PGF2αin the uterus tissuewas assayed by ELISA, and the expression levels of uterine COX-2, phospho (p)-NF-κB p65, NF-κB p65 proteins were detected by Western blot. RESULTS: Compared with the normal group, the levels of PGF2α， COX-2, p-NF-κB p65 and NF-κB p65 in the uterine tissues were significantly increased in the model group (P<0.05). Compared with the model group, the levels of PGF2α and COX-2 in both catgut embedment and medication groups as well as p-NF-κB p65 in the catgut embedment group were significantly decreased (P<0.05). Compared with the medication group, the level of p-NF-κB 65 in the catgut embedment group was significantly decreased (P<0.05). CONCLUSION: The analgesic effect of acupoint catgut embedding may be related to its effects in down-regulating the expression of p-NF-κB and the levels of COX-2 and PGF2αin uteruses of PD rats.

Effects of Acupoint Catgut Embedding on Motor Function in Cerebral Ischemia-reperfusion Injury in Rats / 中国康复理论与实践

Objectives:To investigate the effect of acupoint catgut embedding on motor function of rats with cerebral ischemia-reperfusion, and explore its possible mechanism. Methods:A total of 48 three-month old healthy specified pathogen free male Sprague-Dawley rats were randomly divided into three groups with 16 rats in each group. The right external carotid artery was severed only in sham operation group. Right middle cerebral artery occlusion was induced for 90 minutes under isoflurane anesthesia using a monofilament in model group and acupoint catgut embedding group. Ninety minutes after reperfusion, the acupoint catgut embedding group accepted acupoint catgut embedding on Baihui (DU20) acupoint and anterior oblique line of vertex-temporal. After one, three, seven and 14 days of reperfusion, they were assessed with Neurological Evaluation and Screen Prehensile Test. After 14 days of reperfusion, the infarct volume was measured with TTC staining; the expression of glial fibrillary acidic protein (GFAP) and Synapsin I was detected with immunohistochemistry, Western blotting and reverse transcription real-time quantitative polymerase chain reaction (RT-qPCR). Results:Compared with the sham operation group, the neurological score significantly decreased (t > 11.851, P < 0.001), the prehensile time significantly decreased (t > 6.190, P < 0.001), the expression of GFAP increased (P < 0.05), and the expression of Synapsin I decreased (P < 0.05) in the model group. Compared with the model group, the neurological score significantly increased (t > 3.464, P < 0.001), the prehensile time significantly increased (t > 3.642, P < 0.001), the cerebral infarction volume significantly decreased (F = 93.426, P < 0.001), the expression of GFAP decreased (P < 0.05), and the expression of Synapsin I increased (P < 0.05) in the acupoint catgut embedding group. Conclusion:Acupoint catgut embedding could promote the recovery of motor function of rats with cerebral ischemia-reperfusion injury, which may be related with inhibiting the proliferation of astrocytes, increasing the regeneration of axons in the ischemic penumbra and enhancing synaptic connection.

Effects of different materials for partial sciatic nerve ligation on glial cell activation in rat models of chronic constriction injury / 南方医科大学学报

OBJECTIVE@#To compare the effects of different materials for partial sciatic nerve ligation on glial cell activation in the spinal cord in a rat model of chronic constriction injury (CCI).@*METHODS@#SD rats were randomly divided into the sham group (=15), silk suture CCI group (=15) and chromic catgut CCI group (=14). The mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL) of the rats were detected at 3, 7, 11 and 15 days after the operation. The changes in the sciatic nerve, the activation of spinal cord glial cells and the expression of inflammatory factors were observed using Western blotting and RT-PCR.@*RESULTS@#At 3 to 15 days after the surgery, MWT and TWL of the rats were significantly lower in silk suture group and chromic catgut group than in the control group ( < 0.05), and was significantly lower in chromic catgut group than in the silk suture group ( < 0.05) at 3 days after the surgery. The results of sciatic nerve myelin staining showed that the sciatic nerve was damaged and demyelinated in both the ligation groups. The expressions of CD11b, GFAP, IL-1β and TNF-α in the two ligation groups were similar and all significantly higher than those in the control group ( < 0.05). IL-6 mRNA level was significantly higher in chromic catgut group than in the silk suture group ( < 0.05).@*CONCLUSIONS@#The CCI models established by partial sciatic nerve ligation with silk suture and chromic catgut all show glial activation, and the inflammatory response is stronger in chromic catgut group.

Mechanism of catgut embedding at back- points for nonalcoholic steatohepatitis based on IKK/IKB/NF-κB signaling pathway / 中国针灸

OBJECTIVE@#To explore the mechanism of catgut embedding at back- points on nonalcoholic steatohepatitis (NASH) in rats based on IKK/IKB/NF-κB signaling pathway and downstream inflammatory factors.@*METHODS@#Eighty SPF SD rats were selected, among them 10 rats were selected divided into a normal group (group A), and the remaining 70 rats were fed with high-fat diet to establish NASH model. At the end of 12 weeks, 10 rats were randomly selected to verify whether the model establishment was successful. Then the remaining 60 rats were randomly divided into a model group (group B), a catgut embedding at back- points group (group C), a catgut embedding at abdominal points group (group D), an acupuncture at back- points group (group E), a sham catgut embedding group (group F) and a western medication group (group G), 10 rats in each group. The rats in the group C were treated with catgut embedding at "Ganshu" (BL 18), "Pishu" (BL 20), "Weishu" (BL 21) and "Shenshu" (BL 23); the rats in the group D were treated with catgut embedding at "Daheng" (SP 15), "Fujie" (SP 14), "Huaroumen" (ST 24) and "Tianshu" (ST 25); the rats in the group E were treated with acupuncture at the same acupoints as the group C; the rats in the group F were treated with catgut embedding at back- points but the needle did not enter subcutaneous tissue gamma; the rats in the group G were treated with intragastric administration of vitamin E capsule. All the treatment was given for 4 weeks. The rats in the group A were fed with normal diet until the end of 16 weeks without any intervention. The rats in the group B continued to be fed with high-fat diet until the end of 16 weeks. After the intervention, the liver index was calculated; the liver histomorphology was observed by HE staining; the liver function [alanine aminotransferase (ALT), gamma glutamyl transferase (γ-GGT), alkaline phosphatase (ALP)] and blood lipid [serum total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL)] were measured by serum biochemistry. The serum levels of TNF-α, IL-6 and IL-1βwere detected by ELISA, and the expressions of IKK-α, NF-κBp65, IL-6, IL-1β and TNF-α proteins in liver tissue were detected by Western blot. The temperature of the conception vessel and the governor vessel was measured by infrared thermography.@*RESULTS@#Compared with the group A, the obvious steatosis and inflammatory cell infiltration were observed in the group B, and the body weight, liver wet-weight and liver index were all increased (0.05), while the temperature of the governor vessel in the group C was superior to that in the group D (<0.05).@*CONCLUSION@#The catgut embedding at back- points might inhibit the activation of IKK/IKB/NF-κB signaling pathway to interrupt the inflammatory cascade, and reduce the "second hit" of inflammatory factors on liver, which could slow down NASH progress and prevent and treat NASH.

Acupoint catgut embedding improves dysmenorrhea by suppressing activation of NLRP3 inflammasomes in uterine tissues in primary dysmenorrhea rats / 针刺研究

OBJECTIVE: To observe the effect of acupoint catgut embedding on the expression of nucleotide-binding oligomerization domain (NOD)-like receptor protein 3 (NLRP3) inflammasome, interleukin (IL)-1β and IL-18 in the uterine tissue of primary dysmenorrhea (PD) rats, so as to explore its underlying mechanisms in improving PD. METHODS: Forty female SD rats were randomly divided into control, model, acupoint catgut embedding and medication groups (n＝10 in each group). The PD model was established by subcutaneous injection of Estradiol Benzoate (0.5 mg/rat on the 1st and 10thday, and 0.2 mg/rat from 2nd to 9thday) and Oxytocin (2 U/rat, i．p.). The catgut embedding was applied to bilateral "Sanyinjiao" (SP6) and "Guanyuan" (CV4) on the 1st and 5th day after modeling. Rats of the medication group were treated by intragastric perfusion of Fenbid (0.8 mL/rat, 125 mg/100 mL) once daily for 10 days. The body writhing times in 30 min were recorded. The histopathological changes of the uterine were observed by H．E. staining. Western blot was used to detect the expression of NLRP 3, caspase-1, IL-1β and IL-18 in uterine tissues. RESULTS: The body writhing times were notably more in the model group than in the control group (P0.05). CONCLUSION: The acupoint catgut embedding can significantly alleviate the symptoms and pathological damage in PD rats, which may be related to its effect in inhibiting the activation of NLRP3 inflammasome in the uterine tissue.

Clinical therapeutic effect of hyperlipidemia of turbid phlegm obstruction pattern/syndrome treated with the different Jin's three-needle therapies / 针刺研究

OBJECTIVE: To compare the differences in clinical effects on hyperlipidemia of turbid phlegm obstruction pattern/syndrome treated with the different Jin's three-needle therapies so as to provide a new approach and theoretic evidence for the clinical optimal scheme of acupuncture on hyperlipidemia. METHODS: A total of 90 patients were randomly divided into education group, electroacupuncture group and catgut embedding group (30 cases in each). The routine health education was given to the education group. On the base of the treatment as the education group, electroacupuncture was applied to the electroacupuncture group for 30 min each time, twice a week; and the catgut embedding was applied to the catgut embedding group at the same acupoints as the electroacupuncture group, once a week. The treatment was given consecutively for 8 weeks in each group. Before and after treatment, the obesity indices [weight, waistline, body mass index (BMI)], blood lipid indices[serum total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C)] and insulin resistance indices [fasting blood glucose(FBG), fasting plasma insulin(FINS), homeostasis model assessment-estimated insulin resistance (HOMA-IR)] were observed in the three groups before and after treatment. RESULTS: After treatment, in the electroacupuncture group and the catgut embedding group, the results of the obesity indices, e.g. weight, waistline and BMI, the levels of blood lipid, e.g.TC, TG, LDL-C and the insulin resistance indices, e.g. FINS and HOMA-IR were all obviously decreased compared with those before treatment (P0.05). The total effective rate was 90.0% in the catgut embedding group (27/30) and it was 83.3% (25/30) in the electroacupuncture group, either of them was better than 60.0% (18/30) in the education group , indicating the statistical significance (P<0.01, P<0.05). CONCLUSION: On the base of health education, either the catgut embedding therapy or electroacupuncture of Jin's three-needle treatment achieves the positive regulation on the abnormal lipid metabolism and insulin resistance. The hypoglycemic effect and the impro-ving effect in LDL-C and HDL-C of the catgut embedding therapy are superior to electroacupuncture.

Comparative study of acupoint catgut embedding and bupropion hydrochloride sustained-release tablets for tobacco dependence / 中国针灸

OBJECTIVE@#To compare the clinical efficacy of acupoint catgut embedding and bupropion hydrochloride sustained-release tablets in the treatment of tobacco dependence.@*METHODS@#A total of 100 patients with tobacco dependence who met the inclusion criteria were randomly divided into an acupoint catgut embedding group and a drug group, 50 cases in each group. In the acupoint catgut embedding group, acupoint catgut embedding was applied at Xinshu (BL 15), Shenmen (HT 7), Tianmei (Extra), Taichong (LR 3), the treatment was given once every 2 weeks for 4 times; The bupropion hydrochloride sustained-release tablets was orally administered in the drug group for 7 weeks, 150 mg each time, once a day for the first 3 days, twice daily from day 4 to day 7, and once a day after day 8. The Fagerström test for nicotine dependence (FTND) score before and after treatment, the 4th and 8th week smoking cessation rate, the continuous smoking cessation rate and efficacy, compliance rate and adverse reaction rate were compared in the two groups.@*RESULTS@#A total of 100 patients were enrolled, and 97 patients completed the study (loss rate was 3%), including 49 cases in the acupoint catgut embedding group and 48 cases in the drug group. The FTND scores in the two groups were lower than those before treatment (both 0.05). At the 4th and the 8th week, the smoking cessation rate in the acupoint catgut embedding group was 40.8% (20/49) and 79.6% (39/49) respectively, the smoking cessation rate in the drug group was 41.7% (20/48) and 83.3% (40/48) respectively, the two groups were equally effective (both >0.05). The continuous smoking cessation rate in the acupoint embedding group was 40.8% (20/49), which was equivalent to 41.7% (20/48) in the drug group (>0.05). The rate of complete compliance in the acupoint embedding group was 61.2% (30/49), which was significantly better than 37.5% (18/48) in the drug group (<0.05). The adverse reaction rate in the acupoint catgut embedding group was 12.2% (6/49), which was significantly lower than 29.2% (16/48) in the drug group (<0.05).@*CONCLUSION@#Acupoint catgut embedding can effectively improve the symptoms of tobacco dependence after smoking cessation. Its curative effect is close to that of bupropion hydrochloride sustained-release tablets, and it has good clinical compliance and less adverse reactions.

Adjuvant therapy of acupoint catgut embedding for threatened abortion after in vitro fertilization-embryo transfer: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the effects of acupoint catgut embedding on miscarriage prevention and pregnancy outcome in patients with threatened abortion after in vitro fertilization-embryo transfer (IVF-ET).@*METHODS@#Sixty cases of patients with threatened abortion after IVF-ET were randomly divided into an observation group and a control group, 30 cases in each group. The patients in the control group were treated with intramuscular injection of progesterone (40 mg) once every day, while the patients in the observation group, on the basis of the treatment of control group, were treated with catgut embedding at Geshu (BL 17), Ganshu (BL 18), Shenshu (BL 23), Pishu (BL 20), Weishu (BL 21), Xuehai (SP 10), Diji (SP 8) and Fuliu (KI 7), once every two weeks, six times as a course of treatment. The treatment was given until 12 weeks into pregnancy. The level of serum human chorionic gonadotropin (HCG), estradiol (E) and progesterone (P) before and after treatment was recorded; the TCM syndrome score before and after treatment was compared; the successful pregnancy rate and spontaneous abortion rate after treatment were observed in the two groups.@*RESULTS@#Compared before treatment, the scores of TCM syndrome in both groups were reduced after treatment (both <0.01), and score in the observation group was superior to that in the control group (<0.05). After treatment, the clinical efficacy in the observation group was superior to that in the control group (<0.05). After treatment, the hormone levels (β-HCG, E, P) in both groups were increased steadily; the hormone levels in 6-week pregnancy, 8-week pregnancy and 10-week pregnancy were significantly higher than those in 4-week pregnancy (all <0.05); except the levels of P and β-HCG in 10-week pregnancy, the hormone levels in the observation group were superior to those in the control group (all <0.05). After treatment, the early abortion rate was 16.7% (5/30) in the observation group, which was lower than 33.3% (10/30) in the control group (<0.01); the pregnancy rate was 96.0% (24/25) in the observation group, which was higher than 80.0% (16/20) in the control group (<0.01).@*CONCLUSION@#Acupoint catgut embedding is effective for preventing threatened abortion, which could significantly reduce the spontaneous abortion rate, improve the pregnancy success rate, regulate hormone levels in patients after IVF-ET.

Effect of Bushen Yanggan decoction combine with acupoint catgut embedding therapy in the treatment of patients with premature ovarian failure and its influence on serum follicle stimulating hormone and estradiol levels / 中国基层医药

Objective To study the effect of Bushen Yanggan decoction combine with acupoint catgut embedding therapy in the treatment of patients with premature ovarian failure and its influence on serum follicle stimulating hormone(FSH) and estradiol(E2) levels. Methods From January 2016 to June 2017,76 patients with premature ovarian failure in the First People＇s Hospital of Xiaoshan District were selected. They were divided into observation group(n=38) and control group(n=38) by the random number table method. The control group was given western medicine hormone replacement therapy, the observation group was given Bushen Yanggan decoction combined with acupoint catgut embedding therapy. The patients in the two groups were treated for 3 months. The clinical efficacy,clinical symptoms,serum FSH,E2levels and endometrial thickness before and after treatment were compared between the two groups. Results The total effective rate of the observation group was 86. 84% (33/38), which was slightly higher than 78. 95% (30/38) of the control group,but the difference was not statistically significant (χ2=0. 835,P＞0. 05). The incidence rates of soreness and weakness of waist and knees,hot flashes sweating,sexual decline,loss of control of the observation group after 3 months of treatment were 21. 05% (8/38),26. 32% (10/38), 18.42%(7/38),21. 05% (8/38),respectively,which were significantly lower than those of the control group [44.74%(17/38),50. 00% (19/38),39. 47% (15/38),42. 11% (16/38)],the differences were statistically significant(χ2=4. 828,4. 517,4. 094,3. 897,all P＜0. 05). The serum FSH of the observation group after 3 months of treatment was (31. 44 ± 11. 04) IU/L,which was lower than (60. 38 ± 13. 02) IU/L of the control group,the difference was statistically significant(t =10. 447,P ＜0. 05). The serum E2levels,endometrial thickness of the observation group were (92. 77 ± 10. 72) pmol/L,(7. 95 ± 1. 17) mm,respectively,which were higher than those of the control group[(60.24±11.33)pmol/L,(4.82 ±1.65)mm],the differences were statistically significant(t=12. 856,9. 539,all P＜0. 05). Conclusion Bushen Yanggan decoction combined with acupoint catgut embedding therapy for premature ovarian failure has good curative effect,it can improve the clinical symptoms and serum sex hormone levels,increase the thickness of the endometrium,which is worthy of clinical application.

The key issues and corresponding strategy of acupoint medicated catgut embedding therapy / 中国针灸

Acupoint medicated catgut embedding therapy is a new type of acupuncture combined with medicine，which has great potential in the prevention and treatment of chronic diseases. This paper describes the clinical application of acupoint medicated catgut embedding in the treatment of common disease, medicated thread productionmethods and acupoints selection.To analyze the problems of the unclear mechanism, the lack of standardization of medicated thread production, the lag of the embedding tool, and the unclear adverse reaction. It is expected to promote the further development of acupoint medicated catgut embedding therapy by strengthening the mechanism of action, optimizing medicated catgut thread, rational design experiments, standardizing medicated thread production, innovating embedding tools, rational formulation, and optimizing acupoint selection.