Bloodletting Puncture at Hand Twelve Jing-Well Points Relieves Brain Edema after Severe Traumatic Brain Injury in Rats via Inhibiting MAPK Signaling Pathway / 中国结合医学杂志

OBJECTIVE@#To investigate whether blood-brain barrier (BBB) served a key role in the edema-relief effect of bloodletting puncture at hand twelve Jing-well points (HTWP) in traumatic brain injury (TBI) and the potential molecular signaling pathways.@*METHODS@#Adult male Sprague-Dawley rats were assigned to the sham-operated (sham), TBI, and bloodletting puncture (bloodletting) groups (n=24 per group) using a randomized number table. The TBI model rats were induced by cortical contusion and then bloodletting puncture were performed at HTWP twice a day for 2 days. The neurological function and cerebral edema were evaluated by modified neurological severity score (mNSS), cerebral water content, magnetic resonance imaging and hematoxylin and eosin staining. Cerebral blood flow was measured by laser speckles. The protein levels of aquaporin 4 (AQP4), matrix metalloproteinases 9 (MMP9) and mitogen-activated protein kinase pathway (MAPK) signaling were detected by immunofluorescence staining and Western blot.@*RESULTS@#Compared with TBI group, bloodletting puncture improved neurological function at 24 and 48 h, alleviated cerebral edema at 48 h, and reduced the permeability of BBB induced by TBI (all P<0.05). The AQP4 and MMP9 which would disrupt the integrity of BBB were downregulated by bloodletting puncture (P<0.05 or P<0.01). In addition, the extracellular signal-regulated kinase (ERK) and p38 signaling pathways were inhibited by bloodletting puncture (P<0.05).@*CONCLUSIONS@#Bloodletting puncture at HTWP might play a significant role in protecting BBB through regulating the expressions of MMP9 and AQP4 as well as corresponding regulatory upstream ERK and p38 signaling pathways. Therefore, bloodletting puncture at HTWP may be a promising therapeutic strategy for TBI-induced cerebral edema.

Research advances in the clinical effect of bloodletting puncture at well-points in treatment of acute central nervous injury / 针刺研究

Bloodletting puncture at twelve well-points is a characteristic emergency therapy in traditional Chinese medicine. This article reviewed the research advances in the clinical effect of this therapy in the treatment of acute central nervous injury and its mechanism of action over the past 30 years, and it is found that this therapy can effectively improve disturbance of consciousness, neurological defects, and cerebral edema caused by stroke, traumatic brain injury, and carbon monoxide poisoning. The mechanism involves the improvement of cerebral blood flow and tissue oxygen supply, repair of the blood-brain barrier, and regulation of local ion balance. Well-designed clinical trials and in-depth research on biological mechanisms should be performed in future to promote and guide its clinical application.

Effect of bloodletting acupuncture at twelve -well points of hand on microcirculatory disturbance in mice with traumatic brain injury / 中国针灸

OBJECTIVE@#To observe the effect of bloodletting acupuncture at twelve -well points of hand on microcirculatory disturbance in mice with traumatic brain injury (TBI), and to explore the protective effect of bloodletting therapy on TBI.@*METHODS@#Sixty clean adult male C57BL/6J mice were randomly divided into a sham-operation group, a model group and a treatment group, 20 mice in each group. The TBI model was established by using electronic controlled cerebral cortex impact instrument in the model group and the treatment group. The mice in the treatment group were treated with bloodletting acupuncture at bilateral "Shaoshang" (LU 11), "Shangyang" (LI 1), "Zhongchong" (PC 9), "Guanchong" (TE 1), "Shaochong" (HT 9) and "Shaoze" (SI 1) immediately after trauma. The mice in the sham-operation group only opened the bone window but did not receive the strike. The regional cerebral blood flow (rCBF) was monitored by laser speckle contrast analysis (LASCA) using a PeriCam PSI System before trauma, immediately after trauma and 1, 2, 12, 24, 48, 72 h after trauma. The brain water content was measured by wet-dry weight method 24 h after trauma. The severity of functional impairment at 2, 12, 24, 48 and 72 h after trauma was evaluated by modified neurological scale scores (mNSS).@*RESULTS@#① 2 h after trauma, the mNSS in the model group and treatment group were >7 points, suggesting the successful establishment of model; compared with the sham-operation group, the mNSS was increased significantly from 12 to 72 h after trauma in the model group ( all <0.01), but the mNSS in the treatment group was significantly lower than that in the model group from 2 to 24 h after trauma (<0.01, <0.05). ② Compared with the sham-operation group, rCBF in the model group was decreased significantly immediately after trauma (<0.01), and the rCBF in the model group was lower than that in the sham-operation group from 1 to 72 h after trauma ( all <0.01); rCBF in the treatment group began to rise and was significantly higher than that in the model group 1-2 h after trauma (<0.01); 12-48 h after trauma, the increasing of rCBF in the two groups tended to be gentle until 72 h after injury, and rCBF in the model group was decreased while that in the treatment group continued to rise and was higher than that in the model group (<0.01). ③ 24 h after trauma, the brain water content in the model group was significantly higher than that in the sham-operation group (<0.01), and brain water content in the treatment group was significantly lower than that in the model group (<0.01).@*CONCLUSION@#The bloodletting acupuncture at twelve -well points of hand could improve microcirculation disturbance, increase microcirculation perfusion, alleviate secondary brain edema and promote the recovery of nerve function in mice with TBI.

Clinical study on post-stroke urinary retention treated with acupuncture at the twelve-well points and bladder function training / 中国针灸

<p><b>OBJECTIVE</b>To explore the methods for the therapeutic effect improvement in the treatment of post-stroke urinary retention.</p><p><b>METHODS</b>Sixty-three patients of post-stroke urinary retention were randomized into an observation group (32 cases) and a control group (31 cases). The routine clinical medication of neurology and basic rehabilitation were adopted in the two groups. Additionally, in the control group, the intermittent urinary catheterization and bladder function training were applied. The duration and frequency of catheterization were determined by the autonomic urination and residual urine volume every day. In the observation group, on the basis of the treatment as the control group, acupuncture was applied to the twelve-well points in the sequence offlowing among the twelve meridians [Shaoshang (LU 11), Shangyang (LI 1), Lidui (ST 45), Yinbai (SP 1), Shaochong (HT 9), Shaoze (SI 1), Zhiyin (BL 67), Yongquan (KI 1), Zhongchong (PC 9), Guanchong (TE 1), Zuqiaoyin (GB 44) and Dadun (LR 1)]. Acupuncture was given once a day, 20 treatments were required. In 20 treatments, the clinical therapeutic effects and the residual urine volume were observed.</p><p><b>RESULTS</b>The total effective rate was 90.6% (29/32) in the observation group, better than 67.7% (21/31) in the control group (<0.01)). After treatment, the residue urine volume was all reduced apparently in the patients of the two groups (both<0.01). The result of the residue urine volume in the observation group was lower apparently than that in the control group (<0.01).</p><p><b>CONCLUSION</b>Acupuncture at the-well points in the sequence offlowing among meridians combined with bladder function training achieve the apparent therapeutic effects on post-stroke urinary retention. The results are better than those achieved by the routine western medicine with bladder function training involved.</p>

The Effect of Hand Twelve Jing-Well Points Bloodletting on Blood-brain Barrier Permeability in PMCAO Rats / 上海针灸杂志

Objective To investigate the effect of hand twelve Jing-Well points bloodletting on blood-brain barrier (BBB) permeability in the early stage of focal cerebral ischemic injury in rats with permanent middle cerebral artery occlusion (pMCAO). Method Male Wister rats were randomized into sham operation, model and bloodletting groups. A model of middle cerebral artery occlusion was made by Longa's method. 2%Evans blue (EB) was injected into the caudal vein at three time points:5, 24 and 72 hrs after model making. EB exudation amount was assessed by measurement of EB absorbance in brain tissue to observe BBB permeability. Result Cerebral EB exudation amount was significantly higher in the model group of rats than in the sham operation group (P<0.01) and significantly lower in the bloodletting group than in the model group (P<0.01). Conclusion Hand twelve Jing-Well points bloodletting can reduce blood-brain barrier permeability in pMCAO rats. Its effect is highly significant at 24 and 72 hrs after ischemia.