[ASL-based Observation of Central Nervous System Responses to Acupuncture Analgesia for People with Different Sensitivities].

OBJECTIVE: To examine the effects of different sensitivities on the effectiveness of acupuncture analgesia by observing activation change characteristics of cerebral areas resulting from the influences of constitutions on analgesia effects and to discuss the response mechanism of central nervous system (CNS) to determine the factor of constitutions on acupuncture efficacy using cerebral functional magnetic resonance imaging arterial spin labeling (fMRI-ASL). METHODS: Participants with different sensitivities were assessed according to standard screening and grouped into two groups: insensitivity group (n＝24) and sensitivity group (n＝22). All participants were given acupuncture at the left-sided Zusanli point. Pressure pain threshold (PPT) of their body surface was determined before and after the acupuncture, and the two groups were subsequently compared in terms of analgesic effects and PPT rate of change; cerebral fMRI-ASL was performed; software such as SPM 8 and ASLtbx were utilized to preprocess the results, and correlation between regional cerebral blood flow (rCBF) and visual analog scale (VAS) score was determined using Pearson's correlational analysis. RESULTS: VAS score in the sensitivity group was significantly higher than that in the insensitivity group (P< 0.05); after acupuncture, PPT rate of change in the sensitivity group was higher than that in the insensitivity group (P< 0.05). The analyses revealed that there was a negative correlation between rCBF and VAS score for the right-sided anterior cingulate cortex in the insensitivity group and superior frontal gyrus in the sensitivity group (|r|>0.3 and P<0.05). CONCLUSION: Different sensitivity to acupuncture is one of the crucial factors influencing analgesia effects. The sensitivity group had superior analgesia effect than the insensitivity group. Acupuncture might deactivate cerebral functional areas to generate analgesic effects.The superior frontal gyrus and bilateral anterior cingulate cortex, because of deactivation, play a positive role in sensitive patients, which is probably one of the CNS cerebral areas responding to acupuncture analgesia of people who are sensitive to acupuncture.

[Effect of eletroacupuncture with close-to-bone needling treatment on expression of Sox9, VEGF and ColX in impaired cartilage of rabbits with knee osteoarthritis].

OBJECTIVE: To investigate the effect of eletroacupuncture with close-to-bone needling treatment on expression of Sox9, vascular endothelial growth factor (VEGF) and type X collagen (ColX) in impaired cartilage of rabbits with knee osteoarthritis (KOA) and explore its possible mechanisms. METHODS: Forty New Zealand rabbits were randomized equally into normal control group, KOA model group, eletroacupuncture with close-to-bone needling group (CN group), and normal thrust needing group (NTN group). In the latter 3 groups, KOA was induced by Hulth-Telhag treatment and evaluated with X-ray examination, and 6 weeks after the modeling, eletroacupuncture for 20 min was administered in CN and NTN groups at the acupoints "Zusanli", "Waixiyan", "Neixiyan", "Liangqiu" and "Yinlingquan" in the left knee joints once daily for 5 days as a treatment cycle. After 5 treatment cycles, the rabbits were examined for behavioral changes, cartilage morphology, and Mankin scores; The protein and mRNA expressions of S0x9, VEGF, and ColX were examined using Westen blotting, immunohistochemistry, and RT-PCR as appropriate. RESULTS: The rabbits in the model, CN and NTN groups showed significant changes in behaviors and cartilage histomorphology after the modeling and after the treatments. HE staining showed that cartilage injury was repaired and tended to recovery in CN and NTN groups. The cartilage pathologies was severer in the model group than in the normal control, CN and NTN groups (P<0.01); Sox9 protein increased and VEGF mRNA level decreased in CN and NTN groups after treatment as compared with those in the model group (P<0.01). CONCLUSION: Eletroacupuncture with close-to-bone needling can effectively improve KOA in rabbits probably by enhancing Sox9 and reducing VEGF and ColX expressions in the cartilage to inhibit hypertrophic differentiation of the chondrocytes, maintain chondrogenic phenotype and repair cartilage cells.

[Effects of Short Thrust Needing plus Electroacupuncture Intervention on Cartilage Tissue in Rabbits with Knee Osteoarthritis].

OBJECTIVE: To observe the effectiveness of short thrust needling (STN, close-to-bone needing) plus electroacupuncture (EA) in healing knee cartilage tissue and in regulating expressions of cartilage vitamin K dependent gamma-glutamyl carboxylase (GGCX), matrix metalloproteinase-13 (MMP 13) and serum uncarboxylated matrix gla protein (ucMGP) in rabbits with knee osteoarthritis (KOA), so as to reveal its mechanism underlying improvement of KOA. METHODS: Forty New Zealand rabbits were randomly divided into normal, model, EA and STN+ EA groups (n = 10 in each group). The KOA model was created by cutting the medial lateral ligament and medial parapatellar arthrotomy of rabbits as described by Hulth and colleagues. For rabbits in the STN+ EA group, "Neixiyan" (EX-LE 4) and "Waixiyan" (ST 35) were punctured with filiform needles by controlling the needle-tip obliquely to advance till the bone surface of the knee joint cavity, and "Yinlingquan" (SP 9) and "Zusanli" (ST 36) punctured by holding the filiform needles vertically along the tibia, and "Liangqiu" (ST 34) was punctured by controlling the filiform needle to advance till the thigh-bone, followed by EA stimulation. EA (2 Hz/100 Hz, 1-3 mA) was applied to unilateral EX-LE 4 and ST 35, and ST 36 and SP 9, separately for 20 min, once daily for 20 days except weekends. The pathological changes of the knee cartilage cells were observed using H. E. staining, Toluidine blue staining and electron transmission microscope, respectively. The immunoactivity of GGCX of the knee cartilage was determined by immunohistochemistry and the expression levels of GGCX and MMP 13 proteins in the cartilage were detected by Western blot, and the content of serum ucMGP was assayed by ELISA. RESULTS: H. E. staining, Toluidine blue staining and electron transmission microscope results showed that pathological changes of knee cartilage cells in structure after modeling were improved in both the STN+ EA and EA groups, particularly the former group. In comparison with the normal group, the expression levels of GGCX protein in the cartilage tissue showed by both Western blot and immunohistochemistry were notably down-regulated (P<0.01), and the cartilage MMP 13 protein expression and serum ucMGP content were considerably up-regulated in the model group (P<0.01, P<0.05). After STN+ EA and simple EA, the decreased GGCX and the increased MMP 13 expression and serum ucMGP content were reversed (P<0.01, P<0.05). The effects of STN+EA were significantly superior to those of simple EA in down-regulating MMP13 and ucGLA levels, and upre-gulating GGCX expression. CONCLUSION: Both STN+ EA and simple EA can effectively improve pathological changes of cartilage cells in KOA rabbits, which may be associated with their actions in up-regulating the expression of cartilage GGCX protein and lowering the levels of serum ucMGP content and cartilage MMP 13 protein expression, and the effects of STN+ EA are better.

[Characteristics of Deqi Induced by Needling Zusanli (ST 36) in 527 Healthy Volunteers with Different Constitutions].

OBJECTIVE: To explore the relationship between the theory of constitution in terms of Chinese medicine and clinical efficacy of acupuncture treatment via analyzling the characteristics of Deqi during acupuncture stimulation of Zusanli (ST 36) in healthy volunteers with different constitutions. METHODS: In the present study, a total of 527 healthy undergraduate student volunteers (267 girls and 260 boys) were recruited. They received questionnaire first about their constitutions in accordance with Professor WANG Qi's Classification and Determination of Constitution in terms of Chinese medicine. Then, the subjects were asked to take a supine position on a check-bed, a qualified acupuncturist held a sterilized fifiform needle to rapidly insert it into ST 36 and manipulated the acupuncture needle with uniform reinforcing-reducing technique at a frequency of about 60-90 times/min and an amplitude of 0.3-0.5 cm. The status of Deqi was assessed by using visual analogue scale (VAS). RESULTS: Needling sensations mainly involve soreness, numbness, heaviness, distension, dull pain and propagated sensations along meridian (PSC). During acupuncture stimulation, most subjects experienced distension sensation, accounting for 90.3%, followed by soreness, accounting for 45.9%. Except for PSC reaction, the rest 5 needling sensations had no statistical difference in their occurrence rates in those subjects with different constitutions (P>0.05). The PSC appeared a higher incidence in yin-yang harmony(balanced) constitution subjects than in qi- deficiency, yang-deficiency, blood-stagnation and qi-stagnation constitution subjects (P<0.05). The intensity of soreness was obviously stronger in the balanced constitution subjects than in qi-deficiency, yang-deficiency, yin-deficiency, phlegm-damp, damp-heat and qi-stagnation constitution subjects (P<0.05), while the intensity of distension sensation was apparently stronger in the balanced constitution subjects than in simpleyang-deficiency subjects (P<0.05). CONCLUSIONS: Except for PSC, the Deqi sensations of soreness, numbness, heaviness, distension and dull pain induced by acupuncture stimulation of ST 36 are comparable in the occurrence rates in healthy volunteer subjectswith different (9 types of) constitutions in terms of Chinese medicine, whereas the intensity of soreness may be the important factor for acupuncture induced pain relief. A certain correlation between the constitution and acupuncture effectiveness exists, suggesting that acupuncture treatment should vary from patient to patientin clinical practice.

[Effect of Electroacupuncture with Near-to-bone Needling to Chondrocyte Apoptosis and Proliferation on the Knee Osteoarthritis Model].

OBJECTIVES: To study the effect of electroacupuncture with near-to-bone needling on the proliferation and apoptosis of knee osteoarthritis. METHODS: Totally 40 New Zealand rabbits were randomly divided into two groups, the normal group (A, n =10) and the modeling group (n =30). Hulth-Telhag method was applied 30 rabbits to establish rabbit left knee osteoarthritis model, and evaluated by X-ray after 6 weeks. Then divided the 30 modeling rabbits into electroacupuncture with near-to-bone needling group (C,n =10), electroacupuncture with ordinary needling group (D,n =10) and model group (B ,n =10) randomly. Four treatments (5 d as one course of treatment) were applied to C group and D group, respectively. At the end of the experiment, modeling situation was detected by X-ray, pathological changes of cartilage was detected by HE staining ,and apoptosis of chondrocytes was checked by TUNEL staining; mRNA expressions of Caspase-3 and proliferating cell unclear antigen (PCNA) in chondrocytes were detected by RT-PCR; protein expressions of Caspase-3, PCNA, Bcl-2 and Bax in chondrocytes were detected by Western blot. RESULTS: HE stain demonstrated that the chondrocytes of A group,C group and D group were arranged in a more regular and smooth surface when compared with B group. The expressions of Bcl-2 and PCNA in C and D groups were higher than those of B group, but the expression of Caspase-3 and Bax were lower, when evaluated with Western blot;increased expressions of PCNA and Bcl-2 but decreased expressions of Caspase-3 and Bax in C group were also noticed when compared with D group. RT-PCR results demonstrated that when compared with B group, the expression of PCNA mRNA were increased but Caspase-3 mRNA were decreased in C and D groups; compared with D group, the expression of PCNA mRNA were increased but Caspase-3 mRNA were decreased in C group. CONCLUSIONS: The electroacupuncture with near-to-bone needling method is superior to the electroacupuncture with ordinary needling in decreasing apoptosis and promoting proliferation of chondrocytes.