Perspective of Calcium Imaging Technology Applied to Acupuncture Research.

Acupuncture, a therapeutic treatment defined as the insertion of needles into the body at specific points (ie, acupoints), has growing in popularity world-wide to treat various diseases effectively, especially acute and chronic pain. In parallel, interest in the physiological mechanisms underlying acupuncture analgesia, particularly the neural mechanisms have been increasing. Over the past decades, our understanding of how the central nervous system and peripheral nervous system process signals induced by acupuncture has developed rapidly by using electrophysiological methods. However, with the development of neuroscience, electrophysiology is being challenged by calcium imaging in view field, neuron population and visualization in vivo. Owing to the outstanding spatial resolution, the novel imaging approaches provide opportunities to enrich our knowledge about the neurophysiological mechanisms of acupuncture analgesia at subcellular, cellular, and circuit levels in combination with new labeling, genetic and circuit tracing techniques. Therefore, this review will introduce the principle and the method of calcium imaging applied to acupuncture research. We will also review the current findings in pain research using calcium imaging from in vitro to in vivo experiments and discuss the potential methodological considerations in studying acupuncture analgesia.

Perspective of Calcium Imaging Technology Applied to Acupuncture Research / 中国结合医学杂志

Acupuncture, a therapeutic treatment defined as the insertion of needles into the body at specific points (ie, acupoints), has growing in popularity world-wide to treat various diseases effectively, especially acute and chronic pain. In parallel, interest in the physiological mechanisms underlying acupuncture analgesia, particularly the neural mechanisms have been increasing. Over the past decades, our understanding of how the central nervous system and peripheral nervous system process signals induced by acupuncture has developed rapidly by using electrophysiological methods. However, with the development of neuroscience, electrophysiology is being challenged by calcium imaging in view field, neuron population and visualization in vivo. Owing to the outstanding spatial resolution, the novel imaging approaches provide opportunities to enrich our knowledge about the neurophysiological mechanisms of acupuncture analgesia at subcellular, cellular, and circuit levels in combination with new labeling, genetic and circuit tracing techniques. Therefore, this review will introduce the principle and the method of calcium imaging applied to acupuncture research. We will also review the current findings in pain research using calcium imaging from in vitro to in vivo experiments and discuss the potential methodological considerations in studying acupuncture analgesia.

[Thoughts on improving the design quality of acupuncture clinical randomized controlled trials].

The British Medical Journal published the Acupuncture research album which carried viewpoints, expert consensus, research methods and other genres of papers, providing an authoritative reference for standardizing the design of clinical randomized controlled trial (RCT) of acupuncture and improving the quality of clinical research. Based on the experts' consensus of "acupuncture album" on RCT, combining clinical practice and the related literature reports, and many existing problems existing in the design, we, in the present paper, analyzed ways to improve the design quality of clinical RCT of acupuncture, starting from improving the methodological quality and repeatability of clinica RCT, so as to provide methodological guidance for the design of clinical trials and to promote the standardization of clinical trials of acupuncture.

[Challenges and choices: translational acupuncture research spectrum-a proposal].

For more than half a century，the modern bioresearch in acupuncture has made remarkable advancements, proving scientific basis underlying the traditional, intuitive treatment, as well as leading to some new discoveries with the potential to enhance the effectiveness of acupuncture as we know it. Meanwhile, the clinical researches have started to shift its paradigm from traditional individual observation to modern evidence-based medicine. However, there is little interaction between basic and clinic researches, which are like two separate worlds, not benefiting each other. Also the education and training of acupuncture are still traditional style, little combining with modern studies. To bridging the large gap, we need translational science involving in. In this article, with a critical reviews of the limitations of the traditional methods of acupuncture, the challenges faced by clinic practices and placebo-control studies, and the advantages and disadvantages of basic research, we propose a methodological paradigm of the translational research, Translational Acupuncture Research Spectrum, that meets the current situation of acupuncture researches, hoping to give insights into this field and to promote modern acupuncture to move towards a new stage.

[Enhancing the training of translational researchers is the essential way to accelerate the translational medicine of acupuncture and moxibustion].

Talent team construction is the foundation of translational medicine research of acupuncture and moxibustion. In college education and continuing education after graduation, with the idea of translational medicine, it is necessary to cultivate both the ability of basic research and clinical skills for the students of traditional Chinese medicine, especially those majored in acupuncture and moxibustion, as well as train the acupuncture-moxibustion researchers who qualified with medical practitioner to contact with clinical practice, discover clinical scientific problems and research priorities, and engage in basic research at the same time. Acupuncture-moxibustion practitioners with higher education should be trained to be able to engage in basic and development researches on the premise of improving their clinical ability, so as to cultivate more translational research talents, build translational research team, and promote the pace of research and application of acupuncture-moxibustion translational medicine.

Women in Acupuncture Research: Interviews with Leaders of the Field.

When Tu Youyou was awarded the Nobel Prize for her discovery of artemisinin (qinghaosù) extract to treat malaria, she became the first female scientist from the Peoples Republic of China to win the Nobel Prize, and her prize was the first awarded for a Traditional Chinese Medicine preparation. Inspired by Tu's accomplishment, this special issue in Medical Acupuncture aims to highlight the great contributions of women in the development of acupuncture and Chinese herbal medicine evidence base. We sought to interview some of the key women in acupuncture research whose contributions have moved the science forward. We asked each person: Were there barriers that you had to overcome in your education and career trajectory? What were the facilitators or successes that you have experienced? What lessons might you impart to the next generation of acupuncturists, researchers, and others? Due to time constraints and limited resources, we were not able to interview every woman we know who has made significant and lasting contributions to acupuncture research. We were honored to spend time with the following noted experts: Drs. Debra Betts, Lisa Conboy, Helene Langevin, Kate Levett, Arya Nielsen, and Rosa Schnyer.

A Retrospective Look at 50 Years of Acupuncture in the United States.

This article describes several key events concerning the introduction of acupuncture to the United States, considers the mainstream acceptance of acupuncture and the development of the acupuncture "infrastructure" for the past 50 years, and speculates on acupuncture's future trajectory. In the author's opinion, "the two factors which will contribute the most to the continuing development of acupuncture are acupuncture consumers and scientific research."

Incorporating Acupuncture Into American Healthcare: Initiating a Discussion on Implementation Science, the Status of the Field, and Stakeholder Considerations.

INTRODUCTION: The field of implementation science is the study of methods that promote the uptake of evidence-based interventions into healthcare policy and practice. While acupuncture has gained significant traction in the American healthcare landscape, its journey has been somewhat haphazard and non-linear. METHODS: In June 2019, a group of thirty diverse stakeholders was convened by the Society for Acupuncture Research with the support of a Patient Centered Outcomes Research Institute, Eugene Washington Engagement Award. This group of stakeholders represented a diverse mix of patients, providers, academicians, researchers, funders, allied health professionals, insurers, association leaders, certification experts, and military program developers. The collective engaged in discussion that explored acupuncture's status in healthcare, including reflections on its safety, effectiveness, best practices, and the actual implementation of acupuncture as seen from diverse stakeholder viewpoints. OBJECTIVES: A primary goal was to consider how to utilize knowledge from the field of implementation science more systematically and intentionally to disseminate information about acupuncture and its research base, through application of methods known to implementation science. The group also considered novel challenges that acupuncture may present to known implementation processes. FINDINGS: This article summarizes the initial findings of this in-person meeting of stakeholders and the ongoing discussion among the subject matter experts who authored this report. The goal of this report is to catalyze greater conversation about how the field of implementation science might intersect with practice, access, research, and policymaking pertaining to acupuncture. Core concepts of implementation science and its relationship to acupuncture are introduced, and the case for acupuncture as an Evidence Based Practice (EBP) is established. The status of the field and current environment of acupuncture is examined, and the perspectives of four stakeholder groups--patients, two types of professional practitioners, and researchers--are explored in more detail.

[Closed-loop neuromodulation technique brings new opportunities and challenges to acupuncture and moxibustion therapies].

In recent years, the newly appeared closed-loop neuromodulation technique composed of closed-loop controlled stimulation system and neuromodulation is the product of medicine and inter-disciplines. In medical clinical practice, the idea of closed-loop controlled stimulation can be seen everywhere. When both the patient and acupuncturist achieve the state of "Deqi" simultaneously, it is a kind of feedback adjustment process similar to that of the closed-loop stimulation system. Cross-functional multidisciplinary development is the future trend of medical science progress. The acupuncture-moxibustion discipline can draw lessons from the research experience and achievements of closed-loop neuromodulation techniques to explore the origin of the compatibility of meridians, acupoints, and needling manipulations.

[A novel PPG pulse diagnosis instrument which can be used to assist the application of acupuncture and moxibustion].

For a long time, Chinese medicine has attached great importance to "pulse diagnosis for patients before acupuncture treatment", which emphasizes the close relationship between pulse diagnosis and acupuncture. Pulse diagnosis information is closely related to acupuncture research and runs through the whole process of diagnosis and treatment. However, the lack of repeatable and quantifiable real-time detection means of pulse diagnosis information has affected the application of pulse diagnosis in acupuncture research. Photo plethysmo graphy (PPG) technology has the advantages of convenient acquisition, low price, non-invasive, easy to use and so on. Under the guidance of TCM diagnosis theory, this paper discussed the principle and characteristics of fingertip volumetric pulse wave, studied its relationship with Cunkou pulse diagnosis, developed a new fingertip blood volumetric pulse wave measuring instrument, explored the acquisition and measurement methods of volumetric pulse wave signal, and proposed the relationship between the measuring instrument and acupuncture research. It can provide basic tools and data analysis and support for acupuncture research.

Interpretation of acupoint location in traditional Chinese medicine teaching: Implications for acupuncture in research and clinical practice.

Acupuncture is a therapeutic intervention of traditional Chinese medicine, characterized by the insertion of a fine metal needle through the human body's skin at an acupuncture point (acupoint). Acupuncture has become from cultural curiosity to fast-growing complementary and alternative medicine therapy worldwide, including in the United States. The ability to locate acupoints on the body surface precisely is critical for the acupuncture treatment. However, the location of acupoints varies frequently among practitioners. Therefore, in the present study, the author will address the application of acupoint in traditional Chinese medicine (including the anatomical location of acupoint) to draw attention to the issues about the acupoint location in acupuncture research and clinical practice. Moreover, further studies are needed to determine whether acupoint location with specificity could be validated by employing reliable tools. In the future, the incongruity among acupuncturists regarding acupoint location should be resolved, and the acupoint location methods with more accuracy should be developed.

[Status of placebo acupuncture control research].

There is no criteria of placebo acupuncture method and no suitable method for all kinds of acupuncture research currently. In this paper, the methods and theories of placebo acupuncture were collected in recent 10 years at home and abroad. The analysis was conducted in the aspects of the premise of placebo acupuncture design, the common methods and their advantages and disadvantages, the application of various placebo acupuncture methods and the controversy on placebo acupuncture. It is required to further improve the design of placebo acupuncture control, explore the key questions of it and specify the criteria of its method so as to lay the foundation for the establishment of scientific and rational placebo acupuncture control in acupuncture research.

[From molecular pharmacy to electroceuticals: SPARC program and acupuncture research].

The NIH-funded "Stimulating Peripheral Activity to Relieve Conditions (SPARC)" program has been initiated in Octomber 2016, aiming at developing high resolution neural circuit maps and next generation neural modulation devices. This program has brought great stimulus to acupuncturists and acupuncture researchers both at home and abroad. Is the SPARC program a driving force or a challenge of acupuncture research? In the present study, we introduced the SPARC program and compared it with current acupuncture research. The first step of SPARC is to better map neural circuits associated with disease on the anatomical level so as to identify the best points for intervention, and to decode the neural language at these intervention points for developing a dictionary of patterns associated with health and disease states on the signaling level. Similarly, our acupuncture research also focuses on revealing the neural encoding of acupuncture stimulation and its effect on visceral function, seeking suitable stimulation parameters to regulate the abnormal visceral activity precisely. Therefore, the common point of SPARC program and acupuncture research is the scientific basis of peripheral somatic neuronal regulation, and their difference is that acupuncture regulates the visceral function through multiple neural circuits and neural feedbacks by stimulating the sensitized points or acupoints, achieving homeostasis at last. Acupuncture-induced regulation effect is limited and the therapy is safe. Whereas, "stimulating periphe-ral activity (SPA)" can regulate the visceral organs precisely but without neural feedback. Inevitably, SPA will produce tolerance or side effects. Therefore, there is still much work to be done in terms of the initiation of trigger stimulation and the feedback inhibition of target organ effects. The SPARC program is definitely a powerful force in revealing the mechanisms by which acupuncture works.

[Progress of the application of PET technology in acupuncture research].

To further investigate the application of positron emission tomography (PET) technology in acupuncture research field, with "PET" and "acupuncture" as keywords, the related literature published from 1997 to 2018 was searched in PubMed, CNKI and WANFANG database; then the literature was classified and analyzed. The results showed that in clinical and experimental studies, whether in physiological or pathological conditions, PET technology has verified the specificity of acupoints, bidirectional regulation of acupoints, and the clinical effect of qi-arrival from the level of brain functional activity. It has deeply revealed the central mechanism underlying that acupuncture has multi-target, multi-channel and multi-level overall effects. The purpose of this study is to provide objective scientific basis for acupuncture research, and then potentially guide the clinical practice.

From molecular pharmacy to electroceuticals: SPARC program and acupuncture research / 针刺研究

The NIH-funded "Stimulating Peripheral Activity to Relieve Conditions (SPARC)" program has been initiated in Octomber 2016, aiming at developing high resolution neural circuit maps and next generation neural modulation devices. This program has brought great stimulus to acupuncturists and acupuncture researchers both at home and abroad. Is the SPARC program a driving force or a challenge of acupuncture research? In the present study, we introduced the SPARC program and compared it with current acupuncture research. The first step of SPARC is to better map neural circuits associated with disease on the anatomical level so as to identify the best points for intervention, and to decode the neural language at these intervention points for developing a dictionary of patterns associated with health and disease states on the signaling level. Similarly, our acupuncture research also focuses on revealing the neural encoding of acupuncture stimulation and its effect on visceral function, seeking suitable stimulation parameters to regulate the abnormal visceral activity precisely. Therefore, the common point of SPARC program and acupuncture research is the scientific basis of peripheral somatic neuronal regulation, and their difference is that acupuncture regulates the visceral function through multiple neural circuits and neural feedbacks by stimulating the sensitized points or acupoints, achieving homeostasis at last. Acupuncture-induced regulation effect is limited and the therapy is safe. Whereas, "stimulating periphe-ral activity (SPA)" can regulate the visceral organs precisely but without neural feedback. Inevitably, SPA will produce tolerance or side effects. Therefore, there is still much work to be done in terms of the initiation of trigger stimulation and the feedback inhibition of target organ effects. The SPARC program is definitely a powerful force in revealing the mechanisms by which acupuncture works.

Progress of the application of PET technology in acupuncture research / 中国针灸

To further investigate the application of positron emission tomography (PET) technology in acupuncture research field, with "PET" and "acupuncture" as keywords, the related literature published from 1997 to 2018 was searched in PubMed, CNKI and WANFANG database; then the literature was classified and analyzed. The results showed that in clinical and experimental studies, whether in physiological or pathological conditions, PET technology has verified the specificity of acupoints, bidirectional regulation of acupoints, and the clinical effect of -arrival from the level of brain functional activity. It has deeply revealed the central mechanism underlying that acupuncture has multi-target, multi-channel and multi-level overall effects. The purpose of this study is to provide objective scientific basis for acupuncture research, and then potentially guide the clinical practice.

[A study of acupuncture under the perspective of international discourse power: based on metrological analysis of Web of Science core collection in the last 10 years].

In order to reflect the research achievements of acupuncture on international academic community and study the acupuncture international discourse power from 2007 through 2017, we used text analysis software to analyze 5668 papers that focusing on acupuncture research in the recent 10 years. The results show that international acupuncture research trend has been formed, the research force diverges to the rest of the world with "China-America" as the center, and the study focuses on its sight and the interaction between China and foreign countries is good. Under the perspective of international discourse power, the construction of the national communication platform, the cultivation of academic centers and research fields, and the interaction with international research forces will enhance the quality of Chinese acupuncture research, and these will become an important task in enhancing the international discourse power of Chinese acupuncture.

A Call for More Comparative and Basic Science Acupuncture Research.

Background: The acupuncture profession is stymied by a dearth of comparative research. A review of the literature for acupuncture research reveals no meta-analyses comparing the effectiveness of different clinically popular methods/systems of acupuncture. Rather than comparing different methods/systems, acupuncture research seems more focused on determining if acupuncture, in general, works. Objectives: The aim of this Perspective is to examine the current state of acupuncture research and determine what, if any, problems or gaps in this research exist. Materials and Methods: A number of studies are discussed and analyzed to determine the current state of acupuncture research. Results: There is a lack of focus on details related to clinical practice in much of acupuncture research, and there is lack of diversity of point selection and a subsequent lack of comparison of different acupuncture methods in most acupuncture studies. There are, however, some good exceptions. Conclusions: There is a need for more comparative and basic science research-not only to demonstrate the efficacy and mechanisms of acupuncture to policymakers and insurers, or to help us know the most potent protocols for certain conditions, but also to instill greater confidence in inexperienced practitioners.

A study of acupuncture under the perspective of international discourse power: based on metrological analysis of Web of Science core collection in the last 10 years / 中国针灸

In order to reflect the research achievements of acupuncture on international academic community and study the acupuncture international discourse power from 2007 through 2017, we used text analysis software to analyze 5668 papers that focusing on acupuncture research in the recent 10 years. The results show that international acupuncture research trend has been formed, the research force diverges to the rest of the world with "China-America" as the center, and the study focuses on its sight and the interaction between China and foreign countries is good. Under the perspective of international discourse power, the construction of the national communication platform, the cultivation of academic centers and research fields, and the interaction with international research forces will enhance the quality of Chinese acupuncture research, and these will become an important task in enhancing the international discourse power of Chinese acupuncture.

[The analysis on the funding of Natural Science Foundation of China for acupuncture projects from 2005 to 2015].

The funding of Natural Science Foundation of China (NSFC) for acupuncture projects from 2005 to 2015 was summarized and analyzed. The results indicated during past 11 years, 711 projects regarding acupuncture were funded by NSFC, with a total of 281 million RMB, accounting for 12.39% in TCM projects. It was concluded the funding for acupuncture projects was increased year by year, but was still relatively weak; in addition, the funding was unbalanced in different areas and organizations, mainly in Beijing, Shanghai, Sichuan, Guangdong, Tianjin, and the continuity and variability both existed in research content and direction.