BACKGROUND: Tumor necrosis factor-alpha (TNF-α) in the brain can promote inflammative reaction and thrombosis through inducing the expression of endothelioal adhesion molecule during cerebral ischemic reperfusion.OBJECTIVE: To investigate the good regulation of scalp point through point acupucture with Baihui (GV-20) to Qubin (GB-7) to ischemic cerebral injury, and to inhibition of TNF-α over-expression within the brain as well.DESIGN: A randomized controlled trial.SETTING: Emergency Neurological Department of the Hospital Affiliated to Medical College of Qingdao University.MATERIALS: The experiment was completed from August 2002 to August 2003 at the Institute of Cerebrovascular Disease in Medical College of Qingdao University. A total of 15 healthy female SD rats of clean grade, weighing 230-270 g, provided by Shanghai Experimental Animal Center of Chinese Academy of Sciences, were at random divided as sham operation group,acupuncture group and control group, with 5 rats in each group.for rats in acupuncture group and control groups, the procedur for rats in sham operation group was similar to those in control group, but without obstruction of the middle cerebra artery. After ten minutes ischemia, the rats in acupuncture group were given acupuncture treatment. The hairs in parts correspondent to Baihui (GV-20) and Fengfu (GV-16) points in human were cut down and conventionally sterilized, then a filiform needle in 0.35 mmx40 mm was used to point to point acupucture correspondent to Baihui and Qubin in human to the depth of 0.8 cm. Another needle was used to perpendicularly insert at Fengfu (GV-16) point to the depth of 0.5 cm. A pulse electric machine was applied for 30 minutes, with the positive electrode connecting to Baihui (GV-20) and negative electrode to the Fengfu GV-16), the frequensection and in situ hybridization assay of TNF-α: All rats of every group,after treatment of 2 hours ischemia and 12 hours reperfusion, were deeply anesthetized, quickly given 200 mL normal saline through the catheterized ascending aorta, and continually given 300 mL paraformaldehyde of 40 g/L concentration; then they were decapitated for collecting the brain, the brain was fixed for 1 hour with the same solidification solution. The coronal sec-tion about 7 μm was prepared starting from the part of optic chiasm towards the back. The cytoplasm of TNF-α positive cell was stained brownish yellow, and that of TNF-α negative control cell was not stained. VIDAS-21 image analysing system was used to analyse the image, the result was extissue: After conventional staining with hematoxylin-eosin, the pathological changes of focal areas in both acupuncture group and control group were observed under light microscope.ischemic cerebral tissues in acupuncture group and control group.TNF-α in the cortex and striate body of brain in rats with ischemic reperfusion: Compared with sham operation group, the expressions in acupuncture group and control group were significantly increased (0.302±0.04,0.320±0.02; 0.466±0.08, 0.423±0.02; 0.367±0.03, 0.362±0.02; P ＜ 0.05);compared with acupuncture group, the expression in control group was sigbral tissues: In control group the extent of degeneration and necrosis was more serious, the neuron was degenerative necrosis, the neuroglia cell was in vacuolar degeneration, there was obvious phenomenon of leukocytic aggregation and margination within the vessel, and also leukocytic infiltration around the vessels. In acupuncture group there were only a small nub of neurons being in degenerative degeneration and neuroglia cells in vacuolar degeneration, and less leukocytic aggregation within the vessel.CONCLUSION: The level of TNF-α in the cortex and striate body of brain was increased after ischemic reperfusion. Scalp point through point acupuncture with Baihui (GV-20) to Qubin (GB-7) could markedly inhibit its expression, so that the therapy could effectively check over-expression of inflammatory mediators and their biological effects, hence reducing the inflammatory injury after cerebral ischemia.

Objective To observe the expression of IL-1? and to study the mechanism of acupuncture for focal cerebral ischemia. Methods The ischemia-reperfusion model was established in rats. The immunohistochemistry technique was used to detect the expression of IL-1?in the sham operation group, control group and acupuncture group at 2h, 6h,12h,24h after reperfusion following middle cerebral artery occlusion in rats, TTC staining method was used to observe the infarct volume at 24h after reperfusion. Results The sham operation group showed a baseline expression of IL-1? in cortex and striate body. The cells expressing IL-1? were increased in 2h after reperfusion and peaked at 12h after reperfusion in the control and acupuncture groups. The expression of IL-1? was weaker in acupuncture group as compared to that in the control group at all the time points. Conclusion Acupuncture could downregulate the expression of IL-1?in cortex and striate body and reduce infarct volume. It was indicated in the study that downregulated expression of IL-1? might be one of the mechanisms of acupuncture protecting the brain from ischemic damage.

Aim To investigate the effect of 96 h paradoxical sleep deprivation(PSD) on learning & memory ability of rats and the concomitant gene expression change in the rat hippocampus.Methods PSD model was established by Modified Multiple Platform Method(MMPM).Learning and memory ability of the PSD model was assessed through hexagonal maze compared with the control, and the gene expression in hippocampus of each group was detected by gene chip technology.After that, GO and KEGG enrichment analysis were applied to determine the changes of the gene expression in PSD model compared with the control.Results PSD affected the memory consolidation process in rats.The gene chips showed that 100 genes expressed differently in the hippocampus of PSD model compared with the control, and among them, 25 genes were up-regulated and 75 genes down-regulated.The up-regulated genes mainly involved in cell growth and differentiation, learning and memory, inflammation, oxidative stress, and biological processes such as synaptic transmission, while the down-regulated genes mainly involved in immune response, central nervous system development, synaptic transmission, metabolism, signal transduction, neurotransmitter secretion, cell apoptosis, and so on.KEGG analysis showed that genes differentially expressed mainly involved in cGMP-PKG, metabolism, NF-kappa B and Pathways in cancer, and so on.Conclusion In rats, PSD leads to memory deficit, as well as a variety of gene expression changes in hippocampus of the PSD model.

Objective To observe the expression of IL-6 mRNA and study the mechanism of acupuncture in focal cerebral ischemia.Methods In situ hybridization was used to detect the expression of IL-6 mRNA in the sham operation group, control group and acupuncture group 2 h, 6 h, 12 h, 24 h after reperfusion in the brain of middle cerebral artery occlusion rats, meanwhile and also observe ultrastructure in cortex of ischemic brain tissue 24 h after reperfusion.Results The sham operation group showed a basic expression of IL-6 mRNA in cortex and striate body. The cells expressing IL-6 mRNA were increased 2 h after ischemic reperfusion in cortex and striate body and peaked 24 h after reperfusion in control group and acupuncture group. The cells expressing IL-6 mRNA in cortex of ischemic area were stronger in acupuncture group than in control group at every research time point besides 2 h after ischemic reperfusion. The cells expressing IL-6 mRNA striate body of ischemic area were stronger in acupuncture group than in control group at every research time point. Acupuncture can lighten the degeneration of cell nucleolus and necrosis of cell, resume the integrity of the nucleolus, improve the function of mitochondrial and endoplasmic, and have significant difference with control group. Conclusion Acupuncture can increase the cells expressing of IL-6 mRNA.

Objective:To observe any effect of electroacupuncture applied to the Jialianquan points in treating post-stroke oropharyngeal dysphagia.Methods:Forty-five stroke survivors with oropharyngeal dysphagia were randomly divided into an electroacupuncture group ( n=15), a neuromuscular electrical stimulation group ( n=15) and a control group ( n=15). All groups received 30 minutes of routine swallowing function training 5 times a week for 3 weeks. The electroacupuncture group was additionally provided with 30 minutes of electroacupuncture applied to the Jialianquan (CV23) points, and the neuromuscular electrical stimulation group instead received 30 minutes of neuromuscular electrical stimulation over the bilateral submental muscles. Videofluoroscopic swallowing studies were performed before and after the 3 weeks of treatment. Standardized swallowing assessment was conducted producing functional oral intake scale ratings, modified barium swallow impairment profiles and the penetration-aspiration scale scores. Surface electromyography was also employed to evaluate submental muscle functioning through measuring the swallowing time, average EMG (AEMG) value and peak amplitude. Results:After the treatment, significant improvement was observed in all of the evaluations with both groups, but the average scores were significantly better in the electroacupuncture and neuromuscular electrical stimulation groups compared with the control group and significantly better in the electroacupuncture group than in the neuromuscular electrical stimulation group.Conclusion:Electroacupuncture at the Jialianquan point can significantly improve the swallowing of stroke survivors with oropharyngeal dysphagia. It is more effective than neuromuscular electric stimulation.

Objective:To observe any effect of intermittent theta burst stimulation (iTBS) of a cerebellar hemisphere on the walking of stroke survivors with lower limb dysfunction, and to explore its possible mechanism.Methods:Thirty stroke survivors with walking dysfunction were randomly divided into an experimental group and a control group, each of 15. Before their daily routine rehabilitation, the control group received fake iTBS while the experimental group was given 600 pulses of iTBS over 200s. The experiment continued 5 days a week for 3 weeks. The Berg Balance Scale (BBS), the Fugl-Meyer lower extremity assessment (FMA-LE), the Modified Barthel Index (MBI) and Functional Ambulation Categories (FAC) were used before and after the treatment to evaluate the subjects′ balance, lower extremity motor function, walking and ability in the activities of daily living. Gait analysis was also performed. The amplitude of motor evoked potentials (MEPs) and the cortical silent period (CSP) were also noted to assess corticospinal excitability.Results:After the treatment, the average BBS, FMA-LE and MBI scores, FAC grading, stride length, stride speed, stride frequency, and the percentage of swing period in the walking cycle, as well as MEP amplitude and latency had improved significantly in the experimental group. All were then significantly better, on average, than in the control group. The control group also demonstrated significant improvement in all of the outcomes except the percentage of swing period in the walking cycle.Conclusion:iTBS of the cerebellum can improve the walking of stroke survivors with lower limb dysfunction. The mechanism may be related to the cerebellar regulation of spinal cord excitation of the cerebral cortex.