OBJECTIVETo evaluate the effects of needling depth on clinical efficacy of lumbar disc herniation (LDH).

METHODSTen electronic databases, including China National Knowledge Infrastructure (CNKI), VIP Database, Chinese Biomedical Literature Database (CBM), Wanfang Database, MEDLINE, CENTRAL, CINAHL PLUS, AMED, Embase, PsycINFO, and 6 registry platforms of clinical trials were searched. All randomized controlled trials (RCTs) that compared the effect of needling depth on clinical efficacy of LDH were collected; in addition, the reference lists of the studies included were hand searched. Data were extracted independently by two reviewers. RevMan 5.3 was applied to carry out statistical analysis.

RESULTSTotally 8 716 articles were retrieved, and 10 RCTs were included after screening, involving 1 116 patients. The results showed the effects of deep acupuncture onrelievingpain, reducing the Oswestry disability index (ODI), improving total effective rate and Japanese Orthopaedic Association (JOA) were superior to those of shallow acupuncture in patients with LDH.

CONCLUSIONIt is preliminarily indicated that deep acupuncture is helpful to improve the therapeutic effect of LDH; however, due to the low research quality and small sample size, the evidence is insufficient, and more high-quality researches are needed to further confirm the results.

Sixty-seven textbooks in the Republic of China have been collected and divided into three stages according to their editing modes, named the early stage (1912-1927), the middle stage (1928-1939) and the late stage (1940-1949). The traditional teaching material of acupuncture was predominated at the early stage in the textbook compilation; meanwhile the editing mode was simple, and the content of it focuses on meridians, collaterals and acupoints and the modern scientific theories have been preliminarily introduced. The textbooks at the middle stage were edited as two modes, "western medicine+acupuncture" and "general introduction→meridian points→manipulation (techniques of acupuncture and moxibustion)→treatment". The knowledge in anatomy, physiology and pathology of western medicine has been involved in content, giving the great consideration to the clinical practicability. However, a part of textbooks still followed the traditional theory of acupuncture at the middle stage. At the late stage, the textbooks were edited align with "acupuncture science, moxibustion science, meridian point science and treatment science"; or in supplementation of the "diagnosis" on the base of "general introduction→ meridian points→techniques of acupuncture→treatment", or edited as "general introduction→points→treatment". The compilation of the textbooks at this stage not only followed but also improved the integration of western and Chinese medicine as that at the middle stage, which turned to be more scientific. Additionally, in the teaching content, the acupoint was much more considerable as compared with pulse and the section of diagnosis has been involved. As a result, a framework of acupuncture discipline has been established preliminarily by taking acupuncture technique, moxibustion technique, acupoints and treatment as the core. The development of the editing mode and content of textbooks played a great impact on the unified compilation of the acupuncture textbooks after the foundation of China.

In view of the literature study and clinical practice, the rules of the distribution, the general function and the indication of the meridians points on the spine and back were explored. The TCM mechanism on the rehabilitation of infantile cerebral palsy was studied. The rules of acupoint combination on the spine and back were summarized with meridians, main points and supplementary points involved in the TCM rehabilitation of infantile cerebral palsy. In view of the theoretic study, the advantages on the early infantile motor function, such as body turning, sitting, standing and walking, were analyzed with the long-term intervention of meridian points on the spine and back. It is showed in the rehabilitation of infantile cerebral palsy that the intervention of meridian points on the spine and back improves the motor function on the back and relieves the incoordination in the development between each system and enhances the rehabilitation mechanism of the integration of Chinese and western medicine for the functional development of core stability, which provides much more effective and more precise approach to the diagnosis and treatment of infantile cerebral palsy in clinical practice.

The effect of Dazhu (BL 11) for gonalgia with flexion-extension dysfunction is remarkable, and its mechanism of action is interpreted as the influential point of bone treating bone diseases. However, through the exploration of a variety of literature, the relevant classical research, the views of senior experts, and combined with the author's experience, we put forward some new ideas and views for reference. Through in-depth analysis about pathogenesis of gonalgia with flexion-extension dysfunction and the functional attributes of Dazhu (BL 11), combining meridian tendons differentiation and myofascial meridians, we consider that Dazhu (BL 11), with its unique "location" advantage, plays the role of regulating multiple viscera, meridians, meridian tendons and myofascial meridians, which is the mechanism for gonalgia with flexion-extension dysfunction.

Theof(for short) was officially published as a standard of China Association of Acupuncture and Moxibustion in 2015. From the purpose, methodology, scope, indication, recommended protocol, etc., this was explained to provide convenience for clinical use of acupuncturists. Thiswas developed based oncomprehensive search of literature regarding acupuncture for periarthritis of shoulder, the adoption of best evidence, expert experience, patient value across the world, methods of evidence quality and GRADE, references of clinical experience of famous acupuncturists in the ancient and modern time and expert consensus in the national level, which was hoped to provide solid evidence of acupuncture clinical treatment for periarthritis of shoulder to ensure the safety and effectiveness. In this, the stage-by-stage treatment principle of acupuncture for periarthritis of shoulder was recommended. In the acute stage, the treatment aim was to relieve the pain, and distal acupoints along the meridians were selected with strong stimulation; the local acupoints were combined. In the chronic stage and rehabilitation stage, the treatment aim was to improve the dysfunction of shoulder joint, and acupuncture treatment was based on syndrome differentiation of etiology and meridian; the local acupoints were mainly selected, combined with acupoints based on etiology and acupoints along meridians.

OBJECTIVETo compare the differences in the therapeutic effects on allergic rhinitis between scraping therapy and cetirizine and observe the differences in the clinical therapeutic effects of scraping therapy on the disease of different differentiated patterns/syndromes.

METHODSThe included participants of allergic rhinitis were randomized into a western medication group and three scraping therapy groups, named a lungdeficiency and cold group, a spleendeficiency group and a kidneydeficiency group, 20 cases in each one. In the western medication group, cetirizine was prescribed for oral administration, 10 mg, once a day, totally for 4 weeks. In the scraping therapy groups, the scraping therapy was applied to the running courses of the large intestine meridian of hand-, the governor vessel and the bladder meridian of foot-, focusing on Yingxiang (LI 20), Yintang (GV29), Hegu (LI 4) and Fengmen (BL 12). In the lungdeficiency and cold group, the scraping focused on the lung meridian of hand-, Feishu (BL 13), Taiyuan (LU 9), Fengchi (GB 20) and Lieque (LU 7). In the spleendeficiency group, the scraping focused on the spleen meridian of foot-, Pishu (BL 20) and Zusanli (ST 36). In the kidneydeficiency, the scraping focused on the kidney meridian of foot-, Mingmen (GV 4) and Shenshu (BL 23). The scraping therapy was given once a week, 4 treatments as one session and 1 session required (4 weeks). Separately before treatment, after treatment and in 3-month follow-up visit, the total score of the main symptoms of allergic rhinitis (sneezing, runny nose, nasal obstruction and nasal itch) was observed and the clinical therapeutic effects were evaluated.

RESULTSThe total symptom scores in the patients of the 4 groups after treatment were all reduced as compared with those before treatment (all<0.05). After treatment and in the follow-up visit, the total symptom scores of the 3 scraping therapy groups were lower than those in the western medication group (all<0.05), and the score in the lungdeficiency and cold group was lower than those in the spleendeficiency group and the kidneydeficiency group (all<0.05). After treatment and in the follow-up visit, the therapeutic effects in the 3 scraping therapy groups were better than those in the western medication group (all P<0.05).

CONCLUSIONThe scraping therapy on the basis of the meridians and acupoints selection achieves the definite therapeutic effects on allergic rhinitis of different differentiated patterns/syndromes, which is better than cetirizine. This therapy achieves the much significant short-term and long-term therapeutic effects on allergic rhinitis differentiated as lung qi deficiency and cold.

OBJECTIVETo explore heat-reinforcing needling for the metabolite profiling changes in serum of rheumatoid arthritis (RA) rabbits with liquid chromatograph-mass spectrometer (LC-MS) technique, and to investigate its mechanisms.

METHODSForty clean purple blue rabbits were randomized into a normal group, a model group, a reinforcing-reducing needling (RRN) group, a twirling-reinforcing needling (TRN) group, and a heat-reinforcing needling (HRN) group, 8 cases in each group. RA rabbits with cold syndrome were made with ovalbumin and freezing except those in the normal group. No treatment was given in the normal and model groups. The corresponding manipulations for 7 days were applied at "Zusanli" (ST 36) in the three acupuncture groups, 30 min a time, once a day. After intervention the pain threshold and the local skin temperature of each group were observed. Fresh serum from heart was collected for metabonomics detection. Principal component analysis (PCA) and partial least squares-discriminant analysis (PLS-DA) were adopted. Several metabolites were screened by the variable importance in the projection values (VIP>1) andvalue (<0.05).

RESULTSThe pain threshold and the local skin temperature in the model group were lower than those in the normal group (both<0.05). The pain threshold and the local skin temperature in the three acupuncture groups were higher than those in the model group after intervention (all<0.05), which were better in the HRN group than those in the RRN and TRN groups (all<0.05). The serum metabolites of carnitine, LysoPC (14∶0), LysoPC (18∶3), LysoPE (0∶0/20∶5), LysoPE (0∶0/22∶1), decylic acid, stearic acid and lactic acid in the model group increased compared with those in the normal group, and other metabolites decreased, including leucine, valine, glutamine, pyroglutamic acid, α-ketoglutaric acid, succinic acid, fumaric acid, malic acid, galactose, mannose. Those metabolites were correlated fatty acid, amino acid, citric acid cycle, and glucose metabolism. The metabolites above-mentioned in the three acupuncture groups were regulated in various degrees (all<0.05). Lactic acid decreased and succinic acid, fumaric acid, malic acid, galactose, mannose increased more obviously in the HRN group than those in the RRN and TRN groups.

CONCLUSIONThe specificity of heat-reinforcing needling for RA presents the regulation for citric acid cycle and glucose metabolism.

OBJECTIVETo observe effects of electroacupuncture (EA) at "Weizhong" (BL 40) on morphology and expression of creatine kinase (CK) and interleukin-17 (IL-17) in rats with bupivacaine-induced multifidus muscle injury.

METHODSA total of 32 male SD rats were randomly divided into a control group, a model group, a Weizhong group and a Shenshu group, 8 rats in each one. The rats in the model group, Weizhong group and Shenshu group were treated with intramuscular injection of 0.5% bupivacaine to establish the model of multifidus muscle injury; the rats in the control group were injected with 0.9% sodium chloride solution. The rats in the Weizhong group and Shenshu group were treated with EA (2 Hz/10 Hz in frequency, 1~2 mA in intensity) at "Weizhong" (BL 40) and "Shenshu" (BL 23), 20 min per treatment. No treatment was given in the control group and model group. After 14-day treatment of EA, the inflammatory cell count, scar tissues area and muscle fiber cross sectional area of multifidus muscle were observed with HE and Masson staining method. The activity of CK and serum content of IL-17 were test with enzyme-linked immunosorbent assay (ELISA) method; the expression of IL-17 in multifidus muscle was measured with immunohistochcmical method.

RESULTSAfter intervention, the inflammatory cell count and scar tissues area in the model group, Weizhong group and Shenshu group were higher than those in the control group (all<0.01), but the muscle fiber cross sectional area was significantly reduced (all<0.01); the inflammatory cell count and scar tissues area in the Weizhong group and Shenshu group were lower than those in the model group (all<0.01), and the muscle fiber cross sectional area was significantly increased (<0.01,<0.05). After intervention, the expression of IL-17 in multifidus muscle, serum content of IL-7 and activity of CK in the model group, Weizhong group and Shenshu group were higher than those in the control group (all<0.01); the expression of IL-17 in multifidus muscle, serum content of IL-7 and activity of CK in the Weizhong group and Shenshu group were lower than those in the model group (<0.01,<0.05); compared with the Shenshu group, the down-regulation of IL-17 was more obvisous in the Weizhong group (<0.01).

CONCLUSIONEA at "Weizhong" (BL 40) can down-regulate the overexpression of serum CK and IL-17, alleviate inflammation reaction and improve the repair of multifidus muscle.

OBJECTIVETo judge whether algesia sensitization of some acupoints is existed and whether the acupoint algesia sensitization area is expanded in the patients of intestinal cancer.

METHODSTotally, 30 patients of intestinal cancer and 30 healthy subjects were included. The electronic Von Fray was used to determine the pressure-pain thresholds at 13 acupoints relevant with gastrointestinal disorders and the reference points at the sites 1and 2lateral to those points as well as the sites at the corresponding nerve segments. Compared with the pressure-pain thresholds at the reference points of the different segments, the relative value was calculated. The changes were analyzed in the pressure-pain thresholds at the relevant acupoints on the body surface in the patients of intestinal cancer as compared with the relative pressure-pain thresholds in the healthy volunteers.

RESULTSThe pressure-pain thresholds at Zusanli (ST 36), Shangjuxu (ST 37), Xiajuxu (ST 39), Quchi (LI 11) and Dachangshu (BL 25) in the patients of intestinal cancer were all significantly reduced as compared with those of the healthy subjects (<0.05,<0.01,<0.001). At the non-acupoint sites 1and 2lateral to those acupoints as well as at the sites of the same segments, the pressure-pain thresholds were reduced significantly as compared with the control group (<0.05,<0.01,<0.001). Particularly, the sensitization zone of Yinlingquan (SP 9) focused on the acupoint, the site 1lateral to it as well as the non-acupoint sites of the same segments (<0.01,<0.001).

CONCLUSIONThe acupoint sensitization is displayed at Zusanli (ST 36), Shangjuxu (ST 37), Xiajuxu (ST 39), Quchi (LI 11), Dachangshu (BL 25) and Yinlingquan (SP 9) and the sensitization area is expended in the patients of intestinal cancer.

OBJECTIVETo compare the effects on joint dysfunction after meniscal suture surgery between rehabilitation training combined with modified-acupuncture and simple rehabilitation training.

METHODSSeventy-one patients with meniscal suture surgery were randomized into an observation group (=36) and a control group (=35). Patients in the observation group received modified-acupuncture combined with rehabilitation training. Acupuncture for 8 weeks were at Zutonggu (BL 65), Shugu (BL 66), Neiting (ST 44), Xiangu (ST 43), Xiaxi (GB 43), Zulinqi (GB 41), Dadu (SP 2), Taibai (SP 3), Xingjian (LR 2), and Taichong (LR 3), once a day for continuous 6 days with 1 day for rest. Patients in the control group received simple rehabilitation training for continuous 8 weeks. The training included quadriceps femoris, range of knee joint motion and motion and limb walking on the affected side. The effect score for meniscus injury after treatment from Japanese Orthopaedics Association (JOA) and visual analogue scale (VAS) score were recorded before and after treatment. The effects were compared in the two groups.

RESULTSAfter treatment, the VAS and JOA scores were improved in the two groups (all<0.05), with better results in the observation group (both<0.05). The effective rate was 91.7% (33/36) in the observation group, which was better than 80.0% (28/35) in the control group (<0.05).

CONCLUSIONRehabilitation training combined with-acupuncture achieve better effect than simple rehabilitation training for joint dysfunction after meniscal suture surgery.