The characteristics and clinical application of the arrival of qi in suspended moxibustion was discussed in this paper. Through literature research and clinical practice, three aspects, including characteristics of arrival of qi in suspended moxibustion, the clinical basis regarding arrival of qi in suspended moxibustion improving therapeutic effects and how to acquire arrival of qi in suspended moxibustion, were discussed to clarify the essential role of arrival of qi in suspended moxibustion as well as its importance to the development of moxibustion medicine. The suspended moxibustion at acupoints could produce arrival of qi similar to acupuncture, which was characterized as non-local or non-superficial heat sensation such as penetrating heat, expanding heat, transmitting heat, even non-hot sensation such as aching, numbing, distending, painful, heavy, cold sensation in the applied region. It is heat-sensitive sensation phenomenon that can improve therapeutic effect in suspended moxibustion.
Acupuncture Points ; Humans ; Moxibustion ; methods ; Qi ; Thermosensing

The sensation of heat-sensitive moxibustion (HSM) refers to the heat feeling at distal and deep part of the body when a patient is treated with moxibustion under unhealthy status, which may even transmits to the disease sites, instead of heat feeling at local and superficial part of the body. Professorhas systema-tically studied the HSM sensation and its clinical laws through clinical practice; he points out different HSM sensations contain different physiological and pathological information of the human body, which could reflex the severity of diseases, so the collection of HSM information should be emphasized; the type and intensity of HSM sensation could guide the clinical acupoint selection and precise localization. The appearance and disappearance of HSM sensation could be applied to establish individual amount of moxibustion, and disappearance of HSM sensation is an appropriate signal for sufficient moxibustion time, which break through the concept of fixed time at each acupoint, and provide measurement standard to make full use of moxibustion. The criteria of indications for moxibustion is proposed, indicating the disease in which HSM sensations appear is the optimal indication. The deep and comprehensive understanding on the generation and change of HSM sensation could improve the standardization of HSM standard technique and its efficacy.

Objective:To observe the thermesthesia thresholds of the heat-sensitive acupoints in patients with knee osteoarthritis (KOA), and to provide scientific evidence for acupoint selection based on acupoint sensitization. Methods:Forty-six patients with KOA of swelling type were recruited. By using the quantitative thermesthesia testing, the thermal sensation threshold, thermal pain threshold, and threshold of thermal pain tolerance at Xuehai (SP 10), Neixiyan (EX-LE 4) and Yinlingquan (SP 9) were detected. The subjects were then divided into heat-sensitive groups and non-heat-sensitive groups according to whether there was a phenomenon of heat-sensitive moxibustion sensation at each acupoint, to compare the thermesthesia thresholds between the two groups. Results: The thermal sensation threshold, thermal pain threshold, and threshold of thermal pain tolerance were respectively (38.21±2.03)℃ , (44.4,±1.8,)℃ and (48.,9±0.,4)℃ in the heat-sensitive group of Xuehai (SP 10), versus (3,.,,±1.93)℃ , (42.91±2.0,)℃ and (4,.9,±1.14)℃ in the non-heat-sensitive group of Xuehai (SP 10); the thermal sensation threshold, thermal pain threshold, and threshold of thermal pain tolerance were respectively (3,.4,±1.,,)℃ , (44.,,±1.,3) , and (4,.48±0.4,) in the heat℃℃-sensitive group of Neixiyan (EX-LE 4), versus (3,.92±1.,9)℃ , (42.,2±1.94)℃ and (4,.,3±0.41)℃ in the non-heat-sensitive group of Neixiyan (EX-LE 4); the thermal sensation threshold, thermal pain threshold, and threshold of thermal pain tolerance were respectively (3,.30±2.23)℃ , (44.39±1.92)℃ and (4,.,,±0.,8)℃ in the heat-sensitive group of Yinlingquan (SP 9), versus (3,.0,±1.8,)℃ , (42.,3±1.88)℃ and (4,.91±0.,2)℃ in the non-heat-sensitive group of Yinlingquan (SP 9). The statistical analyses showed that the thermal sensation threshold, thermal pain threshold, and threshold of thermal pain tolerance of each heat-sensitive group (all the three acupoints) were significantly higher than those of each corresponding non-heat-sensitive group (P<0.01). Conclusion:There were differences in the thermesthesia thresholds between heat-sensitized and non-heat-sensitized acupoints in patients with KOA of swelling type; and the thermal sensation threshold, thermal pain threshold, and threshold of thermal pain tolerance of the heat-sensitized points were significantly higher than those of the non-heat-sensitized ones.

OBJECTIVETo analyze and evaluate the clinical efficacy of heat-sensitive moxibustion for symptoms of large intestine cancer.

METHODSSixty patients with large intestine cancer were randomly divided into an observation group and a control group, 30 cases in each one. FOLFOX chemotherapy regimen was used in the two groups,and heat-sensitive moxibustion was added in the observation group. The acupoints were Zusanli(ST 36), Sanyinjiao (SP 6) Xuehai (SP 10) and Geshu (BL 17), etc. The treatment was applied once a day,five-day treatment as one course. Four courses were required. The reaction rates of uncomfortable symptoms by the Chinese version of the M. D. Anderson symptom inventory (MDASI-C) scale and clinical effects were analyzed and evaluated in the two groups.

RESULTSAfter treatment, the MDASI-C reaction rate of uncomfortable symptoms in the observation group was 50.4% which was lower than 53.3% in the control group (P < 0.05). The total effective rate of symptom improvement in the observation group was 83.3% (25/30), which was higher than 60.0% (18/30) in the control group (P < 0.05).

CONCLUSIONHeat-sensitive moxibustion can improve symptoms of chemotherapy for large intestine cancer.

Aged ; Antineoplastic Agents ; adverse effects ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Colorectal Neoplasms ; drug therapy ; Drug-Related Side Effects and Adverse Reactions ; etiology ; therapy ; Female ; Fluorouracil ; adverse effects ; therapeutic use ; Humans ; Intestine, Large ; drug effects ; Leucovorin ; adverse effects ; therapeutic use ; Male ; Middle Aged ; Moxibustion ; instrumentation ; Organoplatinum Compounds ; adverse effects ; therapeutic use ; Treatment Outcome

Objective: To compare moxibustion sensation and infrared thermography by the assessment of heat-sensitization on Guanyuan (CV 4) in patients with primary dysmenorrhea, and to prove the possibility of adopting infrared thermography as an objective demonstration of acupoints heat-sensitization. Methods: Seventy-one patients with primary dysmenorrhea were enrolled to receive moxibustion and infrared to detect the heat-sensitization of Guanyuan (CV 4). The results were then analyzed and compared. Results: The infrared radiation showed a lower temperature when the acupoint Guanyuan (CV 4) was sensitized in patients with primary dysmenorrhea. Compared with moxibustion sensation, its sensitivity rate (real positive rate) was 76.6%, divergence rate (real negative rate) was 70.1%, and the accuracy rate was 74.6%. After giving moxibustion to Guanyuan (CV 4), the infrared radiation area was significantly expanded longitudinally and transversely. Compared with moxibustion test, the sensitivity rate (real positive rate) of infrared test was 78.7%, divergence rate (real negative rate) was 83.3%, and the accuracy rate was 80.3%. Conclusion: To a certain extent, the heat-sensitization of the acupoint Guanyuan (CV 4) in patients with primary dysmenorrhea can be revealed by infrared thermography. The acupoint heat-sensitization phenomena (heat extension or transmission) after giving moxibustion to the heat-sensitized acupoints can also be demonstratedobjectively by infrared thermography, besides experienced subjectively by the receivers.

Objective To divide computed tomography (CT) values into different ranges and investigate the influence of CT value division on dose calculation, and to propose a method to combine magnetic resonance imaging (MRI) with assigned CT values.Methods Ten CT images each were collected from patients with head and neck, chest, and pelvic tumors.Random sampling was performed for the CT values of main tissues or organs at the three parts, and then the mean CT value of each tissue or organ was calculated to divide the CT values into different ranges.A virtual phantom was built in the Varian Eclipse treatment planning system, and for the prescribed dose of 100 cGy, the machine output was recorded at different CT values.The influence of different CT value ranges on dose calculation was analyzed.The treatment plans of intensity-modulated radiotherapy were selected from 5 cervical cancer patients, and new CT values were assigned to the planning target volume (PTV) and organs at risk to obtain new CT images.The plans were transferred to the new CT images and compared with the results on the original CT images in terms of dosimetric parameters.Results After dividing the CT values into different ranges and verifying the results in dose calculation, the CT values corresponding to different human tissues or organs were-100 to 100 HU.The influence of CT value variation on dose calculation was within 3%.In the same treatment plan, there were small differences in dosimetric parameters between new CT images and original CT images.Dmax, Dmean, D98%, D95%, D5%, and D2% of PTV were all below 3%, and Dmax and Dmean of the bladder, rectum, small intestine, femoral head, and bone marrow were below 2%.Conclusions The influence of CT value division on dose calculation in the treatment planning for pelvic tumors is acceptable, so it can be used in combination with MRI.

OBJECTIVE: To establish 2-dimensional electrophoresis (2-DE) graph of A549 and A549/DDP cell lines, to identify the differentially expressed proteins, and to screen multidrug resistance (MDR) related proteins in human lung adenocarcinoma. METHODS: The total proteins of A549 and A549/DDP cells were obtained, and were extracted and separated by 2-DE. PDQuest software was applied to analyze the 2-DE images, and the differential proteins of the 2 types of cells were identified by matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS). Western blot was used to determine the expression levels of the 4 proteins. RESULTS: We established 2-DE maps of total proteins from A549 and A549/DDP. A total of 40 differential protein spots in the 2 cell lines were found, and 23 differential expression proteins were identified by MALDI-TOF-MS. Western blot showed that heat shock protein beta-1, annexin A4, cofilin l, vimentin were differential expression proteins in A549 and A549/DDP, which was consistent with the results of the comparative proteomic analysis. CONCLUSION The 23 differential expression proteins in human lung adenocarcinoma are useful for studying the MDR mechanism of lung adenocarcinoma.
Adenocarcinoma ; genetics ; metabolism ; pathology ; Annexin A4 ; analysis ; Antineoplastic Agents ; pharmacology ; Cell Line, Tumor ; Drug Resistance, Multiple ; genetics ; Drug Resistance, Neoplasm ; genetics ; Electrophoresis, Gel, Two-Dimensional ; HSP27 Heat-Shock Proteins ; analysis ; Humans ; Lung Neoplasms ; genetics ; metabolism ; pathology ; Neoplasm Proteins ; analysis ; classification ; Proteome ; analysis ; Proteomics ; methods

OBJECTIVETo identify the value of lymphography in the location and treatment decision of chyle leakage.

METHODSThe clinic data of 177 patients suffered from chyle leakage admitted in 6 medical centers in Shanghai from February 1998 to December 2014 was analyzed retrospectively. There were 94 male and 83 female patients aging from 9 to 84 years with a mean of 49 years, including 128 cases of chyluria, 34 cases of primary chylothorax and 15 cases of other chyle leakage. All patients had failed to conservative treatment more than 2 weeks. Pedal lymphography was performed in every patient to investigate the site and range of chyle leakage. Effect of surgical or conservative management was compared according to the different results of lymphography.

RESULTSNo serious complication was noticed. For all 177 patients, lymphography showed localized lymphatic diseases in 148 cases (83.6%), including 125 cases of lymphatic renal pelvic leaks, 14 cases of unilateral identified leak within thorax and 9 cases of chyle leakage in neck, heart, abdomen or scrotum. Among these patients, surgical treatment cured 129 and improved 3 patients but failed in 2 patients, while the remaining 14 cases had their leaks decreased after lymphography and cured by conservative management. For those 15 patients having disseminated lymphatic diseases or 14 with no abnormality under lymphography, surgery only cured 2 and improved 1 patient but failed in 8 patients (with 3 death), whereas continuous conservative treatment cured 11 patients, improved 5 patients but only failed in 2 patients (with one death). For localized leakage, surgical treatment showed better efficacy (98.5% vs. 3/11), whereas conservative treatment had significantly higher successful rate than surgical interventions in patients with disseminated lymphatic diseases or no abnormality under lymphography (16/18 vs. 3/11).

CONCLUSIONSLymphography could identify the location and range of complicate chyle leakage failed to primary conservative management. Patients with disseminated lymphatic diseases or no abnormality under lymphography would be better managed by continuous non-operative treatment partly due to therapeutic effect of lymphography, while surgical intervention could be a good option for patients having localized lymphatic etiology.

Abdominal Cavity ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Chyle ; Chylothorax ; diagnosis ; surgery ; Female ; Heart ; Humans ; Kidney Pelvis ; Lymphatic Diseases ; Lymphography ; Male ; Middle Aged ; Neck ; Retrospective Studies ; Scrotum ; Young Adult

BACKGROUNDIntense exercise can cause injury and apoptosis, but few studies have reported its effect on the central nervous system (CNS). The initial reason for hippocampus injury is the excitotoxicity of glutamate and calcium overload. Intracellular free Ca(2+) ([Ca(2+)]i) overload may trigger the apoptosis pathway and neuron damage. The aim of this study was to investigate whether intense exercise could cause hippocampus apoptosis and neuron damage and then to determine which pathway was activated by this apoptosis.

METHODSWe used one bout of swimming exhaustion rats as models. Intracellular [Ca(2+)]i was measured to estimate the calcium overload by Fura-2/AM immediately after exhaustion; glial fibrillary acidic protein (GFAP) and synaptophysin (SYP) immunofluorescence were performed for estimating astrocyte activation and synapse plasticity 24 hours after exhaustion. Apoptosis cells were displayed using dUTP nick end labelling (TUNEL) stain; endoplasmic reticulum (ER) stress-induced apoptosis pathway and mitochondrial apoptosis pathway were synchronously detected by Western blotting.

RESULTSAn increasing level of intracellular [Ca(2+)]i (P < 0.01) was found in the hippocampus immediately after exhaustion. GFAP and SYP immunofluorescence showed that the astrocytes are activated, and the synapse plasticity collapsed significantly 24 hours after exhaustion. TUNEL stain showed that the number of apoptosis cells were notably raised (P < 0.01); Western blotting of the apoptosis pathway showed increasing levels of caspase-3 cleavage (P < 0.01), Bax (P < 0.01), caspase-12 cleavage (P < 0.01), C/EBP-homologous protein (CHOP) (P < 0.01), and phospho-Junaminoterminal kinases (p-JNK; P < 0.01) and decreasing level of Bcl-2 (P < 0.01). Our results proved that exhaustion can induce hippocampus injury and apoptosis by [Ca(2+)]i overload, with collapsed synaptic plasticity as the injury pattern and ER stress-induced apoptosis as the activated pathway.

CONCLUSIONIntense exercise can cause excessive apoptosis and synapse plasticity damage in the hippocampus with [Ca(2+)]i overload as the initial reason, and thus provides leads for therapeutic interventions in the brain health of athletes.

Animals ; Apoptosis ; physiology ; Blotting, Western ; Calcium ; metabolism ; Endoplasmic Reticulum Stress ; physiology ; Glial Fibrillary Acidic Protein ; metabolism ; Hippocampus ; metabolism ; In Situ Nick-End Labeling ; Male ; Physical Conditioning, Animal ; Rats ; Rats, Sprague-Dawley ; Synaptophysin ; metabolism

Based on heat-sensitive moxibustion (HSM) theory, a widely applicable scale was developed to reflect the (arrival of ) sensation of HSM. By documentary method and interviewing method, the items of describing sensation of HSM were collected to establish the pool of candidate items. With expert questionnaire, patient questionnaire and core expert discussion, the items were screened and quantified by method of subjective evaluation to develop the initial draft of the scale. A total of 121 patients were pre-surveyed with the initial draft, and the structural validity of the scale was examined by exploratory factor analysis (principal component) and its internal consistency was assessed by Cronbach's coefficient. As a result, the items in the scale was reduced from 36 to 9; 110 effective questionnaires were reclaimed for statistical analysis. Finally, the scale (Version 1.0) contained 9 items and 4 dimensions, of which, 3 items highlighted the comfort emotional experience, 3 items highlighted autonomic response, 2 items highlighted heat sensation, and 1 item highlighted non-heat sensation. In conclusion, the sensation scale of HSM containes 9 items, which has fair content and structure validity. It is in line with the current clinical understanding of sensation of HSM and has strong clinical operability and wide adaptability.
Hot Temperature ; Humans ; Moxibustion ; Sensation ; Surveys and Questionnaires ; Thermosensing