Objective: To explore the mechanism of An-Pressing manipulation in relieving energy crisis in chronic myofascial trigger points (MTrPs) by observing the effects of An-Pressing manipulation on adenosine triphosphate (ATP), adenosine 5'-monophosphate (AMP)-activated protein kinase (AMPK)/peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α) pathway and mitochondrial ultrastructure of skeletal muscle cells in MTrPs rats. Methods: Forty-eight male Sprague-Dawley rats were randomly divided into a blank group, a model group, a lidocaine group, and an An-Pressing manipulation group, with 12 rats in each group. The model group, lidocaine group and An-Pressing manipulation group were used to replicate the MTrPs rat model by blunt shock and centrifugal motion method. After modeling, the An-Pressing manipulation group was subjected to 7 times An-Pressing manipulation, once every other day; the lidocaine group was treated with 3 times of injection of lidocaine at the MTrPs, once every 6 d. The blank group and the model group were fed normally without intervention. After the intervention, local muscle tissue was taken to detect the content of ATP and the expression of AMPK, phosphorylated AMPK (phospho-AMPK), PGC-1α, and glucose transporter 4 (GluT4), and the ultrastructure of mitochondria was observed under an electron microscope. Results: Compared with the blank group, the ATP content in the model group was decreased (P<0.05), the protein expression levels of phospho-AMPK, PGC-1α, and GluT4 and the ratio of phospho-AMPK to AMPK were decreased (P<0.05); under the electron microscope, the number of mitochondria decreased, and they were deformed, small in volume, and had deformed cristae. Compared with the model group, the ATP contents in the An-Pressing manipulation group and the lidocaine group were increased (P<0.05), and the protein expression levels of phospho-AMPK, PGC-1α, and GluT4 and the ratio of phospho-AMPK to AMPK were increased (P<0.05); under the electron microscope, the number of mitochondria increased, the shape and size of the mitochondria were basically normal, and the cristae could be seen. Compared with the lidocaine group, phospho-AMPK and the ratio of phospho-AMPK to AMPK in the An-Pressing manipulation group were increased (P<0.05); under the electron microscope, the numbers of mitochondria were similar, and the shape and size of the mitochondria were basically normal without swelling, and the cristae could be observed. Conclusion: An-Pressing manipulation can increase the ATP content in MTrPs tissue, improve the expression levels of PGC-1α and GluT4 proteins and the ratio of phospho-AMPK to AMPK; its mechanism may relate to the activation of AMPK/PGC-1α signaling pathway to promote the repair of mitochondrial damages.

Objective To systematically review the therapeutic efficacy of acupuncture plus rehabilitation in treating post-stroke spasm and to summarize the commonly-used acupoints.Method The randomized controlled trials and quasi-randomized trials of acupuncture plus rehabilitation for post-stroke spasm published from January 1 of 2005 to December 31 of 2014 in China were retrieved from CNKI, WanFang database, and VIP database, etc. by using computer. The eligible studies were recruited for review. Result Totally 15 studies were enrolled. The Meta-analysis showed that the most commonly used acupoints in acupuncture treatment for post-stroke spasm were Quchi (LI 11), Jianyu (LI 15), Hegu (LI 4), Tianjing (TE 10), Waiguan (TE 5), Zusanli (ST 36), Sanyinjiao (SP 6), Chize (LU 5), and so on. Compared to the controls, acupuncture plus rehabilitation had significantly better effective rate [OR=3.13, 95%CI (2.00,4.89),P<0.00001], recovery rate [OR=2.42, 95%CI (1.53,3.83),P=0.0002], MAS score [MD=﹣0.48, 95%CI (﹣0.62,﹣0.35),P<0.00001], FMA score [MD=5.58, 95%CI (4.96,6.20),P<0.00001], and NDS score [SMD=﹣0.68,95%CI (﹣0.91,﹣0.44),P<0.00001].Conclusion Acupuncture plus rehabilitation can effectively mitigate the post-stroke spasm and is worth promoting in clinic; more high-quality researches are expected as the quality of the currently recruited trials is not so satisfactory.

OBJECTIVETo compare the difference in the clinical efficacy on infantile food accumulation treated with centripetal tuina therapy at spleen meridian site of different location.

METHODSSixty cases of infantile food accumulation were randomized into a palmar thumb surface group and a radial margin group, 30 cases in each one. In the palmar thumb surface group, the spleen meridian was stimulated with the pushing technique centripetally on the palmar side of the thumb. In the radial margin group, the spleen meridian was stimulated with the pushing, technique centripetally along the radial margin of the thumb. The traditional tuina techniques, such as tuisanguan, yun neibagua were combined in the two groups. The treatment was given once a day, 6 times a week, 12 treatments as one session. After the 1 session of treatment, the main symptom scores before and after treatment were compared in the patients of the two groups, the improvements in the accompanied symptoms were observed, such as appetite, defecation and tongue coating; and the efficacy was evaluated in the two groups.

RESULTSThe total effective rates were 93.3% (28/30) and 90.0% (27/30) in the palmar thumb surface group and the radial margin group respectively and the difference was not significant statistically in comparison of the two groups (P > 0.05). After treatment, the main symptom score was improved significantly in the two groups, indicating the significant difference as compared with that before treatment (both P < 0.05). The improvement in foul breathing in the palmar thumb surface group was better than that in the radial margin group (P < 0.05).

CONCLUSIONBetween the two kinds of pushing techniques at spleen meridian site, pushing on the palmar surface of the thumb and pushing along the radial margin, there is no difference in the total efficacy on infantile food accumulation. Regarding the improvement in foul breathing, the effect in the palmar thumb surface group is better than that in the radial margin group.

Acupuncture Points ; Child ; Child, Preschool ; Defecation ; Female ; Humans ; Infant ; Intestinal Diseases ; physiopathology ; therapy ; Male ; Massage ; Meridians ; Spleen ; physiopathology ; Treatment Outcome

Objective:To observe the effect of electroacupuncture (EA) on the expression of erythropoie-tin-producing hepatocyte receptor B2 (EphB2) in the cortex around the infracted area of middle cerebral artery occlusion (MCAO) rats at different timing, and to reveal the possible mechanism of acupuncture in the treatment of cerebral ischemia.
Methods:A total of 180 male Sprague-Dawley (SD) rats were randomly divided into a sham operation group, a model group, an acupoint group and a non-acupoint group, with 45 rats in each group. Rats in each group were further divided into three subgroups: postoperative 3 d, postoperative 14 d and postoperative 21 d groups, with 15 rats in each subgroup. The MCAO model was made by the modified occlusion method. The neurological function score, 2,3,5-triphenyl tetrazolium chloride (TTC) staining, immunohistochemistry assay, immunofluorescence double labeling method and Western blot were used to detect the corresponding indicators.
Results:The neurological impairment of rats was most obvious at postoperative 3 d, and then gradually improved with time, which was more significant in the acupoint group (P<0.05). The change of infarcted volume was consistent with the neurological function impairment. The number of EphB2 positive cells (EphB2+) around the infarcted area was decreased significantly at postoperative 3 d, and then gradually improved with time, which returned to the same level as that in the sham operation group at postoperative 21 d. The increase was most significant in the acupoint group (P<0.05), and the positive cell number was higher than that in the sham operation group (P<0.01). Western blot and immunohistochemistry results were basically consistent. Immunofluorescence displayed that EphB2+ and postsynaptic density-95 positive (PSD-95+) were co-expressed, after the MCAO operation, in the cortical neuron around the infracted area, and the number of co-expressing cells was increased gradually with time, which was most significant in the acupoint group (P<0.05).
Conclusion:Electroacupuncture at Ganshu (BL 18) and Shenshu (BL 23) can significantly improve the neurological function and cerebral infarcted volume ratio of MCAO rats, which may be related to the activation of EphB2 expression in cortex around the infracted area and the promotion of synaptic remodeling.

Objective:To discuss the clinical efficacy of Liu’s infantile tuina therapy in treating kid’s allergic rhinitis (AR).
Methods:Sixty eligible AR kids were randomized into a tuina group and a Western medication group by their visiting sequence, 30 cases in each group. The tuina group was intervened by Liu’s infantile tuina therapy, once daily, 5 times as a treatment course, with a 2-day interval after a course; the control group was by orally taking Loratadine. The therapeutic efficacies were compared and analyzed after treatment for 4 successive weeks.
Results:After treatment, the symptoms such as itchy nose, sneezing, runny nose, and stuffy nose were significantly improved in both groups (P<0.05), and the improvements in the tuina group were more remarkable than those in the Western medication group (P<0.05). The total effective rate was 90.0% in the tuina group versus 73.3% in the Western medication group, and the difference was statistically significant (P<0.05).
Conclusion:Liu’s infantile tuina therapy can produce a better therapeutic efficacy in treating AR kids compared to oral administration of Loratadine.

Objective: To observe the influence of Nie-pinching the spine manipulation on the excretory rate of urine D-xylose in the infants with diarrhea due to spleen deficiency, and to assess the clinical effects. Methods:Sixty infants in conformity with the diagnostic criteria of diarrhea due to spleen deficiency were randomly divided into a treatment group and a control group by the random digital table, 30 cases in each group. The infants in the treatment group were treated by Nie-pinching the spine manipulation and traditional infantile tuina, in addition to the routine basic treatment. The infants in the control group were treated by the same traditional infantile tuina in addition to the routine basic treatment. The infants in the two groups were treated once every day, 4 weeks as a course. Totally, the treatment was given for a course. The symptom integrals of spleen deficiency were used to assess the improvement in the symptoms. The colorimetry was used to determine the excretory rate of urine D-xylose. Results:In the comparison of the same group before and after the treatment, the differences in the global score of spleen deficiency symptoms and the excretory rate of urine D-xylose in the two groups were statistically significant (allP<0.01). After the treatment, the differences in the global score of spleen deficiency symptoms and the excretory rate of urine D-xylose between the two groups were all statistically significant (bothP<0.01). Conclusion:Chiropractics can reduce the integrals of spleen deficiency symptoms and elevate the excretory rate of urine D-xylose in the infants with diarrhea due to spleen deficiency, so as to enhance the therapeutic effects by alleviating the symptoms of spleen deficiency and the absorptive function of the small intestine.

Objective:To observe the clinical efficacy of brain-benefiting and collateral-unblocking needling technique for chronic alcoholic gastritis complicated with depression. Methods:A total of 92 cases with chronic alcoholic gastritis complicated with depression were included in this trial. They were randomly allocated into an observation group (n=46) and a control group (n=46) by random number (envelope) method. Patients in the observation group received the brain-benefiting and collateral-unblocking needling technique. Scalp points included Shenting (GV 24), Xinhui (GV 22), Qianding (GV 23), Baihui (GV 20), Chengguang (BL 6), Tongtian (BL 7) and Luoque (BL 8). Body points included Neiguan (PC 6), Zusanli (ST 36), Zhongwan (CV 12), Gongsun (SP 4), Shenmen (HT 7), Daling (PC 7), Qimen (LR 14), Xinshu (BL 15) and Taichong (LR 3). The control group only received the same body acupuncture as the observation group. The treatment was conducted once a day, 30 min for each treatment, and 10 times made up a course of treatment. The efficacy was observed after 3 courses of treatment, and there was a 2-d interval between two courses. Results:After 3 courses of treatment, the clinical symptoms and gastroscopic features were significantly improved in the observation group than that in the control group. The clinical efficacy, self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were significantly better than those in the control group (allP<0.05). Conclusion:The brain-benefiting and collateral-unblocking needling technique can significantly improve clinical symptoms in patients with chronic alcoholic gastritis complicated with depression and substantially alleviate their gastroscopic features, anxiety and depression.

Objective:To observe the clinical efficacy of warm needling moxibustion plus flash cupping for remission-stage peripheral facial paralysis (FP) due to wind-cold.
Methods:Fifty eligible patients were randomized into a warm needling moxibustion group and an acupuncture-cupping group, 25 cases in each group. The warm needling moxibustion group was intervened by acupuncture at Fengchi (GB 20), Yangbai (GB 14) towards Yuyao (EX-HN 4), Xiaguan (ST 7), Dicang (ST 4) towards Jiache (ST 6), Quanliao (SI 18), and Hegu (LI 4), plus warm needling moxibustion at Quanliao (SI 18); the acupuncture-cupping group received flash cupping on the affected side in addition to the intervention given to the warm needling moxibustion group. The two groups were both treated once a day, 10 times as a treatment course, for 3 courses in total. The House-Brackmann (H-B) facial nerve grading system was observed before and after the intervention to evaluate the facial nerve function in the two groups, and the therapeutic efficacies were also compared between the two groups.
Results:The two treatment protocols both can promote the recovery of facial nerve function. The total effective rate was 92.0% in the acupuncture-cupping group versus 72.0% in the warm needling moxibustion group, and the between-group difference was statistically significant (P<0.05).
Conclusion:Warm needling moxibustion plus flash cupping can produce a more significant efficacy than dry warm needling moxibustion in treating remission-stage peripheral FP due to wind-cold.

Objective: To investigate the protective effect of moxibustion in initiating the endogenous protection information on gastric mucosa, and its relationship with the pathway of common peroneal nerve.Methods: Forty-eight Sprague-Dawley (SD) rats were randomly divided into a normal group (group A), a model group (group B), a moxibustion model group (group C) and a moxibustion model plus surgery group (group D), 12 in each group. Except for group A, rats in the other groups were treated with dehydrated ethanol and aspirin to prepare gastric mucosal damage model. The rats in group B were not treated with any interventions; rats in group C received moxibustion at Zusanli (ST 36), twice a day for continuous 3 d. The rats in group D were subjected to preparing the gastric mucosal damage model after the common peroneal nerve transection, followed by moxibustion at Zusanli (ST 36). After a 3-day intervention, ulcer index (UI) in each group was observed, and the levels of gastric mucosa-related repair cytokines of tumor necrosis factor-α (TNF-α), interleukin-4 (IL-4) and heat shock protein 70 (HSP70) were detected.Results: Compared with group A, the pathological changes and UI of group B were worse (P=0.000), but TNF-α in serum and tissue was changed significantly (P=0.000,P=0.002), IL-4 in serum and tissue was improved significantly (P=0.000, P=0.000). Compared with group B, TNF-α and IL-4 in group C and group D were significantly improved (TNF-α:P=0.003, P=0.016; IL-4:P=0.000,P=0.002). Compared with group C, the changes of UI in group B and group D were poor (both P=0.000); the levels of TNF-α and IL-4 in serum were significantly decreased (TNF-α:P=0.000,P=0.025; IL-4:P=0.000, P=0.034); and tissue HSP70 levels were decreased significantly (P=0.000,P=0.033).Conclusion: Zusanli (ST 36) can transmit information through the pathway of common peroneal nerve, regulate the release of gastric mucosal protective factors, and up-regulate the expression of cytothesis-related proteins, so as to achieve the effect in repairing gastric mucosa.

Objective To explore the effect of back Tuina on motor behavior,oxidative stress and in-flammation in rats with chronic fatigue syndrome(CFS).Methods Twenty-four Sprague-Dawley rats were randomly divided into a blank group,a model group and a Tuina group,each of 8,according to a random number table.The CFS rat model was prepared by means of forced weight-bearing swimming combined with chronic stress stimulation in 21 days.After modeling,the Tuina group was given daily 20-minute Tuina for 14 days.The general condition semi-quantitative score,exhaustion swimming time and open field experiment(OFE)distance of all groups were recorded.After the experiment,sam-ples were collected,and the histopathological changes of the vertical spine muscles were observed by hematoxylin and eosin(HE)staining.The cross-sectional area and diameter of muscle fibers were calcu-lated using Image Pro Plus software,and the frequency distribution diagram of cross-sectional area of muscle fibers was processed by using the Origin software.The contents of superoxide dismutase(SOD),glutathione peroxidase(GSH-Px)and peroxisome proliferator-activated receptor γ-coactivator 1α(PGC-1α)and tumor necrosis factor(TNF)-α,interleukin(IL)-1β,IL-6 in the serum of rats were mea-sured.Results After the intervention,the general condition semi-quantitative score of the Tuina group was significantly lower than the model group(P<0.01),while the exhaustion swimming time and OFE distance were significantly higher than the latter group(P<0.05,P<0.01).(2)HE staining showed that the significant atrophy of erector spinal muscle cells in the model group,was significantly relieved in the Tuina group.(3)Compared with the blank group,the contents of SOD,GSH-Px and PGC-1α in erectus muscles decreased significantly(P<0.01),while those of TNF-α,IL-1β and IL-6 in the se-rum of the model group increased significantly(P<0.01).However,compared with model group,the contents of SOD,GSH-Px and PGC-1α in erectus muscle increased significantly(P<0.05,P<0.01),while those of TNF-α,IL-1β and IL-6 of the Tuina group decreased significantly(P<0.05,P<0.01).Conclusion Tuina in the back can regulate the oxidative stress response,reliever the inflammatory re-sponse and improve the motor behavior of CFS rats.