OBJECTIVE: To investigate the effect of electroacupuncture (EA) on the p38 mitogen-activated protein kinase (p38 MAPK) and signal transducer and activator of transcription 3 (STAT3) pathway in hippocampus and frontal cortex of diabetic rats with cognitive impairment (CI), as well as the mechanism of EA in protection against CI in diabetic rats. METHODS: Thirty SD rats were divided into normal, model and EA groups (n=10 rats/group). The diabetic model was established by i.p.injection of Streptozotocin solution(25 mg/kg), followed by high-fat diet raising for 1 month, and the CI rats was confirmed by Morris water maze tasks. The rats in the EA group were given acupuncture at "Zusanli" (ST36) "Neiting" (ST44) and "Yishu" (EX-B3) 20 min/d, among which ST36 and ST44 were treated with EA. The treatment was conducted 6 times a week for 4 weeks. The fasting blood glucose (FBG) contents were assayed by glucometer before and after treatment. The rats' learning-memory ability was detected by Morris water maze tasks. The expression levels of IL-6、IL-1β、TNF-α、p38 MAPK、p-p38 MAPK、STAT3 and p-STAT3 in hippocampus and frontal cortex were detected by Western blot and quantitative real-time PCR, separately. The mean fluorescence intensity of p38 MAPK and STAT3 was observed by immunofluorescence histochemistry. RESULTS: After modeling, FBG and the escape latency of Morris water maze tasks were significantly increased in the model group compared with the normal group (P<0.001, P<0.01). Following EA treatment, the increased FBG and average escape latency were markedly reversed in the EA group relevant to the model group (P<0.05). Compared with the normal group, the proteins and mRNAs expression of IL-6, IL-1β, TNF-α, p38 MAPK, p-p38 MAPK, STAT3 and p-STAT3 in hippocampus and frontal cortex were significantly increased in the model group (P<0.001), as well as the mean fluorescence intensity of p38 MAPK and STAT3 in hippocampus and frontal cortex (P<0.001). Following EA intervention, the proteins and mRNAs expression of IL-6, IL-1β, TNF-α, p38 MAPK, p-p38 MAPK, STAT3 and p-STAT3, and the mean fluorescence intensity of p38 MAPK and STAT3 in hippocampus and frontal cortex were down-regulated(P<0.001, P<0.05). CONCLUSION: EA can inhibit the over production of pro-inflammatory cytokines in diabetic rats with CI, possibly by regulating the expression of p38 MAPK and STAT3 pathway.

OBJECTIVE: To investigate the clinical effect of acupuncture combined with western medicine in the treatment of children with abdominal Henoch-Schonlein purpura with spleen-stomach damp-heat syndrome. METHODS: A total of 60 children with abdominal Henoch-Schonlein purpura with spleen-stomach damp-heat syndrome were randomly divided into treatment group and control group, with 30 patients in each group. The patients in the control group were given Hydroprednisone 2 mg•kg-1•d-1, and in addition to the treatment in the control group, those in the treatment group were given acupuncture at Tianshu (ST25), Neiguan (PC6), Zusanli (ST36), Zhongwan (CV12), Qihai (CV6), and Sanyinjiao (SP6) once a day, with a needle retaining time of 15 minutes. Both groups were treated for 7 days. The scores of abdominal pain, hematochezia, hematemesis, vomiting, poor appetite, abdominal distension, purpura, occult blood in stool, and abdominal ultrasound were determined before and after treatment, and the time to the disappearance of abdominal pain was observed. Clinical outcome was evaluated. RESULTS: The treatment group had a significantly higher effective rate than the control group ［96.7% (29/30) vs 80.0% (24/30), P<0.05］. Both groups had significant reductions in the scores of abdominal pain, hematochezia, hematemesis, poor appetite, abdominal distension, purpura, occult blood and abdominal ultrasound and the total score after treatment (P<0.05), and compared with the control group after treatment, the treatment group had significantly lower scores of abdominal pain, poor appetite, abdominal distension, and abdominal ultrasound and total score (P<0.05). The treatment group had a significantly shorter time to disappea-rance of abdominal pain than the control group (P<0.05). CONCLUSION: Acupuncture combined with western medicine has a better clinical effect than western medicine alone in the treatment of abdominal Henoch-Schonlein purpura with spleen-stomach damp-heat syndrome and can significantly improve clinical symptoms and signs and shorten the time to disappearance of abdominal pain.

OBJECTIVE: To observe the short-term and long-term clinical effect on posterior circulation ischemic vertigo treated with "xiao xingnao kaiqiao" acupuncture (minor regaining consciousness and opening orifice) and explore its effect mechanism. METHODS: Ninety patients with posterior circulation ischemic vertigo were randomly divided into a treatment group and a control group, 45 cases in each group. The patients of the two groups were all treated on the base of neurological medicine. In the control group, Flunarizine Hydrochloride was prescribed for oral administration (5 mg, once daily, for 21 days totally). In the treatment group, acupuncture of "xiao xingnao kaiqiao" was provided at Yintang (EX-HN3), bilateral Neiguan (PC6), bilateral Sanyinjiao (SP6), Baihui (GV20), bilateral Fengchi (GB20), bilateral Wangu (GB12) and bilateral Tianzhu (BL10). The needles were retained for 30 min, once daily for 21 days totally. The changes in vertigo score of traditional Chinese medicine (TCM) were observed, and the changes in the mean blood velocity (Vm) of the left vertebral artery (LVA), the right vertebral artery (RVA) and the basilar artery (BA) as well as the vascular pulsatility index (PI) were monitored and determined by transcranial Doppler (TCD). Additionally, the recurrence rate was followed up after 3 months to evaluate the long-term clinical effects. RESULTS: After treatment, the total effective rate of the treatment group was 91.11% (41/45) and 75.56% (34/45) in the control group. The total effective rate in the treatment group was higher than that in the control group (P<0.05). Compared with their own pre-treatment, the vertigo scores of TCM were reduced in either the treatment group or the control group after treatment (P<0.05) and the score in the treatment group was lower than that in the control group (P<0.05). Compared with their own pre-treatment, Vm and PI were all improved after treatment in either group (P < 0.05). After treatment, the improvements in Vm and PI of LVA、RVA and BA in the treatment group were better than those in the control group (P<0.05). In the follow-up after 3 months, the recurrence rate was 19.51% (8/41) in the treatment group and was 50.00% (17/34) in the control group. The recurrence rate in the treatment group was lower than that in the control group (P<0.05). CONCLUSION: "Xiao xingnao kaiqiao" acupuncture obviously relieves the clinical symptoms of posterior circulation ischemic vertigo. The mechanism of acupuncture is potentially related with its effects in improving Vm and PI of LVA,RVA and BA, as well as improving blood supply of brain tissue.

Histological pictures are important parts of medical research articles, and a good histological picture not only visualizes the content of the article, but also makes it easier for readers to understand. With the rapid development of microscopic technology and image processing technology, journals have higher requirements for the quality of histological pictures and more strict requirements for the editing and annotation of pictures. Based on an analysis of the current status of histological pictures in the articles of Acupuncture Research, this article proposes our suggestions and Methods for rational use of histological pictures, so as to provide a reference for improving the quality of histological pictures in the articles published in Acupuncture Research.

OBJECTIVE: To investigate the therapeutic effect of scalp acupuncture and rehabilitation training on balance dysfunction in children with spasmodic hemiplegia so as to provide the reference to the optimization of treatment scheme. METHODS: A total of 60 children with spastic hemiplegia were divided into a routine group and a scalp acupuncture group, 30 cases in each one according to random number table. In the routine group, the rehabilitation training was provided, including exercise training, balance training, spasmotherapy apparatus, electromyography biofeedback apparatus and orthoses. In the scalp acupuncture group, on the base of the treatment as the routine group, scalp acupuncture was supplemented at motor area, foot motor sensory area, equilibrium area and parietal temporal anterior oblique line. Separately, before the treatment, after 3 months treatment and after 6 months treatment, the dimension D and E of the gross motor function measure-88 (GMFM-88) and Berg balance scale (BBS) were adopted to evaluate balance related motor functions and equilibrium function. The differences in the above 3 indicators at different time stages were compared in children between the two groups. RESULTS: Compared with the score before the treatment, BBS score was obviously increased after 3 and 6 months treatment in the patients of the two groups respectively (P<0.05). The score in the dimension D and E after 6-month treatment was increased significantly as compared with the score before treatment and after 3-month treatment in the same group respectively (P<0.05). Compared with the routine group, the score of dimension D and E of GMFM-88 as well as BBS score were all increased obviously in the scalp acupuncture group after 3 and 6 months treatment (P<0.05). CONCLUSION: On the base of routine rehabilitation training, scalp acupuncture can improve balance function of children with spastic hemiplegia better.

OBJECTIVE: To compare the therapeutic effect and safety in treatment of functional constipation between electroacupuncture (EA) and gastro-kinetic drugs. METHODS: Using "functional constipation"， "prucalopride"， "mosapridecitrate"， "electro-acupuncture" and "randomized controlled trial"， both in Chinese and English, as search terms, the articles of randomized controlled trial (RCT) regarding to the comparison of therapeutic effect on functional constipation in the patients between EA and gastro-kinetic drugs were retrieved from CMB, Wanfang, VIP, CNKI, OpenGrey, CINAHL, Cochrane Library, JBI, PubMed, WOS and Ovid databases. The retrieval time was from the establishment date to June 2018. The two researchers screened articles, extracted data and assessed literature quality in reference to Cochrane Handbook. Using RevMan 5.3 software, the meta-analysis was conducted. RESULTS: A total of 11 articles were included finally, with 744 patients involved. It was found after meta-analysis that in EA group, the weekly spontaneous defecation frequency, constipation related quality of life in patients, depression relief and incidence of adverse reaction were all better than those in gastro-kinetic medication group. The therapeutic effect of the improvements in stool character and defecation difficulty in EA group were better or similar to that in gastro-kinetic medication group. CONCLUSION: Regarding the therapeutic effect and safety in treatment of functional constipation, the results of electroacupuncture are superior or similar to gastro-kinetic medication, presenting a satisfactory therapeutic prospect.

OBJECTIVE: To observe the effect of moxibustion on visceral pain, diarrhea, colonic 5-hydroxytryptamine (5-HT) content, and expression of tryptophan hydroxylase 1 (TPH1), serotonin reup take transporter (SERT) and 5-hydroxytryptamine receptor 3 (5-HT3R) in colon tissue of rats with diarrhea irritable bowel syndrome (IBS-D), so as to reveal its underlying mechanisms in treating IBS-D. METHODS: Thirty male SD rats were randomly divided into blank control, model and moxibustion groups (n＝10 rats in each group). The IBS-D model was established by chronic restraint combined with gavage of Senna leaf solution. Moxibustion was applied to bilateral "Tianshu" (ST25) and "Shangjuxu" (ST37) for 30 min, once a day for 7 days. After the treatment, the loose stool rate (number of loose stool/total number of feces granules X100%) and the minimum volume threshold of abdominal reflex (abdominal pain threshold) induced by rectal dilatation were observed. The content of colonic 5-HT was detected by using ELISA, and the expression of TPH1, SERT and 5-HT3R mRNAs and proteins were detected by using quantitative real time-PCR and Western blot, respectively. RESULTS: Compared with the blank control group, the minimum volume threshold of abdominal retraction reflex and the relative expression of SERT protein and mRNA were significantly decreased (P<0.01), and the loose stool rate, colonic 5-HT content, and relative expression of TPH1 and 5-HT3R proteins and mRNAs were notably increased in the model group (P<0.01). After moxibustion, both the decrease of minimum volume threshold and SERT protein and mRNA expressions and the increase of loose stool rate, colonic 5-HT content and TPH1 and 5-HT3R protein and mRNA expressions were reversed (P<0.01). CONCLUSION: Moxibustion of ST25 and ST37 can relieve abdominal hypersensitivity and diarrhea in IBS-D model rats, which is related to its effects in down-regulating colonic 5-HT content and expression of TPH1 and 5-HT3R proteins and mRNAs and in up-regulating expression of SERT protein and mRNA (regulating 5-HT/5-HT3R signaling)．.

OBJECTIVE: To observe the difference of therapeutic effect between hysteretic acupuncture and Celecoxib capsules for knee osteoarthritis(KOA), and to investigate their effects on levels of interleukin 6(IL-6) and tumor necrosis factor α(TNF-α) in articular fluid. METHODS: Seventy-two patients with KOA were randomly divided into hysteretic acupuncture and me-dication groups, with 36 cases in each group. The patients of the hysteretic acupuncture group received hysteretic acupuncture stimulation at Dubi (ST35), Neixiyan (EX-LE4), Zusanli (ST36), Yanglingquan (GB34), Yinlingquan (SP9), Xuehai (SP10), Liangqiu (ST34) and Heding (EX-LE2) as the main acupoints for 30 min once daily. The patients of the medication group received oral administration of Celecoxib capsules(200 mg) once daily. Both of the two groups were treated with 14 days as a course of treatment, with a 2-day rest between each course of treatment, and the treatments were conducted for 2 courses. The visual analogue scale(VAS) score of pain, Lequesne index score, IL-6 and TNF-α level in joint fluid and the change of traditional Chinese medicine(TCM) syndrome score were observed before and after treatment. RESULTS: Compared with pre-treatment, the VAS score, Lequesne index score, IL-6 and TNF-α level, and total TCM syndrome score decreased significantly after treatment in both of the two groups (P<0.05). Hysteretic acupuncture was more effective in reducing VAS score, Lequesne index score, IL-6 and TNF-α level than Celecoxib capsules (P<0.05), and there was no significant difference in total TCM syndrome score and total effective rate between the two groups(P>0.05). No adverse events occurred in both groups during the treatment. CONCLUSION: Hysteretic acupuncture can effectively relieve pain symptoms and improve joint function in KOA patients. Its effect is comparable to that of oral administration of Celecoxib capsules.

OBJECTIVE: To observe the clinical effect of electroacupuncture combined with moxibustion in the treatment of urinary incontinence after stroke due to deficiency of kidney-yang. METHODS: Sixty patients with urinary incontinence after stroke due to kidney-yang deficiency were randomly divided into a control group and an observation group，with 30 cases in each group. The patients in the control group were given oral administration of Jingui Shenqi pills and Suoquan capsules. On the basis of the treatment in the control group, the patients in the observation group were given electroacupuncture treatment at the Foot Motor sensory Area on the head, Shenshu(BL23) and Huiyang(BL35), together with moxibustion at Guanyuan(CV4) and Qihai(CV6) once daily. The treatment was conducted 6 times per week and for 2 successive weeks. The average number of daily urinary incontinence and night urinary incontinence, maximum bladder volume, residual bladder urine volume, degree of urinary incontinence and clinical symptoms score of the two groups before and after treatment were observed. And the clinical efficacy of the two groups were compared. RESULTS: After the treatment, compared with those before the treatment, the average numbers of daily and night urinary incontinence of the two groups were significantly reduced (P<0.01), the maximum bladder volume was significantly increased (P<0.05), and the residual urine volume of the bladder was significantly reduced (P<0.05). The number of cases with urinary incontinence degree Ⅰ and Ⅱ increased (P<0.05), and the score of clinical symptoms of urinary incontinence was significantly reduced (P<0.05). After the treatment, compared with the control group, the number of daily and night urinary incontinence in the observation group decreased (P<0.05), the maximum bladder volume increased (P<0.05), the residual bladder urine volume decreased (P<0.05), and the number of cases with urinary incontinence degree Ⅰ and Ⅱ increased (P<0.05), the clinical symptom score of urinary incontinence was significantly reduced (P<0.05). The total effective rates of the control group and the observation group were 73.3% (22/30) and 93.3% (28/30) respectively, and the effective rate of the observation group was higher than that of the control group (P<0.05). CONCLUSION: The combination of electroacupuncture, moxibustion and traditional Chinese medicine is effective in treating urinary incontinence after stroke due to deficiency of kidney-yang.

OBJECTIVE: To investigate the effect of electroacupuncture (EA) on intestinal Toll-like receptor 4 (TLR4) and nuclear factor-kappa B (NF-κB) in obese rats, so as to explore the mechanism of action of acupuncture in losing weight. METHODS: A total of 50 male Wistar rats were randomly divided into control and model groups. High-fat feed was used to establish a rat model of obesity, and after modeling, the 24 rats were randomly divided into model group, TLR4 inhibitor group, and EA group, with 8 rats in each group. The rats in the EA group were given EA at "Guanyuan" (CV4), "Zhongwan "(CV12), "Zusanli" (ST36), and" Fenglong" (ST40), 10 minutes each time, 3 times a week, and those in the TLR4 inhibitor group were given intraperitoneal injection of TAK-242 three times a week; the course of treatment was 8 weeks for both groups. Body weight and blood glucose were measured every two weeks. Co-immunoprecipitation was used to observe the interaction between TLR4 and NF-κB p65 in the intestinal tissue; electrophoretic mobility shift assay was used to measure the activity of NF-κB p65; Western blot was used to measure the protein expression of TLR4, phosphorylated nuclear factor of kappa light polypeptide gene enhancer in B-cells inhibitor alpha (p-IκBα), and NF-κB p65; quantitative real-time PCR was used to measure the mRNA expression of TLR4, NF-κB p65, and IκBα. RESULTS: Compared with the control group, the model group had significant increases in body weight, blood glucose, and protein and mRNA expression of TLR4 and NF-κB p65 (P<0.01, P<0.05), as well as significant enhancement in the interaction between TLR4 and NF-κB p65 and activity of NF-κB p65 (P<0.05，P<0.01). Compared with the model group, the EA group had a significant reduction in body weight (P<0.05), both of the EA group and the TLR4 inhibitor group had significant reductions in blood glucose, and protein and mRNA expression of TLR4, p-IκBα， and NF-κB p65 (P<0.05，P<0.01), as well as significant reductions in the activity of NF-κB p65 (P<0.01). CONCLUSION: EA can effectively regulate intestinal TLR4, inhibit the interaction between TLR4 and NF-κB p65, and reduce the activity of NF-κB p65, which may be a potential mechanism of EA in reducing body weight and blood glucose in obese rats.