Objective:To investigate whether herb cake-insulated moxibustion affects the expression of cholesterol metabolism-related protein 3-hydroxy-3-methylglutaryl coenzyme A reductase(HMGR)and inhibits the development of atherosclerosis by regulating the exosomal miR-223 expression.Methods:Thirty-six male New Zealand rabbits were randomly assigned to a normal group,a model group,and an herb cake-insulated moxibustion group,with 12 rabbits in each group.The model and the herb cake-insulated moxibustion groups were fed a high-fat diet for 8 weeks to induce an atherosclerosis model.Following successful modeling,the herb cake-insulated moxibustion group was subjected to bundling and herb cake-insulated moxibustion intervention,while the other two groups were subjected only to bundling without moxibustion.After 8 weeks of intervention,hematoxylin-eosin(HE)staining was used to observe aortic morphology;the serum levels of total cholesterol(TC),triglyceride(TG),and low-density lipoprotein cholesterol(LDL-C)were detected using an automatic biochemical analyzer in each group.Exosome morphology was observed using the transmission electron microscope;Western blotting(WB)was used to detect the protein levels of serum exosomal CD63 and CD9 markers,as well as liver HMGR;additionally,real-time fluorescence quantitative polymerase chain reaction was used to quantify serum exosomal miR-223.Results:HE staining showed thickened aortic intima,lipid infiltration,foam cell aggregation,and structural damage to the arterial wall in the model group.Meanwhile,after modeling,the serum levels of LDL-C,TC,and TG increased significantly in the model and herb cake-insulated moxibustion groups compared to the normal group(P<0.05),suggesting successful atherosclerosis rabbit model preparation.The serum exosomes of rabbits in the model group exhibited a saucer-like or semi-concave spherical shape with diameters of 120-150 nm.WB detection results showed positive expression of the exosomal markers CD63 and CD9.After 8 weeks of intervention,the miR-223 level in the model group was significantly lower than that in the normal group(P<0.01).In contrast,the herb cake-insulated moxibustion group demonstrated significantly reduced serum levels of TC,TG,and LDL-C(P<0.05),increased miR-223 expression(P<0.01),and decreased relative liver HMGR protein expression(P<0.05)compared to the model group.Conclusion:Herb cake-insulated moxibustion may alleviate the progression of atherosclerosis by up-regulating exosomal miR-223 expression and down-regulating HMGR protein expression,thereby inhibiting cholesterol anabolic metabolism.

Objective:To observe the analgesic effect and therapeutic mechanism of the dragon-tiger fight needling method in treating lumbar disc herniation(LDH).Methods:A total of 100 patients with LDH were selected and randomly divided into an observation group and a control group,with 50 patients in each group.Both groups received the same basic treatment of Western medicine.The observation group received additional acupuncture treatment using the dragon-tiger fight needling method,administered once every other day for a consecutive month.Before and after treatment,the serum levels of bradykinin(BK),soluble tumor necrosis factor type 1 receptor(sTNF-R1),α1-acid glycoprotein(α1-AGP),phospholipase A2(PLA2),methionine enkephalin(M-ENK),β-endorphin(β-EP),and 6-keto prostaglandin E1α(6-keto-PGE1α)were measured in both groups.Additionally,the sensory conduction velocities(SCV)of the sural nerve and superficial peroneal nerve,as well as the biomechanical indicators of lumbar muscles(including the lumbar flexion-extension ratio and peak torque and average power in the lumbar extension position)were assessed.The Oswestry disability index(ODI)was evaluated,and traditional Chinese medicine(TCM)symptoms were scored for patients in both groups.After treatment,the clinical efficacy of the two groups was compared.Results:After treatment,the serum levels of α1-AGP and PLA2 in both groups decreased compared to their respective pre-treatment levels(P<0.05),and the levels in the observation group were lower than those in the control group(P<0.05).The serum levels of sTNF-R1 in both groups increased compared to their respective pre-treatment levels(P<0.05),and the levels in the observation group were higher than those in the control group(P<0.05).The serum levels of 6-keto-PGE1α and BK in both groups decreased significantly compared to their respective pre-treatment levels(P<0.05),and the levels in the observation group were lower than those in the control group(P<0.05).The serum levels of M-ENK and β-EP in both groups increased compared to their respective pre-treatment levels(P<0.05),and the levels in the observation group were higher than those in the control group(P<0.05).The lumbar flexion-extension ratio in both groups decreased compared to their respective pre-treatment level(P<0.05),and the ratio in the observation group was lower than that in the control group(P<0.05).The peak torque and average power in the lumbar extension position increased in both groups compared to their respective pre-treatment levels(P<0.05),and both values in the observation group were higher than those in the control group(P<0.05).The SCV of the superficial peroneal nerve and sural nerve in both groups increased compared to their respective pre-treatment levels(P<0.05),and the values in the observation group were higher than those in the control group(P<0.05).The ODI and TCM symptom scores in both groups decreased(P<0.05),and the scores in the observation group were lower than those in the control group(P<0.05).Conclusion:Based on Western medicine treatment,acupuncture treatment using the dragon-tiger fight needling method for LDH patients can inhibit inflammatory markers,regulate pain mediator levels,alleviate pain,improve the biomechanical and electromyographic indicators of lumbar extensor muscles,and thus enhance lumbar function and clinical efficacy.

Objective:To study the efficacy of acupuncture combined with Tuina(Chinese therapeutic massage)compared to acupuncture alone and sham acupuncture in aspects of symptom control and mobility functions in farmers suffering from knee osteoarthrosis(KOA).Methods:Individuals enrolled at a community hospital in Thailand were extended invitations to take part in the research project.Those who volunteered provided informed consent and were then randomly assigned to one of three groups,namely the combined group,the acupuncture group,and the control group.Thirty-four cases in the combined group received acupuncture and Tuina treatments;32 cases in the acupuncture group received acupuncture alone;and 30 cases in the control group received sham acupuncture intervention.Each group underwent therapeutic sessions once daily for 10 d.As the main outcome measured,the Western Ontario and McMaster Universities osteoarthritis index(WOMAC)was used to assess pain,stiffness,and function.The secondary outcomes included movement angles measured with a goniometer and balance function evaluated by the timed up and go test.Results:A total of 96 patients were analyzed.After the intervention,WOMAC total score and pain,stiffness,and function scores were significantly reduced and the joint range of motion was improved in both the combined group and the acupuncture group when compared to the control group(P<0.05);there were no significant differences between the combined group and the acupuncture group.Compared to the acupuncture group,a lowered balance score was observed in the combined group(P<0.05).Conclusion:After once-daily interventions for 10 consecutive days in KOA patients,both the combination of acupuncture and Tuina and acupuncture alone proved effective in alleviating pain and improving the range of motion compared to the control group.

Objective:To observe the effect of contralateral needling to regulate tendons and circulate Qi combined with Maitland joint mobilization on ankle joint function and the peri-ankle muscle groups in patients with chronic ankle sprain.Methods:A total of 77 patients with chronic ankle sprain,meeting the inclusion criteria,were randomly divided into a control group(38 cases)and an observation group(39 cases).The control group received conventional acupuncture treatment,while the observation group received contralateral needling to regulate tendons and circulate Qi combined with joint mobilization.Both groups were treated once daily for two consecutive courses.The American Orthopaedic Foot&Ankle Society(AOFAS)ankle-hindfoot scale was used to assess ankle joint function in the two groups,and the biomechanical model of skeletal muscles of lower limbs(Gait2392_simbody)was used to evaluate the muscle strength of the peri-ankle muscle groups.Results:The total effective rate in the observation group was 94.9%,significantly higher than the 79.0%in the control group(P<0.05).After treatment,the AOFAS ankle-hindfoot scores in both groups increased compared to their respective pre-treatment scores(P<0.05),and the scores in the observation group were higher than those in the control group(P<0.05).After treatment,the maximum muscle strength values of the medial and lateral heads of the gastrocnemius,tibialis posterior,and flexor hallucis longus in both groups increased compared to their respective pre-treatment values(P<0.05),and the values in the observation group were higher than those in the control group(P<0.05).The maximum muscle strength values of the soleus and flexor digitorum longus in both groups decreased compared to their respective pre-treatment values(P<0.05),and the values in the observation group were lower than those in the control group(P<0.05).The maximum muscle strength values of the extensor hallucis longus and tibialis anterior in both groups increased compared to their respective pre-treatment values(P<0.05),and the values in the observation group were higher than those in the control group(P<0.05).The visual analog scale(VAS)score in both groups decreased compared to their respective pre-treatment score(P<0.05),and the score in the observation group was lower than that in the control group(P<0.05).Conclusion:Either the combined therapy(contralateral needling to regulate tendons and circulate Qi combined with joint mobilization)or the conventional acupuncture alone can alleviate pain,improve ankle joint function,and enhance the muscle strength of the peri-ankle muscle groups in patients with chronic ankle sprain,but the combined therapy shows superior efficacy.

Objective:To observe the effects of acupuncture on the motor function of Parkinson disease(PD)model mice and to investigate the neuroprotective effects of acupuncture on PD from the perspective of cellular senescence.Methods:C57BL/6J mice were randomly divided into a normal control(NC)group,a 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP)group,an acupuncture(ACU)group,and a rasagiline(RAS)group,with 6 mice in each group.Except for the mice in the NC group,all mice were injected intraperitoneally with MPTP[30 mg/(kg·bw)]to establish a PD mouse model.After the models were successfully established,mice in the ACU group received acupuncture at Baihui(GV20)and bilateral Yanglingquan(GB34)for 15 min,once a day for 14 consecutive days.Mice in the RAS group were treated with gavage of rasagiline mesylate[0.5 mg/(kg·bw)],once daily for 14 d.Mouse balance and motor functions were detected using the mouse fatigue rotating rod apparatus.Immunohistochemistry staining was used to detect the number of tyrosine hydroxylase(TH)-positive neurons and the protein expression levels of special AT-rich sequence-binding protein 1(SATB1),p21,and p53 in the substantia nigra(SN)region of the mouse brain in each group.The glutathione peroxidase(GSH-Px)activity of mouse brain SN tissue was detected by enzyme-linked immunosorbent assay.The protein expression levels of interleukin(IL)-6 and senescence-associated β-galactosidase(SA-β-gal)in the SN tissue of mice in each group were detected by Western blotting.The relative expression of SATB1,p21,and p53 mRNA in the SN of each group was detected by real-time quantitative polymerase chain reaction.Results:Compared to the NC group,the overall rod performance(ORP)score,the number of TH-positive neurons,and GSH-Px activity in the SN region were significantly lower in the mice in the MPTP group(P<0.01);compared to the MPTP group,the ORP score,the number of TH-positive neurons,and GSH-Px activity were significantly increased in the ACU group and the RAS group(P<0.01 or P<0.05).Compared to the NC group,the protein levels of IL-6 and SA-β-gal in the SN tissue,the protein and mRNA expression levels of p21 and p53 were significantly increased(P<0.01);compared to the MPTP group,the protein levels of IL-6 and SA-β-gal in the SN tissue,the protein and mRNA expression levels of p21 and p53 were significantly decreased in the ACU group and the RAS group(P<0.01 or P<0.05).Compared to the NC group,the relative expression of SATB1 protein and mRNA in the SN of mice in the MPTP group was significantly decreased(P<0.01);compared to mice in the MPTP group,mice in the ACU group and the RAS group showed significant increases in the relative expression of SATB1 protein and mRNA(P<0.01 or P<0.05).Conclusion:Acupuncture can improve motor function and increase the number of TH-positive neurons in the SN of PD model mice.Its neuroprotective effect may relate to the regulation of the SATB1/p21 signaling pathway and the inhibition of cellular senescence-related biomarker expression in the SN.

Objective:To compare the effects of manual acupuncture(MA),electroacupuncture(EA),and moxibustion on knee joint cartilage morphology,serum inflammatory factors interleukin(IL)-6 and IL-10,matrix metalloproteinase 13(MMP13),and intestinal flora composition in knee osteoarthritis(KOA)model rats.Methods:Forty male specific-pathogen-free Sprague-Dawley rats aged seven weeks were randomly divided into a normal group(n=8)and a KOA modeling group(n=32).The KOA model was established using sodium iodoacetate induction.The KOA modeling rats were further randomly divided into a model group,an MA group,an EA group,and a moxibustion group,with 8 rats in each group.In the MA,EA,and moxibustion groups,interventions targeting the right Futu(ST32)and Zusanli(ST36)were performed for 15 min,once every other day,for 14 sessions.The normal and model groups were bundled on the self-made fixation frame for 15 min.The rat knee joint diameter was measured on the 8th day of adaptive feeding,after successful modeling,and after the 14th intervention.Lequesne behavioral scoring was performed after successful modeling and after the 14th intervention.After the 14th intervention,hematoxylin-eosin(HE)staining and Masson staining were performed with the cartilage sections of the right knee joint.The pathomorphological changes of the rat joint cartilage were observed and quantified by Mankin's score.Enzyme-linked immunosorbent assay was used to detect the rat serum levels of IL-6,IL-10,and MMP13.Additionally,16S rDNA sequencing was used to detect the composition of rat fecal flora.Results:Compared to the normal group,the right knee joint diameter and the Lequesne score were significantly increased in the model group(P<0.01).Compared to the model group,the right knee joint diameter and the Lequesne score of rats in the MA,EA,and moxibustion groups were significantly reduced(P<0.01),with no significant differences among the three intervention groups(P>0.05).HE staining and Masson staining revealed disordered cartilage structure in the model group,which was improved following interventions in the MA group,EA group,and moxibustion group.Mankin's score was significantly higher in the model group versus the normal group(P<0.05)while significantly lower in the MA,EA,and moxibustion groups versus the model group(P<0.05).Serum analysis showed elevated IL-6 and MMP13 levels and reduced IL-10 level in the model group versus the normal group(P<0.05).Compared to the model group,the serum IL-6 level was significantly reduced(P<0.05),and the IL-10 level was significantly increased(P<0.05)in the MA,EA,and moxibustion groups,but without statistical differences among the three intervention groups(P>0.05);moreover,the MMP13 level in the moxibustion group was significantly lower than that in the model group(P<0.05).The alpha diversity analysis of intestinal flora showed no statistical difference in the number of operational taxonomic units(OTUs)and alpha diversity index among groups(P>0.05).Intestinal flora beta diversity analysis revealed significant differences among groups(P<0.05).Intestinal flora composition analysis showed significantly increased relative abundance of Lactobacillus(P<0.05)and significantly decreased relative abundance of Eubacterium_coprostanoligenes(P<0.05)in the model group compared to the normal group;compared to the model group,the relative abundances of Firmicutes,Lactobacillus,and Romboutsia in the MA,EA,and moxibustion groups were significantly reduced(P<0.05);the relative abundance of Bacteroidetes and Lachnospiraceae_NK4A136 in the MA group increased significantly(P<0.05);Bacteroidetes and Ruminococcaceaae_UGC-005 increased significantly in the moxibustion group(P<0.05).Conclusion:MA,EA,and moxibustion effectively reduced knee joint swelling,improved cartilage tissue morphology,optimized intestinal flora composition,down-regulated expression levels of serum pro-inflammatory factors IL-6 and MMP13,and increased expression level of anti-inflammatory factor IL-10 in KOA rats.Among them,moxibustion exhibited the most obvious regulatory effect on inflammatory factors.

Objective:To observe the effect of point injection at Zusanli(ST36)plus abdominal point application on gastrointestinal dysfunction after laparoscopic surgery.Methods:A total of 204 patients with gastrointestinal dysfunction after laparoscopic surgery were recruited and divided into four groups using the random number table method,with 51 cases in each group.The control group received conventional postoperative intervention.In addition to the treatment in the control group,the point injection group was given point injection at Zusanli(ST36),the application group was offered abdominal point application,and the integrated group received point injection at Zusanli(ST36)and abdominal point application.The treatment lasted 3 consecutive days in all four groups.The recovery time of gastrointestinal function indicators and the incidence rate of postoperative nausea and vomiting(PONV)were observed and recorded.Before and after treatment,the visual analog scale(VAS)was used to assess abdominal pain intensity,the venous blood type 1 helper T cells/type 2 helper T cells(Th1/Th2)was determined,the serum levels of interleukin(IL)-6 and interferon(IFN)-γ were detected using the enzyme-linked immunosorbent assay,and the plasma levels of motilin and gastrin were measured using radioimmunoassay.Results:Compared to the control group,the first exhaust time,the first defecation time,and the time of restoring fluid diet came earlier in the other three groups(P<0.05)and were earlier in the integrated group than in the point injection and application groups(P<0.05).The point injection,application,and integrated groups had a lower PONV incidence rate than the control group,and the integrated group was lower than the point injection and application groups(P<0.05).The intra-group comparisons showed that the VAS score and the levels of IL-6 and INF-γ decreased after treatment in all four groups(P<0.05);the point injection,application,and integrated groups were lower than the control group(P<0.05),and the integrated group was lower than the point injection and application groups(P<0.05).The intra-group comparisons also demonstrated that the levels of Th1/Th2,motilin,and gastrin increased after the intervention in the four groups(P<0.05);the point injection,application,and integrated groups were higher than the control group(P<0.05),and the integrated group was higher than the point injection and application groups(P<0.05).Conclusion:Point injection at Zusanli(ST36)plus abdominal point application can encourage postoperative exhaust,defecation,and the recovery of diet fluid,alleviate postoperative abdominal pain,reduce PONV,balance Th1/Th2,and regulate the secretion of motilin and gastrin in patients with gastrointestinal dysfunction after laparoscopic surgery.

Objective:To observe the effects of transcutaneous electrical point stimulation(TEPS)on awakening,cognition,and immune function in patients undergoing laparoscopic cholecystectomy(LC)under general anesthesia.Methods:Ninety patients undergoing LC under general anesthesia were selected as the study subjects and were divided into a control group and an observation group according to the random number table method,with 45 cases in each group.The control group was operated with conventional general anesthesia.The observation group was treated with the same anesthesia as the control group,and TEPS was performed at Hegu(LI4),Zusanli(ST36),and Neiguan(PC6)before the induction of anesthesia until the completion of the operation.The quality of postoperative awakening,hemodynamic indicators,cognitive function,and immune function of patients in the two groups were compared,and the occurrence of adverse reactions was recorded.Results:The time of recovery of spontaneous breathing and extubation time of the observation group were shorter than those of the control group(P<0.05);there was no statistically significant difference in the heart rate(HR)and mean arterial pressure(MAP)between the two groups at the moment before the induction of anesthesia(T1)(P>0.05);at the moment of extubation(T2)and 5 min after extubation(T3),the HR and MAP of patients in both groups were higher than those at T1(P<0.05),and those of the observation group were lower than those of the control group(P<0.05).Preoperatively,there was no statistically significant difference in the Montreal cognitive assessment scale(MoCA)score between the two groups(P>0.05);3 d postoperatively,the MoCA score of the two groups decreased and was higher in the observation group than in the control group(P<0.05).Preoperatively,there was no statistical difference in the comparison of CD4+,CD8+,and CD4+/CD8+between the two groups(P>0.05);3 d postoperatively,the above indicators decreased in both groups(P<0.05)and were higher in the observation group than in the control group(P<0.05).There was no statistical difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:The application of TEPS at Hegu(LI4),Zusanli(ST36),and Neiguan(PC6)with general anesthesia can improve the quality of postoperative awakening,promote hemodynamic stabilization,and improve cognitive function and immune function in LC patients,with good safety.

Objective:To explore the clinical efficacy of coiling dragon needling plus chin tuck against resistance(CTAR)training for post-stroke deglutition disorders and its impact on surface electromyography.Methods:A total of 100 patients with post-stroke deglutition disorders were randomly divided into two groups,with 50 cases in each group.Both groups received the same CTAR training,and the observation group was treated with additional coiling dragon needling.Both groups were treated for 2 weeks.The clinical efficacy,swallowing function,average value of the maximum amplitude of surface electromyography,quality of life,and the difference in adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was higher than that of the control group(P<0.05).After treatment,the standardized swallowing assessment(SSA),aspiration score,and deglutition disorders score of the videofluoroscopic swallowing study(VFSS)in both groups were significantly lower than those before treatment(P<0.05).The average value of the maximum amplitude of surface electromyography in the relaxed state,dry swallowing state,and the state of swallowing water,and the swallowing quality of life questionnaire(SWAL-QOL)score were all significantly higher than those before treatment in the two groups(P<0.05).After treatment,the SSA score,VFSS aspiration score,and VFSS deglutition disorders score in the observation group were lower than those in the control group(P<0.05),and the average value of the maximum amplitude of surface electromyography in the relaxed state,dry swallowing state,and the state of swallowing water,and the SWAL-QOL score in the observation group were higher than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Compared to CTAR treatment alone,coiling dragon needling plus CTAR treatment can enhance the clinical efficacy in treating patients with post-stroke deglutition disorders,enhancing the contraction ability of swallowing muscles and improving their swallowing function and quality of life.

Objective:To observe the clinical efficacy of intradermal needles and moxibustion combined with bladder irrigation in the treatment of post-stroke urinary retention and its effect on the patient's quality of life and depressive mood.Methods:A total of 80 patients with post-stroke urinary retention were divided into an observation group and a control group by the random number table method,with 45 patients in each group.Both groups received the same basic treatment.In the control group,bladder irrigation was added;in the observation group,intradermal needles and moxibustion were added in addition to the treatment in the control group.After 2 weeks of continuous treatment,the clinical efficacy and the occurrence of adverse events were compared between the two groups,and the changes in the traditional Chinese medicine(TCM)symptom score,urinary function,quality of life,and depressive mood were observed.Results:The total effective rate of the observation group was higher than that of the control group(P<0.05).After treatment,the TCM symptom score,residual urine volume,subjective quality of life profile score,and self-rating depression scale score of both groups were significantly reduced(P<0.05),and those of the observation group were significantly lower than those of the control group(P<0.05).Single maximal voiding volume,maximum cystometric capacity,and intravesical pressure were significantly increased in both groups(P<0.05)and were significantly higher in the observation group than in the control group(P<0.05).No needle shock,needle breakage,or allergic reaction happened in the two groups.Conclusion:Based on conventional treatment,the efficacy of intradermal needles and moxibustion combined with bladder irrigation in the treatment of post-stroke urinary retention was better than that of bladder irrigation.It was effective in reducing clinical symptoms,improving urinary function,improving quality of life and depression,and had a good safety profile.