ObjectiveTo explore the influence of electroacupuncture combined with point bloodletting and cupping for facial nerve function recovery in acute stage of idiopathic facial palsy （IFP）. MethodsEighty patients with IFP in the acute stage were randomly divided into 40 cases each in the treatment group and the control group. In the control group， oral prednisone acetate tablets were administered during the acute stage when the disease duration was less than 10 days； and electroacupuncture and flash cupping were provided during the recovery stage when the disease duration was more than 10 days， five times a week. For treatment group in acute stage， the stellate ganglion， vagus nerve stimulation point in the auricular cavity， Yifeng （TE 17） and Tinghui （GB 2） were needled on the affected side on the basis of the treatment of control group， with Yifeng and Tinghui connecting to electroacupuncture apparatus， once a day； point bloodletting and then cupping in Yifeng 2 times a week； in recovery stage， the treatment was the same as that of the control group. Both groups were treated until the 45th day from onset. The primary outcome was the Toronto facial grading system （SFGS）， and the secondary outcomes included house-brackmann （H-B） grade， facial disability index （FDI） score， and number of H-B grade-Ⅰ cases. Adverse events were recorded in both groups. ResultsThe SFGS scores of the patients in both groups were higher on the 10th， 30th and 45th days after onset of disease compared with those before the treatment （P＜0.05）； the H-B grade was lower on the 30th and 45th days after the onset of the disease compared with those before the treatment （P＜0.05）； and the facial disability index physical function （FDIP） and facial disability index social function （FDIS） scores were higher on the 30th and 45th days after onset of disease （P＜0.05）. SFGS scores of patients in the treatment group were significantly higher than those of the control group on the 30th and 45th days after onset （P＜0.05）； H-B grade was significantly lower than that of the control group on the 30th and 45th days after onset （P＜0.05）； and FDIP scores on the 45th day after onset， and FDIS scores on the 30th and 45th days after onset were significantly higher than those of the control group （P＜0.05）. At the end of treatment， 77.50% （31 cases） achieved H-B grade-Ⅰ in the treatment group， which was more than 55.00% （22 cases） in the control group （P＜0.05）. No adverse events occurred in either group. ConclusionElectroacupuncture combined with point bloodletting and cupping for IFP in acute stage can improve the recovery degree of facial nerve function， improve effectiveness， and show a high degree of safety.

By analyzing the acupuncture clinical thinking polymorphism in the ancient and modern time，it is shown that the guidance theory systems of acupuncture and moxibustion therapy are on the diversity. Classic meridian system is part of the important composition of acupuncture theory system，and it is not the only one guidance for clinical acupuncture. In the ancient time, acupoints were according to local lesion, classical meridian therory, acupoint indication and effect, the disease, the syndrome, cold-hot and deficiency-excess features, pulse, time and season, meridian's - , and needling instrument, etc. In the modern clinical practice, the points are selected according to the above theories and the modern theories such as western medicine anatomy，as well as various micro-acupuncture systems and the new method theories. Through the analysis of the diversity of ancient and modern acupuncture theory, a preliminary idea of the acupuncture-moxibustion theory system is suggested including traditional theory system (classical meridian system, classical non-meridian system and classical TCM system), and modern theory system [nervous system (linear contact system) and non-nervous system (nonlinear contact system)].

As an external therapy, acupuncture has its own essential characteristics and clinical treatment regularity. The nature, the unique view and feasible factor of acupuncture are different totally from those of the internal therapy with Chinese herbal medicine. The thought of the internal therapy does not benefit the essential characteristics of acupuncture clinical practice, named the external therapy is used for either the external disorders or the internal disorders. In macroscopic view, the human body disorder is divided into disorder (body surface disorder, somatopathy) and disorder (internal disorder, splanchnopathy), which contributes to the general rule of the diagnosis and treatment. The classical meridian system is practical, highly-effective and specific in the treatment guidance for somatopathy in light of the rule as using the external therapy for the external disorder. This system is also important in the treatment for the internal disorder. But, a further study is required to remove the flaws.

Objective To investigate the value of standardized ultrasound screening in diagnosis of fetal congenital heart disease (CHD) during the first trimester. Methods This study retrospectively analyzed the clinical data of 8 383 fetuses who received ultrasound screening during the first trimester in the Dongguan Maternal and Child Health Hospital from September 2015 to December 2016. Standardized ultrasound was performed to observe fetal heart position, apical direction, apical four-chamber view, three vessels and trachea view and the thickness of nuchal translucency (NT). Fetuses with thickened NT or fetal CHD observed during the first and second trimester were followed up. Pregnancy outcomes and the growth of newborns within one year after birth were recorded and analyzed. Pathological results after the termination of pregnancy were compared with the results of routine karyotyping and chromosome microarray analysis (CMA). Results (1) A total of 27 cases of fetal CHD were identified during the first trimester giving a detection rate of 0.32% (27/8 383). These included ten (37.0%) of single atrium and/or single ventricle, seven (25.9%) of endocardial cushion defect (including two complicated by persistent arterial trunk), three (11.1%) of hypoplastic right heart syndrome, three (11.1%) of interventricular septal defect, two (7.4%) of hypoplastic left heart syndrome, one (3.7%) of mirror-image dextrocardia and one (3.7%) of right atrial enlargement and severe tricuspid regurgitation. Nineteen out of the 27 cases had NT thickening (NT≥3.0 mm) and 17 of them had a cystic hygroma (NT≥6.0 mm). Among the 27 cases, 22 were terminated in the first trimester which autopsy results were consistent with ultrasound and the other five were rescreened during the second trimester. Thirteen out of the 27 cases received chorionic villus sampling, and seven of them were found to have chromosomal abnormalities by karyotyping and CMA, among whom one was microdeletion of 22q11. (2) Twenty-one cases of CHD were detected in the second-trimester ultrasound screening, including five initially identified in the first trimester. These cases included four (19.0%) of complex cardiac malformations (with three or more malformations), four (19.0%) of interventricular septal defect, three (14.3%) of dextroaortic arch, left subclavian artery vagus and 'U' shaped vascular ring, three (14.3%) of hypoplastic right heart syndrome (including one complicated by coronary artery-right ventricular fistula and one by interventricular septal defect), two (9.5%) of transposition of the great arteries, two (9.5%) of tetralogy of Fallot, one (4.8%) of hypoplastic left heart syndrome, one (4.8%) of Taussig-Bing anomaly and one (4.8%) of coarctation of the aorta. Among the 16 cases first identified in the second trimester, eight had NT thickening, including one with cystic hygroma. Among the 21 cases, two were lost to follow-up after being transferred to another hospital; four with negative results in karyotype analysis and CMA were delivered vaginally at term (37-40 gestational weeks) with 1-min Apgar scores of ten points and postpartum ultrasound of the baby was consistent with the second-trimester ultrasound screening; 15 were terminated and the autopsy confirmed those findings in the second-trimester ultrasound screening. Eleven out of the 21 cases received amniocentesis and five of them were found to be abnormal according to karyotype analysis and CMA, including one of microdeletion of 22q11. Conclusions Standardized first-trimester ultrasound screening is important and of great clinical value in the diagnosis of fetal CHD. Increased NT thickness could be a key indicator of fetal CHD and chromosomal abnormalities in early pregnancy. CMA may facilitate detecting the abnormality of genetic material in fetuses with normal chromosome karyotype.

Clinical evidences of acupuncture and moxibustion for sudden hearing loss(SHL) were completely collected, and the quality of the evidences was evaluated by Jadad scale. Cumulative Meta-analysis and the time tendency test for the results were implemented by STATA 12.0. Descriptive and academic cross-sectional investigation was carried out among senior professional doctors with acupuncture and moxibustion background in 31 provin-ces of China, and the advices of specialists were analyzed by fussy comprehensive evaluation. Thirty-eight researches were included. Cumulative Meta-analysis indicated that acupuncture and moxibustion combined with medication achieved better cured and total effects compared with multiple medicines[RR=1.57, 95%CI(1.38,1.79); RR=1.34, 95%CI(1.28,1.81)], and the efficacy had no time variability. The cured and total effects of acupuncture and moxibustion were superior to those of multiple medicines, but the results needed to be further verified. Five hundred and sixty-one questionnaires were put out in the 31 provinces, and 93.40% of ones were collected and eligible. Fuzzy comprehensive evaluation showed a tendency to overall improvement by acupuncture and moxibustion as the main intervention in the specialists' advice. Cumulative Meta-analysis and fussy comprehensive evaluation are applicable to estimate the effect and intervention level of acupuncture and moxibustion with low quality evidence.

BACKGROUND:The state of ischemic penumbra after cerebral infraction determines the final infarct volume. Decreased selective gene expression and protein synthesis, lactic acidosis and cytotoxic edema, salvage therapy of nerve cels, and continous regulation of neurovascular unit in the ischemic penumbra are areas of interest for recovery of neurological function. OBJECTIVE: Taking the neoangiogenesis process of post-infarction as the research point, to investigate the basic law of neovascularization with time and the effect of electroacupuncture intervention on proliferation of local blood vessels. METHODS: Ninety-six Wistar rats were randomly and evenly divided into model and electroacupuncture groups. The rat models of middle cerebral artery infarction were established by suture method. Immediately after modeling, the rats in the electroacupuncture group were given electrical stimulation (15 Hz, 1mA, 20 minutes) at the Renzhong (Du26) acupoint. The rats in the model group received similar procedures with the exception of no treatment. The angiogenesis was observed using double-immunofluorescence labeling for von Wilebrand Factor (vWF) and Ki-67 antibodies at 3, 6, 12, 24, 48 hours and 3, 7, 12 days after middle cerebral artery occlusion. RESULTS AND CONCLUSION:In the model group, vascular endothelial cel proliferation in the peri-infarct region was not observed at 3, 6 and 12 hours, occurred at 24 hours, increased at 48 hours, reached a maximum at 3 days, began to decrease at 7 days, and disappeared at 12 days after middle cerebral artery occlusion. In the electroacupuncture group, vascular endothelial cel proliferation in the peri-infarct region was not observed at 3 and 6 hours, occurred at 12 hours, increased at 24 and 48 hours, peaked at 3 days, began to decerase at 7 days, and disappeared at 12 days after middle cerebral artery occlusion. Compared with the model group, the time at which vascular endothelial cel proliferation started was earlier, and the number of proliferated vascular endothelial cels was greater in the electroacupuncture group. Vascular endothelial cel proliferation in the infarcted regions and contralateral hemisphere was not observed in either group at al designated time points. These results demonstrate that electroacupuncture intervention can improve the prognosis of cerebral infarction by promoting the proliferation of vascular endothelial cels in the peri-infarct region and advancing the time at which vascular endothelial cel proliferation started in rat models of middle cerebral artery occlusion.

Objective To assess the current situation and quality of clinical randomized controlled trials(RCTs) designed for accessing the treatment of depressive neurosis with acupuncture and moxibustion. Methods Relative clinical research literatures published from year 1980 to 2008 were collected, and composed into "evaluation to all literature of acupuncture and moxibustion treating depressive neurosis message table", according to the clinical epidemic disease and EBM. The quality evaluation on these trails were performed. Results There were altogether 15 articles included in this study. Among them, 5 articles used the correct randomized controlled trials (33.3%), 10 articles used the diagnostic criteria (66.6%), 10 articles used excluded criteria (66.6%), 12 articles used the therapeutic evaluation criteria (80%), 4 articles used blind treals (26.7%), 5 articles reported quit cases (33.3%), and 9 articles reported the adopted statistical methods (60%)4 articles Conclusion The quality of RCT of acupuncture and moxibustion for depressive neurosis needs to be improved.

Objective: To investigate the efficacy of acupuncture of points of three hand yang meridians for treating postapoplectic finger contracture. Methods: Sixty patients with postapoplectic finger contracture were randomly allocated to treatment and control groups, 30 cases each. The treatment group received acupuncture of points of three hand yang meridians and the control group, conventional acupuncture. The curative effects and posttreatment hand myodynamia scores were compared between the two groups. Results and Conclusion: All the cure rate, marked efficacy rate and total efficacy rate were significantly higher in the treatment group than those in the control group (P＜0.05). Hand myodynamia score was significantly lower after treatment than before in both groups (P＜0.05). There was a statistically significant difference between the two groups after treatment. It is indicated that clinical hand function was improved more in the treatment group than in the control group.

Objective To investigate the disease menu of acupuncture and moxibustion therapy grade classification considerations of herpes zoster, and to provide a routine analysis flowsheet to other diseases’ classification. Methods Being subject to the control group for classification and based on the five point classification of evidence-based medicine for evaluation, the internalized documents were evaluated according to the sequence from high level to low. If the conclusion supported by the higher level documents, other lower level documents’ results were given up. Results Acupuncture is effective and safe to herpes zoster, comparing with the international accepted curative drugs such as aciclovir tablet and so on, it is much more effective to relieve pain and make it quickly absorbed and cured. Conclusions Herpes Zostor drugs is the first grade disease menu of acupuncture and moxibustion therapy.

BACKGROUND: Direct observation of infarcted microvaseular perfusion after cerebral infarction is the most immediate evidence in evaluation of therapeutic effects.OBJECTIVE: To observe dynamic changes in flowing quality and field in cerebral ischemic area in rats so as to qualitatively and quantitatively analyze the microvascular state in pia matral encephali ischemic area and the changes of associated leukocytic flowing velocity and flowing morphology.DESIGN: Randomized controlled experiment was designed.SETTING: Department of Acupuncture and Moxibustion of General Hospital Chinese PLA.MATERIALS: The experiment was performed in Research Room of Microcirculation of General Hospital Chinese PLA, in which, 120 female Wis tar rats of 2-month old were employed and randomized into acupuncture group (36 rats), model group (36 rats), sham-operation group (36 rats) and normal group (12 rats). The first 3 groups were subdivided in 3 hours, 6hours and 24 hours groups according to the prescriptive time divisions, 12rats in each group.METHODS: In acupuncture and model groups, after abdominal anesthesia with pentobarbital sodium, the cranium was opened and the occlusion of meddle cerebral artery was performed in cerebrum with heat-coagulation method. In sham-operation group, anesthesia and cranium opening were performed, but the meddle cerebral artery was not occluded. In normal group, no any management was performed. In acupuncture group, 60 minutes after occlusion of meddle cerebral artery in cerebrum, needling was given on Renzhong (GV 26) and Neiguan (PC 6) with electric stimulation of disperse-dense wave, 4-10 Hz frequency and 0.4 V of intensity, lasting for 5 minutes. Afterwards, pecking-acupuncture technique was done on Renzhong (GV 26) to achieve strong stimulation for 10 seconds. In shamoperation and model groups, the rats were in process of grasping and fixation, but acupuncture was not applied. Vascular endotheliocyte fluorescence staining and leukocyte fluorescence tracing method were applied, in combination with microscopic video system and computer imaging analyzing system, to observe in dynamic and quantitatively the influences of acupuncture on pia matral encephali microvascular morphology, density and blood flowing velocity at 3 hours, 6 hours and 24 hours after cerebral occlusion of meddle cerebral artery.morphology, density and blood flowing state at various time divisions observed directly microscopically and vascular endotheliocyte morphology and the state of brain tissue which near the microvascular after infusion with velocity in infarcted area at various time divisions measured in quantity in each group.microvascular endotheliocytes were colored worse and more fluorescent exudation appeared. Those were better remarkably in acupuncture group ty: That in model group was lower than normal group. That at 3 hours, 6hours and 24 hours in acupuncture group was higher remarkably than model group [(6.92±0.42), (3.25±0.52) pces/visual field; (7.61 ±0.51),(3.68±0.32) pces/visual field; (8.24±0.72), (5.49±1.2) pces/visual leukocyte velocity: That in model group was lower remarkably in normal group. That at 3 hours, 6 hours and 24 hours in acupuncture group was higher remarkably than model group [(1 193±358), (600±261) μm/s;(1 112±267), (517±115) μm/s, (1 766±293), (611±291) μm/s, q=4.608.28, P ＜ 0.01].CONCLUSION: At early stage of cerebral infarction, broken blood flow is severe in artery, vein and capillary in ischemic area; the numbers of opened vessels are few, flow rate is slow down and cerebral perfusion is unsatisfactory. Acupuncture amaliorate the microcirculation perfusion state in ischemic area, increases the numbers of opened vessels and improves flowing morphology of blood cell.