The quality of life (QoL) and sleep quality are closely linked to the physical and psychological health of end-stage renal disease (ESRD) patients, especially those underwent hemodialysis (HD) therapy. This study aims to investigate the impact of 830 nm laser treatment on improving QoL and sleep quality in HD patients. Forty ESRD patients participated in this study. 830 nm laser was used to radiate on the palm (at dose of 256.10 J/cm2), ST 36 and KI 1 acupoints (at dose of 109.76 J/cm2) of HD patients, and QoL and sleep quality questionnaires were utilized to assess changes following the treatment. After 830 nm laser radiation, lower global Pittsburgh Sleep Quality Index and Athens Insomnia Scale scores were observed, accompanied by higher physical and mental component summary scores in MOS 36-item short-form health survey version 2 and a global World Health Organization Quality of Life Brief Version score. The laser group also showed significant improvements in QoL and sleep quality indicators. Additionally, pain levels decreased on the third day and after one month according to visual analogue scale. This study revealed the positive effects of 830 nm laser on palm, KI 1 and ST 36 acupoints for improving the QoL and sleep quality in ESRD patients underwent HD treatment. The results suggest that 830 nm laser applied to specific targets could be used as a complementary and alternative approach to increase the QoL and sleep quality in ESRD patients.

To evaluate the effectiveness of the combination of acupoint embedding therapy and traditional Chinese medicine dialectical treatment regimen in improving clinical symptoms, promoting tumor regression, controlling adverse reactions and complications, and enhancing patient satisfaction by comparing and analyzing the clinical data of 120 breast tumor patients. One hundred twenty patients with breast cancer were divided into a treatment group (60 cases) and a control group (60 cases) according to different treatment plans. Patients in the treatment group received a combination of acupoint embedding therapy and traditional Chinese medicine dialectical treatment based on different time points of the menstrual cycle. Including the proportion of reduction in the number of breast masses, the proportion of reduction in mass size, changes in pain severity scores, tumor regression rate, regression time, incidence of adverse reactions and complications, and patient satisfaction. Statistical software was used to analyze the data to evaluate differences between the 2 groups. In terms of clinical symptoms, the proportion of reduction in the number of breast masses in the treatment group averaged 50%, significantly higher than the 25% in the control group; the proportion of reduction in mass size averaged 40%, also higher than the 15% in the control group; and the improvement in pain severity scores was also superior to the control group. Regarding tumor regression, the tumor regression rate in the treatment group reached 85%, with an average regression time of 6.2 weeks, both significantly better than the 55% and 9.8 weeks in the control group. In terms of adverse reactions and complications, the incidence rate in the treatment group was relatively low, and no serious adverse events occurred. Patient satisfaction surveys showed that the treatment group had significantly higher satisfaction with treatment effectiveness, treatment process, and physician service attitude compared to the control group. Based on clinical data from 120 breast tumor patients, the results of this study indicate that breast tumor patients treated with a specific treatment regimen have significant advantages in improving clinical symptoms, tumor regression, controlling adverse reactions and complications, and patient satisfaction. This treatment regimen has high clinical application value and deserves further promotion.

UNASSIGNED: Understanding acupuncture point microenvironments is vital for optimizing treatment efficacy. Evaluating changes in water content at these points can provide further insights into the effects of acupuncture on tissues.
UNASSIGNED: This study aimed to measure tissue dielectric constant (TDC) and assess changes in water content, specifically at stomach 36 (ST36, Zusanli) and spleen 6 (SP6, Sanyinjiao) acupuncture points.
UNASSIGNED: In a controlled, blinded, randomized trial, 113 healthy volunteers were divided into six groups based on TDC sensor diameters (XS, M, and L): three control groups and three acupuncture groups. They were assessed at three time points: T1, baseline; T2, 20 min post-needle withdrawal; and T3, 40 min post-needle withdrawal. Electrical impedance (EI) was also analyzed. Significance level was set at p < 0.001.
UNASSIGNED: TDC at ST36 and SP6 significantly decreased with the XS probe at T2 and T3 compared with that at T1 (F8, 452: 54.61). TDC did not significantly vary between T2 and T3 with M and L probes. EI data indicated that the current passage increased in the SP (F2, 226: 39.32) and ST (F2, 226: 37.32) groups during T2 and T3 compared with that during T1 within their respective groups and controls.
UNASSIGNED: and Relevance: This study demonstrated the efficacy of TDC measurements in detecting water content fluctuations at acupuncture points and their responses to needles. TDC measurements, which were validated against EI, provide valuable insights into acupuncture point microenvironments and thus help optimize treatments.

There is no clear evidence that acupuncture points and meridians are separate organs or specific tissues. However, in traditional Chinese medicine, the mechanism of acupuncture action is associated with the vital energy concept. To identify the body\'s energy source and the material basis of its transmission, transformation, and use, it is necessary to consider it as an energy-generating object, with all its components. By abstracting from the body\'s usual structural view, we found that it is an autonomous energy-generating object. The human body generates energy through the lungs and digestive tract, which are electrochemical generator organs. Because the generated energy must be transferred to the consumer, the body has wire and transformer analogs. It bears an obvious resemblance with an electronic circuit, where cellular structures, tissues, and their combinations act as electrical and radioelements. The heart, brain, and muscles, which have well-known electrical parameters, as well as acupuncture points, offer information about the state of these electronic circuits. This article describes an extra-organ approach for systematizing body structures. It also attempts to represent the meridians and acupuncture points system as integral electro-radioelements, as well as the local circuit components of the whole body\'s electronic scheme.

暂无摘要。

OBJECTIVE: Scalp acupuncture is a unique acupuncture method developed based on brain functional and pathophysiological knowledge. In past decades, there has been significant development in the understanding of the brain pathology of many neurological disorders through cutting-edge brain imaging techniques. Yet, these findings have not been incorporated into scalp acupuncture. In the present paper, we aimed to initiate an attempt to develop/identify scalp acupuncture targets based on neuroimaging findings.
METHODS: Based on the meta-analysis of neuroimaging studies in the Neurosynth database platform (http：//neurosynth.org/), the brain clusters related to neurological disorders were automatically identified according to the search terms \"Parkinson\'s disease\"(PD), \"chronic pain\"(CP), \"aphasia\"(APH), \"dyslexia\"(DYS), \"mild cognitive impairment\", \"Alzheimer\'s disease\" and \"dementia\". Subsequently, the discovered brain region clusters projected onto the brain surface and scalp surface were listed, and the peak points of the clusters projected to the scalp surface were proposed as the potential stimulation targets for the corresponding diseases. Further, by combining the traditional scalp acupoints (including the scalp acupuncture lines) with 10-20 EEG system sites, we made localization suggestions for scalp stimulation targets and made acupuncture operation suggestions by combining with the shape of the brain region clusters. The literature search was conducted on July 30, 2022.
RESULTS: The localization and manipulation suggestions of neuroimage-based scalp acupuncture targets were introduced in two parts. This part (part 1) includes PD, CP, APH, and DYS. Here are 3 target examples of each of these 4 diseases simply introduced due to word limitation. 1) PD. Based on the 175 articles retrieved from Neurosynth, we identified 7 potential scalp acupuncture targets for PD, the locations of the acupuncture stimulation and the recommended acupuncture needle operation (RANO) as well as the corresponding brain regions (CBRs) respectively are as below. PD1：about 0.5 cun (1 cun≈33.3 mm) superior-posterior to the left Xuanlu (GB5)；puncturing subcutaneously and forward-upward；the left premotor area, subfrontal cortex of the island, inferior frontal gyrus and middle frontal gyrus. PD2：about 1 cun lateral-inferior to the left Chengling (GB18)；puncturing subcutaneously and backward-upward；the inferior parietal lobule and postcentral gyrus. PD3：about 0.5 cun lateral-anterior to the left GB18；puncturing subcutaneously and inward-backward；left anterior central gyrus and posterior central gyrus. 2) CP. Based on the retrieved 92 articles, we identified 8 potential scalp acupuncture targets, the location of the acupuncture stimulation and the RANO, and CBRs respectively are as below. CP1：about 1 cun anterior-inferior to the left Xuanli (GB8)；puncturing subcutaneously and backward-inwards；the left inferior frontal gyrus orbitalis and pars triangularis. CP2：about 0.5 cun posterior-superior to the left GB5；puncturing subcutaneously and forward-upward；the left anterior central gyrus and premotor area. CP3：about 0.5 cun posterior-superior to the left GB8；puncturing subcutaneously and forward；left inferior central area/central sulci operculum (second somatosensory area). 3) APH. Based on the retrieved 82 papers, we identified 7 potential scalp acupuncture targets for APH, their locations, RANO, and CBRs respectively are as below. APH1：close to the left GB5；puncturing subcutaneously and forward-downward；left subfrontal gyrus operculi/triangularis. APH2：about 0.5 cun posterior to the left Hanyan (GB4)；puncturing subcutaneously and backward-upward；the left anterior central gyrus and posterior central gyrus. APH3：about 0.5 cun anterior-inferior to the left Qubin (GB7)；puncturing subcutaneously and backward-downward；left medial/superior temporal gyrus. 4) DYS. Based on the retrieved 76 researches, we identified 8 potential scalp acupuncture targets for DYS, their locations, RANO and CBRs respectively are as below. DYS1：about 1 cun anterior-inferior to the left GB5；puncturing subcutaneously and forward-upward；the pars triangularis of the left inferior frontal gyrus. DYS2：about 0.5 cun posterior-superior to the left GB5；puncturing subcutaneously and forward-downward；the left subfrontal gyrus operculum, pars triangularis and anterior central gyrus. DYS3：the midpoint between the left GB5 and GB18；puncturing subcutaneously and forward；the left anterior central gyrus and posterior central gyrus.
CONCLUSIONS: We identified scalp acupuncture targets for several common neurological disorders based on neuroimaging evidence for clinical application and research. The proposed targets may also be used for treating these disorders using brain stimulation methods.
目的: 基于神经影像学研究，总结现代脑科学的研究成果，探索常见神经系统疾病的头针刺激靶点。方法: 基于Neurosynth数据库平台（ http：//neurosynth.org/ ）进行神经影像学研究的Meta分析，识别神经系统疾病的头针与脑刺激靶点并投射至头皮表面，进一步结合传统头部腧穴和脑电10-20系统做出定位建议，结合靶区形态做出操作建议。文献检索于2022年7月30日进行。结果: 研究结果分上下两篇阐述，本文为上篇，包括帕金森病、慢性疼痛、失语症、失读症。帕金森病识别出了7个潜在头针靶点，对应的布罗德曼区（BA）主要为BA6等；慢性疼痛识别出了10个潜在头针靶点，对应脑区主要为BA40等；失语症识别出了7个潜在头针靶点，对应脑区主要为BA22等；失读症识别出了10个潜在头针靶点，对应脑区主要为BA40等。本文提供了以上各潜在靶点的基于神经影像的定位与操作建议。结论: 本研究为头针的临床应用及研究提供了一种基于现代影像学证据的常见神经系统疾病的刺激靶点。这些靶点也可用于神经（脑）刺激治疗相关疾病的探索中。.

OBJECTIVE: To observe the clinical efficacy of acupuncture intervention at different time for patients with sudden hearing loss.
METHODS: According to the timing of acupuncture intervention, 86 patients were divided into early exposure group (n=43) and late exposure group (n=43) . The early exposure group was given acupuncture treatment within 14 days of onset, and the late exposure group was given acupuncture treatment after 14 days of onset. After propensity score matching (PSM, a statistical matching technique for observational data) processing by using SPSS26.0 software, outcomes of 30 cases in the early exposure group and 30 cases in the late exposure group were analyzed. In addition to receiving basic treatment with drugs for vascular dilatation, thrombolysis, nourishing nerve, etc., all patients of the two groups were treated with neck acupuncture (\"Neck Seven Meridian Lines\" acupuncture), once every other day except Sundays, for a total of 12 time. Before, after the treatment and 3 months after the treatment, the total score of the Tinnitus Handicap Inventory (THI, 0, 2 and 4 points for each of the 25 items, total scores = 100 points) scale was used to evaluate the improvement of tinnitus symptoms caused by hearing loss. The clinical therapeutic effect was evaluated according to the efficacy grading criteria in the Guidelines for Diagnosis and Treatment of Sudden Deafness (2015) and the changes of pure tone audiometry curve. Multivariate Logistic regression was used to analyze the effect of factors that might influence efficacy before propensity score matching.
RESULTS: The THI scores of patients in both groups decreased strikingly after the treatment and 3 months\' follow-up (P<0.05). Compared with the same time-points of the late exposure group, the total THI scores of post-treatment and 3 months\' follow-up were evidently lower in the early exposure group (P<0.05). The effective rate of the early exposure group (22/30, 80.00%) was significantly higher (P<0.05) than that of the late exposure group (16/30, 53.33%). The classification of sudden deafness and the application of traditional Chinese medicine in this study were not independent factors affecting the total effective rate.
CONCLUSIONS: The time point of acupuncture intervention is an important factor affecting the effect on hearing and tinnitus disability of patients with sudden deafness. The earlier acupuncture treatment is accepted, the better the therapeutic effect is.
目的: 研究不同针刺介入时机治疗突发性聋患者的临床疗效差异。方法: 纳入突发性聋患者（87例，脱落1例），根据针刺介入时机分为早暴露组和晚暴露组，早暴露组为发病14 d内介入针刺治疗，晚暴露组为发病14 d后介入针刺治疗。应用倾向性评分匹配法均衡组间基线，最终成功匹配30对患者，每组各30例。两组患者均在西医基础治疗同时给予“颈部七线法”针刺治疗，每周针刺3次，隔日1次，共12次。治疗前、治疗后及治疗3个月后观察患者耳鸣残疾评估量表（THI）评分；治疗前后分别对患者进行纯音测听，评价临床疗效；采用多因素Logistic回归分析倾向性评分匹配前可能影响疗效的因素对临床疗效的影响。结果: 与本组治疗前比较，两组患者治疗后及随访时THI评分均下降（P<0.05）；与同时点晚暴露组比较，早暴露组治疗后及随访时THI评分均降低（P<0.05）。早暴露组总有效率为80.00%（24/30），晚暴露组为53.33%（16/30），早暴露组总有效率高于晚暴露组（P<0.05）。多因素Logistic回归分析结果显示，本研究中突发性聋的分型及中药使用情况并非影响总有效率的独立因素。结论: 介入时机是影响针刺治疗突发性聋患者听力疗效及耳鸣残疾程度的重要因素，早期针刺介入的疗效优于晚介入。.

OBJECTIVE: To observe the effect of acupuncture and moxibustion on arterial elasticity in patients with early carotid atherosclerosis.
METHODS: A total of 62 patients with early carotid atherosclerosis were randomly divided into a blank group (12 cases, 1 cases dropped-off), a sham-acupuncture group (25 cases, 5 cases dropped-off) and an acupuncture group (25 cases, 3 cases dropped-off). Patients in the acupuncture group received acupuncture treatment, including ①acupuncture：Baihui (GV20), Yintang (GV24+), Renying (ST9), Neiguan (PC6), Yanglingquan (GB34)；②moxibustion：Yinqiguiyuan (Zhongwan ［CV12］, Xiawan ［CV10］, Qihai ［CV6］, Guanyuan ［CV4］), Sihua (Geshu ［BL17］, Danshu ［BL19］)；③Intradermal needle：Xinshu (BL15), Danshu (BL19). Patients in the sham acupuncture group received placebo acupuncture, moxibustion, an intradermal needle, and the acupoints were the same as the acupuncture group. The above treatments were performed twice a week for 12 weeks. No intervention was given to the patients in the blank group. Diet and lifestyle education was given to the three groups. The ultrafast pulse wave velocity, including beginning-systolic pulse wave velocity (BS) and end-systolic pulse wave velocity (ES), was observed before treatment and 1, 2, 3 months after treatment in the three groups. The blood lipid level and platelet count (PLT) at each time point were observed. The safety of the treatments was also evaluated.
RESULTS: Compared with those before treatment, the BS and ES values of both sides in the acupuncture group decreased at 2 and 3 months after treatment (P<0.05). Compared with the blank group, the bilateral ES of the acupuncture group were decreased at 2 months after treatment (P<0.05), and the bilateral BS and ES were decreased at 3 months (P<0.05). Compared with the sham-acupuncture group, the acupuncture group showed a decrease in left BS and left ES after 3 months of treatment (P<0.05), and the overall decrease on the left side of the acupuncture group was better than that on the right side. There were no significant differences between three groups in the levels of blood lipid and PLT at each time point. No serious adverse safety events occurred in the three groups during the treatment.
CONCLUSIONS: Acupuncture and moxibustion therapy can improve arterial elasticity in patients with early carotid atherosclerosis, and it is safe and effective.
目的: 观察针灸对颈动脉粥样硬化早期患者动脉弹性的影响。方法: 将62例颈动脉粥样硬化早期患者随机分为空白组（12例，脱落1例）、假针灸组（25例，脱落5例）和针灸组（25例，脱落3例）。针灸组予针灸治疗，包括①针刺：百会、印堂、人迎、内关、阳陵泉；②精灸：引气归元（中脘、下脘、气海、关元）、四花（膈俞、胆俞）；③皮内针：心俞、胆俞。假针灸组予安慰针刺、艾灸和皮内针治疗，穴位同针灸组。以上两组每周治疗2次，共治疗12周。空白组不进行干预。3组均予饮食及生活方式宣教。观察3组患者治疗前及治疗1、2、3个月后极速脉搏波速度，包括收缩初期脉搏波速度（BS）和收缩末期脉搏波速度（ES），以及各时点血脂水平和血小板计数（PLT），并进行安全性评价。结果: 与治疗前比较，针灸组治疗2个月和3个月后双侧BS值、ES值均下降（P<0.05）；与空白组比较，针灸组治疗2个月后双侧ES均下降（P<0.05），治疗3个月后双侧BS与ES均下降（P<0.05）；与假针灸组比较，针灸组治疗3个月后左侧BS与左侧ES均下降（P<0.05），针灸组左侧整体下降幅度优于右侧。各组患者治疗前后和组间血脂水平、PLT比较，差异均无统计学意义。治疗期间3组均无严重不良事件发生。结论: 针灸疗法具有改善颈动脉粥样硬化早期患者动脉弹性的作用，且安全有效。.

OBJECTIVE: To observe the effect of electroacupuncture (EA) on behavior and hippocampal protein phosphorylation in rats with chronic fatigue syndrome (CFS), so as to explore its mechanisms underlying improvement of CFS.
METHODS: Male SD rats were randomly divided into control, model and EA groups (n=12 rats in each group). The CFS model was established by chronic multifactor combined with stress stimulation (treadmill training + restraint stress + sleep disturbance + crowded environment). For rats of the EA group, EA (1 mA, frequency of 10 Hz) was applied to \"Shenting\" (GV24) (with an acupuncture needle penetrated from GV24 to \"Baihui\" ［GV20］) and \"Dazhui\" (GV14) for 15 min, once daily for 28 days. After treatment, the body weight, food intake and water intake of rats in each group were observed. The fatigue degree of rats was evaluated by Semi-quantitative score observation table of the general condition of experimental rats.The open field test (OFT) was used to assess the rats\'anxiety severity by detecting the total number of grid-crossing and the times of the central area entered in 5 min, and Morris water maze test was employed to assess the rats\' learning-memory ability by detecting the escape latency in 1 min, and the times of the original platform quadrant crossing in 1 min. The hippocampaus was taken for phosphorylated Label-free quantitative proteomics analysis by using Maxquant technology based on full scan mode to calculate the integral of each peptide signal of liquid chromatography-mass spectrometry(LC-MS). The differentially-expressed proteins (>1.5 folds for up-regulation or <0.67 folds for down-regulation) were evaluated by gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis.
RESULTS: Compared with the control group, the body weight, food intake, and the times of original-platform quadrant crossing of spatial exploring of Morris water maze test were significantly decreased (P<0.01, P<0.05) , and the score of general conditions, times of grid-crossing and center area-entering of OFT, and the escape latency of navigation task were apparently increased (P<0.01) in rats of the model group. After EA intervention, the decreased original-platform quadrant crossing, and the increased score of general conditions, times of grid-crossing and the escape latency of navigation task were all reversed (P<0.01, P<0.05). Outcomes of proteomics analysis indicated that compared with the model group, there were 297 differentially expressed peptide (48 up-regulated and 249 down-regulated) segments in the control group, and there were 245 differentially expressed peptide (185 up-regulated and 60 down-regulated) segments in the EA group, in which, 25 overlapping peptide segments were reversed after EA treatment, corresponding to 24 proteins, mainly involving cytoskeletal structure. GO function annotation analysis showed that the top three differentially expressed phosphorylated proteins involved in the effect of EA intervention were the actin filament polymerization, protein depolymerization and cytoskeletal tissue in the biological process, the actin binding, structural molecular activity and cytoskeletal protein binding in the molecular function, and the cytoskeleton, dendrites and dendritic trees in the cellular component, respectively. The KEGG pathway annotation analysis for differentially expressed phosphorylated proteins showed that theinsulin secretion, axon guidance, phosphatidylinositol signaling system and lysine biosynthesis, etc. were involved in the effect of EA intervention.
CONCLUSIONS: EA of GV24-GV20 and GV14 can improve the general state, anxiety and learning-memory ability of CFS model rats, which may be related to its functions in regulating the hippocampal protein phosphorylation level, and repairing the structure and function of synapses in hippocampus.
目的: 观察电针对慢性疲劳综合征（CFS）大鼠行为学和海马组织蛋白磷酸化的影响，探讨电针治疗CFS的作用机制。方法: 将雄性SD大鼠随机分为空白组、模型组和电针组，每组12只。采用多因素慢性复合应激法制备CFS模型。电针组大鼠给予电针“神庭”（透刺“百会”）和“大椎”治疗，每日1次，每次15 min，连续28 d。治疗结束后观察各组大鼠体质量、摄食量和饮水量，采用实验大鼠一般情况半定量评分观察表评价大鼠的疲劳程度，采用旷场实验及Morris水迷宫实验评价大鼠焦虑程度和学习记忆能力。取各组大鼠海马组织进行磷酸化Label-free定量蛋白质组学检测。结果: 治疗结束后，与空白组比较，模型组大鼠体质量降低（P<0.01），摄食量减少（P<0.05），一般情况半定量评分升高（P<0.01），旷场实验总穿格次数和进入中央区次数均增多（P<0.01），Morris水迷宫实验逃避潜伏期延长（P<0.01）、穿越原平台次数减少（P<0.01）。与模型组比较，电针组大鼠一般情况半定量评分降低（P<0.01），旷场实验总穿格次数减少（P<0.05），Morris水迷宫实验逃避潜伏期缩短（P<0.01）、穿越原平台次数增加（P<0.01）。与空白组比较，模型组有297个差异表达肽段，对应255个蛋白，与模型组比较，电针组有245个差异表达肽段，对应198个蛋白，其中共有24个重合蛋白在电针治疗后表达回调。GO分析表明，电针干预的作用在生物学过程方面主要为对蛋白质聚合和细胞骨架组织的调节，在分子功能聚类上表现为对蛋白质聚合的调节，在细胞组分聚类方面表现为对突触功能的影响。KEGG分析结果显示，电针干预对胰岛素分泌、轴突导引、磷脂酰肌醇信号系统及赖氨酸生物合成等对中枢神经系统组织功能有重要作用的信号通路产生了影响。结论: 电针可以改善CFS模型大鼠的疲劳状态，缓解焦虑情绪，提高学习记忆能力，其机制可能与调节海马组织蛋白磷酸化水平有关。.

OBJECTIVE: To observe the effect of heat-reinforcing needling (HRN) on synovial inflammation, hypoxia-inducible factor-1α (HIF-1α) and glycolytic activity in serum and synovial tissue in rabbits with cold syndrome of rheumatoid arthritis (RA), so as to explore its mechanisms underlying improvement of RA.
METHODS: A total of 32 rabbits were randomly divided into normal, model, inhibitor and HRN groups, with 8 rabbits in each group. The RA with cold syndrome model was induced by injecting ovalbumin dry powder and Freund\'s complete adjuvant combined with cold freezing. Rabbits in the inhibitor group were intraperitoneally injected with 2-methoxyestradiol (2.5 mg/kg), rabbits in the HRN group were received HRN at bilateral \"Zusanli\" (ST36) for 30 min. The treatments were conducted once daily for 14 consecutive days. After the interventions, the knee circumference and pain threshold were measured. The contents of nicotinamide adenine dinucleotide phosphoric (NADPH), Hexokinase II (HK2) and 6-phosphofructo-2-kinase/fructose-2, 6-biphosphatase 3 (PFKFB3) in serum of rabbits were detected by ELISA. The pathological morphology of synovial tissue of the knee joints were observed by HE staining. The positive expressions of tumor necrosis factor (TNF-α), interleukin (IL)-1β, IL-6 and IL-17 in synovial tissue of knee joint were detected by immunohistochemistry. The content of lactic acid in synovial tissue of rabbit knee joint was detected by spectrophotometry. The expression levels of HIF-1α, pyruvate kinase 2 (PKM2) and lactate dehydrogenase (LDHA) in synovial tissue of knee joint were detected by Western blot.
RESULTS: After intervention, compared with the normal group, the knee circumference was significantly enlarged (P<0.05), the pain threshold was significantly decreased (P<0.05)；the synovial tissue of knee joints showed significant cell proliferation and inflammatory infiltration, the pathological score was significantly increased (P<0.05)；positive expressions of TNF-α, IL-1β, IL-6 and IL-17, the content of lactic acid in synovial tissue, the contents of NADPH, HK2 and PFKFB3 in serum, and the protein expression levels of HIF-1α, PKM2 and LDHA in synovial tissue were increased (all P<0.05) in the model group. Compared with model group, the circumference of knee joint was significantly decreased (P<0.05), the pain threshold was significantly increased (P<0.05)；in synovial tissue, the pathological score was decreased (P<0.05)；the positive expressions of TNF-α, IL-1β, IL-6 and IL-17 in synovial tissue were decreased (P<0.05), the lactic acid content in synovial tissue was decreased (P<0.05)；the contents of NADPH, HK2 and PFKFB3 in serum and the protein expression levels of HIF-1α, PKM2 and LDHA in synovial tissue were decreased (P<0.05) in inhibitor group and HRN group. Compared with the inhibitor group, the synovial pathological score was significantly increased (P<0.05), positive expressions of TNF-α, IL-1β, IL-6 and IL-17, the content of lactic acid in synovial tissue, the contents of NADPH, HK2 and PFKFB3 in serum, and the protein expression levels of HIF-1α, PKM2 and LDHA in synovial tissue were increased (all P<0.05) in HRN group.
CONCLUSIONS: HRN can increase the pain threshold, reduce the knee circumference and inhibit the inflammatory response in rabbits with cold syndrome of RA. The possible mechanism is related to the down-regulation of HIF-1α and glycolysis activity.
目的: 观察热补针法对类风湿关节炎（RA）寒证家兔膝关节滑膜炎性反应及滑膜组织、血清中缺氧诱导因子1α（HIF-1α）、糖酵解活性的影响，探讨热补针法治疗RA的机制。方法: 选取32只新西兰兔随机分为正常组、模型组、抑制剂组、热补针法组，每组8只。采用卵蛋白联合弗氏完全佐剂诱导及低温冷冻法复制RA寒证模型。抑制剂组给予2-甲氧基雌二醇腹腔注射，热补针法组给予热补针法针刺“足三里”，留针30 min。各组干预均1次/d，连续14 d。观察家兔膝关节周径及痛阈变化；采用ELISA法检测家兔血清中还原型辅酶Ⅱ（NADPH）、己糖激酶（HK2）、6-磷酸果糖激酶2/2，6-二磷酸果糖激酶3（PFKFB3）含量；HE染色法观察家兔膝关节滑膜组织形态变化；免疫组织化学法检测家兔膝关节滑膜组织中肿瘤坏死因子α（TNF-α）、白细胞介素（IL）-1β、IL-6、IL-17的阳性表达；分光光度法检测家兔膝关节滑膜组织中乳酸含量；Western blot法检测膝关节滑膜组织中HIF-1α、乳酸脱氢酶（LDHA）、丙酮酸激酶2（PKM2）蛋白表达水平。结果: 干预后，与正常组比较，模型组家兔膝关节周径增大（P<0.05），痛阈值降低（P<0.05），可见滑膜细胞中度增生及炎性浸润，滑膜组织病理评分升高（P<0.05），滑膜组织中TNF-α、IL-1β、IL-6、IL-17阳性表达及乳酸含量均升高（P<0.05），血清NADPH、HK2、PFKFB3含量及滑膜组织中HIF-1α、LDHA、PKM2蛋白表达水平均升高（P<0.05）。与模型组比较，抑制剂组及热补针法组家兔膝关节周径缩小（P<0.05），痛阈值升高（P<0.05），滑膜增生、炎性细胞浸润均改善，滑膜组织病理评分降低（P<0.05），滑膜组织中TNF-α、IL-1β、IL-6、IL-17阳性表达及乳酸含量均下降（P<0.05），血清NADPH、HK2、PFKFB3含量及滑膜组织中HIF-1α、LDHA、PKM2蛋白表达水平均下降（P<0.05）。与抑制剂组比较，热补针法组家兔滑膜组织病理评分升高（P<0.05），滑膜组织中TNF-α、IL-1β、IL-6、IL-17阳性表达及乳酸含量均升高（P<0.05），血清NADPH、HK2、PFKFB3含量及滑膜组织中HIF-1α、LDHA、PKM2蛋白表达水平均升高（P<0.05）。结论: 热补针法干预RA寒证家兔可提高痛阈，减小膝关节周径，抑制炎性反应，其作用机制与下调HIF-1α及糖酵解活性相关。.