To observe the clinical therapeutic effect of electroacupuncture (EA) on chronic pain in patients with knee osteoarthritis (KOA) and to investigate its influence on serum biomarkers related to central sensitization.

Ninety patients with chronic pain caused by KOA were randomly assigned to an EA group (45 cases, 3 cases dropped out) and a sham-EA group (45 cases, 5 cases dropped out and 1 case was eliminated). The patients in both groups received health education. Additionally, in the EA group, EA was performed at the acupoints such as Neixiyan (EX-LE4), Dubi (ST35), Heding (EX-LE2) and Xuehai (SP10) on the affected side, with dense-disperse wave, at the frequency of 2 Hz/100 Hz and the electric current of 1 m A to 2 mA, it was operated for 30 min in each session, once daily, 6 sessions a week, and for 4 consecutive weeks. In the sham-EA group, sham-EA was operated at the same acupoints as the EA group, with the same duration of interventions, but without electric stimulation exerted. In the baseline (week 0), and week 2, 4, 8 and 16, the score on numerical rating scale (NRS) for pain at rest and during activity, as well as pressure pain thresholds (PPTs) at the local and distal of knee joint were observed in the two groups separately. In week 0, 4, and 16, the Western Ontario and McMaster universities osteoarthritis index (WOMAC) and the 12-item short form health survey (SF-12) were scored. In week 0 and 4, the score on central sensitization inventory (CSI) and the levels of serum biomarkers related to central sensitization, such as glutamate (Glu), glutamine (Gln), substance P (SP), and calcitonin gene-related peptide (CGRP) were observed in the two groups.

Compared with the baseline, the EA group showed the decrease in NRS scores at rest and during activity in week 2, 4, 8, and 16, in the scores on subscales and the total score of WOMAC in week 4 and 16, as well as in CSI score and serum levels of Glu, Gln, SP, and CGRP in week 4 (P<0.05); and presented higher PPTs at the local and distal knee joint in week 2, 4, 8 and 16 and the scores on physical and mental health of SF-12 in weeks 4 and 16 (P<0.05). The sham-EA group presented the reduced resting-related NRS scores in week 2, 4, and 8, the activity-related NRS score in week 4, the scores on pain and function subscales and the total score of WOMAC in week 4 and 16, and serum CGRP level in week 4 when compared with the baseline, separately (P<0.05); and PPTs at the center of knee point in week 2 and 4 and the lateral side in week 4 increased (P<0.05). After treatment and at each time point of follow-up visit, NRS scores at rest and during activity, the scores on each subscale and the total score of WOMAC, the score of CSI and serum levels of Glu, Gln, SP, and CGRP in the EA group were lower than those in the sham-EA group (P<0.05); PPTs at each site (except at the lateral side of knee point in week 2 and the deltoid point in week 16) and the scores of SF-12 (except mental health score of SF-12 in week 16) were higher in the EA group when compared with the sham-EA group (P<0.05). Change scores of NRS at rest and during activity were positively correlated with those of CSI in the EA group (P<0.05).

Electroacupuncture effectively alleviates chronic pain of KOA, improves joint function and quality of life, which may be achieved through the inhibition of central sensitization.

To explore the effect of electroacupuncture (EA) via regulating the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) signaling pathway on autophagy of synovial tissue in rats with knee osteoarthritis (KOA).

Thirty-six male Sprague-Dawley (SD) rats were randomly divided into a normal group, a model group, and an EA group, with 12 rats in each group. The KOA model was replicated by injection of 50 μL sodium monoiodoacetate (MIA) into the right knee joint cavity. After successful establishment of the model, rats in the EA group received EA treatment at "Dubin" (ST35) and "Zusanli" (ST36) on the affected side, 20 min each time, once a day for 3 consecutive weeks. The Lequesne MG behavioral scale was used to evaluate the knee joint function of rats. The pathological morphology of the synovial tissue was observed after hematoxylin-eosin (HE) staining. The ultrastructure of autophagosomes and autolysosomes in the synovium was observed under transmission electron microscopy. The contents of autophagy-related protein 5 (Atg5) and autophagy-related protein 12 (Atg12) in the synovial tissue were detected by ELISA method. The expression levels of PI3K, Akt, and mTOR mRNA in the synovial tissue were detected by qPCR. The relative expression levels of PI3K, Akt, mTOR, UNC-51-like kinase 1 (ULK1), Beclin-1, and microtubule-associated protein light chain 3 (LC3) protein in the synovial tissue were detected by Western blot.

Compared with the normal group, the Lequesne MG score of the knee joint was increased (P < 0.01) in the model group; the synovial collagen fiber proliferated, inflammatory cell infiltration occurred, the number of autophagosomes and autolysosomes increased; contents of Atg5, Atg12, and relative expressions of ULK1, Beclin-1 protein and LC3Ⅱ/LC3Ⅰ ratio in the synovial tissue were increased (P < 0.01), while the expressions of PI3K, Akt, and mTOR mRNA and protein were decreased (P < 0.01). Compared with the model group, the Lequesne MG score of the knee joint in the EA group was decreased (P < 0.01); the proliferation of synovial collagen fiber was alleviated and they were arranged neatly, the inflammatory cell infiltration was reduced, the number of autophagosomes and autolysosomes was decreased; contents of Atg5, Atg12, and the relative expressions of ULK1, Beclin-1 proteins and LC3Ⅱ/LC3Ⅰ ratio in the synovial tissue were decreased (P < 0.01), while the expressions of PI3K, Akt, and mTOR mRNA and protein were increased (P < 0.05, P < 0.01).

EA at ST35 and ST36 can inhibit the autophagy of synovial tissue, improve the knee joint function and the morphological structure of synovial tissue in KOA rats, and its mechanism may be related to the activation of PI3K/Akt/mTOR signaling pathway.

To investigate the effect of moxibustion on hippocampal mitochondrial dynamics-related proteins in rats with vascular dementia (VD), so as to reveal the underlying mechanisms of moxibustion in treating VD.

SD rats were randomly divided into sham operation, model, moxibustion and medication groups, with 12 rats in each group. The VD model was prepared using an improved bilateral common carotid artery ligation method. Mild moxibstion was applied to “Shenting” (GV24), “Baihui” (GV20) and “Dazhui” (GV14) for 20 min, once daily for 6 days per week. Rats of the medication group were treated with oral administration of nimodipine (12 mg/kg) once daily. All above interventions were performed for 4 weeks. Learning and memory abilities were assessed using Morris water maze test. Histopathological changes of hippocampus was observed with HE staining. Mitochondrial membrane potential (Δψm) and reactive oxygen species (ROS) levels in hippocampal tissue were measured by flow cytometry. The mRNA and protein expression levels of optic atrophy protein 1 (Opa1), mitochondrial fusion protein 1 (Mfn1), mitochondrial fusion protein 2 (Mfn2), dynamics-related protein 1 (Drp1), fission protein 1 (Fis1), mitochondrial fission factor (Mff) in hippocampus was detected by PCR or Western blot, respectively.

Compared with the sham operation group, the escape latency was prolonged (P<0.01), the times of crossing the original platform were reduced (P<0.01), the membrane potential of hippocampus, the mRNA and protein expression levels of Opa1, Mfn1 and Mfn2 in hippocampus were decreased (P<0.01, P<0.001) in the model group, while the average fluorescence intensity of ROS was increased, the mRNA and protein expression levels of Drp1, Fis1 and Mff were increased (P<0.001). In comparison with the model group, the escape latency was significantly shortened (P<0.05), the times of crossing the original platform were increased (P<0.05), the membrane potential of the hippocampus, the mRNA and protein expression levels of Opa1, Mfn1 and Mfn2 were increased (P<0.05, P<0.001) in the moxibustion and medication groups, while the average fluorescence intensity of ROS in the hippocampus, the mRNA and protein expression levels of Drp1, Fis1 and Mff were decreased (P<0.001). The average fluorescence intensity of ROS in the moxibustion group was significantly lower than that in the medication group (P<0.001). HE staining showed loose arrangement of neurons, disappearance of partial nucleolus, and necrocytosis after modeling, which were relatively milder in both moxibustion and medication groups.

Moxibustion can effectively improve the cognitive function of VD rats, and its mechanism may be related to regulating hippocampal mitochondrial dynamics-related proteins, promoting mitochondrial fusion, inhibiting excessive mitochondrial division, thereby improving the imbalance of mitochondrial dynamics and alleviating mitochondrial dysfunction-related conditions.

To observe the clinical efficacy of moxibustion and acupuncture at acupoints of the governor vessel combined with repeated transcranial magnetic stimulation (r TMS) in the treatment of post-stroke fatigue (PSF).

A total of 78 patients with PSF were randomized into an observation group (39 cases, 1 case dropped out) and a control group (39 cases, 1 case dropped out). The patients in both groups received conventional medical basic treatment. In the control group, rTMS was adopted, 20 min each time. On the basis of the treatment in the control group, therapy of moxibustion and acupuncture at acupoints of the governor vessel was delivered in the observation group, Baihui (GV 20), Dazhui (GV 14), Shenting (GV 24), Fengfu (GV 16), Zhiyang (GV 9), Mingmen (GV 4) and Yaoyangguan (GV 3) were selected, Baihui (GV 20) was treated with moxibustion, Dazhui (GV 14) was treated with collateral-pricking, other acupoints were treated with conventional acupuncture, moxibustion and acupuncture were sustained for 30 min. The treatment in both groups was given once a day for continuous two weeks. Before and after treatment, the scores of fatigue severity scale (FSS), Pittsburgh sleep quality index (PSQI) and Fugl-Meyer motor function assessment (FMA) were observed, and the serum levels of C-reactive protein (CRP), interleukin (IL)-1β and IL-6 were detected in both groups.

After treatment, in the two groups, the FSS and PSQI scores, as well as the serum levels of CRP, IL-1βand IL-6 were decreased compared with those before treatment (P<0.05), while FMA scores were increased compared with those before treatment (P<0.05). After treatment, in the observation group, FSS and PSQI scores, as well as the serum levels of CRP, IL-1β and IL-6 were lower than those in the control group (P<0.05), while FMA score was higher than that in the control group (P<0.05). The serum levels of CRP, IL-1β and IL-6 were positively correlated with FSS score in the observation group (P<0.01).

Moxibustion and acupuncture at acupoints of the governor vessel combined with rTMS can effectively alleviate the fatigue, improve the sleep quality and limb function in PSF patients, its mechanism on alleviating fatigue may be related to the down-regulation of serum inflammatory factors.

To evaluate the clinical efficacy and safety of acupuncture combined with bloodletting therapy and Qingwen Xiere decoction in mild to moderate COVID-19 patients.

A total of 100 mild to moderate COVID-19 patients collected from December 2022 to February 2023 were randomly divided into control and observation groups, with 50 patients in each group. Patients in the control group received oral Qingwen Xiere decoction for 6 days. The observation group received acupuncture combined with bloodletting therapy in addition to oral Qingwen Xiere decoction, with the acupuncture (at Kongzui [LU6], Hegu [LI4], Quchi [LI11], Feishu [BL13], Zhongwan [CV12], Qihai [CV6], Yinlingquan [SP9]) administered 30 min each day for 6 days, and bloodletting (at Shaoshang [LU11], Shangyang [LI1], Dazhui [GV14]) administered every other day for 3 times. Traditional Chinese medicine syndrome scores and pulmonary CT scores were recorded before and after treatment. Serum contents of C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF- α) were measured using ELISA. Anxiety and depression degree were assessed using the Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA). Safety of the treatments was evaluated in both groups.

Compared with before treatment, after treatment, the control group showed improvement in fever, dry cough, sore throat, and total traditional Chinese medicine syndrome scores (P<0.01), but no significant improvement in muscle pain or fatigue; the observation group showed significant improvement in total traditional Chinese medicine syndrome and individual symptoms scores (P<0.01); both groups demonstrated reductions in pulmonary CT scores, HAMA score, HAMD score and serum contents of CRP and IL-6 (P<0.01); serum TNF- α content significantly decreased in the observation group (P<0.01). All outcome measures were superior in the observation group to the control group (P<0.01, P<0.05). No adverse reactions were reported in either group.

Acupuncture combined with bloodletting therapy and oral Qingwen Xiere decoction effectively improves clinical symptoms, alleviates pulmonary inflammatory injury, reduces inflammatory cytokine contents, and mitigates anxiety and depression in mild to moderate COVID-19 patients, and without adverse effects.