The influence of electro-acupuncture stimulation to female constipation patients. The Effect of Acupuncture on the Symptoms of Knee Osteoarthritis - An Open Randomised Controlled Study Association between body mass index and risk of total knee replacement, the Singapore Chinese Health Study. Acupuncture in patients with osteoarthritis of the knee: a randomised trial Effectiveness of Moxibustion Treatment in Quality of Life in Patients with Knee Osteoarthritis: A Randomized, Double-Blinded, Placebo-Controlled Trial Electroacupuncture inhibits chronification of the acute pain of knee osteoarthritis: study protocol for a randomized controlled trial Acupuncture for chronic knee pain: a randomized clinical trial. Efficacy of multimodal, systematic non-surgical treatment of knee osteoarthritis for patients not eligible for a total knee replacement: a study protocol of a randomised controlled trial Assessing the comparative effectiveness of Tai Chi versus physical therapy for knee osteoarthritis: design and rationale for a randomized trial [Clinical efficacy comparison between electroacupuncture and meloxicam in the treatment of knee os- teoarthritis at the early and middle stage: a randomized controlled trial]. [Efficacy observation on knee osteoarthritis treated with electroacupuncture and its influence on articular cartilage with T2 mapping]. [Treatment of Knee Osteoarthritis by Tendons of Minimally Invasive Therapy Combined Drug Ther- apy: a Clinical Observation of Sixty Cases]. [Effects of acupotomy, electroacupuncture or round-sharp acupuncture needle interventions on expression of Bcl-2, Bax, Caspase-3 proteins of rectus femoris in rabbits with knee ostarthritis]. [Effects of Short Thrust Needing plus Electroacupuncture Intervention on Cartilage Tissue in Rabbits with Knee Osteoarthritis]. [YANG's pricking-cupping therapy for knee osteoarthritis: a multi-center randomized controlled trial]. Acupuncture in the postoperative setting for breast cancer patients: a feasibility study. Impact of persistent hip or knee pain on overall health status in elderly people: a longitudinal population study.
This study aims to examine electro-acupuncture stimulation ( EA ) assisted therapy with analysis of heart rate variability to underst and autonomic nervous activity variability ( ANAV ) and to track the changes in female patients with constipation . The average ages were 42 ± 12 years old . The participants were divided by a single-blind and r and omized trial into two groups : the electro-acupuncture-point group , and the non-electro-acupuncture-point group . Both of the groups had eight treatments , once a week . For the electro-acupuncture ( EA ) group , needles were inserted into their Zusunli ( ST36 ) , Shangiuxu ( ST37 ) , Tiensu ( ST25 ) , Shueidao ( ST28 ) , Guanyuan ( CV4 ) and Qihai ( CV6 ) points . For the sham electro-acupuncture ( SA ) group , needles were inserted into acu-points that were not the ones mentioned for the EA group . While inserting needles , needles were inserted lightly into the participants ' skin and removed quickly ( mock Transcutaneous Electrical Nerve Stimulation , TENTS ) . After an eight-week treatment period , the autonomic nervous system activities of the SA group did not show significant differences in their heart rate variability . However , the autonomic nervous system activities of the EA group had continuously increased after each session . The normalized high frequency powers ( nHFP ) of their autonomic nervous system activities were 26.79 in the first week , and they increased to 32.28 in the fourth week . In the eighth week , their nHFP had increased to 37.60 ( p < 0.05 ) . The normalized low frequency power ( nLFP ) was 30.81 in the first week . However , it decreased to 25.98 after three weeks of treatment . After the eight-week treatment period , the nLFP decreased to 24.84 ( p < 0.05 ) . After the eight-week treatment , the control group did not appear to undergo any physiological change , while the constipation had been improved for the experimental group . It was found that the activation of parasympathetic nervous system in the experimental group increased after the eight-week treatment . The effects of such a result on the enhancement of the activation of parasympathetic nervous system and the improvement of constipation should be further discussed Background Using an open r and omised controlled study , we examined the effectiveness of manual and electroacupuncture on symptom relief for patients with osteoarthritis of the knee . Methods Patients with symptomatic osteoarthritis of the knee were r and omised to one of three treatment groups . Group A had acupuncture alone , group B had acupuncture but continued on their symptomatic medication , and group C used their symptomatic medication for the first five weeks and then had a course of acupuncture added . Patients receiving acupuncture were treated twice weekly over five weeks . Needles were inserted ( with manual and electrical stimulation ) in acupuncture points for pain and stiffness , selected according to traditional acupuncture theory for treating Bi syndrome . Patients were assessed by a blinded observer before treatment , after five weeks ’ treatment and at one month follow up , using a visual analogue pain scale ( VAS ) and the Western Ontario McMaster ( WOMAC ) question naire for osteoarthritis of the knee . Results The 30 patients in our study were well matched for age , body mass index , disease duration , baseline VAS pain score and baseline WOMAC scores . Repeated measure analyses gave a highly significant improvement in pain ( VAS ) after the courses of acupuncture in groups A ( P=0.012 ) and B ( P=0.001 ) ; there was no change in group C until after the course of acupuncture , when the improvement was significant ( P=0.001 ) . Similarly significant changes were seen with the WOMAC pain and stiffness scores . These benefits were maintained during the one month after the course of acupuncture . Patients ’ rating of global assessment was higher than that of the acupuncturist . Conclusion We conclude that manual and electroacupuncture causes a significant improvement in the symptoms of osteoarthritis  of the knee , either on its own or as an adjunct therapy , with no loss of benefit after one month PURPOSE Data on the association between body mass index ( BMI ) and risk of knee osteoarthritis ( KOA ) are sparse for Asian population s who are leaner than Western population s. We evaluated the association between BMI and risk of  total knee replacement ( TKR ) due to severe KOA among Chinese in Singapore . METHODS We used data from the Singapore Chinese Health Study ( SCHS ) , a population -based prospect i ve cohort of 63,257 Chinese men and women , aged 45 - 74 years at enrollment from 1993 to 1998 . Information on  height , weight , diet and lifestyle factors  were obtained via in-person interviews . TKR cases for severe KOA were identified via linkage with the nationwide hospital discharge data base through 2011 . Cox regression and weighted least squares regression were used in the analysis . RESULTS The mean BMI among cohort participants was 23.1 kg/m(2 ) , and more than two-thirds had BMI below 25 kg/m(2 ) . A total of 1649 had TKR attributable to severe KOA . Risk of TKR increased in a strong dose-dependent manner with increasing BMI throughout the 15 - 32 kg/m(2 ) range and became less clear at BMI > 32 kg/m(2 ) . In the BMI range 16 - 27 kg/m(2 ) , there was a 27 % increase in TKR risk for each unit increase in BMI ( P for trend < 0.001 ) . Compared to BMI 19 - 20 kg/m(2 ) , the risk estimates of TKR were all statistically significant with increasing unit of BMI ≥21 kg/m(2 ) . Results were similar for men and women . CONCLUSION Our results provided evidence for a constant mechanical mechanism underlying BMI and KOA initiation and /or progression BACKGROUND Acupuncture is widely used by patients with chronic pain although there is little evidence of its effectiveness . We investigated the efficacy of acupuncture compared with minimal acupuncture and with no acupuncture in patients with osteoarthritis of the knee . METHODS Patients with chronic osteoarthritis of the knee ( Kellgren grade < or = 2 ) were r and omly assigned to acupuncture ( n=150 ) , minimal acupuncture ( superficial needling at non-acupuncture points ; n=76 ) , or a waiting list control ( n=74 ) . Specialised physicians , in 28 outpatient centres , administered acupuncture and minimal acupuncture in 12 sessions over 8 weeks . Patients completed st and ard question naires at baseline and after 8 weeks , 26 weeks , and 52 weeks . The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis ( WOMAC ) index at the end of week 8 ( adjusted for baseline score ) . All main analyses were by intention to treat . RESULTS 294 patients were enrolled from March 6 , 2002 , to January 17 , 2003 ; eight patients were lost to follow-up after r and omisation , but were included in the final analysis . The mean baseline-adjusted WOMAC index at week 8 was 26.9 ( SE 1.4 ) in the acupuncture group , 35.8 ( 1.9 ) in the minimal acupuncture group , and 49.6 ( 2.0 ) in the waiting list group ( treatment difference acupuncture vs minimal acupuncture -8.8 , [ 95 % CI -13.5 to -4.2 ] , p=0.0002 ; acupuncture vs waiting list -22.7 [ -27.5 to -17.9 ] , p<0.0001 ) . After 52 weeks the difference between the acupuncture and minimal acupuncture groups was no longer significant ( p=0.08 ) . INTERPRETATION After 8 weeks of treatment , pain and joint function are improved more with acupuncture than with minimal acupuncture or no acupuncture in patients with osteoarthritis of the knee . However , this benefit decreases over time Objective . To observe the effects of traditional Chinese moxibustion , compared with sham moxibustion , on the quality of life ( QOL ) in patients with chronic knee osteoarthritis ( KOA ) . Methods . This is a r and omized double-blinded , placebo-controlled trial . 150 patients with KOA were r and omly allocated to either a true moxibustion treatment ( n = 77 ) or a sham moxibustion treatment ( n = 73 ) three times a week for six weeks . The QOL of patients was evaluated with SF-36 at baseline and 3 , 6 , and 12 weeks after baseline . Results . 136 patients were available for analysis . Participants in the true moxibustion group experienced statistically significantly greater improvement in GH ( general health ) scores than the sham group at week 6 ( P = 0.015 ) and week 12 ( P = 0.029 ) . Participants in the true moxibustion group experienced statistically significantly greater improvement in VT ( vitality ) scores than the sham group at week 12 ( P = 0.042 ) . No significant adverse effects were found during the trial . Conclusion . A 6-week moxibustion treatment seems to improve general health and vitality , which are associated with physical and mental quality of life , in patients with KOA up to 12 weeks , relative to credible sham moxibustion . This trial is registered with Clinical trials.gov IS RCT N68475405 Background Previous studies have shown that electroacupuncture ( EA ) has a significant effect on acute pain , but it has not solved the clinical problem of the chronification of acute pain . Diffuse noxious inhibitory controls ( DNIC ) function as a reliable indicator to predict the risk of chronic pain events . DNIC function in knee osteoarthritis ( KOA ) patients has been demonstrated to gradually decrease during the development of chronic pain . The purpose of this study is to conduct a r and omized , controlled clinical trial to determine if EA can repair impaired DNIC function and thus prevent chronification of the acute pain of KOA . Methods / Design This is a multicenter , single blind , r and omized , controlled , three-arm , large-scale clinical trial . A total of 450 KOA patients will be r and omly assigned to three groups . The strong EA group will receive EA with high-intensity current ( 2 mA < current < 5 mA ) at the ipsilateral ‘ Neixiyan ’ ( EX-LE5 ) , ‘ Dubi’(ST35 ) , ‘ Liangqiu’(ST34 ) and ‘ Xuehai ’ ( SP10 ) . The weak EA group will receive EA with low-intensity current ( 0 mA < current < 0.5 mA ) on the same acupoints . The sham EA group will receive EA with low-intensity current ( 0 mA < current < 0.5 mA ) with fine needles inserted superficially into the sites 2 cm lateral to the above acupoints . The patients will be treated with EA once a day , 30 minutes per session , in 5 sessions per week , for 2 weeks . In order to determine the best stage of KOA for effective EA intervention , patients within the treatment groups also will be divided into four stages . The primary outcomes are Visual Analog Scale ( VAS ) , DNIC function and the Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC ) . Clinical assessment s will be evaluated at baseline ( before treatment ) and after 5 to 10 sessions of treatment . Discussion This trial will be helpful in identifying whether strong EA is more effective than weak EA in reversing chronification of acute pain through repairing the impaired DNIC function and in screening for the best stage of KOA for effective EA intervention . Trial registration Chinese Clinical Trial Registry Number : ChiCTR-ICR-14005411 . The date of registration is 31 October 2014 IMPORTANCE There is debate about benefits of acupuncture for  knee pain . OBJECTIVE To determine the efficacy of laser and needle acupuncture for  chronic knee pain . DESIGN , SETTING , AND PARTICIPANTS Zelen- design clinical trial ( r and omization occurred before informed consent ) , in Victoria , Australia ( February 2010-December 2012 ) . Community volunteers ( 282 patients aged ≥50 years with chronic knee pain ) were treated by family physician acupuncturists . INTERVENTIONS No acupuncture ( control group , n = 71 ) and needle ( n = 70 ) , laser ( n = 71 ) , and sham laser ( n = 70 ) acupuncture . Treatments were delivered for 12 weeks . Participants and acupuncturists were blinded to laser and sham laser acupuncture . Control participants were unaware of the trial . MAIN OUTCOMES AND MEASURES Primary outcomes were average knee pain ( numeric rating scale , 0 [ no pain ] to 10 [ worst pain possible ] ; minimal clinical ly important difference [ MCID ] , 1.8 units ) and physical function ( Western Ontario and McMaster Universities Osteoarthritis Index , 0 [ no difficulty ] to 68 [ extreme difficulty ] ; MCID , 6 units ) at 12 weeks . Secondary outcomes included other pain and function measures , quality of life , global change , and 1-year follow-up . Analyses were by intention-to-treat using multiple imputation for missing outcome data . RESULTS At 12 weeks and 1 year , 26 ( 9 % ) and 50 ( 18 % ) participants were lost to follow-up , respectively . Analyses showed neither needle nor laser acupuncture  significantly improved pain ( mean difference ; -0.4 units ; 95 % CI , -1.2 to 0.4 , and -0.1 ; 95 % CI , -0.9 to 0.7 , respectively ) or function ( -1.7 ; 95 % CI , -6.1 to 2.6 , and 0.5 ; 95 % CI , -3.4 to 4.4 , respectively ) compared with sham at 12 weeks . Compared with control , needle and laser acupuncture result ed in modest improvements in pain ( -1.1 ; 95 % CI , -1.8 to -0.4 , and -0.8 ; 95 % CI , -1.5 to -0.1 , respectively ) at 12 weeks , but not at 1 year . Needle acupuncture result ed in modest improvement in function compared with control at 12 weeks ( -3.9 ; 95 % CI , -7.7 to -0.2 ) but was not significantly different from sham ( -1.7 ; 95 % CI , -6.1 to 2.6 ) and was not maintained at 1 year . There were no differences for most secondary outcomes and no serious adverse events . CONCLUSIONS AND RELEVANCE In patients older than 50 years with moderate or severe chronic knee pain , neither laser nor needle acupuncture conferred benefit over sham for pain or function . Our findings do not support acupuncture for these patients . TRIAL REGISTRATION anzctr.org.au Identifier : ACTRN12609001001280 Introduction It is recommended that non-operative treatment of knee osteoarthritis ( KOA ) should be individually tailored and include multiple treatment modalities . Despite these recommendations , no one has yet investigated the efficacy of combining several non-surgical treatment modalities in a r and omised controlled study . The purpose of this r and omised controlled study is to examine if an optimised , combined non-surgical treatment programme results in greater improvements in pain , function and quality of life in comparison with usual care in patients with KOA who are not eligible for total knee arthroplasty ( TKA ) . Methods and analysis This study will include 100 consecutive patients from the North Denmark Region not eligible for TKA with radiographic KOA ( K-L grade ≥1 ) and mean pain during the previous week of ≤60 mm ( 0–100 ) . The participants will be r and omised to receive either a 12-week non-surgical treatment programme consisting of patient education , exercise , diet , insoles , paracetamol and /or NSAIDs or usual care ( two information leaflets containing information on KOA and advice regarding the above non-surgical treatment ) . The primary outcome will be the change from baseline to 12 months on the self-report question naire Knee Injury and Osteoarthritis Outcome Score (KOOS)4 defined as the average score for the subscale scores for pain , symptoms , activities of daily living and quality of life . Secondary outcomes include the five individual KOOS subscale scores , pain on a 100 mm Visual Analogue Scale , EQ-5D , self-efficacy , pain pressure thresholds , postural control and isometric knee flexion and knee extension strength . Ethics and dissemination This study was approved by the local Ethics Committee of The North Denmark Region ( N-20110085 ) and the protocol conforms to the principles of the Declaration of Helsinki . Data collection will be completed by April 2014 . Publications will be ready for su bmi ssion in the summer of 2014 . Trial registration number This study is registered with http:// clinical trials.gov ( NCT01535001 ) Background Knee osteoarthritis ( OA ) causes pain and long-term disability with annual healthcare costs exceeding $ 185 billion in the United States . Few medical remedies effectively influence the course of the disease . Finding effective treatments to maintain function and quality of life in patients with knee OA is one of the national priorities identified by the Institute of Medicine . We are currently conducting the first comparative effectiveness and cost-effectiveness r and omized trial of Tai Chi versus a physical-therapy regimen in a sample of patients with symptomatic and radiographically confirmed knee OA . This article describes the design and conduct of this trial . Methods / Design A single-center , 52-week , comparative effectiveness r and omized controlled trial of Tai Chi versus a st and ardized physical-therapy regimen is being conducted at an urban tertiary medical center in Boston , Massachusetts . The study population consists of adults ≥ 40 years of age with symptomatic and radiographic knee OA ( American College of Rheumatology criteria ) . Participants are r and omly allocated to either 12 weeks of Tai Chi ( 2x/week ) or Physical Therapy ( 2x/week for 6 weeks , followed by 6 weeks of rigorously monitored home exercise ) . The primary outcome measure is pain ( Western Ontario and McMaster Universities WOMAC ) subscale at 12 weeks . Secondary outcomes include WOMAC stkiffness and function domain scores , lower extremity strength and power , functional balance , physical performance tests , psychological and psychosocial functioning , durability effects , health related quality of life , and healthcare utilization at 12 , 24 and 52 weeks . Discussion This study will be the first r and omized comparative-effectiveness and cost-effectiveness trial of Tai Chi versus Physical Therapy in a large symptomatic knee OA population with long-term follow up . We present here a robust and well- design ed r and omized comparative-effectiveness trial that also explores multiple outcomes to eluci date the potential mechanisms of mind-body effect for a major disabling disease with substantial health burdens and economic costs . Results of this study are expected to have important public health implication s for the large and growing population with knee OA.Trial registration Clinical Trials.gov identifier : OBJECTIVE To compare the clinical efficacy on knee osteoarthritis ( KOA ) at the early and middle stage between electroacupuncture ( EA ) and meloxicam . METHODS Ninety patients of KOA at the early and middle stage were r and omized into an EA group and a meloxicam group , 45 cases in each one . In the EA group , EA was applied to Dubi ( ST 35 ) , Neixiyan ( EX-LE 4 ) , Liangqiu ( ST 34 ) , Heding ( EX-LE 2 ) , Xuehai ( SP 10 ) , Yan- glingquan ( GB 34 ) and Zusanli ( ST 36 ) ; the needles were retained for 20 min and EA was applied once every two days . In the meloxicam group , the meloxicam tablets were prescribed for oral administration , 7 . 5 mg , once a day . The treatment lasted for 6 weeks in the two groups . The Western Ontario and McMaster University Osteoarthritis Index ( WOMAC ) score , rectus femoris muscle tension , the 8-foot walking test and 5-time sit-to-st and test were adopted to observe and compare the effects in the two groups . RESULTS After treatment , every item score in WOMAC was reduced after treatment ( all P < 0.05 ) , but the difference was not significant between the two groups ( all P > 0.05 ) . In the EA group , the rectus femoris tension after treatment was reduced as compared with that before treatment ( P < 0.05 ) and the reducing result was much more apparent as compared with that in the meloxicam group ( P < 0.05 ) . For the 8-foot walking test and 5-time sit-to-st and test , the time was shortened after treatment in the two groups ( all P < 0.05 ) and the result in the EA group was much more obvious than that in the meloxicam group ( both P < 0.05 ) . CONCLUSION Both EA and meloxicam are effective in the treatment of KOA at the early and middle stage . EA improves rectus femoris tension and recovers the internal mechanics balance and the efficacy is better than that of meloxicam OBJECTIVE To observe therapeutic efficacy  of osteoarthritis treated by electroacupuncture , and explore its function of promoting cartilage restoration . METHODS According to r and om digital table , sixty cases of knee osteoarthritis ( 60 knees ) were r and omly divided into an electroacupuncture group and a physiotherapy group , 15 cases ( 30 knees ) in each one . The electroacupuncture was applied at Neixiyan ( EX-LE 4 ) , Dubi ( ST 35 ) , Heding ( EX-LE 2 ) and Xuehai ( SP 10 ) in the electroacupuncture group , once every other day . The physiotherapy group was treated by medium-frequency therapeutic apparatus every day . For both groups , 4 weeks of treatment were required . The Lysholm knee scoring scale ( LKSS ) was used to evaluate and compare the knee joints function before and after treatment . At the same time , the GE Signa EXCITE Twin Speed HD 1.5 T was used to take MRI examination of knee joints , and measure the T2 values in 10 sub-regions of the cartilage of tibiofemoral joints . RESULTS Compared before treatment , the LKSS score of both groups were improved with significant differences except item dem and s for support ( P < 0.01 , P < 0.05 ) . Between the two groups after treatment , there were significant differences on total score , item instability and swelling ( all P < 0.05 ) , the electroacupuncture group was better than the physiotherapy group , but no significant difference on the other items ( all P > 0.05 ) . In the electroacupuncture group after treatment , T2 value in anterior lateral tibial sub-region ( LTa ) was significantly lowered ( P < 0.05 ) , but no significant difference in the other nine sub-regions ( all P > 0.05 ) . In the physiotherapy group , T2 value in any sub-region was not significantly different before and after treatment ( all P > 0.05 ) . CONCLUSION Electroacupuncture could effectively improve the symptom , sign and knee joint 's function of patients with knee osteoarthritis . Compared with physiotherapy , it has more superior effect and considered as a better non-operative treatment for osteoarthritis . Electroacupuncture also has positive influence on T2 value in cartilage , indicating that electroacupuncture may have the function of promoting cartilage restoration OBJECTIVE To assess the efficacy of tendons of minimally invasive therapy ( TMIT ) combined drug therapy by comparing it with treatment by drug therapy alone on patients with knee osteoarthritis ( KOA ) . METHODS Totally 60 KOA patients were assigned to the treatment group and the control group according to r and om digit table , 30 in each group . Patients in the control group took Hydrochloric Acid Glucosamine Capsule and Celecoxib Capsule . Patients in the treatment group additionally received TMIT . The treatment course for all was 4 weeks . Scores for visual analogue scale ( VAS ) and the Western Ontario and McMaster Universities ( WOMAC ) Osteoarthritis Index were observed and recorded at week 1 and 4 after treatment by acupotomology mirror . RESULTS Compared with before treatment , improvement was shown in VAS score , pain and stiffness degrees , activities and functions , and WOMAC scores at week 1 and 4 after treatment in all patients with statistical difference ( P < 0.05 ) . Besides , better effect was shown in the treatment group ( P < 0.05 ) . CONCLUSIONS TMIT combined drug therapy could relieve KOA patients ' pain , stiffness and joint activities , elevate the overall efficacy . TMIT was easily operated with less injury OBJECTIVE To observe the effect of acupotomy , electroacupuncture ( EA ) or round-sharp acupuncture needle intervention on the expression of Bcl-2,Bax and Caspase-3 proteins in the rectus femoris in rabbits with knee ostarthritis ( KOA ) , so as to explore their mechanisms underlying improvement of braking-induced joint damage from the cellular apoptosis . METHODS Forty-five New Zeal and rabbits were equally and r and omized into control  group ,  model  group , acupotomy ( AP ) group , EA group and round-sharp acupuncture needle ( RSAN ) group ( n = 9 in each group ) . The knee-joint injury model was established by fixing the left knee joint in extention position with plaster b and age . EA ( 2 Hz/100 Hz , 3 mA , 20 min each time ) was applied to the left " Yanglingquan " ( GB 34)- " Yinlingquan " ( SP 9 ) and left " Neixiyan " ( EX-LE 4)- " Waixiyan"(ST 35 ) for rabbits in the EA group . The EA treatment was given once daily , 3 times a week , 3 weeks in total . For rabbits of the AP group , a needle-knife was held to insert into the front edge of the midpoint , the starting point and the stopping point of the left medial collateral ligamen , lateral collateral ligament and the patellar ligament of the knee to make a loosening manipulation for 5 times in a session of treatment , once a week , 3 times altogether . For rabbits of the RSAN group , a round-sharp needle was performed in the same way to the needle-knife including the stimulation point , the manipulation method and treatment sessions . At the end of the experiment , the left rectus femoris was taken out for detecting the expression of Bcl-2 , Bax and Caspase-3 proteins with Western blot . RESULTS In comparison with the control group , the passive range of motion ( PROM ) level was significantly decreased 4 , 8 and 12 weeks after modeling ( P < 0.01 ) , and the expression levels of Bax and Caspase-3 proteins in the rectus femoris were considerably upregulated in the model group ( P < 0.05 ) , while the ratio of Bcl-2/Bax was notably down-regulated ( P < 0.05 ) in the model group . Compared with the model group , the PROM level at week 12 after modeling in the AP , EA and RSAN groups were significantly increased ( P < 0.01 ) ; while Bax and Caspase-3 expression levels in both AP and RSAN groups were considerably downregulated ( P < 0.05 ) . No significant differences were found among the five groups in Bcl-2 expression levels ( P > 0.05 ) , and between the EA and model groups in Bax and Caspase-3 expression levels and the ratio of Bcl-2/Bax ( P > 0.05 ) . CONCLUSION AP , RSAN and EA interventions are effective in improving the  knee-joint motion range in KOA rabbits , and this effect of both AP and RSAN is closely associated with their actions in lowering the expression of Bax and Caspase-3 proteins of the rectus femoris and in raising ratio of Bcl-2/Bax protein ( reducing muscular cellular apoptosis ) . The mechanism of EA intervention in improving PROM may be different OBJECTIVE To observe the effectiveness of short thrust needling ( STN , close-to-bone needing ) plus electroacupuncture ( EA ) in healing knee cartilage tissue and in regulating expressions of cartilage vitamin K dependent gamma-glutamyl carboxylase ( GGCX ) , matrix metalloproteinase-13 ( MMP 13 ) and serum uncarboxylated matrix gla protein ( ucMGP ) in rabbits with knee osteoarthritis ( KOA ) , so as to reveal its mechanism underlying improvement of KOA . METHODS Forty New Zeal and rabbits were r and omly divided into normal , model , EA and STN+ EA groups ( n = 10 in each group ) . The KOA model was created by cutting the medial lateral ligament and medial parapatellar arthrotomy of rabbits as described by Hulth and colleagues . For rabbits in the STN+ EA group , " Neixiyan " ( EX-LE 4 ) and " Waixiyan " ( ST 35 ) were punctured with filiform needles by controlling the needle-tip obliquely to advance till the bone surface of the knee joint cavity , and " Yinlingquan " ( SP 9 ) and " Zusanli " ( ST 36 ) punctured by holding the filiform needles vertically along the tibia , and " Liangqiu " ( ST 34 ) was punctured by controlling the filiform needle to advance till the thigh-bone , followed by EA stimulation . EA ( 2 Hz/100 Hz , 1 - 3 mA ) was applied to unilateral EX-LE 4 and ST 35 , and ST 36 and SP 9 , separately for 20 min , once daily for 20 days except weekends . The pathological changes of the knee cartilage cells were observed using H. E. staining , Toluidine blue staining and electron transmission microscope , respectively . The immunoactivity of GGCX of the knee cartilage was determined by immunohistochemistry and the expression levels of GGCX and MMP 13 proteins in the cartilage were detected by Western blot , and the content of serum ucMGP was assayed by ELISA . RESULTS H. E. staining , Toluidine blue staining and electron transmission microscope results showed that pathological changes of knee cartilage cells in structure after modeling were improved in both the STN+ EA and EA groups , particularly the former group . In comparison with the normal group , the expression levels of GGCX protein in the cartilage tissue showed by both Western blot and immunohistochemistry were notably down-regulated ( P<0.01 ) , and the cartilage MMP 13 protein expression and serum ucMGP content were considerably up-regulated in the model group ( P<0.01 , P<0.05 ) . After STN+ EA and simple EA , the decreased GGCX and the increased MMP 13 expression and serum ucMGP content were reversed ( P<0.01 , P<0.05 ) . The effects of STN+EA were significantly superior to those of simple EA in down-regulating MMP13 and ucGLA levels , and upre-gulating GGCX expression . CONCLUSION Both STN+ EA and simple EA can effectively improve  pathological changes  of cartilage cells in KOA rabbits , which may be associated with their actions in up-regulating the expression of cartilage GGCX protein and lowering the levels of serum ucMGP content and cartilage MMP 13 protein expression , and the effects of STN+ EA are better OBJECTIVE To evaluate the clinical efficacy of YANG 's pricking-cupping therapy for knee osteoar thritis ( KOA ) . Methods This was a multi-center r and omized parallel controlled trial . One hundred and seventy one patients with KOA were r and omly allocated to a pricking-cupping group ( 89 cases ) and a conventional acu puncture group ( 82 cases ) . Neixiyan ( EX-LE 4 ) , Dubi ( ST 35 ) and ashi points were selected in the two groups . Patients in the pricking-cupping group were treated with YANG 's pricking-cupping therapy ; the seven-star needles were used to perform pricking at acupoints , then cupping was used until slight bleeding was observed . Patients in the conventional acupuncture group were treated with semi-st and ardized filiform needle therapy . The treatment was given for 4 weeks ( from a minimum of 5 times to a maximum of 10 times ) . The follow-up visit was 4 weeks . The Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC ) and the visual analogue scale ( VAS ) were adopted for the efficacy assessment s. RESULTS The pain score , stiffness score , physical function score and total score of WOMAC were all reduced after 4-week treatment and during follow-up visit in the two groups ( all P<0 . 0001 ) . Except that the difference of stiffness score between the two groups was not significant after 4-week treatment ( P>0 . 05 ) , each score and total score of WOMAC in the pricking-cupping group were lower than those in the conventional acupuncture group after 4-week treatment and during follow-up visit ( P<0 . 0001 , P<0 . 01 ) . After 2-week treatment , 4-week treatment and during follow-up visit , the VAS was all reduced compared with that before treatment ( all P<0 . 0001 ) ; with the increase of the treatment , the reducing trend of VAS was more significant ( P<0 . 0001 ) . The scores of VAS in the pricking-cupping group were lower than those in the conventional acupuncture group after 4-week treatment and during follow-up visit ( P < 0 . 01 , P < 0 . 0001 ) . CONCLUSION The YANG 's pricking-cupping and conventional acupuncture therapy can both significantly improve knee joint pain and function in patients with KOA , which are relatively safe . The pricking  cupping therapy is superior to conventional acupuncture with the identical selection of acupoints Acupuncture is used to treat a variety of symptoms and conditions associated with cancer and cancer treatments . The present study was performed to evaluate the feasibility of providing acupuncture in the hospital setting for breast cancer patients and to evaluate the short-term effect of acupuncture on stress , anxiety , and pain . This was an open label study conducted at Mayo Clinic Hospital , Method ist and Saint Marys Campus , Rochester , Minnesota . A total of 20 adult breast cancer patients undergoing mastectomy and /or breast reconstruction were recruited and offered daily acupuncture intervention beginning postoperative day 1 and continuing for the duration of the hospital stay . Outcome measures included the Symptom Visual Analog Scale ( VAS ) and Satisfaction Question and Was-it-Worth-it ( WIWI ) Question naire . It was found that acupuncture is a feasible option for postoperative breast cancer patients . In addition , it can significantly decrease the levels of anxiety ( p = 0.0065 ) , tension/muscular discomfort ( p < 0.001 ) and pain ( p = 0.023 ) . The association between  acupuncture and relaxation was found to be statistically borderline ( p = 0.053 ) . This feasibility study showed that acupuncture can be integrated into a busy postsurgical clinical practice . These results also suggest that acupuncture may be an important intervention in the postoperative setting for breast cancer patients OBJECTIVE To investigate hip or knee symptoms in older persons from a longitudinal , population perspective , and to determine the impact of persistent hip or knee pain on general health status over time . METHODS A postal question naire was sent to a r and om sample of 5,500 individuals ages > or = 65 years containing the Short Form 36 ( SF-36 ) general health survey , Lequesne hip and knee indices , and a hip/knee pain severity item . Respondents reporting hip or knee symptoms at baseline received an identical question naire 12 months later . Respondents were classified into a persistent pain group with either hip or knee pain at both baseline and followup , and a non-persistent pain group who reported hip or knee pain at baseline but no pain at followup . RESULTS At baseline , 1,305 ( 40.7 % ) of 3,210 eligible respondents reported hip or knee pain . At 1 year , 1,072 ( 82.1 % ) of 1,305 individuals responded , of whom 820 ( 76.5 % ) remained symptomatic ( the persistent group ) . In multivariate analysis , baseline factors identified as strongly related to having persistent pain were maximum Lequesne score ( odds ratio [ OR ] 1.09 , P < 0.001 ) , maximum hip/knee pain score ( OR 1.61 , P < 0.001 ) , and number of painful hip and knee joints at baseline ( OR 1.48 , P = 0.004 ) . Following adjustment for age , sex , and baseline score , differences in mean SF-36 change scores of the 2 groups were significant for all dimensions except for mental health . CONCLUSION In older persons , a symptomatic hip or knee frequently progresses in terms of worsening symptoms and accrual of other symptomatic hip or knee joints . The impact of persistent symptoms on general health is substantial
Knee  osteoarthritis ( KOA ) is a common chronic degenerative disease of the elderly .
Electro-acupuncture ( EA ) is considered as a beneficial treatment for KOA , but the conclusion is controversial .
This systematic review compiled the evidence from 11 r and omized controlled trials to objective ly assess the effectiveness and safety of EA for KOA .