Biomechanical response to acupuncture needling in humans. Lenercept (p55 tumor necrosis factor receptor fusion protein) in severe sepsis and early septic shock: A randomized, double-blind, placebo-controlled, multicenter phase III trial with 1,342 patients [Effects of acupuncture at "Zusanli" (ST 36) on cerebral proinflammatory cytokine and plasma neuron specific enolase in septic rats]. Role of Nrf2/ARE Pathway in Protective Effect of Electroacupuncture against Endotoxic Shock-Induced Acute Lung Injury in Rabbits Effect of ERK1/2 Signaling Pathway in Electro-Acupuncture – Mediated Up-Regulation of Heme Oxygenase-1 in Lungs of Rabbits with Endotoxic Shock Low- and high-frequency transcutaneous electrical acupoint stimulation induces different effects on cerebral μ-opioid receptor availability in rhesus monkeys. Role of HO-1 in protective effect of electro-acupuncture against endotoxin shock-induced acute lung injury in rabbits. Effects of electro-acupuncture at Tongli (HT 5) and Xuanzhong (GB 39) acupoints from functional magnetic resonance imaging evidence Acupuncture Stimulation of ST36 (Zusanli) Attenuates Acute Renal but Not Hepatic Injury in Lipopolysaccharide-Stimulated Rats [Effect of electro-acupuncture at zusanli (ST36) on the expression of ghrelin and HMGB1 in the small intestine of sepsis rats]. [Effects of electroacupuncture on hepatic blood flow and lipid peroxidation in septic rats]. Electroacupuncture improves gut barrier dysfunction in prolonged hemorrhagic shock rats through vagus anti-inflammatory mechanism. Effect of Electroacupuncture at ST36 on the Intestinal Mucosal Mechanical Barrier and Expression of Occludin in a Rat Model of Sepsis Electroacupuncture Improves Intestinal Dysfunction in Septic Patients: A Randomised Controlled Trial Protective Effect of Electroacupuncture at Zusanli on Myocardial Injury in Septic Rats Electroacupuncture reduces duration of postoperative ileus after laparoscopic surgery for colorectal cancer.
During acupuncture treatments , acupuncture needles are manipulated to elicit the characteristic " de qi " reaction widely viewed as essential to acupuncture 's therapeutic effect . De qi has a biomechanical component , " needle grasp , " which we have quantified by measuring the force necessary to pull an acupuncture needle out of the skin ( pullout force ) in 60 human subjects . We hypothesized that pullout force is greater with both bidirectional needle rotation ( BI ) and unidirectional rotation ( UNI ) than no rotation ( NO ) . Acupuncture needles were inserted , manipulated , and pulled out by using a computer-controlled acupuncture needling instrument at eight acupuncture points and eight control points . We found 167 and 52 % increases in mean pullout force with UNI and BI , respectively , compared with NO ( repeated- measures ANOVA , P < 0.001 ) . Pullout force was on average 18 % greater at acupuncture points than at control points ( P < 0.001 ) . Needle grasp is therefore a measurable biomechanical phenomenon associated with acupuncture needle manipulation Objective Phase III study to confirm a trend observed in a previous phase II study showing that a single dose of lenercept , human recombinant p55 tumor necrosis factor receptor-immunoglobulin G1 ( TNFR55-IgG1 ) fusion protein , decreased mortality in patients with severe sepsis or early septic shock . Design Multicenter , double-blind , phase III , placebo-controlled , r and omized study . Setting A total of 108 community and university-affiliated hospitals in the United States ( 60 ) , Canada ( 6 ) and Europe ( 42 ) . Patients A total of 1,342 patients were recruited who fulfilled the entry criteria within the 12-hr period preceding the study drug administration . InterventionAfter r and omization , an intravenous dose of 0.125 mg/kg lenercept or placebo was given . The patient was monitored for up to 28 days , during which st and ard diagnostic , supportive , and therapeutic care was provided . Measurements and Main Results The primary outcome measure was 28-day all-cause mortality . Baseline characteristics were as follows : a total of 1,342 patients were r and omized ; 662 received lenercept and 680 received placebo . The mean age was 60.5 yrs ( range , 17–96 yrs ) ; 39 % were female ; 65 % had medical admissions , 8 % had scheduled surgical admissions , and 27 % had unscheduled surgical admissions ; 73 % had severe sepsis without shock , and 27 % had severe sepsis with early septic shock .  Lenercept and placebo groups were similar at baseline with respect to demographic characteristics , simplified acute physiology score II-predicted mortality , profiles of clinical site of infection and microbiological documentation , number of dysfunctioning organs , and interleukin-6 ( IL-6 ) plasma concentration . Lenercept  pharmacokinetics were similar in severe sepsis and early septic shock patients . Tumor necrosis factor was bound in a stable manner to lenercept as reflected by the accumulation of total serum tumor necrosis factor & agr ; concentrations . There were 369 deaths , 177 on lenercept ( 27 % mortality ) and 192 on placebo ( 28 % mortality ) . A one-sided Cochran-Armitage test , stratified by geographic region and baseline , predicted 28-day all-cause mortality ( simplified acute physiology score II ) , gave a p value of .141 ( one-sided ) . Lenercept treatment had no effect on incidence or resolution of organ dysfunctions . There was no evidence that lenercept was detrimental in the overall population . Conclusion Lenercept had no significant effect on mortality in the study population OBJECTIVE To explore protective effects of acupuncture at " Zusanli " ( ST 36 ) on cerebral tissue in rats with sepsis . METHODS Cecal ligation and puncture ( CLP ) was applied to duplicate the rat model of sepsis . According to r and om number table , thirty SD rats were divided into a sepsis model group ( group A ) , a sepsis model plus electroacupuncture ( EA ) group ( group B ) , and a sepsis model plus non-acupoint EA group ( group C ) , ten rats in each one . EA with the same frequency and intensity at " Zusanli " ( ST 36 ) and non-acupoint ( 0.5 cm laterally to " Zusanli " ) for 30 min was applied in the group B and group C , respectively . No treatment was given in the goup A. 6 hours after CLP , blood was acquired from abdominal aorta to measure the levels of neuron specific enolase ( NSE ) . Then the rats were sacrificed by abdominal aorta exsanguination to take their cerebral tissue for measuring the levels of tumor necrosis factor-alpha ( TNF-alpha ) and interleukin-6 ( IL-6 ) . RESULTS Six hours after CLP , the level of NSE was ( 3.51 + /- 0.39 ) ng/mL in group B , which was significantly lower than ( 7.72 + /- 0.64 ) ng/mL in group A ( P<0.05 ) . The level of NSE was ( 8.02 + /- 0.72 ) ng/mL in the group C , which had no statistical significance with group A ( P>0.05 ) . The levels of TNF-alpha , IL-6 in cerebral tissue in group B were significantly lower than that of group A and C ( all P>0.05 ) . CONCLUSION EA at " Zusanli " ( ST 36 ) has certain protective effect on septic rat 's brain , which has some relationship with decreasing levels of cerebral tissue proinflammatory cytokine and plasma NSE .  EA at non-acupoint has no the same action NF-E2 related factor 2 ( Nrf2 ) is a major transcription factor and acts as a key regulator of antioxidant genes to exogenous stimulations . The aim of current study was to determine whether Nrf2/ARE pathway is involved in the protective effect of electroacupuncture on the injured lung in a rabbit model of endotoxic shock . A dose of lipopolysaccharide ( LPS ) 5 mg/kg was administered intravenously to replicate the model of acute lung injury induced by endotoxic shock . Electroacupuncture pretreatment was h and led bilaterally at Zusanli and Feishu acupoints for five consecutive days while sham electroacupuncture punctured at non-acupoints . Fourty anesthetized New Engl and male rabbits were r and omized into normal control group ( group C ) , LPS group ( group L ) , electroacupuncture + LPS group ( group EL ) and sham electroacupuncture + LPS ( group SEL ) . At 6 h after LPS administration , the animals were sacrificed and the blood sample s were collected for biochemical measurements . The lungs were removed for calculation of wet-to-dry weight ratios ( W/D ) , histopathologic examination , determination of heme oxygenase (HO)-1 protein and mRNA , Nrf2 total and nucleoprotein , as well as Nrf2 mRNA expression , and evaluation of the intracellular distribution of Nrf2 nucleoprotein . LPS caused extensive morphologic lung damage , which was lessened by electroacupuncture treatment . Besides , lung W/D ratios were significantly decreased , the level of malondialdehyde was inhibited , plasma levels of TNF-α and interleukin-6 were decreased , while the activities of superoxide dismutase , glutathione peroxidase and catalase were enhanced in the electroacupucnture treated animals . In addition , electroacupuncture stimulation distinctly increased the expressions of HO-1 and Nrf2 protein including Nrf2 total protein and nucleoprotein as well as mRNA in lung tissue , while these effects were blunted in the sham electroacupuncture group . We concluded that electroacupuncture treatment at ST36 and BL13 effectively attenuates lung injury in a rabbit model of endotoxic shock through activation of Nrf2/ARE pathway and following up-regulation of HO-1 expression Background The anti-oxidative and anti-inflammatory activities of electro-acupuncture ( EA ) , a traditional clinical method , are widely accepted , but its mechanisms are not yet well defined . In this study , we investigated the role of extracellular signal-regulated kinases1/2 ( ERK1/2 ) pathways on electro-acupuncture – mediated up-regulation of heme oxygenase-1 ( HO-1 ) in rabbit lungs injured by LPS-induced endotoxic shock . Material / Methods Seventy rabbits were r and omly divided into 7 groups : group C , group M , group D , group SEAM , group EAM , group EAMPD , and group PD98059 .  Male New Engl and white rabbits were given EA treatment on both sides once a day on days 1–5 , and then received LPS to replicate the experimental model of injured lung induced by endotoxic shock . Then , they were killed by exsanguination at 6 h after LPS administration . The blood sample s were collected for serum examination , and the lungs were removed for pathology examination , determination of wet-to-dry weight ratio , MDA content , SOD activity , serum tumor necrosis factor-α , determination of HO-1 protein and mRNA expression , and determination of ERK1/2 protein . Results The results revealed that after EA  treatment , expression of HO-1 and ERK1/2 was slightly increased compared to those in other groups , accompanied with less severe lung injury as indicated by lower index of lung injury score , lower wet-to-dry weight ratio , MDA content , and serum tumor necrosis factor-α levels , and greater SOD activity ( p<0.05 for all ) . After pretreatment with ERK1/2 inhibitor PD98059 , the effect of EA treatment and expression of HO-1 were suppressed ( p<0.05 for all ) . Conclusions After electro-acupuncture stimulation at ST36 and BL13 , severe lung injury during endotoxic shock was attenuated . The mechanism may be through up-regulation of HO-1 , mediated by the signal transductions of ERK1/2 pathways . Thus , the regulation of ERK1/2 pathways via electro-acupuncture may be a therapeutic strategy for endotoxic shock Although systematic studies have demonstrated that acupuncture or electroacupuncture ( EA ) analgesia is based on their accelerating endogenous opioid release to activate opioid receptors and that EA of different frequencies is mediated by different opioid receptors in specific areas of the central nervous system , there is little direct , real-time evidence to confirm this in vivo . The present study was design ed to investigate the effects of transcutaneous electrical acupoint stimulation ( TEAS ) , an analogue of EA , at low and high frequencies on μ-opioid receptor ( MOR ) availability in the brain of rhesus monkeys . Monkeys underwent 95-min positron emission tomography ( PET ) with ( 11 ) C-carfentanil three times r and omly while receiving 0 , 2 , or 100 Hz TEAS , respectively . Each TEAS was administered in the middle 30 min during the 95-min PET scan , and each session of PET and TEAS was separated by at least 2 weeks . The results revealed that 2 Hz but not 100 Hz TEAS evoked a significant increase in MOR binding potential in the anterior cingulate cortex , the cau date nucleus , the putamen , the temporal lobe , the somatosensory cortex , and the amygdala compared with 0 Hz TEAS . The effect remained after the end of TEAS in the anterior cingulate cortex and the temporal lobe . The selective increase in MOR availability in multiple brain regions related to pain and sensory processes may play a role in mediating low-frequency TEAS efficacy Heme oxygenase (HO)-1 has been reported to play a great role in attenuating lung injury during endotoxic shock in our previous research . Although electro-acupuncture has been explored to reduce oxidative stress and decrease inflammatory reaction in animals with endotoxic shock , the mechanism of this effect is still unclear . The aim of this study was to determine whether HO-1 is involved in the effect of electro-acupuncture on the injured lung during endotoxic shock in rabbits . Sixty New Engl and white rabbits were r and omly divided into groups C , Z , ES , EA , AP , and EAZ . Before inducing endotoxic shock , group ES received no electro-acupuncture , while group EA received electro-acupuncture at ST36 ( zusanli ) and BL13 ( feishu ) acupoints on both sides for five days and group AP received electro-acupuncture ( EA ) stimulation at a non-acupoint . Groups ES , AP , EA , and EAZ received LPS to replicate the experimental model of injured lung induced by endotoxic shock , and electro-acupuncture was performed throughout the procedure with the same parameter . Groups EAZ and Z received the HO-1 inhibitor , ZnPP-IX , intraperitoneally . The animals were sacrificed by blood-letting at 6 h after LPS administration . The blood sample s were collected for serum examination , and the lungs were removed for pathology examination , detection of alveolaer epithelial cell apoptosis by terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay ( TUNEL assay ) , determination of wet to dry ratio , measurement of Evans blue ( EB ) contents , and determination of HO-1protein and mRNA expression . According to the results , EA at ST36 and BL13 could increase the expression of HO-1 . At the same time , index of quantitative assessment ( IQA ) score and the number of TUNEL-positive cells decreased , while electro-acupuncture at the other points did not exert this effect , and pretreatment with ZnPP-IX in group EAZ suppressed the efficacy of electro-acupuncture preconditioning . In summary , electro-acupuncture stimulation at ST36 and BL13 , while not the non-acupoint , could attenuate the lung injury during the endotoxic shock , and this effect was due to increased expression of HO-1 Objective To explore the specifificity of Tongli ( HT 5 ) and Xuanzhong ( GB 39 ) paired acupionts in aspects of Deqi sensation and brain activation patterns during electroacupuncture . Methods In this study , 15 healthy subjects were enrolled . All participants suffered two kinds of functional magnetic resonance imaging ( fMRI ) examinations r and omly : Examination A received electro-acupuncture ( EA ) at the bilateral Tongli ( HT5 ) and Xuanzhong ( GB 39 ) acupoints ( ACU ) , and examination B received EA at bilateral non-acupoints ( NAP ) . The subjects reported the feeling of Deqi at each examination later respectively . A multi-voxel pattern analysis method and Statistical Program for Social Sciences were used to analyze the data . Results The ACU group ( Exam A ) reported fullness , heaviness , numbness , soreness and throbbing of signifificantly greater intensity than the NAP group ( Exam B ) . In addition , there was no statistical signifificance between two groups in aching , tingling , deep pressure , sharp pain , dull pain , warmness and cold . Meanwhile , fMRI data revealed differences between two groups in discriminating accuracy of brain somatosensory cortex and language -related cortices . Conclusions Needling HT 5 and GB 39 may modulate language function through a complex brain network , suggesting that it may be benefificial to the recovery of language function in patients with aphasia BACKGROUND : We sought to determine the effects of ST36 acupuncture on sepsis-induced kidney and liver injuries . METHODS : A total of 120 rats were r and omized into 10 groups : 1 ) lipopolysaccharide ( LPS ) , 2 ) normal saline ( N/S ) , 3 ) LPS + ST36 , 4 ) ST36 , 5 ) LPS + P-ST36 , 6 ) P-ST36 , 7 ) LPS + Sham , 8) Sham , 9 ) LPS + P-Sham , and 10 ) P-Sham groups . Rats in the LPS + ST36 , ST36 , LPS + Sham , and Sham groups received ST36 ( design ated as “ ST36 ” ) or a nonacupoint ( design ated as “ Sham ” ) acupuncture for 30 min followed by LPS or N/S injection . Rats in the LPS + P-ST36 , P-ST36 , LPS + P-Sham , and P-Sham groups received LPS or N/S injection for 3 h followed by a 30 min of ST36 or a “ nonacupoint ” acupuncture . Rats were killed at 6 h after LPS injection . RESULTS : LPS caused prominent kidney and liver injuries . The renal and hepatic nitric oxide ( NO ) concentrations and inducible NO synthase ( iNOS ) expression were also increased by LPS . ST36 acupuncture pretreatment significantly attenuated the LPS-induced kidney injury and the increases in renal NO concentration and iNOS expression . However , ST36 acupuncture pretreatment did not affect the LPS-induced liver injury and increases in hepatic NO concentration or iNOS expression . Furthermore , ST36 acupuncture performed after LPS did not affect the LPS-induced organ injuries or increases in NO concentration and iNOS expression . CONCLUSIONS : ST36 acupuncture pretreatment significantly attenuated sepsis-induced kidney , but not liver , injury in rats , whereas ST36 acupuncture performed after sepsis induction had no protective effects against sepsis-induced organ injuries OBJECTIVE To explore the expression of Ghrelin and high mobility group protein B1 ( HMGB1 ) in the serum and the intestinal tissue of sepsis model rats , and to evaluate the effect of electro-acupuncture ( EA ) at Zusanli ( ST36 ) on the expression of HMGB1 and Ghrelin . METHODS Forty-eight male Wistar rats were r and omly divided into four groups , i.e. , the sham-operation ( sham ) , the cecal ligation and puncture group ( CLP ) , the CLP + EA at Zusanli ( ST36 ) group ( EA ) , and the CLP + Ghrelin receptor blocking agent + EA group ( GHSRA ) , 12 in each group . A sepsis rat model was prepared by CLP . The incision of the abdominal wall was immediately sutured along the ventral midline for rats in the Sham group . In the EA group EA at Zusanli ( ST36 ) was performed 20 min after CLP surgery with the constant voltage ( 2 - 100 Hz , 2 mA ) for 30 min . In the GHSRA group , Ghrelin receptor blocking agent , [ D-Arg1 , D-Phe5 , D-Trp79 , Leu11]-substance P ( 700 nmol/kg ) , was administered through intravenous injection immediately after CLP , and 20 min later , EA at Zusanli ( ST36 ) was performed in the same way as for rats in the EA group . Blood sample s were withdrawn 12 h after CLP . The serum levels of Ghrelin and HMGB1 were detected using ELISA . Ghrelin expressions and the number of Ghrelin immunopositive cell in the jejunum were determined by immunohistochemistry . HMGB1 contents of the jejunum tissue were detected by Western blotting . RESULTS Compared with the Sham group , the number of serum immunopositive cells and the expression of HMGB1 in the jejunum tissue significantly increased and levels of Ghrelin and the expression rate of immunopositive cells significantly decreased in the CLP group ( P < 0.05 ) . Compared with the CLP group , the number of serum immunopositive cells and the expression of HMGB1 in the jejunum tissue significantly decreased , but levels of Ghrelin and the expression rate of immunopositive cells significantly increased in the EA group ( P < 0.05 ) . Compared with the EA group , the number of serum immunopositive cells and the expression of HMGB1 in the jejunum tissue significantly increased in the GHSRA group ( P < 0.05 ) , but there was no statistical difference in levels of Ghrelin between the two groups ( P > 0.05 ) . The serum level of HMGB1 was negatively correlated with Ghrelin in the Sham group , the CLP group , and the EA group ( r = -0 . 528 , P < 0.01 ) . CONCLUSIONS EA at Zusanli ( ST36 ) could inhibit the expression of HMGB1 in the jejunum of septic rats , and promote the expression of Ghrelin . The expression of HMGB1 was inhibited by Ghrelin receptor blocking agent , which suggested that the anti-inflammation of EA at Zusanli ( ST36 ) might be associated with Ghrelin OBJECTIVE To investigate the protection effects of electroacupuncture on injury of lipid peroxidation induced by liver ischemia in septic rats . METHODS Forty-eight male SD rats were subjected to sepsis induced by cecal ligation and puncture ( CLP ) , and were r and omly divided into a Sham operation group ( group A ) , a CLP model group ( group B ) , a CLP model plus electroacupuncture at " Zusanli " ( ST 36 ) group ( group C ) , a CLP model plus electroacupuncture at the shame acupoint ( group D ) , a vagotomy plus CLP model group ( group E ) and CLP model plus electroacupuncture group after vagotomy ( group F ) , 8 rats in each group . CLP was performed in group E and group F after the abdominal vagotomy . Bilateral " Zusanli"(ST 36 ) points and the shame acupoint were electroacupunctured ( 2 mA , 2/100 Hz ) for 1 hour in group C , group F and group D , respectively . The hepatic blood flow ( HBF ) was detected by a laser-Doppler flowmetry at 6 h after CLP . The plasma activity of alanine aminotransferase ( ALT ) was also determined and specimens of liver were harvested for evaluation of malondialdehyde ( MDA ) , xanthine oxidase ( XOD ) and assessment of the rate of water content . RESULTS The blood flow of the liver was ( 56.97 + /- 11.95 ) U in group C which was significantly lower than ( 80.12 + /- 19.57 ) U in group A but higher than ( 42.61 + /- 10.97 ) U in group B , ( 44.53 + /- 9.23 ) U in group D , ( 30.05 + /- 4.46 ) U in group E and ( 30.46 + /- 6.38 ) U in group F ( all P < 0.05 ) 6 h after CLP . Meanwhile , the levels of MDA , XOD , ALT and the rates of water content in liver in group C were all significantly higher than those in group A , but lower than those in the other four groups ( all P < 0.05 ) . The levels of MDA , XOD , ALT and the rates of water content in liver in group E and group F were all significantly higher than those in group D ( all P < 0.05 ) , while the blood flow of the liver lower than that in group D ( P < 0.05 ) , and with no significant differences in all above measurements between group E and group F ( all P > 0 . 05 ) . CONCLUSION Electroacupuncture at " Zusanli " ( ST 36 ) can promote hepatic blood flow , inhibit lipid peroxidation and alleviate hepatic edema and dysfunction in septic rats , which might be related with the completeness of cranial nerve AIM To investigate whether electroacupuncture ( EA ) at Zusanli ( ST36 ) prevents intestinal barrier and remote organ dysfunction following prolonged hemorrhagic shock through a vagus anti-inflammatory mechanism . METHODS Sprague-Dawley rats were subjected to about 45 % of total blood volume loss followed by delayed fluid replacement ( DFR ) with Ringer lactate 3h after hemorrhage . In a first study , rats were r and omly divided into six groups : ( 1 ) EAN : EA at non-channel acupoints followed by DFR ; ( 2 ) EA : EA at ST36 after hemorrhage followed by DFR ; ( 3 ) VGX/EA : vagotomy ( VGX ) before EA at ST36 and DFR ; ( 4 ) VGX/EAN : VGX before EAN and DFR ; ( 5 ) α-bungarotoxin (α-BGT)/EA : intraperitoneal injection of α-BGT before hemorrhage , followed by EA at ST36 and DFR ; and ( 6 ) α-BGT/EAN group : α-BGT injection before hemorrhage followed by EAN and DFR . Survival and mean arterial pressure ( MAP ) were monitored over the next 12 h. In a second study , with the same grouping and treatment , cytokine levels in plasma and intestine , organ parameters , gut injury score , gut permeability to 4 kDa FITC-dextran , and expression and distribution of tight junction protein ZO-1 were evaluated . RESULTS MAP was significantly lowered after blood loss ; EA at ST36 improved the blood pressure at corresponding time points 3 and 12 h after hemorrhage . EA at ST36 reduced tumor necrosis factor-α and interleukin (IL)-6 levels in both plasma and intestine homogenates after blood loss and DFR , while vagotomy or intraperitoneal injection of α-BGT before EA at ST36 reversed its anti-inflammatory effects , and EA at ST36 did not influence IL-10 levels in plasma and intestine . EA at ST36 alleviated the injury of intestinal villus , the gut injury score being significantly lower than that of EAN group ( 1.85 ± 0.33 vs 3.78 ± 0.59 , P < 0.05 ) . EA at ST36 decreased intestinal permeability to FITC-dextran compared with EAN group ( 856.95 ng/mL ± 90.65 ng/mL vs 2305.62 ng/mL ± 278.32 ng/mL , P < 0.05 ) . EA at ST36 significantly preserved ZO-1 protein expression and localization at 12 h after hemorrhage . However , EA at non-channel acupoints had no such effect , and abdominal vagotomy and α-BGT treatment could weaken or eliminate the effects of EA at ST36 . Besides , EA at ST36 decreased blood aminotransferase , MB isoenzyme of creatine kinase and creatinine vs EAN group at corresponding time points . At the end of 12-h experiment , the survival rate of the EA group was significantly higher than that of the other groups . CONCLUSION EA at ST36 attenuates the systemic inflammatory response , protects intestinal barrier integrity , improves organ function and survival rate after hemorrhagic shock via activating the cholinergic anti-inflammatory mechanism Objective To observe the effect of electroacupuncture ( EA ) at ST36 on the intestinal mucosal mechanical barrier and expression of the tight junction ( TJ ) protein , occludin , in a rat model of sepsis . Methods 60 male Wistar rats were r and omly divided into six groups ( n=10 rats each ) : Control , Control+EA , CLP ( caecal ligation and puncture ) , CLP+EA , CLP+Sham-EA , and Sham-CLP . Rats of the CLP , CLP+EA and CLP+Sham-EA groups underwent CLP modeling of sepsis ; those in the Sham-CLP underwent sham surgery and those in the Control and Control+EA groups remained unoperated . Rats in the CLP+EA and Control+EA groups received verum EA at ST36 and rats in the CLP+Sham-EA groups received EA at non-traditional acupuncture points . After three days , serum D-lactate concentrations were measured and ileal mucosa was collected for haematoxylin and eosin staining , morphological observation and Chiu 's scoring . The intestinal epithelial cells were observed under transmission electron microscopy ( TEM ) , while protein expression of occludin was measured by immunohistochemistry and Western blotting . Results TJs of the Control , Sham-CLP and Control+EA groups were continuous under TEM but discontinuous in the CLP , CLP+EA and CLP+Sham-EA groups . Plasma D-lactate levels were significantly higher in the CLP , CLP+EA and CLP+Sham-EA groups compared with the Control , Sham-CLP and Control+EA groups ( P<0.01 ) . Protein expression of occludin , reflected by immunohistochemistry scores ( IHS ) and the results of Western blotting , were significantly reduced in the CLP , CLP+EA and CLP+Sham-EA groups when compared with the Control , Sham-CLP and Control+EA groups ( P<0.01 ) . Compared with the CLP group , the IHS and Western blotting results of the CLP+EA group were both significantly higher ( P<0.05 ) , while those of the CLP+Sham-EA group were similar to the CLP group . Conclusions Electrical stimulation at ST36 in rats with sepsis can increase protein expression of occludin , reduce serum D-lactate levels and increase permeability of the intestinal barrier Objective To investigate the effects of electroacupuncture ( EA ) at “ Zusanli ” ( ST36 ) and “ Shangjuxu”(ST37 ) on reducing inflammatory reaction and improving intestinal dysfunction in patients with sepsis-induced intestinal dysfunction with syndrome of obstruction of the bowels Qi . Methods A total of 71 patients with sepsis-induced intestinal dysfunction with syndrome of obstruction of the bowels Qi were r and omly assigned to control group ( n=36 ) and treatment group ( n=35 ) . Patients in control group were given conventional therapies including fluid resuscitation , anti-infection , vasoactive agents , mechanical ventilation , supply of enteral nutrition , and glutamine as soon as possible . In addition to conventional therapies , patients in treatment group underwent 20 minutes of EA at ST36-ST37 twice a day for five days . At baseline , day 1 , day 3 , and day 7 after treatment , the plasma levels of procalcitonin ( PCT ) , tumor necrosis factor-α ( TNF-α ) , intestinal fatty acid-binding proteins ( I-FABP ) , D-lactate , citrulline , and TCM quantitative score of intestinal dysfunction were measured and recorded , respectively . And days on mechanical ventilation ( MV ) , length of stay in intensive care unit ( ICU ) , and 28d mortality were recorded . Results During treatment , the plasma levels of PCT , TNF-α , I-FABP , D-lactate , and TCM quantitative score of intestinal dysfunction were declining in both groups , while the treatment group showed a significant decline ( P<0.05 ) . Plasma levels of citrulline were increasing in both groups , while the treatment group showed a significant increase ( P<0.05 ) . However , there were no significant differences in the days on MV , length of stay in ICU , and 28d mortality between two groups ( P>0.05 ) . Conclusions EA at ST36-ST37 can reduce inflammatory reaction and has protective effects on intestinal function in patients with sepsis-induced intestinal dysfunction with syndrome of obstruction of the bowels Qi . Trial Registration This trial was registered at http://www.chictr.org.cn/(ChiCTR-IOR-17010910 ) The protective effect of electroacupuncture ( EA ) at Zusanli points ( ST36 ) on myocardial injury in a model of sepsis was observed . Forty-eight male Sprague-Daley rats were subjected to sepsis by cecal ligation and puncture ( CLP ) and r and omly divided into 4 groups ( n=12 ; A : sepsis + EA ; B : sepsis + sham acupuncture ; C : sepsis + vagotomy ; D : sepsis + vagotomy + EA ) . Bilateral points were stimulated ( 2mA , 2 - 100 Hz ) for 1 hour . Abdominal vagotomy was performed in groups C and D. At 6h after CLP , the plasma activity of creatine kinase-MB ( CK-MB ) was determined . A part of cardiac muscle was harvested for evaluating levels of tumor necrosis factor ( TNF-α ) , nitric oxide ( NO ) , myeloperoxidase ( MPO ) , and the rate of water content . The activities of CK-MB , TNF-α , NO , and MPO and the rate of water content in group A were significantly lower than those of the other groups 6h after CLP . EA after vagotomy showed less anti-inflammatory and protective effects . The results indicated that EA obviously reduced the increased levels of the proinflammatory factors at 6h after CLP , and vagotomy could weaken or eliminate the effects of EA . Cholinergic anti-inflammatory pathway is one of the main mechanisms of cardioprotective effect of EA BACKGROUND & AIMS We investigated the efficacy of electroacupuncture in reducing the duration of postoperative ileus and hospital stay after laparoscopic surgery for colorectal cancer . METHODS We performed a prospect i ve study of 165 patients undergoing elective laparoscopic surgery for colonic and upper rectal cancer , enrolled from October 2008 to October 2010 . Patients were assigned r and omly to groups that received electroacupuncture ( n = 55 ) or sham acupuncture ( n = 55 ) , once daily from postoperative days 1 - 4 , or no acupuncture ( n = 55 ) . The acupoints Zusanli , Sanyinjiao , Hegu , and Zhigou were used . The primary outcome was time to defecation . Secondary outcomes included postoperative analgesic requirement , time to ambulation , and length of hospital stay . RESULTS Patients who received electroacupuncture had a shorter time to defecation than patients who received no acupuncture ( 85.9 ± 36.1 vs 122.1 ± 53.5 h ; P < .001 ) and length of hospital stay ( 6.5 ± 2.2 vs 8.5 ± 4.8 days ; P = .007 ) . Patients who received electroacupuncture also had a shorter time to defecation than patients who received sham acupuncture ( 85.9 ± 36.1 vs 107.5 ± 46.2 h ; P = .007 ) . Electroacupuncture was more effective than no or sham acupuncture in reducing postoperative analgesic requirement and time to ambulation . In multiple linear regression analysis , an absence of complications and electroacupuncture were associated with a shorter duration of postoperative ileus and hospital stay after the surgery . CONCLUSIONS In a clinical trial , electroacupuncture reduced the duration of postoperative ileus , time to ambulation , and postoperative analgesic requirement , compared with no or sham acupuncture , after laparoscopic surgery for colorectal cancer . Clinical Trials.gov number , NCT00464425
nan