Major depressive disorder (MDD) is a common disorder with a high prevalence and significant social and economic impacts. Nevertheless, the treatment of MDD is far from satisfactory. Acupuncture treatment has emerged as a promising method for treating MDD. However, the neural mechanism by which acupuncture reduces depressive symptoms is not fully understood. Studies have shown that the corticostriatal reward circuitry is associated with the pathophysiology of MDD; thus, we investigated the corticostriatal resting-state functional connectivity (rsFC) before and after real and sham acupuncture treatments combined with the antidepressant fluoxetine. Forty-six female major depressive patients were assigned to either verum acupuncture plus fluoxetine (n = 22) or sham acupuncture plus fluoxetine (n = 24) treatment for 8 weeks, and resting state functional magnetic resonance imaging (fMRI) data were collected before the first and after the last treatment sessions. The results showed that compared with sham acupuncture, the verum acupuncture group showed: (1) significantly increased rsFC between inferior ventral striatum and medial prefrontal cortex, ventral rostral putamen and amygdala/parahippocampus, as well as dorsal caudate and middle temporal gyrus; (2) significantly decreased rsFC between right ventral rostral putamen and right dorsolateral prefrontal cortex, and right dorsal caudate and bilateral cerebellar tonsil. The increased rsFC between the inferior ventral striatum and medial prefrontal cortex, ventral rostral putamen and amygdala/parahippocampus were significantly positively associated with decreased clinical scores (Montgomery-Åsberg Depression Rating Scale and Self-Rating Depression Scale scores) at the end of the eight-week treatment. Our findings suggest that acupuncture may achieve treatment effects by modulating the corticostriatal reward/motivation circuitry in MDD patients.

Major depressive disorder (MDD) is a common disorder with a high prevalence and significant social and economic impacts. Nevertheless, the treatment of MDD is far from satisfactory. Acupuncture treatment has emerged as a promising method for treating MDD. However, the neural mechanism by which acupuncture reduces depressive symptoms is not fully understood. Studies have shown that the corticostriatal reward circuitry is associated with the pathophysiology of MDD; thus, we investigated the corticostriatal resting-state functional connectivity (rsFC) before and after real and sham acupuncture treatments combined with the antidepressant fluoxetine. Forty-six female major depressive patients were assigned to either verum acupuncture plus fluoxetine (n = 22) or sham acupuncture plus fluoxetine (n = 24) treatment for 8 weeks, and resting state functional magnetic resonance imaging (fMRI) data were collected before the first and after the last treatment sessions. The results showed that compared with sham acupuncture, the verum acupuncture group showed: (1) significantly increased rsFC between inferior ventral striatum and medial prefrontal cortex, ventral rostral putamen and amygdala/parahippocampus, as well as dorsal caudate and middle temporal gyrus; (2) significantly decreased rsFC between right ventral rostral putamen and right dorsolateral prefrontal cortex, and right dorsal caudate and bilateral cerebellar tonsil. The increased rsFC between the inferior ventral striatum and medial prefrontal cortex, ventral rostral putamen and amygdala/parahippocampus were significantly positively associated with decreased clinical scores (Montgomery-Åsberg Depression Rating Scale and Self-Rating Depression Scale scores) at the end of the eight-week treatment. Our findings suggest that acupuncture may achieve treatment effects by modulating the corticostriatal reward/motivation circuitry in MDD patients.

OBJECTIVE:To observe the clinical effect of acupuncture intervention on abdominal obesity by stimulation of"Belt Vessel (Daimai) Regulation Acupoint Recipe".

METHODS:A total of 35 abdominal obesity outpatients were recuited in the present study. The"Belt Vessel (Daimai) Regulation Acupoint Recipe"was composed of Daimai (GB 26), Tianshu (ST25), Daheng (SP 15), Zhongwan (CV 12), Liangmen (ST 21), Shuidao (ST 28), Zusanli (ST 36), Shangjuxu (ST 37), Fenglong (ST 40) and Zulinqi (GB 41, both sides except CV 12). In addition, electroacupuncture was also applied to bilateral GB 26 and ST 25. The treatment was conducted once every other day, 8 weeks altogether. The body weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), Waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and body fat rate [ = 1.2 x BMI + 0.23 x age-5.4-10.8 x sex (male = 1, female = 0)] were measured or calculated. The thickness of abdominal adipose layer (i.e.; S1 = distance from the interface of the skin and subcutaneous fat to the linea alba abdominis at the midpoint between the xiphoid-process and the umbilicus; S2 = distance from the interface of the skin and subcutaneous fat to the anterior bounder of the external oblique muscle of abdomen on the right side closely to the umbilicus center) and visceral fat layer thickness (V 1 = distance from the midpoint of the linea alba abdominis to the anterior bounder of the vertebra body; V 2 = distance from the peritoneum to the right bounder of the vertebra body at the umbilicus level) were measured for calculating ultrasound viscerofatty index [UVI = (V 1 + V2)/(S 1 + S 2)] by using a color Doppler ultrasonography.

RESULTS:After 8 weeks' treatment, the body weight, BMI, waist and hips circumferences, WHtR and percentage of body fat were declined significantly (P<0.05, P<0.001). The WHR was decreased compared to that of pre-treatment, but without statistical significance (P>0.05). The thickness of abdominal subcutaneous adipose and visceral adipose layers and UVI were decreased significantly following the treatment (P<0.05, P<0.001). The reduction of visceral adipose layer was superior to that of the abdominal subcutaneous one (P<0.001).

CONCLUSION:Acupuncture intervention has a significant effect on reducing abdominal obesity in abdominal obesity patients.

OBJECTIVE:To observe the clinical effect of acupuncture intervention on abdominal obesity by stimulation of"Belt Vessel (Daimai) Regulation Acupoint Recipe".

METHODS:A total of 35 abdominal obesity outpatients were recuited in the present study. The"Belt Vessel (Daimai) Regulation Acupoint Recipe"was composed of Daimai (GB 26), Tianshu (ST25), Daheng (SP 15), Zhongwan (CV 12), Liangmen (ST 21), Shuidao (ST 28), Zusanli (ST 36), Shangjuxu (ST 37), Fenglong (ST 40) and Zulinqi (GB 41, both sides except CV 12). In addition, electroacupuncture was also applied to bilateral GB 26 and ST 25. The treatment was conducted once every other day, 8 weeks altogether. The body weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), Waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and body fat rate [ = 1.2 x BMI + 0.23 x age-5.4-10.8 x sex (male = 1, female = 0)] were measured or calculated. The thickness of abdominal adipose layer (i.e.; S1 = distance from the interface of the skin and subcutaneous fat to the linea alba abdominis at the midpoint between the xiphoid-process and the umbilicus; S2 = distance from the interface of the skin and subcutaneous fat to the anterior bounder of the external oblique muscle of abdomen on the right side closely to the umbilicus center) and visceral fat layer thickness (V 1 = distance from the midpoint of the linea alba abdominis to the anterior bounder of the vertebra body; V 2 = distance from the peritoneum to the right bounder of the vertebra body at the umbilicus level) were measured for calculating ultrasound viscerofatty index [UVI = (V 1 + V2)/(S 1 + S 2)] by using a color Doppler ultrasonography.

RESULTS:After 8 weeks' treatment, the body weight, BMI, waist and hips circumferences, WHtR and percentage of body fat were declined significantly (P<0.05, P<0.001). The WHR was decreased compared to that of pre-treatment, but without statistical significance (P>0.05). The thickness of abdominal subcutaneous adipose and visceral adipose layers and UVI were decreased significantly following the treatment (P<0.05, P<0.001). The reduction of visceral adipose layer was superior to that of the abdominal subcutaneous one (P<0.001).

CONCLUSION:Acupuncture intervention has a significant effect on reducing abdominal obesity in abdominal obesity patients.

This case report details the unexpected and sustained relief from chronic low back pain in a patient after a single acupuncture treatment. The treatment administered on that occasion was based on the jingjin (i.e.,"meridian sinew") model of traditional acupuncture. Treatments based on the jingjin model involve needling the ah shi (i.e., locally tender) points in myofascial tissue along the jingjin pathway. Tight chains can be needled to treat symptoms that are either close to or at some distance from the site of the needling treatment. In this patient, the points were in the gastrocnemius muscle and the hamstring muscles, which are part of the Bladder jingjin pathway. The patient, a 69-year-old woman, had had back pain for more than 40 years. The relief from the pain occurred within a day after the treatment and, at the time of this report, the relief has persisted for 5 months. This report examines two possible mechanisms for such a result: (1) a local increase in the extensibility of the hamstrings could be responsible or (2) the complex interactions within the central nervous system that are involved in acupuncture treatment could be more important factors.

Xerostomia is a common and usually irreversible side effects in patients receiving radiation therapy (> 50 Gy) for head and neck cancer. Of 38 patients with radiation-induced xerostomia, 20 in the experimental group were treated with classical acupuncture and 18 patients in the control group received superficial acupuncture as placebo. Within both groups the patients showed significantly increased salivary flow rates after the acupuncture treatment. In the experimental group 68% and in the control group 50% of the patients had increased salivary flow rates at the end of the observation period. Among those patients who had had all their salivary glands irradiated, 50% in both groups showed increased salivary flow rates (> 20%) by the end of the observation period of 1 year. The study indicates that among the patients who had increased salivary flow rates already after the first 12 acupuncture sessions, the majority had high probability of continual improvement after the completion of acupuncture treatment. The improved salivary flow rates usually persisted during the observation year. The changes observed in the control group were somewhat smaller and appeared after a longer latency phase. Significant differences for salivary flow rates could be observed only within each group, and there were no statistically significant differences between the groups. There were no differences in the improvement of salivary flow rates between those patients who were irradiated within a year before the acupuncture treatment and those who had received radiation therapy several years earlier. The results indicate that acupuncture might be a useful method for the treatment of radiation-induced xerostomia, and that superficial acupuncture should preferably not be used as placebo acupuncture.

Xerostomia is a common and usually irreversible side effects in patients receiving radiation therapy (> 50 Gy) for head and neck cancer. Of 38 patients with radiation-induced xerostomia, 20 in the experimental group were treated with classical acupuncture and 18 patients in the control group received superficial acupuncture as placebo. Within both groups the patients showed significantly increased salivary flow rates after the acupuncture treatment. In the experimental group 68% and in the control group 50% of the patients had increased salivary flow rates at the end of the observation period. Among those patients who had had all their salivary glands irradiated, 50% in both groups showed increased salivary flow rates (> 20%) by the end of the observation period of 1 year. The study indicates that among the patients who had increased salivary flow rates already after the first 12 acupuncture sessions, the majority had high probability of continual improvement after the completion of acupuncture treatment. The improved salivary flow rates usually persisted during the observation year. The changes observed in the control group were somewhat smaller and appeared after a longer latency phase. Significant differences for salivary flow rates could be observed only within each group, and there were no statistically significant differences between the groups. There were no differences in the improvement of salivary flow rates between those patients who were irradiated within a year before the acupuncture treatment and those who had received radiation therapy several years earlier. The results indicate that acupuncture might be a useful method for the treatment of radiation-induced xerostomia, and that superficial acupuncture should preferably not be used as placebo acupuncture.

A 45-year-old man presented with phantom limb pain and phantom limb sensation 12 weeks after an above-elbow amputation of his right arm. He underwent seven sessions of acupuncture at weekly intervals carried out by his general practitioner on his intact left arm, with complete relief of the phantom limb pain and considerable improvement of the phantom limb sensation of his right arm. This case demonstrates the possible benefits from the use of short acupuncture sessions for a potentially chronic condition undertaken within the constraints of a busy general medical practice.

A 45-year-old man presented with phantom limb pain and phantom limb sensation 12 weeks after an above-elbow amputation of his right arm. He underwent seven sessions of acupuncture at weekly intervals carried out by his general practitioner on his intact left arm, with complete relief of the phantom limb pain and considerable improvement of the phantom limb sensation of his right arm. This case demonstrates the possible benefits from the use of short acupuncture sessions for a potentially chronic condition undertaken within the constraints of a busy general medical practice.

Three case histories are presented in which amputees with acute or chronic phantom limb pain and phantom limb sensation were treated with Western medical acupuncture, needling the asymptomatic intact limb. Two out of the three cases reported complete relief of their phantom limb pain and phantom limb sensation. Acupuncture was successful in treating phantom phenomena in two of these cases, but a larger cohort study would be needed to provide more evidence for the success rate of this treatment technique for this indication.

OBJECTIVE:To explore the therapeutic effect of acupuncture in the treatment of polycystic ovarian syndrome (PCOS) patients with abdominal obesity by regulating glucose metabolism, insulin resistance, sex hormones, etc.

METHODS:Eligible PCOS volunteers were randomly divided into treatment group(=30) and control group(=28). The treatment group received acupuncture therapy three times a week combined with diet control and exercise. EA (2 Hz/100 Hz, 4-8 mA) was applied to bilateral Daimai (GB 26)and Tianshu (ST 25) for 20 min/time, and bilateral Daheng (SP 15), Shenshu (BL 23), Ciliao (BL 32), Guilai (ST 29), Zulinqi (GB 41) and Waiguan (SJ 5) were stimulated with filiform needles, with the needles retained for 20 min. Patients of the control group were asked to restrict intake of dietary calories (low fat, appropriate proteins, and high carbohydrate) and aerobic exercise (>40 min/time), 3 times/week. The treatment duration lasted 12 weeks. Before and after the treatment, serum fasting insulin (FINS), fasting blood-glucose (FBG), Testosterone (T), luteinizing hormone (LH) and follicle stimulating hormone (FSH) contents were assayed using immuno-fluorometry, the homeostasis model assessment of insulin resistance (HOMA -IR) and ratio of LH/FSH were calculated, and body mass index (BMI), waist circumference (WC) and waist-hip ratio (WHR) were measured, separately.

RESULTS:Comparison with their own individual pre-treatment, the levels of FINS, HOMA -IR, T, LH, LH/FSH, BMI, WC and WHR (not FBG) in both control and treatment groups were significantly decreased (<0.05,<0.01), and the levels of FINS, HOMA-IR and WC were significantly lower in the treatment group than in the control group (<0.01,<0.05). No marked differences were found between two groups in the levels of FBG, T, LH, LH/FSH, BMI and WHR (>0.05).

CONCLUSION:Acupuncture can effectively reduce FINS, HOMA-IR and WC levels in PCOS patients with abdominal obesity, down-regulating insulin resistance, which is significantly superior to simple diet control plus exercise.

BACKGROUND:Ovarian endometriotic cysts, also known as 'chocolate' cysts or ovarian endometriomas, appear as endometrial tissue outside the uterine cavity which grows inside ovaries. Endometriotic cysts can cause chronic pelvic pain, dysmenorrhea, dyspareunia, impairment of ovarian function in regards to subfertility, etc. Traditional Chinese Medicine (TCM) is effectively treating subfertility associated with endometriosis for years, and the treatment gives positive results in achieving pregnancy. With the acupuncture treatment, blood circulation is promoted, external physical factors - eliminated, the stasis is dissolved, the menstrual cycle is regulated, and inflammation is diminished.

CASE REPORT:Our treated patient is 29-year-old woman diagnosed with ovarian endometrioma, slightly - elevated prolactin levels and inability to get pregnant after trying for two years. Ningteen acupuncture treatments were done on the meridians of Pericardium, Spleen, Stomach, Liver, Ren Mai, Kidney, Large intestine, Du Mai and Bladder. After the acupuncture treatments, the endometrioma was decreased in size and the patient got pregnant spontaneously in a short period.

CONCLUSION:Acupuncture, as part of the TCM, gives positive results and can successfully add up to variety of non - surgical infertility treatment options in women with endometrioma(s).

OBJECTIVE:To evaluate the effects of acupuncture in the treatment of low back pain in pregnant women in the second and third trimesters of pregnancy.

METHOD:A quasi-experimental pre-post design was applied to pregnant women at a gestational age between 14 and 37 weeks, who had complaints of low back pain. Acupuncture sessions were performed, working systemic and auricular points. The McGill questionnaire was used to assess pain, as well as the instrument for identifying the sociodemographic, clinical and obstetric profile.

RESULTS:The acupuncture technique performed in up to six sessions in 56 pregnant women with low back pain had positive effects on the participants' health. According to the pain assessment, there was a statistically significant reduction in the low back pain among the pregnant women as early as in the second session, with a gradual improvement with the advancement of the number of sessions. There were no serious adverse events related to acupuncture.

CONCLUSION:Acupuncture offered significant effects for reducing or relieving pain in pregnant women. The participants expressed satisfaction and well-being as they left each session.

Obesity is a growing chronic health problem worldwide. Studies about acupuncture for obesity treatment are many. But there are some doubts about the effectiveness of acupuncture versus sham acupuncture in treating obesity due to its lack of medical evidence. Therefore, the aim of this study is to assess the efficacy of acupuncture for obesity treatment and provide clinic evidence. Four English databases (PubMed, EMBASE, Web of Science and Cochrane Central Register of Controlled Trials) and four Chinese databases (China National Knowledge Infrastructure, Chinese BioMedical Database, Chinese Scientific Journal Database and Wan-Fang Data) were searched from their receptions to August 2019. Randomized controlled trials (RCTs) using the comparison between acupuncture and sham acupuncture to treat simple obesity were included. The primary outcome of body mass index (BMI) would be used to measure the effect of acupuncture on obesity. According to the trial data extraction form based on the Cochrane Handbook, two reviewers separately extracted the data. Risk of bias of the RCTs was assessed by the Cochrane Risk of Bias Tool. The study included 8 RCTs with 403 patients. When compared with sham acupuncture, acupuncture showed obviously effect in BMI reduction (MD=1.0kg/m2, 95% CI=0.6 to 1.4, P<0.001). There was also significant reduction in body weight (MD=1.85kg, 95%CI=0.82 to 2.88, p<0.001), WC (MD=0.97cm, 95%CI=0.24 to 1.71, p=0.01) and body fat mass percentage (MD=1.01, 95%CI=0.25 to 1.77, p<0.05). However, WHR (MD=0.01, 95%CI=0 to 0.03, p>0.05) was not statistically and significantly different between the acupuncture and control groups. Adverse effects were reported in 3 studies. The review suggests that acupuncture is an effective therapy for simple obesity rather than a placebo effect. This potential benefit needs to be further evaluated by longer-term and more rigorous RCTs.

To study the biological effects of acupuncture on depression, we hypothesized that acupuncture will exert its antidepressant effect through a bottom-up neuromodulation of the autonomic dysfunction in depression. The participants received press needle (PN) acupuncture for 72 h continuously in a sham-controlled design. Psychological assessments and Holter electrocardiography were performed before and after PN acupuncture. We evaluated their autonomic functions through the heart rate variability (HRV). As a result, following PN acupuncture participants showed significant improvement in the Beck's Depression Inventory scores (P = 0.031), systolic/diastolic blood pressures (P = 0.002/P = 0.011), and coefficient of variation of the R-R interval (P < 0.0001), compared to sham PN. The present findings showed PN acupuncture induced alterations in vagal function, blood pressure, and Beck's Depression Inventory scores. It was suggested that vagal stabilization effect by acupuncture may be associated with the therapeutic mechanism in depression.

To study the biological effects of acupuncture on depression, we hypothesized that acupuncture will exert its antidepressant effect through a bottom-up neuromodulation of the autonomic dysfunction in depression. The participants received press needle (PN) acupuncture for 72 h continuously in a sham-controlled design. Psychological assessments and Holter electrocardiography were performed before and after PN acupuncture. We evaluated their autonomic functions through the heart rate variability (HRV). As a result, following PN acupuncture participants showed significant improvement in the Beck's Depression Inventory scores (P = 0.031), systolic/diastolic blood pressures (P = 0.002/P = 0.011), and coefficient of variation of the R-R interval (P < 0.0001), compared to sham PN. The present findings showed PN acupuncture induced alterations in vagal function, blood pressure, and Beck's Depression Inventory scores. It was suggested that vagal stabilization effect by acupuncture may be associated with the therapeutic mechanism in depression.

OBJECTIVE: This report of one case illustrates the potential effect of acupuncture on low back pain and curvature progression in adult degenerative scoliosis. CLINICAL FEATURES: A 74-year-old woman experienced low back pain and kyphoscoliosis for 2 years. She received regular rehabilitation and medications for 2 years, but the curvature of the lumbar spine and backache still progressed. The Cobb angle was 31 degrees and surgical intervention was suggested to reduce the pain. INTERVENTION AND OUTCOME: Before surgery, the patient was treated with acupuncture three times per week starting on May 29, 2008. After 6 weeks of treatment, the patient's lower backache decreased and follow-up radiographs showed that the Cobb angle decreased by 10 degrees . She underwent surgery on October 3 to have a better quality of life. CONCLUSIONS: Acupuncture was associated with a reduction in the degree of curvature in this case, after 2 years of conventional medical treatment had failed to stop the backache and curvature progression. This suggests that acupuncture not only plays an important role in pain control, but can also improve curvature progression for certain patients with degenerative scoliosis.