The spontaneous regression of herniated cervical discs is not a well-established phenomenon. However, we encountered a case of a spontaneous regression of a severe radiculopathic herniated cervical disc that was treated with acupuncture, pharmacopuncture, and herb medicine. The symptoms were improved within 12 months of treatment. Magnetic resonance imaging (MRI) conducted at that time revealed marked regression of the herniated disc. This case provides an additional example of spontaneous regression of a herniated cervical disc documented by MRI following non-surgical treatment.

Abstract Objectives: The purpose of this study was to investigate the levels of electromyographic (EMG) activation and maximal molar bite force before and after a 3-month acupuncture therapy in individuals with temporomandibular disorder (Helkimo Index) from a pool of subjects attending the Special Care Course of the Ribeirão Preto Dental School, São Paulo University, Brazil. Design: All 17 patients, aged between 37 and 50 years (44.2 +/- 4.84 years), with an average weight of 71 +/- 9.45 kg and height of 1.64 +/- 0.07 m, were clinically examined with regard to pain and dysfunctions of the masticatory system. The temporomandibular acupuncture points of needling were IG4, E6, E7, B2, VB14, VB20, ID18, ID19, F3, E36, VB34, E44, R3, and HN3. EMG measures were acquired before and after the treatment using a MyoSystem-BR1 electromyographer. The data collected at rest, protrusion, left and right laterality, and clenching were normalized by maximum voluntary contraction. Maximal bite force in right and left molar regions were registered using a dynamometer with a capacity of up to 1000 N, adapted for oral conditions. The highest value out of three recordings was considered to be the individual's maximal bite force. The results were statistically analyzed using the paired t test (SPSS version 15.0) during the comparison before and after treatment. Results: We found decreased EMG activity at rest, protrusion, left and right laterality, and clenching; as well as increased values of maximal bite force after acupuncture treatment. Conclusions: Acupuncture promoted alterations in the EMG activity of masticatory muscles, increased maximal molar bite force, and led to remission of the subjects' painful symptomatology.

Abstract Objectives: The purpose of this study was to investigate the levels of electromyographic (EMG) activation and maximal molar bite force before and after a 3-month acupuncture therapy in individuals with temporomandibular disorder (Helkimo Index) from a pool of subjects attending the Special Care Course of the Ribeirão Preto Dental School, São Paulo University, Brazil. Design: All 17 patients, aged between 37 and 50 years (44.2 +/- 4.84 years), with an average weight of 71 +/- 9.45 kg and height of 1.64 +/- 0.07 m, were clinically examined with regard to pain and dysfunctions of the masticatory system. The temporomandibular acupuncture points of needling were IG4, E6, E7, B2, VB14, VB20, ID18, ID19, F3, E36, VB34, E44, R3, and HN3. EMG measures were acquired before and after the treatment using a MyoSystem-BR1 electromyographer. The data collected at rest, protrusion, left and right laterality, and clenching were normalized by maximum voluntary contraction. Maximal bite force in right and left molar regions were registered using a dynamometer with a capacity of up to 1000 N, adapted for oral conditions. The highest value out of three recordings was considered to be the individual's maximal bite force. The results were statistically analyzed using the paired t test (SPSS version 15.0) during the comparison before and after treatment. Results: We found decreased EMG activity at rest, protrusion, left and right laterality, and clenching; as well as increased values of maximal bite force after acupuncture treatment. Conclusions: Acupuncture promoted alterations in the EMG activity of masticatory muscles, increased maximal molar bite force, and led to remission of the subjects' painful symptomatology.

PURPOSE OF REVIEW:Aromatase inhibitor-induced arthralgia (AIA) is a very common syndrome which significantly affects breast cancer survivors' quality of life, and it often leads to non-compliance with aromatase inhibitor (AI) therapy. However, the treatment of AIA remains a clinical challenge. Here, we will review the current data for acupuncture and vitamin D in the management of AIA.

RECENT FINDINGS:Acupuncture has been shown to improve AIA symptoms, but it has not consistently been proven to offer significantly more clinical benefit than sham acupuncture. Similarly, while some vitamin D trials have shown benefit, the studies have not consistently shown improvement in AIA symptoms. Neither acupuncture nor vitamin D can be touted as standard treatments for AIA. However, many patients do experience subjective improvement of their symptoms with these therapies. When other treatments, such as exercise and duloxetine, are not feasible or not effective, it is reasonable to offer a trial of acupuncture or vitamin D to patients who are suffering from AIA, as the potential harms are very few, and they do offer possible relief from AIA symptoms.

BACKGROUND:Acupuncture and other modalities of Chinese/East Asian medicine have been used to treat women's health for many centuries. Gynecology specialties focus particularly on menstrual and reproductive disorders. Both the adoption of the use of acupuncture outside Asia, and the incorporation of scientific analysis in Asia have challenged biomedical conceptions of what can be achieved with this treatment method. The scale of research activity in relation to acupuncture and women's health has increased over the last 20 years.

OBJECTIVE:This review aims to explore the research evidence in relation to acupuncture use for women's reproductive disorders, focusing on both clinical findings and experimental research on acupuncture's mechanisms of action in relation to women's health.

METHODS:A narrative literature search was undertaken using searches of electronic databases and manual searches of journals and textbooks. The search included all literature published prior to June 2013. The literature was assessed as to the nature of the study it was reporting and findings synthesized into a commentary.

RESULTS:For acupuncture's mechanism of action the search resulted in 114 relevant documents; in relation to clinical reports on the use of acupuncture for women's health 204 documents were found and assessed.

CONCLUSION:There is preliminary data indicating acupuncture may improve menstrual health and coping for women experiencing delays falling pregnant. There is experimental data showing that acupuncture can influence female reproductive functioning, although the actual mechanisms involved are not yet clarified. Further well-conducted clinical research would benefit our understanding of the usefulness of acupuncture to women's health.

OBJECTIVE: To observe therapeutic effect of acupuncture on peripheral diabetic neuropathies in the African area. METHODS: Five Shiu points on the four limbs were selected. Jing (well-point) was needled by pricking method for blood letting, and acupuncture was given at points Xing (spring-point), Shu (stream-point), Jing (river-point) and He (sea-point), and after arrival of qi, the needles were retained for 30 min, once every other day, for 2 therapeutic courses. RESULTS: Forty-five cases were markedly effective and 68 cases were effective, the total effective rate being 89.68%. CONCLUSION: Acupuncture has obvious therapeutic effect on diabetic neuropathies in the African area.

OBJECTIVE: To observe therapeutic effect of acupuncture on peripheral diabetic neuropathies in the African area. METHODS: Five Shiu points on the four limbs were selected. Jing (well-point) was needled by pricking method for blood letting, and acupuncture was given at points Xing (spring-point), Shu (stream-point), Jing (river-point) and He (sea-point), and after arrival of qi, the needles were retained for 30 min, once every other day, for 2 therapeutic courses. RESULTS: Forty-five cases were markedly effective and 68 cases were effective, the total effective rate being 89.68%. CONCLUSION: Acupuncture has obvious therapeutic effect on diabetic neuropathies in the African area.

BACKGROUND:Acupuncture has been associated with improved cerebral circulation, analgesia, neuromodulatory function and neurogenesis. In particular, acupuncture at ST36 has been widely used in several central nervous system (CNS) disorders, including neurodegenerative diseases. However, its effects on hydrocephalus have not been studied. Our aim was to evaluate the effects of acupuncture at ST36 on behaviour, motor development and reactive astrogliosis in infantile rats with hydrocephalus.

METHODS:Hydrocephalus was induced in sixteen 7-day-old pup rats by injection of 20% kaolin into the cisterna magna. One day after hydrocephalus induction, acupuncture was applied once daily (for 30 min) for a total of 21 days in eight randomly selected animals (HAc group) while the remaining eight remained untreated (H group). An additional eight healthy animals were included as controls (C group). All animals were weighed daily and, from the fifth day after hydrocephalus induction, underwent MRI to determine the ventricular ratio (VR). Rats were also exposed to modified open-field tests every 3 days until the end of the experiment. After 21 days all the animals were euthanased and their brains removed for histology and immunohistochemistry.

RESULTS:Hydrocephalic rats showed an increase in VR when compared with control rats (P<0.01). In addition, these animals exhibited delayed weight gain, which was attenuated with acupuncture treatment. Hydrocephalic animals treated with acupuncture performed better in open field tests (P<0.05), and had a reduction in reactive astrocyte cell density in the corpus callosum and external capsule, as assessed by GFAP (glial fibrillary acidic protein) immunohistochemistry (P<0.05).

CONCLUSIONS:These findings indicate that acupuncture at ST36 has a neuroprotective potential mediated, in part, by inhibition of astrogliosis.

OBJECTIVE:To compare the efficacy differences between acupuncture at Zhibian (BL 54) through Shuidao (ST 28) and regular acupuncture for polycystic ovary syndrome.

METHODS:One hundred and one patients, by using random digital table, were randomly divided into an observation group (49 cases) and a control group (52 cases). Patients in the observation group were treated with acupuncture at Zhibian (BL 54) through Shuidao (ST 28) as main acupoints, and accompanied acupoints were selected according to syndrome differentiation. Elongated needles (175 mm in length) were inserted at Zhibian (BL 54) with an angle of 200 with sagittal plane. The insertion depth was 100-115 mm, reaching Shuidao (ST 28) and making acupuncture sensation arrive at diseased location. Patients in the control group were treated at the same acupoints with regular acupuncture technique. The menstruation condition was ignored for patients in both groups. The treatment was given once a day, 15 times as one session, and 5 consecutive sessions were given. The basic temperature and level of sex hormone were observed before and after treatment in the two groups, and clinical efficacy was compared.

RESULTS:The cured rate was 65.3% (32/49) and the effective rate was 91.8% (45/49) in the observation group after treatment, which was significantly superior to 48.1% (25/52) and 63.5% (33/52) in the control group (both P<0.01). The number of patients with typical biphasic fever and patients with atypical biphasic fever in the observation group was higher, than that in the control group, but that of unidirectional temperature was less than that in the control group (P<0.05). After treatment, the follicle-stimulating hormone (FSH), luteinizing hormone (LH), LH/FSH, testos terone (T) were significantly reduced in the observation group (P<0.01, P<0.05); the LH and T were also apparently reduced in the control group (P<.01, P<0.05). The reduction of FSH, LH, LH/FSH and T in the observation group after treatment was more significant than that in the control group (P<0.05, P<0.01).

CONCLUSION:Acuouncture at Zhibian (BL 54) through Shuidao (ST 28) could significantly improve the basic temperature of patients with polycystic ovary syndrome, and regulate hormone level of reproductive endocrine, which is superior to regular acupuncture.

OBJECTIVE:To compare the efficacy differences between acupuncture at Zhibian (BL 54) through Shuidao (ST 28) and regular acupuncture for polycystic ovary syndrome.

METHODS:One hundred and one patients, by using random digital table, were randomly divided into an observation group (49 cases) and a control group (52 cases). Patients in the observation group were treated with acupuncture at Zhibian (BL 54) through Shuidao (ST 28) as main acupoints, and accompanied acupoints were selected according to syndrome differentiation. Elongated needles (175 mm in length) were inserted at Zhibian (BL 54) with an angle of 200 with sagittal plane. The insertion depth was 100-115 mm, reaching Shuidao (ST 28) and making acupuncture sensation arrive at diseased location. Patients in the control group were treated at the same acupoints with regular acupuncture technique. The menstruation condition was ignored for patients in both groups. The treatment was given once a day, 15 times as one session, and 5 consecutive sessions were given. The basic temperature and level of sex hormone were observed before and after treatment in the two groups, and clinical efficacy was compared.

RESULTS:The cured rate was 65.3% (32/49) and the effective rate was 91.8% (45/49) in the observation group after treatment, which was significantly superior to 48.1% (25/52) and 63.5% (33/52) in the control group (both P<0.01). The number of patients with typical biphasic fever and patients with atypical biphasic fever in the observation group was higher, than that in the control group, but that of unidirectional temperature was less than that in the control group (P<0.05). After treatment, the follicle-stimulating hormone (FSH), luteinizing hormone (LH), LH/FSH, testos terone (T) were significantly reduced in the observation group (P<0.01, P<0.05); the LH and T were also apparently reduced in the control group (P<.01, P<0.05). The reduction of FSH, LH, LH/FSH and T in the observation group after treatment was more significant than that in the control group (P<0.05, P<0.01).

CONCLUSION:Acuouncture at Zhibian (BL 54) through Shuidao (ST 28) could significantly improve the basic temperature of patients with polycystic ovary syndrome, and regulate hormone level of reproductive endocrine, which is superior to regular acupuncture.

OBJECTIVES: Acupuncture has been known to be effective in ischemia, and glutamate excitotoxicity is an important factor for the neuronal cell death. We examined the effect of acupuncture on glutamate level in the ischemic stroke model. METHODS: A global ischemia was induced using the method of 11-vessel occlusion in rat. Rats were randomly divided into two groups: the control group (n=5, with 11-vessel occlusion) and the acupuncture group (n=5, with 11-vessel occlusion + acupuncture). The extracellular glutamate level was assessed using an intracerebral biosensor system measuring 256 samples per second. Simultaneously, the cerebral blood flow was measured and the electroencephalogram data were recorded. The time schedule of the experiment was as follows: 10 minutes of baseline measurement, 10 minutes of occlusion and 30 minutes of follow-up monitoring. Acupuncture stimulation was applied to the acupuncture points GB34 (Yangneungcheon) and GB39 (Hyeonjong) during the occlusion period. RESULTS: In the control group, the extracellular glutamate level was changed as 135.19 +/- 23.76 microM (mean +/- standard deviation) from the baseline level. However, this increase was suppressed in the acupuncture group (72.20 +/- 27.15 microM, p<0.01 versus the control group). The changes of cerebral blood flow and electroencephalogram were not significantly different between the groups. DISCUSSION: This result suggests that the effect of acupuncture might be closely associated with modulation of the brain glutamate release in the ischemic condition.

OBJECTIVES: Acupuncture has been known to be effective in ischemia, and glutamate excitotoxicity is an important factor for the neuronal cell death. We examined the effect of acupuncture on glutamate level in the ischemic stroke model. METHODS: A global ischemia was induced using the method of 11-vessel occlusion in rat. Rats were randomly divided into two groups: the control group (n=5, with 11-vessel occlusion) and the acupuncture group (n=5, with 11-vessel occlusion + acupuncture). The extracellular glutamate level was assessed using an intracerebral biosensor system measuring 256 samples per second. Simultaneously, the cerebral blood flow was measured and the electroencephalogram data were recorded. The time schedule of the experiment was as follows: 10 minutes of baseline measurement, 10 minutes of occlusion and 30 minutes of follow-up monitoring. Acupuncture stimulation was applied to the acupuncture points GB34 (Yangneungcheon) and GB39 (Hyeonjong) during the occlusion period. RESULTS: In the control group, the extracellular glutamate level was changed as 135.19 +/- 23.76 microM (mean +/- standard deviation) from the baseline level. However, this increase was suppressed in the acupuncture group (72.20 +/- 27.15 microM, p<0.01 versus the control group). The changes of cerebral blood flow and electroencephalogram were not significantly different between the groups. DISCUSSION: This result suggests that the effect of acupuncture might be closely associated with modulation of the brain glutamate release in the ischemic condition.

OBJECTIVES: This study was designed to investigate the neuroprotective effect of acupuncture in the middle cerebral artery occlusion-induced ischemia model. METHODS: Sprague-Dawley rats were randomly divided into two experimental groups: middle cerebral artery occlusion group (MCAO, n=8), and middle cerebral artery occlusion plus acupuncture group (MCAO + Acu, n=8). Acupuncture stimulation was given immediately after reperfusion. The effect of its stimulation to both GB34 and GB39 on the size of the brain infarct and the functional status of the brain cells after middle cerebral artery occlusion was examined by nissl staining and neuron-specific nuclear protein immunohistochemistry. RESULTS: The infarction volume was significantly decreased in the MCAO + Acu group (16.4 +/- 4.8%), compared with the MCAO group (39.9 +/- 10.2%). The number of neuron-specific nuclear protein-positive cells in the MCAO group was significantly decreased by 42.3 +/- 12.6% in the striatum and by 45.8 +/- 5.8% in the motor cortex, but the neuron-specific nuclear protein-positive cells in the MCAO + Acu group were rescued by 67.0 +/- 3.8% in the striatum and by 68.1 +/- 4.5% in the motor cortex, compared with the contralateral side (100%). DISCUSSION: This study showed that acupuncture had neuroprotective effects against focal ischemia in the middle cerebral artery occlusion model.

OBJECTIVES: This study was designed to investigate the neuroprotective effect of acupuncture in the middle cerebral artery occlusion-induced ischemia model. METHODS: Sprague-Dawley rats were randomly divided into two experimental groups: middle cerebral artery occlusion group (MCAO, n=8), and middle cerebral artery occlusion plus acupuncture group (MCAO + Acu, n=8). Acupuncture stimulation was given immediately after reperfusion. The effect of its stimulation to both GB34 and GB39 on the size of the brain infarct and the functional status of the brain cells after middle cerebral artery occlusion was examined by nissl staining and neuron-specific nuclear protein immunohistochemistry. RESULTS: The infarction volume was significantly decreased in the MCAO + Acu group (16.4 +/- 4.8%), compared with the MCAO group (39.9 +/- 10.2%). The number of neuron-specific nuclear protein-positive cells in the MCAO group was significantly decreased by 42.3 +/- 12.6% in the striatum and by 45.8 +/- 5.8% in the motor cortex, but the neuron-specific nuclear protein-positive cells in the MCAO + Acu group were rescued by 67.0 +/- 3.8% in the striatum and by 68.1 +/- 4.5% in the motor cortex, compared with the contralateral side (100%). DISCUSSION: This study showed that acupuncture had neuroprotective effects against focal ischemia in the middle cerebral artery occlusion model.

BACKGROUND:It is important to manage inflammation after craniotomy. It may be prudent to reduce the excessive usage of antibiotics and to add supplementary treatments like acupuncture, which would be effective and safe. However, there are only a few studies available to date on the effects of acupuncture on anti-inflammatory response after craniotomy. The aim of this study was to explore the anti-inflammatory effects of acupuncture in patients after a craniotomy.

METHODS:This study was a single-center, prospective, open-label, controlled trial. Forty-four subjects who underwent craniotomy for an unruptured aneurysm, facial spasm, or brain tumor were allocated to either an acupuncture group or a control group. Both groups received postoperative routine care in the Department of Neurosurgery. The subjects in the acupuncture group also received a total of 6 acupuncture treatments sessions within 8 days after craniotomy. Acupuncture treatments included acupuncture, electroacupuncture, and intradermal acupuncture. The serum interleukin (IL)-1β and IL-6, tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and erythrocyte sedimentation rate levels were assessed four times within 7 days after surgery. The presence of fever, use of additional antibiotics, presence of infection including pneumonia or urinary tract infection, and safety were also reviewed.

RESULTS:The IL-1β levels of subjects who underwent aneurysmal clipping were significantly lower in the acupuncture group (P = .02). TNF-α levels of subjects who underwent aneurysmal clipping at the seventh postoperative day were also significantly lower in the acupuncture group (P = .03). Six cases of fever of unknown origin were observed in the control group, while none were seen in the acupuncture group, revealing that the incidence of fever was significantly lower in the acupuncture group (P = .02). No adverse events occurred during the trial.

CONCLUSION:Acupuncture showed a possibility of alleviating inflammation by attenuating the levels of proinflammatory cytokines and significantly reduced the incidence of fever of unknown origin in patients after craniotomy. Acupuncture would be suitable as an adjunctive therapy to alleviate inflammation after craniotomy.

BACKGROUND The aim of this pragmatic study was to explore the intervention of acupuncture combined with hydrotherapy and perceived effects in type 2 diabetic patients with recently diagnosed, mild, lower-extremity arterial disease (LEAD) in comparison with a control group. MATERIAL AND METHODS One hundred twenty-six diabetes patients who were diagnosed mild LEAD according to ankle-brachial blood pressure index (ABPI) and peripheral neuropathy symptom were randomly assigned to either an experimental (n=64) or control group (n=62). The experimental group attended and completed (1) a 30-min session of acupuncture in certain selected points, and (2) a 30-min hydrotherapy exercise every 2 days for 15 weeks. The outcome parameters were assessed at baseline, after intervention, and at 6-week follow-up. RESULTS The intervention was associated with an improvement in leg flow conductance and partial physical capacities, including chair-sit-and-reach, the walking impairment questionnaire (WIQ), and physical component summary score (PCS), compared to the control group. The treatment benefits were sustained throughout the 6-week follow-up endpoint. There was no difference in fasting glucose levels, Hb1Ac, blood pressure, or BMI after the intervention. At the endpoint of 6-week follow-up, acupuncture plus hydrotherapy appeared to reduce inflammatory response by decreasing IL-6, TNF-α, malondialdehyde, and SOD, and increasing glutathione. CONCLUSIONS Acupuncture plus hydrotherapy, without significant glycemic-controlling effects in the type 2 diabetic patients with mild LEAD, exerts a measurable benefit in disease-specific physical functions and health-related quality of life.Our results suggest that the combined therapy regulates the inflammatory process and oxidative stress and contributes to immune protection.

BACKGROUND:Patients with rheumatoid arthritis (RA) have a higher risk of coronary heart disease (CHD). Acupuncture, a commonly used treatment for patients with RA, has not been reported to prevent CHD in patients with RA. We aimed to assess the risk of developing CHD in acupuncture users and non-users of patients with RA.

METHODS:We identified 29,741 patients with newly diagnosed RA from January 1997 to December 2010 from the Registry of Catastrophic Illness Patients Database from the Taiwanese National Health Insurance Research Database. Among them, 10,199 patients received acupuncture (acupuncture users), and 19,542 patients did not receive acupuncture (no-acupuncture users). After performing 1:1 propensity score matching by sex, age, baseline comorbidity, conventional treatment, initial diagnostic year, and index year, there were 9932 patients in both the acupuncture and no-acupuncture cohorts. The main outcome was the diagnosis of CHD in patients with RA in the acupuncture and no-acupuncture cohorts.

RESULTS:Acupuncture users had a lower incidence of CHD than non-users (adjusted HR = 0.60, 95% CI = 0.55-0.65). The estimated cumulative incidence of CHD was significantly lower in the acupuncture cohort (log-rank test, p < .001). Subgroup analysis showed that patients receiving manual acupuncture of traditional Chinese medicine style, electroacupuncture, or combination of both all had a lower incidence of CHD than patients never receiving acupuncture treatment. The beneficial effect of acupuncture on preventing CHDwas independent of age, sex, diabetes mellitus, hypertension, hyperlipidemia, and statins use.

CONCLUSIONS:This is the first large-scale study to reveal that acupuncture might have beneficial effect on reducing the risk of CHD in patients with RA. This study may provide useful information for clinical utilization and future studies.

The therapeutic effects of acupuncture in decreasing blood pressure are ambiguous and underlying acupuncture in hypertension treatment has not been investigated. Our objective was to observe the change of quality of life and compare the differences in brain functional connectivity by investigating instantaneous and short-term acupuncture treatment in essential hypertension patients. A total of 30 patients were randomly divided into the LR3 group and sham acupoint group. Subjects received resting-state fMRI among preacupuncture, postinstantaneous, and short-term acupuncture treatment in two groups. Hypothalamus was selected as the seed point to analyze the changes in connectivity. We found three kinds of results: (1) There was statistical difference in systolic blood pressure in LR3 group after the short-term treatment and before acupuncture. (2) Compared with sham acupoint, acupuncture at LR3 instantaneous effects in the functional connectivity with seed points was more concentrated in the frontal lobe. (3) Compared with instantaneous effects, acupuncture LR3 short-term effects in the functional connectivity with seed points had more regions in frontal lobe, cerebellum, and insula. These brain areas constituted a neural network structure with specific functions that could explain the mechanism of therapy in hypertension patients by LR3 acupoint.