Parkinson's disease (PD) is a common neurodegenerative disease. The pathological hallmark of PD is a progressive loss of dopaminergic neurons in the substantia nigra (SN) pars compacta in the brain, ultimately resulting in severe striatal dopamine deficiency and the development of primary motor symptoms (e.g., resting tremor, bradykinesia) in PD. Acupuncture has long been used in traditional Chinese medicine to treat PD for the control of tremor and pain. Accumulating evidence has shown that using electroacupuncture (EA) as a complementary therapy ameliorates motor symptoms of PD. However, the most appropriate timing for EA intervention and its effect on dopamine neuronal protection remain unclear. Thus, this study used the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-lesioned mouse model (systemic-lesioned by intraperitoneal injection) and the 1-methyl-4-phenylpyridinium (MPP⁺)-lesioned rat model (unilateral-lesioned by intra-SN infusion) of PD, to explore the therapeutic effects and mechanisms of EA at the GB34 (Yanglingquan) and LR3 (Taichong) acupoints. We found that EA increased the latency to fall from the accelerating rotarod and improved striatal dopamine levels in the MPTP studies. In the MPP⁺ studies, EA inhibited apomorphine induced rotational behavior and locomotor activity, and demonstrated neuroprotective effects via the activation of survival pathways of Akt and brain-derived neurotrophic factor (BDNF) in the SN region. In conclusion, we observedthat EA treatment reduces motor symptoms of PD and dopaminergic neurodegeneration in rodent models, whether EA is given as a pretreatment or after the initiation of disease symptoms. The results indicate that EA treatment may be an effective therapy for patients with PD.

Amyotrophic lateral sclerosis (ALS) is a paralyzing disorder that is characterized by the progressive degeneration and death of motor neurons. Acupuncture or electroacupuncture (EA) has been used for the treatment of various conditions including osteoarthritis, asthma, and other types of chronic pain conditions. It has been hypothesized that acupuncture exerts anti-inflammatory and anti-nociceptive effects on inflammatory reactions processes. The purpose of this study was to determine whether acupuncture at a specific acupoint could produce anti-inflammatory responses and suppress motor neuron loss in the hG93ASOD1 mouse, commonly used as a model for inherited ALS. We delivered EA at the Zusanli (ST36) acupuncture point in the symptomatic hSOD1G93A animal model. The EA-treated mutant hSOD1 transgenic mice showed decreases in microglial cell activity and TNF-alpha expression in the spinal cord and brain stem. Furthermore, EA significantly improved motor activity compared to the control group and reduced neuronal cell loss in hSOD1G93A mice. Our research suggests a potential functional link between EA therapy and anti-neuroinflammatory response in an ALS animal model.

Inflammation after stroke is the main cause of cerebral ischemia/reperfusion injury. Cascading events after injury can lead to cell death. Heat shock protein 70 and other endogenous injury-signaling molecules are released by damaged cells, which can lead to systemic stress reactions. Protecting the brain through repair begins with the stress-injury-repair signaling chain. This study aimed to verify whether acupuncture acts through this chain to facilitate effective treatment of ischemic stroke. Rat models of cerebral ischemia/reperfusion injury were established by Zea Longa's method, and injury sites were identified by assessing neurological function, 2,3,5-triphenyltetrazolium chloride staining, and hematoxylin-eosin staining. Electroacupuncture at acupoints Baihui (DU20) and Zusanli (ST36) was performed in the model rats with dilatational waves, delivered for 20 minutes a day at 2-100 Hz and an amplitude of 2 mA. We analyzed the blood serum from the rats and found that inflammatory cytokines affected the levels of adrenotrophin and heat shock protein 70, each of which followed a similar bimodal curve. Specifically, electroacupuncture lowered the peak levels of adrenocorticotrophic hormone and heat shock protein 70. Thus, electroacupuncture was able to inhibit excessive stress, reduce inflammation, and promote the repair of neurons, which facilitated healing of ischemic stroke.

OBJECTIVES: To investigate the clinical effect of electroacupuncture (EA) for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). METHODS: We recruited 63 participants meeting the U.S. National Institutes of Health (NIH) consensus criteria for CP/CPPS. After the inclusion/exclusion criteria were applied, 39 men were randomized to 3 treatment groups: group 1, advice and exercise plus 12 sessions of EA; group 2, advice and exercise plus 12 sessions of sham EA (SEA); and group 3, advice and exercise alone (A&E) for 6 weeks. A total of 6 acupuncture points were used to stimulate the sacral nerve and release the piriformis muscle using an electrical pulse generator. Symptoms related to CP/CPPS were assessed using the NIH-Chronic Prostatitis Symptom Index (NIH-CPSI). Prostaglandin E(2) and beta-endorphin levels in postmassage urine samples were measured using an enzyme-linked immunosorbent assay. RESULTS: At 6 weeks, the NIH-CPSI total score had decreased significantly in the EA group compared with the SEA and A&E groups (P < .001). On a subscale analysis of the NIH-CPSI, the EA group showed significant decreases in pain-related symptoms compared with the SEA and A&E groups (P < .01). All 12 EA participants experienced at least a 6-point decrease in the NIH-CPSI total score compared with 2 of 12 SEA participants (16.7%) and 3 of 12 A&E participants (25.0%; P < .0001). The mean prostaglandin E(2) level in the postmassage urine samples had significantly decreased in the EA group (P = .023). In contrast, it had increased in the other 2 groups. CONCLUSIONS: In a 3-arm randomized trial investigating the clinical effects of EA on CP/CPPS, EA therapy proved to have independent therapeutic effects, particularly for pain relief superior to SEA or A&E therapy.

Electroacupuncture (EA) is reported to effectively relieve the central poststroke pain (CPSP). However, the underlying mechanism remains unclear. The present study investigated the detailed mechanisms of action of EA treatment at different frequencies for CPSP. A CPSP model was established with a single collagenase injection to the left ventral posterolateral nucleus of the thalamus. The EA-treated groups then received EA treatment at frequency of 2, 2/15, or 15 Hz for 30 min daily for five days. The pain-related behavioral responses, neuronal apoptosis, glial activation, and the expression of pain signal transmission-related factors (β-catenin, COX-2, and NK-1R) were assessed using behavioral tests, Nissl staining, TUNEL staining, and immunohistochemical staining, respectively. The low-frequency EA treatment significantly (1) reduced brain tissue damage and hematoma sizes and (2) inhibited neuronal apoptosis, thereby exerting abirritative effects. Meanwhile, the high-frequency EA treatment induced a greater inhibition of the aberrant astrocyteactivation, accompanied by the downregulation of the expressions of COX-2, β-catenin, and subsequently NK-1R, thereby alleviating inflammation and producing strong analgesic effects. Together, these findings suggest that CPSP is closely related to pathological changes of the neocortex and hippocampus. EA treatments at different frequencies may exert abirritative effects by inhibiting brain neuronal apoptosis and aberrant astrocyte activation in the brain.

Sleep disturbance is considered as an important symptom of acute and protracted opiate withdrawal. Current results suggest that sleep disturbance may be taken as a predictor of relapse. Appropriate sleep enhancement therapy will be in favor of the retention in treatment for opiate addicts. Our previous studies have shown that electroacupuncture (EA) is effective in suppressing morphine withdrawal syndrome. The aim of the present study is to investigate the effect of 2 and 100 Hz EA on the sleep disturbance during morphine withdrawal. Rats were made dependent on morphine by repeated morphine injections (escalating doses of 5-80 mg kg(-1), subcutaneously, twice a day) for 5 days. EA of 2 or 100 Hz was given twice a day for 3 days, starting at 48 h after the last morphine injection. Electroencephalogram and electromyogram were monitored at the end of the first and the last EA treatments, respectively. Results showed that non-rapid eye movement (NREM) sleep, REM sleep and total sleep time decreased dramatically, while the sleep latency prolonged significantly during acute morphine withdrawal. Both 2 and 100 Hz EA produced a significant increase in NREM sleep, REM sleep and total sleep time. It was suggested that EA could be a potential treatment for sleep disturbance during morphine withdrawal.

BACKGROUND: Due to the quick rhythm of life and work pressure, more and more people suffer from sleep quality problems. In this study, we investigated the effect of electroacupuncture on sleep quality of chronic insomniacs and the safety of electroacupuncture therapy. METHODS: Four courses of electroacupuncture treatment were applied to 47 patients. With pre-treatment and post-treatment self-control statistical method, Pittsburgh sleep quality index (PSQI) scores were used for evaluating sleep quality. Polysomnogram was used for detecting insomniacs' changes in sleep architecture. The safety of electroacupuncture was evaluated by monitoring the self-designed adverse events and side effects during treatment and post-treatment. RESULTS: Electroacupuncture considerably improved insomniacs' sleep quality and social function during the daytime. Electroacupuncture had certain repairing effect on the disruption in sleep architecture. At the same time, electroacupuncture prolonged slow wave sleep (SWS) time and relatively rapid eye movement sleep (REM sleep) time. There was no hangover, addiction or decrements in vigilance during the daytime (incidence rate was 0). However, insomnia rebound rate was about 23% within one month. CONCLUSIONS: These results suggest that electroacupuncture has beneficial effect on sleep quality improvement in the patients with chronic insomnia, which may be associated with repairing sleep architecture, reconstructing sleep continuity, as well as prolonging SWS time and REM sleep time. Electroacupuncture treatment for chronic insomnia is safe. Therefore, electroacupuncture therapy could be a promising avenue of treatment for chronic insomnia.

Nonalcoholic fatty liver disease (NAFLD) is considered one of the most common and most important conditions affecting the liver, because of its increasing prevalence all over the world. It is usually associated with elevated liver enzymes and ranges from simple steatosis to liver cirrhosis. This study was conducted to compare the effects of electroacupuncture (EA) versus aerobic interval training (AIT) exercise and how they affect liver functions in people suffering from nonalcoholic fatty liver.This study was carried out on 50 female patients suffering from NAFLD with age ranging from 30 to 55 years; they were randomly divided into two equal groups: group A received (EA) stimulation at points of liver 3 (LR3), liver 14 (LR14), gall bladder 34 (GB34), and stomach 36 (ST36), whereas group B received AIT exercise. All patients in both groups A and B received 3 sessions per week for 6 weeks (receiving noninterrupted 18 sessions) in addition to their standard medications. Evaluation of all patients in both groups A and B was carried out before and after the treatment program by measuring the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), triglycerides (TGs), and C-reactive protein (CRP).There is a significant decrease ( < 0.05) of ALT, AST, TGs, and CRP within each group, A and B, after 6 weeks of treatment sessions. A significant difference post-treatment was found between both groups in ALT, AST, and TGs ( < 0.05). However, there was no significant difference in CRP ( > 0.05) between both groups post-treatment.It can be concluded that both EA and AIT exercise are potent modalities that improve liver functions in people with NAFLD with better effect toward EA.

OBJECTIVE:We aimed to explore the feasibility of evaluating the comparative effectiveness and safety of electroacupuncture (EA) relative to manual acupuncture (MA) for the treatment of knee osteoarthritis (KOA).

METHODS:A multicenter randomized controlled clinical trial was conducted in Beijing from September 2017 to January 2018. A total of 60 participants with KOA were randomly allocated to either EA ( = 30) or MA ( = 30) groups. Participants in the EA group were treated with EA at six to seven local traditional acupuncture points orpoints, and two to three distal points. Participants in the MA group had the same schedule as the EA group except that the electrical apparatus featured a working power indicator without actual current output, constituting a sham EA procedure, in order to blind participants. Both groups received 24 sessions over 8 weeks. The primary outcome was response rate, defined as a change of ⩾50% from baseline in the total scores of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) after 8 weeks. Secondary outcomes included pain, stiffness, function, quality of life, and acupuncture-related adverse events (AEs) at 4 and 8 weeks.

RESULTS:Of 60 participants randomized, 53 (88%) completed the study. Response rates were 43% for the EA group and 30% for the MA group by the intention-to-treat analysis. Although significant differences were observed in WOMAC pain, stiffness, and function scores within both groups, between-group differences at 8 weeks did not reach statistical significance (odds ratio = 1.75 (95% confidence interval = 0.593-5.162)). Rates of AEs were low and similarly distributed between groups.

CONCLUSION:Both EA and MA interventions in KOA were feasible and appeared safe. Whether or not EA may have a stronger impact on pain and function requires further evaluation through larger, adequately powered, randomized controlled trials.

TRIAL REGISTRATION NUMBER:NCT03274713.

OBJECTIVE: To observe the therapeutic effect of electroacupuncture (EA) warming therapy on myasthenia gravis (MG) and effect on IL-4 in the patient. METHODS: Sixty patients with MG were randomly divided into two groups, 30 patients in each group. The observation group were treated with EA warming therapy with Tanzhong (CV 17), Shimen (CV 5), Guanyuan (CV 4), Zhongwan (CV 12), Yanglingquan (GB 34) selected as main points, and oral administration of Pyridostigmine (90 - 240 mg each day) and Prednisone (30 - 60 mg each day). The control group were treated with oral administration of Pyridostigmine (240-480 mg each day) and Prednisone (60-100 mg each day). Clinical therapeutic effects and serum Interleukin-4 (IL-4) levels before and after treatment were observed. RESULTS: The total effective rate was 93.3% in the observation group, which was better than 70.0% in the control group (P < 0.01); after treatment, the serum IL-4 levels in the two groups significantly decreased (P < 0.01), the decrease of IL-4 in the observation group being significantly better than the control group (P < 0.05). CONCLUSION: EA warming therapy combined with western medicine has a significant therapeutic effect on myasthenia gravis. One of the mechanisms possibly is to restrain specific immune reaction by regulating the level of IL-4.

BACKGROUND AND AIMS:The role of electroacupuncture (EA) in reducing sedative and analgesic requirements during EUS is uncertain. The aim of the current study is to investigate the efficacy of EA in reducing procedure-related pain and discomfort during EUS.

METHODS:This was a double-blinded randomized controlled study conducted between March 2014 and July 2016. Consecutive patients who were scheduled for diagnostic EUS were recruited and randomized to receive electroacupuncture (EA) or sham-electroacupuncture (SA). The primary outcome was the dosage of propofol used. Other outcome measurements included pain scores, anxiety scores, satisfaction scores, patients' willingness to repeat the procedure, total procedure time, and adverse events.

RESULTS:One hundred twenty-eight patients were recruited to the study. The patients that received EA had significantly fewer PCA requirements. The median (IQR range) number of demands for PCA (2 [1 - 5] vs 16.5 [8.5 - 33.8], P<0.001), the number of successful demands (2 [1 - 4] vs 9 [5.3 - 13], P<0.001), the total dose of propofol (0.15 [0.08 - 0.34] vs 0.77 [0.38 - 1.09], P<0.001) and alfentanil (0.38 [0.20 - 0.86] vs 1.92 [0.94 - 2.72], P<0.001) were all significantly less. Patients that received EA also had significantly less procedural pain scores and anxiety scores (P<0.001), higher satisfaction scores (P<0.001), and they are more willing to repeat the procedure (P<0.001). Both being in the SA group and the procedural time were significant predictors to increased PCA demands (P<0.001 and P = 0.009 respectively).

CONCLUSION:In conclusion, the use of EA reduced sedative and analgesic demands, improved patient experience, and was associated with low risk of adverse events during diagnostic EUS.

OBJECTIVE: To explore the analgesic effect of electroacupuncture (EA) combined with acupoint-injection in treating lumbar intervertebral disc herniation. METHODS: Sixty patients with lumbar intervertebral disc herniation were divided randomly into treatment group (30 cases, group A) and control group (30 cases, group B) according to random digits table. Involved 31 males and. 29 females in the study,the age was from 35 to 62 years with an average of 48.3 years. The patients in group A were treated with EA (once a day, a total of 10 times) and acupoint-injection (once every two days, a total of 5 times) at L4 Jiaji (EX-B2), L5 Jiaji (EX-B2), Zhibian (BL54), Huantiao (GB30), Yanglingquan (GB34), Weizhong (BLA0) and Kunlun (BL60); and the patients in group B were treated with single EA (Once a day, a total of 10 times). After 10 days of treatment, the visual analogue scale (VAS) was adopted to examine and compare the main pain score, and the clinical effects were compared between two groups from the symptoms and signs in accordance with efficacy criteria. RESULTS: The paregoric effect of group A was better than that of group B, there was significant differences in the main pain score between two groups (t = 7.18, P<0.01). The clinical effect of group A was better than that of group B,there was significant differences between two groups (u = 2.91, P<0.01). CONCLUSION: EA combined with acupoint-injection is a convenient and highly effective therapy for lumbar intervertebral disc herniation, which can effectively relieve the pain of the patients, should be to promote clinical use.

OBJECTIVE: To explore the analgesic effect of electroacupuncture (EA) combined with acupoint-injection in treating lumbar intervertebral disc herniation. METHODS: Sixty patients with lumbar intervertebral disc herniation were divided randomly into treatment group (30 cases, group A) and control group (30 cases, group B) according to random digits table. Involved 31 males and. 29 females in the study,the age was from 35 to 62 years with an average of 48.3 years. The patients in group A were treated with EA (once a day, a total of 10 times) and acupoint-injection (once every two days, a total of 5 times) at L4 Jiaji (EX-B2), L5 Jiaji (EX-B2), Zhibian (BL54), Huantiao (GB30), Yanglingquan (GB34), Weizhong (BLA0) and Kunlun (BL60); and the patients in group B were treated with single EA (Once a day, a total of 10 times). After 10 days of treatment, the visual analogue scale (VAS) was adopted to examine and compare the main pain score, and the clinical effects were compared between two groups from the symptoms and signs in accordance with efficacy criteria. RESULTS: The paregoric effect of group A was better than that of group B, there was significant differences in the main pain score between two groups (t = 7.18, P<0.01). The clinical effect of group A was better than that of group B,there was significant differences between two groups (u = 2.91, P<0.01). CONCLUSION: EA combined with acupoint-injection is a convenient and highly effective therapy for lumbar intervertebral disc herniation, which can effectively relieve the pain of the patients, should be to promote clinical use.

Complex regional pain syndrome (CRPS) is a debilitating pain disorder for which patients commonly receive physiotherapy. The objective of this literature review is to assess how effective physiotherapy is in the management of adult and childhood CRPS type I. An electronic literature search was performed of the databases AMED, Cinahl, Embase, Ovid Medline, Pubmed, PEDro and PsycINFO, from their inception to November 2004. Human subjects clinical trials, written in English, which could assist in answering the research question were included. Twenty-five (of 748) papers met the inclusion criteria and were reviewed. The review suggests that exercise, motor imagery and mirror feedback exercises, relaxation techniques, acupuncture, electroacupuncture, transcutaneous nerve stimulation and combined treatment programmes may help in the treatment of CRPS type I. However, since numerous methodological weaknesses (e.g. small sample sizes, not employing control groups, not evaluating findings against statistical tests) littered the limited literature, it was not possible to determine the effectiveness of individual treatments. Recommendations are made to develop the evidence base.

BACKGROUND: An increase in inflammatory response and an imbalance between T-helper (Th) 1 and 2 functions have been implicated in major depression. The aims of the present study were to 1) study the relationship between pro- and anti-inflammatory cytokines and between Th1 and Th2 produced cytokines in depressed patients and 2) evaluate and compare the effect of treatments with electroacupuncture (EA) and fluoxetine on these cytokines. METHODS: 95 outpatients with major depressive disorder were treated for 6 weeks with EA, fluoxetine or placebo. Hamilton Depression Rating Scale (HDRS) and Clinical Global Impression (CGI) were used to assess severity and therapeutic effects. 30 volunteers served as controls. Serum cytokine concentrations were measured by ELISA. RESULTS: Increased proinflammatory cytokine interleukin (IL)-1beta and decreased anti-inflammatory cytokine IL-10 were found in the depressed patients. By contract, Th1 produced proinflammatory cytokines, tumor necrosis factor (TNF)-alpha and interferon (IFN)-gamma were decreased, and Th2 produced cytokine IL-4 was significantly increased in depressed patients. The ratio of IFN/IL-4 was also increased. Both acupuncture and fluoxetine treatments, but not the placebo, reduced IL-1beta concentrations in responders. However, only acupuncture attenuated TNF-alpha concentration and INF-gamma/IL-4 ratio towards the control level. DISCUSSION: These results suggest that an imbalance between the pro- and anti-inflammatory cytokines (IL-1 and IL-10), and between Th1 and Th2 cytokines (INF-gamma or TNF-alpha and IL-4) occurred in untreated depressed patients. Both EA and fluoxetine had an anti-inflammatory effect by reducing IL-1beta. EA treatment also restored the balance between Th1 and Th2 systems by increasing TNF-alpha and decreasing IL-4. Georg Thieme Verlag KG Stuttgart - New York.

BACKGROUND:Obesity is an increasing global health problem, and current methods of management are limited. Preliminary research data suggest that acupuncture may have an influence on metabolic parameters related to obesity.

OBJECTIVE:To determine the electroacupuncture (EA) protocol to be used in a future clinical trial examining the effect of acupuncture on metabolic parameters related to obesity and to examine whether a single EA treatment can change fasting blood glucose in obese subjects.

METHODS:16 obese women aged 30-52 years with body mass index>30 kg/m(2) were assigned consecutively into three groups and their fasting blood glucose was measured before and after administering a single session, lasting 30 min, of one of three EA treatment protocols. The Dorsal group received EA to dorsal segmental acupuncture points BL18-23 bilaterally (corresponding to the segmental levels innervating the pancreas); the Ear group received EA to ear points in the cavum conchae; and the Limb group received EA to points in the arms and legs (LI10-LI11, ST36-Zongping).

RESULTS:After a single session of EA there was a statistically significant decrease in fasting blood glucose in the Dorsal and Limb groups, but there was no change and even a trend towards an increase in the glucose level in the Ear group.

CONCLUSIONS:The findings of this small pilot study suggest that EA to either dorsal segmental points corresponding to the pancreas or to muscle points in all four limbs may exert a beneficial effect on glucose metabolism in obese women.

OBJECTIVE: To observe the influence of electroacupuncture (EA) on T cell immunologic function in the aged rats so as to reveal its underlying mechanism in anti-aging effect. METHODS: Fifty SD rats (half male and half female) were randomly divided into normal control (young rats), aging model (model), EA group, immunosuppression (IS), and EA+ IS groups. Aging model (in the late 4 groups) was duplicated by subcutaneous injection of D-galactose for 40 days. Guanyuan (CV 4) and bilateral Zusanli (ST 36) were punctured and stimulated electrically (2 Hz, 1 mA), 15 min every time, six times a week and for four weeks. IS model was induced by i. p. i. of cytoxan (60 mg/kg) after 26 and 27 days' EA treatment. Splenetic T lymphocyte proliferation index was assayed by Methylthiazolyldiphenyl-tetrazolium bromide (MTT) chromatometry. IL-2/IL-2 receptor (R) expression level of T cells was measured by enzyme linked immunosorbent assay (ELISA). CD8+ CD28(+) -T cell subset fluorescence intensity was detected by flow cytometry. RESULTS: Compared with normal control group, the splenetic T lymphocyte proliferation index, IL-2 and IL-2R expression levels, and CD8+ CD28(+) -T cell density in model and IS groups decreased significantly (P<0.01). In comparison with model group, the abovementioned indexes in EA and EA + IS groups increased significantly (P<0.01), and those indexes levels of EA + IS group were also significantly higher than those in IS group ( P<0.05, P<0.01). Comparison between EA and EA+ IS groups showed that CD8+ CD2+ T cell expression of the later group was significantly lower than that in EA group (P<0 05). No significant differences were found between EA and EA + IS groups in T cell proliferation rate and IL-2 and IL-2R expression levels (P>0.05) CONCLUSION: EA of CV 4 and ST 36 induced upregulation of T cell proliferation and IL-2/IL-2R, and CD8+ CD(+)28 -T cell may contribute to its antiaging and immuno-enhancement effects in the aged rats.

Neuronal stimulation improves physiological responses to infection and trauma, but the clinical potential of this strategy is unknown. We hypothesized that transdermal neural stimulation through low-frequency electroacupuncture might control the immune responses to surgical trauma and expedite the postoperative recovery. However, the efficiency of electroacupuncture is questioned due to the placebo effect. Here, electroacupuncture was performed on anesthetized patients to avoid any placebo. This is a prospective double-blinded pilot trial to determine whether intraoperative electroacupuncture on anesthetized patients improves postoperative recovery. Patients with electroacupuncture required 60% less postoperative analgesic, even they had pain scores similar to those in the control patients. Electroacupuncture prevented postoperative hyperglycemia and attenuated serum adrenocorticotropic hormone in the older and heavier group of patients. From an immunological perspective, electroacupuncture did not affect the protective immune responses to surgical trauma, including the induction of interleukin-6 and interleukin-10. The most significant immunological effect of electroacupuncture was enhancing transforming growth factor-β1 production during surgery in the older and lighter group of patients. These results suggest that intraoperative electroacupuncture on anesthetized patients can reduce postoperative use of analgesics and improve immune and stress responses to surgery.

Selective serotonin reuptake inhibitors (SSRIs) are first-line antidepressants, however, only around 60% of patients could benefit from them. Acupuncture is supported by insufficient evidence to help with symptom relieving and SSRIs tolerance. This pragmatic randomized controlled trial compared SSRIs alone versus SSRIs together with manual acupuncture (MA) or electroacupuncture (EA) in moderate to severe depressed patients. Patients were randomly allocated to receive MA + SSRIs (161), EA + SSRIs (160), or SSRIs alone (156) for six weeks, and then followed up for another four weeks. The primary outcome was response rate of the 17-item Hamilton Depression Scale (HAMD-17) at 6th week. The secondary outcomes were HAMD-17 (remission rate, early onset rate, total score), Self-Rating Depression Scale (SDS: total score), Clinical Global Impression (CGI), Rating Scale for Side Effects (SERS: total and domain scores), number of patients with adjusted dosage of SSRIs and adverse events (AEs). Both MA + SSRIs and EA + SSRIs were significantly better than SSRIs at 6th week on HAMD-17 response rate (RR = 1.21, 95% CI 1.04, 1.42, P = 0.013; RR = 1.27, 95% CI 1.09, 1.48, P = 0.0014), HAMD-17 early onset rate (P < 0.0001), HAMD-17 and SDS total scores (P < 0.05), CGI (P < 0.01), SERS total score (P < 0.01), number of patients with increased dosage of SSRIs (P < 0.01). For HAMD-17 remission rate, EA + SSRIs was significantly higher than SSRIs (P = 0.0083), while MA + SSRIs showed no significant difference at 6th week (P = 0.092). No unintended acupuncture-related severe AE was observed. This study identified that both MA and EA showed beneficialeffects in addition to SSRIs alone in patients with moderate to severe depression, and were well tolerated. Clinical trials registration: ChiCTR-TRC-08000297.

OBJECTIVES:Although acupuncture and microcurrent are widely used for chronic pain, there remains considerable controversy as to their therapeutic value for neck pain. We aimed to determine the effect size of microcurrent applied to lower back acupuncture points to assess the impact on the neck pain.

DESIGN:This was a cohort analysis of treatment outcomes pre- and postmicrocurrent stimulation, involving 34 patients with a history of nonspecific chronic neck pain.

SUBJECTS AND SETTINGS:Consenting patients were enrolled from a group of therapists attending educational seminars and were asked to report pain levels pre-post and 48 hours after a single MPS application.

INTERVENTIONS AND MEASUREMENTS:Direct current microcurrent point stimulation (MPS) applied to standardized lower back acupuncture protocol points was used. Evaluations entailed a baseline visual analog scale (VAS) pain scale assessment, using a VAS, which was repeated twice after therapy, once immediately postelectrotherapy and again after a 48-h follow-up period. All 34 patients received a single MPS session. Results were analyzed using paired t tests. Results and Outcomes: Pain intensity showed an initial statistically significant reduction of 68% [3.9050 points; 95% CI (2.9480, 3.9050); p = 0.0001], in mean neck pain levels after standard protocol treatment, when compared to initial pain levels. There was a further statistically significant reduction of 35% in mean neck pain levels at 48 h when compared to pain levels immediately after standard protocol treatment [0.5588 points; 95% CI (0.2001, 0.9176); p = 0.03], for a total average pain relief of 80%.

CONCLUSIONS:The positive results in this study could have applications for those patients impacted by chronic neck pain.