Mechanism And Clinical Application Of Protective Effect Of Acupuncture On Brain

Objective To investigate the effect of electroacupuncture (EA) preconditioningon the AMP-activated protein kinase (AMPK) in hippocampus and cortex, and toevaluate its effects on the neurological behavior scores (NBS), the neurons apoptosis,and the protein expressions of Bax, caspase-9and caspase-3in hippocampus andcortex.Methods80healthy, male C57BL6mice, aged7weeks, were randomly dividedinto5groups: Normal group: the animals did not accept any treatment measures;Sham-operation group: bilateral common carotid arteries were exposed but notoccluded for comparison; I/R group: establish forebrain ischemic reperfusion models;EA preconditioning group: the mice in this group received EA pretreatment, then theforebrain I/R models were established; Sham-acupuncture group: EA was applied atacupoint Baihui (GV20) by2mm for comparison. Acupuncture methods: Theacupoint Baihui (GV20), which is located at the intersection of the sagittal midlineand the line drawn to connect two ears, was stimulated as standard criteria in mice.Acupuncture needles (0.25×65mm) were connected to a generator that producedelectric currents with the intensity of1mA and frequency of2/15Hz. The intensitywas maintained just below the level that induced visible beard contraction. Thestimulation was for30min per day for five consecutive days. The Sham-acupuncturegroups received the same electrical stimulation at a lateral point to aforementionedacupoint (GV20by2mm apart). Afterwards, at24hours after EA pretreatmentestablish bilateral common carotid artery occlusion (BCCAO) models. A15minforebrain ischemia mouse model was used in this study. Obeservation:(1) At72hafter reperfusion, neurological behavior scores were evaluated for all the mice.(2)Afterwards,8mice from each group were sacrificed for hematoxylin and eosin (HE)staining and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling(TUNEL) positive cells in hippocampus and cortex.(3) The other8mice weresacrificed for Real-time quantitative PCR (RT-qPCR) of AMPK2mRNA andwestern blot analysis of total AMPK, pAMPK, Bax, caspase-9and caspase-3in hippocampus and cortex.Results (1) The NBS, the number of apoptotic neurons and the amount ofprotein Bax, caspase-9, caspase-3and p-AMPK significantly increased in the I/R, EApreconditioning and sham-acupuncture group versus the normal and sham-operationgroup(P<0.05).(2) The NBS, the number of apoptotic neurons and the amount of Bax,caspase-9, caspase-3significantly decreased but the level of protein p-AMPKevidently increased in the EA preconditioning group versus the I/R andsham-acupuncture group(P<0.05).(3) No significant differences were detected in the AMPK2mRNA and totalAMPK expression level among the five groups (P>0.05).Conclusion EA pretreatment has a significant neuroprotective effect on cerebralischemia reperfusion，which is closely related to its effect in activating AMPK. Objective To investigate the effects of acupuncture on serum NSE and S-100βconcentrations and postoperative cognitive function of the elderly patientsundergoing hip replacement.Methods86patients, aged70-80years, weighed48-89kg, ASA graded Ⅱ～Ⅲ,undergoing hip replacement were randomly assigned to control group (group N, n=46)and acupuncture group (group A, n=40). In group A, acupuncture was given in theoperation. Combined spinal and epidural anesthesia and midazolam sedation wereperformed in the patients. Obeservation:(1) Sore on cognitive function of all patientsbefore the surgery1day (T0), after the surgery3days and7days (T1-T2) withmini-mental state examination (MMSE)(2) The rate of postoperative cognitivedysfunction (POCD) at3days (T1),1week (T2) of the two groups were observed.(3)The serum level of NSE and S-l00β at the time before anesthesia (t0), the end ofsurgery (t1) and6hours,24hours,48hours after the surgery (t2-t4) were measured.(4)Comparison of two groups of surgery and operative time, intraoperative midazolamdosage, infusion volume, the amount of bleeding, urine output, atropine andephedrine usage and other serious complicationsResults (1) Compared with group N, the rate of POCD at each time weredecreased in group A (P<0.05).(2) Compared with group N, the level of NSE waslower at t2-t4, the level of S-l00β were lower at t1-t4in group A (P<0.05). In group N,the level of NSE at t2-t4was higher versus the t0, the level of S-l00β were higher att1-t4versus t0(P<0.05). In group A, the level of NSE at t2、t4was higher versus the t0,the level of S-l00β were higher at t1、t4versus t0(P<0.05).Conclusion Acupuncture can reduce the level of serum NSE and S-100βconcentrations, and it can reduce the rate of POCD in the elderly patients undergoinghip replacement.