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ObjectiveTo observe effects of electroacupuncture at Fengchi acupoint on expression of myosatellite cells, myogenic determining factor (MyoD), proliferating cell nuclear antigen (PCNA), Toll-like receptor 4 (TLR4), myeloid differentiation primary response gene 88 (MyD88) and nuclear factor-kappa B p65 (NF-κBp65) protein in rat with chronic cervical muscle injury, so as to explore possible mechanism of electroacupuncture in promoting the repair of chronic cervical muscle injury.MethodsTen Wistar rats were selected from 45 Wistar rats as blank group, and the remaining rats were divided into model group, electroacupuncture group (EA group) and meloxicam group according to random number table method, with 10 rats in each group (5 rats were unsuccessful in modeling). Chronic cervical muscle injury model of rats was established by long-term head flexion fixation and hypertonic saline injection. After 3 months of modeling, the morphological changes of posterior cervical muscle were observed by ultrasonic diagnostic detector. The success of modeling was verified by EMG. The EA group received electroacupuncture at Fengchi acupoint on both sides, 25 min each time, once a day, for 10 consecutive days as one course of treatment, with an interval of two days between courses of treatment, for 2 courses of treatment. After intervention, the posterior cervical muscle tissue of rats in each group was collected and the morphological changes of posterior cervical muscle tissue were observed under electron microscope. The protein contents of PCNA, MyoD, TLR4, MyD88 and NF-κBp65 were detected by immunohistochemistry.Results1) Morphological detection: Compared with the blank group, ultrasonic diagnosis results of the model group showed that tissue of posterior cervical muscle of rats was discontinuous and thickness was significantly narrower. Electrophysiological test results showed that amplitude and frequency of electromyographic significantly decreased in the model group. Compared with the blank group, muscle electron microscopy results of the model group showed that the arrangement of myofibrils was discontinuous, some mitochondria were swollen, and there were breaks between muscle fibers and muscle segments, and there were vacuoles. Compared with the model group, the EA group showed that myofibrils were clearly visible, cross-section of the myofibrils was punctured, sarcomere and serosa were intact, some mitochondria were swollen, and a few of them had vacuoles at the fracture of myofibrils. Myofibril structure of the meloxicam group was occasionally irregular, with vacuoles at the fracture of myofibril and a small amount of mitochondrial swelling. 2) Immunohistochemistry: Compared with the blank group, expression of PCNA and MyoD in model group was weakly positive, and protein expression of TLR4, MyD88 and NF-κBp65 significantly increased (PPPP>0.05).ConclusionThe treatment of chronic cervical muscle injury by electroacupuncture at Fengchi acupoint may be related to promoting the proliferation and differentiation of myosatellite cells, and the mechanism may be achieved by regulating the TLR4/MyD88/NF-κB signal transduction pathway.

Purpose: Chronic cervical muscle injury is the first common cause of the development of cervical spondylosis, and Tuina can effectively promote the repair of chronic cervical muscle injury and alleviate neck pain, but the mechanism behind its efficacy is still unknown. The proliferation and differentiation of muscle satellite cells and the apoptosis of cervical myocytes play important roles in the repair of chronic cervical muscle injuries; therefore, this study aimed to explore the potential mechanisms of Tuina to promote the repair of cervical muscle injuries in terms of the proliferation and differentiation of satellite cells and the apoptosis of myocytes. Patients and Methods: Twenty-eight Wistar rats were randomly divided into control group, model group, Tuina group, and meloxicam group, with 7 rats in each group. Except for the control group, each group were establish a chronic cervical muscle injury model (CCMI). Meloxicam (0.79 mg/kg) was administered by gavage, and in the Tuina group, pressure was applied to the Fengchi acupoint on the affected side once a day. Morphological changes of cervical muscle tissues were detected by ultrasonic diagnostic instrument and HE staining, electrophysiological recordings of electromyographic changes, apoptosis rate was detected by TUNEL staining, and positive expression of Bax, Bcl-2, IGF-1, MyoD, and Pax-7 were detected by Immunohistochemistry and Western blot. Results: In CCMI model rats, we observed that the cervical muscle fibers were disorganized, with irregular morphology, and the amplitude of electromyography was significantly weakened, while Tuina could significantly improve these symptoms and effectively promote the repair of chronic cervical muscle injury. Meanwhile, compared with the model group, Tuina could significantly increase the expression levels of IGF-1 (P< 0.01) and MyoD (P< 0.05) and decrease the expression level of Pax7 (P< 0.05). In addition, we found that the number of apoptotic cells in cervical myocytes was reduced after Tuina intervention (P< 0.05), and Tuina inhibited the expression of pro-apoptotic factor Bax (P< 0.01) and promoted the expression of anti-apoptotic factor Bcl-2 (P< 0.05). Conclusion: Tuina can promote the proliferation and differentiation of satellite cells to repair chronic cervical muscle injury by regulating the expression of Pax7, MyoD, and IGF-1, as well as inhibiting the expression of Bax and promoting the expression of Bcl-2 to ameliorate the apoptosis of cervical myocytes in CCMI model rats. [ABSTRACT FROM AUTHOR]

Objective To investigate the mechanism of inducing macrophage polarization induced by acupoint effect of electroacupuncture to promote the repair of acute skeletal muscle injury. Methods 45 SD rats were randomly divided into blank group, model group, electroacupuncture group(EA group), sodium chrominate group (DSCG group) and electroacupuncture + sodium chrominate group (hereinafter referred to as EA + DSCG group), with 9 rats in each group. The rats in the EA group and the EA + DSCG group were subjected to EA intervention at the right "Chengshan" (BL57) and "Yanglingquan" (GB34), with a frequency of 2 Hz/100 Hz. The gait changes of rats were recorded by animal gait analyzer. The morphological changes of the right gastrocnemius were observed by HE staining. The changes of mast cell aggregation and degranulation in local skin muscles of "chengshan" point were observed by toluidine blue staining. The expressions of Pax7, MyoD and skin mast cells and 5-HT in the right gastrocnemius were detected by immunofluorescence method. The positive expressions of CD68 and CD206 in right gastrocnemius macrophage was observed by immunohistochemical staining. Results Compared with blank group, the wiggle time of the right hind leg in model group and DSCG group increased, stride length decreased, HE staining showed inflammatory cell infiltration, myocyte enlargement, degeneration and necrosis. The degranulation rate of local skin mast cells in "Chengshan" (BL57) area increased, and the expressions of mast cell tryptase, 5-HT, Pax7, MyoD, CD68 and CD206 increased (P<0.05). Compared with model group, the wiggle time of the right hind leg in EA group and EA + DSCG group decreased, stride length increased, HE staining showed that inflammatory cell infiltration was reduced, muscle cells were uniform in size and arranged neatly. Mast cell degranulation rate increased significantly in EA group, and the expressions of mast cell tryptase, 5-HT, Pax7, MyoD and CD206 increased (P<0.05), while CD68 expression decreased (P<0.05). Compared with EA + DSCG group, the degranulation rate of mast cells and the expressions of mast cell tryptase, 5-HT, Pax7, MyoD and CD206 increased (P<0.05), while CD68 expression decreased in EA group (P<0.05). Conclusion EA "Chengshan" (BL57) and "Yanglingquan" (GB34) can stimulate acupuncture points to locally induce mast cell degranulation, promote the polarization of macrophages, and then activate muscle satellite cells to play the regulatory process of repairing skeletal muscle injury. [ABSTRACT FROM AUTHOR]

Currently, there is no international standard for the methodology of patient versions of guideline development. In China, the development of patient versions of guidelines is still in its infancy, and there are no registered or published patient versions of guidelines in the field of acupuncture. This paper introduces two methods of developing patient versions of guidelines: directly converting clinical practice guidelines into patient versions guidelines and developing patient versions of guidelines independently. The relationship and differences between patient guidelines and clinical practice versions of guidelines are compared. By integrating the unique characteristics of acupuncture, this paper analyzes and discusses the significance, problems, and challenges of developing patient versions of guidelines in the field of acupuncture, aiming to provide methodological references for the future development of acupuncture patient versions of guidelines.

As an important supplementary approach to randomized controlled trial, process evaluation(PE) aims to evaluate implementation of complex intervention and contextual factors associated with variation in outcomes, in order to explain the observed results in a comprehensive manner. However, PE has not been well applied in the clinical research of acupuncture. Based on existing literature, this paper summarized the main methodological frameworks of PE, as well as the status-quo of its application in acupuncture research. Meanwhile, it explored the research perspectives and implementation factors that were potentially relevant to PE in parallel with acupuncture trials. In addition, the paper put forward preliminary considerations on key contents corresponding to each step during the development of PE for acupuncture trials, in order to provide useful reference and innovative pathway for future studies that strive for comprehensive evaluation of acupuncture's effect.