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Objective: The research regarding the central mechanism of acupuncture deqi (arrival of qi ) based on functional magnetic resonance imaging (fMRI) in recent 10 years was analyzed to summarize existing research achievements and experience., Methods: The literature regarding fMRI-based deqi research published from January of 2007 through December of 2016 in CNKI and PubMed databases was collected. The research content and methods, including research design, inclusion criteria, acupoint selection and deqi evaluation, were analyzed., Results: Totally 18 articles regarding the central mechanism of acupuncture deqi based on fMRI was included. According to research content, the literature was divided into two categories: deqi research and deqi sensation research. In deqi research, the differences of deqi and not deqi on brain functional activity were compared to summarize the central response pattern of deqi ; in deqi sensation research, the differences of different sensations and intensities of deqi on central response were compared to explore the effects of different sensations and intensities of deqi on brain functional activity. In recent 10 years, the number of research gradually increased, and the type of design was various, mainly RCT and paired design. The majority of participants was healthy people, and single acupoint was the focus of researches, including Zusanli (ST 36), Waiguan (TE 5), Hegu (LI 4), etc. The evaluation of deqi was based on visual analogue scale (VAS). The research contents were mainly the effects of deqi and not deqi and different deqi sensations on brain function activities. The present studies confirmed that deqi and not deqi as well as different deqi sensations had different impacts on brain functional effects, and different acupoints had specific activated brain areas. There was a positive correlation between the degree of deqi and the intensity of the activation of brain regions. Furthermore, tingling sensation was not included to deqi sensations., Conclusion: The number and quality of fMRI-based deqi research need to be improved; the research content is simple, and research method is in exploratory stage. The results obtained in the literature are the phenomena of deqi in the central level, and it is imperative to summarize the essential link between deqi and the central effect through these phenomena to reveal the mechanism of deqi . The specific impact of deqi for brain function needs more clinical exploration.

Objective: To evaluate the effects of needling depth on clinical efficacy of lumbar disc herniation (LDH)., Methods: Ten electronic databases, including China National Knowledge Infrastructure (CNKI), VIP Database, Chinese Biomedical Literature Database (CBM), Wanfang Database, MEDLINE, CENTRAL, CINAHL PLUS, AMED, Embase, PsycINFO, and 6 registry platforms of clinical trials were searched. All randomized controlled trials (RCTs) that compared the effect of needling depth on clinical efficacy of LDH were collected; in addition, the reference lists of the studies included were hand searched. Data were extracted independently by two reviewers. RevMan 5.3 was applied to carry out statistical analysis., Results: Totally 8 716 articles were retrieved, and 10 RCTs were included after screening, involving 1 116 patients. The results showed the effects of deep acupuncture onrelievingpain, reducing the Oswestry disability index (ODI), improving total effective rate and Japanese Orthopaedic Association (JOA) were superior to those of shallow acupuncture in patients with LDH., Conclusion: It is preliminarily indicated that deep acupuncture is helpful to improve the therapeutic effect of LDH; however, due to the low research quality and small sample size, the evidence is insufficient, and more high-quality researches are needed to further confirm the results.

The paper is a systematic review on the efficacy of acupuncture manipulation on primary dysmenorrhea. Ten medical literatures database at home and abroad were retrieved, including CNKI, VIP, CBM, WANFANG, MEDLINE, Cochrane, CENTRAL, CINAHL PLUS, EMBASE, AMED and PsycINFO, as well as 6 clinical trial registration platforms. All of randomized controlled trials (RCTs) on primary dysmenorrhea treated with different acupuncture manipulations were collected. The data were extracted by two persons. Finally, RevMa 5.3 software was used for statistical analysis. Totally, 5 148 pieces of literature were retrieved and 8 pieces on RCTs were screened with 644 cases included. According to the results of statistical analysis on the total effective rate and other indicators of pain degree, it was showed that the effects of the manipulation with filiform needle, deep puncture with strong stimulation, and specific reinforcing and reducing needling technique were better than those without manipulation applied or with shallow puncture and weak stimulation and even needling technique in the treatment of primary dysmenorrhea. It is believed initially that acupuncture manipulation contributes to the improvement of the therapeutic effects of primary dysmenorrheal, but much higher quality studies are required for the further confirmation. Protocol registration number:PROSPERO:CRD42016038515.

The effects of deqi (arrival of qi ) on acupoint effects in patients with primary dysmenorrhea (PD) were evaluated.Ten literature databases,including China National Knowledge Infrastructure (CNKI),VIP Database,Wanfang Database,Chinese Biomedical Literature Database (CBM),Cochrane Library CENTRAL,MEDLINE,Embase,AMED, CINAHL Plus,PsycINFO were selected.In addition,5 registers of ongoing trials,the reference lists of included articles and grey literature website OpenGrey were added.The search time was from date of database establishment to August 2016;no restrictions were made on language or status of publication.All randomized controlled trials (RCTs) and quasi-randomized controlled trials (q-RCTs) which compared the effects of deqi and non- deqi on PD or compared the effects of different deqi elements on PD were included.The research quality was assessed according to Cochrane bias risk evaluation tool 5.1.0.The RevMan 5.3.5 was applied for quantitative analysis if insignificant clinical heterogenicity with I 2 ≤ 75%,otherwise the results was summarized by qualitative analysis.As a result,6 RCTs involving 645 patients were included.Because of considerable clinical heterogeneity,only qualitative analysis was performed,which indicated ① acupuncture could reduce pain and anxiety regardless of deqi ,and the effects of deqi on pain relief were superior or equivalent to that of none- deqi ,and the effects of deqi on anxiety relief were similar to that of none- deqi ;② the more intensity of deqi and higher number of acupoints selected,the better effects on pain alleviation,symptom relief and pain duration;③ the higher rate of deqi had a better acupoint effect on alleviating anxiety,but was not on pain relief;④ deqi appeared early and propagated to affected area could lead to faster onset on pain relief;⑤ the effects on relieving pain and symptoms was better when warm sensation in deqi or qi reaching affected area.Due to the few number,low quality and potential bias of included studies,it was not sufficient to draw clear conclusion regarding the effects of deqi on PD patients.This study protocol was registered in PROSPERO (CRD42016038518).

Qi arrival is the meridian qi response to acupuncture stimulation. Through analyzing the relevant concepts of qi arrival and summarizing the general understanding of it in clinic and on the basis of the collection of the relevant literature at home and abroad on the determination of qi arrival and its strength, the characteristics are analyzed on the present method and the method for the determination of qi arrival and its strength is discussed in terms of the results in the needling sensation scale. It is believed that the needling sensation and its strength can be used to determine whether the qi is arrived or not and its strength. The components of different types of needling sensation are much better applicable for the analysis on the characteristics and rules on the influence on qi arrival. This method is in compliance not only with the theoretic connotation of qi arrival, but also with the clinical general understanding, which lays the foundation for the analysis on the scale results.

From the time of Neijing (Internal Classic) and Nanjing (Classic of Medical Problems) till the end of Qing dynasty, the medical scholars of each dynasty had taken the recognition of deqi as the subject in the stud- ies. Through the historical analysis, the content of regulating deqi was further understood in relevant ancient liter- ature. By checking the ancient works of acupuncture in each dynasty till the end of Qing dynasty, in reference to the evidences in over 10 works, such as Zhenjiu Dacheng (Great Compendium of Acupuncture and Moxibustion) , Zhenjing Zhinan (Instruction of Acupuncture Canon), Zhenjiu Daquan, and in association with the academic views of acupuncture masters in modern time, it was discovered that the medical scholars after the time of Neijing and Nanjing had enriched the understandings of deqi, such as the connection of cold and heat reaction, radiation to the affected site, reinforcing and reducing purpose in qi regulation. The methods of deqi regulations had, been explored till the end of Qing dynasty since the time of Neijing and Nanjing and the understandings of it were vari- ous among scholars.