Figure - available from: Frontiers in Neuroscience
This content is subject to copyright.
Study design and bloodletting puncture at hand twelve Jing-well points (BL-HTWP) treatment in mice. (A) Schematic of workflow for experiments. CCI, controlled cortical impact injury; BL, BL-HTWP; CBP, cerebral blood perfusion; CPP, cerebral perfusion pressure; MEP, motor-evoked potential; mNSS, modified neurological severity score; CCTs, conventional coagulation tests; TEG, thromboelastography; BBB, brain-blood barrier permeability; and BWC, brain water content assay. (B) After CCI, mice received immediate treatment of BL-HTWP once. BL-HTWP was located at the tips of the mouse toes (left), corresponding to the human fingers (right), including Shaoshang (LU11), Shangyang (LI1), Zhongchong (PC9), Guanchong (TE1), Shaochong (HT9), and Shaoze (SI1).
Source publication
Traumatic brain injury (TBI) contributes to hypocoagulopathy associated with prolonged bleeding and hemorrhagic progression. Bloodletting puncture therapy at hand twelve Jing-well points (BL-HTWP) has been applied as a first aid measure in various emergent neurological diseases, but the detailed mechanisms of the modulation between the central nerv...
Citations
... /fneur. . specific nucleus activation, which can play a role in regulating vasoconstriction to a certain extent (56). The above summary provides the theoretical basis for our findings and a reference for subsequent studies. ...
Background
Tension-type headache (TTH) is one of the most common primary headaches. Several studies have confirmed the efficacy of acupuncture therapies for TTH, but it is uncertain which treatment is most effective.
Objective
This study aimed to compare the effectiveness and safety of different acupuncture therapies for TTH using Bayesian Network Meta-analysis to provide new ideas for treating TTH.
Methods
Nine databases were searched for randomized controlled trials (RCTs) about different acupuncture therapies for TTH up to December 1, 2022. The outcome indicators analyzed in our study were total effective rate, visual analog scale (VAS), headache frequency, and safety. Pairwise meta-analysis and risk of bias assessment were performed using Review Manager 5.4. Stata 15.0 generated a network evidence plot and detected publication bias. Finally, a Bayesian network meta-analysis of the data was used by RStudio.
Results
The screening process resulted in 30 RCTs that met the inclusion criteria, including 2,722 patients. Most studies failed to report details of trials and were therefore assessed as unclear risks. Two studies were considered high risk because they did not report on all pre-specified outcome indicators or had incomplete data on outcome indicators. The NMA results showed that for total effective rate, bloodletting therapy had the most considerable SUCRA value (0.93156136), for VAS, head acupuncture combined with Western medicine ranked first (SUCRA = 0.89523571), and acupuncture combined with herbal medicine was the most effective in improving headache frequency (p > 0.05).
Conclusion
Acupuncture can be used as one of the complementary or alternative therapies for TTH; bloodletting therapy better improves the overall symptoms of TTH, head acupuncture combined with Western medicine is more effective in reducing VAS scores, and acupuncture combined with herbal medicine seems to reduce headache frequency, but the difference is not statistically significant. Overall, acupuncture for TTH is effective with mild side effects, but future high-quality studies are still necessary.
Systematic review registration
https://www.crd.york.ac.uk/prospero/, PROSPERO [CRD42022368749].
... Also, another investigation showed that bloodletting by wet cupping could have noticeable antiinflammatory effects in asthmatic mice which is comparable with oral corticosteroids [14]. Furthermore, experimental studies based on Chinese traditional medicine have shown that bloodletting at the distal ends of the fingers (Jing-well points) could improve microcirculation disturbance [15], reduce systemic and cerebral inflammation and brain edema [16], and coagulopathy [17] following TBI. Despite these facts, the effectiveness of phlebotomy on brain damage following TBI has not been conducted yet. ...
Objective
In spite of the great advances in the field of traumatic brain injury (TBI), it still remains as a global health problem. Phlebotomy has been mentioned as an effective treatment for TBI in Persian medicine. This study aimed to evaluate the possible effect of saphenous vein phlebotomy (SVP) on the alleviation of neuroinflammation and oxidative stress after TBI.
Methods
Seventy-two adult male Wistar rats were randomly divided into three main groups: sham, TBI and TBI+SVP group. Animal model of TBI was made through a controlled cortical impactor (CCI) device and SVP treatment was applied 10 min after TBI. Then, neurological function, body temperature, cerebral edema, blood-brain barrier integrity, brain apoptosis, oxidative stress, and inflammation were assessed.
Results
Our results indicated that SVP was associated with improvement of neurological scores 24 h post-TBI. In addition, SVP application significantly alleviated proinflammatory cytokines (IL- 1β, IL-17, and TNF-α) and oxidative stress factors as shown by reduction of malondialdehyde (MDA) and elevation of superoxide dismutase (SOD) with no significant effect on glutathione peroxidase (GPx) and nitric oxide (NO) in the brain 6 h after TBI. Besides, it reduced body temperature, attenuated severity of brain edema, and also reduced caspase-3 and number of apoptotic neurons.
Conclusion
This study showed that SVP could ameliorate the severity of acute TBI, partly through alleviation of neuroinflammation, oxidative stress, and apoptosis. Further studies are necessary for more understanding the involved mechanism(s).
... The anti-inflammatory effect of wet cupping has been shown in a recent investigation on migraine headaches [64]. Furthermore, an experimental study reported that bloodletting from fingertips (Jing-Well Points) could ameliorate coagulopathy that leads to the reduction of bleeding tendency following TBI [65]. ...
Since the edifice of conventional medicine is built on the pillars of past achievements, review or re-investigate the old medical manuscripts may lead to significant achievements. Avicenna was a famous Persian medieval physician and one of the pioneers of neuroscience. The aim of this study is to evaluate Avicenna's approach to traumatic brain injury (TBI), based on his main book on medicine, “Canon of Medicine”. Avicenna divided the TBI treatments into three categories: topical therapies, oral therapies, such as diets and medications, and manipulation therapies including phlebotomy, enema, foot bath, cupping, and massage. Although some of these recommendations are supported by current knowledge, many of them are still unknown and need scientific investigation to expand our knowledge of TBI treatments in the medieval period.
... Our previous study and others from domestic and foreign scientific groups have confirmed that acupuncture on HTWP has a definite awakening effect on ACNIinduced coma, and can improve cerebrovascular circulation disorder leading to the symptoms of consciousness obstacle, nerve defect, and brain edema [19] . Acupuncture also reverses the hypocoagulability state after acute TBI by regulating multiple markers of TBI hypercoagulability, causing the level of procoagulant factor synthesis, reducing vasogenic and cytotoxic edema, and finally achieving the arousal effect after TBI-induced coma and improving the neurological function deficit [89] . ...
Traumatic brain injury (TBI) is a brain injury caused by direct external forces, and its prognosis depends on the extent of the damage and the changes in level of consciousness. Timely awakening from a coma is the first thorny problem to be solved in TBI treatment. Therefore, there is a need for the development of safe and effective methods for timely awakening after TBI coma. Dopamine (DA) and its receptors in the nervous system are involved in the regulation of wakefulness. The amount and activity of dopaminergic neurons can affect cellular function and neuroinflammatory response, and are also significant for the awakening process after TBI. The current common awakening therapy for TBI may also be related to the activation of dopaminergic neurons. Acupuncture plays a beneficial role in timely awakening, recovery of conscious level, and functional rehabilitation after TBI. The mechanism may be related to the targeted regulation of DA and its receptors via acupuncture. Among acupuncture first aid therapies, acupuncture at hand 12 Jing-Well points, with its advantages of simple operation and ultra-early intervention, has shown great promise in timely awakening following TBI and triggering a series of subsequent nerve repair effects in the treatment of TBI. We here present a review that provides a new perspective for the timely awakening from TBI-induced coma, with a focus on the role of DA in the regulation of wakefulness and the efficacy and potential mechanism of DA systems in the treatment of TBI by acupuncture.
... On the other hand, the use of well acupoints to treat diseases was extremely limited in the present study. Traditionally, well acupoints are primarily used to treat acute diseases [19,20], with indications limited to the induction of labor and brain injury in the current database. Given that the clinical trials covered only a small number of acute diseases, we cannot the rule out the possibility that the discrepancies in the usage rate of the ve-phase acupoints may be related with the characteristics of the included diseases. ...
Background: An unbiased assessment of clinical outcomes may provide greater insight into the characteristics of individual acupoints. In this study, we used machine-learning methods to examine clinical trial data for diseases treated using prescribed five-phase acupoint patterns.
Methods: We performed a search of acupuncture treatment regimens used in randomized controlled trials included in the Cochrane Database of Systematic Reviews. The frequencies of 60 five-phase acupoints were calculated based on 421 clinical trials on 30 diseases. The characteristics of prescribed five-phase acupoints were further analyzed using multidimensional scaling and K-means clustering.
Results: Among the five-phase acupoints, stream and sea acupoints were the most widely used, with well, spring, and river acupoints less common. Multidimensional scaling and cluster analysis revealed that the LR3, ST36, GB34, BL60, KI3, LI11, and HT7 acupoints exhibited distinct characteristics based on distances representing the similarity between acupoint indications.
Conclusions: The results suggest that stream and sea acupoints exhibit distinct characteristics compared to the other acupoints. Such data-driven approaches will improve our understanding of five-phase acupoints and facilitate the establishment of new models of analysis and educational resources for major acupoint characteristics.
... It records cerebral blood flow (CBF) 48 h after TBI modeling as previously described. (18) The rats were anesthetized by gas anesthesia system in prone position, and a cranial window was prepared for each rat. The room temperature was controlled at 25-27 ℃, the humidity was maintained between 40%-60%, and there was no direct sunlight, obvious air convection, or infrared radiation. ...
... We previously reported that HTWP acupuncture promotes consciousness in comatose patients and improves the neurological score of patients suffering from TBI, stroke, or carbon monoxide poisoning Yu et al., 2020). Multiple experimental studies also showed that HTWP acupuncture alleviates brain edema and improves tissue perfusion, blood-brain barrier integrity, and nerve function in rodents with TBI and strokes (Yu et al., 2017;Li et al., 2019Li et al., , 2020. Despite these promising results, the mechanisms by which HTWP acupuncture induces consciousness in acute coma patients have not been elucidated. ...
The induction of a coma by traumatic brain injury (TBI) is a crucial factor for poor clinical prognoses. We report that acupuncture at the hand 12 Jing -Well points (HTWP) improved consciousness and neurologic function in TBI rats. Gene chip analyses showed that HTWP acupuncture mostly activated genes modulating neuronal projections ( P2rx7, P2rx3, Trpv1, Tacr1 , and Cacna1d ), protein secretion ( Exoc1, Exoc3l1, Fgb , and Fgr ), and dopamine (DA) receptor D3 ( Drd3 ) in the ventral periaqueductal gray (vPAG), among which the expression rate of P2rx7 was the most obviously increased. Acupuncture also increased the expression and excitability of DA and P2RX7 neurons, and the DA neurons expressed P2RX7, P2RX3, and TRPV1 in the vPAG. Intracerebroventricular administration of P2RX7, P2RX3, or TRPV1 antagonists blocked acupuncture-induced consciousness, and the subsequent injection of a P2RX7 antagonist into the vPAG nucleus also inhibited this effect. Our findings provide evidence that acupuncture alleviates TBI-induced comas via DA neurons expressing P2RX7 in the vPAG, so as to reveal the cellular and molecular mechanisms of the improvement of TBI clinical outcomes by HTWP acupuncture.
Objective
To explore the protective effect of bloodletting acupuncture at twelve Jing-well points on hand (BAJP) on acute hypobaric hypoxia (AHH)-induced brain injury in rats and its possible mechanisms.Methods
Seventy-five Sprague Dawley rats were divided into 5 groups by a random number table (n=15), including control, model, BAJP, BAJP+3-methyladenine (3-MA), and bloodletting acupuncture at non-acupoint (BANA, tail tip blooding) groups. After 7-day pre-treatment, AHH models were established using hypobaric oxygen chambers. The levels of S100B, glial fibrillary acidic protein (GFAP), superoxide dismutase (SOD), and malondialdehyde (MDA) in serum were measured by enzyme-linked immunosorbent assay. Hematoxylin-eosin staining and the terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling method were used to assess hippocampal histopathology and apoptosis. Transmission electron microscopy assay was used to observe mitochondrial damage and autophagosomes in hippocampal tissues. Flow cytometry was used to detect mitochondrial membrane potential (MMP). The mitochondrial respiratory chain complexes I, III and IV activities and ATPase in hippocampal tissue were evaluated, respectively. Western blot analysis was used to detect the protein expressions of Beclin1, autophagy protein 5 (ATG5), microtubule-associated protein 1 light chain 3 beta (LC3B), phosphatase and tensin homolog induced kinase 1 (PINK1), and Parkin in hippocampal tissues. The mRNA expressions of Beclin1, ATG5 and LC3-II were analyzed by quantitative real-time polymerase chain reaction.ResultsBAJP treatment reduced hippocampal tissue injury and inhibited hippocampal cell apoptosis in AHH rats. BAJP reduced oxidative stress by decreasing S100B, GFAP and MDA levels and increasing SOD level in the serum of AHH rats (P<0.05 or P<0.01). Then, BAJP increased MMP, the mitochondrial respiratory chain complexes I, III and IV activities, and the mitochondrial ATPase activity in AHH rats (all P<0.01). BAJP improved mitochondrial swelling and increased the autophagosome number in hippocampal tissue of AHH rats. Moreover, BAJP treatment increased the protein and mRNA expressions of Beclin1 and ATG5 and LC3-II/LC3-I ratio in AHH rats (all P<0.01) and activated the PINK1/Parkin pathway (P<0.01). Finally, 3-MA attenuated the therapeutic effect of BAJP on AHH rats (P<0.05 or P<0.01).ConclusionBAJP was an effective treatment for AHH-induced brain injury, and the mechanism might be through reducing hippocampal tissue injury via increasing the PINK1/Parkin pathway and enhancement of mitochondrial autophagy.
Objective:
To explore the protective effect and possible mechanisms of bloodletting acupuncture at Jing-well points (BAJP) pre-treatment on acute hypobaric hypoxia (AHH)-induced myocardium injury rat.
Methods:
Seventy-five rats were randomly divided into 5 groups by a random number table: a control group (n=15), a model group (n=15), a BAJP group (n=15), a BAJP+3-methyladenine (3-MA) group (n=15), and a BANA (bloodletting at nonacupoint; tail bleeding, n=15) group. Except for the control group, the AHH rat model was established in the other groups, and the corresponding treatment methods were adopted. Enzyme-linked immunosorbent assay (ELISA) was used to detect creatine kinase isoenzyme MB (CK-MB) and cardiac troponins I (CTnI) levels in serum and superoxide dismutase (SOD) and malondialdehyde (MDA) levels in myocardial tissue. Hematoxylin-eosin (HE) staining was used to observe myocardial injury, and terminal deoxynucleotidyltransferase-mediated dUTP-biotin nick end labeling (TUNEL) staining was used to observe cell apoptosis. Transmission electron microscopy detection was used to observe mitochondrial damage and autophagosomes in the myocardium. The mitochondrial membrane potential of the myocardium was analyzed with the fluorescent dye JC-1. Mitochondrial respiratory chain complex (complex I, III, and IV) activities and ATPase in the myocardium were detected by mitochondrial respiratory chain complex assay kits. Western blot analysis was used to detect the autophagy index and hypoxia inducible factor-1α (HIF-1α)/Bcl-2 and adenovirus E1B 19k Da-interacting protein 3 (BNIP3) signaling.
Results:
BAJP reduced myocardial injury and inhibited myocardial cell apoptosis in AHH rats. BAJP pretreatment decreased MDA levels and increased SOD levels in AHH rats (all P<0.01). Moreover, BAJP pretreatment increased the mitochondrial membrane potential (P<0.01), mitochondrial respiratory chain complex (complexes I, III, and IV) activities (P<0.01), and mitochondrial ATPase activity in AHH rats (P<0.05). The results from electron microscopy demonstrated that BAJP pretreatment improved mitochondrial swelling and increased the autophagosome number in the myocardium of AHH rats. In addition, BAJP pretreatment activated the HIF-1α/BNIP3 pathway and autophagy. Finally, the results of using 3-MA to inhibit autophagy in BAJP-treated AHH rats showed that suppression of autophagy attenuated the treatment effects of BAJP in AHH rats, further proving that autophagy constitutes a potential target for BAJP treatment of AHH.
Conclusion:
BAJP is an effective treatment for AHH-induced myocardial injury, and the mechanism might involve increasing HIF-1α/BNIP3 signaling-mediated autophagy and decreasing oxidative stress.
