OBJECTIVE:To investigate the effects of electroacupuncture intervention on behavioral performance, hippocampal structure, and function in chronic fatigue syndrome (CFS) rats and to explore the underlying mechanisms. METHODS:Specific pathogen free-grade male Sprague-Dawley rats were randomly allocated into a control group (Con group, n =12) and a modeling group. The latter underwent a 21-d CFS induction viaan improved chronic multi-factor compound stress stimulation protocol. Successfully modeled CFS rats were then randomly assigned to a model group (Mod group, n =12) and an electroacupuncture group (EA group, n =12). During the 14-d treatment period, both the Mod and EA groups continued to receive chronic stress stimuli. Rats in the EA group received electroacupuncture at Shenting (GV24) through to Baihui (GV20), with additional stimulation on Dazhui (GV14). Each session lasted 15 min, administered twice daily with a 6-h interval between morning and afternoon treatments. After modeling and treatment, the general semi-quantitative score (GSQS) was used to evaluate the rats' general health, while the Morris water maze test (MWMT), open field test (OFT), and exhaustive treadmill test (ETT) were applied to assess their learning/memory, emotional state, and fatigue levels, respectively (n =12 per group). After the treatment phase, cerebral glucose metabolism was assessed by 1;⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) imaging (n =3 per group), while hippocampal cornu ammonis 1 (CA1) morphology was examined using hematoxylin-eosin (HE) and Nissl staining (n =3 per group). RESULTS:Behavioral assessments demonstrated that electroacupuncture intervention significantly improved rat performance as measured by GSQS, MWMT, OFT, and Exhaustive Treadmill Test. Both HE and Nissl staining results confirmed that, compared with the blank control group, the model group exhibited abnormal cellular morphology, disorganized arrangement, and reduced Nissl bodies in the hippocampal CA1 region. These pathological alterations were ameliorated in the electroacupuncture group relative to the model group. 18F-FDG PET/CT imaging revealed that following treatment, the mean and maximum standardized uptake values (SUV) in the anterior-dorsal and posterior hippocampus were significantly decreased in the Mod group compared to the Con group. In contrast, electroacupuncture treatment significantly increased both SUV-mean and SUV-max in these hippocampal subregions in the EA group relative to the Mod group (all P <0.05). CONCLUSION:Electroacupuncture intervention alleviated cognitive impairment, hippocampal pathological structural changes, and glucose metabolism dysfunction in a rat model of chronic fatigue syndrome induced by an improved chronic multi-factor compound stress stimulation method.

Chronic fatigue syndrome (CFS) is a global public health problem affecting more than 65 million patients worldwide. The combined prevalence rate of CFS was 45.2% after 4 weeks in patients with novel coronavirus. Women, people over 40 years of age, and low-income people are susceptible groups, which have a significant impact on immune, nervous, endocrine, and other system functions. First, from the perspective of epidemiology, this paper reviews the global epidemic trend of CFS, the differences in incidence and prevalence in different regions and populations, and risk factors such as heredity, infection, and childhood trauma. Second, the development of diagnostic techniques for CFS, including the evolution of clinical diagnostic criteria, research progress on immune and metabolic biomarkers, and the application of MRI and other imaging techniques in the diagnosis of CFS, is described, followed by an in-depth discussion of the genetics of CFS, including genetic susceptibility, genomic association, and familial aggregation. The pathophysiological mechanism of CFS was also analyzed, revealing abnormalities in NK cell function and immune factors in the immune system, dysfunction of the hypothalamic-pituitary-adrenal axis in the neuroendocrine system, and disorders of energy and lipid metabolism in the metabolic system. This paper focuses on the study of acupuncture and moxibustion treatment of CFS, traces back to the historical application of acupuncture and moxibustion treatment of CFS, analyzes the relationship between the pathological mechanism of CFS and acupuncture and moxibustion intervention, expounds the theoretical basis of traditional Chinese medicine and modern mechanism of action of acupuncture and moxibustion treatment, and introduces the results of clinical trials, efficacy evaluation methods, and individualized treatment strategies for acupuncture and moxibustion treatment of CFS. The innovative application of acupuncture techniques, such as electroacupuncture and acupoint catgut embedding, as well as the synergistic effect of acupuncture combined with traditional Chinese medicine and psychotherapy, are shown. At the same time, disputes and challenges in the efficacy, safety, and ethics of acupuncture treatment for CFS were pointed out, and future research directions, potential breakthroughs, and international cooperation opportunities of acupuncture treatment for CFS are discussed. This study provides a comprehensive reference for clinical treatment and research on CFS.

Clinical analgesia requires balancing effective pain relief against opioid-related risks. Transcutaneous electrical nerve stimulation (TENS), a nonpharmacological and noninvasive modality, demonstrates synergistic potential with opioids, which may enhance analgesia, reduce opioid consumption, and minimize adverse effects. This review synthesizes evidence on TENS-opioid synergy, categorizes TENS modalities and parameters, and examines their interactive mechanisms. We discuss optimization strategies, including early TENS application, parameter individualization, and a "TENS + low-dose opioid" regimen. This combination represents a promising multimodal approach integrating pharmacological and nonpharmacological therapies, potentially improving outcomes while reducing opioid-related harms. Future work should prioritize rigorous pharmacological studies to confirm synergy, alongside multicenter trials, parameter optimization, development of intelligent personalized systems, and further mechanistic research to advance precision pain medicine.

Background: Perioperative neurocognitive disorder (PND), particularly under ischemic conditions in older adults, is closely associated with circadian rhythm disruption and aberrant orexin-A (OxA) signaling. This study aimed to investigate the therapeutic potential and mechanistic underpinnings of electroacupuncture (EA) and suvorexant (SUV), individually and in combination, in a rat model of ischemia-associated PND (iPND). Methods: A randomized, controlled preclinical study was conducted using late-adult Sprague–Dawley rats subjected to bilateral common carotid artery occlusion to establish the iPND model. Animals received 28 days of EA, SUV, or EA + SUV treatment. Behavioral assessments included circadian rhythm analysis, novel object recognition, and Morris water maze tests. Transcriptomic profiling, qPCR, western blotting, immunofluorescence, and ultrastructural imaging were used to explore molecular and cellular mechanisms, with a focus on OxA, circadian clock genes (Bmal1–Per/Cry axis), and Aβ accumulation. Results: EA and SUV each significantly improved cognitive performance, normalized circadian rhythmicity, and reduced Aβ deposition in the hippocampus. Notably, combined EA + SUV therapy produced greater improvements in escape latency ( P < 0.01) and cognitive flexibility than either monotherapy. Two-way ANOVA confirmed a significant interaction effect between EA and SUV on cognitive outcomes ( P = 0.005), supporting a synergistic tendency. EA and SUV also suppressed hippocampal OxA, Bmal1, and Aβ expression, restored cAMP/pCREB signaling, and preserved mitochondrial synaptic integrity. Double immunostaining further revealed reduced co-localization of OxA and Aβ following treatment. Conclusions: EA and SUV exert complementary effects in alleviating iPND through modulation of the OxA/circadian axis and inhibition of Aβ pathology. Their combination offers enhanced neuroprotection, supporting a multimodal therapeutic strategy targeting both circadian and neurodegenerative mechanisms. These findings provide a rationale for integrative approaches in perioperative cognitive care and merit further translational investigation. Graphical abstract available at: http://links.lww.com/JS9/H337

ObjectiveTo observe the effects of moxibustion at “Shenque” （CV8） and “Guanyuan” （CV4） on gut microbiota， intestinal barrier and blood–brain barrier （BBB）， peripheral and central neuroinflammation， and 5-hydroxytryptamine （5-HT）ergic neurons in the dorsal raphe nucleus （DRN） in a mouse model of chronic fatigue syndrome （CFS） based on the gut–brain axis theory， so as to explore the underlying mechanisms of moxibustion in treating CFS.MethodsMale C57BL/6 mice were randomly divided into control group， model group， and moxibustion group， with 10 mice in each group. The CFS model was established by combining exhaustive swimming with food restriction. Concurrently with modeling， the moxibustion group received moxibustion at CV8 and CV4 once daily， 10 min per session， for 28 consecutive days. After treatment， fatigue-like behaviors were evaluated by open field test， forced swimming test， and tail suspension test. Gut microbiota diversity and composition were analyzed by 16S rDNA sequencing. Colonic mRNA expression of tight junction proteins zonula occludens-1 （ZO-1） and Occludin was detected by real-time quantitative PCR. Serum levels of interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-α） were measured by multiplex flow cytometry； serum lipopolysaccharide （LPS） and S100 calcium-binding protein β （S100β） levels were determined by ELISA. Immunofluorescence was used to detect positive expression of ionized calcium-binding adapter molecule 1 （Iba-1） and IL-1β， as well as the number of 5-HTergic neurons in the DRN. Spearman correlation analysis was performed to assess the associations between gut microbiota and various gut–brain axis parameters.ResultsCompared with the control group， the model group showed prolonged immobility time in the open field， tail suspension， and forced swimming tests （P<0.05， P<0.01）； increased α-diversity indices （Chao and Shannon） of gut microbiota （P<0.01， P<0.05）； β-diversity analysis revealed a clear spatial separation between model and control groups. The model group also exhibited decreased abundance of Lactobacillus （P<0.001）， and increased abundances of Spirochaetes， Treponema， Clostridium vadinBB60 group， Ruminococcus， and Desulfovibrionaceae （P<0.05， P<0.01， P<0.001）； reduced colonic ZO-1 and Occludin mRNA expression （P<0.01， P<0.05）； elevated serum levels of LPS， IL-6， TNF-α， and S100β （P<0.05， P<0.01）； increased Iba-1 and IL-1β positive expression in the DRN （P<0.001， P<0.01）， and an increased number of 5-HTergic neurons （P<0.01）. Compared with the model group， all the above parameters were reversed in the moxibustion group （P<0.01， P<0.05， P<0.001）. Correlation analysis revealed that the abundance of Lactobacillus was significantly negatively correlated with the number of 5-HTergic neurons in the DRN （ρ=-0.900， P<0.001）， and was also significantly correlated with behavioral improvement， intestinal barrier repair， and alleviation of inflammatory responses （P<0.05， P<0.01， P<0.001）.ConclusionMoxibustion can significantly improve fatigue-like behaviors in CFS mice， and its mechanism may involve regulation of the gut–brain axis， i.e.， through modulating gut microbiota， repairing the intestinal barrier and BBB， alleviating peripheral and central neuroinflammation， thereby inhibiting the aberrant increase of 5-HTergic neurons in the DRN and restoring peripheral–central homeostasis.

OBJECTIVE: To observe the effects of moxibustion at Zusanli(ST36) on rats with chronic fatigue syndrome(CFS) and to analyze the mechanisms of moxibustion through hippocampal Proteomics. METHODS: Male Sprague-Dawley(SD) rats were randomly divided into three groups: control group(CON), model group(MOD), and moxibustion group(MOX), with 12 rats in each group. The MOD and MOX groups underwent chronic multi-factor stress stimulation for 35 d to establish the CFS model. After modeling, the rats in the MOX group received mild moxibustion at Zusanli(ST36)(bilateral) for 10 minutes daily for 28 d. During the treatment period, rats in both the MOD and MOX groups continued modeling, while the CON group was kept under normal breeding conditions. The general condition of the rats was monitored, and behaviors were assessed using the Open Field Test(OFT), Exhaustion Treadmill Test, and Morris Water Maze(MWM). Hematoxylin and eosin(HE) staining and transmission electron microscopy(TEM) were employed to observe morphological changes in the hippocampus. Label-free Proteomics were utilized to identify differentially expressed proteins(DEPs) in the hippocampus, followed by bioinformatics analysis. The reliability of the Proteomics results was verified using Parallel Reaction Monitoring. RESULTS: A: Moxibustion at Zusanli(ST36) significantly reduced the general condition score of CFS rats, improved their behavioral performance in OFT, treadmill and MWM, and repaired the pathological and synaptic structural damage in the hippocampus.B: We identified DEPs by applying a fold change threshold of 1.2 and a significance level of P < 0.05. In the comparison between the CON and the MOD, we identified a total of 72 DEPs(31 up-regulated and 41 down-regulated) associated with the development of CFS. In the comparison between the MOX and the MOD group, we identified a total of 103 DEPs(40 up-regulated and 63 down-regulated) related to the therapeutic effects of moxibustion. Gene Ontology(GO) enrichment analysis showed that CFS and moxibustion treatment were related to multiple biological processes, molecular functions, and cellular components. Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment analysis revealed that CFS pathogenesis was linked to base excision repair, steroid biosynthesis, and systemic lupus erythematosus, Furthermore, the treatment of CFS with moxibustion was relevant to terpenoid skeleton biosynthesis.C: Compared with the two comparison groups, we identified 16 potential biomarkers, noting that moxibustion reversed the upregulation of 14 DEPs and the down-regulation of 2 DEPs in CFS. These proteins are mainly associated with synaptic plasticity, ribosomal function, neurotransmitter secretion, glycine metabolism, and mitochondrial function. CONCLUSION: Moxibustion at Zusanli(ST36) is effective in treating CFS, the potential biomarkers identified by Proteomics confirm that the mechanisms of moxibustion involve multiple targets and pathways, which may be key to regulating the structural and functional damage in the hippocampus associated with CFS, highlighting their significant value for future research.

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a multifaceted disorder characterized by persistent fatigue, post-exertional malaise (PEM), cognitive dysfunction, sleep disturbance, pain, psychological distress, orthostatic intolerance, and impaired multidimensional health status and functioning. In the absence of reliable biomarkers, standardized symptom assessment is essential for accurate diagnosis and comparability across studies. This narrative literature review synthesized studies identified through PubMed and Web of Science up to June 2024, covering assessment instruments across major ME/CFS symptom domains. Tools were evaluated for their psychometric validity, clinical applicability, and key limitations. Overall, existing scales demonstrate acceptable reliability but vary in sensitivity and disease specificity. Harmonized, multidimensional, and digitally or objectively validated measures are needed to improve diagnostic precision, longitudinal monitoring, and clinical translation in ME/CFS.

Chronic fatigue syndrome (CFS) is a debilitating multisystem disorder with an increasing prevalence, significantly impairing patients' quality of life. Several challenges remain, including unclear pathogenesis, the absence of specific diagnostic criteria, and limited therapeutic efficacy. Animal models play a crucial role in understanding the pathogenesis of CFS and testing potential therapies, necessitating the construction and evaluation of these models to be objective and scientifically rigorous. This study provides a comprehensive review of the methods for developing and assessing CFS models, analyzes their strengths and limitations, identifies key challenges in current research, and guides the development of clinically relevant CFS animal models.

BACKGROUND:The efficacy of acupuncture therapy in treating chronic fatigue syndrome remains a matter of intense debate owing to contradictory findings. This article describes a systematic review and meta-analysis to study its effect on fatigue, functional mobility, and mental health. METHODS:A thorough search of PubMed, PEDro, CINAHL, SportDiscus, and Scopus was performed. The studies meeting the PICO criteria for the Population, Intervention, Comparison, and Outcome were independently screened, and the data were extracted. Standardized mean differences with 95% confidence intervals (CI) were calculated using fixed or random-effects models. Publication bias and study quality were assessed to ensure reliability. RESULTS:Acupuncture demonstrated potential benefits in improving near-term fatigue (RR = -1.21, 95% CI: -1.38 to -1.04), long-term fatigue (RR = -0.56, 95% CI: -0.70 to -0.42), somatic and mental health (RR = -0.30, 95% CI: -1.03 to 0.44), and reducing depression incidence (RR = -0.28, 95% CI: -2.11 to 1.56) in patients with CFS as an effective treatment modality. CONCLUSIONS:Acupuncture, especially when combined with rehabilitation, seems to improve fatigue and quality of life among patients with CFS. However, results should be considered carefully since some methodological weaknesses are worth mentioning, such as diversity between studies and the inclusion of lower-quality clinical trials. Future research should consider the importance of conducting large-scale, multicenter randomized controlled trials with standardized methodology to confirm these findings.

Chronic Fatigue Syndrome (CFS) is an unexplained, persistent, or recurring fatigue accompanied by physical and cognitive decline that cannot be relieved, lasting for a duration of more than 6 months. This article provides a systematic review of the background of CFS, the application of acupuncture in traditional Chinese medicine for fatigue symptoms, the early application and effectiveness assessment of acupuncture in CFS treatment, analysis of acupuncture’s relief effect on the main symptoms of CFS, assessment of acupuncture’s improvement effect on the quality of life of CFS patients, comparative studies between acupuncture and conventional treatment methods, mechanism research on acupuncture treatment for CFS, the position and role of acupuncture in multidisciplinary comprehensive treatment, as well as challenges and limitations in acupuncture treatment for CFS. The aim is to provide scientific evidence for the clinical treatment of acupuncture.

Neurodegenerative diseases are a diverse group of neurological disorders, in which abnormal mitochondrial function is closely associated with their development and progression. This has generated significant research interest in the field. The proper functioning of mitochondria relies on the dynamic regulation of the mitochondrial quality control system. Key processes such as mitochondrial biogenesis, mitophagy, and mitochondrial dynamics (division/fusion) are essential for maintaining this balance. These processes collectively govern mitochondrial function and homeostasis. Therefore, the mitochondrial quality control system plays a critical role in the onset and progression of neurodegenerative diseases. This article provides a concise overview of the molecular mechanisms involved in mitochondrial biogenesis, mitophagy, and mitochondrial dynamics, explores their interactions, and summarizes current research progress in understanding the mitochondrial quality control system in the context of neurodegenerative diseases.

OBJECTIVES:To observe the changes in the regional homogeneity (ReHo) and functional brain network in treatment of chronic fatigue syndrome (CFS) with anxiety and depression comorbidity with the mind-regulation electroacupuncture (EA), using resting-state functional magnetic resonance imaging (rs-fMRI). METHODS:Thirty CFS patients with anxiety and depression comorbidity were enrolled from medical staffs as the observation group. The other 30 healthy subjects were recruited from medical university students as the control group, matching gender, age and education years with the observation group. No any acupuncture intervention was delivered in the control group, and EA for regulating the mind was operated in the observation group. Main points were the emotional area of Sun's scalp acupuncture, the regions 1 and 8 of Sun's abdominal acupuncture. Supplementary acupoints included Baihui (GV 20), Guanyuan (CV 4) and bilateral. RESULTS:The scores of the five domains in MFI-20 (i.e. general fatigue, physical fatigue, mental fatigue, reduced motivation and reduced activity), the total score of MFI-20, and the scores of SDS, SAS and PSQI in the observation group before treatment were higher than those of the control group (P<0.05). Except the score of reduced motivation in MFI-20, the scores of the other domains and the total score of MFI-20, as well as the scores of SDS, SAS and PSQI after treatment were lower than those before treatment in the observation group (P<0.05). Compared with the values before treatment, ReHo value was increased in the the right precuneus and decreased in the left inferior temporal gyrus and the left angular gyrus of the brain in the observation group after treatment. In the observation group, when compared with the control group, ReHo values were increased in the left inferior cerebral lobe, the interhemispheric region, the right occipital lobe and the thalamus; and it was reduced in the left middle temporal gyrus, the right posterior central gyrus, the right middle temporal gyrus, the right orbital middle frontal gyrus, the paracentral lobule and the right fusiform gyrus before treatment. In the observation group, the functional connectivity was decreased between the right thalamus and the left posterior central gyrus, the right hippocampus and the right fusiform gyrus before treatment, respectively; it was re-constructed after treatment between the right thalamus and the left posterior central gyrus, and the right fusiform gyrus. Compared with the control group, the functional connectivity between the right thalamus and the left posterior central gyrus, the right hippocampus, and the right fusiform gyrus was reduced before treatment; while after treatment, the functional connectivity was reduced between the right thalamus and the hippocampus in the observation group. With Spearman correlation analysis between the differential brain regions and the scores of MFI-20, SAS, SDS and PSQI, it was found that the left middle temporal gyrus, the paracentral lobule, the right precuneus, and the left inferior temporal gyrus had a partial positive correlation with the above clinical scales; and the interhemispheric region, the thalamus, the right fusiform gyrus, and the right middle temporal gyrus showed a partial negative correlation. CONCLUSIONS:There is the decrease of ReHo in many brain regions and the numbers of the local brain functional network connectivity in CFS patients with anxiety and depression comorbidity. The mind-regulation electroacupuncture therapy may relieve the clinical symptoms of the patients through adjusting the abnormal brain regions and activating emotion-related brain regions.

OBJECTIVES:To observe the effect of electroacupuncture (EA) on behavior and hippocampal protein phosphorylation in rats with chronic fatigue syndrome (CFS), so as to explore its mechanisms underlying improvement of CFS.METHODS:Male SD rats were randomly divided into control, model and EA groups (n=12 rats in each group). The CFS model was established by chronic multifactor combined with stress stimulation (treadmill training + restraint stress + sleep disturbance + crowded environment). For rats of the EA group, EA (1 mA, frequency of 10 Hz) was applied to "Shenting" (GV24) (with an acupuncture needle penetrated from GV24 to "Baihui" ［GV20］) and "Dazhui" (GV14) for 15 min, once daily for 28 days. After treatment, the body weight, food intake and water intake of rats in each group were observed. The fatigue degree of rats was evaluated by Semi-quantitative score observation table of the general condition of experimental rats.The open field test (OFT) was used to assess the rats'anxiety severity by detecting the total number of grid-crossing and the times of the central area entered in 5 min, and Morris water maze test was employed to assess the rats' learning-memory ability by detecting the escape latency in 1 min, and the times of the original platform quadrant crossing in 1 min. The hippocampaus was taken for phosphorylated Label-free quantitative proteomics analysis by using Maxquant technology based on full scan mode to calculate the integral of each peptide signal of liquid chromatography-mass spectrometry(LC-MS). The differentially-expressed proteins (>1.5 folds for up-regulation or <0.67 folds for down-regulation) were evaluated by gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis.RESULTS:Compared with the control group, the body weight, food intake, and the times of original-platform quadrant crossing of spatial exploring of Morris water maze test were significantly decreased (P<0.01, P<0.05) , and the score of general conditions, times of grid-crossing and center area-entering of OFT, and the escape latency of navigation task were apparently increased (P<0.01) in rats of the model group. After EA intervention, the decreased original-platform quadrant crossing, and the increased score of general conditions, times of grid-crossing and the escape latency of navigation task were all reversed (P<0.01, P<0.05). Outcomes of proteomics analysis indicated that compared with the model group, there were 297 differentially expressed peptide (48 up-regulated and 249 down-regulated) segments in the control group, and there were 245 differentially expressed peptide (185 up-regulated and 60 down-regulated) segments in the EA group, in which, 25 overlapping peptide segments were reversed after EA treatment, corresponding to 24 proteins, mainly involving cytoskeletal structure. GO function annotation analysis showed that the top three differentially expressed phosphorylated proteins involved in the effect of EA intervention were the actin filament polymerization, protein depolymerization and cytoskeletal tissue in the biological process, the actin binding, structural molecular activity and cytoskeletal protein binding in the molecular function, and the cytoskeleton, dendrites and dendritic trees in the cellular component, respectively. The KEGG pathway annotation analysis for differentially expressed phosphorylated proteins showed that theinsulin secretion, axon guidance, phosphatidylinositol signaling system and lysine biosynthesis, etc. were involved in the effect of EA intervention.CONCLUSIONS:EA of GV24-GV20 and GV14 can improve the general state, anxiety and learning-memory ability of CFS model rats, which may be related to its functions in regulating the hippocampal protein phosphorylation level, and repairing the structure and function of synapses in hippocampus.

Objective: To investigate the effects of ligustrazine on neuropathic pain (NPP) in rats with sciatic nerve injury and to provide new scientific insight for broadening the clinical application of ligustrazine. Methods: Human spinal cord cell line STR cells were transfected with TLR4-mimic or mimic negative control (mimic-NC). After transfection, the STR cells were treated with different concentrations of ligustrazine (0, 0.25, 0.5, 1, 2 mu m) for 24 h or 48 h. Cell proliferation was detected by MTT assay and colony formation assay. A rat model was further constructed to evaluate mechanical and cold pain sensitivity behaviors by fiber mechanical stimulation and freezing spray. The extracellular fluids of medial prefrontal cortex (mPFC) and central amygdala (CeA) were collected by intracranial dual-site simultaneous microdialysis. The contents of glutamic acid (Glu), aspartate (Asp), glycine (Gly), and gamma-aminobutyric acid (GABA) in extracellular fluids were detected by HPLC. Results: Compared to the 0 mu m group, ligustrazine concentration at 0.5 mu m significantly decreased the relative cell viability of STR cells and promoted the cell apoptosis rate. Ligustrazine at 0.25 mu m significantly reduced the colony number of STR cells (all P<0.05). Compared to the control group, 1 M ligustrazine significantly increased the protein expression of Bax and cleaved caspase 3 in STR cells but decreased the protein expression of Bcl-2 (all P<0.001). Compared to the control group, 2 M ligustrazine treatments significantly reduced the protein levels of TLR4 and p-Akt in STR cells (all P<0.001). However, 2 M ligustrazine treatments did not change the protein expression of Akt (P>0.05). Compared to the control group, the level of TLR4 in STR cells transfected with TLR4-mimic was significantly increased (P<0.001). Compared to the control group, transfection of TLR4-mimic reversed the anti-proliferative and pro-apoptotic effects of ligustrazine on STR cells (all P<0.001). Conclusion: The analgesic effect of Ligustrazine on neuropathic pain caused by spinal cord injury may be related to its inhibition of the release of excitatory amino acid transmitters Glu and Gly through the TLR4/NF-kappa B pathway, regulation of the dynamic balance of excitatory and inhibitory amino acid neurotransmitters, and alleviation of the central sensitization effect caused by the excitotoxicity of Glu.

OBJECTIVES:To observe the effect of electroacupuncture (EA) on the changes of behavior and hippocampal inflammatory factors in rats with chronic fatigue syndrome (CFS), so as to explore its possible mechanisms in the treatment of CFS.METHODS:Twenty-seven SD rats were randomly divided into control, model and electroacupuncture (EA) groups (n=9 rats in each group). The CFS model was established by multi-factor compound stress stimulation method. Rats of the EA group received EA (10 Hz) at "Shenting" (GV24) penetrating "Baihui" (GV20), "Dazhui" (GV14) for 15 min, twice a day for 14 days. The general conditions, Morris water maze test, open field test, the exhausted running platform were conducted for determining the rats' locomotor and learning-memory activities. H.E. staining was used to observe the morphological structure of neurons in hippocampal CA1 region. The contents of interleukin (IL)-10, IL-17 and transforming growth factor (TGF) β1 in hippocampus and serum of rats were detected by ELISA, and the positive expressions of IL-10, IL-17 and TGF-β1 in hippocampal CA1 region were detected by immunofluorescence staining.RESULTS:Compared with the control group, the score of general condition was increased (P<0.05), the escape latency was prolonged (P<0.05), the number of crossing the original platform was decreased (P<0.05), the numbers of crossing the grid and entering the central area were increased (P<0.05), and the exhaustive treadmill time was shortened (P<0.05) in the model group. The contents of IL-10 in the hippocampus and serum were decreased (P<0.05), while IL-17 and TGF-β1 contents were increased (P<0.05). The immunofluorescence intensity of IL-10 in the hippocampus was decreased (P<0.05), while the intensity of IL-17 and TGF-β1 were increased (P<0.05). After treatment, compared with the model group, the score of general condition was decreased (P<0.05), the escape latency was shortened (P<0.05), the number of crossing the original platform was increased (P<0.05), the numbers of crossing the grid and entering the central area were decreased (P<0.05), and the exhaustive treadmill time was prolonged (P<0.05) in the EA group. The contents of IL-10 in the hippocampus and serum were increased (P<0.05), while IL-17 and TGF-β1 levels were decreased (P<0.05). The immunofluorescence intensity of IL-10 in the hippocampus was increased (P<0.05), while the intensity of IL-17 and TGF-β1 were decreased (P<0.05). H.E. staining showed that in the model group, the number of neurons in the hippocampus decreased, with disordered arrangement and loose structure, and a small numbers of neuronal nuclei were missing. The degree of tissue damage of the EA group was milder than that of the model group.CONCLUSIONS:EA can alleviate fatigue and spatial learning and memory impairment in CFS rats, which may be related to the regulation of peripheral and central inflammation.

Objective To observe the effect of scalp-abdominal acupuncture combined with donepezil hydrochloride on cognition and life ability of patients with Alzheimer's disease(AD),so as to evaluate its clinical efficacy.Methods Sixty AD patients were collected and randomly divided into control group(30 cases)and observation group(30 cases).Patients in the control group were treated with oral donepezil hydrochloride(5 mg,once daily).Patients in the observation group were treated with scalp-abdominal acupuncture at Baihui(GV20),Yintang(GV24+),Sishencong(EX-HN1),"emotional area",Shenting(GV24),"abdominal area 1""abdominal area 8",and bilateral Fengchi(GB20),Taixi(KI3),Xuanzhong(GB39),Zusanli(ST36)on the basis of control group,and electroacupuncture(10 Hz/50 Hz,0.5 to 5.0 mA)was applied to EX-HN1,"emotional area""abdominal area 1"and"abdominal area 8",once daily,30 min each time.Four weeks as a course of treatment,both the two groups were treated for two consecutive courses.Before and after treatment,the mini-mental state examination(MMSE),AD assessmennt scale-cognitive subscale(ADAS-Cog)and activity of daily living scale(ADL)were evaluated.The clinical efficacy index was calculated and safety was evaluated.Results After treatment,the MMSE and ADL scores were higher(P<0.05)and the ADAS-Cog score was lower(P<0.05)than those before treatment in both groups.Compared with the control group,the MMSE and ADL scores were increased(P<0.05)and ADAS-Cog score was decreased(P<0.05)in the observation group.The total effective rate of the observation group(26/30,86.67%)was higher(P<0.05)than that of the control group(23/30,76.67%).No adverse reactions occurred in both groups during the treatment.Conclusion Scalp-abdominal acupuncture combined with donepezil hydrochloride can effectively improve the cognitive ability and daily living ability of AD patients,and the efficacy is better than that of oral donepezil hydrochloride alone.

Objective To observe the effect of simulated repeated transcranial acupuncture(rTAS)on learning and memory abilities and cerebral microvascular flow in vascular dementia(VD)model rats,so as to explore the potential mechanism of rTAS in treating VD.Methods Thirty-two Wistar rats were randomly divided into normal,model,acupuncture and rTAS groups(n=8 rats in each group).The VD model was established by permanent ligation of bilateral common carotid arteries.For rats of the acupuncture group,"Baihui"(GV20)and"Shenting"(GV24)were needled,and for rats of the rTAS group,GV20 and GV24 were stimulated by simulated repeated transcranial manipulation(200 r/min,for 5 min).The treatment was conducted once daily for 14 days.After the intervention,learning and memory abilities were evaluated using the Morris water maze test.Laser speckle technology was used to measure the average cerebral microvascular flow.ELISA was performed to measure the contents of vascular endothelial growth factor(VEGF),endothelin-1(ET-1),nitric oxide(NO),and inducible nitric oxide synthase(iNOS)in the hippocampal tissues.Results In comparison with the normal group,the escape latency of rats in the model group was prolonged(P<0.01),and the times of crossing the platform were decreased(P<0.01).The average cerebral microvascular flow and the VEGF content in the hippocampus were significantly decreased,while the contents of NO,iNOS,and ET-1 were significantly increased(P<0.01).In comparison with the model group,the escape latency was significantly shortened(P<0.01),the average cerebral microvascular flow and VEGF content in the hippocampus were significantly increased(P<0.05,P<0.01),while contents of iNOS were significantly decreased(P<0.05,P<0.01)in both acupuncture and rTAS groups;and the times of crossing the platform were increased(P<0.01),the contents of NO and ET-1 in hippocampus were significantly decreased(P<0.01)in the rTAS group.The effects of rTAS were significantly superior to those of acupuncture in up-regulating the average cerebral microvascular flow(P<0.05)and VEGF content(P<0.01),and down-regulating the NO,iNOS and ET-1 contents(P<0.01,P<0.05).Conclusion rTAS can increase cerebral microvascular flow,improve spatial cognition and enhance learning and memory abilities of VD rats.The underlying mechanism may be involved in promoting angiogenesis,improving endothelial function and mitigating oxidative stress.

Chronic Fatigue Syndrome (CFS) is a complex and perplexing medical disorder primarily characterized by persistent and debilitating fatigue, often accompanied by a constellation of symptoms, including weakness, dyspnea, arthromyalgia, sore throat, and disrupted sleep patterns. CFS is defined by its persistent or recurrent manifestation for a minimum duration of six months, marked by an enduring and unrelenting fatigue that remains refractory to rest. In recent decades, this condition has garnered significant attention within the medical community. While the precise etiology of CFS remains elusive, it is postulated to be multifactorial. CFS is potentially associated with various contributory factors such as infections, chronic stress, genetic predisposition, immune dysregulation, and psychosocial influences. The pathophysiological underpinnings of CFS encompass viral infections, immune system dysregulation, neuroendocrine aberrations, heightened oxidative stress, and perturbations in gut microbiota. Presently, clinical management predominantly relies on pharmaceutical interventions or singular therapeutic modalities, offering alleviation of specific symptoms but exhibiting inherent limitations. Traditional Chinese Medicine (TCM) interventions have emerged as a promising paradigm, demonstrating notable efficacy through their multimodal, multi-target, multi-pathway approach, and holistic regulatory mechanisms. These interventions effectively address the lacunae in contemporary medical interventions. This comprehensive review synthesizes recent advancements in the understanding of the etiological factors, pathophysiological mechanisms, and interventional strategies for CFS, drawing from a corpus of domestic and international literature. Its aim is to furnish valuable insights for clinicians actively involved in diagnosing and treating CFS, as well as for pharmaceutical researchers delving into innovative drug development pathways. Moreover, it seeks to address the intricate challenges confronted by clinical practitioners in managing this incapacitating condition.

Sjogren’s syndrome (SS) is a chronic autoimmune disease. Mainly due to the infiltration of lymphoplasmic cells into the exocrine glands, especially the salivary glands and lacrimal glands, resulting in reduced tear and saliva secretion. Reduced tear flow can trigger Sjogren’s syndrome dry eye (SSDE). Although the pathophysiology of SSDE xerosis remains incompletely understood, recent advances have identified aquaporin-5 (AQP5) as a critical factor in dysregulation of the exocrine gland and epithelium, influencing the clinical presentation of SSDE through modulation of inflammatory microenvironment and tear secretion processes. This review aims to explore AQP5 regulatory mechanisms in SSDE and analyze its potential as a therapeutic target, providing new directions for SSDE treatment.