INTRODUCTION:Myofasciitis, a prevalent cause of musculoskeletal pain, is associated with thoracolumbar fascial changes. Acupuncture is effective for pain relief, but its role in fascial repair remains unclear. This study examined the effects of electroacupuncture (EA) at BL23 (Shenshu) and BL40 (Weizhong) on fascial tissue repair in a rat model of thoracolumbar fasciitis (TLF). METHODS:The study involved 42 six-week-old Sprague-Dawley rats divided into control (n = 15) and modeling (n = 27) groups. TLF was induced by injecting complete Freund's adjuvant into the thoracolumbar fascia. Three rats in the control and modeling groups were used for model validation. The remaining 24 modeled rats were split into model and EA groups (n = 12 each). EA was administered at BL23 and BL40 to rats in the EA group for 20 min daily for 9 days. Assessments included skin pain sensitivity, musculoskeletal ultrasound, histological evaluation of fascial thickness, and measurement of inflammatory markers and fibroblast activity. RESULTS:EA-treated rats showed significant improvements, including reduced mechanical pain sensitivity, decreased fascial thickness and lower expression of pro-inflammatory markers (tumor necrosis factor-α, interleukin 1β) and fibroblast activity markers (proliferating cell nuclear antigen, α-smooth muscle actin, and vimentin). There was also a favorable balance in extracellular matrix components (increased type I/III collagen and matrix metalloproteinase (MMP)-1/tissue inhibitor of MMP (TIMP)-1 ratios), which was linked to reduced activity of the transforming growth factor (TGF)-β1/suppressor of mother against decapentaplegic (Smad)2 pathway. CONCLUSION:EA at BL23 and BL40 reduces inflammation, inhibits fibroblast proliferation and activation, and promotes fascial repair, likely via modulation of the TGF-β1/Smad2 pathway. These findings support the therapeutic potential of EA for the treatment of myofasciitis, potentially aiding in chronic musculoskeletal pain management and fascial tissue repair.

Cervical Spondylosis Radiculopathy (CSR), a degenerative condition affecting the cervical spine,characterized by the irritation and compression of nerve roots, leading to a range of clinical symptoms such as numbness and pain in the neck, shoulders, upper limbs, and fingers. Neural Mobilization (NM)combined with Cervical Traction (CT) has emerged as a noteworthy therapeutic approach for CSR, gaining recognition for its effectiveness. This study endeavors to conduct a comprehensive and systematic review of available randomized controlled trials (RCTs) on NMCT. The objective is to critically assess the efficacy and safety of NM as a treatment modality for CSR.The study will analyze the methodologies, results, and any specific findings from the RCTs, providing a comprehensive assessment of the role of NMCT in managing CSR.

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) P <0.01) and MyoD (P<0.05) P <0.05) and decrease the expression level of Pax7 (P<0.05). P <0.05). In addition, we found that the number of apoptotic cells in cervical myocytes was reduced after Tuina intervention (P<0.05), P <0.05), and Tuina inhibited the expression of pro-apoptotic factor Bax (P<0.01) P <0.01) and promoted the expression of anti-apoptotic factor Bcl-2 (P<0.05). 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 Bcl2 to ameliorate the apoptosis of cervical myocytes in CCMI model rats.

OBJECTIVE:To observe the effects of electroacupuncture on threshold of pain, gait, proliferation and differentiation of muscle satellite cell in rats with acute blunt trauma of gastrocnemius muscle, and to explore the possible mechanism of electroacupuncture in promoting the repair of acute injury of skeletal muscle.METHODS:A total of 48 SD rats were randomly divided into a blank group (6 rats), a model group (24 rats) and an electroacupuncture group (18 rats). In the model group and the electroacupuncture group, the model of acute blunt trauma of gastrocnemius muscle was established by self-made impactor. In the electroacupuncture group, electroacupuncture was applied at "Chengshan" (BL 57) and "Yanglingquan" (GB 34) on the right side, with disperse-dense wave, in frequency of 2 Hz/100 Hz, once a day, 30 min each time. Electroacupuncture intervention was performed for 3, 7 and 14 days according to the sampling time. On the 1st, 3rd, 7th and 14th days after modeling, the mechanical withdrawal pain threshold of hindfoot was detected by Von Frey method; the standing time and the maximum contact area of the right hindfoot were recorded by Cat Walk XTTM animal gait analysis instrument; the morphology of the right gastrocnemius muscle and the number of inflammatory cells were observed by HE staining; the positive expression of paired box gene 7 (Pax7) and myogenic differentiation (MyoD) of the right gastrocnemius muscle was detected by immunofluorescence.RESULTS:After modeling, the muscle fiber rupture and massive infiltration of red blood cells and inflammatory cells were observed in the right gastrocnemius muscle; after electroacupuncture intervention, the morphology of muscle fiber was intact and the infiltration of inflammatory cells was improved. Compared with the blank group, in the model group, the differences of mechanical withdrawal pain threshold between the left and right foot were increased (P<0.05), the standing time was shortened and the maximum contact area of the right hindfoot was decreased (P<0.05), the number of inflammatory cells and the positive expression of Pax7 and MyoD of the right gastrocnemius muscle were increased (P<0.05) on the 1st, 3rd, 7th and 14th days after modeling. Compared with the model group, in the electroacupuncture group, the differences of mechanical withdrawal pain threshold were decreased (P<0.05), the standing time was prolonged (P<0.05), the number of inflammatory cells of right gastrocnemius muscle was decreased (P<0.05) on the 7th and 14th days after modeling; the maximum contact area of the right hindfoot was increased (P<0.05), the positive expression of MyoD of the right gastrocnemius muscle was increased (P<0.05) on the 3rd, 7th and 14th days after modeling; the positive expression of Pax7 of the right gastrocnemius muscle was increased (P<0.05) on the 3rd day after modeling.CONCLUSION:Electroacupuncture can effectively improve the pain threshold and gait in rats with acute blunt trauma of gastrocnemius muscle, and promote the repair of skeletal muscle injury, the mechanism may be related to the up-regulation of Pax7 and MyoD, so as to promoting the proliferation and differentiation of muscle satellite cell.

目的 探讨电针干预远近端穴位治疗肌筋膜疼痛综合征(MPS)的外周镇痛机制.方法 将24只SD大鼠随机分为空白组、模型组、近端组、远端组,每组6只.除空白组外,其余各组采用"打击结合离心运动"方式制备MPS模型.造模后近端组大鼠在局部激痛点结节即阿是穴处进行电针干预,频率2/100Hz、电压2～4V的疏密波,电流强度以大鼠左下肢出现轻微颤动为宜,每日1次,每次15min,连续14天.远端组大鼠电针阳陵泉穴加阴陵泉穴,余同近端组.空白组和模型组只做抓取和套头,不做其他干预.干预后测定左右足机械缩足反射阈值(PWMT),计算差值;进行左下肢股内侧肌肌骨超声影像学、肌电监测检测;HE染色法观察左下肢股内侧肌肌肉形态学变化;免疫组化法检测肌肉组织中P物质(SP)、降钙素基因相关肽(CGRP)、CD68、CD206的阳性表达;ELISA法检测腹主动脉血清中白细胞介素1β(IL-1β)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、白细胞介素10(IL-10)、白细胞介素8(IL-8)的含量.结果 与空白组相比,模型组大鼠左下肢股内侧肌肌纤维断裂、扭曲、纤维粗细不等,肌筋膜断裂,出现纤颤电位,肌细胞增大、核内移,肌间隙增宽,左右足PWMT差值明显增大,股内侧肌SP、CGRP、CD68、CD206水平明显升高(P＜0.01),血清IL-8、TNF-α水平明显升高(P＜0.05或P＜0.01).与模型组比较,近端组与远端组肌纤维形态完整,排列有序,肌筋膜连续无断裂,肌细胞形态规则,IL-8水平明显降低(P＜0.01);近端组自发性放电幅度及频率降低,左右足PWMT差值显著降低,股内侧肌SP、CGRP、CD68水平明显降低,CD206水平明显升高(P＜0.05或P＜0.01);远端组出现复杂性放电,股内侧肌CD68水平下降,CD206水平升高(P＜0.01).与近端组相比,远端组IL-8水平明显升高(P＜0.05).结论 电针近端穴位能显著改善大鼠痛阈和局部肌组织形态,其作用机制可能与降低致痛物质及相关炎症因子水平,促进巨噬细胞极化有关;电针远端穴位镇痛作用不明显,机制尚不清楚.

Objective:To observe the effects of electropuncture（EA） on myoelectric activity and apoptosis of posterior cervical muscle cells in rats with chronic cervical muscle injury.Methods:Seven Wistar rats were randomly selected from 34 Wistar rats and assigned to the blank group, and the remaining rats were used to establish a chronic cervical muscle injury model（as detected by ultrasonic diagnosis, six rats failed for model induction and were excluded）.The model rats were randomly divided into a model group, an EA group, and a meloxicam group, with seven rats in each group.The rats in the EA group received EA treatment at bilateral Fengchi（GB 20）,25 min each time, once a day, for 10 consecutive days as a course of treatment, with a two-day interval between the two courses of treatment, for a total of two courses.An ultrasonic diagnostic system was used to detect the morphological changes in rat posterior cervical muscle tissues, and electrophysiological records presented the changes in rat cervical muscle myoelectricity.Cell apoptosis rate was detected using the TUNEL method, and protein expression levels of B-cell lymphoma 2（Bcl-2）,Bcl-2-associated X protein（Bax）,cysteinyl aspartate-specific protease 3（Caspase-3）,and cysteinyl aspartate-specific protease 9（Caspase-9） were detected by immunohistochemistry.Results:The results of the ultrasonic examination showed that the arrangement of muscle fibers was orderly and the muscle thickness increased after EA treatment as compared with the conditions in the model group.The results of the electrophysiological test showed that the amplitude and frequency of myoelectricity in the model group were significantly attenuated, and the amplitude and frequency of myoelectricity after EA were significantly higher than those in the model group.TUNEL results showed that the number of apoptotic cells in the EA group was significantly reduced compared with that in the model group（P＜0.05）.Immunohistochemical results showed that the number of Bcl-2 positive cells in the model group was lower and the number of Bax, Caspase-3,and Caspase-9 positive cells was higher than those in the blank group（P＜0.05）.The number of Bcl-2 positive cells in the EA group was higher, and the number of Bax, Caspase-3,and Caspase-9 positive cells was lower than those in the model group（P＜0.05）.Conclusion:EA can repair chronic cervical muscle injury, and its mechanism may be attributed to increasing the amplitude of cervical muscle electromyography and inhibiting apoptosis in rats with chronic cervical muscle injury, which may be realized by inhibiting the activity of the mitochondrial pathway.

OBJECTIVE:To observe the effect of chiropractics on intervertebral disk extracell matrix metalloproteinase (MMP)-1, MMP-3, MMP-13, cellular collagen type Ⅱ (COL-Ⅱ), tissue inhibitor 1 of metalloproteinase (TIMP-1) and extracellular matrix (ECM) in the rats with cervical spondylosis, so as to explore its mechanism underlying improvement of cervical spondylosis. METHODS:A total of 40 SD rats were randomized into a sham group, a model group, a chiropractics group and a mobic group, 8 rats in each one. The model was established by static-dynamic imbalance method. The rats in the chiropractics group were treated with chiropractic therapy for two courses, 14 times a day and 14 days as a course. The rats in the mobic group were treated with intragastric administration of mobic. The expression of MMP-1, MMP-3, MMP-13, COL-Ⅱ and TIMP-1 in the intervertebral disk tissue were detected by immunohistochemistry, and the protein expression of ECM was detected by Western blot. RESULTS:Compared with those in the sham group, the expressions of MMP-1, MMP-3, MMP-13 in the model group increased (all P<0.05), and COL-Ⅱ, TIMP-1 decreased (both P<0.05).Compared with those in the model group, the expressions of MMP-1, MMP-3, MMP-13 in the chiropractics group and the mobic group decreased (all P<0.05), and COL-Ⅱ, TIMP-1 increased (all P<0.05). Compared with that in the sham group, the expression of ECM protein in the model group decreased (P<0.05). Compared with that in the model group, the expression of ECM protein in the chiropractics group and the mobic group increased (both P<0.05). CONCLUSIONS:Chiropractics may improve the degeneration in rats with cervical spondylosis by regulating intervertebral disc ECM system and relevant metabolic enzymes.

目的:探讨电针在颈椎病大鼠模型椎间盘软骨细胞的凋亡,以及磷脂酰肌醇3-激酶/丝氨酸-苏氨酸蛋白激酶(PI3 K/Akt)信号传导通路中的两个蛋白PI3K、Akt的影响.方法:将40只SD大鼠按随机数字表法分成电针组、莫比可组、假手术组、模型组4组各8只,雌雄各半.电针组给予“颈夹脊”、“手三里”穴治疗25 min/d/次,14 d为1个疗程共2个疗程,中间休息2d;莫比可组用莫比可进行灌胃处理;模型组、假手术组无任何治疗只做固定,其治疗疗程同电针组.疗程结束,取大鼠颈部椎间盘组织测生化相关指标.结果:电针治疗后可见颈椎病大鼠模型软骨细胞中PI3K、P-Akt、Bcl-2的蛋白含量表达上升且幅度大,Bax的表达则出现抑制.结论:电针能延缓颈椎病大鼠椎间盘软骨细胞的凋亡过程,其机制与PI3 K/Akt信号传导通路与Bcl-2、Bax的含量可能有关.

中老年肥胖是常见临床表现,与健康密切相关,健脾益肾推拿治疗肥胖有其优势,文章通过分析肥胖产生的中医病因病机、治法、及治疗起效可能的机制进行初步探究.

睑黄瘤属于黄瘤病,其发病与脂质代谢障碍有关,好发眼睑内眦部,为常见的损容性皮肤病,陈友义教授运用中医火针治疗该病优势独特,简要论述其治疗经验,以供临床参考.

穴位埋线治疗单纯性肥胖,具有独特优势.从中医学角度对肥胖形成的病因病机、治法、辨证选穴方面略述一二,并举例予以说明.