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BACKGROUND: The role of the piriform cortex (PC) in olfactory information processing remains largely unknown. The anterior part of the piriform cortex (APC) has been the focus of cortical-level studies of olfactory coding, and associative processes have attracted considerable attention as an important part in odor discrimination and olfactory information processing. Associational connections of pyramidal cells in the guinea pig APC were studied by direct visualization of axons stained and quantitatively analyzed by intracellular biocytin injection in vivo. RESULTS: The observations illustrated that axon collaterals of the individual cells were widely and spatially distributed within the PC, and sometimes also showed a long associational projection to the olfactory bulb (OB). The data showed that long associational axons were both rostrally and caudally directed throughout the PC, and the intrinsic associational fibers of pyramidal cells in the APC are omnidirectional connections in the PC. Within the PC, associational axons typically followed rather linear trajectories and irregular bouton distributions. Quantitative data of the axon collaterals of two pyramidal cells in the APC showed that the average length of axonal collaterals was 101 mm, out of which 79 mm (78% of total length) were distributed in the PC. The average number of boutons was 8926 and 7101, respectively, with 79% of the total number of boutons being distributed in the PC. The percentage of the total area of the APC and the posterior piriform cortex occupied by the average distribution region of the axon collaterals of two superficial pyramidal (SP) cells was about 18 and 5%, respectively. CONCLUSION: Our results demonstrate that omnidirectional connection of pyramidal cells in the APC provides a substrate for recurrent processes. These findings indicate that the axon collaterals of SP cells in the PC could make synaptic contacts with all granule cells in the OB. This study provides the morphological evidence for understanding the mechanisms of information processing and associative memory in the APC.

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<p><b>OBJECTIVE</b>To observe the improvement of acupuncture and moxibustion on symptoms of-deficiency syndrome as well as their differences on the parameters of heart rate variability (HRV).</p><p><b>METHODS</b>Thirty patients with-deficiency syndrome and 15 healthy volunteers were recruited. Thirty patients with-deficiency syndrome were randomly assigned into an acupuncture group and a moxibustion group, 15 cases in each one. Fifteen healthy volunteers were allocated as a healthy control group. Patients in the acupuncture group and healthy control group were treated with acupuncture while patients in the moxibustion group were treated with moxibustion. Guanyuan (CV 4) and Zusanli (ST 36) were chosen for treatment, once every other day, for totally 10 times. All the patients were evaluated with-deficiency assessment scale (QDAS) and HRV parameters before treatment, after 4th treatment and after all treatment. The correlation was analyzed between QDAS and HRV parameters, and HRV parameters were compared among the three groups before treatment, after 4th treatment and after all treatment.</p><p><b>RESULTS</b>Compared before treatment, the scores of QDAS were decreased in the acupuncture group and the moxibustion group after 4th treatment and after all treatment (all<0.05); after all treatment the score of QDAS in the moxibustion group was lower than that in the acupuncture group (<0.05). The HRV parameters of-deficiency syndrome were significantly lower than those of healthy volunteers with higher correlation with QDAS. Compared before treatment, the mean heart rate was decreased after treatment (<0.05), while total HRV and low frequency were increased in the moxibustion group (both<0.05). The mean heart rate in the healthy control group was increased after treatment (<0.05). The differences of HRV parameters before and after treatment were not significant in the acupuncture group (all>0.05).</p><p><b>CONCLUSIONS</b>Total HRV can reflect the severity of-deficiency syndrome. Both acupuncture and moxibustion can improve symptoms of-deficiency patients, which is superior in moxibustion. The possible mechanism is likely to be related with improved sustainable activation of autonomic nervous system.</p>

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In order to investigate the different effects of acupuncture and moxibustion on chronic fatigue syndrome (CFS) and alterations in the autonomic nervous system by measuring heart rate variability (HRV). Forty-five participants were recruited and randomly divided into 3 groups using a randomization schedule. The control group (CG, n = 15) and the acupuncture group (AG, n = 15) were treated by manipulation acupuncture, and the moxibustion group (MG, n = 15) was treated by indirect moxibustion. Primary outcomes were the scores of the Fatigue Assessment Instrument (FAI). Secondary outcomes were the HRV parameters which can reflect activity of the autonomic nervous system. This trial considered both instantaneous changes and long-term effectiveness. FAI scores decreased after the 4th and 10th treatments in the 3 groups. The decrease in FAI in the MG was greater than that in the AG. Acupuncture was more effective in instantaneous changes of HRV and moxibustion in long-term aspects. Both acupuncture and moxibustion improved fatigue in CFS patients, but moxibustion was more effective. The possible mechanism of the intervention may be through activation of the vagus nerve. Moxibustion was more effective than acupuncture in long-term treatment of CFS.

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To study the effects of acupuncture analgesia on the hippocampus, we observed the effects of electroacupuncture (EA) and mitogen-activated protein kinase (MEK) inhibitor on pain-excited neurons (PENs) and pain-inhibited neurons (PINs) in the hippocampal area CA1 of sham or chronic constrictive injury (CCI) rats. The animals were randomly divided into a control, a CCI, and a U0126 (MEK1/2 inhibitor) group. In all experiments, we briefly (10-second duration) stimulated the sciatic nerve electrically and recorded the firing rates of PENs and PINs. The results showed that in both sham and CCI rats brief sciatic nerve stimulation significantly increased the electrical activity of PENs and markedly decreased the electrical activity of PINs. These effects were significantly greater in CCI rats compared to sham rats. EA treatment reduced the effects of the noxious stimulus on PENs and PINs in both sham and CCI rats. The effects of EA treatment could be inhibited by U0126 in sham-operated rats. The results suggest that EA reduces effects of acute sciatic nerve stimulation on PENs and PINs in the CA1 region of the hippocampus of both sham and CCI rats and that the ERK (extracellular regulated kinase) signaling pathway is involved in the modulation of EA analgesia.

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Treatment by auricular acupuncture has a long history. Ear-acupoint research has been advancing step by step in China and also in Europe. Auricles are rich in nerves, therefore a close relationship with different functions of the human body has been proved by the research teams of the two main authors of this article from China and Austria. In recent years, great progress has been made in the research of regulating human body functions through electroacupuncture at the auricular branch of the vagus nerve, which is part of auricular acupuncture therapy. It is well known that the auricular branch of the vagus nerve is the only peripheral pathway to the cerebral cortex. Studies of the Chinese team on hypertension, diabetes, epilepsy and depression have shown that the mechanism of auricular vagus nerve stimulation (VNS) may be comparable with cervical VNS in terms of pathways. Auricular VNS has a broad clinical application prospect.

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BACKGROUND AND AIMS: The yellow laser constitutes a totally new option in the field of laser acupuncture, in addition to the already existing red, near infrared, green and violet lasers. Especially for so called lifestyle-related diseases, this could open up new methods of integrative therapy. The goal of the present study was to investigate among other parameters blood pressure (BP), heart rate (HR), heart rate variability (HRV), and temperature effects before, during, and after stimulation of different acupoints with yellow laser. SUBJECTS AND METHODS: We recruited 26 healthy volunteers (13 female, 13 male; mean age ± SD 24.1 ± 3.3 years) at the Medical University of Graz. The acupoints Baihui, Neiguan, Taichong and a placebo point were stimulated with a 589 nm (50 mW, 500 µm; 5 min) yellow laser. Blood pressure was measured noninvasively at the wrist; for the registration of the electrocardiogram a medilog AR12 HRV system was used. Effects on temperature were measured with a Flir i7 infrared camera. RESULTS: There were significant decreases after yellow laser acupuncture in the systolic BP, diastolic BP also decreased (n.s.). HRV in both (men and women) increased. The temperature during the yellow laser stimulation decreased significantly in all measured points. After the stimulation it increased again significantly. Based on a questionnaire volunteers reported a significantly decreased level of stress after yellow laser stimulation. CONCLUSION: Significant positive effects on BP and well-being were found after yellow laser stimulation. The results are very promising and can be very important especially for the treatment of lifestyle related diseases.

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We observed the inhibitive effect of electroacupuncture (EA) at Zusanli on inflammatory mediators of postoperative intra-abdominal adhesions to find out the relationship between EA and the cholinergic anti-inflammatory pathway. Sixty-four rats were divided into 8 groups (A-H, each = 8): A = sham control; B = abdominal adhesions model; C = abdominal adhesions plus EA; D = sham acupoint control; E = abdominal adhesions plus vagotomy; F = abdominal adhesions plus EA after vagotomy; G = abdominal adhesions plus α-bungarotoxin (BGT); and H = abdominal adhesions plus EA after α-BGT. α-BGT (1 µg/kg) was injected into the abdominal cavity after surgery, and the bilateral celiac vagotomy was done during the surgery. On the third day the levels of inflammatory mediators (TNF-α, nitric oxide (NO), and nitric oxide synthase (NOS)) in tissues were evaluated. The abdominal adhesion groups developed obvious edema. Compared with sham control, the abdominal adhesion resulted in a significant elevation of inflammatory mediators. EA lowered the elevated levels of inflammatory mediators significantly; EA plus α-BGT and vagotomy showed less anti-inflammatory effects. The activation of the cholinergic anti-inflammatory pathway might be one of the mechanisms of EA at Zusanli acupoints to exert the anti-inflammatory effects.

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Hypertension is one of the major risk factors for cardiovascular disease worldwide. Over 70% of the patients use antihypertensive drugs, so nonpharmacological treatments in addition to the medication are important. Our goal was to investigate acupuncture treatment on the Quchi acupoint using heart rate (HR) and heart rate variability (HRV) and to find out whether there is a laterality in acute effects. Sixty hypertensive patients (36 female, 24 male; mean age ± SD 55.8 ± 9.7 years) were randomly assigned to two manual needle acupuncture groups (group A: left Quchi (LI11) acupoint, group B: right Quchi acupoint). There was a significant (P < 0.05) decrease in HR immediately after inserting and stimulating the needle at the left and the right Quchi acupuncture point. In contrast, total HRV increased immediately after inserting the needle, but this increase was significant only towards the end of the stimulation phase and after removing the needle. There were some differences between stimulation of the left and right Quchi acupoint, but they remained insignificant. This study provides evidence that there is a beneficial effect on heart rate variability in patients with hypertension and that there are some effects of laterality of the acupoint Quchi.

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We observed the effect of scalp point cluster-needling treatment on learning and memory function and neurotransmitter levels in rats with vascular dementia (VD). Permanent ligation of the bilateral carotid arteries was used to create the VD rat model. A Morris water maze was used to measure the rats' learning and memory function, and the changes in neurotransmitter levels in the rats' hippocampus were analyzed. The results show that scalp point cluster-needling can increase the VD rat model's learning and memory score. The VD rat model's learning and memory score was significantly different when compared with that of the sham operation group (P < 0.05). Hippocampal acetylcholine (ACh), dopamine (DA), and 5-hydroxytryptamine (5-HT) concentrations significantly decreased in the rat model. Compared with the model group, the scalp point cluster-needling group's ACh concentration markedly increased and DA and 5-HT levels increased as well. In conclusion, scalp point cluster-needling can improve learning and memory function in VD rats, and its function may be related to an increase in neurotransmitter release.

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Tongue acupuncture (TA) is a method which is not used in western medicine and even in China it is applied very rarely in clinical practice. This study aimed at investigating whether additional TA can improve the efficacy of body acupuncture (BA) in patients with depression. Twenty patients with a mean age of ± SD of 42.9 ± 11.2 years were randomly divided into two groups (n = 10 patients each), one group receiving BA (Zusanli, Sanyinjiao, Neiguan, Shenting, Yintang, and Baihui) and the other receiving BA and TA (Liver, Heart, and Brain). The quantitative and qualitative outcome measures were heart rate (HR), heart rate variability (HRV), and different clinical scores. We found that in both groups all scores and HR improved significantly, whereas HRV increased partly significantly. It seems that TA can enhance acute and treatment effects of BA in patients with depression. The investigation of de qi sensation in TA needs further attention.

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Acute skin surface temperature effects on the knee were investigated after a manual therapy developed by Mohamed Khalifa (RegentK) compared to standard physiotherapy in patients with completely ruptured anterior cruciate ligament (ACL). Twenty patients participated in this study. They were randomly assigned to group A (receiving RegentK) or group B (physiotherapy). Each group consisted of 10 patients. Temperature values were registered on four spots (three on the knee, one on the foot) of the injured and the healthy leg (control). Skin temperature increased significantly after RegentK on all sites of the injured leg, but after physiotherapy only the measurement spots on the knee showed significant increases. After RegentK the temperature had also increased significantly on the control leg, whereas in group B, the results were not significant. Experimental and clinical testing of technical equipment, e.g., infrared thermography, for ACL injuries is important for a better understanding of the different physiological/pathophysiological mechanisms underlying different therapy approaches.

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Background: Within this study, a new system which measures and analyzes electrical skin impedance in 48 channels within a 2.5 × 3.5 cm matrix is used in rehabilitation medicine for the first time. Methods: Electrodermal activity was measured in 20 patients before and after two different non-surgical treatments of a completely ruptured anterior cruciate ligament. The first treatment, RegentK, was developed by Mohamed Khalifa, the second is a standard physiotherapy. Results: The patients in the two groups were age-matched, and all demographic data showed no significant differences. It was interesting that electrodermal activity was significantly decreased only after RegentK. Conclusion: We conclude that not only local effects of pressure application are responsible for these results, rather as yet unknown neurovegetative mechanisms have to be taken into consideration.

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BACKGROUND: According to Traditional Chinese Medicine (TCM) theory, acupuncture effects are based on the integrity function of meridians. Meridians are thought to regulate body function through the normal flow of qi and/or blood. Disturbances in this flow are thought to cause disease, and acupuncture techniques are believed to cure disease by regulating this flow. However, it is still difficult to understand the exact meaning of qi and to evaluate the activation of meridians. Thus, more and more attention has been focused on the relationship of acupuncture and circulation. METHODS: In this narrative review, the authors focus on the state of the art in acupoint activation, microcirculation response, and on investigation of mast cells, based on current literature research. RESULTS: Altogether, 52 references are cited and discussed critically. A schematic diagram of the relationship between acupuncture stimulation, changes of microcirculation and mast cells is presented as result. CONCLUSION: The block diagram presented in this review article shows that mast cells might play an important role in circulation response after acupoint stimulation.

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The goal of this study was to investigate the impact and acceptability of providing continuous auricular electroacupuncture as an adjunct to conventional medications for patients with depression. Ten patients with a mean age ± SD of 43.3 ± 10.4 years were able to provide informed consent. The quantitative and qualitative outcome measures were heart rate, heart rate variability (HRV), and different clinical scores. The study documented that a special kind of auricular electro acupuncture, applied over a period of three days, can improve various aspects of quality of life significantly but also highlighted the significant increase of HRV whilst having acupuncture treatment. In conclusion, our study shows stimulation-related and quantifiable clinical and physiological alterations in parameters after continuous auricular acupoint stimulation in patients with depression. Improved access to electro acupuncture treatment would be of major benefit for these patients. Further studies are necessary in order to verify the gained results.

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Changes of light intensity of different colors can shift many physiological parameters and conditions like melatonin, alertness, body temperature, heart rate (HR), and heart rate variability (HRV). The aim of this pilot study was to investigate acute temperature, HR, HRV, and state of mind reactivities after illumination with red (631 nm) and blue (456 nm) light (illuminance 140 lux for both). Seven healthy volunteers (5 females, 2 males; mean age ± SD 34.1 ± 11.9 years) were investigated at the Medical University of Graz, using new color light panels. Significant decreases were found only after 10 min blue light stimulation in nose temperature (P = 0.046), HR (P < 0.05), and total HRV (P = 0.029), in association with a significant alteration of the emotional state (stress level score, P = 0.006). However, red light stimulation of the same persons did not induce the same effects in these parameters. The effect of blue light as environmental stimulation on human health is not clarified in detail and needs further investigations.

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We investigated manual needle and laser needle acupuncture as a complementary therapy for patients with burnout syndrome. Twenty patients with a mean age ± SD of 38.7 ± 8.4 years were assigned to two groups, each consisting of ten patients. One group was treated with manual needle acupuncture and the other with laser needle acupuncture. Heart rate, heart rate variability (HRV), and a new score called dynamic acupuncture treatment score (DATS) served as evaluation parameters. The study documented significant effects on heart rate after needle acupuncture treatment and significant effects on HRV caused by both needle and laser needle acupuncture. Based on new neurovegetative acupuncture treatment evaluation scores, it can be stated that both noninvasive laser needle acupuncture and manual needle acupuncture have the potential to be a powerful approach for evidence-based complementary treatment of patients with burnout syndrome. Further transcontinental studies to verify or refute the preliminary findings are in progress.

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The purpose of this study was to evaluate the influence of the duration of interstitial laser acupuncture therapy effects on neurovegetative and neurobioelectrical parameters like heart rate (HR), heart rate variability (HRV), and electroencephalogram (EEG). We investigated 6 male Sprague-Dawley rats. They underwent 10 min, 20 min, and 30 min interstitial laser acupuncture (in randomized order, with a break of at least 30 min between the different measurement conditions) at the acupoint Neiguan. HR changed significantly only during 20 min red laser stimulation, whereas 10 and 30 min stimulation did not induce significant changes. HRV did not change significantly during any of the different durations; however, an increase was found during 20 min irradiation. Neither the LF/HF ratio of HRV nor the integrated EEG showed significant changes. In this study, it could be experimentally proved that some effects of laser acupuncture are time dependent, and therefore the dosage, as well known from theory, also depends on the time factor. We could especially demonstrate that different treatment times lead to different effects on neurovegetative and neurobioelectrical parameters. Further studies are needed to verify or refute these results.

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The aim of this study was to observe the effect of electroacupuncture (EA) at the ST36 acupoint on the firing rate of gastric-related neurons in the spinal dorsal horn (SDH) and nucleus tractus solitarius (NTS). There were different effects of gastric distention in SDH and NTS in 46 male Sprague-Dawley rats. In 10 excitatory neurons in SDH, most of the neurons were inhibited by homolateral EA. The firing rates decreased significantly (P < 0.05) in 10 excitatory gastric-related neurons in NTS; the firing rates of 6 neurons were further excited by homolateral EA, with a significant increase of the firing rates (P < 0.05); all inhibitory gastric-related neurons in NTS were excited by EA. The inhibition rate of homolateral EA was significantly increased in comparison with contralateral EA in gastric-related neurons of SDH (P < 0.05). There was no significant difference between homolateral and contralateral EA in gastric-related neurons of NTS. EA at ST36 changes the firing rate of gastric-related neurons in SDH and NTS. However, there are some differences in responsive mode in these neurons. The existence of these differences could be one of the physiological foundations of diversity and complexity in EA effects.

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There are only few scientific publications dealing with the basic investigation of the effects of only one or two acupoints or comparing one single point with another single point, using different stimulation methods in the same persons. The aim of this needle-controlled, randomized crossover study was to investigate the neurovegetative parameters heart rate (HR) and heart rate variability (HRV) using two different acupoints, Baihui (GV20) and Neiguan (PC6), in separate sessions. We investigated 11 healthy volunteers (3 m, 8 f) with a mean age ± SD of 22.9 ± 2.8 years. The two acupoints were stimulated for 10 minutes each with manual needle acupuncture, red laser acupuncture (658 nm), and violet laser acupuncture (405 nm), in randomized order. Needle and red laser stimulation of the Baihui acupoint decreased HR significantly. Only violet laser stimulation at the Neiguan acupoint induced a significant increase of total HRV. Further studies using other neurovegetative parameters and more volunteers are necessary to confirm the preliminary results.

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This study investigated the protective effect and mechanism of electroacupuncture at ST36 points on the intestinal barrier dysfunction and remote organ injury after intestinal ischemia and reperfusion injury in rats. Rats were subjected to gut ischemia for 30 min, and then received electroacupuncture for 30 min with or without abdominal vagotomy or intraperitoneal administration of cholinergic α 7 nicotinic acetylcholine receptor ( α 7nAChR) inhibitor. Then we compared its effects with electroacupuncture at nonchannel points, vagal nerve stimulation, or intraperitoneal administration of cholinergic agonist. Cytokine levels in plasma and tissue of intestine, lung, and liver were assessed 60 min after reperfusion. Intestinal barrier injury was detected by histology, gut injury score, the permeability to 4 kDa FITC-dextran, and changes in tight junction protein ZO-1 using immunofluorescence and Western blot. Electroacupuncture significantly lowered the levels of tumor necrosis factor- α and interleukin-8 in plasma and organ tissues, decreased intestinal permeability to FITC-dextran, and prevented changes in ZO-1 protein expression and localization. However, abdominal vagotomy or intraperitoneal administration of cholinergic α 7nAChR inhibitor reversed these effects of electroacupuncture. These findings suggest that electroacupuncture attenuates the systemic inflammatory response through protection of intestinal barrier integrity after intestinal ischemia injury in the presence of an intact vagus nerve.