Wenbin Fu

Role of AC-cAMP-PKA Cascade in Antidepressant Action of Electroacupuncture Treatment in Rats

Adenylyl cyclase (AC)-cyclic adenosine monophosphate (cAMP)-cAMP-dependent protein kinase A (PKA) cascade is considered to be associated with the pathogenesis and treatment of depression. The present study was conducted to explore the role of the cAMP cascade in antidepressant action of electroacupuncture (EA) treatment for chronic mild stress (CMS)-induced depression model rats. The results showed that EA improved significantly behavior symptoms in depression and dysfunction of AC-cAMP-PKA signal transduction pathway induced by CMS, which was as effective as fluoxetine. Moreover, the antidepressant effects of EA rather than Fluoxetine were completely abolished by H89, a specific PKA inhibitor. Consequently, EA has a significant antidepressant treatment in CMS-induced depression model rats, and AC-cAMP-PKA signal transduction pathway is crucial for it.

The optimized acupuncture treatment for neck pain caused by cervical spondylosis: a study protocol of a multicentre randomized controlled trial

BackgroundNeck pain is one of the chief symptoms of cervical spondylosis (CS). Acupuncture is a well-accepted and widely used complementary therapy for the management of neck pain caused by CS. In this paper, we present a randomized controlled trial protocol evaluating the use of acupuncture for CS neck pain, comparing the effects of the optimized acupuncture therapy in real practice compared with sham and shallow acupuncture.Methods/DesignThis trial uses a multicentre, parallel-group, randomized, sham acupuncture and shallow acupuncture, controlled single-blind design. Nine hospitals are involved as trial centres. 945 patients who meet inclusion criteria are randomly assigned to receive optimized acupuncture therapy, sham acupuncture or shallow acupuncture by a computerized central randomization system. The interventions past for 4 weeks with eight to ten treatments in total. The group allocations and interventions are concealed to patients and statisticians. The Northwick Park Neck Pain Questionnaire (NPQ) is used as the primary outcome measure, and the McGill Pain Questionnaire (MPQ) and The Short Form (36) Health Survey (SF-36) are applied as secondary outcome measures. The evaluation is performed at baseline, at the end of the intervention, and at the end of the first month and the third month during follow-up. The statistical analyses will include baseline data comparison and repeated measures of analysis of variance (ANOVA) for primary and secondary outcomes of group and time differences. Adverse events (AEs) will be reported if they occur.DiscussionThis trial is a multicentre randomized control trial (RCT) on the efficacy of acupuncture for CS neck pain and has a large sample size and central randomization in China. It will strictly follow the CONSORT statement and STRICTA extension guideline to report high-quality study results. By setting the control groups as sham and shallow acupuncture, this study attempts to reveal the effects of real acupuncture versus placebo or non-classic acupuncture treatment and evaluate whether classic Chinese medical acupuncture is effective on CS neck pain. This study will provide evidence for the effects of acupuncture on CS neck pain.Trial RegistrationChinese Clinical Trial Registry: ChiCTR-TRC-00000184.

Deqi Sensation in Placebo Acupuncture: A Crossover Study on Chinese Medicine Students

Objective. To evaluate the similarity of deqi sensation of real and noninvasive placebo acupuncture in healthy people with knowledge of Chinese medicine. Methods. In a crossover design, volunteers recruited from Chinese medicine college students were randomized to two groups to receive two phases of intervention with a one-week washout interval. In Group A, the participants were firstly treated by real acupuncture and then by sham needle, and the treatment sequence was reversed in Group B. VAS for pain intensity and deqi sensation was evaluated as outcomes. Results. Sixty-three volunteers were recruited and 60 were included and finished the study. In Group A, VAS was higher in Phase I than in Phase II (P = 0.017). Only treatment methods were selected as factor to VAS difference (P = 0.046) in ANOVA test. More positive deqi was reported in Group A in Phase I when treated by real acupuncture (P = 0.039), but the difference was not significant in Phase II (P = 0.301). Conclusion. The noninvasive placebo acupuncture device can effetely simulate the deqi sensation as real acupuncture, but it is less likely to evoke the active effect of deqi in real practice. This trial is registered with Chinese Clinical Trial Registry: ChiCTR-ORC-09000505.

A similarity based learning framework for interim analysis of outcome prediction of acupuncture for neck pain

Chronic neck pain is a common morbid disorder in modern society. Acupuncture has been administered for treating chronic pain as an alternative therapy for a long time, with its effectiveness supported by the latest clinical evidence. However, the potential effective difference in different syndrome types is questioned due to the limits of sample size and statistical methods. We applied machine learning methods in an attempt to solve this problem. Through a multi-objective sorting of subjective measurements, outstanding samples are selected to form the base of our kernel-oriented model. With calculation of similarities between the concerned sample and base samples, we are able to make full use of information contained in the known samples, which is especially effective in the case of a small sample set. To tackle the parameters selection problem in similarity learning, we propose an ensemble version of slightly different parameter setting to obtain stronger learning. The experimental result on a real data set shows that compared to some previous well-known methods, the proposed algorithm is capable of discovering the underlying difference among different syndrome types and is feasible for predicting the effective tendency in clinical trials of large samples.

Deep learning for acupuncture point selection patterns based on veteran doctor experience of Chinese medicine

The inheritance of clinical experience of veteran doctors of Chinese medicine (CM) plays a key role in the development and effectiveness enhancement of Chinese medicine in the history. The clinical experience are classified as the patterns of disease diagnosis and Chinese medical Zheng diagnosis, the identification of core elements of Zheng, the treatment experience and relation of herbal medicine formulae, Zheng and disease, and the common law of diagnosis and treatment in real practice. The source of the experience mainly originates from literature and manuscripts of CM masters, which are being electronically recorded during the last two decades. As a result, it makes feasible to apply data mining to the knowledge discovery through the experience of veteran CM doctors. However, the current focus on this field is limited to the published literature such as journal papers, conference proceedings and textbooks, but the paper based manuscripts personally written by the veteran doctors are usually neglected. In this paper, we established a database for Dr Situ Ling, who is a deceased famous CM acupuncture master in southern China. The study objective is to discover the acupuncture point selection patterns which require profession knowledge and experience from senior CM doctors. It is believed these patterns are deposited as underlying knowledge with various middle level concepts that can be analyzed and discover by a serial of algorithms. Thus in this work, we formularized the patterns of acupuncture point selection as a learning task with deep architecture, which attempts to capture either existent or underlying concepts so as to simulate the planning process of the combined diagnosis of western medicine and Chinese medicine. The Restricted Boltzmann Machines (RBM) was used as the main model for deep learning to process to medical record data with international standard diagnosis (ICD-10) previously made by trained doctors. Then the ICD-10 based diagnosis dataset was introduced into our framework to enhance the concepts diversity. After applying this model, the learning accuracy based on the medical record database of Dr Situ Ling was raised up to 75%. Thus this model can serve as a solution to discover the acupuncture point selection patterns of CM acupuncture veteran doctors. Furthermore, the data mining study model linked by international diagnosis standard (i.e. ICD-10), point selection patterns, and clinical symptoms will provide useful cues to reveal the essence of Zheng diagnosis through experience of CM veteran doctors.

Gender-Related Differences in Outcomes on Acupuncture and Moxibustion Treatment Among Depression Patients

OBJECTIVES This study sought to (1) assess the effectiveness of acupuncture and moxibustion with a method of soothing the liver and regulating the mind on the quality of life among patients with depression and (2) study the sex differences of acupuncture and moxibustion in the treatment of depression on the basis of patient-reported outcomes. METHODS In a single-blind, randomized, controlled trial conducted in Guangdong Province, China, in January and December 2010, 163 patients who met the criteria for depression were enrolled. Eligible patients were allocated to three treatment groups (soothing liver and regulating mind group, acupoint shallow puncturing group, and non-acupoint shallow puncturing group). In all three groups, the treatment was given twice a week for 12 weeks. The Hamilton Depression Rating Scale (HAMD) and Symptom Checklist 90 (SCL90) were used to quantitatively assess patients before and 1 and 3 months after treatment. RESULTS Non-statistically significant differences in the acupuncture and moxibustion therapeutic effects of soothing liver and regulating mind treatment were found between men and women (p>0.05). An item-by-item analysis of the SCL90 and HAMD scores showed sex differences between the efficacy of the soothing liver and regulating mind group and the group receiving acupoint shallow puncturing. Women obtained lower scores in somatization, interpersonal relationship, anxiety, terror, and extremeness items and HAMD scores in the soothing liver and regulating mind group than in the acupoint shallow puncturing group (p<0.05), while men showed no significant differences between the soothing liver and regulating mind group and the acupoint shallow puncturing group (p>0.05). CONCLUSIONS The therapeutic effect of soothing liver and regulating mind is similar for both sexes, but women were more sensitive to the efficacy of the soothing liver and regulating mind treatment compared with other methods. These findings could indicate an important issue to consider for the different acupuncture and moxibustion treatments for depression in men and women.

A kernel-decision tree based algorithm for outcome prediction on acupuncture for neck pain: A new method for interim analysis

Neck pain is a common disorder in modern society as the result of changes in working and life style. Acupuncture is a traditional treatment of Chinese medicine for neck pain, whose therapeutic mechanism follows the classic knowledge and understanding of Chinese medicine. Syndrome-based diagnosis and treatment is a significant feature of Chinese medicine, and guides the practice of acupuncture. In the treatment of neck pain, acupuncture provides a standard prescription whose effect is support by latest multi-center RCTs. However, the potential difference of its effectiveness in different syndrome types is challenged due to small sample size and limits of statistical power. In our study, we apply the machine learning methods to a data set of the outcomes of a multi-center RCT clinical trial, which consists of demographical information and efficacy outcomes. A decision tree with kernel mapping was applied as the main algorithm to discover the underlying relationship and difference between clinical outcomes among different syndrome types, and to predict its tendency in trials with larger sample size. Kernel function is used to map the input data items to a feature space with better representation, which yields a smooth KNN classification boundary. Non-Dominated Sort (NDS) is used to obtain an optimal order of the three efficacy outcomes from a small sample at the beginning. Then the proposed method was tested with the clinical data from a large sample from a multi-center RCT conducted from 2006 to 2010. The result shows the proposed algorithm is capable of discovering the underlying difference among different syndrome types and feasible to predict the effective tendency in clinical trials of large sample. Therefore, it provides a potential solution for interim analysis of clinical trials, which overcomes the limitation of conventional statistical methods.

A clinical outcome evaluation model with local sample selection: A study on efficacy of acupuncture for cervical spondylosis

Local learning is a special learning framework that considers training samples located in a small region concentric of the query sample. In many applications the concept label of query sample can be evaluated effectively only by similar training samples, such as the famous K-nearest neighbors (KNN) classifier. The metric of locality or similarity is essential in local learning, which is often application oriented and implied in local geometry of input space. In this paper, we propose to apply local learning to the task of outcome assessment and evaluation on acupuncture for cervical spondylosis (CS) in a multi-center clinical trial. The analytic data are measures of three questionnaires which are recognized tools for subjective patient-reported outcomes (PROs) evaluation. We propose a similarity evaluation method based on both Euclidean distance and the therapy effect of recent records. A Non-Dominated Sort (NDS) based methods is applied to obtain a ranking of therapy effect. A WEKA implementation decision tree classifier is applied as the main learner in our work, with comparison to two base line methods. The result shows that the proposed local learning method dramatically outperforms the global version in both classification accuracy and computational costs.

Soluble N-ethylmaleimide-sensitive Factor Attachment Receptor (SNARE) Protein Involved in the Remission of Depression by Acupuncture in Rats

This study aims to investigate the molecular mechanisms of acupuncture in the remission of depression. A depressive disorder model was induced by exposing Sprague-Dawley rats to chronic unpredictable stress. The rats were divided into five groups: healthy (blank group) and stressed rats (model group), and stressed rats treated with acupuncture (acupuncture group), riluzole (riluzole group), acupuncture combined with botulinum toxin A (BTX-A) injection (acupuncture+BTX-A group) or riluzole combined with BTX-A injection (riluzole+BTX-A group). Behavioral analysis showed significant differences in sucrose consumption, weight, and horizontal or vertical movements between the model and both the riluzole and acupuncture groups. No obvious differences between the riluzole+BTX-A and acupuncture+BTX-A groups were found. Moreover, no significance differences in glutamate content in the hippocampus were found among the riluzole+BTX-A, acupuncture+BTX-A and model groups (p>0.05). Western blots and reverse transcription polymerase chain reactions were employed to detect protein and mRNA expressions of VGLUT2, SNAP25, VAMP1, VAMP2, VAMP7, and syntaxin1; no obvious differences among the riluzole+BTX-A, acupuncture+BTX-A and model groups were found. These data suggest that soluble N-ethylmaleimide-sensitive factor attachment receptor proteins are involved in the remission of depression in rats treated with acupuncture.

Investigation on the feasibility of selecting soft tissue elasticity as the objective evaluating indicator of the neck type of cervical spondylosis

The objective of this research is to discuss the feasibility of selecting soft tissue elasticity as the objective evaluating indicator of the neck type of cervical spondylosis. This article reviews the evaluation indicators currently used treatment of cervical syndrome achievement. Through comparative study, the authors believe the soft tissue elasticity can be more objective evaluation of cervical syndrome treatment results.