Characteristics of electroacupuncture-induced analgesia in mice: variation with strain,frequency, intensity and opioid involvement

The present study was conducted to evaluate the characteristics of electroacupuncture (EA)-induced analgesia in mice. Three inbred strains of mice (DBA/2, C57BL/6J, BALB/c) and three outbred strains (ICR, LACA, NIH) were used in the experiment. Two pairs of metallic needles were inserted into acupoints ST 36 and SP 6 connected to an electric pulse generator. EA parameters were set as constant current output with alteration of a positive and negative square wave, 0.6 ms in pulse width for 2 Hz and 0.3 ms for 100 Hz. Tail-flick latencies evoked by radiant heat were measured before, during and after EA stimulation. We found that (1) DBA/2 mice showed a significantly more potent analgesic effect than the other five strains in response to both 100 and 2 Hz EA. In this case, the intensities were 1.0-2.0-2.0 mA, 10 min for each intensity totally 30 min. (2) EA analgesia increased as the intensity of stimulation increased from 0.5 to 2.0 mA, but it remained at this plateau when the intensity further increased from 2.0 to 3.0 mA. (3) 10.0 mg x kg(-1) naloxone was needed to block the analgesic effect induced by 2 Hz EA of 2.0 mA, but to block that by 100 Hz, 25.0 mg x kg(-1) was necessary. (4) A positive correlation was observed between analgesia induced by morphine at the dose of 5.0 mg x kg(-1) and by 100 Hz EA in two tested strains DBA/2 and C57BL/6J. In conclusion, EA induces reliable, strain-dependent analgesia in mice. The naloxone-reversibility of EA, a measure of whether it is opioid or non-opioid mediated, is dependent upon intensity and frequency.     

Tolerance to electroacupuncture and its cross tolerance to morphine

Electroacupuncture (EA) applied to both legs of the rat for 30 min (1session) raised the average tail flick latency to 89% above the control level. Repeated electroacupuncture for 6 sessions, with 30 min between successive sessions, resulted in a gradual decline in the hypoalgesic effect. The time-course of the development and disappearance of acupuncture tolerance was studied. A bidirectional cross-tolerance between electroacupuncture and morphine points to the similarity between the underlying mechanisms of electroacupuncture hypoalgesia and morphine analgesia.     

Change of vanilloid receptor 1 expression in dorsal root ganglion and spinal dorsal horn during inflammatory nociception induced by complete Freund's adjuvant in rats

The present study aimed to systematically observe the change of vanilloid receptor 1 (VR1) during inflammatory nociception induced by intraplantar injection of complete Freund's adjuvant (CFA) into the left hind paw in rats. Hot plate latency (HPL) was used to evaluate resulting thermal hyperalgesia and immunohistochemistry to observe VR1 expression in dorsal root ganglion and spinal cord dorsal horn. Results showed that HPL decreased from day 1 to day 28 after CFA injection, with shortest at day 14. VR1 expression correspondingly increased from day 1 to day 21 with peak at day 14, and returning to the control level at day 28. A shift of VRI expression from small to medium DRG neurons over the observation period was seen. These results suggest that VR1 could play an important role in the early stage, but not the late stage, of CFA inflammatory nociception.     

Modulation of cold pain in human brain by electric acupoint stimulation: evidence from fMRI

The purpose of this study is to investigate the modulation of pain responses in the human brain by electric acupoint stimulation (EAS). Eight healthy subjects were enrolled; each received real or mock EAS treatment in separate sessions. Cool (18 degrees C) and cold (2 degrees C) stimuli were delivered, during which functional magnetic resonance imaging scans were performed, before and after treatment. Real EAS specifically increased the pain-specific activation in bilateral secondary somatosensory area, medial prefrontal cortex, and Brodmann area (BA) 32, while it decreased the activation in contralateral primary somatosensory area, BA7, and BA24. We suggest that EAS may induce an analgesic effect via modulation of both the sensory and the emotional aspect of pain processing.     

Roles of 5-hydroxytryptamine (5-HT) receptor subtypes in the inhibitory effects of 5-HT on C-fiber responses of spinal wide dynamic range neurons in rats

5-Hydroxytryptamine (5-HT; serotonin) plays an important role in the descending control of nociception. 5-HT and its receptors have been extensively studied in the modulation of nociceptive transmission at the spinal level using behavioral tests that may be affected by the effects of 5-HT on motor performance and skin temperature. Using electrophysiological methods, the present study aimed to systematically investigate the roles of 5-HT receptor subtypes on the inhibitory effects of 5-HT on responses of the spinal wide dynamic range (WDR) neurons to C-fiber inputs in rats. Under basal conditions, topical application of 5-HT to the spinal cord inhibited the C-fiber responses of WDR neurons dose-dependently, whereas antagonists of 5-HT(1A) [WAY 100635 [N-[2-[4-(2-methoxyphenyl)-1-piperazinyl]ethyl]-N-2-pyridinyl-cyclohexanecarboxamide maleate salt]], 5-HT(1B) [GR 55562 [3-[3-(dimethylamino)propyl]-4-hydroxy-N-[4-(4-pyrid-dinyl)phenyl]benzamide dihydrochloride]], 5-HT(2A) [ketanserin [3-[2-[4-(fluorobenzoyl)-1-piperidinyl]ethyl]-2,4[1H,3H]-quinazolinedione tartrate]], 5-HT(2C) [RS 102221 [8-[5-(2,4-dimethoxy-5-(4-trifluoromethylphenylsulfonamido)phenyl-5-oxopentyl]-1,3,8-triazaspiro[4.5]decane-2,4-dione hydrochloride]], 5-HT(3) [MDL 72222 [3-tropanyl-3,5-dichlorobenzoate]], and 5-HT(4) [GR 113808 ([1-[2-[(methylsulfonyl)-amino]ethyl]-4-piperidinyl]methyl 1-methyl-1H-indole-3-carboxylate)] had no effect on their own. The inhibitory effects of 5-HT were reversed by antagonists of 5-HT(1B) (GR 55562), 5-HT(2A) (ketanserin), 5-HT(2C) (RS 102221), 5-HT(3) (MDL 72222), and 5-HT(4) (GR 113808) but not by 5-HT(1A) (WAY 100635) receptor antagonists. Topical administration of agonists of 5-HT(1A) [(2R)-(+)-8-hydroxy-2-(di-n-propylamino)tetralin hydrobromide], 5-HT(1B) [CGS 12066 [7-trifluoromethyl-4-(4-methyl-1-piperazinyl)pyrrolo-[1,2-a]quinoxaline maleate salt]], 5-HT(2A) (alpha-methyl-5-hydroxytryptamine maleate), 5-HT(2C) [MK 212 [6-chloro-2-(1-piperazinyl)pyrazine hydrochloride]], 5-HT(3) [1-(3-chlorophenyl)biguanide hydrochloride], and 5-HT(4) [2-[1-(4-piperonyl)piperazinyl]benzothiazole] also inhibited the C-responses. These results suggest that, under basal conditions, there is no tonic serotonergic inhibition on the C-responses of dorsal horn neurons, and multiple 5-HT receptor subtypes including 1B, 2A, 2C, 3, and 4 may be involved in mediating the inhibitory effects of 5-HT.     

穴位体表电刺激治疗三叉神经痛28例报告

本文采用韩氏穴位神经刺激仪（ＨＡＮＳ）治疗三叉神经痛。通过体表电极对穴位施加刺激，刺激频率为２／１００Ｈｚ变频方波，刺激部位以双侧合谷为主穴，第一支配患侧“阳白”和“下关”；第二支配患侧“四白”和“颊车”及手背“落枕”穴；第三支配患侧“翳明”和“听会”。部分患者配合耳针治疗，治疗结果，２８例中有７例痊愈（沾２５％），显效、有效、无效各７例（各占２５％）。我们的结果表明，穴位体表电刺激可以作为治疗三     

Preoperative evaluation with T-staging system for hilar cholangiocarcinoma

AIM： To investigate the clinical value of T-staging system in the preoperative assessment of hilar cholangiocarcinoma. METHODS： From March 1993 to January 2006, 85 patients who had cholangiocarcinoma diagnosed by operative tissue-biopsy were placed into one of three stages based on the new T-staging system, and it was evaluated the resectability and survival correlated with T-staging. RESULTS： The likelihood of resection and achieving tumor-free margin decreased progressively with increasing T stage （P 〈 0.05）. The cumulative 1-year survival rates of T1, T2 and T3 patients were 71.8%, 50.8% and 12.9% respectively, and the cumulative 3-year survival rate was 34.4%, 18.2% and 0% respectively; the survival of different stage patients differed markedly （P 〈 0.001）. Median survival in the hepatic resection group was greater than in the group that did not undergo hepatic resection （28 mo vs 18 mo; P 〈 0.05）. The overall accuracy for combined MRCP and color Doppler Ultrasonagraphy detecting disease was higher than that of combined using CT and color Doppler Ultrasonagraphy （91.4% vs 68%; P 〈 0.05 ）. And it was also higher in detecting port vein involvement （90% vs 54.5%; P 〈 0.05）.CONCLUSION： The proposed staging system for hilar cholangiocarcinoma can accurately predict resectability, the likelihood of metastatic disease, and survival. A concomitant partial hepatectomy would help to attain curative resection and the possibility of longterm survival. MRCP/MRA coupled with color Doppler UItrasonagraphy was necessary for preoperative evaluation of hilar cholangiocarcinoma.（OR = 2.46, 95% CI = 0.98-6.14）, and a significantly elevated risk of developing esophageal cancer among alcohol drinkers among alcohol drinkers （OR = 9.86, 95% CI = 3.10-31.38）. CONCLUSION： ADH2 and ALDH2 genotypes areassociated with esophageal cancer risk. ADH2＊1 allele and ALDH2＊2 allele carriers have a much higher risk of developing esophageal cancer, especially among alcohol drinkers.     

A comparison between spontaneous electroencephalographic activities induced by morphine and morphine-related environment in rats

Previous studies demonstrated that drug cues could elicit drug-like or withdrawal-like effect, both subjectively and physiologically. However, few studies have compared the central activities induced by a drug-related environment and the drug itself. The aim of this study was to observe and compare electroencephalographic (EEG) changes induced by acute morphine administration and by the morphine-related environment. EEG activities were recorded via twelve skull electrodes scattered on the left and right cortex in conscious, freely moving rats, either after acute morphine administration or after successful training of conditioned place preference. Acute administration of morphine (0.1, 0.5, 1, 5, 10, 20 mg/kg, i.p.) produced an increase in absolute EEG power in the delta, theta, alpha1, alpha2, beta1, and beta2 bands, as well as a decrease in the gamma band. Topographic mapping revealed a maximal increase in the lateral leads in the theta band and a maximal change in the centro-frontal region in the remaining bands. After place conditioning training, the morphine-related environment induced a diffuse decrease in absolute power in the delta, theta, alpha1, alpha2, beta1, and beta2 bands, which was opposite to the changes induced by acute morphine administration. In addition, the changes in relative power induced by the two situations also diverged. These results indicate that the central mechanisms underlying the motivation of morphine-induced place preference may be somehow different from those underlying the reward effects produced by acute morphine administration.     

NR2B-containing NMDA receptor is required for morphine-but not stress-induced reinstatement

Glutamate receptors are known to be densely distributed in the forebrain rewarding circuits, and glutamatergic transmission is actively involved in the regulation of rewarding and reinstating effects of drugs of abuse. Here we investigated the possible involvement of the N-methyl-D-aspartate (NMDA) receptors in the reinstatement of extinguished morphine conditioned place preference (CPP) in rats. We found that previously extinguished morphine (3 mg/kg, i.p.) CPP was markedly reinstated by a priming injection of morphine (2 mg/kg, i.p.) or an acute environmental stressor (forced swim for 10 min), but not by the stress induced by a 24-h food deprivation. Parallel with this, protein levels of the NMDA receptor 2B subunit (NR2B) were elevated in the nucleus accumbens (NAc) and the hippocampus, but not the prefrontal cortex, of reinstated rats. Systemic administration of an NR2B selective antagonist ifenprodil (1, 3, 10 mg/kg, i.p.) attenuated the reinstatement induced by a priming morphine injection, although not by the forced swim. Ifenprodil (2.0 microg/rat) directly injected into the NAc shell or the CA1 region of the dorsal hippocampus produced a similar effect. These results indicate that the NR2B-containing NMDA receptors in the NAc and the dorsal hippocampus play a significant role in mediating the reinstatement of rewarding responses to morphine.