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Objective: Aging which is accompanied by loss of skeletal muscle and increase of body fat in some adults older than 60 years does not only result in remarkable influences on daily life function but also increases the risk of cardiovascular events. This study used electrical acupuncture together with essential amino acid supplementation to treat sarcopenic obesity (SO) in male older adults. Methods: A total of 48 male participants with SO (>60 years old) were randomized to electrical acupuncture with oral essential amino acids (EA + AA) or oral essential amino acids alone (AA). Acupuncture points on the limbs were punctured and stimulated electrically once every 3 days for 12 weeks. All participants received essential amino acids orally, twice per day for 28 weeks. Body fat percentage (BFP) and appendicular skeletal muscle index (ASM/H²) was determined by bioelectrical impedance analysis. Results: Both groups exhibited significant changes in BFP after 12, 20, and 28 weeks compared with baseline values; for ASM/H², there were significant differences to baseline values after 12, 20, and 28 weeks in the EA + AA group, but only after 28 weeks in the AA group. Between the two groups, there were significant differences in BFP after 12, 20, and 28 weeks, and in ASM/H² after 20 and 28 weeks. Conclusion: Both methods decrease BFP and increase ASM/H². In male older adults, electrical acupuncture with oral essential amino acids is more effective and can increase muscle mass in a shorter time than oral essential amino acids alone.

Peripheral nerve injury not only affects the site of the injury, but can also induce neuronal apoptosis at the spinal cord. However, many acupuncture clinicians still focus only on the injury site, selecting acupoints entirely along the injured nerve trunk and neglecting other regions; this may delay onset of treatment efficacy and rehabilitation. Therefore, in the present study, we compared the clinical efficacy of acupuncture at Governor vessel and local meridian acupoints combined (GV/LM group) with acupuncture at local meridian acupoints alone (LM group) in the treatment of patients with peripheral nerve injury. In the GV/LM group (n = 15), in addition to meridian acupoints at the injury site, the following acupoints on the Governor vessel were stimulated: Baihui (GV20), Fengfu (GV16), Dazhui (GV14), and Shenzhu (GV12), selected to treat nerve injury of the upper limb, and Jizhong (GV6), Mingmen (GV4), Yaoyangguan (GV3), and Yaoshu (GV2) to treat nerve injury of the lower limb. In the LM group (n = 15), only meridian acupoints along the injured nerve were selected. Both groups had electroacupuncture treatment for 30 minutes, once a day, 5 times per week, for 6 weeks. Two cases dropped out of the LM group. A good or excellent clinical response was obtained in 80% of the patients in the GV/LM group and 38.5% of the LM group. In a second study, an additional 20 patients underwent acupuncture with the same prescription as the GV/LM group. Electomyographic nerve conduction tests were performed before and after acupuncture to explore the mechanism of action of the treatment. An effective response was observed in 80.0% of the patients, with greater motor nerve conduction velocity and amplitude after treatment, indicating that electroacupuncture on specific Governor vessel acupoints promotes functional motor nerve repair after peripheral nerve injury. In addition, electromyography was performed before, during and after electroacupuncture in one patient with radial nerve injury. After a single session, the patient's motor nerve conduction velocity increased by 23.2%, indicating that electroacupuncture at Governor vessel acupoints has an immediate therapeutic effect on peripheral nerve injury. Our results indicate that Governor vessel and local meridian acupoints used simultaneously promote functional repair after peripheral nerve injury. The mechanism of action may arise from an improvement of the local microenvironment in injured nervous tissue, as well as immediate effects of Governor vessel and local meridian acupoint stimulation to ensure the continuity between the peripheral and central nervous systems.

Effectively reducing the inflammatory response after spinal cord injury (SCI) is a challenging clinical problem and the subject of active investigation. This study employed a porous scaffold-based three dimensional long-term culture technique to obtain human umbilical cord mesenchymal stem cell (hUC-MSC)-derived Small Extracellular Vesicles (sEVs) (three dimensional culture over time, the “4D-sEVs”). Moreover, the vesicle size, number, and inner protein concentrations of the MSC 4D-sEVs contained altered protein profiles compared with those derived from 2D culture conditions. A proteomics analysis suggested broad changes, especially significant upregulation of Epidermal Growth Factors Receptor (EGFR) and Insulin-like Growth Factor Binding Protein 2 (IGFBP2) in 4D-sEVs compared with 2D-sEVs. The endocytosis of 4D-sEVs allowed for the binding of EGFR and IGFBP2, leading to downstream STAT3 phosphorylation and IL-10 secretion and effective induction of macrophages/microglia polarization from the pro-inflammatory M1 to anti-inflammatory M2 phenotype, both in vitro and in the injured areas of rats with compressive/contusive SCI. The reduction in neuroinflammation after 4D-sEVs delivery to the injury site epicenter led to significant neuroprotection, as evidenced by the number of surviving spinal neurons. Therefore, applying this novel 4D culture-derived Small Extracellular Vesicles could effectively curb the inflammatory response and increase tissue repair after SCI.

IntroductionInsomnia affects physical and mental health due to the lack of continuous and complete sleep architecture. Polysomnograms (PSGs) are used to record electrical information to perform sleep architecture using deep learning. Although acupuncture combined with cognitive–behavioural therapy for insomnia (CBT-I) could not only improve sleep quality, solve anxiety, depression but also ameliorate poor sleep habits and detrimental cognition. Therefore, this study will focus on the effects of electroacupuncture combined with CBT-I on sleep architecture with deep learning.Methods and analysisThis randomised controlled trial will evaluate the efficacy and effectiveness of electroacupuncture combined with CBT-I in patients with insomnia. Participants will be randomised to receive either electroacupuncture combined with CBT-I or sham acupuncture combined with CBT-I and followed up for 4 weeks. The primary outcome is sleep quality, which is evaluated by the Pittsburgh Sleep Quality Index. The secondary outcome measures include a measurement of depression severity, anxiety, maladaptive cognitions associated with sleep and adverse events. Sleep architecture will be assessed using deep learning on PSGs.Ethics and disseminationThis trial has been approved by the institutional review boards and ethics committees of the First Affiliated Hospital of Sun Yat-sun University (2021763). The results will be disseminated through peer-reviewed journals. The results of this trial will be disseminated through peer-reviewed publications and conference abstracts or posters.Trial registration numberCTR2100052502.