Many preclinical studies show that electroacupuncture (EA) on PC6 and ST36 can reduce infarct size after ischemia-reperfusion (IR) injury. Yet studies to enhance the treatment effect size are limited. The purpose of this study was to explore whether EA has additional myocardial protective effects on an ischemia-reperfusion (IR) injury rat model when back-shu EA and moxibustion are added. SD rats were divided into several groups and treated with either EA only, EA + back-shu EA (B), or EA + B + moxibustion (M) for 5 consecutive days. Transthoracic echocardiography and molecular and immunohistochemical evaluations were performed. It was found that although myocardial infarct areas were significantly lower and cardiac function was also significantly preserved in the three treatment groups compared to the placebo group, there were no additional differences between the three treatment groups. In addition, HSP20 and HSP27 were expressed significantly more in the treatment groups. The results suggest that adding several treatments does not necessarily increase protection. Our study corroborates previous findings that more treatment, such as prolonging EA duration or increasing EA intensity, does not always lead to better results. Other methods of increasing treatment effect size should be explored.

Objectives : The purpose of this study is to investigate the effects of warm needling therapy in a patient with cervical myelopathy caused by ossification of posterior longitudinal ligament. Methods : A 53-year-old Korean male patient diagnosed with cervical myelopathy due to ossification of posterior longitudinal ligament was treated with warm needling therapy on posterior neck aside from the routine inpatient treatment from June 26th to July 16th. Clinical improvement was evaluated with visual analogue scale(VAS), Japanese orthopedic score(JOA), grip and release test, finger escape sign and patient satisfaction was measured using a five-point Likert scale. Results : After 21 days of treatment, the patient showed improvement in VAS, JOA, grip and release test and finger escape sign. The patient also expressed satisfaction with the treatment. Conclusions : The results suggest that warm needling therapy may be an effective additional treatment for cervical myelopathy and other symptoms related to ossification of posterior longitudinal ligament(OPLL). Further studies should be carried out regarding possible long-lasting effects.

ObjectiveTo explore the experiences of patients with atrial fibrillation (AF) in the context of a prospective, two-parallel-armed, participant-blinded and assessor-blinded sham-controlled randomised trial.DesignA nested qualitative study within an ongoing randomised controlled trial to explore acupuncture's antiarrhythmic effects on drug refractory acupuncture in persistent atrial fibrillation (AF) (ACU-AF trial).ParticipantsParticipants were recruited using purposeful sampling and a maximum variation strategy with regard to treatment allocation (treatment or control) and protocol completion (completion or non-completion).SettingThis was a single-centre in-depth interview qualitative study conducted at a tertiary-level university hospital in Seoul, Republic of Korea.ResultsData saturation was reached after 8 participants. Thematic analysis identified that most patients were not aware of their condition until medical check-up; physician referral was the main reason for trial participation, and patients had high expectations regardless of previous acupuncture experiences. Patients tended to depend on their physicians' opinions because they felt helpless of their condition. No one questioned their assigned treatment groups and generally believed acupuncture treatment was different for cardiovascular diseases. A few patients expressed disappointment in the strict and rigid protocols, in which most practitioners refrained from explaining their acupuncture procedures.ConclusionsFor cardiovascular patients their physician's advice was one of the biggest reasons for enrolling in the acupuncture trial therefore relying on standard recruitment methods may not be effective. Fortunately both real and sham acupuncture groups in our sample were receiving treatment as intended, but in the future, designing a more pragmatic trial (better reflecting clinical settings, expanding the inclusion criteria and using more treatment points) will allow researchers to better explore the comprehensive effects of acupuncture. The findings of this study will allow researchers to improve the currently ongoing ACU-AF trial and to further help interpretation of main trial outcomes once the trial is completed.Trial registration number:NCT02110537.

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Objectives : The aim of this study is to investigate the state of cervical disc herniation according to the degree of cervical lordosis and age. Methods : 67 records of inpatients who were diagnosed with herniated intervertebral disc(HIVD) of the cervical spine were analyzed. Cobb's method, Jochumsen method and the Ishihara index were used to measure the degree of cervical lordosis. The state of the cervical disc was identified using magnetic resonance imaging(MRI) of the cervical spine. Then correlations among cervical lordosis, age and cervical disc herniation were analyzed. Results : Disc bulging was associated with hypolordosis and disc protrusion was associated with hyperlordosis and age. Disc extrusion was not associated with either cervical lordosis or age. The number of disc herniations in the cervical spine was correlated with age significantly, but not with cervical lordosis. Conclusions : Cervical disc herniation had a tendency to correlate with age and cervical lordosis, although this is not definite. Future studies that analyze more radiographic images of patients with HIVD of the cervical spine might be necessary to identify the influence of cervical lordosis on cervical disc herniation.