世界卫生组织传统医学合作中心2009年年度报告---英文版
1. Work performed in relation to the Terms of Reference
1.1 To develop clinical research on acupuncture for validating its safety and efficacy;
1.2 To carry out the experimental research on the mechanisms of acupuncture to improve its application, with particular reference to its neurophysiological, neuromorphological, neuropharmacological and molecular biological techniques;
1.3 To provide training opportunities for foreign scientists and medical doctors on both scientific research and clinical practice.
2. Main performance in 2009
2.1 Clinical trials
2.1.1 Doctors from hospitals affiliated Shanghai Medical College of Fudan University (Zhong-Shan Hospital, Hua-Shan Hospital, etc) treated over 7815 person-time patients suffering from various diseases with therapeutic method of integration of Traditional Chinese Medicine and Western Medicine including acupuncture treatment.
2.1.2 Four physicians and acupuncturists who came from United States, Germany and Hongkong were trained in the Department of Acupuncture, the Hua-Shan Hospital in 2009 for one week.
2. 2 Experimental researches
2.2.1 Study of acupuncture analgesia
2.2.1.1 Accumulating evidence showed that spinal interleukin-1 (IL-1β) plays a critical role in inflammatory pain. Electroacupuncture can effectively attenuate inflammatory hyperalgesia. Spinal IL-1β/IL-1RI system was involved in EA-induced anti-hyperalgesia in inflammatory pain.
2.2.1.2 We gave the first report that kisspeptin and GPR54 were expressed in the small to large-sized neurons, and co-localized with Bandeiraea simplicifolia isolectin B4 (IB4), calcitonin-generelatedpeptide (CGRP) and neurofilament 200 (NF200) in the L4/5 dorsal root ganglion (DRG) of naive rats. It suggested that indicating a possible involvement of the kisspeptin/GPR54 system in chronic inflammatory pain.
2.2.2 Study on neuroendocrine regulation by EA treatment and Chinese herbs
2.2.2.1 Adult female rats continuously exposed to androgens from prepuberty had reproductive and metabolic features of polycystic ovary syndrome (PCOS). Rats with DHT-induced PCOS had disrupted estrous cyclicity and an increased number of hypothalamic cells expressing GnRH, most likely mediated by AR activation. Repeated low-frequency EA normalized estrous cyclicity and restored GnRH and AR protein expression. These results might help explain the beneficial neuroendocrine effects of low-frequency EA in women with PCOS.
2.2.2.2 Central mechanism of triptorelin therapeutic effects on female precocious puberty in rats was studied. The day of vaginal opening, the estrous cycles, the development of uterus and ovaries as well as the hypothalamus were examined. The effect of triptorelin might be via depressed the hyperfunction of hypothalamus.
2.2.2.3 The ovariectomized rats were treated by acupuncture in order to observe the differences and similarities of hypothalamic neuroendocrine signal conduction pathway under the physiological and pathological status, which might explore the mechanisms of neuroendocrinal signal conduction/transduction of acupuncture therapeutic effect on peri-menopausal syndrome.
2.2.3 Study of acupuncture and drug against depression.
Growing evidence indicated that glia pathology contributes to the pathophysiology and possibly the etiology of depression. The study investigated changes in behaviors and glial fibrillary associated protein (GFAP) in the rat hippocampus after chronic unpredictable stress (CUS), a rat model of depression. The beneficial effects of clomipramine treatment provided further validation of our hypothesis that glial dysfunction contributes to the pathophysiology of depression and that glial elements might represent viable targets for new antidepressant drug development.
2.2.4 Study of acupuncture on retinal neuropathy
To observe the effect of acupuncture on photoreceptor cell apoptosis in rats with retinitis pigmentosa induced by N-methyl-N-nitrosourea (MNU), acupuncture could restrain the MNU induce d apoptosis of photoreceptor cells, and the effect was correlated, to as certain degree with the status of the apoptosis occurrence.
2.2.5 Study on neuroimmuno-regulatory effect of EA
2.2.5.1 In this study, the contribution of EA on toll-like receptors 2 and 4 (TLR2/TLR4) and pro-inflammatory cytokine expression after surgical trauma stress were investigated. EA at “Zusanli” acupoint significantly inhibited surgical trauma-induced TLR2 mRNA and TLR2/4 protein expression in spleen and pro-inflammatory cytokine expression in the spleen and plasma. EA inhibits TLR2/4 and pro-inflammatory cytokines to produce an anti-inflammatory effect in a surgical trauma stress model, without adrenal gland involvement.
2.2.5.2 Traumatic stress was well characterized to develop immuno-depression in our previous report. the data indicated that immunological processes in response to traumatic stress was age dependent, Fyn-ERK1/2signal pathway was required to convey the recovery signals.
2.3 Training program
2.3.1 One graduate student fulfilled Ph.D. degree, and three fulfilled Master degree.
2.3.2 The course of ‘the outline of fundamental of integrative medicine” was given to 40 graduate and 64 undergraduate students. The course of “The idea and method of integrative medicine” and “Principles of neural sciences” were given to 10 junior or senior graduate students.
2.3.3 Four domestic research fellows were trained in our center, each for one to three months. One post doctor was trained for her second year in our center.
2.3.4 Four physicians and acupuncturists from United States, Germany and Hongkong were trained in the department of acupuncture, the Hua-Shan hospital for one week
2.4 Academic exchange
2.4.1 International and Domestic interchange
In November 2009, Prof. Gen-Cheng Wu and Yan-Qing Wang were invited to attend the fifth Meeting of the Doctors of WHO CCs for TRM, Medicine, Melbourne, Australia.
In 2009, two teachers who were trained at Michigan State University, USA and Gothenburg University, Sweden came back.
In 2009, some teachers and graduate students attended academic meetings domestically for 15 person-times.
2.4.2 International visiting to our center
Dr. Wei-Jun Zhang from the Center for East-West Medicine, UCLA, USA visited our center and had a video interview with Prof. Xiao-Ding Cao and Gen-Cheng Wu in March of 2009.
In September of 2009, Associate Prof. Guo-Ying Bing, Department of Anatomy and Neurology, Kentucky University, United States visited our center and had his special lecture.
In December, 2009, Prof. Schoeder and Salchow, Hamburg University, Germany visited our center and signed the cooperation.
In 2009, Associate Prof. Ying Xia, Medical Center, Yale University, USA, visited our center for five times, and cooperated to write the monograph about acupuncture research(English issue).
2.4.3 International consultation
In 2009, as a consultant of traditional medicine program in WHO, Prof. Xiao-Ding Cao received some documents inquiring the policy of Traditional Medicine and Complementary/Alternative Medicine from WHO, and gave some suggestions.
2.5 Evaluation
In 2009, through the efforts of all members of our center, we obtained some achievements in carrying on clinical practice and basic scientific research of acupuncture, and academic exchange and training at home and abroad.
2.6 Recommendations
The terms of reference mentioned above were set up by our center with WHO officials after 1983 (the latest re-designation was March, 2008). During the more than twenty years we have completed various activities and accumulated some experiences on basic and clinic researches and training in the field of traditional medicine, especially acupuncture. We will continue our effort to practice these terms in the new designation period.
We also fully understood the instruction of WHO-TRM and WPRO in November, 2009 in Melbourne, Australia. In addition to thorough development of study and training for acupuncture treatment, our further aims are to develop the international and traditional medicine, as well as the cooperation with other countries.
According to the specific condition of Shanghai Medical College of Fudan University, we plan to expand our work as followings:
.Based on the long-term Clinical and experimental experiences, as well as the good reputation in the world, our center plan to emphasis on the safety and effects of integrative medicine, combination with Western Medicine with TCM, and do our best to set up a series of standard strategies.
.To enhance the research on Chinese herbs and develop the utilization of Chinese Herbs.
.To improve the close connection and communication with other international modern teaching system, promote the confluence of traditional medicine into the western medicine.
3. Collaboration between the center and WHO
We have a long history in collaboration with WHO in the field of Traditional Medicine. We have also attended many meetings held by WHO. In November of 2009, Prof. Gen-Cheng Wu and Yan-Qing Wang attended the fifth meeting of the doctors of WHO CCs for TRM, Medicine, and Melbourne, Australia. In June, Prof. Gen-Cheng Wu join the Workshop on WHO Collaborating Centre in Beijing held by Ministry of Public Health, China. In December, the director meeting of WHO collaborating center in Shanghai was also held by the Shanghai Municipal Health Bureau. Dr. Christopher Tunon, and other WHO officers in Beijing, gave us some important suggestions. Prof. Xiao-Ding Cao and Gen-Cheng Wu attended this meeting.
As a member of WHO Expert Advisory Panel on Traditional Medicine, Prof. Xiao-Ding Cao has been keeping close contact with WHO and giving her suggestions on some issues about the policy of Traditional Medicine or Complementary and Alternative Medicine.
4. Collaboration with other WHO collaborating centers
Activities of our center also include the collaboration with other WHO collaborating centers in other countries as well as in China. In China, we visited and interchanged with other Traditional Medical Centers and did some joint researches, such as Shanghai University of TCM, Chinese Academy of TCM in Beijing and Nanjing University of TCM. Furthermore, we have established the scientific relationship with other WHO collaborating centers for other medical fields in China. We also shared some information with the other WHO collaborating centers in other countries.
We shall always pay attention to the instructions from WHO and WPRO, and try to do our best for the great goal of world health.
5. Proposal in 2010
5.1 Our center has successfully held the “National Acupuncture Anesthesia, Acupuncture Analgesia and Acupuncture Modulation Effects Conference” for nine times since 1986. In June of 2010, we will hold the tenth conference in shanghai, providing an opportunity to communicate and cooperate, as well as summarize the performance of above research.
5.2 To Further enhance the cooperation with Yale University of United States, Gothenburg University of Sweden and Hamburg University of Germany. We plan to dispatch 15 person-times to go abroad to give lectures, join the conference and set up the cooperation. Meanwhile, we will also train the doctors and research from all over the world.
5.3 To revise the text book ‘the outline of fundamental integrative medicine”.
5.4 To join the writing of an English monograph “Acupuncture Therapy for Neurological Diseases”，which will be published by Springer Publishing House. This book will be an important tool for Acupuncture Therapy for international acupuncturists.
5.5 To establish new websites including Chinese and English versions to link to websites of WHO TRM directly.
Publication List in 2009:
.Wen-Li Mi, Qi-Liang Mao-Ying, Qiong Liu, Xiao-WeiWang, Xiu Li, Yan-QingWang, Gen-ChengWu, The distribution of kisspeptin and its receptor GPR54 in rat dorsal root ganglion and up-regulation of its expression after CFA injection. Brain Research Bulletin, 2009,78:254–260.
.Ming-Juan Song, Yan-QingWang, Gen-ChengWu, Additive anti-hyperalgesia of electroacupuncture and intrathecal antisense oligodeoxynucleotide to interleukin-1 receptor type I on carrageenan-induced inflammatory pain in rats. Brain Research Bulletin, 2009,78:335–341.
.Qiong Liu, Bing Li, Hai-Yan Zhu, Yan-Qing Wang, Jin Yu, Gen-Cheng Wu, Clomipramine treatment reversed the glial pathology in a chronic unpredictable stress-induced rat model of depression. European Neuropsychopharmacology, 2009,19:796–805.
.Jun Wang, Hui Zhao, Qi-Liang Mao-Ying, Xiao-Ding Cao, Yan-QingWang, Gen-ChengWu, Electroacupuncture downregulates TLR2/4 and pro-inflammatory cytokine expression after surgical trauma stress without adrenal glands involvement. Brain Research Bulletin, 2009, 80: 89–94
.Sheng Xiao, Jun Wang, Jianwei Jiang, Xiaoding Cao, Gencheng Wu, Hui Zhao, Characterization of Fyn signaling on the age-dependentimmuno-modulation on traumatic rats. Brain research, 2009, 1255:162-169.
.Hui Zhao, Xiaoding Cao, Gencheng Wu ,Horace H. Loh,Ping-Yee Law, Neurite Outgrowth is Dependent on the Association of c-Src and Lipid Rafts. Neurochem Res., 2009, 34:2197–2205.
.Lei Zhang, Hui Zhao, YuQiu, Horace H. Loh, and Ping-Yee Law, Src Phosphorylation of μ-Receptor Is Responsible forthe Receptor Switching from an Inhibitory to a Stimulatory Signal, The Journal of Biology Chemistry, 2009,284: 1990-2000.
.N Lu, M Han, ZL Yang, YQ Wang, GC Wu *, YQ Zhang *. Nociceptin/orphanin FQ in PAG modulates the release of amino acids, serotonin and norepinephrine in the rostral ventromedial medulla and spinal cord in rats. Pain, online, doi:10.1016/j.pain.2009.11.025
.Yi Feng, Julia Johansson1, Ruijin Shao1, Louise Mannera, Julia Fernandez-Rodriguez, Ha°kan Billig1,Elisabet Stener-Victorin1,Hypothalamic Neuroendocrine Functions in Rats with Dihydrotestosterone-Induced Polycystic Ovary Syndrome: Effects of Low-Frequency Electro-Acupuncture, PLoS ONE | www.plosone.org, August 2009, 4(8):e6638
.Weili Bao, Jin Yu, Susanne Heck and Karina Yazdanbakhsh, akhsh, nonresponder mice Regulatory T-cell status in red cell alloimmunized responder and nonresponder mice, Blood, 2009, 113: 5624-5627.
.Sun Shan, Tang Hong-Mina, Feng Yi, Gao Jun-Peng, Fan Yue, Tang Yan-Hong, Yang Yun-K, Li Wen-Wei, Wang Xiang-Yu, Ma Juna, Wang Guo-Huaa, Huang Ya-Ling, Li Hua-Wei, Cai Ding-Fang, NEW evidences for fractalkine/CX3CL1 involved in substantia nigral microglial activation and behavioral changes in a rat model of Parkinson’s disease, Neurobiology of Aging. doi:10.1016/j.neurobiolaging.2009.03.004
. Hanwei Huang and Hui Zhao, Fyn-dependent muscle-immune interaction after sciatic nerve injury. Muscle Never. xxx (2009) xxx–xxx
. San-shan Chen, Jian Yu, Zhan-Zhuang Tian. Central mechanism of triptorelin therapeutic effects on female precocious puberty in rats, Chin J New Drugs Clin Rem, 2009, 28 (2):134-137. (in Chinese with English Abstract)
. Feng Guan, Su-lan Ma, Bo-ying Chen. Effects of electro-acupuncture on signal transduction pathway of hypothalamic neuroendocrine system in ovariectomized rats. J Chin Integr Med / Zhong Xi Yi Jie He Xue Bao. 2009; 7 (6): 563-568. (in Chinese with English Abstract
.Ruiling Ma, Guo-Min Zhou, Gencheng Wu, Ren Zhang. Restraining Effects of Acupuncture on Photoreceptor Cell Apoptosis in Rats with Retinitis Pigmentosa Induced by N-methyl-N-nitrosourea. Chinese Journal of Integrated Traditional and Western Medicine /Zhong Guo Zhong Xi Yi Jie He Za Zhi. 2009; 29(1): 43-45. (in Chinese with English Abstract)