human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: UNLABELLED It has been postulated that sensory stimulation ( acupuncture ) affects the cardiovascular system via the autonomic nervous system . Previously , skin temperature , thermography , plethysmography and blood pressure changes have been used in evaluation of sympathetic nerve activity following acupuncture . By using power spectral analysis , the low frequency and high frequency components of heart rate variability can be calculated reflecting the sympathetic and parasympathetic activity . The purpose of this study was to investigate to what extent acupuncture applied into the thenar muscle and into the cavum concha of the ear induced changes in the sympathetic and /or parasympathetic nervous system in healthy subjects . MATERIAL S AND METHODS Twelve healthy volunteers , six men and six women , mean age 34.4 ( range 23 - 48 ) participated in three balanced , r and omly distributed sessions . At an individual initial visit the 12 volunteers were introduced to the needle sensation by having a needle inserted into the point LI 11 . The needle sensation was evoked and the subject was trained to identify the characteristic needle sensation . The introduction was followed by three test sessions . SESSION A A short acupuncture needle , ( Seirin no 3 , ∅0.20x15 mm ) was inserted perpendicular into the earpoint , Lu 1 , in the left inferior hemi-conchae . SESSION B An acupuncture needle ( Hwato , ∅0.30x30 mm ) was inserted perpendicular into the Hegu point ( LI 4 ) in the middle of the right dorsal thenar muscle . SESSION C An acupuncture needle ( Hwato , ∅0.30x30 mm ) was inserted perpendicular superficially into the skin overlying the Hegu point on the left h and . Results . Stimulation of the ear induced a significant increase in the parasympathetic activity during the stimulation period of 25 min ( P<0.05 ) and during the post-stimulation period of 60 min ( P<0.05 ) . No significant changes were observed in either the sympathetic activity , blood pressure or heart rate . Stimulation of the thenar muscle result ed in a significant increase in the sympathetic and the parasympathetic activity during the stimulation period ( P<0.01 ) and during the post-stimulation period ( P<0.01 and P<0.001 , respectively ) . A significant decrease in the heart rate frequency ( P<0.05 ) at the end of the post-stimulation period was also demonstrated . The superficial needle insertion into the skin overlaying the right thenar muscle caused a pronounced balanced increase in both the sympathetic and parasympathetic activity during the post stimulation period of 60 min ( P<0.01 ) while no changes were observed during the stimulation period . CONCLUSION It is indicated that sensory stimulation ( acupunctura ) in healthy persons is associated with changed activity in the sympathetic and parasympathetic nervous system depending on site of stimulation and period of observation Acupuncture is known to influence autonomic nervous activity . Acupuncture on Zusanli points has been shown to enhance the regularity of gastric myoelectrical activity and accelerate gastric emptying , partly through the vagal pathway , in dogs . The aim of this study was to evaluate whether atropine-induced autonomic nervous alteration , measured by heart rate variability ( HRV ) , could be amended by electroacupuncture on Zusanli points . HRV measurements were recorded in 15 healthy volunteers before , during and after electroacupuncture . Each subject was studied for three sessions in a r and omized sequence , which included electroacupuncture on the Zusanli ( St 36 ) points with or without premedication of atropine and placebo stimulation on a non-acupoint . The analysis of low frequency ( LF ) , high frequency ( HF ) and LF/HF ratios were compared between different sessions . Serum levels of gastrin , motilin and pancreatic polypeptide ( PP ) levels were also measured . There was an increase in the LF/HF ratio ( indicating increased sympathetic activity ) during the post-acupuncture period with 2 Hz of electrical stimulation on the Zusanli acupoints . When IV atropine was used immediately before the electroacupuncture , there was a decrease in the LF power and HF power during the acupuncture and post-acupuncture periods . In addition , there was a significant increase in the LF/HF ratio during the acupuncture and post-acupuncture periods . There was a significant decrease in serum PP in the post-acupuncture period after premedication with IV atropine . In conclusion , atropine-induced HRV change might be mediated via the vagal pathway . However , atropine-induced HRV alteration is not amended by electroacupuncture on Zusanli points Abstract Objective To investigate whether a sham device ( a vali date d sham acupuncture needle ) has a greater placebo effect than an inert pill in patients with persistent arm pain . Design A single blind r and omised controlled trial created from the two week placebo run-in periods for two nested trials that compared acupuncture and amitriptyline with their respective placebo controls . Comparison of participants who remained on placebo continued beyond the run-in period to the end of the study . Setting Academic medical centre . Participants 270 adults with arm pain due to repetitive use that had lasted at least three months despite treatment and who scored ≥3 on a 10 point pain scale . Interventions Acupuncture with sham device twice a week for six weeks or placebo pill once a day for eight weeks . Main outcome measures Arm pain measured on a 10 point pain scale . Secondary outcomes were symptoms measured by the Levine symptom severity scale , function measured by Pransky 's upper extremity function scale , and grip strength . Results Pain decreased during the two week placebo run-in period in both the sham device and placebo pill groups , but changes were not different between the groups ( −0.14 , 95 % confidence interval −0.52 to 0.25 , P = 0.49 ) . Changes in severity scores for arm symptoms and grip strength were similar between groups , but arm function improved more in the placebo pill group ( 2.0 , 0.06 to 3.92 , P = 0.04 ) . Longitudinal regression analyses that followed participants throughout the treatment period showed significantly greater downward slopes per week on the 10 point arm pain scale in the sham device group than in the placebo pill group ( −0.33 ( −0.40 to −0.26 ) v −0.15 ( −0.21 to −0.09 ) , P = 0.0001 ) and on the symptom severity scale ( −0.07 ( −0.09 to −0.05 ) v −0.05 ( −0.06 to −0.03 ) , P = 0.02 ) . Differences were not significant , however , on the function scale or for grip strength . Reported adverse effects were different in the two groups . Conclusions The sham device had greater effects than the placebo pill on self reported pain and severity of symptoms over the entire course of treatment but not during the two week placebo run in . Placebo effects seem to be malleable and depend on the behaviours embedded in medical rituals OBJECTIVES The aim of this single-blind r and omized crossover study was to evaluate specific effects of manual acupuncture on central and vegetative nervous system activity measured by quantitative electroencephalography ( qEEG ) and heart rate variability ( HRV ) . DESIGN Twenty ( 20 ) healthy volunteers ( mean : 25.2 + /- 3.6 years ) were monitored simultaneously using a qEEG system and a 12-channel electrocardiogram recorder during verum acupuncture ( VA ) at acupuncture point Large Intestine 4 ( Hegu ) ( LI4 ) or placebo acupuncture ( PA ) at a sham point . RESULTS In the EEG conduction of the occipital area , needle stimulation in VA increased alpha1-frequency significantly , and the ratio alpha1/theta was shifted to the benefit of alpha1 over all electrodes . The HRV parameters showed a significant increase of the low frequency/high frequency ( HF ) ratio during the first minute of stimulation in VA , indicating an initial increase of sympathetic activation . However , an increase of HF power in the minute after stimulation followed by a decrease in heart rate suggests delayed vagal activation . De qi ( a sensation that is typical of acupuncture needling ) occurred in 16 subjects during VA and in 9 volunteers during PA ( 80 % versus 45 % ) . CONCLUSIONS Manual stimulation on LI4 seems to lead to specific changes in alpha EEG-frequency and in HRV parameters . A linear relationship between the HRV parameters and the alpha EEG b and might point to a specific modulation of cerebral function by vegetative effects during acupuncture Vagal withdrawal and /or sympathetic overactivity is always accompanied by various kinds of stress and is dangerous to the body . We proposed that mild acupuncture on the Sishencong points may effectively enhance vagal activities but suppress sympathetic regulations of the heart in humans . Experiments were carried out on nine healthy male volunteers , while they were lying in a quiet room during 2 - 4 P.M.  Acupuncture was applied 2 mm deep into the skin using st and ard stainless acupuncture needles at the Sishencong points , which are located on the vertex of the head , each 1 cm away from Baihui ( GV 20 ) in four directions . Four points around the temporal area were selected as control points . Forty minutes of precordial ECG signals before , during , and after acupuncture were recorded continuously . Frequency-domain analysis of the stationary RR intervals was performed to evaluate the total variance , high-frequency power ( HF , 0.15 - 0.40 Hz ) and low-frequency power ( LF , 0.04 - 0.15 Hz ) in normalized units ( LF% ) . Acupuncture on the Sishencong points result ed in an increased HF but a decreased LF% compared with the before acupuncture stage . Such effects did not occur when manual acupuncture was applied to the control points . The differences in the heart rate dynamics between Sishencong and the control groups took place 10 min after initiation of acupuncture and persisted even after the removal of the needles . Based on these results , we concluded that manual acupuncture on the Sishencong points enhanced cardiac vagal and suppressed sympathetic activities in humans . The underlying mechanisms and potential applications warrant further investigations The objective of this study was to assess the effects of acupuncture applied at Hegu ( LI 4 ) points and Neiguan ( PC6 ) points on heart rate variability ( HRV ) in normal subjects under fatigue and non-fatigue states using power spectral analysis . Twenty-nine normal male subjects were r and omly divided into three groups . Subjects in Group A and Group B performed a simulated driving task for 3 h and acupuncture needles were then inserted perpendicularly into the LI 4 points in the middle of the dorsal thenar muscle and PC 6 points situated between the tendons of the palmaris longus and carpi radialis muscles for 15 min for Group A but inserted subcutaneously to the acupuncture points for Group B as a control . Acupuncture needles were directly inserted perpendicularly into the LI 4 points and PC 6 points for 15 min for Group C. Stimulations of the acupuncture points induced a significant decrease in heart rate ( HR ) , HRV total power ( TP ) , low frequency ( LF ) power and ratio of low frequency to high frequency ( LF/HF ) , and a significant increase in the HF power in normalized units ( NU ) during the post stimulation period in fatigue state ( P<0.05 ) . Stimulation of acupuncture points result ed in a significant increase both in the LF power and HF power in absolute units ( AU ) ( P<0.05 ) but no significant change in NU was found during the post stimulation period in non-fatigue state . It was concluded that the modulating effect of acupuncture on heart rate variability not only depended on the points of stimulation such as acupuncture or non-acupuncture points but also on the functional state of the subject , namely whether the subjects are in a state of fatigue or not Acupuncture at the Neiguan ( P6 ) point has been shown to lessen nausea and vomiting which are related to vagal modulation . This study investigated whether acupuncture at the P6 point could improve vagal modulation by using heart rate variability analysis . We compared the heart rate variability measures of 39 subjects receiving acupuncture at the P6 point , 38 subjects receiving sham acupuncture , and 34 subjects receiving no treatment at all .  The normalized high-frequency power was used as the index of vagal modulation , and the low-/high-frequency power ratio was used as the index of sympathovagal balance . The normalized high-frequency power after acupuncture  increased significantly from 28.1 + /- 12.6 nu ( mean + /- SD ) to 30.7 + /- 14.1 nu in the P6 acupuncture group , but not in the sham acupuncture ( 30.6 + /- 13.7 nu versus 31.8 + /- 13.8 nu ) or no-treatment group ( 30.1 + /- 15.0 nu versus 30.1 + /- 15.7 nu ) . In both the P6 and sham acupuncture groups , the mean RR interval ( the intervals between consecutive R waves in the electrocardiogram ) increased significantly after acupuncture . In the no-treatment group , there was no statistical difference in all heart rate variability measures in the initial and later sessions . In conclusion , acupuncture at the P6 point can increase vagal modulation of the subjects . This result may be helpful in the underst and ing of the mechanism underlying the effect of acupuncture or acupressure at P6 on the lessening of nausea and vomiting in clinic Objective 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: UNLABELLED It has been postulated that sensory stimulation ( acupuncture ) affects the cardiovascular system via the autonomic nervous system . Previously , skin temperature , thermography , plethysmography and blood pressure changes have been used in evaluation of sympathetic nerve activity following acupuncture . By using power spectral analysis , the low frequency and high frequency components of heart rate variability can be calculated reflecting the sympathetic and parasympathetic activity . The purpose of this study was to investigate to what extent acupuncture applied into the thenar muscle and into the cavum concha of the ear induced changes in the sympathetic and /or parasympathetic nervous system in healthy subjects . MATERIAL S AND METHODS Twelve healthy volunteers , six men and six women , mean age 34.4 ( range 23 - 48 ) participated in three balanced , r and omly distributed sessions . At an individual initial visit the 12 volunteers were introduced to the needle sensation by having a needle inserted into the point LI 11 . The needle sensation was evoked and the subject was trained to identify the characteristic needle sensation . The introduction was followed by three test sessions . SESSION A A short acupuncture needle , ( Seirin no 3 , ∅0.20x15 mm ) was inserted perpendicular into the earpoint , Lu 1 , in the left inferior hemi-conchae . SESSION B An acupuncture needle ( Hwato , ∅0.30x30 mm ) was inserted perpendicular into the Hegu point ( LI 4 ) in the middle of the right dorsal thenar muscle . SESSION C An acupuncture needle ( Hwato , ∅0.30x30 mm ) was inserted perpendicular superficially into the skin overlying the Hegu point on the left h and . Results . Stimulation of the ear induced a significant increase in the parasympathetic activity during the stimulation period of 25 min ( P<0.05 ) and during the post-stimulation period of 60 min ( P<0.05 ) . No significant changes were observed in either the sympathetic activity , blood pressure or heart rate . Stimulation of the thenar muscle result ed in a significant increase in the sympathetic and the parasympathetic activity during the stimulation period ( P<0.01 ) and during the post-stimulation period ( P<0.01 and P<0.001 , respectively ) . A significant decrease in the heart rate frequency ( P<0.05 ) at the end of the post-stimulation period was also demonstrated . The superficial needle insertion into the skin overlaying the right thenar muscle caused a pronounced balanced increase in both the sympathetic and parasympathetic activity during the post stimulation period of 60 min ( P<0.01 ) while no changes were observed during the stimulation period . CONCLUSION It is indicated that sensory stimulation ( acupunctura ) in healthy persons is associated with changed activity in the sympathetic and parasympathetic nervous system depending on site of stimulation and period of observation Acupuncture is known to influence autonomic nervous activity . Acupuncture on Zusanli points has been shown to enhance the regularity of gastric myoelectrical activity and accelerate gastric emptying , partly through the vagal pathway , in dogs . The aim of this study was to evaluate whether atropine-induced autonomic nervous alteration , measured by heart rate variability ( HRV ) , could be amended by electroacupuncture on Zusanli points . HRV measurements were recorded in 15 healthy volunteers before , during and after electroacupuncture . Each subject was studied for three sessions in a r and omized sequence , which included electroacupuncture on the Zusanli ( St 36 ) points with or without premedication of atropine and placebo stimulation on a non-acupoint . The analysis of low frequency ( LF ) , high frequency ( HF ) and LF/HF ratios were compared between different sessions . Serum levels of gastrin , motilin and pancreatic polypeptide ( PP ) levels were also measured . There was an increase in the LF/HF ratio ( indicating increased sympathetic activity ) during the post-acupuncture period with 2 Hz of electrical stimulation on the Zusanli acupoints . When IV atropine was used immediately before the electroacupuncture , there was a decrease in the LF power and HF power during the acupuncture and post-acupuncture periods . In addition , there was a significant increase in the LF/HF ratio during the acupuncture and post-acupuncture periods . There was a significant decrease in serum PP in the post-acupuncture period after premedication with IV atropine . In conclusion , atropine-induced HRV change might be mediated via the vagal pathway . However , atropine-induced HRV alteration is not amended by electroacupuncture on Zusanli points Abstract Objective To investigate whether a sham device ( a vali date d sham acupuncture needle ) has a greater placebo effect than an inert pill in patients with persistent arm pain . Design A single blind r and omised controlled trial created from the two week placebo run-in periods for two nested trials that compared acupuncture and amitriptyline with their respective placebo controls . Comparison of participants who remained on placebo continued beyond the run-in period to the end of the study . Setting Academic medical centre . Participants 270 adults with arm pain due to repetitive use that had lasted at least three months despite treatment and who scored ≥3 on a 10 point pain scale . Interventions Acupuncture with sham device twice a week for six weeks or placebo pill once a day for eight weeks . Main outcome measures Arm pain measured on a 10 point pain scale . Secondary outcomes were symptoms measured by the Levine symptom severity scale , function measured by Pransky 's upper extremity function scale , and grip strength . Results Pain decreased during the two week placebo run-in period in both the sham device and placebo pill groups , but changes were not different between the groups ( −0.14 , 95 % confidence interval −0.52 to 0.25 , P = 0.49 ) . Changes in severity scores for arm symptoms and grip strength were similar between groups , but arm function improved more in the placebo pill group ( 2.0 , 0.06 to 3.92 , P = 0.04 ) . Longitudinal regression analyses that followed participants throughout the treatment period showed significantly greater downward slopes per week on the 10 point arm pain scale in the sham device group than in the placebo pill group ( −0.33 ( −0.40 to −0.26 ) v −0.15 ( −0.21 to −0.09 ) , P = 0.0001 ) and on the symptom severity scale ( −0.07 ( −0.09 to −0.05 ) v −0.05 ( −0.06 to −0.03 ) , P = 0.02 ) . Differences were not significant , however , on the function scale or for grip strength . Reported adverse effects were different in the two groups . Conclusions The sham device had greater effects than the placebo pill on self reported pain and severity of symptoms over the entire course of treatment but not during the two week placebo run in . Placebo effects seem to be malleable and depend on the behaviours embedded in medical rituals OBJECTIVES The aim of this single-blind r and omized crossover study was to evaluate specific effects of manual acupuncture on central and vegetative nervous system activity measured by quantitative electroencephalography ( qEEG ) and heart rate variability ( HRV ) . DESIGN Twenty ( 20 ) healthy volunteers ( mean : 25.2 + /- 3.6 years ) were monitored simultaneously using a qEEG system and a 12-channel electrocardiogram recorder during verum acupuncture ( VA ) at acupuncture point Large Intestine 4 ( Hegu ) ( LI4 ) or placebo acupuncture ( PA ) at a sham point . RESULTS In the EEG conduction of the occipital area , needle stimulation in VA increased alpha1-frequency significantly , and the ratio alpha1/theta was shifted to the benefit of alpha1 over all electrodes . The HRV parameters showed a significant increase of the low frequency/high frequency ( HF ) ratio during the first minute of stimulation in VA , indicating an initial increase of sympathetic activation . However , an increase of HF power in the minute after stimulation followed by a decrease in heart rate suggests delayed vagal activation . De qi ( a sensation that is typical of acupuncture needling ) occurred in 16 subjects during VA and in 9 volunteers during PA ( 80 % versus 45 % ) . CONCLUSIONS Manual stimulation on LI4 seems to lead to specific changes in alpha EEG-frequency and in HRV parameters . A linear relationship between the HRV parameters and the alpha EEG b and might point to a specific modulation of cerebral function by vegetative effects during acupuncture Vagal withdrawal and /or sympathetic overactivity is always accompanied by various kinds of stress and is dangerous to the body . We proposed that mild acupuncture on the Sishencong points may effectively enhance vagal activities but suppress sympathetic regulations of the heart in humans . Experiments were carried out on nine healthy male volunteers , while they were lying in a quiet room during 2 - 4 P.M.  Acupuncture was applied 2 mm deep into the skin using st and ard stainless acupuncture needles at the Sishencong points , which are located on the vertex of the head , each 1 cm away from Baihui ( GV 20 ) in four directions . Four points around the temporal area were selected as control points . Forty minutes of precordial ECG signals before , during , and after acupuncture were recorded continuously . Frequency-domain analysis of the stationary RR intervals was performed to evaluate the total variance , high-frequency power ( HF , 0.15 - 0.40 Hz ) and low-frequency power ( LF , 0.04 - 0.15 Hz ) in normalized units ( LF% ) . Acupuncture on the Sishencong points result ed in an increased HF but a decreased LF% compared with the before acupuncture stage . Such effects did not occur when manual acupuncture was applied to the control points . The differences in the heart rate dynamics between Sishencong and the control groups took place 10 min after initiation of acupuncture and persisted even after the removal of the needles . Based on these results , we concluded that manual acupuncture on the Sishencong points enhanced cardiac vagal and suppressed sympathetic activities in humans . The underlying mechanisms and potential applications warrant further investigations The objective of this study was to assess the effects of acupuncture applied at Hegu ( LI 4 ) points and Neiguan ( PC6 ) points on heart rate variability ( HRV ) in normal subjects under fatigue and non-fatigue states using power spectral analysis . Twenty-nine normal male subjects were r and omly divided into three groups . Subjects in Group A and Group B performed a simulated driving task for 3 h and acupuncture needles were then inserted perpendicularly into the LI 4 points in the middle of the dorsal thenar muscle and PC 6 points situated between the tendons of the palmaris longus and carpi radialis muscles for 15 min for Group A but inserted subcutaneously to the acupuncture points for Group B as a control . Acupuncture needles were directly inserted perpendicularly into the LI 4 points and PC 6 points for 15 min for Group C. Stimulations of the acupuncture points induced a significant decrease in heart rate ( HR ) , HRV total power ( TP ) , low frequency ( LF ) power and ratio of low frequency to high frequency ( LF/HF ) , and a significant increase in the HF power in normalized units ( NU ) during the post stimulation period in fatigue state ( P<0.05 ) . Stimulation of acupuncture points result ed in a significant increase both in the LF power and HF power in absolute units ( AU ) ( P<0.05 ) but no significant change in NU was found during the post stimulation period in non-fatigue state . It was concluded that the modulating effect of acupuncture on heart rate variability not only depended on the points of stimulation such as acupuncture or non-acupuncture points but also on the functional state of the subject , namely whether the subjects are in a state of fatigue or not Acupuncture at the Neiguan ( P6 ) point has been shown to lessen nausea and vomiting which are related to vagal modulation . This study investigated whether acupuncture at the P6 point could improve vagal modulation by using heart rate variability analysis . We compared the heart rate variability measures of 39 subjects receiving acupuncture at the P6 point , 38 subjects receiving sham acupuncture , and 34 subjects receiving no treatment at all .  The normalized high-frequency power was used as the index of vagal modulation , and the low-/high-frequency power ratio was used as the index of sympathovagal balance . The normalized high-frequency power after acupuncture  increased significantly from 28.1 + /- 12.6 nu ( mean + /- SD ) to 30.7 + /- 14.1 nu in the P6 acupuncture group , but not in the sham acupuncture ( 30.6 + /- 13.7 nu versus 31.8 + /- 13.8 nu ) or no-treatment group ( 30.1 + /- 15.0 nu versus 30.1 + /- 15.7 nu ) . In both the P6 and sham acupuncture groups , the mean RR interval ( the intervals between consecutive R waves in the electrocardiogram ) increased significantly after acupuncture . In the no-treatment group , there was no statistical difference in all heart rate variability measures in the initial and later sessions . In conclusion , acupuncture at the P6 point can increase vagal modulation of the subjects . This result may be helpful in the underst and ing of the mechanism underlying the effect of acupuncture or acupressure at P6 on the lessening of nausea and vomiting in clinic Objective 
    Output:
    