Interactive effects of acupuncture on pain and distress in major burns: An experiment with rats

Acupuncture for rheumatoid vasculitis complicated by refractory foot ulcer: A case report

INTRODUCTION

Rheumatoid vasculitis (RV) is a frequently encountered complication of rheumatoid arthritis (RA), wherein skin vasculitis lesions are observed as a common clinical manifestation, encompassing skin purpura, erythema, vascular occlusion, ulcers, and gangrene. As a matter of fact, it marks the most severe extra-articular manifestation of RA. And the resultant ulcers tend to pose a greater challenge with regard to therapeutic interventions. We report a case of RV complicated by refractory foot ulcer that was successfully treated with puncture.

CASE PRESENTATION

A 62-year-old man with RV caused by RA developed refractory foot ulcers. Despite the application of topical antibiotics, the wound gradually expanded and remained unhealed for 7 months. Consequently, the patient sought an integrated therapeutic approach involving Traditional Chinese Medicine and was subsequently treated with acupuncture. After 12 weeks of acupuncture, the foot ulcers healed completely.

CONCLUSION

Acupuncture has the potential to facilitate wound healing and may serve as a viable alternative treatment modality for wounds unresponsive to traditional therapeutic interventions.

Effect of Manual Acupuncture and Laser Acupuncture on Wound Closure in Rat with Deep Partial Thickness Burn Injury

Background

Burns are defined as tissue damage that occurs as a result of the action of heat. Although many advanced treatments have been made in burn therapy, slow wound healing remains a challenge in burn treatment. Acupuncture can accelerate burn healing through its anti-inflammatory effect, increasing re-epithelialization and angiogenesis.

Objectives

This study assessed the effect of manual acupuncture and laser acupuncture on the healing of burns that were observed macroscopically and microscopically.

Methods

Thirty-six male Wistar rats with deep partial thickness burns were randomly divided into control group (n = 12), acupuncture group (n = 12), and laser acupuncture group (n = 12). Wound measurements and treatments were given every 2 days for 14 days.

Results

On the 14th day of macroscopic evaluations, there was a significant difference (P = 0.009) between the acupuncture group (66.96 ± 9.17) and the control group (49.93 ± 9.15), and a significant difference (P = 0.009) between laser acupuncture group (72.48 ± 14.62) and the control group. However, there was no significant difference (P = 0.451) between acupuncture and laser acupuncture groups. On the 14th day of microscopic evaluations, there was a significant difference (P < 0.001) between the acupuncture group (16.17 ± 1.17) and the control group (10.33 ± 1.21), and a significant difference (P = 0.004) between the laser acupuncture group (17.83 ± 1.47) and the control group. However, there was no significant difference (P = 0.058) between acupuncture and laser acupuncture groups.

Conclusion

The results showed that either acupuncture therapy or laser acupuncture therapy could be used as an adjunct therapy to accelerate burn healing.

Efficacy of Acupuncture on Pain Mechanisms, Inflammatory Responses, and Wound Healing in the Acute Phase of Major Burns: An Experimental Study on Rats

OBJECTIVES

We investigated acupuncture, a potential contributor for burn-care, on physiological and pathological pain mechanisms and systemic and local inflammatory responses in a rat experimental burn model.

METHODS

Forty male Sprague-Dawley rats were divided into 2 groups. One-hour groups(5 rats/group) were observed for 1 hour and included Sh1(sham/observation), ShA1(sham+acupuncture/observation), Brn1(burn/observation), and BrnA1(burn+acupuncture/observation). Seven-day groups(5 rats/group) were observed for 7 days and included Sh7(sham/observation), ShA7(sham+acupuncture/observation), Brn7(burn/observation), and BrnA7(burn+acupuncture/observation). "Pain-distress scores" were noted daily, acupuncture was repeated within every wound-dressing change on alternate days. After observation periods, blood samples for interleukin-6 and beta-endorphin and skin biopsies for inflammatory-changes and immunohistochemical-staining of interleukin-6 were collected for analysis( P< .05 ).

RESULTS

In 1-hour groups, interleukin-6 accumulation in burn wounds of BrnA1 was less than Brn1, with Brn1 having the highest mean blood level(P< .05). Mean beta-endorphin levels were higher in ShA1, Brn1, and BrnA1 than in Sh1(P< .05). In all 7-day groups, the agonizing period was 48 to72 hours after burn, with Brn7 most affected(P< .05). Microvessels were multiplied in Brn7group, with significantly higher numbers in burn wounds of BrnA7(P˂ .05). Burn wounds of BrnA7 had less accumulation of interleukin-6 than Brn7 with Brn7-group having the highest mean blood level and Sh7, ShA7, and BrnA7 having similarly low levels(P˃ .05). Beta-endorphin levels in ShA7, Brn7, and BrnA7 were lower than in Sh7(P< .05).

CONCLUSIONS

Acupuncture contributed to management of physiological and pathological pain, modulation of inflammatory responses, and associated enhancement of angiogenesis in acute phase of burn injury in rats.

Protective Effect of Calcium Dobesilate on Induced AKI in Severely Burned Mice

BACKGROUND

Early acute kidney injury (AKI) predicts a high mortality rate in severely burned patients. However, the pathophysiology of early AKI induced by severe burn has not been well-defined. This study was designed to examine the protective effects of calcium dobesilate (CaD) against severe burn-induced early AKI in mice and explore the mechanism.

METHODS

The shaved backs of mice were immersed in 100°C water for 10 s to make severe burn (40% of the total body surface area). CD-57 male mice were randomly divided into sham, burn, burn + vehicle, and burn + CaD groups. Renal function, reactive oxygen species generation, tubular necrosis, and phosphorylation of mitogen-activated protein kinase, protein kinase B (Akt), and nuclear factor (NF)-κB were measured at 24 and 48 h after the burn. Renal histology, ELISA, qRT-PCR, and Western blotting were performed on the renal tissue of mice to examine the effects and mechanisms at 24 and 48 h after the burn.

RESULTS

Tubular damage, cast formation, and elevations of serum creatinine, BUN, and renal tissue kidney injury molecule 1 levels were all observed in the burned mice, and these were all alleviated in the mice with CaD treatment. In addition, the levels of oxidation-reduction potential and malondialdehyde were decreased, while the activities of the endogenous antioxidative enzymes were increased in the kidney tissues from the mice after CaD treatment. Furthermore, the activities of Akt, p38, extracellular sign-regulated kinase, Jun N-terminal kinase, and NF-κB signaling were increased in the kidney of burned mice and normalized after CaD treatment.

CONCLUSION

This study has established, for the first time, the protective effect of CaD against early AKI in severely burned mice. CaD may exert its protective effect through alleviating oxidative stress, apoptosis, and inflammation, as well as modulating some signaling pathways in the kidney.

Efficacy of acupuncture in treating scars following tissue trauma

INTRODUCTION

Anecdotally, acupuncture is used in the treatment of scar tissue in order to improve scar quality and reduce symptoms of pain and pruritus. Unlike conditions such as lower back pain, knee osteoarthritis and migraines, there are no systematic reviews to confirm treatment efficacy. This systematic literature review aims to assess the current level of evidence for the use of acupuncture for treating abnormal scars such as hypertrophic or other symptomatic scars.

METHODS

A comprehensive database search was performed followed by reviewing reference lists, grey literature databases and Google Scholar. Study quality was assessed using the Oregon CONSORT STRICTA instrument (OCSI) for clinical trials and the Joanna Briggs Institute (JBI) checklist for case reports.

RESULTS

The search strategy discovered five case studies, one retrospective cohort study, one cohort study and three clinical trials that investigated the use of acupuncture for scars. Studies rated as low to moderate quality (26-50%) on the OCSI checklist due to lack of detailed reporting, use of non-validated outcome measures and heterogeneity of participant cohorts. Three case studies rated as moderate quality (5-6/8) and two as low quality (<2/8) on the JBI checklist.

DISCUSSION

All studies reported positive outcomes for the use of acupuncture for scar symptoms; however, treatment frequency, duration, number of treatments and points used varied between studies.

CONCLUSION

Acupuncture for the treatment of abnormal scars has a low level of evidence thus requiring further well-designed, controlled trials to be performed. Recommended treatment protocols for future studies have been provided.

Effects of hydrogen-rich saline on early acute kidney injury in severely burned rats by suppressing oxidative stress induced apoptosis and inflammation

Background

Early acute kidney injury (AKI) in severely burned patients predicts a high mortality that is multi-factorial. Hydrogen has been reported to alleviate organ injury via selective quenching of reactive oxygen species. This study investigated the potential protective effects of hydrogen against severe burn-induced early AKI in rats.

Methods

Severe burn were induced via immersing the shaved back of rats into a 100°C bath for 15 s. Fifty-six Sprague–Dawley rats were randomly divided into Sham, Burn + saline, and Burn + hydrogen-rich saline (HS) groups, and renal function and the apoptotic index were measured. Kidney histopathology and immunofluorescence staining, quantitative real-time PCR, ELISA and western blotting were performed on the sera or renal tissues of burned rats to explore the underlying effects and mechanisms at varying time points post burn.

Results

Renal function and tubular apoptosis were improved by HS treatment. In addition, the oxidation–reduction potential and malondialdehyde levels were markedly reduced with HS treatment, whereas endogenous antioxidant enzyme activities were significantly increased. HS also decreased the myeloperoxidase levels and influenced the release of inflammatory mediators in the sera and renal tissues of the burned rats. The regulatory effects of HS included the inhibition of p38, JNK, ERK and NF-κB activation, and an increase in Akt phosphorylation.

Conclusion

Hydrogen can attenuate severe burn-induced early AKI; the mechanisms of protection include the inhibition of oxidative stress induced apoptosis and inflammation, which may be mediated by regulation of the MAPKs, Akt and NF-κB signalling pathways.

Astaxanthin attenuates early acute kidney injury following severe burns in rats by ameliorating oxidative stress and mitochondrial-related apoptosis

Early acute kidney injury (AKI) is a devastating complication in critical burn patients, and it is associated with severe morbidity and mortality. The mechanism of AKI is multifactorial. Astaxanthin (ATX) is a natural compound that is widely distributed in marine organisms; it is a strong antioxidant and exhibits other biological effects that have been well studied in various traumatic injuries and diseases. Hence, we attempted to explore the potential protection of ATX against early post burn AKI and its possible mechanisms of action. The classic severe burn rat model was utilized for the histological and biochemical assessments of the therapeutic value and mechanisms of action of ATX. Upon ATX treatment, renal tubular injury and the levels of serum creatinine and neutrophil gelatinase-associated lipocalin were improved. Furthermore, relief of oxidative stress and tubular apoptosis in rat kidneys post burn was also observed. Additionally, ATX administration increased Akt and Bad phosphorylation and further down-regulated the expression of other downstream pro-apoptotic proteins (cytochrome c and caspase-3/9); these effects were reversed by the PI3K inhibitor LY294002. Moreover, the protective effect of ATX presents a dose-dependent enhancement. The data above suggested that ATX protects against early AKI following severe burns in rats, which was attributed to its ability to ameliorate oxidative stress and inhibit apoptosis by modulating the mitochondrial-apoptotic pathway, regarded as the Akt/Bad/Caspases signalling cascade.