Morphological Studies on Crushed Sciatic Nerve of Rabbits with Electroacupuncture or Diclofenac Sodium Treatment

Use of low-power He-Ne laser therapy to accelerate regeneration processes of injured sciatic nerve in rabbit

Background

Photostimulation using low-power laser had been used for nervous repair with interesting results. This study aimed to evaluate the influence of 20 mW low-power He-Ne laser on the regeneration of a peripheral sciatic nerve after trauma using the Albino rabbit as an animal model for experimental treatment.

Methods

Six adult male rabbits were randomly assigned into two equal groups (control- and laser-treated). General anesthesia was administered intramuscularly, and exploration of the sciatic nerve was done in the lateral aspect of the legs. Complete longitudinal and reverse sections of the nerve were performed, which was followed by crushing of the neural sheath. Treatment was carried out directly after the trauma. Irradiation doses of low-level laser therapy (LLLT-31.5 J/cm²) with once a day application for 10 consecutive days and observed for 30 days. The animals were followed up for an extra 2 weeks. Two important factors were examined histopathology and functionality of the nerve.

Results

Compared to the control group, significant variations in regeneration were observed, including thicker nerve fibers, and more regular myelin layers in the treated group.

Conclusions

The results of the present study suggest that laser therapy may be a viable approach for nerve regeneration and repair.

Acupuncture for Locomotor Disabilities in a South American Red-Footed Tortoise (Geochelone Carbonaria) – a Case Report

The literature contains numerous reports of the effect of acupuncture on domestic or experimental animals, but only a few involving wild animals. This paper reports on acupuncture treatment for locomotor disabilities in a South American red-footed tortoise ( Geochelone carbonaria, SPIX, 1824), an endangered land tortoise found in Brazil's Cerrado region. The animal was captured and kept in an aquatic pen, subsequently developing respiratory symptoms and locomotor disabilities. The respiratory symptoms resolved in response to antibiotic treatment. However, despite the use of nutritional supplements, the motor symptoms remained unchanged. After 16 months, the tortoise was given six acupuncture sessions. No other changes were made to its environment or management. The location of the acupuncture points was transposed from canine charts. After acupuncture, the animal's motor functions, which had remained unchanged during the preceding 16 months, were restored, enabling it to eat and walk unaided. The improvement persisted during 18 months follow up. The transposition of acupuncture points from canine charts is a viable alternative for chelonians.

Acupuncture Treatment for Chemotherapy-Induced Peripheral Neuropathy – a Case Series

Chemotherapy induced peripheral neuropathy (CIPN) occurs in 10 to 20% of cancer patients treated with neurotoxic chemotherapy. A mixture of sensory, sensorimotor and autonomic nervous system dysfunction can occur, resulting in deterioration in function and worsened quality of life. A major feature is discomfort and pain. Early termination of treatment and dose reduction of chemotherapy may be necessary. The clinical course is variable and depends on the chemotherapy agents and their cumulative dose. Although symptoms can resolve completely, in most patients CIPN is either only partially reversible or completely irreversible. Current management for CIPN is symptomatic using membrane stabilising medications and antidepressants. The use of nerve growth factors is still experimental.

Dysaesthesia and pain involving the feet and hands are described in both traditional Chinese medicine (TCM) and Western biomedicine. In TCM, the pathogenesis is related to the inability to direct Qi and Blood to the extremities, and is associated with Qi, Blood, Yang and Kidney deficiencies. Acupuncture is moderately effective in treating diabetic neuropathy. However, to date, there is no report of the usefulness of acupuncture for CIPN.

We report the result of a pilot prospective case series of five patients treated with an acupuncture protocol that aims to correct Qi, Blood and Yang deficiencies and directs Qi and Blood to the extremities, with the goal of improving the symptoms of CIPN. The responses were encouraging, and cannot be easily explained by the known neurophysiological mechanisms of acupuncture.

The Efficacy of Acupuncture for the Treatment of Sciatica: A Systematic Review and Meta-Analysis

Background. Sciatica is one of the most frequently reported complaints; it affects quality of life and reduces social and economic efficacy. Clinical studies on the efficacy of acupuncture therapy in sciatica are increasing, while systematic reviews assessing the efficacy of acupuncture therapy are still lacking. Objective. This study aims to assess the effectiveness of acupuncture therapy for sciatica. Methods. Comprehensive searches of 8 databases were conducted up until April 2015. Outcomes included effectiveness (proportion of patients who improved totally or partly in clinical symptoms), pain intensity, and pain threshold. Effect sizes were presented as risk ratio (RR) and mean difference (MD). Pooled effect sizes were calculated by fixed effects or random effects model. Results. A total of 12 studies (involving 1842 participants) were included. Results showed that acupuncture was more effective than conventional Western medicine (CWM) in outcomes effectiveness (RR 1.21, 95% CI: 1.16–1.25), pain intensity (MD −1.25, 95% CI: −1.63 to −0.86), and pain threshold (MD: 1.08, 95% CI: 0.98–1.17). Subgroup and sensitivity analysis found that the results did not change in different treatment method and drug categories substantially. The reported adverse effects were acceptable. Conclusions. Acupuncture may be effective in treating the pain associated with sciatica.

Far-Infrared Therapy Promotes Nerve Repair following End-to-End Neurorrhaphy in Rat Models of Sciatic Nerve Injury

This study employed a rat model of sciatic nerve injury to investigate the effects of postoperative low-power far-infrared (FIR) radiation therapy on nerve repair following end-to-end neurorrhaphy. The rat models were divided into the following 3 groups: (1) nerve injury without FIR biostimulation (NI/sham group); (2) nerve injury with FIR biostimulation (NI/FIR group); and (3) noninjured controls (normal group). Walking-track analysis results showed that the NI/FIR group exhibited significantly higher sciatic functional indices at 8 weeks after surgery (P < 0.05) compared with the NI/sham group. The decreased expression of CD4 and CD8 in the NI/FIR group indicated that FIR irradiation modulated the inflammatory process during recovery. Compared with the NI/sham group, the NI/FIR group exhibited a significant reduction in muscle atrophy (P < 0.05). Furthermore, histomorphometric assessment indicated that the nerves regenerated more rapidly in the NI/FIR group than in the NI/sham group; furthermore, the NI/FIR group regenerated neural tissue over a larger area, as well as nerve fibers of greater diameter and with thicker myelin sheaths. Functional recovery, inflammatory response, muscular reinnervation, and histomorphometric assessment all indicated that FIR radiation therapy can accelerate nerve repair following end-to-end neurorrhaphy of the sciatic nerve.

Effects of early and delayed laser application on nerve regeneration

The aim of this study is to analyze the differences between early and delayed use of low-level laser therapy (LLLT) in functional and morphological recovery of the peripheral nerve. Thirty male Wistar rats were divided into three groups after the sciatic nerve was crushed: (1) control group without laser treatment, (2) early group with laser treatment started immediately after surgery and lasted 14 days, and (3) delayed group with laser treatment starting on the postoperative day 7 and lasted until day 21. A 650-nm diode laser (model: DH650-24-3(5), Huanic, China) with an output power of 25 mW exposed transcutaneously at three equidistant points on the surgical mark corresponding to the crushed nerve. The length of the laser application was calculated as 57 s to satisfy approximately 10 J/cm(2). A Sciatic Functional Index (SFI) was used to evaluate functional improvement in groups at pre- and post-surgery (on days 7, 14, and 21). Compound action potential (CAP) was measured after the sacrifice and histological examination was performed for all groups. SFI results showed that there was no significant difference between groups at different days (p > 0.05). On the other hand, the latency of CAP decreased significantly (p < 0.05) in the delayed group. Histological examination confirmed that the number of mononuclear cells was lower (p < 0.05) in both early and delayed groups. In conclusion, results supported the hypothesis that LLLT could accelerate the rate of recovery of injured peripheral nerves in this animal model. Though both laser groups had positive outcomes, delayed group showed better recovery.

S100β Levels in CSF of Nonambulatory Dogs with Intervertebral Disk Disease Treated with Electroacupuncture

The aim of the study was to investigate S100β levels in the cerebrospinal fluid of nonambulatory dogs with intervertebral disk disease treated with electroacupuncture: 10 dogs with thoracolumbar disk extrusion graded 3 to 5 (EA group) and 7 dogs without neurologic dysfunction (control group). All dogs regained ambulation. S100β was detected by Western blot analysis where EA group dogs were evaluated at two time points (M1 = before EA and M2 = when the dogs return ambulation) and at one time point from control group. In EA group dogs M1-S100β levels were significantly higher than in control group. EA group dogs were divided into subgroups A (n = 7-early motor recovery; 6.7 ± 7.8 days) and B (n = 3-late motor recovery; 76 ± 17.0 days). M1-S100β levels were similar between subgroups A and B. However, M2-S100β levels were significantly higher in subgroup B than in subgroup A. An elevated S100β levels were observed in dogs with late motor recovery. S100β may be associated with neuroplasticity following spinal cord injuries with intervertebral disk extrusion. Further studies with larger numbers of subjects and control group with affected dogs are necessary to investigate the relationship between neurotrophic factors and electroacupuncture stimulation.

Sweet bee venom pharmacopuncture for chemotherapy-induced peripheral neuropathy

INTRODUCTION

Chemotherapy-induced peripheral neuropathy (CIPN) is sensory and motor nerve damage to the peripheral nervous system caused by chemotherapeutic agents. It often causes pain and other varying degrees of neuropathic symptoms accompanied by functional limitations and reduced quality of life. Currently, there is no standard treatment protocol for the treatment of CIPN.

OBJECTIVE

In need of more research to develop new therapeutic options focusing on their safety, efficacy, and long-term sustained clinical effects, a pilot study of sweet bee venom pharmacopuncture (SBVP) for CIPN was conducted to build up preliminary efficacy data in the process of preparing for a future larger scale randomized controlled SBVP trial for CIPN.

METHODS

We conducted a prospective case series by analyzing the clinical observations made of CIPN patients treated with SBVP. A total of 11 eligible consecutive CIPN patients who visited East-West Cancer Center from June 1, 2010, to February 28, 2011, were treated with total of six SBVP treatments given within the 3-week period. The outcomes were measured using World Health Organization Common Toxicity Criteria for Peripheral neuropathy (WHO grading system), Patient Neurotoxicity Questionnaire (PNQ), Visual Analogue System (VAS), and Health-Related Quality of Life (HRQOL) collected at the baseline, post-second, fourth, and the final treatment. Patients were followed 3 weeks into no intervention to determine the sustained effects of pharmacopuncture.

RESULTS

Both of the WHO CIPN grade and PNQ scores have shown a decrease in the level of neuropathy. VAS pain level has also shown a great decrease and improvement in patients' quality of life have also been detected though modest. Changes in WHO grade, VAS and Total HRQOL scores between the baseline and after the last treatment session were significant. Changes in WHO grade, Total PNQ, PNQ-sensory, VAS, Total HRQOL, and HRQOL-functional scores between the baseline and the 3-week follow-up were significant.

CONCLUSION

The positive result of the study supports the potential value of conducting a fully powered trial to explore further efficacy of SBVP for CIPN. However a single positive result within this pilot study must be interpreted with caution.

Evaluation of electroacupuncture treatment for thoracolumbar intervertebral disk disease in dogs

OBJECTIVE

To evaluate use of electroacupuncture combined with standard Western medical treatment versus Western medical treatment alone for treatment of thoracolumbar intervertebral disk disease in dogs.

DESIGN

Prospective controlled study.

ANIMALS

50 dogs with signs of thoracolumbar intervertebral disk disease.

PROCEDURES

Dogs were randomly allocated to 1 of 2 treatment groups and classified as having grade 1 to 5 neurologic dysfunction. Dogs in group 1 received electroacupuncture stimulation combined with standard Western medical treatment; those in group 2 received only standard Western medical treatment. A numeric score for neurologic function was evaluated at 4 time points to evaluate effects of treatments.

RESULTS

Time (mean +/- SD) to recover ambulation in dogs with grade 3 and 4 dysfunction in group 1 (10.10 +/- 6.49 days) was significantly lower than in group 2 (20.83 +/- 11.99 days). Success (able to walk without assistance) rate for dogs with grade 3 and 4 dysfunction in group 1 (10/10 dogs) was significantly higher than that of similarly affected dogs in group 2 (6/9 dogs). Dogs without deep pain perception (grade 5 dysfunction) had a success (recovery of pain sensation) rate of 3 of 6 and 1 of 8 in groups 1 and 2, respectively, but the difference was not significant. Overall success rate (all dysfunction grades) for group 1 (23/26; 88.5%) was significantly higher than for group 2 (14/24; 58.3%).

CONCLUSIONS AND CLINICAL RELEVANCE

Electroacupuncture combined with standard Western medical treatment was effective and resulted in shorter time to recover ambulation and deep pain perception than did use of Western treatment alone in dogs with signs of thoracolumbar intervertebral disk disease.

Hyperbaric oxygenation in peripheral nerve repair and regeneration

Peripheral nerves are essential connections between the central nervous system and muscles, autonomic structures and sensory organs. Their injury is one of the major causes for severe and longstanding impairment in limb function. Acute peripheral nerve lesion has an important inflammatory component and is considered as ischemia-reperfusion (IR) injury. Surgical repair has been the standard of care in peripheral nerve lesion. It has reached optimal technical development but the end results still remain unpredictable and complete functional recovery is rare. Nevertheless, nerve repair is not primarily a mechanical problem and microsurgery is not the only key to success. Lately, there have been efforts to develop alternatives to nerve graft. Work has been carried out in basal lamina scaffolds, biologic and non-biologic structures in combination with neurotrophic factors and/or Schwann cells, tissues, immunosuppressive agents, growth factors, cell transplantation, principles of artificial sensory function, gene technology, gangliosides, implantation of microchips, hormones, electromagnetic fields and hyperbaric oxygenation (HBO). HBO appears to be a beneficial adjunctive treatment for surgical repair in the acute peripheral nerve lesion, when used at lower pressures and in a timely fashion (<6 hours).