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      Acupoint Embedding of Polyglactin 910 Sutures in Patients with Chronic Pain due to Cervical Spondylotic Radiculopathy: A Multicenter, Randomized, Controlled Clinical Trial

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          Abstract

          Objective

          We aimed to investigate the effectiveness of acupoint polyglactin 910 (PGLA) embedding in patients with cervical spondylotic radiculopathy (CSR).

          Methods

          A total of 102 CSR patients with neck and shoulder pain were recruited and assigned randomly into three groups: the sham acupoint embedding (SAE) group, the middle-layer acupoint PGLA embedding (MAPE) group, and the deep-layer acupoint PGLA embedding (DAPE) group. The primary outcomes were Visual Analog Scale (VAS) scores showing the analgesic effects of treatment. Secondary outcomes included clinical symptoms (evaluated by the Yasuhisa Tanaka 20 (YT-20) score and the neck disability index (NDI)) and patient health status (evaluated by the 36-item short-form survey (SF-36)) as reported in the trial.

          Results

          Compared with the SAE group, VAS scores were significantly reduced at 1, 2, 3, 4, and 10 weeks after the first treatment in both the DAPE and MAPE groups ( P < 0.001). Moreover, there were statistically significant increases in the weekly YT-20 scores and significant reductions of the weekly NDI scores compared with baseline values in both the DAPE and MAPE groups ( P < 0.001). Compared with baseline values, both the physical component summary (PCS) and the mental component summary scores of the SF-36 at 2, 3, 4, and 10 weeks were significantly higher in the DAPE and MAPE groups ( P < 0.001). There were significant lower VAS scores ( P < 0.01), higher PCS scores ( P < 0.05) at 3 weeks, and lower NDI scores ( P < 0.05) at 4 weeks in the DAPE group compared with the MAPE group.

          Conclusions

          Both DAPE and MAPE showed significant and long-lasting effects on alleviating pain and improving clinical symptoms as well as quality of life in CSR patients with neck and shoulder pain. A more intense effect was seen in the DAPE group compared with the MAPE group.

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          Most cited references18

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          Sterilization, toxicity, biocompatibility and clinical applications of polylactic acid/polyglycolic acid copolymers.

          This is a review of salient studies of sterilization, toxicity, biocompatibility, clinical applications and current work in the field of orthopaedics, using implants made of polylactic acid (PLA), polyglycolic acid (PGA) and their copolymers. The intrinsic nature of these biomaterials renders them suitable for applications where temporally slow releases of bioactive agents in situ may be required. They are also desirable as fixation devices of bone, because they can virtually eliminate osteopenia associated with stress shielding or additional surgery. The majority of currently available sterilization techniques are not suitable for these thermoplastic materials and it may be desirable to develop new sterilization standards, which can account for the special character of PLA-PGA materials. Biocompatibility and toxicity studies suggest that, overall, PLA-PGA biomaterials may be suitable for orthopaedic applications, although certain problems, especially pertaining to reduction in cell proliferation, have been reported. Clinical applications are also promising, albeit not without problems usually associated with transient tissue inflammation. The future of these materials appears bright, especially in soft tissues. They may be used to address the exceedingly complex problem of osteochondral repair, but also as a means to enhance fixation and repair processes in tendons and ligaments.
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            Sterilization, toxicity, biocompatibility and clinical applications of polylactic acid/ polyglycolic acid copolymers

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              Acupuncture for migraine prophylaxis: a randomized controlled trial.

              Acupuncture is commonly used to treat migraine. We assessed the efficacy of acupuncture at migraine-specific acupuncture points compared with other acupuncture points and sham acupuncture. We performed a multicentre, single-blind randomized controlled trial. In total, 480 patients with migraine were randomly assigned to one of four groups (Shaoyang-specific acupuncture, Shaoyang-nonspecific acupuncture, Yangming-specific acupuncture or sham acupuncture [control]). All groups received 20 treatments, which included electrical stimulation, over a period of four weeks. The primary outcome was the number of days with a migraine experienced during weeks 5-8 after randomization. Our secondary outcomes included the frequency of migraine attack, migraine intensity and migraine-specific quality of life. Compared with patients in the control group, patients in the acupuncture groups reported fewer days with a migraine during weeks 5-8, however the differences between treatments were not significant (p > 0.05). There was a significant reduction in the number of days with a migraine during weeks 13-16 in all acupuncture groups compared with control (Shaoyang-specific acupuncture v. control: difference -1.06 [95% confidence interval (CI) -1.77 to -0.5], p = 0.003; Shaoyang-nonspecific acupuncture v. control: difference -1.22 [95% CI -1.92 to -0.52], p < 0.001; Yangming-specific acupuncture v. control: difference -0.91 [95% CI -1.61 to -0.21], p = 0.011). We found that there was a significant, but not clinically relevant, benefit for almost all secondary outcomes in the three acupuncture groups compared with the control group. We found no relevant differences between the three acupuncture groups. Acupuncture tested appeared to have a clinically minor effect on migraine prophylaxis compared with sham acupuncture. Clinicaltrials.gov NCT00599586.
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                Author and article information

                Contributors
                Journal
                Evid Based Complement Alternat Med
                Evid Based Complement Alternat Med
                ECAM
                Evidence-based Complementary and Alternative Medicine : eCAM
                Hindawi
                1741-427X
                1741-4288
                2018
                26 September 2018
                : 2018
                : 3465897
                Affiliations
                1Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Fudan University, Shanghai, China
                2Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
                3The Institute of Integrative Medicine, Fudan University, Shanghai, China
                4Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai, China
                5The Community Health Service Center in Meilong, Shanghai, China
                6Department of Acupuncture, The Second People's Hospital of Shanghai, China
                7Department of Traditional Chinese Medicine, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
                8The Community Health Service Center in Wujing, Shanghai, China
                Author notes

                Academic Editor: Morry Silberstein

                Author information
                http://orcid.org/0000-0002-3191-1179
                http://orcid.org/0000-0003-0163-3865
                Article
                10.1155/2018/3465897
                6178190
                7f569ba3-25cc-411e-a8b7-80469cb7f605
                Copyright © 2018 Yu-Xia Chu et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 14 June 2018
                : 3 September 2018
                : 18 September 2018
                Funding
                Funded by: National Key R&D Program of China
                Award ID: 2017YFB0403803
                Funded by: National Natural Science Foundation of China
                Award ID: 31600852
                Award ID: 81473749
                Award ID: 81771202
                Funded by: Science and Technology Commission of Shanghai Municipality
                Award ID: 15411969600
                Funded by: Development Project of Shanghai Peak Disciplines-Integrated Chinese and Western Medicine
                Categories
                Research Article

                Complementary & Alternative medicine
                Complementary & Alternative medicine

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