Octanol alleviates chronic constriction injury of sciatic nerve-induced peripheral neuropathy by regulating AKT/mTOR signaling.

OBJECTIVE: Activation of gap junction channels can induce neuropathic pain. Octanol can limit the conductance of gap junctions containing connexin 43 proteins. Thus, this study focused on the roles of octanol in chronic constriction injury (CCI)-induced peripheral neuropathy in mice and its mechanisms of action. METHODS: Male mice were assigned into control, sham, CCI, CCI + Octanol-20 mg/kg, CCI + Octanol-40 mg/kg and CCI + Octanol-80 mg/kg groups. CCI was performed by applying three loose ligations to mouse sciatic nerve, and the mice with CCI was administered with 20 mg/kg, 40 mg/kg, or 80 mg/kg octanol. The neuropathic pain development was examined by assessing thermal withdrawal latency, paw withdrawal mechanical threshold, and sciatic functional index. Histopathological changes were evaluated by hematoxylin and eosin staining. The phosphorylation of protein kinase B (Akt) and mammalian target of rapamycin (mTOR) was examined by western blotting. The expression of Akt and mTOR was also evaluated by immunofluorescence staining. RESULTS: Octanol alleviated the CCI-induced mechanical and thermal hyperalgesia and sciatic functional loss. Additionally, octanol relieved the CCI-induced abnormal histopathological changes. Mechanistically, octanol inactivated the Akt/mTOR pathway in the mice with CCI. CONCLUSION: In conclusion, octanol can alleviate CCI-induced peripheral neuropathic by regulating the Akt/mTOR pathway and might be a novel pharmacological intervention for neuropathic pain.

Comparison of outcomes between nonsurgical and surgical treatment of distal radius fracture: a systematic review update and meta-analysis.

INTRODUCTION: This study was a systematic review comparing the clinical outcomes of nonsurgical and surgical management for distal radius fractures. MATERIALS AND METHODS: A comprehensive literature search was conducted using multiple databases, including Medline, Embase, and Cochrane. All databases were searched from the earliest records through June 2019 using the following Boolean operators: distal radius fracture, conservative treatment, nonoperative treatment, nonsurgical treatment, surgical treatment, and operative. All prospective and retrospective controlled trials were retrieved that directly compared the functional outcomes between the nonsurgical and surgical groups. RESULTS: Five prospective studies and six retrospective comparative studies were retrieved. A total of 1049 patients were included: 529 in the nonsurgical group and 520 in the surgical group. Both types of treatment led to similar results with respect to DASH and grip strength, as well as and most other functional assessments. However, there was significant difference in radial inclination, radial length, ulnar variance and range of wrist flexion. CONCLUSIONS: No significant differences in most functional assessments were found when comparing surgical and nonsurgical management of distal radius fractures. Although there were significant differences in radial inclination, radial deviation, ulnar variance, and wrist flexion, they did not seem to have impacts on the quality of wrist. Nonsurgical treatment for the distal radius fractures should be considered firstly. Indications for operative fixation should be considered carefully in the treatment of DRFs. LEVEL OF EVIDENCE: Therapeutic study (systematic review), Level III.

Better rotational control but similar outcomes with the outside-in versus the transtibial drilling technique for anterior cruciate ligament reconstruction: a systematic review of comparative trials.

INTRODUCTION: This study was a systematic review comparing the clinical outcomes of using the transtibial (TT) versus the outside-in (OI) technique for anterior cruciate ligament (ACL) reconstruction. MATERIALS AND METHODS: A comprehensive literature search was conducted using multiple databases, including Medline, Embase, and Cochrane. All databases were searched from the earliest records through August 2017 using the following Boolean operators: transtibial AND (outside-in OR out-in OR two incisions) AND anterior cruciate ligament. All prospective and retrospective controlled trials were retrieved that directly compared physical examination and knee function scores and patient-rated outcomes between the TT and OI techniques. RESULTS: Four prospective and three retrospective articles were identified by the search, and the findings suggested that the OI was superior to the TT technique for preparing the femoral tunnel based on the pivot shift test (p = 0.05). There was no statistically significant difference between the two treatment groups in International Knee Documentation Committee (IKDC) grades, IKDC scores, Lysholm scores, Tegner scores, or the Lachman test. CONCLUSIONS: No statistically significant differences were found in clinical functional results when comparing patients who underwent ACL reconstruction with the TT or OI techniques. However, the OI technique was found to be advantageous in conferring increased rotational stability as revealed by the pivot shift test. Additional studies with larger sample sizes are needed to make more precise conclusions. LEVEL OF EVIDENCE: Therapeutic study (systematic review), Level III.

Verapamil inhibits scar formation after peripheral nerve repair in vivo.

The calcium channel blocker, verapamil, has been shown to reduce scar formation by inhibiting fibroblast adhesion and proliferation in vitro. It was not clear whether topical application of verapamil after surgical repair of the nerve in vivo could inhibit the formation of excessive scar tissue. In this study, the right sciatic nerve of adult Sprague-Dawley rats was transected and sutured with No. 10-0 suture. The stoma was wrapped with gelfoam soaked with verapamil solution for 4 weeks. Compared with the control group (stoma wrapped with gelfoam soaked with physiological saline), the verapamil application inhibited the secretion of extracellular matrix from fibroblasts in vivo, suppressed type I and III collagen secretion and increased the total number of axons and the number of myelinated axons. These findings suggest that verapamil could reduce the formation of scar tissue and promote axon growth after peripheral nerve repair.