Pulsed electromagnetic fields for postmenopausal osteoporosis and concomitant lumbar osteoarthritis in southwest China using proximal femur bone mineral density as the primary endpoint: study protocol for a randomized controlled trial.

BACKGROUND: Osteoporosis (OP) and osteoarthritis (OA) are prevalent skeletal disorders among postmenopausal women. Coexistence is common especially that of postmenopausal osteoporosis (PMO) and lumbar OA. An hypothesis has been raised that OP and OA might share the same pathogenic mechanism, and pulsed electromagnetic fields (PEMFs) were reported to have anti-osteoporosis and anti-osteoarthritis properties, but this suggestion was based primarily on biomarker data. Therefore, whether these two effects could take place simultaneously has not yet been investigated. This randomized controlled trial (RCT) is designed to explore the effect of PEMFs for PMO and concomitant lumbar OA. METHODS/DESIGN: The study will include PMO patients (postmenopausal women; aged between 50 and 70 years; have been postmenopausal for at least 5 years and diagnosed with OP using proximal femur T-score) with concomitant lumbar OA (patients with confounding disorders like diabetes, hypertension, hyperlipidemia, and previous fracture history, etcetera, will be excluded) will be randomly assigned to two arms: PEMFs group and sham PEMFs group. There will be 25 participants in each arm (50 in total) and the outcome assessment, including the primary endpoint (proximal femur bone mineral density), will be performed at 5 weeks, 3 months and 6 months after enrollment. DISCUSSION: PMO and lumbar OA are prominent public health problem, especially for postmenopausal women. We hope this RCT will provide scientific evidence to primary care of the postmenopausal women regarding the use of these nonpharmaceutical, noninvasive modalities, PEMFs, in managing PMO and lumbar OA. TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR-TRC-14005156 (28 August 2014).

[Pulsed electromagnetic field therapy inhibits chondrocyte apoptosis in rabbits with osteoarthritis].

OBJECTIVE: To determine the effect of pulsed electromagnetic field (PEMF) treatment on chondrocyte morphology, chondrocyte apoptosis, and the expression of apoptosis related proteins in rabbits. METHODS: 24 white New Zealand rabbits were randomly divided into three groups: normal control group (NC group), anterior cruciate ligament transection without treatment (ACLT group), and anterior cruciate ligament transection with pulsed electromagnetic field treatment (PEMF group). Six weeks after anterior cruciate ligament transection, the rabbits in the PEMF group were given 2 weeks of pulsed electromagnetic field treatment. RESULTS: Rabbits in the PEMF group had significantly lower Mankin scores than those in the ACLT group, although the scores were higher than that of the NC group. The rabbits in the PEMF groups also had significantly lower levels of apoptosis index of chondrocytes and expression of caspase-3 compared with those in the ACLT group. The expression of caspase-8 in the rabbits in the PEMF group was higher compared to the NC group, but no significant difference compared with that of the ACLT group. CONCLUSION: Pulsed electromagnetic field treatment has therapeutic effect on the experimental osteoarthritis, which is likely a result of inhibition of apoptosis in chondrocytes.

[The effect of low-frequency pulsed electromagnetic fields on balance ability of patients with post-menopausal osteoporosis].

OBJECTIVE: To assess the effect of pulsed electromagnetic fields (PEMFs)on balance ability of postmenopausal women with osteoporosis. METHODS: 43 eligible patients were randomly divided into experimental (n = 24) and control (n = 19) groups. Patients in both groups received conventional drug therapy. Meanwhile, patients in the experimental group were given PEMFs once a day for 30 days. RESULTS: The Berg Balance Scale (BBS) scores increased and the timed upand to test (TUG) scores, sway index (forward-backward), rectangle area and sway path decreased in the patients in the experimental group (P < 0.05). In the patients in the control group, only changes in BBS scores and sway path were statistically significant (P < 0.05). The decrease of sway index (forward-backward) in the experimental group was greater than that of the control group (P < 0 01). CONCLUSION: PEMFs can improve the balance ability of patients with post-menopausal osteoporosis.

[The estrogen-like and antioxidant effects of pilose antler blood wine in female rats with ovariectomy].

OBJECTIVE: To investigate whether pilose antler blood wine has the effects of estrogen-like activity and antioxidant in the ovariectomized (OVX) female rats. METHODS: The rat model of oxidative stress was established by ovariectomy. The female rats were divided into 6 groups: normal control group, OVX group, base wine group, and 3 pilose antler blood wine treated OVX groups (low, medium and high dose of wine at a dose of 4.5 g/kg, 9.1 g/kg and 13.6 g/kg respectively). After the feeding of pilose antler blood wine (saline in control and OVX group) for 31 days, the serum estrodial level, serum superoxide dismutase (SOD), and the content of methane dicarboxylic aldehyde (MDA) were measured. RESULTS: The one month treatment of daily drink of pilose antler blood wine could significantly promote the serum estrodial level in OVX rats (P < 0.05). Either low or medium dose could inhibit the decrease of serum SOD activity and the increase of MDA content in OVX rats, and the inhibition effects were more obvious in low dose group compared with high dose group (P < 0.05). CONCLUSION: The daily drink of pilose antler blood wine showed the effects on increasing estrodial level and antioxidation in OVX rats.

Pulsed electromagnetic fields on postmenopausal osteoporosis in Southwest China: a randomized, active-controlled clinical trial.

A randomized, active-controlled clinical trial was conducted to examine the effect of pulsed electromagnetic fields (PEMFs) on women with postmenopausal osteoporosis (PMO) in southwest China. Forty-four participants were randomly assigned to receive alendronate or one course of PEMFs treatment. The primary endpoint was the mean percentage change in bone mineral density of the lumbar spine (BMDL), and secondary endpoints were the mean percentage changes in left proximal femur bone mineral density (BMDF), serum 25OH vitamin D3 (25(OH)D) concentrations, total lower-extremity manual muscle test (LE MMT) score, and Berg Balance Scale (BBS) score. The BMDL, BMDF, total LE MMT score and BBS score were recorded at baseline, 5, 12, and 24 weeks. Serum concentrations of 25(OH)D were measured at baseline and 5 weeks. Using a mixed linear model, there was no significant treatment difference between the two groups in the BMDL, BMDF, total LE MMT score, and BBS score (P ≥ 0.05). For 25(OH)D concentrations, the effects were also comparable between the two groups (P ≥ 0.05) with the Mann-Whitney's U-test. These results suggested that a course of PEMFs treatment with specific parameters was as effective as alendronate in treating PMO within 24 weeks.

[Effect of pulsed electromagnetic fields on biomechanical properties of femur in ovariectomized rats].

OBJECTIVE: To test the effect of pulsed electromagnetic fields (PEMFs) with different length of treatment on the biomechanical properties of femurs in ovariectomized rats. METHODS: Fifty female SD rats were randomly divided into five groups: (1) SHAM control (no PEMFs treatment), (2) OVXo control (no PEMFs treatment), (3) OVX(I) (PEMFs treatment at 8 Hz frequency with 3.8 mT intensity, 20 min daily for 30 days), (4) OVX(II) (PEMFs treatment at 8 Hz frequency with 3. 8 mT intensity, 40 min daily for 30 days), and (5) OVX(III) (PEMFs treatment at 8 Hz frequency with 3.8 mT intensity, 60 min daily for 30 days). All of the rats were subject to bilateral overiectomy except those in the SHAM control group. The biomechanical properties of the femurs were assessed at the end of the PEMFs treatment. RESULTS: The rats in the OVX0 control group had significantly lower values in the biomechanical properties than the rats in the other four groups (P < 0.05 or P < 0.01). The rats treated with PEMFs showed no significant differences in the biomechanical properties compared with the sham controls (P > 0.05). CONCLUSION: PEMFs therapy at 8 Hz and 3.8 mT magnetic intensity for 20 to 60 min everyday prevents decline in biomechanical properties of femurs in ovariectomized rat.

[Systematic assessment of acupoint stimulating therapy for deglutition disorders after apoplexy].

OBJECTIVE: To assess the therapeutic effect of acupoint stimulating therapy on deglutition disorders after apoplexy, so as to provide basis for clinical treatment and further study. METHODS: According to Cochrane systematic assessment method of evidence-based medicine, Meta analysis on randomized controlled trials or half randomized controlled trials of acupoint stimulating therapy for deglutition disorders after apoplexy were made. RESULTS: In 37 Chinese literatures, 3 697 patients in total were enrolled, and the results indicated that the effective rate of acupoint stimulating therapy on deglutition disorders after apoplexy was better than that in the control group [RR was 1.38, 95% CI (1.28, 1.49), Z = 8.38, P < 0.01]; and the cured rate also was better than that of the control group [RR was 2.56, 95% CI (2.15, 3.04), Z = 10.70, P < 0.01]. CONCLUSION: The therapeutic effect of acupoint stimulating therapy on deglutition disorders after apoplexy is better than that of the control group, but more randomized, double blind, controlled trials with good designs are needed to confirm this result.

[Clinically multi-central randomized controlled study on scalp electroacupuncture for treatment of vascular dementia].

OBJECTIVE: To provide reliable evidence for acupuncture treatment of vascular dementia (VD). METHODS: Multi-central randomized controlled trial method was adopted and 270 cases enrolled were randomly assigned to an acupuncture-medicine group, an electroacupuncture group and a medication group. The acupuncture-medicine group were treated by scalp electroacupuncture on Sishencong (EX-HN 1), Baihui (GV 20), Shenting (GV 24), Fengchi (GB 20) and oral administration of Nimodipine; the electroacupuncture group were treated with scalp electroacupuncture; the medication group were treated with simple oral administration of Nimodipine. They were treated for 6 weeks. Mini-mental state scale (MMSE), ability of daily life-rating scale (ADL-R) and P300 were detected before and after treatment. RESULTS: The total effective rate for cognition improvement was 86.59% in the acupuncture-medicine group, 82.05% in the electroacupuncture group and 43.21% in the medication group, the electroacupuncture group and the acupuncture-medicine group being better than the medication group; and their total effective rates for improvement of ability of daily life were 59.76%, 65.38% and 32.10%, respectively, the electroacupuncture group and the acupuncture-medicine group being better than the medication group. Scores for MMSE and ADL-R and P300 examination indicated that there were significant differences as the acupuncture-medicine group and the electroacupuncture group compared with the medication group (P < 0.01). CONCLUSION: Scalp electroacupuncture or scalp electroacupuncture combined with oral administration of Nimodipine has a better therapeutic effect in improvement of recognition function and the ability of life activity than simple oral administration of Nimodipine with a higher safety.

[Experimental study of the therapeutic effect and mechanism of "Shenxian Fuyuan capsule" on chronic renal failure in rats].

OBJECTIVE: To study the therapeutic effect and mechanism of "Shenxian Fuyuan Capsule" (SXFYC) on chronic renal failure in rats with 5/6 nephrectomy. METHODS: The animal model with chronic renal failure was established by using the method of 5/6 nephrectomy. The animals were randomly divided into four groups: SXFYC treatment group, losartan treatment group, control group and pseudo-operation group (normal group). Since the next day after operations, the rats in the SXFYC treatment group and the losartan treatment group had been intragastrically administrated with SXFYC 300 mg/kg x d and losartan 150 mg/kg x d respectively. The rats in the normal group and control group were fed with sodium chloride twice a day. Four, eight and twelve weeks later, histological and biochemical tests were undertaken to examine changes of the remnant kidney such as alpha-SMA, collagen I, blood urea nitrogen, serum creatinine and proteinuria. The connective tissue growth factor (CTGF) mRNA was detected by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR). RESULTS: Both SXFYC and losartan ameliorated the histological change of remnant kidney, decreased the level of CTGF mRNA, serum creatinine and proteinuria (P<0.01). There were no significant differences between the SXFYC and losartan treatment groups (P>0.05). CONCLUSION: "Shenxian Fuyuan Capsule" can improve the renal function of the 5/6 nephrectomized rats. It performs as well as losartan. "Shenxian Fuyuan Capsule" might have played an important role in preventing CTGF-mediated renal fibrosis in the 5/6 nephrectomized rats.