Tuina for diabetic peripheral neuropathy: A protocol for a systematic review and meta-analysis.

BACKGROUND: Diabetic peripheral neuropathy (DPN) is one of the most common microvascular complications of diabetes mellitus, with an incidence ranging from 60% to 90%. With the change in modern dietary structure, the incidence of diabetes is increasing year by year, and DPN is also on the rise. Tuina therapy has been widely used in the treatment of DPN, but there is no systematic review on the treatment of DPN. Therefore, this study aimed to conduct a meta-analysis of Tuina in the treatment of DPN to clarify its efficacy. METHODS: The following electronic databases will be searched: PubMed, the Cochrane Library, Embase, Web of Science, Medline, CNKI, Chinese Biomedical Literature Database, VIP, and Wan Fang databases. We will consider articles published between database initiation and May 2021. We will use Review Manager 5.4, provided by the Cochrane Collaborative Network for statistical analysis. Clinical randomized controlled trials related to Tuina for diabetic peripheral neuropathy were included in this study. Language is limited to both Chinese and English. Research selection, data extraction, and research quality assessments were independently completed by two researchers. We then assessed the quality and risk of the included studies and observed the outcome measures. RESULTS: This study provides a high-quality synthesis to assess the effectiveness and safety of Tuina for treating diabetic peripheral neuropathy. CONCLUSION: This systematic review will provide evidence to determine whether Tuina is an effective and safe intervention for patients with diabetic peripheral neuropathy. ETHICS AND DISSEMINATION: The protocol of the systematic review does not require ethical approval because it does not involve humans. This article will be published in peer-reviewed journals and presented at relevant conferences. REGISTRATION NUMBER: INPLASY202150027.

A Laser-Activated Biocompatible Theranostic Nanoagent for Targeted Multimodal Imaging and Photothermal Therapy.

Multifunctional nanoparticles have been reported for cancer detection and treatment currently. However, the accurate diagnosis and efficient treatment for tumors are still not satisfied. Here we report on the development of targeted phase change multimodal polymeric nanoparticles for the imaging and treatment of HER2-positive breast cancer. METHODS: We evaluated the multimodal imaging capabilities of the prepared nanoparticles in vitro using agar-based phantoms. The targeting performance and cytotoxicity of the nanoparticles were examined in cell culture using SKBR3 (over-expressing HER2) and MDA-MB-231 (HER2 negative) cells. We then tested the magnetic resonance (MR)/ photoacoustic (PA)/ ultrasound (US)/ near-infrared fluorescence (NIRF) multimodal imaging properties and photothermal effect of the nanoparticles in vivo using a SKBR3 breast xenograft model in nude mice. Tissue histopathology and immunofluorescence were also conducted. RESULTS: Both in vitro and in vivo systematical studies validated that the hybrid nanoparticles can be used as a superb MR/US/PA/NIRF contrast agent to simultaneously diagnose and guide tumor photothermal therapy (PTT). When irradiated by a near infrared laser, the liquid PFP vaporizes to a gas, rapidly expelling the contents and damaging surrounding tissues. The resulting micro-sized bubbles provide treatment validation through ultrasound imaging. Localization of DIR and SPIO in the tumor region facilitate photothermal therapy for targeted tumor destruction. The mice treated with HER2 targeted nanoparticles had a nearly complete response to treatment, while the controls showed continued tumor growth. CONCLUSION: This novel theranostic agent may provide better diagnostic imaging and therapeutic potential than current methods for treating HER2-positive breast cancer.

Injectable and thermally contractible hydroxypropyl methyl cellulose/Fe3O4 for magnetic hyperthermia ablation of tumors.

The development of efficient strategies for the magnetic hyperthermia ablation of tumors remains challenging. To overcome the significant safety limitations, we developed a thermally contractible, injectable and biodegradable material for the minimally invasive and highly efficient magnetic hyperthermia ablation of tumors. This material was composed of hydroxypropyl methyl cellulose (HPMC), polyvinyl alcohol (PVA) and Fe3O4. The thermal contractibility of HPMC/Fe3O4 was designed to avoid damaging the surrounding normal tissue upon heating, which was confirmed by visual inspection, ultrasound imaging and computed tomography (CT). The efficient injectability of HPMC/Fe3O4 was proven using a very small needle. The biosafety of HPMC/Fe3O4 was evaluated by MTT and biochemical assays as well as flow cytometry (FCM). All the aforementioned data demonstrated the safety of HPMC/Fe3O4. The results of in vitro and ex vivo experiments showed that the temperature and necrotic volume of excised bovine liver were positively correlated with the HPMC/Fe3O4 weight, iron content and heating duration. The in vivo experimental results showed that the tumors could be completely ablated using 0.06 ml of HPMC/60%Fe3O4 after 180 s of induction heating. We believe that this novel, safe and biodegradable material will promote the rapid bench-to-bed translation of magnetic hyperthermia technology, and it is also expected to bring a new concept for the biomaterial research field.

Low-intensity focused ultrasound (LIFU)-induced acoustic droplet vaporization in phase-transition perfluoropentane nanodroplets modified by folate for ultrasound molecular imaging.

The commonly used ultrasound (US) molecular probes, such as targeted microbubbles and perfluorocarbon emulsions, present a number of inherent problems including the conflict between US visualization and particle penetration. This study describes the successful fabrication of phase changeable folate-targeted perfluoropentane nanodroplets (termed FA-NDs), a novel US molecular probe for tumor molecular imaging with US. Notably, these FA-NDs can be triggered by low-intensity focused US (LIFU) sonication, providing excellent US enhancement in B-mode and contrast-enhanced US mode in vitro. After intravenous administration into nude mice bearing SKOV3 ovarian carcinomas, 1,1'-dioctadecyl-3,3,3',3' -tetramethylindotricarbocya-nine iodide-labeled FA-NDs were found to accumulate in the tumor region. FA-NDs injection followed by LIFU sonication exhibited remarkable US contrast enhancement in the tumor region. In conclusion, combining our elaborately developed FA-NDs with LIFU sonication provides a potential protocol for US molecular imaging in folate receptor-overexpressing tumors.

Effect of Aqueous Extract from Morinda officinalis F. C. How on Microwave-Induced Hypothalamic-Pituitary-Testis Axis Impairment in Male Sprague-Dawley Rats.

The present study aimed to assess the protective effects of aqueous extract from Morinda officinalis F. C. How on microwave-induced reproductive impairment in male rats. Microwave exposure injury was induced by exposure of 900 MHz microwaves at 218 µm/cm(2)radiation densities, 24 hours/day for 10 days. Male Sprague-Dawley rats were randomized to: normal control, microwave exposure model, or water layer or ethyl acetate layer of aqueous extract 40 g/kg treatment groups. After 2 weeks of treatment, sexual performance, serum levels of gonadotrophin-releasing hormone (GnRH), luteinizing hormone (LH), follicle-stimulating hormone (FSH) or testosterone, morphological analysis of testis and epididymis, and GnRH protein expression in the hypothalamus were measured. Pretreatment with water layer of aqueous extract 40 g/kg significantly improved sexual performance, increased serum testosterone level, and decreased LH and GnRH level compared with microwave exposed model rats (all P < 0.05). Water layer of aqueous extract treatment significantly increased seminiferous cell or sperm number in testis and epididymis. Protein expression of GnRH in the hypothalamus significantly decreased in the water layer of aqueous extract treated group (P < 0.05). Ethyl acetate layer of aqueous extract did not show obvious effects on the measured parameters. These findings suggest that water layer of aqueous extract 40 g/kg ameliorates microwave-reduced reproductive impairment.

[Morinda officialis how extract improves microwave-induced reproductive impairment in male rats].

OBJECTIVE: To investigate the effects of different concentrations of Morinda Officialis How (MOH) extracts on microwave radiation-induced injury to the spermatogenic function of male rats. METHODS: Forty SD male rats were equally divided into four groups: control, microwave injury model, aqueous extract of MOH treatment, and alcohol extract of MOH treatment. Models of microwave-induced injury were made by exposing the rats to microwave radiation from a microwave signal generator (900 MHz 1.0 W) at 218 microm/cm2, 12 h/d, for 2 weeks. The model rats of the two treatment groups were intragastrically given aqueous extract and alcohol extract of MOH, respectively, both at 20 g per kg per day for 2 weeks. Then we observed the growth, capture incubation period (CIP), capture times (CT), changes in testicular and epididymal weight and morphology, sperm concentration and malformation, and levels of serum testosterone. RESULTS: Compared with the controls, the rats of the model group showed a slightly reduced body weight, markedly prolonged CIP and decreased CT (P < 0.05), significantly reduced sperm concentration (P < 0.05) and remarkably in- creased sperm malformation (P < 0.05), but no statistically significant differences in the testosterone level. The two treatment groups exhibited obviously decreased body weight, CIP and sperm malformation compared with the control group (P < 0.05) but markedly increased CT, sperm concentration and testosterone level as compared with the models (P < 0.05). The microwave radiation-induced testis injury was repaired perfectly in the two treatment groups, the epididymal ducts filled with sperm and cast-off cells. CONCLUSION: Both aqueous and alcohol extracts of MOH can promote spermatogenesis and repair of reproductive injury induced by microwave radiation.