Low level light therapy/photobiomodulation for diabetic peripheral neuropathy: protocol of a systematic review and meta-analysis.

INTRODUCTION: Diabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes that strongly impact the patients' quality of life and working ability. Evidence indicated that low level light therapy (LLLT)/photobiomodulation might be effective for neuropathy. However, the effect of LLLT for DPN is not clear. The objective of this systematic review and meta-analysis is to determine the effects and safety of LLLT/photobiomodulation for DPN, in comparison with other methods such as sham light, no treatment, other active treatment and LLLT as an additional treatment compared with another treatment alone. METHODS AND ANALYSIS: We will search eight databases from their inception to the date before the review submission. Randomised controlled trials (RCTs) will be included. Two reviewers will independently extract data using a structured data extraction method and assess the risk of bias in the included studies. Data will be synthesised using standardised mean difference or risk ratio with 95% CIs for continuous and dichotomous data, respectively. The primary outcome will be change in pain and secondary outcomes will include global symptom improvement, functional impairment and disability, impairment of sensation, quality of life, nerve conduction, and adverse events. Sensitivity and subgroup analysis will be employed to explore the influence of possible clinical and methodological characteristics. Publication bias will be assessed using funnel plot. We will conduct meta-analysis with RevMan V.5.4 and evaluate quality of the evidence using GRADE approach. ETHICS AND DISSEMINATION: This study does not require ethics approval. Our findings will be disseminated in the peer-reviewed publications. PROSPERO REGISTRATION NUMBER: CRD42021276056.

[Bone proportional measurement on the chest and abdomen among 101 young females].

OBJECTIVE: To examine the bone proportional measurement standard on the chest and abdomen of modern women. METHODS: The height, weight and distances of bone proportional measurement chest and abdomen of 101 young females were measured. The height was divided by 75 to calculate the data of bone proportional measurement, and compared with the national standard published in 2006 and the ancient literature of Miraculous Pivot: Gudu. RESULTS: The bone proportional distances between two nipples and two coracoid processes of women were 8 cun and 12 cun respectively, which were in line with the 2006 national standard. The bone proportional distance from navel to superior margin of pubic symphysis (Qugu) was 6.5 cun, which was consistent with the ancient literature of Miraculous Pivot: Gudu. The bone proportional distance from suprasternal fossa to the middle point of xiphisternal synchondrosis (Qigu) was less than 9 cun, while the bone proportional distance from Qigu to navel was more than 8 cun, resulting in the ratio less than 9︰8. The bone proportional distance from suprasternal fossa to the middle point of xiphoid process was 9 cun, corresponding to the ratio of 9︰8 when comparing with the measurement from the middle point of xiphoid process to navel. CONCLUSION: The bone proportional distance measurement between two nipples and two coracoid processes of women should follow the 2006 national standard, and the bone proportional distance measurement from navel to superior margin of pubic symphysis should follow the standard of Miraculous Pivot: Gudu. The middle point of xiphisternal synchondrosis should be replaced by the middle point of xiphoid process.

Effect of Compound Laser Acupuncture-Moxibustion on Blood Glucose, Fasting Insulin and Blood Lipids Levels in Type 2 Diabetic Rats.

OBJECTIVE: To investigate the effect of compound laser acupuncture-moxibustion on blood glucose, fasting insulin and blood lipids levels in type 2 diabetes mellitus (T2DM) rats. METHODS: Forty male Wistar rats were randomly divided into 4 groups, including the normal group, model control group, laser group and sham laser group (n=10 per group). The rats in the normal group were fed with a standard diet. Rats in other groups were fed with a high-sugar and high-fat diet for 4 weeks, then intraperitoneally injected with 1% streptozotocin to induce T2DM model. The laser group was irradiated by 10.6 µm and 650 nm compound laser on bilateral Pishu (BL 20), Shenshu (BL 23) and Sanyinjiao (SP 6) for 5 min, 6 times a week for 5 weeks. The sham laser group received the same treatment as the laser group, but without laser output. The model control group and normal group were not treated. Blood glucose levels were measured before and after 1, 2, 3, 4 and 5 weeks of treatment. The serum levels of fasting insulin, total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were analyzed after the last treatment. RESULTS: The blood glucose levels in the model control group increased during the 5 weeks of treatment compared with the normal group (P<0.05), while those in the laser group were significantly lower than the model control group after weekly treatment (P<0.01 or P<0.05). After 1, 2 and 3 weeks of treatment, the blood glucose levels in the laser group decreased obviously compared with the sham laser group (P<0.01 or P<0.05). Compared with the normal group, the levels of fasting insulin, TC and LDL in the model control group notably increased (P<0.01 or P<0.05), while their levels in the laser group were significantly lower than the model control group after 5 weeks of treatment (P<0.05 or P<0.01). However, no statistically significant differences were observed in TG or HDL levels among the 4 groups (P>0.05). CONCLUSION: The compound laser acupuncture-moxibustion of 10.6 µm and 650 nm had positive effects on the regulation of hyperglycemia and insulin resistance in T2DM rats, which may be a potential treatment for T2DM, and also provide an alternative to the traditional acupuncture and moxibustion therapy.

[Effect of devascularization on volt-ampere characteristic of acupoints].

OBJECTIVE: To observe the effects of forearms devascularization on the volt-ampere (V-A) characteristics of Neiguan (PC 6) and Taiyuan (LU 9) so as to investigate the relationship among functions of acupoints, qi and blood in human body and V-A characteristics of acupoints. METHODS: Either forearms of 23 healthy volunteers were devascularized and the changes of V-A characteristics in ipsilateral Neiguan (PC 6) and Taiyuan (LU 9) in normal and devascularization statuses were detected by home-made intelligent V-A detecting system. RESULTS: Compared with the normal status, both range-increasing and range-decreasing V-A areas of Neiguan (PC 6) and Taiyuan (LU 9) were significantly increased in devascularization status (P < 0.05, P < 0.01), and the change rates of these two V-A areas of Neiguan (PC 6) were larger than those of Taiyuan (LU 9) (both P < 0.05). The inertia areas of Neiguan (PC 6) but not Taiyuan (LU 9) became significantly larger after devascularization (P < 0.01). CONCLUSION: The changes in V-A characteristics of Neiguan (PC 6) and Taiyuan (LU 9) can reflect the alteration of local blood supply, and Neiguan (PC 6) is more sensitive to changes of blood flow than Taiyuan (LU 9).

Effects of laser irradiation on arthritic histopathology and heat shock protein 70 expression in C57 black mice with osteoarthritis.

OBJECTIVE: To study the effects of three different laser treatments (650 nm alone, 10.6 µm alone and combined laser of 650 nm and 10.6 µm) on experimental osteoarthritis of the knees in C57 black mice. METHODS: Sixty C57 black mice were divided randomly into 6 groups. Ten mice were assigned to a normal control group (no intervention) and the other 5 groups were subjected to a forced running regimen to induce osteoarthritis. One group was set as the model control group. The other 4 groups were given 90 s of a 650 nm laser, 90 s of a 10.6 µm laser, 90 s of a combined laser, or a sham treatment on acupoint Dubi (ST35) of the rear left leg 3 times per week for 4 weeks. The modified Mankin score was used to evaluate the degree of cartilage degradation. Immunohistochemical staining for heat shock protein (HSP) 70 was conducted. RESULTS: Mankin scores of the model control group and the sham control group were significantly higher than that of the normal control group (P<0.01). Mankin score of the combined laser group was significantly lower than that of the model control group (P<0.01). Compared with the normal control group, there was a significant induction of HSP70 in the arthritic chondrocytes of the combined laser group. CONCLUSION: The arthritic cartilage induced in C57 black mice improved significantly after combined laser treatment of 650 nm and 10.6 µm lasers. This effect may be related to the induction of HSP70 in the arthritic chondrocytes. The two different lasers appear to have a synergistic effect.

[Effect of infrared laser on pituitrin-induced bradycardia in rabbits].

OBJECTIVE: To observe the effect of infrared laser stimulation on Neiguan (PC 6) for bradycardia of rabbits induced by injection of pituitrin. METHODS: 10.6 microm CO(2) infrared laser, 650 nm semiconductor red laser and the compound laser of their aggregation were sent out by a compound laser sanatory instrument to stimulate Neiguan (PC 6) respectively for the purpose of analyzing the differences of the effects exerted by infrared laser and red laser as well as the changes of the effects after their aggregation. RESULTS: After 30 min and 40 min of the injection of pituitrin, the heart rate showed no significant difference between 10.6 microm CO(2) infrared laser group and the normal control group (P>0.05). However, the heart rate showed significant difference between the 650 nm semiconductor red laser group and the normal control group (P<0.05). After 30 min of the injection of pituitrin, the heart rate of the compound laser group were significantly different to that of the untreated group (P<0.05), and it was not significantly different to that of the normal control group (P>0.05). However, the heart rate of non-acupoint stimulated by the compound laser group showed no significant difference to that of the untreated group (P>0.05), and it was significantly different to that of the normal control group (P<0.05). CONCLUSION: Stimulation on Neiguan with 10.6 microm CO(2) infrared laser can evidently improve the bradycardia induced by injection of pituitrin, while the 650 nm semiconductor red laser has no such function, but they have coordinating effect. The thermal effect produced by CO(2) infrared laser stimulating acupoint is probably beneficial for semiconductor laser penetrating skin as well as the biochemical reactions it carries. The improvement of heart rate produced by the laser stimulation on Neiguan (PC 6) has relative specificity.

Effect of different LLLT on pituitrin-induced bradycardia in the rabbit.

The objective of this paper was to observe the effect of low-level combined- or single-laser irradiation on bradycardia produced by pituitrin in rabbits. A combined-laser apparatus was made. A 10.6-microm CO2 laser and a 650-nm semiconductor laser, transmitted by different optical fibers, converged to output and irradiate on the Neiguan (PC6) acupuncture point in rabbits with bradycardia produced by pituitrin. Thirty minutes after the model was set, the heart rates of the combined-laser Neiguan group made quicker recoveries than those of the model control group, the laser-control group, or the single-laser Neiguan group (P<0.05), and the heart rates of the single-CO2-laser Neiguan group were similar to those of the normal group (P>0.05). However, there were significant differences between the 650-nm-laser Neiguan group and the normal control group (P<0.05). The combined-laser irradiation certainly has a curative effect on bradycardia produced by pituitrin. A single CO2 laser could accelerate the recovery from bradycardia, while single 650-nm-laser irradiation on the Neiguan acupoint does not produce such an effect.