Affiliated Hospital of Chengdu University of Traditional Chinese Medicine

Postoperative pain is a significant yet inadequately managed complication following surgery, and auriculotherapy to alleviate acute postoperative pain (APP) and reduce the use of opioids remains controversial.

We searched the MEDLINE, Web of Science, Embase, Cochrane Library, CINAHL Complete, and ClinicalTrials.gov from inception to January 23, 2024 for all randomized controlled trials (RCTs) of auriculotherapy in the treatment of APP. The extracted data underwent risk of bias assessment, meta-analysis, subgroup analyses, sensitivity analysis, meta-regression analysis, and evidence rating.

A total of 24 studies involving 2131 patients were included in the meta-analysis. Low-quality evidence indicated that auriculotherapy was effective in reducing pain intensity at 24 [MD(95 %CI)=-0.64(-1.09, -0.19), I²=77 %, P＜0.01], 48 [MD(95 %CI)=-0.49(-0.97, 0.00), I²=71 %, P=0.05], and 72 [MD(95 %CI)=-0.80(-1.32, -0.28), I²=52 %, P＜0.01] hours after surgery, while moderate-quality evidence showed a decrease in total opioid consumption [MD(95 %CI)=-24.41 OME (-38.28, -10.54), I²=95 %, P＜0.01]. However, no significant effects were observed in reducing postoperative nausea or vomiting [RR(95 %CI)=0.61(0.32, 1.16), I²=71 %, P=0.13; RR(95 %CI)=0.32(0.09, 1.18), I²=71 %, P=0.09; RR (95 %CI)=0.34(0.11, 1.06), I²=28 %, P=0.06; for postoperative nausea and vomiting (PONV), postoperative nausea or postoperative vomiting respectively], with evidence ranging from moderate to very low. Additionally, two RCTs found that auriculotherapy could delay the time to the first request for analgesia.

The summary estimates indicate that auriculotherapy may be beneficial in reducing APP and opioid consumption in specific surgeries based on low-to-moderate quality evidence. However, high-quality RCTs are still further studied in different surgical populations.

PROSPERO database, CRD42024506989.

Hip fractures, particularly femoral neck and intertrochanteric fractures, represent approximately 6.37 % of all fractures, with incidence rates showing an upward trend annually.

This report presents a case of a 55-year-old female with a femoral neck fracture who underwent internal fixation. One-year post-surgery, the patient continued to experience hip pain, and computed tomography (CT) scans revealed non-union of the fracture. The patient received an integrated treatment approach combining traditional Chinese and Western medicine, involving the alternating administration of osteopeptide tablets and Guijia Jiangu capsules, a proprietary herbal formulation. No additional pharmacological or surgical interventions were employed. Seven months after initiating the treatment, digital radiography (DR) examinations showed that the fracture had largely healed. At the seven-month follow-up, and nearly four years thereafter, the patient reported no discomfort in the hip region. Subsequent DR examinations revealed no signs of avascular necrosis of the femoral head, and no adverse events were noted. The internal fixation device was removed five years post-fracture.

The results indicate that integrated traditional Chinese and Western medicine may effectively treat non-union after internal fixation of femoral neck fractures, though further studies are warranted to confirm these outcomes.

Studies have shown that saikosaponin D (SSD) has favorable neurotherapeutic effects. Therefore, the objective of this study was to explore the efficacy and possible molecular mechanisms of SSD on pilocarpine (PP)‐induced astrocyte injury. Primary astrocytes were isolated from juvenile rats and identified using immunofluorescence. The cells were treated with PP and/or SSD for 6 h and 12 h, respectively, followed by measurement of their viability through 3‐(4,5‐dimethylthiazol)‐2,5‐diphenyl‐tetrazolium bromide (MTT) assay. Next, quantitative real‐time polymerase chain reaction (qRT‐PCR) was used to measure the expression levels of Glial fibrillary acidic protein (GFAP), C3, S100 calcium binding protein A10 (S100a10), pentraxin 3 (Ptx3), toll‐like receptor 4 (TLR4), and RAG in astrocytes after different treatments. Enzyme‐linked immunosorbent assay and biochemical tests were utilized to evaluate the level of inflammatory factors [interleukin (IL)‐1β, IL‐6, and tumor necrosis factor alpha (TNF‐α)] secreted by cells and the content of oxidative stress‐related factors (malondialdehyde [MDA] and glutathione [GSH]) or enzyme activity (catalase [CAT] and glutathione peroxidase [GPX]) in cells. The JC‐1 mitochondrial membrane potential (MMP) fluorescence probe was used to measure the MMP in astrocytes. Additionally, western blot was applied to test the expression of proteins related to the nod‐like receptor protein 3 (NLRP3)/caspase‐1 signaling pathway. PP treatment (1 mM) induced cell injury by significantly reducing the viability of astrocytes and expression of cellular markers. SSD treatment (4 μM) had no toxicity to astrocytes. Besides, SSD (4 μM) treatment could significantly up‐regulate the cell viability and marker expression of PP‐induced astrocytes. Furthermore, SSD could be employed to inhibit inflammation (reduce IL‐1β, IL‐6, and TNF‐α levels) and oxidative stress (decrease MDA level, elevate GSH level, the activity of CAT and GPX), and ameliorate mitochondrial dysfunction (upregulate JC‐1 ratio) in PP‐induced astrocytes. Moreover, further mechanism exploration revealed that SSD treatment significantly reduced the activity of the NLRP3/caspase‐1 signaling pathway activated by PP induction. SSD increased cell viability, inhibited inflammation and oxidative stress response, and ameliorated mitochondrial dysfunction in PP‐induced astrocyte injury model, thus playing a neuroprotective role. The mechanism of SSD may be related to the inhibition of the NLRP3/caspase‐1 inflammasome.