Geneology International

Category: Alternative Medicine

  • UC Davis Health Responsible for World’s First Successful Spina Bifida Stem Cell Treatment

    UC Davis Health Responsible for World’s First Successful Spina Bifida Stem Cell Treatment

     

    UC Davis Health Responsible for World’s First Successful Spina Bifida Stem Cell Treatment

    By Riley Szenasi

    SACRAMENTO, CA-– UC Davis Wellness recently performed the 1st productive spina bifida treatment in a demo recognised as the “Cellular Remedy for In Utero Repair of Myelomeningocele” or the “CuRe Trial”.

     

    The Mayo Clinic defines spina bifida, or myelomeningocele, as a “birth defect that takes place when the spine and spinal wire do not type properly” and “can range from mild to critical, relying on the sort of defect, dimension, spot and complications”. 

     

    Spina bifida has long been a wellness problem in the U.S. The Fetal Health and fitness Basis states the defect influences “1,500 to 2,000 youngsters in the U.S. each year”. It is ordinarily diagnosed by means of blood checks and an ultrasound, as early as the next trimester of pregnancy.

     

    UC Davis Health’s write-up on the accomplishment of the trial mentions that Diana Farmer, 1 of the guide scientists in this treatment method task, has worked in multiple medical trials focusing on the outcomes of spina bifida. Her choice to achieve out to Aijun Wang, a thriving biomedical engineer, proved significant in her investigate.

     

    Wang’s career has focused on “developing technologies that blend stem mobile engineering and biomaterial engineering to advertise tissue regeneration.” Wang assisted Farmer establish the UC Davis Overall health Biomedical Engineering Laboratory to further more their stem mobile exploration.

     

    Tricia Tomiyoshi, the Senior Public Data Officer at UC Davis Wellness, notes that it was a 10-year course of action that authorized researchers to attain a point where by they could get started the cure of human fetuses. With further progress created, they commenced working with animal people in their scientific trials. 

     

    She states that the scientists shipped balanced lambs, bulldogs, and other animals that were ready to stroll “without apparent disability”. Right after monitoring the animals for the months following their beginning, Farmer’s investigate staff proved that the process was thriving as a long-lasting cure. In accordance to UC Davis Wellbeing, the group commenced performing with human people with the “CuRe Trial” in the spring of 2021.

     

    In the past, spina bifida has been dealt with via operation performed in utero or shortly right after birth, though it has been noted that these surgical procedures have not verified fully powerful. It is for this explanation that investigate on option remedies of spina bifida continues to be important.

     

    As an choice approach, the “CuRe Trial” focuses on the reversal of “paralysis and other irregular capabilities of spina bifida in advance of birth”. For this demo, it was significant to deal with people as fetuses, as spinal destruction normally worsens as the being pregnant progresses. To prevent this injury, the study staff utilized stem cells derived from human “mesenchymal stromal cells” to take care of the fetuses even though in the womb.

     

    According to UC Davis Wellness, the “stem mobile patches” are created by way of a 4-day technique in which the health care lab staff “manufactures scientific quality stem cells – mesenchymal stem cells – from placental tissue in the UC Davis Health’s CIRM (California Institute for Regenerative Medication) -funded Institute for Regenerative Cures”. As described by Tomiyoshi, the stem cells get the job done to “repair and restore destroyed spinal tissue, further than what surgical procedures can attain alone”.

     

    The contributors integrated a full of 35 client volunteers. To be a section of the trial, they should transfer to Sacramento for the surgical treatment and agree to return for adhere to-up appointments to make certain that the cure labored as a long-lasting cure and that no new issues come up next the delivery. 

     

    The initially participant in the trial, Emily, had her surgery in July 2021, all through her second trimester.

     

    The UC Davis Overall health web page describes her process as obtaining gone seamlessly. The healthcare team utilized “the stem cell patch…directly more than the uncovered spinal twine of the fetus…then shut the incision to enable the tissue to regenerate”.

     

    Emily’s little one, Robbie, was born on Sept. 20, 2021, the 1st to be born with this remedy. Farmer was current through the shipping and delivery and claimed that it was apparent on delivery that the surgery was productive as “the minute she was born that she was kicking her legs”.

     

    At the moment, three of the 35 clients have been born, exhibiting no signals of flaws connected to spina bifida. The UC Davis Health and fitness staff awaits the arrival of the remaining patients in the coming months.

     

    To validate the achievements of the remedy, the babies included in the demo will be supplied a 30-month test-up and will carry on to be observed intently for the very first six several years of their life.

     

  • Fact Checking Jessica Alba’s New Honest Corporate Claims

    Fact Checking Jessica Alba’s New Honest Corporate Claims

    With Honest corporation inventory down 83{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} in the past 18 months, co-founder Jessica Alba is producing the media rounds to check out and keep away from a shareholder lawsuit. (1)

    Almost nothing improper with that, she has a obligation to make them funds. Regrettably, she is continue to trapped in 2012 when it comes to promoting. She thinks she can only get if she tears science down. Her appearance at the 2022 Makers Meeting did extra than just lie about her solutions remaining safer, she attempted to suggest that she confronted sexism getting the corporation released.

    In truth, the sexism she could have faced came from her mates in Hollywood. Undertaking capitalists funded her thought – they never hand $27 million to just anybody – mainly because they realized that wealthy elites considered in alternatives to things like vaccines and other medicine, food items, strength, you identify it. However even however she pitched her corporation as internet marketing to prosperous, white girls she attempts to allege it was sexist for the men she was pitching to check with abundant, white gals if they’d get what she was offering. 

    In this article are just a number of items that fail fact examining.

    Fact Checking Jessica Alba’s New Honest Corporate Claims

    In actuality, you are much more likely to be harmed from Alba’s products and solutions, mainly because they are exempt from Fda scrutiny. Her cosmetics, and the health supplement, alternate medication, and natural and organic foods industries, totaling $160 billion per yr now, have been presents from the 1990s Commander In Woo, President Clinton. He practically took the nonsense beliefs endorsed by his private expert Mark Hyman and exempted them all from govt oversight just by telling them to use a fantastic print disclaimer ‘These statements have not been evaluated by the FDA’…(2)

    The challenge with her financially-inspired blinders is that the stuff she statements is non-toxic, eco-helpful, and even organic and natural is only real if China can confirm it. Which is where by so lots of of her newborn products and solutions are manufactured.(3)  She has to fake to rely on them for the reason that her firm is bankrupt if she isn’t going to fake they are telling the reality.

    If I get caffeine, a all-natural compound, from a plant or build it synthetically. can you inform the distinction? No, and neither can Alba.

    She was sued for COVID-related fraud too, so there is obviously one particular way her enterprise may be even worse than regulated rivals – ethics. 

    NOTES:

    (1) With the booming financial state we are instructed we have, and surveys stating her poltical bash will consider over the Senate soon after following month’s election and handle all of authorities other than the Supreme Court, it is difficult to realize how her inventory is undertaking so poorly. Her shoppers have to have cash to burn up, California on your own has a bigger economic climate than Germany.

    (2) The Democratic war on nuclear vitality and NASA set local weather alter progress again by many years but his war on science developed the anti-vaccine movement and the typical belief that medication and food are company conspiracies. We have no way to even calculate that damage. 

    (3) China also reported they experienced nothing to do with SARS-CoV-2 though they sandblasted the Wuhan labs accomplishing get of function investigate on coronavirus for 9 straight months – in advance of even permitting the Earth Wellness Organisation inside of the structures. For 4 hrs. And inquiring no queries not pre-authorised by the communist dictatorship. But she believes they are telling her the fact about a label, when no a person can convey to the change? 

  • India’s alternative medicine industry grows, boosted by COVID-19 pandemic

    India’s alternative medicine industry grows, boosted by COVID-19 pandemic

    Natural drugs industry bodies in India are searching to improve sales and acceptance of these types of conventional drugs amid India’s big force to develop into a hub for option therapies.

    Rise IN Attractiveness For the duration of PANDEMIC

    The COVID-19 pandemic has presented the choice medication field a raise. 
     
    Ayurvedic drug firms recorded far more than US$18 billion in sales in 2020, 4 moments the amount of money in 2014. 

    “During the COVID-19 pandemic, individuals observed that modern medication wasn’t handy for all people. There was a development of people today drinking herbal concoctions that produced people them sense superior, and it was so effortless. That designed folks have confidence in herbal cures,” claimed Ms Rajni Jain, co-founder of the Sansthanam Abhaydanam Ayurvedic Medical center. 

    As a end result of the pandemic, her ayurvedic orchard has grow to be extensively preferred, and now she and her team are looking at manufacturing their personal medicines in a bid to capitalise on marketplace-wide need.

    The growth of the alternate drugs field has occur on the back of a concerted energy by the Indian authorities to increase the sector. 

    It created regulatory frameworks, delivers tax incentives and supplies study funding. 

    The establishment of a dedicated ministry to oversee all items substitute medicines in 2014 encouraged self-confidence among the quite a few initially-time customers and diminished counterfeit solutions recommended by non-licensed practitioners that experienced ailed the sector for many years, market gamers stated. 

    Mr Milan Mehta, secretary of the Ayurvedic Drug Suppliers Affiliation mentioned absent are the days when standard medication intended questionable unfastened powder. 

    “That may possibly be a marketplace at the village level. But at city amount and export – it’s given in suitable packaging with adherence to most current principles and laws expected by the regulators of India and abroad,” he claimed.

    Improving Standards

    Indian’s sector bodies want makers to adhere to the greatest techniques approved by the Earth Overall health Corporation (WHO) to strengthen exports.

    They regard the WHO’s stamp of acceptance as very important for the intercontinental uptake of standard medication.

    The worldwide health and fitness entire body is also keen to widen the use of classic medicine.

    In April this year, the world wide health and fitness body’s director-basic Dr Tedros Ghebreyesus stated: “As nonetheless, the contribution of regular medication in direction of countrywide overall health techniques is not thoroughly realised. This international centre for regular medicine will be a highly effective auto for taking their journey ahead.”

    WHO has also recognised India’s purpose in the world of option medication – it labored with the federal government to establish the region as the herbal drugs capital of the planet.

    In March this 12 months, it established up the WHO World Centre for Traditional Medicine in Prime Minister Narendra Modi’s household state Gujarat.

    In spite of the growing recognition and acceptance of ayurvedic medicine, practitioners of far more conventional drugs are sceptical, amid lingering issues more than excellent. 

    Lots of say substituting classic drugs for modern medication could guide to a community well being disaster.

    The fact however is that by the WHO’s estimate, all around 80 for every cent of men and women about the entire world previously use conventional drugs.

    Authorities hope that rigid regulation could be what will make sure the excellent of alternate medications and minimise wellness threats.

  • Northeast Alternatives Dominates Fall Competition Scene   | Business

    Northeast Alternatives Dominates Fall Competition Scene   | Business

    Tumble RIVER, Mass.–(Business enterprise WIRE)–Nov 4, 2021–

    Northeast Options (NEA) proudly extra 12 new awards to its developing trophy situation at the New England Cannabis Convention (NECANN) and the Commonwealth Cannabis Levels of competition (COMCANCOMP), and the first-ever Massachusetts Substantial Occasions Cannabis Cup: People’s Preference Version this tumble.

    This push launch characteristics multimedia. Look at the full release listed here: https://www.businesswire.com/information/house/20211104006187/en/

    Northeast Options Usually takes Dwelling 9 Awards at NECANN and COMCANCOMP (Picture: Business enterprise Wire)

    These new prizes deliver NEA’s trophy count to 32 awards for flower (14), edibles (4), vapes (1), concentrates (8), tinctures (2), and over-all excellence as a dispensary (3).

    This week, NEA took property 3 prizes and two honorable mentions for flower, edibles, and concentrates at the Large Situations Hashish Cup. The dispensary was awarded:

    • 2nd Prize in Hybrid Flower for Ice Product Gentleman
    • 2nd Prize in Indica Flower for Runtz OG
    • 2nd Prize in Fruity, non-Gummy Edibles for Forbidden Fruit Dried Mango Slices

    NEA also gained honorable mentions for Cannatini Cranberry Lime Mojito Gummies and Tangarin Cookies OG THCa Diamonds in a D8:D9 1:1 Terp Sauce.

    Previously this thirty day period, NEA dominated the competition at COMCANCOMP on Oct 2. NEA took property many awards for flower and concentrates, and a person new award for edibles, including:

    • 2nd prize in THC Flower for Mandarin Cookies
    • 3rd prize in THC Flower for Gorilla Breath
    • 2nd prize in CBD Flower for Bitter Tsunami
    • 2nd prize in THC Concentrates for Lemonade Mandaruntz Batter
    • 3rd prize in THC Concentrates for its Environmentally friendly Tangerine Crack Cookies Batter
    • 3rd prize in THC Edibles for its Garlic Chili Oil

    Just two weeks prior, NEA gained three more awards at the NECANN competitiveness held in Boston on September 12, together with:

    • 1st prize in CBD Flower for Sour Tsunami
    • 1st prize in Vape Cartridges for Eco-friendly Tangerine Crack Cookies Vape
    • 2nd prize in Edibles for its Warm Cocoa Mix

    These awards mark great milestones for the dispensary as they head into the closing stages of the 2021 competition year.

    NEA proceeds to shine in both the CBD and THC flower categories. Bitter Tsunami’s wins at NECANN and COMCANCOMP occur on the heels of the strain’s 1st-at any time flower award at Terptown Throwdown this August. Mandarin Cookies’ COMCANCOMP acquire provides its award overall to three prizes, when Ice Product Man’s Large Times award helps make it the most-awarded NEA pressure with 4 prizes. Two brand name new NEA strains, Gorilla Breath and Runtz OG grew to become the newest award winners with their wins at COMCANCOMP and Substantial Moments.

    “I’m outside of proud of our remarkable staff of growers for continuing to carry home major-notch recognition across the state,” claims Kyle Bishop, NEA COO. “Our growers place their heart into anything they do, and I couldn’t be happier that they’re having the recognition they are worthy of.”

    Right after professing their first victory for edibles at Terptown Throwdown in August, NEA’s Marijuana-Infused Solutions (MIP) kitchen area introduced the warmth to NECANN, COMCANCOMP, and Substantial Periods. The Forbidden Fruit Dried Mango Slices, an additional brand new NEA item, took house 2nd Prize for Fruity, non-Gummy Edibles at High Situations, while the Cannatini Cranberry Lime Mojito Gummies took home an honorable point out in the Gummy Edibles group. NEA debuted two much more new products and solutions, Hot Cocoa Combine and Garlic Chili Oil, that took property wins in the THC Edibles class at NECANN and COMCANCOMP.

    “These wins are a substantial morale raise to the kitchen team,” stated Shelby Griebel, MIP Director. “We appreciate the passion for infused products and solutions that competitions encourage, and we love how competitions convey all of our departments jointly, from conception and creation to packaging and advertising. It seriously is a crew hard work.”

    The Inexperienced Tangerine Crack Cookies Vape Cartridge acquire at NECANN is the initially-ever NEA vape victory. Our extracts team carries on to dominate the competitors scene, with the specially-crafted Lemonade Mandaruntz Batter and Green Tangerine Crack Cookies Batter claiming two out of a few places at COMCANCOMP. NEA’s Tangarin Cookies OG THCa Diamonds in a D8:D9 1:1 Terp Sauce took household an honorable point out at Significant Instances.

    “We are all quite passionate about the perform we do below at NEA,” says Noel Barry, Director of Extracts. “I am amazingly proud of the extraction group, and we are all actually humbled and appreciative of the recognition.”

    “As constantly, these competitions wouldn’t be attainable without the amazing organizers, judges, and competitors,” Bishop claims. “We also want to lengthen our deepest gratitude and send mad props to the NEA fam! Thank you men all over again, this crew has unreal expertise, and it definitely exhibits every day on the shelf and all through competitiveness time.”

    The NEA workforce is wanting ahead to The Harvest Cup, the season’s last competitors, on November 14.

    About Northeast Solutions:

    Northeast Options (NEA) is a vertically built-in hashish dispensary serving grownup-use and medical prospects due to the fact 2018. Located in Fall River, Massachusetts, NEA remains the most-awarded hashish dispensary in the state, with 32 awards and counting. NEA is committed to delivering a variety of superior-good quality cannabis goods, which includes flower, edibles, concentrates, and topicals, to adult customers 21+. Learn extra about our products and solutions and our motivation to excellence here.

    Look at resource variation on businesswire.com:https://www.businesswire.com/news/household/20211104006187/en/

    Make contact with: Media

    Emma Gauthier, Information Internet marketing Professional

    Northeast Possibilities

    [email protected]

    Search phrase: MASSACHUSETTS UNITED STATES NORTH The usa

    Market Keyword: Alternative Medication All-natural Assets OTHER Wellness Well being OTHER Organic Methods

    Source: Northeast Options

    Copyright Organization Wire 2021.

    PUB: 11/04/2021 02:51 PM/DISC: 11/04/2021 02:51 PM

    http://www.businesswire.com/information/dwelling/20211104006187/en

  • Nigeria’s slow, tedious road to herbal medicine development | The Guardian Nigeria News

    Nigeria’s slow, tedious road to herbal medicine development | The Guardian Nigeria News

    • NAFDAC’s insistence on scientific trials for traditional medicines just before acceptance divides scientists
    • Natural medication regulation justifies separate, independent agency, say practitioners

    The deficiency of encouragement for regional organic cures and treatments for disorders by the Federal Government (FG) and its companies, primarily the Countrywide Company for Foods and Drug Administration and Regulate (NAFDAC), has lifted issues amid practitioners.

    In fact, traditional drugs has come to be the mainstay of major economies like the United States, India, China and even Ghana.

    Unconfirmed report implies that the FG and its agencies acquire heaps of grants from Western nations and do not experience incentivized to glance for regional treatments. Regrettably, Nigeria is not benefitting from the world wide natural/common medication market place, which is reported to be well worth in excess of N141 trillion.

    According to the report posted by Business Fortune Insight in February 2022, the world herbal drugs market place dimension was $185.86 billion in 2020 and is projected to increase from $230.03 billion in 2021 to $430.05 billion in 2028 at a compound yearly development charge (CAGR) of 11.32 per cent throughout the 2021-2028 periods.

    Chinese expertise
    THE Guardian investigations disclosed that it took over 50 several years before Artemisinin from Chinese salad plant could be recognized by the Earth Health and fitness Organisation (WHO), and Western markets, far more specifically, as a ‘cure’ for malaria.

    Artemisinin is the active component in Artemisinin-primarily based Blend Therapies (Functions) globally authorized by the WHO for malaria procedure.

    Archaeological conclusions indicate that qinghao (Artemisia annua) has been employed as a standard remedy in China for in excess of two thousand yrs. Even so, it took in excess of 4 many years of investigation on the biochemistry, physiology, and breeding of Artemisia annua, right before the West acknowledged the drug.

    Natural medicine and COVID-19
    Investigations also recommend that Nigerians and indeed Sub-Saharan Africa practically survived COVID-19 for the reason that of the use of herbal therapies such as concoction of garlic, ginger, lemon, turmeric and onions, amid other items.

    The West had predicted that COVID-19 would decimate Africa due to the fact of weak health programs in most nations around the world. It was projected that human bodies would litter the streets of major African metropolitan areas if nothing at all was performed urgently.

    WHO and NAFDAC also condemned the Madagascar organic COVID-19 treatment. But the lively ingredient from the solution, Artemisinin, has now been approved for the treatment method of COVID-19 and other ailments.

    Concerns
    NAFDAC had, in May possibly 2022, announced a disclaimer to the IHP Detox tea cure for COVID-19 manufactured by Bioresources Improvement and Conservation Group (BDCG). In the same way, the company, in 2020, at the peak of the COVID-19 pandemic, disclaimed Pax Herbals’ Cugzin COVID-19 heal.

    Disclaiming Cugzin, a Pax Organic treatment, NAFDAC had on May 2, 2020, mentioned: “… We wish to tell the community that PAX CVD Plus has not been registered nor detailed for remedy of COVD-19, neither have we registered nor listed any other remedy for COVID-19.

    “To established the documents straight, at no time did the Director-Basic of NAFDAC, Prof Mojisola Christianah Adeyeye, or any individual in the Company appoint any expert or workers to work with PAXHERBAL on any project.”

    Pax Natural Cugzin experienced before been developed underneath the brand name ‘CVD PLUS’ prior to it was rebranded to ‘Paxherbal Cugzin’.

    Pax Organic is a Nigerian alternate medicine products production firm started by Fr. Anselm Adodo, in 1996, at Ewu Monastery, Esan Central Council of Edo Condition.

    NAFDAC experienced on Could 29, 2022, debunked the assert of the efficacy of IHP Detox Tea for the cure of COVID-19 individuals, purportedly manufactured by the Main Government Officer of BDCP, Prof. Maurice Iwu, in a nationwide newspaper, not The Guardian.

    NAFDAC’s Director Standard, Prof. Mojisola Adeyeye, in a media statement signed by the agency’s Resident Media Consultant, Sayo Akintola, in Abuja, mentioned: “Only NAFDAC has the mandate to make any pronouncement on the good quality, basic safety and efficacy of all controlled products that demonstrate satisfactory scientific proof.”

    Preliminary conclusions of a clinical examine on IHP Detox tea by professional medical doctors at the Faculty of Drugs University of Lagos (CMUL)/Lagos College Educating Medical center (LUTH) Idi-Araba located the products protected and powerful in dealing with COVID-19 patients.

    The conclusions were offered at CMUL/LUTH in May perhaps 2022. A workforce from WHO was there for the duration of the presentation. Curiously, the WHO has refused to make any assertion on the results up till now.

    Likewise, preliminary conclusions of clinical trials of IHP Detox tea by health professionals at Nnamdi Azikiwe College Teaching Medical center, Nnewi, Anambra Point out, confirmed the merchandise was safe and sound and effective in treating COVID-19 patients.
    THE organisation denounced media experiences ostensibly circulated at the occasion of the promoters of IHP Detox Tea, which claimed that the herbal medicine was the only product or service approved by the agency for procedure of the virus.

    International Centre for Ethnomedicine and Drug Improvement (InterCEDD), makers of Interceded Wellness Goods (IHP), is a subsidiary of BDCP, which is a non-governmental non-earnings organisation.

    Far more inquiries than answers
    THE scenario has elevated many queries: Why are FG and NAFDAC having to pay lip support to organic/conventional medication? Are scientific trials important in advance of approval of natural cures? Who must sponsor the cash undertaking? What should FG and its organizations like NAFDAC be carrying out towards endorsing herbal treatments? What is the way forward in the direction of quick-tracking the enhancement of novel natural cures like IHP tea and Cugzin for the gain of Nigerians?

    A supply in a single of the agencies less than the Federal Ministry of Science and Technologies, who favored anonymity told The Guardian: “I imagine a thorough investigative report required to be done on the difficulties lifted in this contact, in particular to verify the cause of new remarks of NAFDAC on IHP Detox Tea and Pax Herbals’ Cugzin for COVID-19. I am declaring this because I am aware of the formal document (2022 Appropriation) in the general public area that states FG has appropriated funds for funds tasks to have out Scientific Exploration on Natural Therapies made with Nigerian Medicinal Vegetation.

    “This investigation wanted to be accomplished vis-a-vis the strategies stipulated by WHO and NAFDAC for carrying out Medical Exploration on Natural Therapies which entails TMK (Regular Drugs Awareness), literature reviews on the plant’s elements, pre-medical investigation of the therapies, observational research on human, then the phases of clinical trials (1-4) in purchase to build the reality from rumours.”

    FG spending lip support
    On the other hand, Minister of Health and fitness, Dr Osagie Ehanire, in his remarks at the Nationwide Traditional, Complementary and Choice Drugs (TCAM) held on June 4, 2022, in Abuja, which he manufactured accessible to The Guardian, reported: “Traditional Medication is all we had in our portion of the environment, prior to the emergence of orthodox drugs and the very same goes without a doubt for all cultures and civilizations, who all have their track record in regular medication. Orthodox Medicine in excess of time advanced from a foundation of Standard Medicine in ancient Greece, which is properly recognized by individuals who researched the Heritage of Medication.

    “Applying scientific equipment to this historic knowledge in excess of plenty of generations is what yielded Orthodox Medication of right now. Consequently, continued curiosity and investigation into Conventional Drugs is the proper way to go, for even further enhancement of these historical Arts. There will need not be a conflict in between orthodox and conventional medicine we will have to rather, look for to seem into the health care expertise and techniques of our forefathers for increased value addition we can derive from it, in line with the aspiration of this administration, to check out all avenues for Universal Overall health Coverage.”

    Ehanire explained the excellent portion of common medication arrives from the efficacy located in potions derived from herbs and barks: just one illustration is Quinine, which is derived from tree bark extract employed by indigenous medicine practitioners in South The usa.

    “Our region is abundantly blessed with fauna and flora, 1000’s of which are exclusive to our natural environment, and have yet unexplored medicinal qualities, which our forefathers harnessed around innumerable generations, for well being gains to our individuals. It is of vital relevance to start out classification and documentation of this physique of knowledge, lest it is dropped or degraded around time, due to neglect,” he said.

    Specialists talk
    On the other hand, a foremost advocate of herbal drugs in Nigeria and Director of Pax Herbals Clinic in Ewu, Edo Point out, Rev Fr Anselm Adodo, explained to The Guardian there is a want for far more enlightenment and clarification on the function of authorities agencies in the regulation, enhancement and verification of organic medication.

    Adodo mentioned NAFDAC is accountable for the regulation of meals and medications. “This means they make certain that food and medicine are protected for community intake. On the other hand, people today frequently talk to, is organic drugs food stuff or medication? Initially, NAFDAC does not control agricultural items marketed in the area market place, these kinds of as tomato, pepper, mango, yam, beans and many others. Having said that, when these are packaged to be sold in supermarkets and retailers, they require its certification,” he claimed.

    Adodo explained, on the other hand, pharmaceutical medications with unique well being statements have to also be certified by NAFDAC as safe and sound.

    He claimed there is a require for much more enlightenment so that the typical public and organic practitioners can be better educated.

    “In my conferences with conventional medicine practitioners, they typically talk to if herbal medication is categorised as food items or medications. There is a will need to apparent this confusion so that the public is better educated. I have the effect that NAFDAC assumes that their Nigerian consumers are uneducated and uninformed, producing them take care of their consumers higher-handedly and with minimal respect. I observed that when purchasers from Asia or Europe approach NAFDAC, they are handled with more respect than Nigerians. Of course, this is just component of a normal frame of mind issue among Nigerians, but in my look at, it results in a profound lack of mutual respect and believe in. Men and women that are privileged to be in an administrative posture of authority need to have be reminded that they are general public servants and not ‘public masters’,” Adodo claimed.

    On why FG and NAFDAC are shelling out lip provider to organic/conventional drugs, Adodo stated it is excellent to acknowledge that there has been a great deal of progress in the efforts of the federal government to formally integrate organic/common/alternate medication into the countrywide wellness procedure. He said the Invoice on Common Drugs has arrived at an highly developed phase and may well shortly be passed by the National Assembly. “I commend those people doing the job driving the scenes, frequently with good inconvenience and personalized sacrifice, to see that the bill sees the gentle of day.

    Regrettably, this bill has taken far too lengthy to go thanks to the Nigerian factor and unwanted bureaucratic bottlenecks, which have discouraged stakeholders. The fact is that there are lots of conflicting pursuits and forces within federal government circles functioning for and against common herbal medication. Some are organization interests who want to guard their trade, and some experience threatened by the money influence of a blooming herbal drugs marketplace on their profession. Some who have been benefiting from the standing quo do not want any transform in plan, as it will influence them economically. There is so much inside politics of moi and greed, which has resulted in what we now contact ‘lip support,” he mentioned.

    On whether or not scientific trials are essential right before approval of natural cures, Adodo said: “I want to make it clear that I am unhappy about the lack of creativity, unbiased-mindedness and adaptability that characterises the difficulty of a clinical trial in Nigeria. There are a few phases in herbal medicine manufacturing. Very first is the uncooked elements stage. That is the phase the place you basic dry leaves, barks, roots, and stems of vegetation and use them as teas, infusions, and decoctions. Some of these supplies are set into teabags or capsules. Most herbal products and solutions in Nigeria are registered and offered in this form. The next phase is the manufacturing of crude extracts. This is a extra complex procedure involving getting rid of the fibres and chaff in the raw products to have a more concentrated and lesser dose of the active components. The crude extract is then set into tender gels or tablets. This makes it less difficult to decide the action of the product and management the dosage, but it also suggests that some of the advantages from the fibre and chaff would have been missing, which does not take place in the very first phase.

    “We have so numerous gurus in Nigeria who can design medical demo protocols for the different groups of organic formulations and drug advancement primarily based on nearby realities if our key goal is to have a excellent area healthcare technique for the folks. If we do this, even the WHO will appear to understudy what we are accomplishing and discover from it.”

    Countrywide Chairman, Clinical Pharmacists Affiliation of Nigeria (CPAN), Dr. Joseph Madu, informed The Guardian: “My just take is that NAFDAC is a regulatory system proven by legislation and mandated to control foodstuff and drugs administration and control utilizing some predetermined procedures and strategies. These conventional working methods for the regulation of packaged food items, equipment, natural goods and prescribed drugs are globally recognized to be in general public well being fascination.

    “I do not assume that NAFDAC will clamp down on, or discourage regional herbal cures even with their efficacy and acceptance. NAFDAC officers do not have these kinds of powers but they have veto powers to safeguard the wellbeing of the nation.”

    He continued: “They may well not bother about public acceptance as that does not translate to efficacy or security, but it is their responsibility to assure the safety and appropriateness of medicines, packaged foods, gadgets and prescribed drugs or connected items by way of verifiable scientific techniques.

    “One issue we usually get completely wrong in this component of the globe is when we see modern medicines acceptance as a political difficulty. No, that is not correct. There is no area for politics in science.”

    Madu stated the FG proven NAFDAC to regulate foodstuff and medicines administration and manage, such as natural products. “If NAFDAC is not dwelling up to expectation, I don’t feel we will blame it on the FG, apart from if the FG does not launch the desired guidance these kinds of as resources to NAFDAC. This can have an impact on the get the job done of the federal parastatals including NAFDAC.

    “However, it is important to be aware that NAFDAC can not just approve a product or service just since it is allegedly uncovered by a Nigerian professor, or since of its public acceptance. This is for the reason that even a placebo can be claimed to be productive in curing sickness in the eyes of the public,” he reported.

    The pharmacist mentioned clinical trials are needed right before the acceptance of all medicines which includes herbal solutions.

    To him, a investigate institute, university pharmaceutical providers, states Federal Authorities or even persons could sponsor the trials. Madu claimed it is not the responsibility of NAFDAC to sponsor medical trials, other than the management picks exclusive passions to do so.

    Way Ahead
    ON what FG and its organizations like NAFDAC ought to do, Adodo explained: “If the FG is severe about the improvement of natural/classic medication. The time is ripe to have a specialised company or an unbiased device in NAFDAC to aim on regulating organic medicines: both of those the exercise alone and the products need to have to be controlled. This indicates that the practitioners, the merchandise and herbal clinics/centres are to be certified. There are three areas to this regulation: The observe/discipline by itself, that is, the organic practitioner, then the solution, that is, the organic medication, and then the natural clinic, the put where the sick is attended to.

    As you can see, this sort of a device or company will perform with major wellbeing care centres in the ministry of well being in every single state, in particular in the neighborhood governments, with the Nigeria Purely natural Medicine Enhancement Company (NMDA), and the Nigeria Institute of Medical Investigate (NIMR). These are my particular opinions as a single who has been totally included in practising and building traditional drugs for about 23 many years. Hence, natural medication regulation deserved a separate and unbiased agency.”

    He stated the way forward, in the direction of quick-tracking the progress of novel organic cures like IHP tea for the benefit of Nigerians is for the government to proficiently fund study institutes such as the National Institute for Pharmaceutical Exploration and Drug Advancement (NIPRD), as effectively as universities.

    “Individuals who are wealthy can also be encouraged to sponsor analysis in the growth of our herbal solutions,” Madu reported.

    The medical pharmacist reported NAFDAC way too are not able to be exonerated and ought to motivate the enhancement of homemade solutions, as some of them have been located to be efficient, safe and sound and efficacious.

    He explained it is the responsibility of NAFDAC to make sure that all the important parameters are investigated. “For occasion, a solution may perhaps be capable to overcome a illness but may possibly not be safe when applied in selected types of individuals these kinds of as expecting women, the aged, breastfeeding mothers or kids.

    “The scenario of Thalidomide, which led to limb deformities in small children born in the 1960s is however clean in the eye of the earth. Some products and solutions may also not be efficacious when mixed with other treatments or foods, or when used in specified comorbid ailments. All these and lots of additional will have to be thoroughly cross-checked prior to acceptance of a drug for use in people,” Madu said.

  • Acupuncture Therapy for Postoperative Pain

    Acupuncture Therapy for Postoperative Pain

    Introduction

    Postoperative pain foremost refers to the acute pain that occurs immediately after surgery and consists mainly of pain from somatic and visceral trauma caused by surgical operations and pain from inflammatory irritation around nerve endings,1 which attributes to injurious pain.2 If it continues to be poorly controlled, pathological remodeling of the central and peripheral nervous system occurs3 and the nature of the pain changes to neuropathic pain or mixed pain, then it progresses to chronic postoperative pain. More than 300 million patients undergo surgery worldwide each year.4 Between 30{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} and up to 80{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of patients report moderate to severe pain in the days following surgery, and approximately 20{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} developing chronic pain.5 Persistent pain not only affects the patient’s recovery and leads to longer hospital stays,6 but also adds to the psychological burden of the patient, causing anxiety and depression.7,8 For families and society, both the direct increase in hospitalization expenses and consumption of medical resources, and the consequent indirect decline of individual labor force and even unemployment,9 are issues that should not be underestimated.

    Currently, pharmacological analgesia remains the dominant modality for the treatment of postoperative pain. Analgesics can meet the requirements of short-term and rapid analgesia, however, their side effects such as the addiction of opioids,10 the gastrointestinal harm and possible cardiovascular risks of non-steroidal anti-inflammatory drugs (NSAIDs),11,12 are also evident. Furthermore, although numerous postoperative pain management recommendations have been available over the years, the drugs recommended are generalized for all procedures.13 The efficacy of pain medication may vary depending on the type of surgical procedure,14 so it is difficult for specialists to find an effective solution for a particular procedure, and many patients report unsatisfactory results in terms of postoperative pain control.15 This all indicates to the fact that pharmacological analgesia is not a long-term solution. Searching for green, safe, low adverse effects and targeted analgesia gradually becomes one of the most important concerns of clinicians.

    Acupuncture therapy, a series of traditional Chinese medical treatment internationally accepted and applied for its undeniable effectiveness of therapeutic effects in the treatment of various pain-related conditions and nerve disorders,16,17 is one of the ideal non-pharmacological treatments to control post-operative pain. Studies have found that acupuncture therapy can intervene in pain through mechanisms such as increasing endogenous opioid peptides in the brain,18,19 modulating abnormal neurological function,20 and influencing intracellular signaling pathways.21 A randomized controlled trial (RCT) showed that acupuncture was effective in relieving postoperative pain in patients undergoing hemorrhoidectomy.22 Another RCT also found that acupuncture therapy was safe and effective in the management of post-cesarean pain.23

    Bibliometric analysis is a method for evaluating and quantifying literature information using mathematical and statistical methods,24 which can help to recognize the research advances in a specific field of science comprehensively.25 This analytical method has been applied to many areas with a large body of research accumulated, including pain management. In one of these studies, Gao et al26 analyzed the field of acupuncture for analgesia, and it can be seen in this study that acupuncture therapy for postoperative pain has also received considerable attention. However, despite the heat in the clinical and research area, no studies have yet explored current research trends in the treatment of postoperative pain with acupuncture therapy and continued in-depth study of this field using bibliometric analysis is highly warranted.

    The approach of bibliometric was applied in this study to analyze the literatures about acupuncture therapy for postoperative pain over the last 20 years, through multiple perspectives such as journals, authors, institutions, countries, keywords, and references. And the results were presented in the form of scientific knowledge maps by using the CiteSpace software, then the maps were further interpreted and analyzed, to gain an intuitive and comprehensive understanding of the research in the field, identify research hotspots and provide new research ideas.

    Methods

    Data Sources and Search Strategy

    All data for this study were obtained from the Web of Science (WoS) core collection database on 1 March 2022. The data search strategy included the topics “postoperative pain” and “acupuncture therapy”, with the publications period of the literatures ranging from 2001–01-01 to 2022–02-28. Only English-language papers were included, the country and category of the study were not restricted. Duplicates and articles without full text were excluded. Secondary search for references and relevant reviews in the literatures was conducted in order to avoid omissions. The specific search strategies and results were shown in Table 1. Eventually, 840 articles were obtained.

    Table 1 The Topic Search Query

    Analysis Tool

    This research applies CiteSpace (V5.8.R3 64-bits) combined with Excel to organize and visualize data for analysis, including: (1) statistical and descriptive analysis: for parameters such as annual publication volume, authors, countries, institutions and journals; (2) collaborative network analysis: mainly for the three dimensions of countries (regions), institutions and authors;(3) co-occurrence analysis: for keywords; (4) co-citation analysis: for authors, journals and references; (5) citation burst analysis: mainly for keywords and references; (6) cluster analysis.

    The specific parameters for the visualization analysis were set as follows. The threshold of “Top N{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} per slice” was 50 for all calculations. The time span was from January 2001 to February 2022, and the time slice setting for all analyses conducted with CiteSpace was “1 year per slice”. Clustering labels were extracted by using the LLR algorithm.

    Charts Interpretation

    The nodes in the maps generated by CiteSpace represent the objects being analyzed (such as different authors, institutions, or keywords); the size of the diameter of the nodes reflects the frequency (such as the output or citation frequency.); different colors correspond to different years (such as the year of publication); the lines between the nodes indicate the collaboration or co-occurrence relationship between the two, the color of the line indicates the time of the first collaboration and the thickness of the line reflects the strength of the relationship between the two.

    Results

    Annual Publications and Trends

    The retrieval of database found that a total of 860 articles have been published in the field of acupuncture therapy for postoperative pain in the past 20 years, and the number and trend of annual articles are shown in Figure 1. 2001 to 2014 could be seen as one phase. During this period, the annual number of articles published showed a fluctuating and slow growth trend, with an annual average of about 24 articles. There were four small peaks of growth successively, but all of them were quickly followed by a fall back. 2015 to the present is another phase. The number of publications in 2015 surged to 60, and after a small rebound, 2016 to 2019 saw a sustained and significantly accelerated increase in the number of publications, with the heat of attention increasing and stabilizing at an average of over 80 publications per year for the period 2019 to 2021, which was the highest record over the past 20 years. Only two months of data are currently available for 2022, but based on the above, it can be deduced that the number of publications this year will also be considerable and the research fever in the field of acupuncture for postoperative pain will continue.

    Figure 1 The number of annual publications on acupuncture treatment for postoperative pain.

    Note: In this figure, the number of articles published in 2022 is marked with an “*” and indicated by a dashed line, since only two months of data are available for this year.

    Analysis of Journals and Cited Journals

    Journals

    The total number of journals that published these 860 articles on acupuncture treatment for postoperative pain was 344 and the top 10 journals with the highest cumulative number of publications were listed in Table 2. The most published journals, accounting for about 14{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of the total number of articles published, were Evidence-Based Complementary and Alternative Medicine (40 articles), Acupuncture in Medicine (39 articles), and Medicine (38 articles). Anesthesia and Analgesia had the highest impact factor (IF) of 5.178, with 21 articles published, ranking 5th.

    Table 2 The Top 10 Journals with the Highest Frequency on Acupuncture Treatment for Postoperative Pain

    Cited Journals

    In conjunction with centrality, CiteSpace was used to generate a map of cited journals with 645 nodes and 5770 links (Figure 2), reflecting the co-citation relationships between journals. A node represented a journal, which gave a total of 645 journals involved in co-citation in the field of acupuncture therapy for postoperative pain. Shown in Table 3, the top five contributing journals as cited are Pain, Anesthesia and Analgesia, Anesthesiology, British Journal of Anaesthesia, and Acupuncture in Medicine. In the cited journal map, the purple ring outside the node reflected the size of the centrality of the journal it represented. Table 4 listed the journals with the highest centrality in the field of acupuncture therapy for postoperative pain, with Clinical Journal of Pain and European Journal of Anaesthesiology being the top, both at 0.07.

    Table 3 Top 5 Cited Journals with the Highest Frequency on Acupuncture Treatment for Postoperative Pain

    Table 4 Top 7 Cited Journals with the Highest Centrality on Acupuncture Treatment for Postoperative Pain

    Figure 2 Co-citation map of journals on acupuncture treatment for postoperative pain.

    Analysis of Countries

    Statistically, articles on acupuncture therapy for postoperative pain mainly came from 53 countries. The five countries with the highest contribution to the number of articles and the highest centrality were shown in Table 5 respectively, and a map of country cooperation networks was generated accordingly (Figure 3). As seen from it, China, the top publisher, has a weak chain of partnerships with other countries and need more international cooperation to enhance the global promotion of acupuncture therapy for postoperative pain. As the first of the pivot nodes, the US published a large amount of relevant literature and established collaborative relationships with quite a few countries. In addition, several countries forming a salient hexagonal circle of cooperation were visible in the upper right of the map. The mutual cooperation between these countries was developed early and closely. Meanwhile, they also maintained a certain cooperative relationship with Germany, one of the pivot nodes.

    Table 5 Top 5 Countries with the Highest Frequency and Centrality on Acupuncture Treatment for Postoperative Pain

    Figure 3 Map of countries cooperation network on acupuncture treatment for postoperative pain.

    Analysis of Institutions

    The top five institutions in terms of volume and centrality were listed in Table 6. China Medical Univ and Kyung Hee Univ both ranked first with 25 articles, followed by Korea Inst Oriental Med, Chinese Acad Sci and Shanghai Univ Tradit Chinese Med. China Med Univ, which had the highest number of articles, had the the highest centrality meanwhile, and Shanghai Univ Tradit Chinese Med was also tied. The inter-institutional collaboration network was generated accordingly, as shown in Figure 4. During this process, it was found that there were many instances where the names of institutions were not written normally, causing CiteSpace to identify the same institution as a different node. Such cases were all merged manually.

    Table 6 Top 5 Institutions with the Highest Frequency and Centrality on Acupuncture Treatment for Postoperative Pain

    Figure 4 Map of inter-institutional collaboration network on acupuncture treatment for postoperative pain.

    Analysis of Authors and Cited Authors

    Authors

    A total of 623 authors contributed to these 840 articles in the field of acupuncture therapy for postoperative pain and a map was generated using CiteSpace to show the collaborative relationships between the different authors (Figure 5). The nodes marked with names in the graph were the authors with three or more publications. And the authors with more than five publications, seven in total, were the core authors in this field. The most prolific author was Inhyunk Ha, with 10 publications. With him at the center, the graph presented a collaborative block linking up highly productive authors such as Byungcheul Shin (8 publications) and Meriong Kim (6 publications). Man Zheng was also active, with 6 publications, and he was part of the same team as Zhen Zheng, who had 5 publications. Lianbo Xiao and Di Sessler also had 5 publications. The map also manifested some loosely linked teams, most of which were multiple authors of the same paper. The collaborations between the different teams were less. Other relevant information about core authors were listed in Table 7. The “Year” column in the table manifested when the author first published, reflecting how early the author had been interested in the field. The “Nationality” column showed that the core authors were mainly from Korea and China. Moreover, the “Author” and “Country” modules were overlaid to obtain a new graph (Figure 6), where the distribution of authors by nationality can also be observed.

    Table 7 Top 7 Authors with the Highest Frequency on Acupuncture Treatment for Postoperative Pain

    Figure 5 Map of authors cooperation network on acupuncture therapy for postoperative pain.

    Figure 6 Authors-countries collaboration map on acupuncture therapy for postoperative pain.

    Cited Authors

    In combination with centrality and applying “pathfinder” and “pruning sliced networks”, CiteSpace was used to generate a co-citation map of authors from the field of acupuncture therapy for postoperative pain with 745 nodes and 2824 connected lines (Figure 7). The five most frequently co-cited authors whose articles had the highest impact were Han JS, Sun Y, Lee A, Lin JG and Wang SM, listed in Table 8. The seven authors with the highest centrality were demonstrated in Table 9, with four of them, Han JS, Vickers AJ, Wang SM and Ernst E, having centrality greater than or equal to 0.1.

    Table 8 Top 5 Cited Authors with the Highest Frequency on Acupuncture Treatment for Postoperative Pain

    Table 9 Top 6 Cited Authors with the Highest Centrality on Acupuncture Treatment for Postoperative Pain

    Figure 7 Co-citation Map of Authors on Acupuncture Therapy for Postoperative Pain.

    Keywords Co-Occurrence Analysis

    The 840 articles of acupuncture therapy for postoperative pain brought together a total of 517 keywords. “Pathfinder” and “pruning sliced networks” applied, a co-occurrence map of keywords, Figure 8, was generated. The 10 most frequently occurring words have been listed in Table 10, and 6 keywords occurred more than 100 times. Of interest were the “electroacupuncture” ranked 4th and “auricular acupuncture” ranked 8th. The frequency of these two keywords about therapeutic techniques was particularly high. Meanwhile, the keyword “auricular acupuncture” and two keywords related to electroacupuncture research, “electrical stimulation” and “electrical nerve stimulation”, had a high centrality (Table 11).

    Table 10 Top 10 Keywords with the Highest Frequency on Acupuncture Treatment for Postoperative Pain

    Table 11 Top 11 Keywords with the Highest Centrality on Acupuncture Treatment for Postoperative Pain

    Figure 8 Co-occurrence map of keywords on acupuncture therapy for postoperative pain.

    Further clustering based on the co-occurrence map resulted in a total of 12 clusters presented in Figure 9. The five largest clusters were “#0 postoperative nausea”, “#1 spinal nerve ligation”, “#2 systematic review”, “#3 postoperative ileus”, “#4 gi endoscopy”, “#5 undergoing autologous hematopoietic stem cell transplantation”. These were the most talked about topic in this area. Transforming the map into a Timeline view (Figure 10) allowed to observe the evolution of hot spots in the field of acupuncture therapy for postoperative pain research over the last 20 years.

    Figure 9 Cluster map of keywords co-occurrence on acupuncture therapy for postoperative pain.

    Figure 10 Timeline map of keywords co-occurrence on acupuncture therapy for postoperative pain.

    References Co-Citation Analysis

    A total of 855 references were extracted from the 840 articles of acupuncture therapy for postoperative pain to analyze cited references. The earliest cited literature was published in 1996 and the most recent reference was published in 2020. The five most frequently cited publications were listed in Table 12. Three of these were systematic reviews, one clinical randomized controlled trial, and one review. The Efficacy of Acupuncture in Post-Operative Pain Management: A Systematic Review and Meta-Analysis by Wu MS et al,27 published in 2016 topped the list with 44 citations. Table 13 demonstrated the top 5 papers ranked according to centrality. Three of these were clinical randomized controlled trials, one was a systematic review, and one was a review article. Written by Sun Y et al, Acupuncture and related techniques for postoperative pain: a systematic review of randomized controlled trials,28 published in 2008 had the highest centrality of 0.22.

    Table 12 Top 5 Cited References with the Highest Frequency on Acupuncture Treatment for Postoperative Pain

    Table 13 Top 5 Cited References with the Highest Centrality on Acupuncture Treatment for Postoperative Pain

    As shown in Figure 11, there was a co-citation map of references generated by CiteSpace. All references marked on the graph were those with more than 8 citations, and it can be seen that a large number of highly cited literatures were published in the last 10 years. Based on this, 19 valid clusters were obtained (Figure 12). The five largest clusters were #0 acupuncture analgesia, #1 evidence-based nonpharmacologic strategies, #2 postoperative complication, #3 randomized controlled trail, #4 ambulatory anesthesia, #5 capsicum plaster.

    Figure 11 Co-citation map of references on acupuncture therapy for postoperative pain.

    Figure 12 Cluster map of references co-citation on acupuncture therapy for postoperative pain.

    Citation Burst Analysis

    Burst keywords refer to keywords that have seen a spike in citations over a period and represent the research hotspot for the corresponding time. The 840 included articles were measured via CiteSpace and a total of 16 burst keywords were extracted, as shown in Figure 13. These keywords first appeared in 2001 or before, but the burstness began and ended at different times (shown as the red bars). Among them, “postoperative nausea” had the highest value of burst intensity, with a “Strength” of 8.36. Keywords having the longest duration of the burstness were “acupuncture analgesia” and “trial”, both beginning in 2008 and ending in 2016. The three latest burst keywords, “pain relief” from 2018, “systematic review” from 2019 and “osteoarthritis” from 2020, have been still ongoing.

    Figure 13 Top 16 keywords with the strongest citation bursts.

    A reference citation burst is a surge in the frequency of the reference being cited over a period, which can help to identify areas at the forefront of current research. A total of 15 references of citation burst were extracted for this study and were displayed in Figure 14. Four references with the latest burstness were identified. An article by Zhang RX published in 201429 and an article by Lee A published in 201530 both began bursting in 2017, with the former ending bursting in 2019 and the latter in 2020. The next burst reference was the same as the most frequently cited article (Wu MS, 2016),27 and meanwhile it had the highest value of burst intensity (15.32). This reference and another one by Chou R were both published in 2016,31 with their citation bursts beginning in 2018 and continuing until now.

    Figure 14 Top 15 references with the strongest citation bursts.

    Discussion

    General Information on Publications

    The 840 publications included spanned the period from January 2001 to February 2022. Analysis of the annual volume of literature published revealed that the volume of publications in the field of acupuncture for postoperative pain had increased to varying degrees each year. This increase was relatively steady in the early stage, more prominent after 2015, and stabilized at its highest level during the latest 3 years. This indicates that the field is in a period of rapid development and has great scope for exploration and research value. From the analysis of journals, the impact factors (IF) of the top ten journals with the highest cumulative number of publications are generally low. This indicates that the influence of acupuncture techniques for postoperative pain control in international applications is still relatively limited, and the quality of relevant publications needs to be improved. The highly cited journals mainly reflect the sources of journals that are the knowledge base of the relevant literatures. Most of them are comprehensive medical journals that serve as a bridge of knowledge between conventional and complementary alternative therapies, and they are more influential, with having a higher impact factor.

    In terms of the number of national publications, the contributions of China and USA are the most prominent. The parameters of the cooperation map show that the density of national collaborative networks is not low, which means that to some extent an international environment for collaborative research in the field of acupuncture for postoperative pain has been formed, with European and American countries such as the USA, UK and Germany playing a larger role, while Asian countries, represented by China and Korea, have more fragmented links. Institutions in Chinese and Korean are the main locations for research in this field. Medical schools and their affiliated medical institutions are the main institutional form. None of the top five institutions in the centrality ranking has a value above 0.10, suggesting that even the representative institutions are only collaborating on a small scale.

    In terms of authors, Inhyuk Ha and his partners have published the most articles, focusing on the application of acupuncture therapy for postoperative pain in the low back, with the most influential article being cited 42 times. This meta-analysis has provided evidence to support the use of acupuncture for acute pain occurring within one week of back surgery.32 From China, Man Zheng is member of a research team investigating the role of acupuncture therapy in perioperative pain prevention, particularly in thoracic and abdominal surgery. A randomized controlled trial conducted by the team demonstrated that in patients undergoing gynecological laparoscopy surgeries, a single electroacupuncture session within 24 hours before surgery was effective in preventing postoperative pain.33 The author who has the highest frequency of being cited and centrality is Han JS, whose most cited paper is a review published in Pain in 2011,34 which focuses on the consensus and controversy surrounding the research on the efficacy and mechanisms of acupuncture-related therapy, including the selection of acupoints, stimulation methods and intensity, and neurological effects, providing a reference for both clinical application and trial protocols.

    Research Hotspots and Frontiers

    Keywords and references reflect the content of the research from different aspects. Observed in the spatial dimension, the level of their frequency, centrality and burst intensity, and clustering distribution can suggest research hotspots. And in the temporal dimension, the dynamic changes of them can reflect research trends and help identify research frontiers.

    Highly Concerned Treatment Techniques and Types of Surgery

    Based on the frequency and centrality of the keywords, it can be determined that electroacupuncture and auricular acupuncture are probably the therapeutic techniques that have received the most attention from researchers in this field. A multicenter randomized controlled trial demonstrated that electroacupuncture combined with conventional care was superior to conventional care alone for the relief of non-acute pain following back surgery.35 Another randomized controlled trial also showed that auricular acupuncture could provide postoperative analgesia and reduce the application of analgesic medication and was safe to perform.36

    Studies on the control of postoperative pain with acupuncture have covered a variety of surgical types, including low back surgery, osteoarthritis surgery, lung cancer surgery, cardiac surgery, brain surgery, laparoscopic surgery, tonsillectomy, hysterectomy, total knee replacement, hip replacement, caesarean section, oral surgery, spinal surgery, shoulder and neck surgery, gastric cancer surgery, and anorectal surgery. The studies on chronic lower back pain due to the aftermath of low back surgery are the most, with 58 occurrences of related keywords.

    Hot Research Topics and Directions

    The results of clustering and burstness of keywords revealed a consistently high level of concern for postoperative nausea. The largest cluster was “postoperative nausea”. Of the 16 burst keywords, “postoperative nausea” was the keyword with the earliest occurrence (beginning in 2002) and the greatest intensity of burstness. Moreover, the keyword “nausea” had a second citation burst in 2014. Both nausea and pain are the most common complications after surgery. Meanwhile, there is also a degree of causality between the two. Opioid analgesics have been found to be one of the main causes of postoperative nausea and vomiting.37,38 The problem of nausea can be addressed to a great extent if postoperative pain can be relived with minimal use of such medications. Acupuncture therapy has attracted the attention of researchers as an excellent complementary and alternative therapy. A systematic review by Pouy S et al showed that acupuncture therapy can prevent and reduce the occurrence of post-tonsillectomy pain and nausea in pediatric patients.39 A popular direction of research derived from this research hotspot is PC6 acupoint stimulation. The acupoint of Neiguan (PC6), located on the pericardium meridian, is a specific point for the treatment of nausea and vomiting.40 Studies on the relief of postoperative complications of pain and nausea have been conducted as early as 1996 by applying pressure to the Neiguan point.41 A systematic review and meta-analysis by Cheong KB et al demonstrated the safety and effectiveness of acupuncture stimulation of the PC6 acupoint or with the combination of other acupuncture points to alleviate postoperative vomiting associated with anesthetic analgesia.42

    In addition, transcutaneous electrical nerve stimulation (TENS) is another hot direction of research in this field, as reflected in the keyword clustering and burstness. This technique is also combined with auricular acupuncture techniques.43 A similar technique arising from the disciplinary crossover is transcutaneous electrical acupoint stimulation (TEAS).44–46

    Research Trends and Forefront

    From an overall perspective, keywords whose burstness occurred in the first decade mainly reflected a concentrated discussion of postoperative pain management and acupuncture analgesic techniques, with the main form of research being mostly RCTs. In the recent decade the main focus has been on pain symptom relief and postoperative quality of life, with a gradual increase in the number of systematic reviews. Moreover, animal experiments, as well as mechanism-related studies, also have a place, as evidenced by the burst keyword “rat” and the second largest cluster “#1 spinal nerve ligation” (a kind of rat modelling technique). Looking at the three newest burst keywords, “pain relief” shows the constant attention received by the topic of postoperative pain management. The rise in heat of “systematic review” reflects the development of evidence-based medicine in this field. 2020 saw the burstness of the term “osteoarthritis”, indicating that in the last two years acupuncture analgesic techniques have started to be used in osteoarthritis surgery more often and intensive research has been conducted.47,48

    The citation status of the references also manifests a distinctly evidence-based medical color. The most influential literatures in this field are of a variety which is dominated by RCTs and systematic reviews of clinical studies. In the results of clusters, both “#1 evidence-based nonpharmacologic strategies” and “#3 randomized controlled trail” have a relatively large size. The most frequently cited reference suggested that certain modes of acupuncture did have implications for alleviating postoperative pain and reducing opioid use.27 That acupuncture could control acute postoperative pain and reduce the side effects of pharmacological analgesia was supported by the reference with the highest centrality.28

    According to the newest burst references, electroacupuncture could alleviate pain by activating a range of bioactive substances including opioids, N/OFQ, 5-hydroxytryptamine, norepinephrine and others.29 Lee A et al evaluate the preventive effect of several methods of stimulating the PC6 acupoint on nausea and vomiting resulted from surgical analgesia and anesthesia.30 This fits in with the direction of research embodied in the keywords. The last is a guideline on postoperative pain management published in 2016.31 In this guideline, TENS is supported by moderate quality evidence and is recommended as a complementary therapy. In contrast, the effectiveness of other acupuncture therapies remains controversial, although there is adequate evidence for their safety. However, most of their citations and evidence are of results published before 2005 and their evidence needs to be updated. This suggests that the current focus in the field of acupuncture therapy for postoperative pain is still on proving the effectiveness of acupuncture therapy and that there is a long way to go in terms of conducting high quality clinical research.

    Conclusion

    In this study, the analysis of annual volume of publications and journals suggests that the field of acupuncture therapy for postoperative pain relief is currently in a period of rapid development. The analysis from country to institution to author shows a progressively more microscopic perspective of observation and consistency is evident among them: there may be more localized individual collaborations, but the overall collaborative network is not yet mature. In terms of keywords and references, electroacupuncture and auricular acupuncture (therapeutic techniques), low back surgery (types of surgery), “postoperative pain, nausea and vomiting” and their derivatives are research hotspots in this field. Improvement of postoperative life quality, proof of clinical efficacy and evidence-based evaluation are the current research trends and frontiers. Overall, the field of acupuncture for postoperative pain has great potential for development, and more international exchanges and collaborations as well as high-quality research results are needed in the future.

    Strength and Limitation

    The strength of this study is that literatures on acupuncture therapy for postoperative pain were analyzed by applying bibliometrics and visualization for the first time, and the results were interpreted from multiple perspectives, with the information presented in the macroscopic perspective sufficiently explored, revealing the research hotspots and trends in the field. The limitation of this study is that only literature from the Web of Science was analyzed. This is because CiteSpace cannot combine and analyze data from multiple sources at the same time, and other databases cannot export the corresponding citation formats for citation analysis.

    Abbreviations

    NSAIDs, non-steroidal anti-inflammatory drugs; RCT, randomized controlled trial; WoS, Web of Science; IF, impact factor; TENS, transcutaneous electrical nerve stimulation; TEAS, transcutaneous electrical acupoint stimulation.

    Data Sharing Statement

    The raw data of this article was collected from the online database WoS, which can be obtained directly by logging in or contacting the authors.

    Ethics Approval and Informed Consent

    This study did not contain any human or animal test subjects. Thus, the requirement for ethics approval was waived.

    Acknowledgments

    The authors would like to express their appreciation to Prof. Chaomei Chen for developing CiteSpace and opening its access.

    Author Contributions

    All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

    Funding

    This study was supported by the National Natural Science Foundation of China (U21A20404); the Innovation Team and Talents Cultivation Program of National Administration of Traditional Chinese Medicine (ZYYCXTD-D-202003).

    Disclosure

    The authors report no potential conflicts of interest in this work.

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