Study On The Dosimetry For The Safety Of Focused Ultrasound Exposed On Acupoint

BackgroundCurrently, following the respiration, pulse, temperature and blood pressure,pain has been recognized as one of the "5 great life indications of human ". With the accelerating pace of modern life and the arriving of aging society, the incidence of pain is increasing. Chronic pain has become the third major health problems, after the heart-attack and cerebrovascular diseases, and has been seriously affecting the life quality of patients and increased in patients accompanied with body dysfunction. Pain has been a trouble problem to the public, chronic pain such as bone and joint pain suffer the people, although the treatment varied, but most of them are difficult to be cured, some people refer to it as "die as cancer". Thus to explore the mechanisms of pain, to find a safe and effective treatment method for pain relief, is a urgent need in medical research work for medical researchers. Objective⑴With different doses of radiation on "ST 36" Point and sciatic nerve on Rabbits, to test whether the point area of the skin, muscle and nerve could be damaged;⑵In the safety range of irradiation, with different doses of focused ultrasound irradiation on "knee eye" in patients with knee osteoarthritis, using the VAS score and Lequesne score, we have evaluated the clinical efficacy of acupuncture for providing theoretical basis of further programs of focused ultrasound irradiation providing the safe and effective treatment of clinical pain.Methods1. With the power of 4 W (other parameters unchanged), respectively, the lasting time of focused ultrasound irradiated of 5 min, 10 min, 15 min and 20 min each at "ST 36" Point and sciatic nerve. With the light microscope, to observe whether the skin, muscle is damaged; as well as by light microscopy and electron microscopy, to evaluate whether neural stem action potentials and nerve conduction velocity of the sciatic nerve is damaged.2. Focused ultrasound irradiation was used in treating knee osteoarthritis, by observing whether side effect of burn happens, VAS score and Lequesne score have been calculated, and to comparing with those of celecoxib capsules to treat knee osteoarthritis. Results1. Optical microscope observe: after 5mins irradiation, collagen fiber bundle is in different thickness, lines up in a mess and interweaves nets. After 10mins irradiation, subcutaneous dense connective tissues become loose, collagen fiber bundle is in different thickness, a few leukomonocyte can be saw in part collagen fibers. After 15mins irradiation, subcutaneous dense connective tissues become loose, collagen fiber bundle is in different thickness, part of collagen fibers break and loss. After 20mins irradiation, subcutaneous dense connective tissues become loose, collagen fibers break and loss, collagen bundle break into spot film. Muscle cells showed no changes as membrane integrity, smooth, red staining cytoplasm, clear nucleus etc.2. Light microscope Observation: After 5mins irradiation, sciatic nerve fibers arranged in close, continuous axons, Schwann cells were normal. After 10mins irradiation, herring osteoid lesions were seen. After 15mins irradiation, sciatic nerve osteoporosis, herring osteoid lesions were more obvious. After 20mins irradiation, slight deformation of the myelin sheath was seen.3. Electron microscopy Observation: With 5 min irradiation there has not obvious changes happened. Slight deformation of the myelin sheath, mild atrophy of the axon, swelling of Schwann cells were observed after FU irradiation 10 min; Deformation of the myelin, delamination, axon compression were observed after FU irradiation 15 min; Slight demyelination lesions were observed after FU irradiation 20 min.4. Comparing with those of the normal group, It has showed no significant difference (P >0.05) in neural stem action potential and nerve conduction velocity5. Treatment and after treatment, no burns or other adverse reactions were observed. After 8 weeks, the VAS and Lequesne of the total effective rate of A group were 90.2% and 82.4%, while those of B group were 74.5% and 66.7%; There was a significant deferent between A group and B group (P <0.05).Conclusion1. With the power of 4 W focused ultrasound irradiation, respectively, With 5 min, 10 min, 15 min and 20 min, it only caused minor skin burns, muscle was normal, sciatic nerve damage was not seen, It has indicated that the treatment of focused ultrasound acupoint irradiation is safe.2. To treat knee osteoarthritis with Pulsed focused ultrasound irradiation on "knee-eye" point can significantly reduce pain, increasing joint mobility, relieving joint swelling, and it is more effective than those with oral celecoxib capsule, and also is a safe, effective, simple way.