Objectives Chemotherapy-induced peripheral neuropathy (CIPN) can produce severe neurological defi cits and neuropathic pain and is a potential reason for terminating or suspending chemotherapy treatments. Specifi c and effective curative treatments are lacking. Methods A pilot study was conducted to evaluate the therapeutic effect of acupuncture on CIPN as measured by changes in nerve conduction studies (NCS) in six patients treated with acupuncture for 10 weeks in addition to best medical care and fi ve control patients who received the best medical care but no specifi c treatment for CIPN. Results In fi ve of the six patients treated with acupuncture, NCS improved after treatment. In the control group, three of fi ve patients did not show any difference in NCS, one patient improved and one showed impaired NCS. Conclusion The data suggest that acupuncture has a positive effect on CIPN. The encouraging results of this pilot study justify a randomised controlled trial of acupuncture in CIPN on the basis of NCS. INTRODUCTIONChemotherapy-induced peripheral neuropathy (CIPN) involves damage to the peripheral nervous system and can produce severe neuropathic pain or gait impairment and may be a reason to terminate or suspend chemotherapy treatments. Specifi c and effective curative treatments are lacking. The major groups of drugs that induce CIPN include the taxanes, vinca alkaloids and platinum compounds. The incidence of CIPN is high and can reach levels of up to 92%. 1 Publications in English language journals on acupuncture as a symptomatic treatment for CIPN have been limited to only a few case studies, all of which report an improvement in symptoms.2 3 A Chinese study described acupuncture as more effective than cobamamide for the treatment of sensory symptoms in paclitaxel-induced CIPN. 4 We conducted a pilot study in 2006 in 192 patients with peripheral neuropathy diagnosed on the basis of nerve conduction studies (NCS). Patients were evaluated over a period of 1 year, measured by NCS. The aim of this Acupuncture for chemotherapy-induced peripheral neuropathy (CIPN): a pilot study using neurography

Diabetic foot ulcers as one of the most common complications of diabetes mellitus are defined as nonhealing or long-lasting chronic skin ulcers in diabetic patients. Multidisciplinary care for the diabetic foot is common, but treatment results are often unsatisfactory. Low level laser therapy (LLLT) on wound areas as well as on acupuncture points, as a noninvasive, pain-free method with minor side effects, has been considered as a possible treatment option for the diabetic foot syndrome. A systematic literature review identified 1764 articles on this topic. Finally, we adopted 22 eligible references; 8 of them were cell studies, 6 were animal studies, and 8 were clinical trials. Cell studies and animal studies gave evidence of cellular migration, viability, and proliferation of fibroblast cells, quicker reepithelization and reformed connective tissue, enhancement of microcirculation, and anti-inflammatory effects by inhibition of prostaglandine, interleukin, and cytokine as well as direct antibacterial effects by induction of reactive oxygen species (ROS). The transferral of these data into clinical medicine is under debate. The majority of clinical studies show a potential benefit of LLLT in wound healing of diabetic ulcers. But there are a lot of aspects in these studies limiting final evidence about the actual output of this kind of treatment method. In summary, all studies give enough evidence to continue research on laser therapy for diabetic ulcers, but clinical trials using human models do not provide sufficient evidence to establish the usefulness of LLLT as an effective tool in wound care regimes at present. Further well designed research trials are required to determine the true value of LLLT in routine wound care.

Chemotherapy-induced neuropathy (CIPN) has a relevant impact on the quality of life of cancer patients. There are no curative conventional treatments, so further options have to be investigated. We conducted a systematic review in English and Chinese language databases to illuminate the role of medical herbs. 26 relevant studies on 5 single herbs, one extract, one receptor-agonist, and 8 combinations of herbs were identified focusing on the single herbs Acorus calamus rhizoma, Cannabis sativa fructus, Chamomilla matricaria, Ginkgo biloba, Salvia officinalis, Sweet bee venom, Fritillaria cirrhosae bulbus, and the herbal combinations Bu Yang Huan Wu, modified Bu Yang Huan Wu plus Liuwei Di Huang, modified Chai Hu Long Gu Mu Li Wan, Geranii herba plus Aconiti lateralis praeparata radix , Niu Che Sen Qi Wan (Goshajinkigan), Gui Zhi Jia Shu Fu Tang (Keishikajutsubuto), Huang Qi Wu Wu Tang (Ogikeishigomotsuto), and Shao Yao Gan Cao Tang (Shakuyakukanzoto). The knowledge of mechanism of action is still limited, the quality of clinical trials needs further improvement, and studies have not yielded enough evidence to establish a standard practice, but a lot of promising substances have been identified. While CIPN has multiple mechanisms of neuronal degeneration, a combination of herbs or substances might deal with multiple targets for the aim of neuroprotection or neuroregeneration in CIPN.