Role of pulsed electromagnetic fields after joint replacements

Although the rate of patients reporting satisfaction is generally high after joint replacement surgery, up to 23% after total hip replacement and 34% after total knee arthroplasty of treated subjects report discomfort or pain 1 year after surgery. Moreover, chronic or subacute inflammation is reported in some cases even a long time after surgery. Another open and debated issue in prosthetic surgery is implant survivorship, especially when related to good prosthesis bone ingrowth. Pulsed Electro Magnetic Fields(PEMFs) treatment, although initially recommended after total joint replacement to promote bone ingrowth and to reduce inflammation and pain, is not currently part of usual clinical practice. The purpose of this review was to analyze existing literature on PEMFs effects in joint replacement surgery and to report results of clinical studies and current indications. We selected all currently available prospective studies or RCT on the use of PEMFs in total joint replacement with the purpose of investigating effects of PEMFs on recovery, pain relief and patients’ satisfaction following hip, knee or shoulder arthroplasty. All the studies analyzed reported no adverse effects, and good patient compliance to the treatment. The available literature shows that early control of joint inflammation process in the first days after surgery through the use of PEMFs should be considered an effective completion of the surgical procedure to improve the patient’s functional recovery.

Low-frequency pulsed electromagnetic field pretreated bone marrow-derived mesenchymal stem cells promote the regeneration of crush-injured rat mental nerve

Bone marrow-derived mesenchymal stem cells （BMSCs） have been shown to promote the regeneration of injured peripheral nerves. Pulsed electromagnetic field （PEMF） reportedly promotes the proliferation and neuronal differentiation of BMSCs. Low-frequency PEMF can induce the neuronal differentiation of BMSCs in the absence of nerve growth factors. This study was designed to investigate the effects of low-frequency PEMF pretreatment on the proliferation and function of BMSCs and the effects of low-frequency PEMF pre-treated BMSCs on the regeneration of injured peripheral nerve using in vitro and in vivo experiments.In in vitro experiments, quantitative DNA analysis was performed to determine the proliferation of BMSCs, and reverse transcription-polymerase chain reaction was performed to detect S100 （Schwann cell marker）, glial fibrillary acidic protein （astrocyte marker）, and brain-derived neurotrophic factor and nerve growth factor （neurotrophic factors） mRNA expression. In the in vivo experiments, rat models of crush-injured mental nerve established using clamp method were randomly injected with low-frequency PEMF pretreated BMSCs, unpretreated BMSCs or PBS at the injury site （1 × 106 cells）. DiI-labeled BMSCs injected at the injury site were counted under the fluorescence microscope to determine cell survival. One or two weeks after cell injection, functional recovery of the injured nerve was assessed using the sensory test with von Frey filaments. Two weeks after cell injection, axonal regeneration was evaluated using histomorphometric analysis and retrograde labeling of trigeminal ganglion neurons. In vitro experiment results revealed that low-frequency PEMF pretreated BMSCs proliferated faster and had greater mRNA expression of growth factors than unpretreated BMSCs. In vivo experiment results revealed that compared with injection of unpretreated BMSCs, injection of low-frequency PEMF pretreated BMSCs led to higher myelinated axon count and axon density and more DiI-labeled neurons in the trigeminal ganglia, contributing to rapider functional recovery of injured mental nerve. These findings suggest that low-frequency PEMF pretreatment is a promising approach to enhance the efficacy of cell therapy for peripheral nerve injury repair.

The Effects of High-intensity Pulsed Electromagnetic Field on Proliferation and Differentiation of Neural Stem Cells of Neonatal Rats in vitro

The effects of high-intensity pulsed electromagnetic stimulation （HIPEMS） on proliferation and differentiation of neonatal rat neural stem cells in vitro were investigated. Neural stem cells derived from neonatal rats were exposed to 0.1 Hz, 0.5–10 Tesla （T） [8 groups of B–I, respectively], 5 stimuli of HIPEMF. The sham exposure controls were correspondingly established. Inverted phase contrast microscope was used to observe the cultured cells, MTT assay to detect the viability of the cells as expressed by absorbance （A） value, and flow cytometry to measure differentiation of neural stem cells. The results showed that A values of neural stem cells in both 3.0 T and 4.0 T groups were significantly higher than the other groups 24 to 168 h post HPEMS, indicating a strong promotion of the growth of neural stem cells （P〈0.05）. The A values of neural stem cells in the 6.0 T, 8.0 T, and 10.0 T groups were lower than the sham exposure control group, indicating a restraint of the growth of neural stem cells. The rate of neuron-specific enolase-positive neurons revealed by flow cytometry in HPEMS groups was the same as that in control group （P〉0.05）. It was suggested that 0.1 Hz, 5 pulses stimulation of HPEMS within certain scale of intensity （0.5–10.0 T）, significantly promoted the growth of neural stem cells with the rational intensity being 4.0 T.

Pulsed electromagnetic field stimulation enhances neurite outgrowth in neural cells and modulates inflammation in macrophages

Nerve regeneration following traumas remains an unmet challenge.The application of pulsed electromagnetic field(PEMF)stimulation has gained traction for a minimally invasive regeneration of nerves.However,a sys-tematic exploration of different PEMF parameters influencing neuron function at a cellular level is not available.In this study,we exposed neuroblastoma F11 cells to PEMF to trigger beneficial effects on neurite outgrowth.Different carrier frequencies,pulse repetition frequencies,and duty cycles were screened with a custom ad hoc setup to find the most influential parameters values.A carrier frequency of 13.5 MHz,a pulse repetition frequency of 20 Hz,and a duty cycle of 10%allowed maximal neurite outgrowth,with unaltered viability with respect to non-stimulated controls.Furthermore,in a longer-term analysis,such optimal conditions were also able to in-crease the gene expression of neuronal expression markers NeuN and Tuj-1 and transcription factor Ngn1.Finally,the same optimal stimulation conditions were also applied to THP-1 macrophages,and both pro-inflammatory(TNF-α,IL-1β,IL-6,IL-8)and anti-inflammatory cytokines(IL-10,CD206)were analyzed.The optimal PEMF stimulation parameters did not induce differentiation towards an M1 macrophage phenotype,decreased IL-1β and IL-8 gene expression,decreased TNF-α and IL-8 cytokine release in M1-differentiated cells,increased IL-10 and CD206 gene expression,as well as IL-10 cytokine release in M0 cells.The specific PEMF stimulation regime,which is optimal in vitro,might have a high potential for a future in vivo translation targeting neural regeneration and anti-inflammatory action for treating peripheral nerve injuries.

Cytogenetic Effects of Pulsing Electromagnetic Field on Domestic Pig Lymphocytes in Vitro

The effects of pulsing electromagnetic fields(PEMFs)on cells are very important subjects in the field of bioelectromagnetics.In this experiment,the cytogenetic effects of PEMF on domestic pig lymphocytes were tested in vitro.Pig lymphocytes in RPMI 1640 medium were exposed to PEMFs of 100 kHz and 200 kHz for 12,24 and 48 hours.Chromosomal aberrations(aneuploidy,breaks,gaps,et al)were significantly increased in exposed cultures,and of these aberrations,56%chromosomal or chromatid breaks and 42%gaps induced by PEMFs were the points of pig chromosomal fragile sites.The baseline frequency of sister chromatid exchange(SCE)increased after exposing lymphocytes continuously to PEMFs of 100 kHz and 200 kHz for 48 hours.These results suggested that the exposure to PEMFs might induce a type of DNA lesion and chromosomal aberrations.

Inverse problem of pulsed eddy current field of ferromagnetic plates

To determine the wall thickness, conductivity and permeability of a ferromagnetic plate, an inverse problem is established with measured values and calculated values of time-domain induced voltage in pulsed eddy current testing on the plate. From time-domain analytical expressions of the partial derivatives of induced voltage with respect to parameters,it is deduced that the partial derivatives are approximately linearly dependent. Then the constraints of these parameters are obtained by solving a partial linear differential equation. It is indicated that only the product of conductivity and wall thickness, and the product of relative permeability and wall thickness can be determined accurately through the inverse problem with time-domain induced voltage. In the practical testing, supposing the conductivity of the ferromagnetic plate under test is a fixed value, and then the relative variation of wall thickness between two testing points can be calculated via the ratio of the corresponding inversion results of the product of conductivity and wall thickness. Finally, this method for wall thickness measurement is verified by the experiment results of a carbon steel plate.

High-precision chaotic radial basis function neural network model:Data forecasting for the Earth electromagnetic signal before a strong earthquake

The Earth’s natural pulse electromagnetic field data consists typically of an underlying variation tendency of intensity and irregularities.The change tendency may be related to the occurrence of earthquake disasters.Forecasting of the underlying intensity trend plays an important role in the analysis of data and disaster monitoring.Combining chaos theory and the radial basis function neural network,this paper proposes a forecasting model of the chaotic radial basis function neural network to conduct underlying intensity trend forecasting by the Earth’s natural pulse electromagnetic field signal.The main strategy of this forecasting model is to obtain parameters as the basis for optimizing the radial basis function neural network and to forecast the reconstructed Earth’s natural pulse electromagnetic field data.In verification experiments,we employ the 3 and 6 days’data of two channels as training samples to forecast the 14 and 21-day Earth’s natural pulse electromagnetic field data respectively.According to the forecasting results and absolute error results,the chaotic radial basis function forecasting model can fit the fluctuation trend of the actual signal strength,effectively reduce the forecasting error compared with the traditional radial basis function model.Hence,this network may be useful for studying the characteristics of the Earth’s natural pulse electromagnetic field signal before a strong earthquake and we hope it can contribute to the electromagnetic anomaly monitoring before the earthquake.

Microstructure Refinement of Al-5Ti-B Grain Refiner with Electromagnetic Energy

The influence of the electromagnetic energy on the microstructure of Al-5Ti-B grain reflner was discussed.In this study,the electromagnetic energy was applied above the liquid phase line temperature.Compared with Al-5Ti-B without electromagnetic energy applied,the experimental results show that the size of secondary particles is reduced and its size distribution becomes more uniform.Simultaneously,the secondary phase particles are uniformly spread in the matrix response to the electromagnetic energy.Moreover,when adding Al-5Ti-B with electromagnetic energy to the pure aluminum melt,it is clear that the electromagnetic energy has a signiflcantly impact on reflning properties of Al-5Ti-B.The mean size of pure aluminum is reduced by 27.6%in maximum with more uniform size distribution.The change in the microstructure is attributed to the electromagnetic energy changes the melt structure.With the electromagnetic energy entry into the system,the electromagnetic energy reduces the size of atomic clusters and increases the number of atomic clusters,thus the number of nuclei increases.

Clinical efficacy of electromagnetic field therapy combined with traditional Chinese pain-reducing paste in myofascial pain syndrome

BACKGROUND Pulsed electromagnetic field(PEMF)therapy is widely used to treat myofascial pain syndrome(MPS).Damp-clearing and pain-reducing paste(DPP)comprises medical herbs and has been a traditional method of reducing myofascial pain in China for a long time,and it is usually administered with heating.However,the synergistic effect of PEMF therapy on heating-DPP in patients with MPS is unclear.AIM To investigate the synergistic effect of PEMF therapy plus heating-DPP in lumbar MPS.METHODS This double-blind,randomized,placebo-controlled trial was conducted on 120 patients with lumbar MPS who were randomly divided into an experimental group(EG,n=60)and a control group(CG,n=60).Patients in both groups were treated with heating-DPP combined with PEMF therapy;however,the electromagnetic function of the therapeutic apparatus used in the CG was disabled.Each treatment lasted for 20 min and was applied five times a week for two weeks.The short-form McGill Pain Questionnaire was applied at five time points:pretest,end of the first and second weeks of treatment,and end of the first and fourth week after completing treatment.Visual analog scale(VAS),present pain intensity index(PPI),and pain rating index(PRI;total,affective pain,and sensory pain scores)scores were then analyzed.RESULTS Compared with the CG,the VAS,PPI and PRI scores(total,affective pain and sensory pain scores)in the EG were significantly lower after treatment and during follow-up.CONCLUSION PEMF therapy combined with heating-DPP showed better efficacy than heating-DPP alone in reducing the overall intensity of pain and sensory and affective pain.

Enhancing cartilage repair with optimized supramolecular hydrogel-based scaffold and pulsed electromagnetic field

Functional tissue engineering strategies provide innovative approach for the repair and regeneration of damaged cartilage.Hydrogel is widely used because it could provide rapid defect filling and proper structure support,and is biocompatible for cell aggregation and matrix deposition.Efforts have been made to seek suitable scaffolds for cartilage tissue engineering.Here Alg-DA/Ac-β-CD/gelatin hydrogel was designed with the features of physical and chemical multiple crosslinking and self-healing properties.Gelation time,swelling ratio,biodegradability and biocompatibility of the hydrogels were systematically characterized,and the injectable self-healing adhesive hydrogel were demonstrated to exhibit ideal properties for cartilage repair.Furthermore,the new hydrogel design introduces a pre-gel state before photo-crosslinking,where increased viscosity and decreased fluidity allow the gel to remain in a semi-solid condition.This granted multiple administration routes to the hydrogels,which brings hydrogels the ability to adapt to complex clinical situations.Pulsed electromagnetic fields(PEMF)have been recognized as a promising solution to various health problems owing to their noninvasive properties and therapeutic potentials.PEMF treatment offers a better clinical outcome with fewer,if any,side effects,and wildly used in musculoskeletal tissue repair.Thereby we propose PEMF as an effective biophysical stimulation to be 4th key element in cartilage tissue engineering.In this study,the as-prepared Alg-DA/Ac-β-CD/gelatin hydrogels were utilized in the rat osteochondral defect model,and the potential application of PEMF in cartilage tissue engineering were investigated.PEMF treatment were proven to enhance the quality of engineered chondrogenic constructs in vitro,and facilitate chondrogenesis and cartilage repair in vivo.All of the results suggested that with the injectable self-healing adhesive hydrogel and PEMF treatment,this newly proposed tissue engineering strategy revealed superior clinical potential for cartilage defect treatment.

Magnetic mitohormesis:A non-invasive therapy for inflammatory disorders?

An organism’s survival depends on its ability to adapt to stress.Mitochondria are the cellular integrators of environmental stressors that ultimately translate their responses at the organismal level,and are thus central to the process whereby organisms adapt to their respective environments.Mitochondria produce molecular energy via oxidative phosphorylation that then allows cells to biosynthetically respond and adapt to changes in their environment.Reactive oxygen species(ROS)are by-products of oxidative phosphorylation that can be either beneficial or damaging,depending on the context;ROS are hence both the conveyors of environmental stress as well as cellular“adaptogens”.Mitohormesis refers to the process whereby low levels of oxidative stress spur survival adaptations,whereas excessive levels stymie survival.Low energy and frequency pulsing electromagnetic fields have been recently shown capable of stimulating mitochondrial respiration and ROS production and instilling mitohormetic survival adaptations,similarly to,yet independently of,exercise,opening avenues for the future development of Magnetic Mitohormetic interventions for the improvement of human health.This viewpoint explores the possibilities and nuances of magnetic-based therapies as a form of clinical intervention to non-invasively activate magnetic mitohormesis for the management of chronic diseases.

Clinical update of pulsed electromagnetic fields on osteoporosis

Objective To understand the effects of low-frequency pulsed electromagnetic fields （PEMFs） on chronic bony pain, bone mineral density （BMD）, bone strength and biochemical markers of bone metabolism in the patients of osteoporosis. Data sources Using the key words “pulsed electromagnetic fields” and “osteoporosis”, we searched the PubMed for related studies published in English from January 1996 to December 2007. We also searched the China National Knowledge Infrastructure （CNKI） for studies published in Chinese from January 1996 to December 2007.Study selection Inclusion criteria： （1） all articles which referred to the effects of low-frequency pulsed magnetic fields on osteoporosis either in primary osteoporosis or secondary osteoporosis; （2） either observational studies or randomized controlled studies. Exclusion criteria： （1） articles on experimental studies about osteoporosis; （2） repetitive studies; （3） case reports; （4） meta analysis.Results Totally 111 related articles were collected, 101 of them were published in Chinese, 10 were in English. Thirty-four were included and the remaining 84 were excluded.Conclusions Low-frequency PEMFs relieves the pain of primary osteoporosis quickly and efficiently, enhances bone formation and increases BMD of secondary osteoporosis. But the effects of PEMFs on bone mineral density of primary osteoporosis and bone resorption were controversial.

Altered Expression of Matrix Metalloproteinases and Tight Junction Proteins in Rats following PEMF-Induced BBB Permeability Change

Objective To investigate the expression of occludin,ZO‐1,MMP‐2,and MMP‐9 in cerebral microvasculature following Pulse Electromagnetic Field（PEMF） induced BBB permeability change.Methods Sprague‐Dawley rats were randomized into PEMF and sham exposed groups（n=8）.After exposure to PEMF at 0.5,1,3,6,and 12 h,BBB permeability was measured by Evans‐Blue extravasation.The expression of occludin,ZO‐1,MMP‐2,and MMP‐9 were detected by real‐time quantitative reverse transcriptase PCR and western blotting.MMP‐2 and MMP‐9 activity were detected by EnzChek gelatinase assay.Results Compared with the sham group,PEMF exposure led to increased permeability of the BBB to EB,which was prolonged after exposure.BBB permeability became progressively more severe,and recovered at 6 h.The gene and protein expression of occludin and ZO‐1 were significantly decreased,while MMP‐2 and MMP‐9 expression were significantly increased after exposure to PEMF.All levels of expression recovered 12 h following PEMF.Conclusion Changes to BBB permeability were related to the alteration expression of tight junction proteins and matrix metalloproteinase after exposure to PEMF.

Metallurgical Applications of Pulsed Electromagnetic Field

This paper reviews the current applied research of the pulsed electromagnetic field in the metallurgical area of solidification,plastic deformation and electro-deposition.The possibilities of developing the field applications are analyzed when viewing from the processes of the metallurgy industry.It covers refining grain in the solidification process under the pulsed electromagnetic field,rolling of the thin plate deformation with the help of the electro-plastic effects by the pulsed power supplies and pulsed plating of pure metals or alloys onto the surface of the running steel strip.

Effect of electroacupuncture combined with osteoporosis treatment apparatus on bone metabolism in patients with spinal cord injury

Objective:To observe the effect of electroacupuncture combined with low-frequency pulsed electromagnetic field on bone metabolism in patients with spinal cord injury(SCI).Methods:The 60 SCI patients who met the inclusion criteria were randomly divided into 2 groups by means of a random number table.In the control group,30 patients were treated with osteoporosis treatment apparatus.In the observation group,30 patients were treated with osteoporosis treatment apparatus and electroacupuncture at the foot-shaoyangacupoints [Yánglíngquán(阳陵泉GB 34) and Xuánzhōng(悬钟GB 39) of both sides].The treatment was applied once a day,5 days a week,for 8 weeks.Before and after treatment,the changes of indexes in the two groups,including the bone mineral density(BMD),bone gla-containing protein(BGP),serum alkaline phosphatase(ALP),procollagen type I C-peptide(PICP),and 25-hydroxy-vitamin D [25(OH)D],were observed for comparison.Results:After treatment,in the two groups,the BMD and 25(OH)D indexes of the femoral neck,greater trochanter,and Ward’s triangle region were not significantly changed in comparing with those before treatment(P>0.05),while the BGP,ALP,and PICP indexes were significantly higher than those before treatment(P<0.05).After treatment,in the observation group,the BGP and ALP indexes were significantly increased in comparing with those of the control group,and the difference was statistically significant(P<0.05),whilst the BMD,PICP,and 25(OH)D indexes of the femoral neck,greater trochanter,and wards triangle region,were not significantly different in comparing with the control group(P>0.05).Conclusion:The osteoporosis treatment apparatus can improve bone metabolism in SCI patients,and the curative effect can be enhanced when combined with electroacupuncture at foot-shaoyangacupoints.

Comparison between four treatment modalities for active myofascial triggers points

Aim:The study aimed at the painful trigger points(TrPs)for the purpose of ablating muscle spasms and restoring normal muscle length to find the most effective treatment for alleviating pain and improving mouth range of motion in patients with myofascial pain dysfunction.Methods:We enrolled 72 patients with pain and reduced mouth opening due to temporomandibular joint dysfunction.Patients assigned to four groups and four treatment modalities used to treat myofascial TrPs pain.We used mean and standard deviation values.The Mann–Whitney U-test was used to compare the two groups.The Wilcoxon signed-rank test was used to study the changes by the time in mean pain scores.The Student’s t-test was used to compare maximum mouth opening(MMO)groups.Then paired t-test was also used to study the changes of time in an MMO.Results:The results showed that pulsed electromagnetic field(PEMF)therapy is the most effective treatment modality regarding for pain relief.Both the anesthesia and PEMF groups showed a reduction in mean pain scores throughout all follow-up periods,and a statistically significant increase in mean MMO.Conclusion:The findings suggest that PEMF is the most effective treatment for alleviating pain and improving mouth range of motion in patients with myofascial pain.