Polymer Testing 101 (2021) 107298

Contents lists available at ScienceDirect

Polymer Testing
journal homepage: www.elsevier.com/locate/polytest

Progress in absorbable polymeric thread used as acupoint

embedding material
Jinrong Zhao, Mingming Wang, Jun Xu, Ying Yang *
The People’s Hospital of Suzhou New District, Suzhou, 215129, Jiangsu, China

A R T I C L E I N F O A B S T R A C T

Keywords: Acupoint embedding therapy is a treatment that embeds absorbable thread into target acupoints, so as to provide
Acupoint embedding continuous stimulation to acupoints and to replace retained acupuncture. Many types of absorbable threads are
Threads available and generally can be divided into natural and synthetic polymers according to the source of material.
Review
According to the literature, the threads currently used in acupoint embedding have some limitations, and may
cause side effects in clinical practice. Bioactive threads may be used to further reduce side effects and promote
application of acupoint embedding.

Acupoint embedding therapy embeds absorbable thread into target
acupoints and the embedded thread can continuously stimulate the
acupuncture point, thus avoiding retained acupuncture [1]. This treat­
ment is related to tissue therapy, intradermal acupuncture therapy, and
hypodermic acupuncture therapy [2]. It arose on the basis of tissue
embedding therapy and acupuncture. “Suwen - Lihe Zhenxie Lun” states
that “acupuncture with static and longer needle-retaining time”;
“Zhenjiu Dacheng” also reads: “retaining acupuncture to treat stagnant
diseases”, which means that after needling sensation (de qi), the reten­
tion time of the needle can be appropriately extended. Acupoint
embedding therapy may not only work as short-term acupuncture to
dredge meridian, but also exert long-term stimulation on acupoints.
Due to foreign body reaction caused by the thread, acupoint
embeding may be complicated by clinical side effects such as allergy,
nodule, fever, infection, pain, thread dispelling and secondary symp­
toms [3,4]. Therefore, in order to successfully embed thread at acu­
points, optimal thread material is essential in reducing side effects.
Embedding threads commonly used in clinical practice and bioactive
threads that may be considered for acupoint embedding are reviewed
here. A brief summary of studies on different embedding threads is given
in Table 1.
1. Common embedding threads
1.1. Natural materials
1.1.1. Collagen thread
This category mainly includes sheep catgut and other collagen
threads extracted from specific animal tendon through enzyme digestion
and other processes. In clinical practice, sheep catgut is most commonly
used and has a relatively long application history. It is a thread made of
collagen from the mucosa of sheep’s small intestine, and both plain and
chromic catguts are available. However, at present plain catgut is rarely
used in China because of its high immunogenicity and poor flexibility.
Therefore, in order to reduce tissue inflammatory reaction, catgut is
usually treated with chromic acid to obtain chromic catgut [5].
When acupoint embedding therapy was first introduced into clinical
practice in the 1970s, catgut was widely used as embedding material
because of its relatively low price. However, due to its organic protein
nature, patients’ body may experience rejection and allergic reaction to
this foreign protein, therefore symptoms such as increased temperature,
redness, rash, and itching may occur at the embedding site [6]. In
addition, due to differences in individual patient’ body state, disease and
local blood supply, nodules, cyst or mass may be observed at the
embedding site in some patients [7–10]. Therefore, although catgut is
widely used and has lower price, due to its relatively frequent side ef­
fects, and in order to promote the implementation of the standard
operating procedure of the Chinese national standard for acupoint
embedding, it is not recommended to continue using catgut for acupoint

* Corresponding author.
E-mail address: 342940190@qq.com (Y. Yang).

https://doi.org/10.1016/j.polymertesting.2021.107298
Received 21 May 2021; Received in revised form 9 July 2021; Accepted 13 July 2021
Available online 14 July 2021
0142-9418/© 2021 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/by-nc-nd/4.0/).
J. Zhao et al. Polymer Testing 101 (2021) 107298

Table 1 1.1.2. Chitosan thread

Studies on different embedding materials. Chitosan is a polyglucosamine obtained by deacetylating chitin [13].
Author Material Subjects Findings Chitin is widely present in higher fungi and the shell of shrimp, crabs,
insects, etc. In the natural environment. It is abundant and the second
Zhang Catgut 4 cases Increased
et al. temperature, largest nitrogen-containing natural organic polymer after protein. Chi­
[6] redness, rash, and tosan molecule has good biocompatibility and biodegradability, and is
itching widely used for biomedical material such as absorbable suture,
Wu Medicated catgut vs 132 adolescents with Superior to oral TCM anti-adhesion material, artificial ligament, bone and skin, medical
et al. TCM constipation
[12]
dressing, sustained-release agent, etc. Chitosan can be catabolized by
Wang Medicated chitosan 86 patients with Chitosan thread is enzymes into glycoproteins and carbon dioxide in human body [14]. It
et al. thread vs catgut lumbar spinal stenosis superior to catgut in has no immunogenicity, can stimulate immune system and activate
[15] terms of efficacy and macrophages, and can exert a broad-spectrum antibacterial effect by
safety.
destroying the cell wall of bacteria.
Liu [21] PLGA vs catgut 150 patients with PLGA causes less side
various diseases effects. Wang et al. [15] compared medicated chitosan thread with catgut in
Tang PLGA vs catgut 125 obese patients PLGA causes less side the acupoint embedding of lumbar spinal stenosis. 86 patients with
et al. effects. lumbar spinal stenosis were randomized into chitosan thread group and
[22] sheep catgut group. The recovery rates of the chitosan thread group and
Pan PLGA vs catgut 60 obese patients PLGA causes less side
[23] effects.
the sheep catgut group were 95.3% and 88.4%, respectively. The chi­
Chen PLGA vs catgut 50 obese patients PLGA causes less side tosan group had much less side effects such as skin redness, cutaneous
[24] effects. infection, and thread expelling. The chitosan thread is superior to the
Sun PLGA embedding vs 90 patients with PLGA embedding catgut in terms of both efficacy and safety. Moreover, Wang et al. [16]
et al. acupuncture cervicalspondylotic shows better efficacy
developed a new natural composite thread. From inside out, there are
[25] radiculopathy
Zheng PLGA embedding vs 86 obese patients PLGA embedding three layers, i.e. chitosan fiber core, a collagen layer, and a carbox­
et al. electro- shows better efficacy ymethyl chitosan layer, with a thickness ratio of 2: x: (3-x), wherein 1 <
[26] acupuncture x < 3. This design combines the high biocompatibility of collagen thread
Ding Conventional 279 patients with Acupoint embedding and good antibacterial effect of chitosan and carboxymethyl chitosan,
et al. acupuncture vs intractable facial is superior to
and also avoids fast degradation of collagen thread, so as to prolong the
[29] catgut embedding paralysis acupuncture, and
vs PDS embedding catgut embedding thread embedding effect. The rationale behind this design is a good
and PDS embedding example to learn from and shows promise in future clinical use.
showed the same
efficacy.
1.2. Synthetic polymer thread
Feng PDS vs catgut 92 patients with PDS causes less side
et al. cervical spondylosis effects.
[30] 1.2.1. Polylactic acid-glycolic acid thread
Feng PDS embedding vs 360 patients PDS causes less side Polylactic acid-glycolic acid (PLGA) is a copolymer of lactic acid (LA)
et al. catgut embedding cervicalspondylotic effects than catgut. and glycolic acid (GA). It has been widely used in biomedical engi­
[31] vs acupuncture radiculopathy
Ding PDS vs catgut 186 patients with PDS causes less side
neering, such as sustained-release system, bioabsorbable suture, built-in
et al. intractable facial effects than catgut. isolation material, orthopedic fixation and tissue repair material, etc.
[32] paralysis [17,18] The glycolic acid and lactic acid required for preparing PLGA
Ren Catgut vs silver- 40 healthy adults PLGA and silver- are extracted mainly from plants such as corn and sugar beet, and then
et al. coated PLGA vs coated PLGA threads
processed [19]. The metabolic degradation of PLGA in the human body
[41] PLGA cause less rejection
than catgut. is mainly through the hydrolysis of ester bonds and generates small LA
and GA molecules. Through the tricarboxylic acid cycle, LA can be
metabolized into CO2 and water, which are subsequently excreted. GA
embedding treatment. can be hydrolyzed into glycolic acid, which can be directly excreted into
On the other hand, researchers developed medicinal catgut using urine, or metabolized into normal human metabolites such as CO2,
conventional medicinal catgut and traditional Chinese medicine pre­ glycine or pyruvate [20]. As compared to polylactic acid, an advantage
scriptions. By combining sheep catgut with prescriptions, Ren [11] of PLGA is flexible segment of polyglycolic acid, which enhances both
developed 4 types of patented drug catguts to handle different syn­ the hydrophilicity of polylactic acid and its degradation rate. By
dromes: No. 1 catgut is for clearing heat and resuscitation; No. 2 is for adjusting the ratios of polylactic acid and polyglycolic acid, the degra­
activating blood circulation and removing blood stasis; No. 3 is for dation and absorption rate of PLGA may be adjusted to weeks or months.
invigorating qi and blood; No. 4 is for nourishing yin and reinforcing Therefore, PLGA is a biodegradable polymer with high biocompatibility
kidney. According to patients’ syndrome, different catgut may be and largely adjustable degradation rate [20].
selected. Wu et al. [12] prepared a medicated sheep catgut by soaking Clinical studies compared the efficacy and side effects of PLGA
sheep catgut in a traditional Chinese medicine decoction for con­ thread, as shown in Fig. 1 and sheep catgut and found that although
stipation for over 30 days, and used it for acupoint embedding to treat there was no significant difference in efficacy between PLGA thread and
functional constipation among adolescent patients (medicated catgut sheep catgut, the PLGA group had much less adverse events than the
group). The control group received oral Maren Runchang Pill. Results catgut group, e.g. tenderness, redness, induration, mild fever, allergy,
showed that the catgut group had better short-term (3 months after etc. [21–24].
treatment) and long-term (6 months after treatment) efficacy than the A clinical observation by Sun [25] compared PLGA acupoint
control group, and the effect in the catgut group also lasted longer. embedding and acupuncture in the treatment of cervicalspondylotic
Although there have been scarce clinical study on the incidence of side radiculopathy. After treatment, the PLGA embedding group reached
effects caused by medicated catgut, the clinical application of medicated significantly better total PRI, VAS and PPI scores than the acupuncture
catgut according to syndromes provides insight into the development group, indicating that the PLGA embedding group had better efficacy
and application of thread embedding therapy with dual-effect of than the acupuncture group. Zheng et al. [26] compared the clinical
acupuncture and medication. efficacy of PLGA acupoint embedding and electro-acupuncture among
patients with simple obesity. After 2 months of treatment, the overall

2
J. Zhao et al.
Fig. 1. PLGA acupoint embedding.
response rates of the embedding group and the electro-acupuncture
group were 93.0% and 88.4%, respectively. There was no statistical
difference. However, a follow-up six months later found that waist
circumference and BMI index of the embedding group were significantly
better than those of the electro-acupuncture group, demonstrating that
the clinical efficacy of PLGA acupoint embedding is better than
electro-acupuncture.
1.2.2. Polydioxanone thread
Polydioxanone (PDS) fiber is prepared by ring-opening polymeriza­
tion of p-dioxanone (poly-p-dioxanone) [27]. It has extremely high
biocompatibility, hydrophobicity, flexibility, strength, toughness and
impact resistance. An in vitro degradation experiment by Kimura et al.
[28] showed that PDS took about 180 days to degrade, and may
compensate fast degradation of catgut.
Ding et al. [29] compared the clinical efficacy of conventional
acupuncture, catgut embedding, and PDS thread embedding in the
treatment of refractory facial paralysis. The results showed that all three
interventions achieved clinical response. Acupoint embedding was su­
perior to acupuncture, whereas there is no significant difference in
clinical efficacy between catgut embedding and PDS embedding. Feng
et al. [30] did a comparative study among 92 patients with cervical
spondylosis. Jiaji acupoints on both sides of the cervical spine
(C3/C5/C7, in total 6 acupoints per patient) were chosen. Among them,
3 acupoints on the left received PDS thread embedding, and 3 acupoints
on the right received catgut embedding. Both groups experienced side
effects such as tenderness, induration, redness and swelling immediately
after embedding treatment, and there was no statistical difference. The
catgut group experienced significantly more adverse events than the
PDS thread group 1 week and 2 weeks after treatment, including
tenderness, induration, redness and swelling. Feng et al. [31] and Ding
et al. [32] also confirmed that the incidence of adverse events of PDS
thread is lower than that of sheep catgut through multiple clinical ob­
servations, and it is an excellent implant.
As synthetic polymer absorbable threads, both PLGA and PDS
threads have adjustable degradation rate and good biocompatibility.
Moreover, acupoint embedding therapy has better clinical efficacy than
conventional acupuncture and electro-acupuncture. While maintaining
the same efficacy as traditional catgut, PLGA and PDS threads effectively
reduce or avoid side effects in acupoint embedding therapy. They have
certain clinical advantages over currently used natural embedding
threads. Nevertheless, all the threads described above may cause some
side effects in clinical use, which also limit widespread clinical appli­
cation of acupoint thread-embedding to certain degree. Since almost all
embedding threads originated from surgical absorbable threads,
3
Polymer Testing 101 (2021) 107298
bioactive threads that have wide surgical application and fewer side
effects may be candidates for embedding thread.
2. Bioactive threads
2.1. Antibacterial thread
2.1.1. Antimicrobial coated thread
This category mainly involves adding antibacterial agents to the
material or the thread during the preparation of the absorbable thread,
in an attempt to avoid or prevent postoperative infection. Triclosan
coated absorbable thread has been relatively well studied.
Due to its antibacterial effect and low toxicity to human body, tri­
closan has been used in a variety of commercial products, such as soap,
shower gel and toothpaste [33]. Multiple in vivo studies of triclosan
coated thread have shown that, without compromising the mechanical
strength of the suture, the bacterial colonies around the infected site
were significantly reduced, proving its antibacterial effect [34,35].
However, because triclosan can be absorbed by the human body, this has
raised patients’ concern about its adverse health effects. Furthermore,
although triclosan can inhibit the growth of bacteria, it cannot kill
existing bacteria. Therefore, researchers turned their eyes to antimi­
crobial peptides with broad-spectrum bactericidal effect. Studies of the
effectiveness of a new antibacterial thread coated with poly [(amino­
ethyl methacrylate)-co-(butyl methacrylate)] (PAMBM) showed that
PAMBM coated thread had significant bactericidal activity and could
quickly kill Staphylococcus aureus [36,37]. In addition, researchers have
developed a nanofiber thread that may induce endogenous antimicro­
bial peptides: an absorbable thread containing 25-hydroxyvitamin D3
and pam3CSK4 peptide is prepared through coaxial electrostatic depo­
sition and rolling process. pam3CSK4 can activate cellular toll-like re­
ceptors. Once activated, toll-like receptors induce a specific enzyme to
convert 25D3 into 1,25-dihydroxyvitamin D3, which in turn activates
vitamin D receptors. As the activity of vitamin D receptor increases, the
expression of its target gene increases, thus inducing the production of
antimicrobial peptide hCAP18/LL37, which kills microorganisms by
destroying the bacterial cell wall [38]. In the practice of acupoint
embedding, in addition to strict aseptic procedure, using antimicrobial
coated thread may largely reduce the incidence of infection at the
embedding site.
2.1.2. Silver nanoparticle thread
Polymer medical devices coated or impregnated with silver nano­
particle have wide antibacterial spectrum [39], which may provide an
insight into the development of antibacterial threads. Silver
J. Zhao et al.
nanoparticle is a natural and environment friendly non-antibiotic anti­
microbial. Because of its anti-inflammatory effect [40], in addition to
acupoint embedding effect as with other threads, it also has the medical
effect of silver itself. It can effectively promote tissue repair and
regeneration, and can eliminate human body rejection and allergic
reaction.
Ren et al. [41] investigated the difference between acupoint
embedded catgut, silver-coated PLGA thread and PLGA thread on
infrared thermogram using AGA782 infrared camera and TC-800 com­
puter. In the first 5 d after embedding, skin temperature of the sites
embedded with these three threads increased. Thereafter, the temper­
ature trends of three threads varied significantly. The catgut group
maintained high temperature, peaked on day 7 and then gradually
decreased. The temperature of the PLGA thread group gradually
returned to the baseline level before embedding, and after the first 5
days, the temperature of the silver-coated PLGA thread group decreased
continuously to the baseline level before embedding. It can be assumed
that PLGA and silver-coated PLGA threads cause less rejection in human
body than catgut. Moreover, besides all the advantages of PLGA thread,
silver-coated PLGA thread also has significant sterilization and
anti-inflammatory effects. It is a new medical material with promising
clinical application. However, one concern is that this material is rela­
tively expensive and thus may not be accepted by the general
population.
2.2. Sustained-release thread
Researchers developed a thread with a controllable degrading rate
and capable of releasing drug [42]. It is produced from monofilament or
multifilament spun from the spinning solution, which are chitin, chito­
san and/or their derivatives, as well as their corresponding lytic en­
zymes. One characteristic is that the lytic enzymes scatter on the surface
and inside of the monofilament or multifilament. A composite ultrafine
fiber with at least one ultrafine fiber taking the form of a core-shell
structure is prepared from multiple ultrafine spun fibers through coax­
ial co-spinning technology and post-processing. The core material con­
tains bioactive ingredients and the shell is biodegradable. The
biologically active ingredients can be antibacterial and
anti-inflammatory drugs, anti-cancer drugs, analgesics, growth factors,
anticoagulants, and/or coagulants. In acupoint embedding, according to
patients’ condition, by controlling the degradation rate of the thread and
adding different sustained-release drugs, both acupuncture and medi­
cation may be achieved by a single therapy, on which further clinical
researches are granted.
3. Conclusion
In summary, acupoint embedding therapy is widely used in clinical
practice because of its well-known efficacy and safety. Since both the
material and prescription of thread-embedding therapy are controllable,
and there is no need to attend to ever changing techniques [16], it may
facilitate the regulation and standardization of acupuncture research. To
facilitate the application of thread embedding therapy, the thread ma­
terial should be harmless to the body; foreign organic protein should be
avoided; stimulation intensity and time should be adjustable; and the
thread should be easy to store and use [16]. Among the threads
described above, catgut is not a good choice because it contains foreign
organic protein and may trigger intense rejection. Chitosan threads have
a broad-spectrum antibacterial effect, but till now preparing dedicated
embedding thread with chitosan has not been well studied. Researches
on combining it with collagen and synthetic polymers to develop new
embedding thread are promising.
As synthetic polymer threads, PLGA and PDS have good strength,
biocompatibility and controllable degradation rate, and they are better
choices for embedding thread. Additionally, bioactive threads coated
with antimicrobial, coated or impregnated with silver nanoparticle, and
4
Polymer Testing 101 (2021) 107298
with sustained-release drug also provide insight into selection and
development of embedding threads. As new biomedical thread materials
become available, the clinical application of acupoint thread embedding
holds a promising future.
Author statement
Ying Yang: conceived and performed the manuscript. Jinrong Zhao
and Mingming Wang wrote the manuscript and are the co-first authors.
Jun Xu: contributed equally to this work.
Declaration of competing interest
The authors declare that they have no known competing financial
interests or personal relationships that could have appeared to influence
the work reported in this paper.
References
[1] Natcm, Gb/t21709.10-2008: Standardized Manipulations of Acupuncture and
Moxibustion, 2009. Part 10: thread-embedding therapy.
[2] X.Y. Wu, G.Z. Chen, Y.T. Li, Y.X. Xu, The key issues and corresponding strategy of
acupoint medicated catgut embedding therapy, Zhongguo zhen jiu= Chinese
acupuncture & moxibustion 39 (2019) 81–85.
[3] X.L. Wang, G.H. Lin, N. Xu, J.C. Zeng, D.H. Xu, S.X. Wang, Analysis of adverse
reactions of acupoint catgut embedding therapy, Zhongguo zhen jiu= Chinese
acupuncture & moxibustion 40 (2020) 193–196.
[4] J. Liu, T. Xu, J. Liang, S. Zhao, T. Wu, S. Su, R. Yan, Adverse reactions of acupoint
embedding and its treatment, Zhongguo zhen jiu= Chinese acupuncture &
moxibustion 36 (2016) 1166–1168.
[5] Y. Hu, Overview and degradation researches on non-absorbable surgical sutures,
China Medical Device Information 25 (2019) 53–54+168.
[6] W. Zhang, L. Yang, T. Jixiang, Rejection reactions after acupoint embedding with
chromic catgut: case report and discussion, Zhongguo zhen jiu= Chinese
acupuncture & moxibustion 35 (2015) 372–374.
[7] A. Bharathi, D.D. Reddy, G.S. Kote, A prospective randomized comparative study of
vicryl rapide versus chromic catgut for episiotomy repair, J. Clin. Diagn. Res.: J.
Clin. Diagn. Res. 7 (2013) 326.
[8] J.A. Greenberg, E. Lieberman, A.P. Cohen, J.L. Ecker, Randomized comparison of
chromic versus fast-absorbing polyglactin 910 for postpartum perineal repair,
Obstet. Gynecol. 103 (2004) 1308–1313.
[9] T. Hugh, M. Kelly, Endoscopic extraction of a calculous bile duct cast formed on a
nidus of chromic catgut, Aust. N. Z. J. Surg. 62 (1992) 975.
[10] M. Walton, Strength retention of chromic gut and synthetic absorbable sutures in a
nonhealing synovial wound, Clin. Orthop. Relat. Res. (1991) 294–298.
[11] X. Ren, Introduction to origin and mechanism of acupoint embedding, China J
Traditional Chinese Med Pharm 19 (2004) 757–759.
[12] W. Wu, M. Lei, H. Zhu, Efficacy of acupoint embedding with medicated thread to
treat functional constipation among 132 adolescent cases, J New Chinese Med 43
(2011) 98–99.
[13] S. Kou, L. Peters, M. Mucalo, Chitosan: a review of sources and preparation
methods, Int. J. Biol. Macromol. 169 (2020) 85–94.
[14] D. Raafat, H.G. Sahl, Chitosan and its antimicrobial potential–a critical literature
survey, Microbial biotechnology 2 (2009) 186–201.
[15] J. Wang, W. Qu, Clinical study on treatment of lumbar spinal stenosis by acupoint
embedding with chitosan thread treated with traditional Chinese medicine and
discussion on its rationale, J Hebei Traditional Chinese Med Pharm 30 (2015)
49–51.
[16] D. Wang, R. Wang, Development of a novel controllable degradable surgical suture,
Letters in Biotechnology 24 (2013) 702–704.
[17] J. Reinbold, A.K. Uhde, I. Müller, T. Weindl, J. Geis-Gerstorfer, C. Schlensak, H.
P. Wendel, S. Krajewski, Preventing surgical site infections using a natural,
biodegradable, antibacterial coating on surgical sutures, Molecules 22 (2017)
1570.
[18] F.A. Sheikh, H.W. Ju, B.M. Moon, O.J. Lee, J.H. Kim, H.J. Park, D.W. Kim, D.
K. Kim, J.E. Jang, G. Khang, et al., Hybrid scaffolds based on plga and silk for bone
tissue engineering, Journal of tissue engineering and regenerative medicine 10
(2016) 209–221.
[19] W. Sun, Z. Tan, A novel biomedical material for microinjection acupuncture
application, Shanghai Journal of Acupuncture and Moxibustion 29 (2010)
131–132.
[20] J. Sun, W. He, Study on relationship of biodegradable properties of pgla film in
vivo and in vitro, Sheng wu yi xue gong cheng xue za zhi= Journal of biomedical
engineering 21 (2004) 717–720.
[21] H. Liu, Clinical comparison of poly-lactic-co-glycolic acid new catgut embedding
material and catgut, J. Clin. Rehabilitative Tissue Eng. Res. 16 (2012) 7185–7192.
[22] Q. Tang, H. Cai, Observational study on treating simple obesity by embedding
different threads through minimally invasive procedure, Jiangsu J Traditional
Chinese Med 45 (2013) 45–46.
J. Zhao et al.
[23] Y. Pan, Efficacy and Safety of Simple Obesity Treatment by Acupoint Embedding
with Different Threads, Ph.D. thesis. Guangzhou University of Chinese Medicine,
2015.
[24] L. Chen, Efficacy Comparison and Safety Evaluation of Simple Obesity Treatment
by Acupoint Embedding with Different Threads, Ph.D. thesis. Nanjing University of
Chinese Medicine, 2014.
[25] W. Sun, Y. Wang, W. Lu, Pgla embedding for the treatment of cervical spondylosis
of nerve root type, J Clinical Acupuncture and Moxibustion 29 (2013) 43–45.
[26] X. Zheng, H. Ji, L. Nie, X. Zhu, Therapeutic observation of acupoint embedding
with pgla thread for simple obesity, Shanghai JAcupuncture and Moxibustion 37
(2018) 391–394.
[27] S. Kim, H. Yang, T.K. Kim, J.Y. Jeong, C. Shin, S.H. Oh, In vitro and in vivo
biocompatibility and degradability evaluation of modified polydioxanone plate,
J. Craniofac. Surg. 31 (2020) 2059–2062.
[28] S. Kimura, K. Yasuda, N. Hara, T. Sakai, S. Mikami, A. Minami, H. Tohyama,
Implantation sites and fiber diameters affect the rate of degradation in absorbable
polydioxanone fibers, Arthrosc. J. Arthrosc. Relat. Surg. 19 (2003) 68–74.
[29] M. Ding, H. Feng, C. Jin, L. Xu, T. Lin, Intractable facial paralysis treated with
different acupuncture and acupoint embedding therapies: a randomized controlled
trial, Chin. Acupunct. Moxibustion 35 (2015) 997–1000.
[30] H. Feng, Y. Jiang, M. Ding, T. Lin, Comparative study on adverse effects on patients
with cervical spondylosis with embedding by different materials, J Nanjing Univ
Traditional Chinese Med 28 (2012) 484–486.
[31] H. Feng, M. Ding, Y. Jiang, T. Lin, Efficacy and safety study on treatment of
cervical spondylotic radiculopathy through minimally invasive thread embedding,
Jiangsu JTraditional Chinese Med 44 (2012) 59–60.
[32] M. Ding, H. Feng, T. Lin, Clinical observation of micro-invasive thread embedding
with different materials for chronic facial paralysis, Shanghai J Acupuncture
Moxibustion 34 (2015) 1183–1185.
Polymer Testing 101 (2021) 107298
[33] H.P. Schweizer, Triclosan: a widely used biocide and its link to antibiotics, FEMS
Microbiol. Lett. 202 (2001) 1–7.
[34] M.L. Storch, S.J. Rothenburger, G. Jacinto, Experimental efficacy study of coated
vicryl plus antibacterial suture in Guinea pigs challenged with staphylococcus
aureus, Surg. Infect. 5 (2004) 281–288.
[35] A. Gomez-Alonso, F. Garcia-Criado, F. Parreno-Manchado, J. Garcia-Sanchez,
E. Garcia-Sanchez, A. Parreno-Manchado, Y. Zambrano-Cuadrado, Study of the
efficacy of coated vicryl plus® antibacterial suture (coated polyglactin 910 suture
with triclosan) in two animal models of general surgery, J. Infect. 54 (2007) 82–88.
[36] M.N. Melo, R. Ferre, M.A. Castanho, Antimicrobial peptides: linking partition,
activity and high membrane-bound concentrations, Nat. Rev. Microbiol. 7 (2009)
245–250.
[37] M. Zasloff, Antimicrobial peptides of multicellular organisms, Nature 415 (2002)
389–395.
[38] S. Chen, L. Ge, A.F. Gombart, F.D. Shuler, M.A. Carlson, D.A. Reilly, J. Xie,
Nanofiber-based sutures induce endogenous antimicrobial peptide, Nanomedicine
12 (2017) 2597–2609.
[39] F. Furno, K.S. Morley, B. Wong, B.L. Sharp, P.L. Arnold, S.M. Howdle, R. Bayston,
P.D. Brown, P.D. Winship, H.J. Reid, Silver nanoparticles and polymeric medical
devices: a new approach to prevention of infection? J. Antimicrob. Chemother. 54
(2004) 1019–1024.
[40] X. Dai, X. Xu, Z. Chen, C. Zhang, X. Pei, Observation on microbicidal efficacy of
silver nanoparticles aqueous solution to bacteriophages and bacteria, Chinese
Journal of Disinfection 25 (2008) 242–244.
[41] X. Ren, S. Zhou, H. Li, Study on the difference between silver nanoparticle coated
thread and catgut embedded at acupoints in infrared thermogram, J Beijing Univ
Traditional Chinese Med (Clinical Medicine) (2009) 24–25.
[42] P. Shen, A Biodegradable Suture with Bioactivity, 2015. CN201310603436.5[P].