Effectiveness of a Teach-Back Education Program on Perioperative Pain in Patients With Lung Cancer: An Intervention Study Using Behavior Change Wheel.

OBJECTIVE: To assess the effect of a teach-back educational intervention using Behavior Change Wheel (BCW) framework on perioperative pain among patients with lung cancer. METHODS: A prospective quasi-experimental study was conducted in 88 patients with lung cancer from a tertiary hospital in China. According to the order of admission, they were allocated to either control group or intervention group, with 44 patients in each group. Patients in the control group received routine nursing care, while patients in the intervention group were given a teach-back education program based on BCW framework. The visual analog scale (VAS) was adopted to evaluate patients' pain on the day of surgery (T0), 1 (T1), 2 (T2), and 3 (T3) days after surgery. We also recorded the use of patient-controlled analgesia (PCA), the length of hospital stay, and the degree of patients' satisfaction. RESULTS: Rest pain, pain when coughing, and pain during activity that patients in the intervention group experienced were significantly less severe than those in the control group on T0 and T1. The pain when coughing in the intervention group was also significantly milder on T2 and T3. In addition, the number of self-control time, use duration, and total dose of PCA were significantly lower in the intervention group. Moreover, patients' satisfaction of nursing service was significantly higher in the intervention group. CONCLUSION: A teach-back education program based on BCW framework was effective in pain management among the perioperative patients with lung cancer. This study demonstrates the application of teach-back method and the BCW in the development of patient education intervention to mitigate perioperative pain.

Effect of perioperative goal-directed fluid therapy on postoperative complications after thoracic surgery with one-lung ventilation: a systematic review and meta-analysis.

BACKGROUND: An understanding of the impact of goal-directed fluid therapy (GDFT) on the outcomes of patients undergoing one-lung ventilation (OLV) for thoracic surgery remains incomplete and controversial. This meta-analysis aimed to assess the effect of GDFT compared to other fluid therapy strategies on the incidence of postoperative complications in patients with OLV. METHODS: The Embase, Cochrane Library, Web of Science, and MEDLINE via PubMed databases were searched from their inception to November 30, 2022. Forest plots were constructed to present the results of the meta-analysis. The quality of the included studies was evaluated using the Cochrane Collaboration tool and Risk Of Bias In Non-Randomized Study of Interventions (ROBINS-I). The primary outcome was the incidence of postoperative complications. Secondary outcomes were the length of hospital stay, PaO2/FiO2 ratio, total fluid infusion, inflammatory factors (TNF-α, IL-6), and postoperative bowel function recovery time. RESULTS: A total of 1318 patients from 11 studies were included in this review. The GDFT group had a lower incidence of postoperative complications [odds ratio (OR), 0.47; 95% confidence interval (95% CI), 0.29-0.75; P = 0.002; I 2, 67%], postoperative pulmonary complications (OR 0.48, 95% CI 0.27-0.83; P = 0.009), and postoperative anastomotic leakage (OR 0.51, 95% CI 0.27-0.97; P = 0.04). The GDFT strategy reduces total fluid infusion. CONCLUSIONS: GDFT is associated with lower postoperative complications and better survival outcomes after thoracic surgery for OLV.

The remediation effects of microbial organic fertilizer on soil microorganisms after chloropicrin fumigation.

Soil fumigation with chloropicrin (CP) is an effective means of overcoming continuous cropping obstacles (CCO) in Panax notoginseng and improving its yield and quality. CP fumigation can change the microbial community of soil. Therefore, a key step after CP fumigation is the rapid restoration of soil microorganisms and the promotion of beneficial microorganism proliferation as the dominant flora. In this study, continuously cropped soil of P. notoginseng was fumigated with CP, and general organic fertilizer (GOF) or microbial organic fertilizer (MOF) was used to restore soil microorganisms after fumigation. Soil physical and chemical properties, soil microorganisms, and quality of P. notoginseng were investigated. The application of MOF and GOF after CP fumigation promoted increases in soil nitrogen (9.88% and 8.21%, respectively), phosphorus (21.39% and 11.57%, respectively), potassium (7.99% and 2.75%, respectively), and the quality of P. notoginseng; it also promoted the accumulation of saponins in the main roots (23.62% and 9.12%, respectively). Application of MOF and GOF can restore the diversity of microorganisms in the soil. MOF increased the relative abundance of the beneficial soil microorganisms Glomeromycota, Mortierellomycota, Humicola and Bacillus, thereby lowering the relative abundance of the harmful Ascomycota and Fusarium relative to GOF. In summary, CP fumigation reduces the diversity of microorganisms in the soil. The addition of organic fertilizer can promote microbial diversity and increase the relative abundance of beneficial species. Moreover, the promotion effect of MOF is better than that of GOF, thereby improving soil fertility and ultimately promoting the quality and yield of P. notoginseng.

Evaluation of Safety and Effectiveness of Catheter Ablation of Atrial Fibrillation in Patients Aged ≥80 Years.

AIMS: The prevalence and incidence of atrial fibrillation (AF) significantly increase with age. Catheter ablation is already recommended in the guidelines for this selected elderly population. This study aimed to explore the safety and effectiveness of AF catheter ablation in patients aged ≥80 years. METHODS: The data were based on the China-AF study. Patients with AF aged ≥80 years who received catheter ablation from August 2011 to December 2020 were selected. Catheter ablation included bilateral circumferential pulmonary vein antrum isolation with or without additional linear ablation. Patients were followed up every 6 months. Arrhythmia-free curves were generated using Kaplan-Meier analysis. Cox proportional hazards regression models were used to analyse the predictors for post-ablation recurrence. RESULTS: A total of 270 patients were included in the study. Many patients had comorbidities: 73.7% had hypertension and 29.3% had diabetes mellitus. All patients achieved successful bilateral circumferential pulmonary vein antrum isolation. Total complications were noted in nine of 270 (3.3%) patients and nine of 286 (3.1%) ablation procedures. After the first ablation procedure, 74% of the whole cohort-78% patients with paroxysmal AF, and 66% patients with persistent AF - were free from atrial tachyarrhythmia at follow-up to 12 months. Patients with persistent AF, longer AF duration, and history of ischaemic stroke were more likely to have AF recurrence. CONCLUSION: Patients with AF aged ≥80 years, although with many comorbidities, had low complication rates and favourable outcomes after catheter ablation. Catheter ablation was a safe and effective treatment to achieve sinus rhythm in the selected elderly patients.

Dispatched nurses' experience of wearing full gear personal protective equipment to care for COVID-19 patients in China-A descriptive qualitative study.

AIMS AND OBJECTIVES: We explored dispatched nurses' experiences of wearing full gear personal protective equipment to care for patients with coronavirus disease-2019 (COVID-19) in Wuhan, China. BACKGROUND: Full gear personal protective equipment is the primary and foremost measure to prevent the contact and transmission of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV2); however, working in full gear personal protective equipment may hinder nursing care activities and thus negatively affect patients' and nurses' health. DESIGN: This descriptive qualitative inquiry followed the COREQ guidelines. METHODS: Individual semi-structured telephone interviews were conducted in a purposive sample of 15 frontline nurses who were dispatched to the outbreak epicentre from March to April 2020. Verbatim transcripts were content analysed. RESULTS: Four themes emerged from the data: inadequate preparedness for working with full gear personal protective equipment, full gear personal protective equipment stimulated stress responses, coping strategies and professional growth. Participants learned a great deal from problem-focussed and emotion-focussed strategies to tackle challenges related to the prolonged wearing of full gear personal protective equipment for quality nursing care and reduced risk of exposure. They became more vigilant to the adherence to evolving protocols and appropriate training concerning full gear personal protective equipment use. CONCLUSIONS: Frontline nurses confronted various but diminishing challenges related to the use of full gear personal protective equipment when caring for patients with COVID-19 across the approximate 40-day period. Consistent use of coverall personal protective equipment to protect from SARS-CoV-2 in high exposure settings would be feasible if nurses were better prepared; therefore, scenario-based skill training concerning the prolonged use of full gear personal protective equipment should be offered regularly and intensively. RELEVANCE TO CLINICAL PRACTICE: This study informs future decisions concerning improved full gear personal protective equipment-related psychomotor training and promoting ways for nurses to cope with the stress that comes from working in highly contiguous environments.

A special symptom of olfactory dysfunction in coronavirus disease 2019: report of three cases.

Three patients of coronavirus disease (COVID-19) showed the symptoms of olfactory dysfunction. Clinical characteristics and treatment were retrospective analyzed. Olfactory disorders are uncommon symptoms of COVID-19 in China. Early diagnosis and intervention are keys to the recovery of olfactory disorders. Particular attention should be devoted to olfactory dysfunction.

Nuclear magnetic resonance evaluation of inflammatory activity from chronic viral Hepatitis B.

OBJECTIVES: To discuss the value of applying magnetic resonance diffusion-weighted imaging (DWI) to evaluate inflammatory activity from chronic viral hepatitis B. METHODS: One hundred forty-two patients with chronic viral hepatitis B who received treatment at The Fifth Medical Center of Chinese PLA General Hospital from January 2014 to December 2015 and 20 healthy persons in the control group who were scheduled to undergo nuclear magnetic resonance scanning and DWI examinations (b value = 0, 800 s/mm2), and the apparent diffusion coefficients (ADCs) were measured and compared with the biopsy results of hepatic tissue. RESULTS: The ADC value of the group with hepatitis B was lower than that of the healthy group (P<0.05), and the ADC value of the group with mild inflammation (G1) significantly differed from that of the group with moderate inflammation (G2) and that of the group with severe inflammation (G3-G4) (P<0.05). CONCLUSIONS: Magnetic resonance diffusion-weighted imaging technology has high clinical value for evaluating the inflammatory activity from chronic hepatitis B, and the measured ADC value corresponds to the pathological grade well, so this method is worth clinical promotion and application.

Unusual presentation of primary hyperparathyroidism: report of three cases.

BACKGROUND: Primary hyperparathyroidism is an endocrinopathic condition characterized by hypersecretion of parathyroid hormone. Excess parathyroid hormone results in an altered state of osseous metabolism involving bone resorption and tissue change known as osteitis fibrosa cystica, which is the end stage of primary hyperparathyroidism. Osteitis fibrosa cystica is associated with the development of brown tumors, which are rare because hyperparathyroidism is now usually diagnosed and treated before symptoms develop. Brown tumors are rarely the first symptom of hyperparathyroidism and can occasionally be mistaken for malignancy. CASE PRESENTATION: We herein report three cases of primary hyperparathyroidism with an unusual presentation of brown tumors. All three patients were Asian. In the first case, a 42-year-old man was admitted with a mass mimicking a malignant bone neoplasm in the right mandible as the first manifestation of primary hyperparathyroidism. The second case involved a 25-year-old man admitted with a fracture of his right femur. The third case involved a 43-year-old man with multiple brown tumors in both lower limbs. All three patients underwent successful parathyroidectomy for parathyroid adenomas; one case was complicated by a papillary thyroid carcinoma. CONCLUSION: Complete evaluation of the medical history and biochemical and radiographic findings is necessary to achieve a correct diagnosis and avoid unnecessary bone resections in patients with primary hyperparathyroidism.

Infantile Hemangioma: Clinical Characteristics and Efficacy of Treatment with the Long-Pulsed 1,064-nm Neodymium-Doped Yttrium Aluminum Garnet Laser in 794 Chinese Patients.

OBJECTIVE: This study aimed to evaluate the clinical characteristics of infantile hemangiomas (IHs) and the safety and efficacy of the long-pulse 1,064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser for definitive treatment of IHs in 794 Chinese patients. METHODS: Infants with hemangiomas who had received long-pulse 1,064-nm Nd:YAG laser treatment in our department in the last 5 years were recruited. Demographic and clinical characteristics were recorded and outcomes of long-pulse 1,064-nm Nd:YAG laser treatment were assessed. Statistical analyses were performed to identify factors that affected the efficacy of treatment. RESULTS: The efficacy of long-pulse 1,064-nm Nd:YAG laser for the treatment of IHs in all patients in our study was 87.57%. Efficacy did not depend on sex or the location of the lesion. Older age and superficial hemangioma were the primary factors contributing to greater efficacy of long-pulse 1,064-nm Nd:YAG laser treatment for IHs. The most common side effects were pigment changes, skin atrophy, and wrinkled redundant skin, which usually resolved spontaneously within 1 to 3 years. CONCLUSIONS: Long-pulse 1,064-nm Nd:YAG laser is a safe and efficacious treatment for IHs.

Comparison of diagnosis-related groups (DRG)-based hospital payment system design and implementation strategies in different countries: The case of ischemic stroke.

Diagnosis-related groups (DRG) based hospital payment systems are gradually becoming the main mechanism for reimbursement of acute inpatient care. We reviewed the existing literature to ascertain the global use of DRG-based hospital payment systems, compared the similarities and differences of original DRG versions in ten countries, and used ischemic stroke as an example to ascertain the design and implementation strategies for various DRG systems. The current challenges with and direction for the development of DRG-based hospital payment systems are also analyzed. We found that the DRG systems vary greatly in countries in terms of their purpose, grouping, coding, and payment mechanisms although based on the same classification concept and that they have tended to develop differently in countries with different income classifications. In high-income countries, DRG-based hospital payment systems have gradually begun to weaken as a mainstream payment method, while in middle-income countries DRG-based hospital payment systems have attracted increasing attention and increased use. The example of ischemic stroke provides suggestions for mutual promotion of DRG-based hospital payment systems and disease management. How to determine the level of DRG payment incentives and improve system flexibility, balance payment goals and disease management goals, and integrate development with other payment methods are areas for future research on DRG-based hospital payment systems.

Injectable Photothermal PDA/Chitosan/ß-Glycerophosphate Thermosensitive Hydrogels for Antibacterial and Wound Healing Promotion.

Controlling infections while reducing the use of antibiotics is what doctors as well as researchers are looking for. As innovative smart materials, photothermal materials can achieve localized heating under light excitation for broad-spectrum bacterial inhibition. A polydopamine/chitosan/ß-glycerophosphate temperature-sensitive hydrogel with excellent antibacterial ability is synthesized here. Initially, the hydrogel has good biocompatibility. In vitro experiments reveal its noncytotoxic property when cocultured with gingival fibroblasts and nonhemolytic capability. Concurrently, the in vivo biocompatibility is confirmed through liver and kidney blood markers and staining of key organs. Crucially, the hydrogel has excellent photothermal conversion performance, which can realize the photothermal conversion of hydrogel up to 3 mm thickness. When excited by near-infrared light, localized heating is attainable, resulting in clear inhibition impacts on both Staphylococcus aureus and Escherichia coli, with the inhibition rates of 91.22% and 96.69%, respectively. During studies on mice's infected wounds, it is observed that the hydrogel can decrease S. aureus' presence in the affected area when exposed to near-infrared light, and also lessen initial inflammation and apoptosis, hastening tissue healing. These findings provide valuable insights into the design of antibiotic-free novel biomaterials with good potential for clinical applications.

Health equity assessment of machine learning performance (HEAL): a framework and dermatology AI model case study.

Background: Artificial intelligence (AI) has repeatedly been shown to encode historical inequities in healthcare. We aimed to develop a framework to quantitatively assess the performance equity of health AI technologies and to illustrate its utility via a case study. Methods: Here, we propose a methodology to assess whether health AI technologies prioritise performance for patient populations experiencing worse outcomes, that is complementary to existing fairness metrics. We developed the Health Equity Assessment of machine Learning performance (HEAL) framework designed to quantitatively assess the performance equity of health AI technologies via a four-step interdisciplinary process to understand and quantify domain-specific criteria, and the resulting HEAL metric. As an illustrative case study (analysis conducted between October 2022 and January 2023), we applied the HEAL framework to a dermatology AI model. A set of 5420 teledermatology cases (store-and-forward cases from patients of 20 years or older, submitted from primary care providers in the USA and skin cancer clinics in Australia), enriched for diversity in age, sex and race/ethnicity, was used to retrospectively evaluate the AI model's HEAL metric, defined as the likelihood that the AI model performs better for subpopulations with worse average health outcomes as compared to others. The likelihood that AI performance was anticorrelated to pre-existing health outcomes was estimated using bootstrap methods as the probability that the negated Spearman's rank correlation coefficient (i.e., "R") was greater than zero. Positive values of R suggest that subpopulations with poorer health outcomes have better AI model performance. Thus, the HEAL metric, defined as p (R >0), measures how likely the AI technology is to prioritise performance for subpopulations with worse average health outcomes as compared to others (presented as a percentage below). Health outcomes were quantified as disability-adjusted life years (DALYs) when grouping by sex and age, and years of life lost (YLLs) when grouping by race/ethnicity. AI performance was measured as top-3 agreement with the reference diagnosis from a panel of 3 dermatologists per case. Findings: Across all dermatologic conditions, the HEAL metric was 80.5% for prioritizing AI performance of racial/ethnic subpopulations based on YLLs, and 92.1% and 0.0% respectively for prioritizing AI performance of sex and age subpopulations based on DALYs. Certain dermatologic conditions were significantly associated with greater AI model performance compared to a reference category of less common conditions. For skin cancer conditions, the HEAL metric was 73.8% for prioritizing AI performance of age subpopulations based on DALYs. Interpretation: Analysis using the proposed HEAL framework showed that the dermatology AI model prioritised performance for race/ethnicity, sex (all conditions) and age (cancer conditions) subpopulations with respect to pre-existing health disparities. More work is needed to investigate ways of promoting equitable AI performance across age for non-cancer conditions and to better understand how AI models can contribute towards improving equity in health outcomes. Funding: Google LLC.

Emergency medical rescue efforts after a major earthquake: lessons from the 2008 Wenchuan earthquake.

Major earthquakes often result in incalculable environmental damage, loss of life, and threats to health. Tremendous progress has been made in response to many medical challenges resulting from earthquakes. However, emergency medical rescue is complicated, and great emphasis should be placed on its organisation to achieve the best results. The 2008 Wenchuan earthquake was one of the most devastating disasters in the past 10 years and caused more than 370,000 casualties. The lessons learnt from the medical disaster relief effort and the subsequent knowledge gained about the regulation and capabilities of medical and military back-up teams should be widely disseminated. In this Review we summarise and analyse the emergency medical rescue efforts after the Wenchuan earthquake. Establishment of a national disaster medical response system, an active and effective commanding system, successful coordination between rescue forces and government agencies, effective treatment, a moderate, timely and correct public health response, and long-term psychological support are all crucial to reduce mortality and morbidity and promote overall effectiveness of rescue efforts after a major earthquake.

GPs in UK: From Health Gatekeepers in Primary Care to Health Agents in Primary Health Care.

After 75 years of reformed practice, general practitioners (GPs) in the UK have transformed from health gatekeepers who simply provide medical decision-making such as diagnostic and treatment services and referral services, to health agents who proactively provide more relevant health services such as immunizations, health monitoring and health management, etc. In order to discuss this transformation of the role of the general practitioner and the conditions for the evolution of the role, this study chose the documentary analysis method to provide a comprehensive overview of the legal and normative documents related to the general practitioner. Furthermore, this study uses a comparative analysis method to conclude the definition and role characteristics of GPs as health agents. This study summarises the general pattern of evolution of GPs into health agents. The transformation into a health agent relies on the interpersonal trust and rigorous institutional of society on the general practitioner system. The expansion of GPs' clientele and range of services, together with the motivation to proactively provide services, have combined to push for a "qualitative change" in the GP's role as health agent. The transformation of the role of the general practitioner to a health agent is a historical necessity. It responds to the evolution of society's understanding of health and the need for higher levels of health. Therefore, recognizing the role of GPs as health agents is important for optimizing the use of health care resources and improving the health of society by taking advantage of this role.

The Health Insurance Fund Participates in Controlling the Epidemic: Insights from German Experience in Dealing with the COVID-19 Pandemic.

To reveal the importance of the participation of the health insurance fund in the prevention and control of serious infectious diseases, this research retrospectively analyzed the case of the German statutory health insurance fund in response to the COVID-19 epidemic. Based on Germany's practical experience, this research offers a strategy idea for other countries with a social health insurance system, aiming to ensure that the health care system does not collapse rapidly due to medical resource shortage in the event of a pandemic. Firstly, this research conducted a documentary analysis to systematically collate the temporary and additional coverage measures provided by the health insurance fund from January to the end of July 2020, which sheds light on the pivotal role of these funds in epidemic prevention and control. Secondly, this research used comparative analysis to examine the time sequence of implementing these different types of coverage measures in the progression of the epidemic to illustrate how the health insurance fund adjusted its response measures. The health insurance fund was actively involved in the development of core strategies for combating the epidemic when it broke out, by taking part in joint multisectoral consultations. By using payment instruments flexibly, the fund led the implementation of epidemic prevention and control measures, as it could allocate health resources quickly and efficiently in emergencies. Furthermore, the health insurance fund played a critical role in transmitting information on the epidemic and guiding the insured to take appropriate protective measures. By fulfilling its role in health promotion, particularly in the area of health education, the fund provided important complementary and synergistic contributions to the prevention and control of the spread of infectious diseases. In summary, this research provides a new model for other countries for mobilizing a multi-sectoral response to infectious disease prevention and control, and emphasises the key role of the health insurance fund in responding to major public health crises.

Physical Exercise and Diet: Regulation of Gut Microbiota to Prevent and Treat Metabolic Disorders to Maintain Health.

Each person's body is host to a large number and variety of gut microbiota, which has been described as the second genome and plays an important role in the body's metabolic process and is closely related to health. It is common knowledge that proper physical activity and the right diet structure can keep us healthy, and in recent years, researchers have found that this boost to health may be related to the gut microbiota. Past studies have reported that physical activity and diet can modulate the compositional structure of the gut microbiota and further influence the production of key metabolites of the gut microbiota, which can be an effective way to improve body metabolism and prevent and treat related metabolic diseases. In this review, we outline the role of physical activity and diet in regulating gut microbiota and the key role that gut microbiota plays in improving metabolic disorders. In addition, we highlight the regulation of gut microbiota through appropriate physical exercise and diet to improve body metabolism and prevent metabolic diseases, aiming to promote public health and provide a new approach to treating such diseases.

Assessing the effects of China's Three-North Shelter Forest Program over 40 years.

Forests provide vital ecosystem services such as soil and water conservation, climate regulation, and carbon storage. Large-scale afforestation programs are being attempted in many countries to improve environmental conditions in deteriorated or unfavorable locations. China's Three Northern Protected Forest Program (TNSFP), accounting for 42.40 % of China's total land area, is the world's largest afforestation program to date. The TNSFP has continued providing critical ecosystem services to humans over 73 years (1978-2050) with a total investment of CNY 93.3 billion. To facilitate understanding of the TNSFP's contribution, the effects of the TNSFP for last 43 years were comprehensively evaluated by using integrated review of structured literature, bibliometric analysis, and thematic analysis. We incorporated and expanded the direct ecosystem services evidence of the TNSFP from wind and sand control, soil erosion control and carbon sequestration to indirect economic benefits, e.g. increasing crop yield and promoting economic development. We found that over the past 40 years of TNSFP construction, wind and sand hazards and soil erosion in China's Three-North areas have been effectively controlled, and forest carbon sequestration, grain production and economic output have steadily increased. The ecosystem services provided by the TNSFP are highly consistent with the thrust of the UN Sustainable Development Goals, and the TNSFP has contributed to the realization of SDG2, SDG8, SDG13, and SDG15. Although achieving tremendous ecological, economic, and social benefits, the TNSFP still has knowledge gaps in its scientific basis. And the limited local engagement and insufficient investment highly hinder the TNSFP from playing its multiple functions. We suggest several urgent actions and directions to address these limitations. This review could help researchers gain insight into key areas of ecological restoration in the TNSFP, providing a reference for future research in the TNSFP construction in China and other regions of the world embarking on similar journeys.

Successful treatment of large area oral verrucous hyperplasia using diode laser ablation combined with photodynamic therapy: A case report.

Oral verrucous hyperplasia (OVH) refers to a whitish or pink elevated plaque or mass on the oral mucosa with either verrucous or papillary surface. Given its potential of malignant transformation, it is crucial to pursue aggressive treatment and close surveillance to the lesion. Herein, we present a case of a 43-year-old male patient with large area OVH on the left buccal mucosa who was successfully treated using diode laser ablation combined with 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT). After two sessions of treatment, the lesions regressed completely, and no recurrence was observed at the 18-month follow-up. Therefore, diode laser ablation combined with ALA-PDT may be an efficient and safe treatment modality for large area OVH.

[Interactive scalp acupuncture for hemiplegic upper extremity motor dysfunction in patients with ischemic stroke: a randomized controlled trial].

OBJECTIVE: To compare the curative effect between interactive scalp acupuncture and traditional scalp acupuncture on hemiplegic upper extremity motor dysfunction in the patients with ischemic stroke. METHODS: Seventy cases of hemiplegic upper extremity motor dysfunction of ischemic stroke were randomly divided into an interactive scalp acupuncture group (35 cases, 1 case breaked off) and a traditional scalp acupuncture group (35 cases, 1 case dropped off). The patients of the two groups received the secondary prevention medication and routine rehabilitation therapy. Besides, in the interactive scalp acupuncture group, the upper extremity occupational therapy was operated during the needle retaining of scalp acupuncture; and in the traditional scalp acupuncture group, the upper extremity occupational therapy was delivered after the completion of scalp acupuncture. The same points were selected in the two groups such as Fuxiang head area, Fuxiang upper-limb-shoulder point, Fuxiang upper-limb-elbow point and Fuxiang upper-limb-wrist point. The needles were inserted perpendicularly by flying-needle technique and manipulated by triple technique of gentle twisting, heavy pressure and vibrating. The needles were retained for 30 min. Based on the degree of the upper extremity motor impairment, the regimen of the upper extremity occupational therapy was formulated individually and one treatment took 30 min. In the two groups, the therapies were delivered once daily, 5 times a week, lasting 4 weeks. Before and after treatment, the scores of Fugl-Meyer assessment of upper extremity (FMA-UE), Wolf motor function test (WMFT), the modified Barthel index (MBI) and the modified Ashworth scale (MAS) grade in the two groups were observed before and after treatment. RESULTS: After treatment, the scores of FMA-UE, WMFT and MBI were higher than those before treatment (P<0.01), and MAS grade was improved (P<0.05) in the two groups. The scores of FMA-UE, WMFT and MBI in the interactive scalp acupuncture group were higher than those in the traditional scalp acupuncture group (P<0.01, P<0.05), and there was no statistical significance in the difference of MAS grade between the two groups (P>0.05). CONCLUSION: The interactive scalp acupuncture can effectively improve the motor function of the hemiplegic upper extremities and the activities of daily living in the patients with ischemic stroke and its efficacy is better than traditional scalp acupuncture. But these two types of scalp acupuncture obtain the similar effect on spasticity.