Value of magnetic resonance T 2 mapping in the diagnosis of early cervical disc degeneration in adolescents / 中国基层医药

Objective:To analyze the value of magnetic resonance T 2 mapping in the diagnosis of early cervical disc degeneration in adolescents. Methods Patients who underwent cervical MRI examination and magnetic resonance T 2 mapping in Wenzhou Hospital of Traditional Chinese Medicine between November 2019 and September 2020 were included in this study. They were divided into observation and control groups ( n = 50 per group) according to the time of lowering their heads (≥ 2 hours) every day. The T 2 values corresponding to the nucleus pulposus of cervical intervertebral disc in each segment was compared between the two groups. Cervical disk degeneration was graded using the Pfirrmann classification. T 2 value was compared between different Pfirrmann disc grades. The efficacy of T 2 value in the diagnosis of early cervical disc degeneration in adolescents was evaluated using the receiver operating characteristic curve. The specificity and sensitivity of T 2 value in the diagnosis of early cervical disc degeneration in adolescents and the area under the receiver operating characteristic curve were calculated. Results:T 2 value measured in each cervical intervertebral disc segment in the observation group was significantly greater than that in the control group ( t = 5.06, 4.47, 3.57, 2.93, 4.98 for C2-3, C3-4, C4-5, C5-6, C6-7 segments, all P < 0.05). In the observation group, the number of patients with Pfirrmann grade II cervical intervertebral disc degeneration was highest, accounting for 42% (21/50). There was a significant difference in cervical intervertebral disc segment T 2 value between different Pfirrmann disc grades ( t = 2.62, P = 0.018, vs. Pfirrmann disc grade I ; t = 2.12, P = 0.045, vs. Pfirrmann disc grade II; t = 2.24, P = 0.049, vs. Pfirrmann disc grade III). The higher Pfirrmann grade, the lower T 2 value of cervical intervertebral disc nucleus pulposus. The receiver operating characteristic curve showed that the sensitivity and specificity of T 2 value in the diagnosis of early cervical disc degeneration and the area under the receiver operating characteristic curve were 81.2%, 79.8% and 0.756, respectively. Conclusion:T 2 mapping imaging technology can predict early cervical intervertebral disc degeneration in adolescents by quantitatively analyzing the T 2 value of cervical intervertebral disc nucleus pulposus and has a high value in the diagnosis of cervical intervertebral disc degeneration. This achievement is of innovation and science.

Comparison of Prediction Models based on Risk Factors and Retinal Characteristics Associated with Recurrence One Year after Ischemic Stroke.

OBJECTIVES: To develop risk estimation models for 1-year ischemic stroke recurrence using clinical risk factors and retinal characteristics. METHODS: From June 2017 to January 2019, 332 patients with first-ever ischemic stroke were enrolled and followed up in the Shenzhen Traditional Chinese Medicine hospital in China. The primary endpoint was defined as fatal or recurrent stroke after 1 year of the index stroke. Clinical risk factors and retinal characteristics were identified by multivariate logistic models. RESULTS: The multivariate logistic model with only clinical risk factors showed that Cerebral Atherosclerosis (OR 1.68, 95%CI: 1.000-2.81), white matter lesions (OR 3.61, 95%CI: 2.18-5.98), and Cardiac disease (OR 1.88, 95%CI: 1.02-3.46) were statistically significantly associated with higher stroke recurrence risk. The sensitivity and specificity of this model were 69.1% and 68.4% respectively. The multivariate logistic model with only retinal characteristics showed that central retinal venule equivalent (OR .34, 95%CI: .14-.83), hemorrhage (OR .6, 95%CI: .41-.88), exudate (OR 1.64, 95%CI: 1.16-2.32), central retinal artery equivalent (OR 2.95, 95%CI: 1.23-7.08), and Aangle (OR 0.8, 95%CI: .61-1.004) were statistically significantly associated with stroke recurrence. The sensitivity and specificity of the model were 62.0% and 64.4% respectively. The multivariate logistic model with both clinical risk factors and retinal characteristics showed that cerebral atherosclerosis (OR 1.74, 95%CI: 1.020-2.981), white matter lesions (OR 3.65, 95%CI: 2.17-6.13), cardiac disease (OR 1.99, 95%CI: 1.06-3.74), hemorrhage (OR .68, 95%CI: .49-.96), exudate (OR 1.65, 95%CI: 1.16-2.36) were independent risk factors of stroke recurrence. The sensitivity and specificity of the model were 72.5% and 70.7% respectively. CONCLUSIONS: Combining the traditional risk factors of stroke with the retinal vessels characteristics to establish the recurrent cerebral infarction prediction model may improve the accuracy of the prediction.

CT features of gastric neuroendocrine neoplasm / 中华消化外科杂志

Objective:To investigate the computed tomography (CT) features of gastric neuroendocrine neoplasm (GNEN).Methods:The retrospective and descriptive method was conducted. The clinicopathological data of 30 GNEN patients who were admitted to two domestic medical centers (13 cases in Wenzhou Hospital of Traditional Chinese Medicine and 17 cases in Wenzhou People′s Hospital) from January 2010 to December 2018 were collected. There were 23 males and 7 females, aged (62±4)years, with a range from 27 to 78 years. The patients underwent abdominal CT plain scan and dynamic enhancement scan. Two associate chief radiologists with more than 20 years of work experience observed and analyzed all the images respectively. Observation indicators: (1) CT examination; (2) treatment and postoperative pathological examination; (3) follow-up. Follow-up was conducted using outpatient examination and telephone interview to detect the survival of patients up to December 2018. Measurement data with normal distribution were represented as Mean± SD. Measurement data with skewed distribution were described as M (range). Results:(1) CT examination: of the 30 patients, 14 had the tumor located in the fundus of stomach, 10 had the the tumor located in the body of stomach, and 6 had the tumor located in the antrum. The tumor was elliptical in 18 cases and irregular in 12 cases. There were 15 cases of endogenous type, 13 cases of exogenous type, and 2 cases of intramural type. Patients with G1 neuroendocrine tumor had the maximum diameter of (6.8±1.6)cm, of which 4 cases had the maximum diameter less than 5.0 cm and 4 cases had the maximum diameter of 5.0 to 10.0 cm. Patients with G2 neuroendocrine tumor had the maximum diameter of (8.3±2.7)cm, of which 1 case had the maximum diameter less than 5.0 cm, 4 cases had the maximum diameter of 5.0 to 10.0 cm, and 2 cases had the maximum diameter greater than 10.0 cm. Patients with G3 neuroendocrine carcinoma had the maximum diameter of (17.8±2.2)cm, of which 6 cases had the maximum diameter of 5.0 to 10.0 cm and 9 cases had the maximum diameter more than 10.0 cm. The tumor showed swelling growth in 14 cases and invasive growth in 16 cases. The tumor boundary was clear in 14 cases and unclear in 16 cases. CT plain scan showed homogeneous tumor density in 10 cases and heterogeneous density in 20 cases. Nine patients had iso-density in the tumor parenchymal part, and the CT value was (34.0±3.5)HU. In the 18 cases of low density, the CT value was (16.6±1.4)HU. In the 3 cases of high density, the CT value was (45.3±3.6)HU. Of the 30 patients, 21 cases had small punctate or small round necrotic cyst lesions in the tumor, 10 cases had mesenteric lymph node, peritoneum, liver metastasis and adjacent omentum invasion; 17 cases had abdominal effusion. In the CT enhancement examination, 12 cases showed mild enhancement, and the CT value was (56.5±6.3)HU; 15 cases showed moderate enhancement, and the CT value was (66.0±5.4)HU; 3 cases showed significant enhancement, and the CT value was (76.6±5.8)HU. Seven cases showed homogeneous enhancement and 23 cases had heterogeneous enhancement. There were 8 cases with tortuous vessels. (2) Treatment and postoperative pathological examination: of the 30 patients, 10 cases with mesenteric lymph nodes, peritoneum, liver metastasis and adjacent omentum invasion underwent radical total gastrectomy; 14 cases without surrounding tissue invasion or metastasis underwent radical subtotal gastrectomy; 6 cases with tumor diameter less than 4.0 cm and without surrounding tissue invasion or metastasis underwent endoscopic resection. All the 30 patients were confirmed GNEN by postoperative pathological examination, including 8 cases of G1 neuroendocrine tumor, 7 cases of G2 neuroendocrine tumor, and 15 cases of G3 neuroendocrine carcinoma. Results of immunohistochemical staining showed that 30 patients were positive for synaptophysin, 23 were positive for chromogranin A, and 9 were positive for cytokeratin. (3) Follow-up: all the 30 patients were followed up for 10-80 months, with a median follow-up time of 39 months. The 5-year survival rate of 30 patients was 43.3% (13/30). The 5-year survival rates were 6/8, 3/7 and 4/15 of patients with G1 neuroendocrine tumor, G2 neuroendocrine carcinoma, and G3 neuroendocrine carcinoma.Conclusions:GNEN has the main manifestation as abdominal pain, with G3 as pathological classification, which is common in fundus and body of stomach. The CT findings of GNEN are characterized by swelling or infiltrating growth and round or irregular low-density masses. Tumors are prone to cystic transformation, and showed the mildly to moderately heterogeneous enhancement.

Clinical observation on electroacupuncture at local points plus point injection for Bell palsy during pregnancy / 针灸推拿医学（英文版）

Objective:To observe the therapeutic effect of electroacupuncture (EA) at local points plus point injection on House-Brackmann facial nerve function classification grade (H-B) and facial disability index (FDI) in pregnant women with Bell palsy (BP). Methods:A total of 40 eligible BP patients during pregnancy were randomized into a treatment group (n=20) and a control group (n=20). The treatment group was intervened by EA at Sizhukong (TE 23), Tongziliao (GB 1), Sibai (ST 2), Quanliao (SI 18), Yifeng (TE 17), Dicang (ST 4), Jiache (ST 6) and point injection at Zusanli (ST 36) and Yanglingquan (GB 34) on the affected side, 30 min every time, 10 sessions as a course, for 2 courses in total while control group by EA with the same points, manipulation and courses as the treatment group. Results:After the treatment, the H-B classification in the treatment group was better than that in the control group, with a significant inter-group difference (P<0.05); after the treatment, the change of FDI score in the treatment group was significantly different from that in the control group (P<0.05). Conclusion:EA at local points plus point injection can produce a more significant efficacy than EA in the treatment of BP during pregnancy.

Effect of ear acupuncture plus injection at Zusanli (ST 36) on shoulder pain and cytokines after gynecologic laparoscopic surgery / 针灸推拿医学（英文版）

Objective: To explore the clinical efficacy of ear acupuncture plus injection at Zusanli (ST 36) in treating shoulder pain after laparoscopic gynecological surgery, and to observe its effect on cytokines. Methods: Two hundred patients with shoulder pain after laparoscopic gynecological surgery were randomized into two groups based on their visiting sequence, 100 cases each. The observation group was intervened by ear acupuncture plus injection at Zusanli (ST 36), and the control group was intervened by oral administration of Ibuprofen, 10 d as a treatment course. The clinical efficacies of the two groups were compared after 2 treatment courses; the visual analogue scale (VAS), present pain intensity (PPI) and 36-item short-form health survey (SF-36) were measured before and after the treatment;the changes of interleukin (IL)-6 and IL-10 after the treatment were also observed. Results: The VAS and PPI scores were significantly changed after the treatment in both groups (both P<0.01). After the treatment, the VAS score in the observation group was significantly different from that in the control group (P<0.05). The component scores of SF-36 were significantly changed after the treatment in both groups (P<0.01); after the treatment, the scores of physical functioning (PF), bodily pain (BP), social functioning (SF), and mental health (MH) in the observation group were significantly different from those in the control group (all P<0.05). The contents of IL-6 and IL-10 dropped significantly after the intervention in both groups (both P<0.01), and the between-group differences were also statistically significant (both P<0.01). The total effective rate of the observation group was higher than that of the control group (P<0.05). Conclusion: Ear acupuncture plus injection at Zusanli (ST 36) can significantly improve the shoulder pain after laparoscopic gynecological surgery, down-regulate the expressions of IL-6 and IL-10, and boost the recovery.

Therapeutic Observation of Auricular Acupuncture plus Acupoint Injection at Zusanli (ST 36) for Shoulder Pain Due to Gynecologic Laparoscopy / 上海针灸杂志

Objective To observe the clinical efficacy of auricular acupuncture plus acupoint injection at Zusanli (ST 36) in treating shoulder pain due to gynecologic laparoscopy.Method Totally 120 patients with shoulder pain due to gynecologic laparoscopy were randomized into a treatment group and a control group, 60 cases in each group. The treatment group was intervened by auricular acupuncture plus acupoint injection at Zusanli (ST 36), while the control group was by ordinary analgesics. The clinical efficacies were compared after 2 treatment courses.Result The Visual Analogue Scale (VAS) scores, Present Pain Intensity (PPI), and the item scores of the Short-Form (36) Health Survey (SF-36) were significantly changed in both groups after treatment (P0.05). The total effective rate was 95.0% in the treatment group versus 75.0% in the control group, and the difference was statistically significant (P<0.05).Conclusion Auricular acupuncture plus acupoint injection at Zusanli (ST 36) is effective in treating shoulder pain due to gynecologic laparoscopy, and it can effectively reduce the occurrence of complications.

The "regulating conception-governor vessel" acupuncture method for infertility of polycystic ovarian syndrome / 中国针灸

<p><b>OBJECTIVE</b>To compare clinical efficacy differences between"regulating conception-governor vessel" acupuncture method and clomiphene for infertility of polycystic ovarian syndrome (PCOS).</p><p><b>METHODS</b>One hundred patients of PCOS were randomly assigned into an observation group and a control group, 50 cases in each one. The patients in the observation group were treated with"regulating Conception-Governor Vessel" acupuncture method at Zhongwan (CV 12), Guanyuan (CV 4), Qihai (CV 6), Zhongji (CV 3), Mingmen (GV 4), Yaoyangguan (GV 3) and Yaoshu (GV 2). The acupuncture treatment started at the end of menstruation, once every other day; after four treatments, the follicle was tested with B ultrasound; when follicle was longer than 18 mm or above, the acupuncture treatment was given once a day until follicle was discharged and acupuncture treatment finished. The patients in the control group were treated with oral administration of clomiphene from 5 days into menstruation, 50 mg per day for 5 consecutive days. Both groups were treated for three menstruation cycle. The menstrual cycles, endometrial thickness, endometrium types (A, B and C), cervical mucus scores, basal body temperature (BBT), cases of ovulation, cases of pregnancy were observed.The levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E), prolactin (PRL), progesterone (P) and testosterone (T) in serum were detected before and after the treatment.</p><p><b>RESULTS</b>After the treatment, the menstrual cycles were shortened (both<0.05),the endometrial thickness and cervical mucus scores were increased in the two groups (<0.05,<0.01); the improvement of endometrial thickness and cervical mucus score in the observation group were higher than those in the control group (both<0.01). The percentages of type-A endometrium in both groups were higher than those before the treatment (both<0.05); the number of type-A endometrium in the observation group was higher than that in the control group (<0.05). The ovulation rate was 88.0% (44/50) in the observation group, which was superior to 70.0% (35/50) in the control group (<0.05). After treatment, the levels of LH were reduced in the two groups (<0.05,<0.01), which was more significant in the observation group (<0.05).</p><p><b>CONCLUSIONS</b>The"regulating Conception-Governor Vessel" acupuncture method could improve menstrual cycles, increase endomet-rial thickness and promote the development of follicles in PCOS patient; in addition, it could decrease serum LH level, improve the ovarian functions and increase ovulation rate, which is superior to oral administration of clomiphene.</p>

Observations on the Efficacy of Warm Needling plus Palm Pressing Spine Reduction Technique in Treating Postpartum Thoracic Facet Joint Disorder / 上海针灸杂志

Objective To investigate the clinical efficacy of warm needling plus palm pressing spine reduction technique in treating postpartum thoracic facet joint disorder.Methods Forty patients with postpartum thoracic facet joint disorder were randomly allocated to treatment and control groups, 20 cases each. The treatment group received warm needling plus palm pressing spine reduction technique and the control group, warm needling alone. The numeric pain rating scale (NPRS) score, the Oswestry Disability Index (ODI) score and the Quality of Life Scale score were recorded in the two groups before and after treatment and the clinical therapeutic effects were compared between the two groups.Results The total efficacy rate was 95.0% in the treatment group and 75.0% in the control group; there was a statistically significant difference between the two groups (P<0.01). There were statistically significant pre-/post-treatment differences in the NPRS score and the ODI score in the treatment group (P<0.01). There was a statistically significant pre-/post-treatment difference in the NPRS score in the control group (P<0.01). There were statistically significant post-treatment differences in the NPRS score and the ODI score between the treatment and control groups (P<0.01,P<0.05). There were statistically significant pre-/post-treatment differences in the SF-36 PF, RP, BP, VT, SF and MH scores in the treatment group (P<0.01,P<0.05). There were statistically significant pre-/post-treatment differences in the SF-36 PF BP, SF and MH scores in the control group (P<0.01,P<0.05).Conclusion Warm needling plus palm pressing spine reduction technique is an effective way to treat postpartum thoracic facet joint disorder.