Tongue diagnosis index of chronic kidney disease.

BACKGROUND: To apply non-invasive Automatic Tongue Diagnosis System (ATDS) in analyzing tongue features in patients with chronic kidney disease (CKD). METHODS: This was a cross-sectional, case-controlled observational study. Patients with CKD who met the inclusion and exclusion criteria were enrolled and divided into the following groups according to renal function and dialysis status: non-dialysis CKD group; end-stage renal disease (ESRD) group; and control group. Tongue images were captured and eight tongue features-shape, color, fur thickness, saliva, fissure, ecchymosis, teeth marks, and red dots-were imaged and analyzed by ATDS. RESULTS: 117 participants (57 men, 60 women) were enrolled in the study, which included 16 in control group, 38 in non-dialysis CKD group, and 63 in ESRD group. We demonstrated significant differences in the fur thickness (p = 0.045), color (p = 0.005), amounts of ecchymosis (p = 0.010), teeth marks (p = 0.016), and red dot (p < 0.001) among three groups. The areas under receiver operating characteristic curve for the amount of ecchymosis was 0.757 ± 0.055 (95% confidence interval, 0.648-0866; p < 0.001). Additionally, with increase in ecchymosis by one point, the risk of CKD dialysis rose by 1.523 times (95% confidence interval, 1.198-1.936; p = 0.001). After hemodialysis, the amount of saliva (p = 0.038), the area of saliva (p = 0.048) and the number of red dots (p = 0.040) were decreased significantly among patients with ESRD. On the contrary, the percentage of coating (p = 0.002) and area of coating (p = 0.026) were increased significantly after hemodialysis. CONCLUSION: Blood deficiency and stasis with qi deficiency or blood heat syndrome (Zheng pattern) is common in patients with CKD. The risk of CKD dialysis increases with increasing ecchymosis. Hemodialysis can affect saliva, tongue coating, and relieve heat syndrome among ESRD patients.

Acupuncture Analgesia in Patients With Traumatic Rib Fractures: A Randomized-Controlled Trial.

Pain management for traumatic rib fracture is important to prevent complications and reduce associated comorbidities. This trial investigated the analgesic efficacy of acupuncture on traumatic rib fracture. Patients with traumatic rib fracture were randomly assigned to traditional acupuncture (TA), laser acupuncture (LA) or sham laser acupuncture (SLA) groups in a 1:1:1 ratio. The intervention was performed on days 1 to 3 after treatment allocation. The acupoints included bilateral LI4 (Hegu), SJ6 (Zhigou), ST36 (Zusanli) and GB34 (Yanglingquan). The primary outcome was Numeric Rating Scale (NRS) scores for pain after the intervention. Secondary outcomes included sustained maximal inspiration (SMI) lung volume, stress responses, the use of analgesics, and associated complications. Data were analyzed via one-way analysis of variance (ANOVA) with Scheffé's post hoc testing or chi-squared testing. Of the 120 study participants, 109 completed all interventions and measurements. The primary outcomes, which indicated average pain intensity levels and pain while deep breathing, were both significantly lower in the TA and LA groups than in the SLA group after 2 treatments. No between-group differences were observed in SMI lung volume, stress response, analgesics use or associated complications. These findings suggest that TA and LA are safe and effective analgesic modalities for pain management for traumatic rib fracture. Clinical Trial Registration: [ClinicalTrials.gov], identifier [NCT03822273].

Effect of laser acupuncture on adhesive small bowel obstruction: A prospective double-blind randomized controlled trial.

BACKGROUND: Adhesive small bowel obstruction (ASBO) is one of the most common complications and is a major cause of re-admission after intra-abdominal surgery. The initial management of patients with ASBO is nonoperative treatment such as nil per os and decompression using a nasogastric tube. However, the ideal management of ASBO remains controversial. METHODS: This study will be a prospective, single-center, double-blind randomized controlled trial. Ninety two participants diagnosed with ASBO will be randomly assigned to either the verum or the sham laser acupuncture (SLA) group in a 1:1 ratio. All participants will undergo laser acupuncture (LA) or SLA once a day on 6 acupoints (LI4, PC6, ST25, ST36, CV4 and CV12) for 6 consecutive days after enrollment. The primary outcome measure will be the success rate of conservative treatment for ASBO. Secondary outcomes will be time to oral intake and length of hospital stay. The serum levels of lipase, amylase, cortisol, motilin, ghrelin, and intestinal fatty acid binding protein (I-FABP) will also be measured before intervention, on day 4, and on the day of discharge, respectively. Data will be analyzed by Chi-Squared test or t test between 2 groups. OBJECTIVES: The aim of this protocol is to investigate the clinical efficacy of LA on ASBO. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04318821. Registered on 24 March 2020.