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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.
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Isquemia Encefálica/patologia , Técnicas de Apoio para a Decisão , Fotografação , Vasos Retinianos/patologia , Acidente Vascular Cerebral/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Isquemia Encefálica/diagnóstico por imagem , Isquemia Encefálica/mortalidade , Isquemia Encefálica/terapia , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Recidiva , Medição de Risco , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/mortalidade , Acidente Vascular Cerebral/terapia , Fatores de TempoRESUMO
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.
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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.
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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.
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<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>
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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.
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By retrospectively reviewing the current status of traditional Chinese medicine (TCM) and Western medicine treatments of chronic nonbacterial prostatitis (CNP), the TCM understanding of its etiologies and pathogenesis, the therapeutic principles and the mechanisms of acupuncture treatment of CNP, the clinical study strategies of acupuncture treatment for CNP were further proposed, which could provide more scientific basis and support for the definite longer-term therapeutic efficacy of acupuncture treatment of CNP. Breakthrough in the treatment of CNP will be achieved with the application of acupuncture therapy both in clinical practice and experimental research.
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Objective To observe the effect of electroacupuncture(EA) on hippocampal structure in splenic asthenia pedo-rats.Methods A total of 15 SD male rats were randomly assigned to normal control group(n=5),model group(n=5) and EA group(n=5).Splenic asthenic syndrome model was established by intragastric administration of rhubarb and intraperitoneal injection of Reserpine for 14d.EA(1mA,3Hz/15Hz) was applied to bilateral "Zusanli"(ST 36) and "Sanyinjiao"(SP 6) for 20min,once a day for 14 days.The cellular structure of hippocampus was observed by light microscope and transmission electron microscope.Results Optical microscopic observation showed that in normal control group,the cellular nucleus was distinct,and the granular cell layer well-arranged and tight.In model group,the intracellular space was widened,and the granular cell layer was out of order in the arrangement.In EA group,the cellular nucleus and the granular cell layer were nearly normal.Results of the electronic microscope showed that cells in model group had a karyopyknosis with irregular appearance and clear incisure,and some of them presented dissolving and necrotic phenomena;and those in EA group were milder in injury,had nearly-normal nucleus with visible nucleoli and relatively-intact nuclear membrane.Regarding the cellular plasma,in comparison with rich normal organelles of control group,the mitochondria in model group were swelling,with vague,dissolved and broken cristae,while in EA group,majority of the organelles were well-kept,and slightly dissolved mitochondrial cristae found.In regard to the synaptic structure,in comparison with control group,synaptic apomorphosis and swelling mitochondria were found in model group.While in EA group,milder swelling and hydropic degeneration were seen.Different from the distinct pre-and post-synaptic membrane and synaptic vesicles of control group,the synaptic clefts and vesicles of model group were vague in the profile;while those in EA group were nearly-normal.Conclusion Electroacupuncture can effectively relieve splenasthenic syndrome induced pathohistological changes of neurons of the hippocampus in the rat.