[Clinical observation on treatment of PC-BPPV by dynamic and static acupuncture method combined with manual reduction].

OBJECTIVE: To observe the clinical effect and advantages of dynamic and static acupuncture method combined with manual reduction on posterior semicircular canal benign paroxysmal positional vertigo (PC-BPPV). METHODS: Ninety patients with PC-BPPV who met the inclusion criteria were randomly divided into manual reduction control group, acupuncture control group and experimental group, with 30 cases in each group. Epley reduction method was used for manual reduction control treatment of patients in the manual reduction control group, until there was no obvious vertigo of patients. Patients in the acupuncture control group received ordinary acupuncture treatment, while patients in the experiment group received dynamic and static acupuncture treatment, both on the basis of manual reduction control treatment. Baihui(GV20) and Yintang(GV24+), Sanyinjiao(SP6), Zhongzhu(TE3), Houxi(SI3) and Waiguan(TE5) on the healthy side, and the vertigo-auditory area and Fengchi(GB20) on the affected side were selected for acupuncture intervention, which was performed once a day, with needles retained for 30 minutes in two acupuncture groups. Every six times was taken as a session and two sessions were required. Dizziness handicap inventory (DHI) scale and visual analogue score (VAS) were used to evaluate the degree of vertigo before, after 1 and 2 sessions of treatment respectively. RESULTS: Compared with those before treatment, the DHI score and VAS score of each group after 1 and 2 sessions of treatment were both significantly decreased (P<0.05). Compared with the acupuncture control group and the manual reduction control group, the DHI score of the experiment group was significantly decreased (P<0.05) after 1 and 2 sessions of treatment. VAS score of the experiment group was significantly decreased compared with that of the manual reduction control group(P<0.05) after 1 and 2 sessions of treatment. The total effective rate of the experiment group was 86.67%, better than those of the acupuncture control group (83.33%, P<0.05) and the manual reduction control group(66.67%, P<0.05). CONCLUSION: The dynamic and static acupuncture method combined with manual reduction effectively improved vertigo symptoms in PC-BPPV with rapid and lasting effects, which is worthy of further clinical promotion and application.

[Effects of electroacupuncture at "Siguan" points on the expression of colonic 5-hydroxytryptamine and fecal short-chain fatty acids in rats with post-stroke depression].

OBJECTIVE: To observe the effects of electroacupuncture at "Siguan" points on behavior, colonic 5-hydroxytryptamine (5-HT) and fecal short-chain fatty acids (SCFAs) in rats with post-stroke depression (PSD), and explore the effect mechanism of electroacupuncture at Siguan points on PSD. METHODS: Fifty SD rats were randomly divided into a sham-operation group, a stroke group, a PSD group, a drug group and an electroacupuncture group, with 10 rats in each one. The stroke model was established by middle cerebral artery occlusion (MCAO) method in the stroke group; except for the sham-operation group, the rats in the other groups were intervened with MCAO combined with solitary and chronic unpredictable mild stress (CUMS) to establish PSD model. In the electroacupuncture group, electroacupuncture was delivered at "Hegu" (LI 4) and "Taichong" (LR 3), with disperse-dense wave, 2 Hz/10 Hz in frequency, for 30 min in each intervention, once daily, for consecutive 21 days. Simultaneously, distilled water (0.01 L•kg-1•d-1) was administrated intragastrically. Fluoxetine solution (2.33 mg•kg-1•d-1) was given by gavage , once a day and for 21 days in the drug group. The same procedure of fixation and gavage with distilled water were adopted in the sham-operation group, the stroke group and the PSD group. Separately, before stroke modeling, after PSD modeling and after 21-day intervention, the consumption of sugar water and the scores of horizontal movement and vertical movement in open-field test were observed. After 21-day intervention, the content of colonic 5-HT was detected by immunohistochemical method, and that of fecal SCFAs was determined by gas chromatography mass spectrometry. RESULTS: After PSD modeling, compared with the stroke group, the sugar water consumption, the horizontal movement scores and vertical movement scores of the open-field test were all reduced in the PSD group, the drug group and the electroacupuncture group (P<0.05). After 21-day intervention, the sugar water consumption and the scores of horizontal movement and vertical movement of the open-field test were increased in the drug group and the electroacupuncture group (P<0.05) when compared with the PSD group; and the horizontal movement score in the electroacupuncture group was lower than that of the drug group (P<0.05). Compared with the sham-operation group, the contents of total fecal SCFAs and acetic acid were lower in the stroke group (P<0.05), and the contents of colonic 5-HT and total fecal SCFAs, acetic acid, propionic acid and butyric acid were reduced in the PSD group (P<0.05). In comparison with the PSD group, the contents of colonic 5-HT and total fecal SCFAs, acetic acid and propionic acid were increased in the drug group and the electroacupuncture group (P<0.05); and the content of colonic 5-HT in the electroacupuncture group was lower than that of the drug group (P<0.05). The level of colonic 5-HT was positively correlated with the contents of total fecal SCFAs and propionic acid (r=0.424, P=0.005; r=0.427, P=0.004). CONCLUSION: Electroacupuncture at "Siguan" points can relieve the depression-like behavior of PSD rats, and its underlying mechanism may be related to the regulation of fecal SCFAs, which affects the release of colonic 5-HT.

The design and application of an individualized 3D printing assisted guide plates in assisting sacroiliac screws insertion.

OBJECTIVE: Currently, the sacroiliac screws insertion still faces several challenges in the fixation of pelvic and acetabular injuries. This study was aimed to design a personalized three-dimensional (3D) printing assisted guide plates to assist sacroiliac screws insertion, so as to provide a reference for further clinical applications. METHODS: Eight pelvic specimens (5 males and 3 females) of normal adults were used to simulate actual operation. After thin-layer CT scanning, the 3D models of pelvis were established based on the images data. Furthermore, in Mimics 17.0 software, the screw entry points and screw channels of sacroiliac screws were further simulated and designed, and the appropriate range of the posterior superior iliac spine was selected to establish and print the virtual guide plates. Then, the simulated screws insertion was performed in vitro, the pelvic specimens after screws insertion were scanned again by CT, and the effect of screws insertion was further evaluated. RESULTS: A total of 16 sacroiliac screw guide plates were designed and printed, and 48 screws were inserted on both sides. Therein, 45 screws were completely located in the sacral vertebra, which was determined as grade 0, with an accuracy rate of 93.2%. The other 3 screws penetrated the anterior cortex or sacral canal of sacral vertebra, including 2 screws in Grade 1 (4.1%) and 1 screw in Grade 2 (2.1%). Compared with the simulated screw channels, the anterior and posterior offset angles of the cross section were (0.912 ± 0.625) ° and (0.802 ± 0.681) ° respectively, with no significant difference (p > 0.05). The upper and lower offset angles of coronal plane were (1.158 ± 0.823) ° and (1.034 ± 0.908) ° respectively, and there was no significant difference (p > 0.05). CONCLUSIONS: 3 D printing guide plates assisted sacroiliac screws insertion can enhance the stability of pelvic posterior ring fixation and assist surgeons to reduce the difficulty of operation.

[Influence of Herbal-cake-separated Moxibustion on Contents of 5-HT, DA and NE in Hypothalamus in Rats with Functional Dyspepsia of Liver Stagnation and Spleen Deficiency Syndrome].

OBJECTIVE: To observe the influence of herbal cake-separated moxibustion on the contents of 5-hydroxy tryptamine (5-HT), dopamine (DA) and norepinephrine (NE) in the hypothalamus in rats with functional dyspepsia (FD) of syndrome of liver stagnation and spleen deficiency, so as to explore its mechanism underlying improvement of FD. METHODS: Sixty SD rats were randomly divided into 6 groups: control, model, herbal cake-separated moxibustion, moxa-cone moxibustion, Xiaoyaosan (decoction for relieving liver stagnation) and Domperidon, with 10 rats in each group. The FD model was established by applying chronic restraint stress + excessive fatigue + irregular food + tail clipping+ shaking for 21 consecutive days. Moxibustion (herbal cake-separated or moxa-cone) was applied to bilateral "Ganshu" (BL 18), "Pishu" (BL 20) and "Weishu" (BL 21), or "Zhangmen"(LR 13), "Qimen" (LR 14) and "Zhongwan" (CV 12) for 30 min, once daily for 14 d. For rats of the two medication groups, Xiaoyaosan [1 mL (2 g)/100 g] and Domperidone [1 mL (0.3 g)/100 g] were administrated by gavage, respectively. The contents of 5-HT, DA and NE in the hypothalamus tissue were detected by high performance liquid Phrnm.tnrnh, RESULTS: The gastric empty rate was obviously lower in the model group than in the control group (P<0. 01). After the treatment, the gastric empty rate in the herbal cake-separated moxibustion, moxa-cone moxibustion, Xiaoyaosan and Domperidone groups were significantly increased in comparison with the model group ( P<0. 01) , but there were no significant differences among the four treatment groups (P > 0.05). Compared to the control group, the contents of 5-HT, DA and NE in the hypothalamus were markedly decreased in the model group (P < 0.01), while compared to the model group, the contents of hypothalamic 5- HT, DA and NE contents were significantly up-regulated in both the herbal cake-separated moxibustion and Xiaoyaosan groups (P < 0.01), rather than in the moxa-cone moxibustion and Domperidone groups (P > 0.05). No significant differences were found between the herbal cake-separated moxibustion and Xioayaosan groups in increasing hypothalamic 5-HT, DA and NE levels (P > 0.05). CONCLUSION: Herbal cake-separated moxibustion can promote the gastric empty rate in FD rats, which may be associated with its effects in inhibiting stress induced decrease of hypothalamic 5-HT, DA and NE levels.