[Effect of thunder-fire moxibustion combined with electroacupuncture on urodynamics in patients with neurogenic bladder after spinal cord injury].

OBJECTIVE: To investigate the effect of electroacupuncture combined with thunder-fire moxibustion on urodynamics in patients with neurogenic bladder (NB) after spinal cord injury(SCI). METHODS: A total of 60 patients with NB after SCI were divided into control group and observation group using a random number table, with 30 patients in each group. Bladder management protocol was performed for both groups. The patients in the control group were given electroacupuncture at Shangliao (BL31), Zhongliao (BL33), Xialiao (BL34), and Ciliao (BL32) at both sides, and those in the observation group were given thunder-fire moxibustion as mild-warm moxibustion at Yaoyangguan (GV3), Mingmen (CV4), Qihai (CV6), Guanyuan (CV4), and Zhongji (CV3) in addition to the treatment in the control group; electroacupuncture or moxibustion was performed for 20 min each time, once a day, with 10 times as one course of treatment, and both groups were treated for 3 courses. Number of times of voluntary urination, maximum single urine volume, and number of times of urethral catheterization were recorded at 3 d before and after treatment; maximum urinary flow rate during urination, maximum bladder capacity during urination, bladder pressure during the bladder filling period, and residual urine volume were recorded before and after treatment, and bladder compliance was calculated; clinical outcome was evaluated for both groups. RESULTS: After treatment, both groups had significant reductions in the numbers of times of urination and urethral catheterization (P<0.05) and a significant increase in maximum single urine volume (P<0.05), and the observation group had significantly better results than the control group (P<0.05). After treatment, both groups had significant reductions in residual urine volume and bladder pressure during the bladder filling period, and the observation group had significantly greater reductions than the control group (P<0.05); both groups had significant increases in bladder compliance, maximum bladder capacity during urination, and maximum urinary flow rate during urination, and the observation group had significantly higher values than the control group (P<0.05). The observation group had a significantly higher response rate than the control group ï¼»90.00% (27/30) vs 63.33% (19/30), P<0.05ï¼½. CONCLUSION: Thunder-fire moxibustion combined with electroacupuncture can effectively improve bladder urodynamics and has a marked clinical effect in patients with NB after SCI.

New application of multimodal ultrasound imaging for identification of myofascial trigger points in the trapezius muscle.

BACKGROUND: The study aimed to quantify the characteristics of trapezius myofascial trigger points (MTrPs) using shear wave elastography (SWE) and contrast-enhanced ultrasound (CEUS) and explore the application value of the new ultrasound techniques in identifying MTrPs. METHODS: Forty patients participated in this study. MTrPs in the trapezius muscle were determined by palpation, and SWE and CEUS were used to quantify the focal and adjacent areas. The elastic modulus values and CEUS parameters between the focal area of MTrPs and adjacent areas were evaluated and compared. Pathological biopsy was performed according to the above two methods, and the pathological tissues were observed by Masson staining, immunohistochemistry and electron microscope. RESULTS: The elastic modulus values were significantly higher for the focal area of MTrPs compared to those for adjacent areas (P<0.05). There were statistically significant differences in MTrP parameters, including peak intensity, mean transit time, and area between the focal and adjacent areas (P<0.05). Masson staining showed that there were inflammatory cell infiltration dominated by lymphocytes in the vascular wall. Electron microscopy showed a large number of fibroblast proliferation, lamellar collagen proliferation and lysosomal deposition; immunohistochemical results: the expression of CD3+, CD4+, CD8+, CD68+, mhc-1+, dys+, CD8 was more than that of CD20 (F=4.385, P=0.036). CONCLUSIONS: Combined use of SWE and CEUS provides a new detection approach for quantitative identification of MTrPs in the trapezius muscle, which has high application value and is a method worthy of wider use in clinical practice.

The role of ultrasound in determining the amount of pleural effusion.

BACKGROUND: There is no standardized system to evaluate pleural effusion size on ultrasound (US). We aimed to explore the role of US in determining the amount of pleural effusion, with an attempt to provide evidence for clinical efficacy evaluation and treatment program selection. METHODS: A total of 98 patients undergoing thoracoscopy at our center were enrolled in this study. The patients take a sitting position, then the maximum depths of the pleural effusion by US at the subscapular line, posterior axillary line, midaxillary line, anterior axillary line, and midclavicular line, as well as the maximum thickness of the pleural effusion at the subscapular line, were measured before pleural effusion drainage. Then, the corresponding values in the lateral position were also measured. The relationships between the actual pleural effusion amounts and the measurements at these lines were analyzed using the multivariate linear regression model (MLRM). RESULTS: The regression equation of the group with a pleural effusion amount of 500-1,000 mL in the sitting position showed statistical significance (P=0.001). The P values of the maximum depths at the subscapular line (X1) and midclavicular line (X5) and the maximum thickness at the subscapular line (X6) were below 0.05. Thus, a final model was established using X1, X5, and X6 as the independent variables. CONCLUSIONS: The combination of US examination and MLRM enables the quantitative determination of pleural effusion.

High-frequency ultrasound as an adjunct to neural electrophysiology: Evaluation and prognosis of Bell's palsy.

Bell's palsy is a form of temporary facial nerve paralysis that occurs primarily in young adults. Previously, various methods were used to assess outcomes in facial nerve disease. The aim of the present study was to characterize the main branches of the normal and abnormal facial nerve using high-frequency ultrasonography (HFUS). A total of 104 healthy volunteers, 40 patients with acute onset of Bell's palsy and 30 patients who underwent 3-month routine therapy for Bell's palsy disease were included in the study. The healthy volunteers and patients were selected for HFUS examination and VII nerve conduction. The results showed significant differences in nerve diameter, echogenicity, delitescence and amplitude in different groups. Statistically significant correlations were identified for severity grading in one of the experimental groups during HFUS examinations. In conclusion, HFUS as a complementary technique paired with neural electrophysiology may establish the normal values of facial nerve. Additionally, HFUS was beneficial in the process of evaluation and prognosis of Bell's palsy disease.

Prevalence of deep venous thrombosis in patients with acute exacerbation of chronic obstructive pulmonary disease.

BACKGROUND: Acute exacerbation of chronic obstructive pulmonary disease (COPD) is always associated with a high incidence and mortality. Because of the presence of some concomitant risk factors such as immobilization, bronchial superinfection, patients who are admitted for acute exacerbations of COPD are generally considered to be at moderate risk for the development of venous thromboembolism. In this study, we investigated the prevalence and the clinical manifestations of deep venous thrombosis (DVT) in patients with acute exacerbation of COPD. METHODS: From March 2007 to March 2009, 520 consecutive patients were included in this study. On admission, color Doppler ultrasound of lower extremities in all cases was performed for diagnosing DVT. Patients with DVT were compared with those without DVT from such aspects as demographics, symptoms, physical signs and risk factors. RESULTS: Among the 520 patients, DVT was found in 46 cases (9.7%). In patients with DVT, the duration of hospitalization was longer (P = 0.01), and the mechanical ventilation requirement increased (P < 0.001). Other indicators for patients with more possibility of DVT were immobility exceeding 3 days (P < 0.001); pneumonia as concomitance (P = 0.01); respiratory failure type II (P = 0.013); current smoking (P = 0.001). Lower extremity pain was more common in DVT cases in comparison to those without DVT (34.8% vs. 15.2%, P = 0.01). CONCLUSIONS: The acute exacerbation of COPD patients, who were immobilized for over 3 days, complicated by pneumonia and had respiratory failure type II, had a higher risk of DVT. In addition, DVT detection awareness should be increased in cases that had a lower extremity pain.