Auricular acupressure combined with Tongtian oral liquid for acute attacks of migraine without aura: a single-center, retrospective study.

OBJECTIVE: To observe the effect of auricular acupressure combined with Tongtian Oral Liquid for immediate pain relief in patients with acute migraine without aura, and to analyze the risk factors that affect the number of acute attacks of migraine without aura. METHODS: This retrospective study analyzed data of 180 patients diagnosed with acute migraine without aura who were admitted to Affiliated Hospital of Nanjing University of Chinese Medicine (Jiangsu Province Hospital of Chinese Medicine). The patients were divided into an intervention group 1 (n=60), an intervention group 2 (n=60), and a control group (n=60) according to different treatment methods. The intervention group 1 received auricular acupressure + Tongtian oral liquid, the intervention group 2 received Jing point bloodletting + Tongtian oral liquid, and the control group received ibuprofen + flunarizine. Before treatment, 60 minutes and 120 minutes after treatment, the visual analogue scale (VAS) and the short-form McGill pain questionnaire (SF-MPQ) were used to score the pain in the three groups to evaluate the efficacy of immediate analgesia. Symptoms including fatigue, drowsiness, nausea, and vomiting after 2 hours of treatment were observed. The amount of ibuprofen used within 24 hours was calculated. The drug treatment was continued for one month. The frequency of migraine attacks was compared among the three groups. The relevant factors affecting the number of migraine attacks were analyzed. RESULTS: The VAS and SF-MPQ scores of the three groups were all decreased 120 minutes after treatment as compared with those before treatment (P<0.01). The decline rate in the intervention group 1 > that in intervention group 2 > that in control group (P<0.01). The immediate analgesic efficiency at 60 minutes, intervention group 1 > intervention group 2 > control group (100% vs. 76.67% vs. 56.67%, P<0.001). After 2 hours of treatment, more cases of fatigue and lethargy occurred in the control group (P<0.05). There was no significant difference in nausea and vomiting among the three groups (P>0.05). The 24-hour ibuprofen dosage and headache recurrence ratio, control group > intervention group 2 > intervention group 1 (P<0.05). The number of headache attacks within 30 days was significantly higher in the control group than in the intervention groups (P=0.012). There was no significant statistical difference between the two intervention groups (P=0.568). Regression analysis found that age (OR=1.036, 1.006-1.068), body mass index (OR=1.101, 1.008-1.201), hypertension (OR=2.879, 1.187-6.986), chronic gastritis (OR=2.839, 1.213-6.647), children with educational problems (OR=0.333, 0.164-0.676), and residual fatigue symptoms (OR=4.539, 1.828-11.271) affected the number of headache attacks within the one month of treatment. CONCLUSIONS: Auricular acupressure combined with Tongtian Oral Liquid can relieve the acute pain of migraine without aura and reduce the number of pain episodes. The curative effect of this combination is better than that of western medicine alone.

Deciphering the influencing mechanism of hydraulic retention time on purification performance of a mixotrophic system from the perspective of reaction kinetics.

At present, eutrophication is increasingly serious, so it is necessary to effectively reduce nitrogen and phosphorus in water bodies. In this study, a pyrite/polycaprolactone-based mixotrophic denitrification (PPMD) system using pyrite and polycaprolactone (PCL) as electron donors was developed and compared with pyrite-based autotrophic denitrification (PAD) system and PCL-based heterotrophic denitrification (PHD) system through continuous flow experiment. The removal efficiency of NO3--N (NRE) and PO43--P (PRE) and the contribution proportion of PAD in the PPMD system were significantly increased by prolonging hydraulic retention time (HRT, from 1 to 48 h). When HRT was equal to 24 h, the PPMD system conformed to the zero-order kinetic model, so NRE and PRE were mainly limited by the PAD process. When HRT was equal to 48 h, the PPMD system met the first-order kinetic model with NRE and PRE reaching 98.9 ± 1.1% and 91.8 ± 4.5%, respectively. When HRT = 48 h, the NRE and PRE by PAD system were 82.7 ± 9.1% and 88.5 ± 4.7%, respectively, but the effluent SO42- concentration was as high as 152.1 ± 13.7 mg/L (the influent SO42- concentration was 49.2 ± 3.3 mg/L); the NRE by PHD system was 98.5 ± 1.7%, but the PO43--P could not be removed ideally. The concentrations of NO3--N, total nitrogen, PO43--P, and SO42- in the PPMD system also showed distinct changes along the reactor column. In addition, the microbial diversity analysis showed that prolonging HRT (from 24 to 48 h) increased the abundance of autotrophic denitrifying microorganisms in the PPMD system, ultimately increasing the contribution proportion of PAD.

The enrichment of more functional microbes induced by the increasing hydraulic retention time accounts for the increment of autotrophic denitrification performance.

With pyrite (FeS2) and polycaprolactone (PCL) as electron donors, three denitrification systems, namely FeS2-based autotrophic denitrification (PAD) system, PCL-supported heterotrophic denitrification (PHD) system and split-mixotrophic denitrification (PPMD) system, were constructed and operated under varying hydraulic retention times (HRT, 1-48 h). Compared with PAD or PHD, the PPMD system could achieve higher removals of NO3--N and PO43--P, and the effluent SO42- concentration was greatly reduced to 7.28 mg/L. Similarly, the abundance of the dominant genera involved in the PAD (Thiobacillus, Sulfurimonas, and Ferritrophicum, etc.) or PHD (Syntrophomonas, Desulfomicrobium, and Desulfovibrio, etc.) process all increased in the PPMD system. Gene prediction completed by PICRUSt2 showed that the abundance of the functional genes involved in denitrification and sulfur oxidation all increased with the increase of HRT. This also accounted for the increased contribution of autotrophic denitrification to total nitrogen removal in the PPMD system. In addition, the analysis of metabolic pathways disclosed the specific conversion mechanisms of nitrogen and sulfur inside the reactor.

Start-up phase optimization of pyrite-intensified hybrid sequencing batch biofilm reactor (PIHSBBR): Mixotrophic denitrification performance and mechanism.

Pyrite-based autotrophic denitrification (PAD) is an emerging biological process to diminish nitrate pollution, but the relatively low NO3--N removal rate limits its practical application. In this research, a pyrite-intensified hybrid sequencing batch biofilm reactor (PIHSBBR) was designed to treat low C/N ratio domestic wastewater. The results showed that PIHSBBR could achieve optimal removal of COD, NH4+-N, and TN under the aeration rate of 1.0 L/L∙min and the hydraulic retention time (HRT) of 8 h, with removal rates of 69.67 ± 4.37%, 77.04 ± 4.84%, and 63.92 ± 6.66%, respectively. The PAD efficiency in PIHSBBR during the stable operation was not high (13.05-31.01%), and the main nitrogen removal pathway in PIHSBBR, especially in the aerobic zone, was simultaneous nitrification and denitrification (SND). High-throughput sequencing analysis unraveled that Planctomycetota (3.65%) had a high abundance in the anoxic zone of PIHSBBR, implying that anaerobic ammonium oxidation (anammox) might have occurred in the anoxic zone. In addition, the nitrogen cycle function gene with the highest abundance was nirBD, indicating the possible presence of dissimilatory nitrate reduction to ammonium (DNRA) within the system (aerobic and anoxic zones). Our research can provide useful information for the improvement and future application of PIHSBBR.

Effect of hydraulic retention time on performance of autotrophic, heterotrophic, and split-mixotrophic denitrification systems supported by polycaprolactone/pyrite: Difference and potential explanation.

Biological denitrification is still the most important pathway to purifying nitrate-containing wastewater. In this study, pyrite (FeS2 ) and polycaprolactone (PCL) were used as electron donors to construct sole or combined denitrification systems, that is, pyrite-based autotrophic denitrification (PAD) system, PCL-supported heterotrophic denitrification (PHD) system, and split-mixotrophic denitrification system (combined PAD + PHD), all of which were operated under five different hydraulic retention times (HRTs) for 150 days. The results showed that the removal rates (RE) of nitrate (NO3 - -N) and inorganic phosphorus (PO4 3- -P) by PAD were 91% and 94%, respectively, but the effluent sulfate (SO4 2- ) concentration was as high as 168.2 mg/L; the removal rate of NO3 - -N by PHD was higher than 99%, but the PO4 3- -P could not be removed ideally; the removal rates of NO3 - -N and PO4 3- -P by PAD + PHD were higher than 95% and 99%, respectively, and the effluent SO4 2- concentration was only 7.2 mg/L. Through the analysis of the surface scanning electron microscope (SEM) images of the two kinds of media before and after use, it was found that the coupled mode of PAD + PHD was more favorable for biofilm formation than the sole PAD or PHD process, and the microorganisms in the PAD + PHD mode made more full use of electron donors. Moreover, the biomass of the PAD + PHD mode was lower than that of the PAD or PHD process, but the denitrification efficiency of the coupled mode was more efficient, indicating that the functional microorganisms in the PAD + PHD mode might have a certain synergistic effect. PRACTITIONER POINTS: Removal rates of NO3 -, PO4 3 -, and SO4 2 - by PAD were 91%, 94%, and -233%, respectively. Removal rate of NO3 - by PHD exceeded 99%, but PO4 3 - could not be removed ideally. Removal rates of NO3 -, PO4 3 -, and SO4 2 - by PAD + PHD were 95%, 99%, and 86%, respectively. The coupled mode was more favorable for biofilm formation than the sole PAD or PHD. The coupled mode had lower biomass but got more excellent denitrification efficiency.

[Effect of acupuncture on analgesia and sedation in elderly patients with severe pneumonia during invasive mechanical ventilation].

OBJECTIVE: To observe the analgesic and sedative effects of acupuncture in elderly patients with severe pneumonia during invasive mechanical ventilation. METHODS: A total of 188 elderly patients with severe pneumonia were randomly divided into an observation group and a control group, 94 cases in each group. Both groups were treated with routine nursing and treatment of severe pneumonia such as invasive mechanical ventilation, analgesia and sedation. Based on these, the observation group was treated with acupuncture at Neiguan (PC 6), Hegu (LI 4), Yintang (GV 29) and Baihui (GV 20), twice a day until the mechanical ventilation was offline. The critical care pain observation tool (CPOT) score and Richmond agitation-sedation score (RASS) were observed before treatment and 0.5 h after analgesia and sedation; the average time of reaching the standard, the reaching standard rate of shallow sedation and analgesia within 0.5 h and 72 h as well as the dosage of analgesic and sedative drugs and compilations were compared between the two groups. The mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR) and blood oxygen saturation (SpO2) were observed before treatment and 0.5 h, 1 h and 2 h after analgesia and sedation. The levels of partial pressure of blood oxygen (PaO2), partial pressure of carbon dioxide (PaCO2) and lactic acid (Lac) were observed before treatment and 12 h, 24 h, 48 h, 72 h, 96 h, 120 h and 144 h after analgesia and sedation. The white blood cell (WBC), neutrophil percentage (NEUT%), high-sensitivity C-reactive protein (hs-CRP), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and creatinine (Cr) were observed before treatment and 72 h after analgesia and sedation. The tracheal intubation time and ICU hospitalization time were compared between two groups. RESULTS: At the time point of 0.5 h after treatment, the CPOT and RASS scores in the two groups were lower than those before treatment (P<0.05); the average time of reaching the standard in the observation group was shorter than that in the control group (P<0.01); the 30 min reaching standard rates of CPOT and RASS scores as well as the rate of reaching the shallow sedation and analgesia within 72 h in the observation group were higher than those in the control group (P<0.01, P<0.05). The dosage and duration of dexmedetomidine, propofol and butorphanol in the observation group were less than those in the control group (P<0.05), and the occurrence times of hypotension, respiratory depression, bradycardia, constipation as well as average tracheal intubation time and average ICU hospitalization time in the observation group were less than those in the control group (P<0.05). After 0.5 h, 1 h and 2 h of treatment, the HR and RR were lower than those before treatment in the two groups (P<0.05), MAP and SpO2 were higher than those before treatment in the two groups (P<0.05); the MAP 0.5 h after treatment in the observation group was higher than that in the control group (P<0.05); the HR after 1 h and 2 h of treatment in the observation group was lower than that in the control group (P<0.05). Compared before treatment, the levels of PaCO2 and Lac were reduced and the levels of PaO2 were increased 12 h, 24 h, 48 h, 72 h, 96 h, 120 h and 144 h after treatment in both groups (P<0.05); compared before treatment, the WBC, NEUT%, hs-CPR, ALT and Cr were reduced 72 h after treatment in the two groups (P<0.05), and the hs-CRP in the observation group was lower than that in the control group (P<0.05). CONCLUSION: Acupuncture has analgesic and sedative effect in elderly patients with severe pneumonia during invasive mechanical ventilation, which could reduce the dosage of sedative and analgesic drugs and the occurrence of complications, improve blood oxygen, and has good safety.

[Effect of acupuncture on diaphragmatic function in patients with AECOPD typeâ ¡ respiratory failure evaluated by ultrasound detection].

OBJECTIVE: To observe the therapeutic effect of acupuncture combined with western conventional therapy on type Ⅱ respiratory failure of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and evaluate the effect of acupuncture on diaphragmatic function and prognosis by bedside ultrasound. METHODS: A total of 111 patients with AECOPD type Ⅱ respiratory failure were randomized into an acupuncture group, a conventional treatment group and a non-acupoint acupuncture group, 37 cases in each one. The routine AECOPD nursing care and treatment with western medicine were provided in the 3 groups. Additionally, in the acupuncture group, acupuncture was applied at Dingchuan (EX-B 1), Feishu (BL 13), Taiyuan (LU 9), Danzhong (CV 17) and Zhongwan (CV 12), etc. In the non-acupoint acupuncture group, acupuncture was given at the points 5 to 10 mm lateral to each of the acupoints selected in the acupuncture group. Acupuncture was given once every day, 30 min each time, consecutively for 10 days in the above two groups. Separately, before treatment, on day 3, 7 and 10 of treatment, arterial partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2) and diaphragm thickening fraction (TFdi) were observed in each group. Before and after treatment, the inflammatory and immune indexes (levels of white blood cell [WBC], procalcitonin [PCT], hypersensitive C-reactive protein [hs-CRP] and T lymphocyte percentage [ %]), auxiliary respiratory muscle movement score, the score of chronic obstructive pulmonary disease (COPD) assessment test (CAT), the score of the modified British Medical Research Council dyspnea scale (mMRC) and the TCM syndrome score were compared in each group. The duration of mechanical ventilation, relative complications, 14-day clinical controlled discharge rate and the therapeutic effect were observed in each group. RESULTS: On day 3, 7 and 10 of treatment, PaO2 and TFdi were all increased as compared with those before treatment (P<0.01) and PaCO2 was reduced as compared with that before treatment in each group (P<0.01). After treatment, % was increased as compared with that before treatment in each group (P<0.01), WBC, PCT, hs-CRP, auxiliary respiratory muscle movement score, CAT score, mMRC score and TCM syndrome score were all reduced as compared with those before treatment in each group (P<0.01). After treatment, PaCO2, WBC, PCT, hs-CRP, auxiliary respiratory muscle movement score, CAT score and mMRC score in the acupuncture group were all lower than the other two groups (P<0.01), PaO2 and TFdi were higher than the other two groups (P<0.01); % was higher and TCM syndrome score was lower in the acupuncture group compared with those in the non-acupoint acupuncture group (P<0.01). The duration of mechanical ventilation and the total incidence of complications in the acupuncture group were all lower than the other two groups (P<0.01), and the 14-day clinical controlled discharge rate and total clinical effective rate were higher than the other two groups (P<0.01). CONCLUSION: Acupuncture as adjunctive therapy achieves significant therapeutic effect on AECOPD type Ⅱ respiratory failure. It improves diaphragmatic function, promotes oxygenation and relieves carbon dioxide retention of artery, alleviates clinical symptoms and reduces the time of mechanic ventilation and hospitalization. Besides, the bedside ultrasound detection can objectively reflect the effect of acupuncture on diaphragmatic function in the patients with AECOPD complicated with typeⅡrespiratory failure.

Robust Waterborne Superhydrophobic Coatings with Reinforced Composite Interfaces.

Waterborne superhydrophobic coatings have attracted tremendous attention recently, but their practical applications are severely limited by hydrophobic instability and poor mechanical durability. Herein, a novel robust waterborne PTFE-CP&MgO-AOP superhydrophobic coating was successfully fabricated by reinforcing composite interfaces. Combined with the self-polymerization of dopamine and the in situ grown MgO, CNTs-polydopamine&MgO (CP&MgO) particles with improved interfacial compatibility were obtained. Through the cross-linking and hydrogen bonding interactions, phosphate networks (CP&MgO-AOP) with the aluminum orthophosphate (AOP) binder were formed during dehydration polymerization. The phosphate networks not only enhanced the interfacial interaction among CP&MgO to form coral-like structures but also strengthened the interfacial binding force between the waterborne polytetrafluoroethylene (PTFE) coating and the substrate. With the enhanced composite interfacial strength, the waterborne PTFE-CP&MgO-AOP coating exhibited excellent wear-resistance, which can withstand more than 1.27 × 105 abrasion cycles. Moreover, the chemical bonding between the functional groups of phosphate networks and metal substrate improved the adhesion strength from grade 5 to 1. Furthermore, the prepared coating surface with the reticular/coral-like composite structures can lock the stable gas layer to maintain excellent hydrophobic stability, even under the conditions of strong acidic/alkaline, high-temperature, xenon lamp irradiation, and mechanical wear. Thus, this study is expected to open new insights into interfacial enhancement of robust waterborne superhydrophobic coatings.