[Changes of brain pain center and default mode network an electro acupuncture in Weizhong and Dachangshu acupoints: a task-fMRI study].

OBJECTIVE: To investigate the functional brain pain center and default mode network response to electro acupuncture stimulate in weizhong acupoints(BL40) and dachangshu acupoints(BL25). METHODS: During January to February 2015, volunteers were enrolled in this study from the staff and student interns of Gansu Province Traditional Chinese Medicine Hospital. A total of 20 healthy, right-handed subjects, male 9, female 11, age (23±3) years, participated in this study. Block design task functional magnetic resonance imaging(fMRI) 3.0 T was performed in all subjects by electro acupuncture stimulating at BL40 and BL25 from the same experienced acupuncturist.The needle connected electric acupuncture apparatus through tow long coaxial-cable. A block design with five 120 s blocks of rest time (OFF block, electric acupuncture turn off ) interspersed between five 60 s blocks of stimulation (ON block, electric acupuncture turn on) fMRI scan. Magnetic resonance data of brain function was collected and FSL(fMRI Software Library) software was used to analyze the data. RESULTS: All subjects' data were analyzed except 2 cases whose head movement were more than 2 mm. Activated brain function regions by electro acupuncture stimulate included temporal lobe lateral sulcus, lobus insularis, thalamus, supramarginal gyrus, prefrontal medial frontal gyrus. Negative activated brain regions included middle frontal gyrus, parahippocampal gyrus, cingulate cortex abdominal segment, parietal cortex.The functional pain central and default mode network were changed when electro acupuncture stimulate in(BL40) and(BL25). CONCLUSION: There are several brain activation regions and negative activated brain regions when administering electro acupuncture stimulation at BL40 and BL25.

Open versus laparoscopic pyloromyotomy for pyloric stenosis: a meta-analysis of randomized controlled trials.

OBJECTIVE: Aim of the study was to compare the outcomes after laparoscopic pyloromyotomy (LP) with those of open pyloromyotomy (OP) for infantile pyloric stenosis. METHOD: We conducted searches until February 2009 in multiple databases and identified randomized controlled trials comparing LP with OP for pyloric stenosis. Results were expressed using the odds ratio (OR) for categorical variables and standard weighted mean differences (SMD) for continuous outcomes. Study quality was assessed using the Cochrane Handbook 5.0.1 guidelines and statistical analysis was performed using RevMan 5.0.8 software. RESULTS: 3 studies totaling 492 infants were included. The results showed no significant differences in complications between the groups with regard to wound infection (OR: 1.77, 95% CI 0.58-5.35), mucosal perforations (OR: 0.96, 95% CI: 0.22-4.26), incisional hernia or granuloma (OR: 1.39, 95% CI: 0.41-4.73), incomplete pyloromyotomy (OR: 0.13, 95% CI: 0.02-1.07), substantial vomiting (OR: 0.67, 95% CI: 0.30-1.52) and total complications (OR: 0.91, 95% CI: 0.54-1.53). Although the combined result of 2 studies also indicated an insignificant discrepancy in time-related outcomes for full time to feeds, length of stay after surgery and operating time (SMD: 0.78, 95% CI: -0.50-2.06; SMD: 1.27, 95% CI: -1.56-4.10; SMD: -0.46, 95% CI: -1.11-0.20, respectively), another study indicated shorter times for LP procedures (p=0.002, 0.027, and 0.008, respectively). CONCLUSIONS: Only a few trials were available for analysis. Heterogeneity was seen between studies, but the available trials were of high quality. The present study shows that both OP and LP are equally safe and effective procedures for the management of pyloric stenosis in children. However, there was a trend in LP toward shorter time time-related outcomes.