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With the increasing number of Chinese medical aid and the overseas development of Chinese medicine, acupuncture has spreaded to and the Republic of Guinea and saw develoment. At present, only China Guinea Friendship Hospital and Astatin Hospital have set up Acupuncture Department, which have equipped with basic acupuncture instruments and acupuncture is used as the main treatment method, and acupuncture is a self funded project. There is no acupuncture major in the local education system, neither laws and regulations on acupuncture and moxibustion. Language barrier also makes it difficult for doctors in the two countries to communicate. Thus, it is recommended to consider geographic, diet, and medical factors when formulating acupuncture treatment plans which are suitable for local conditions, and launching new projects such as laser acupuncture treatment and ear concha electroacupuncture treatment, while improving the language level of foreign aid physicians, designing suitable teaching materials, and using multimedia technology for teaching. Besides, we should promote legislation, conduct academic and cultural exchanges, so as to better promote the development of acupuncture and moxibustion in Guinea.
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OBJECTIVE@#To compare the effect difference between acupuncture combined with western medication and simple western medication for Meniere's disease.@*METHODS@#Ninety-six patients with Meniere's disease were randomly assigned into a combination group (48 cases, 12 cases dropping) and a medication group (48 cases, 9 cases dropping). Betastatin mesylate tablets (once 12 mg, 3 times a day) and mecobalamin tablets (once 0.5 mg, 3 times a day) were prescribed orally in the two groups. Acupuncture was used in the combination group, twice a week, 20 min a time, and the acupoints were Baihui (GV 20), Fengchi (GB 20), Tinggong (SI 19), Hegu (LI 4), Quchi (LI 11), Zusanli (ST 36), Fenglong (ST 40), Taichong (LR 3), Taixi (KI 3) and Tianshu (ST 25). All the treatment was given for continuous 12 weeks. The symptoms were observed by dizziness handicap inventory (DHI), tinnitus handicap inventory (THI), pure tone audiometry score and stuffy ear visual analogue scale (VAS). The effects were compared in the aspects of dizziness, hearing and activity.@*RESULTS@#The scores of DHI, THI, pure tone audiometry and VAS scores after treatment were lower than those before treatment in the two groups (all <0.05), with lower scores of the above 4 indexes in the combination group after treatment (all <0.05). The difference values before and after treatment of the 4 indexes in the combination group were higher than those in the medication group (all <0.05). The effective rates of dizziness, hearing and activity in the combination group were 97.2% (35/36), 91.7% (33/36), 88.9% (32/36), which were better than 71.8% (28/39), 74.4% (29/39) and 69.2% (27/39) in the medication group (all <0.05).@*CONCLUSION@#Acupuncture combined with conventional medication achieve better effect than simple conventional medication.
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Humans , Acupuncture Therapy , Meniere Disease , Therapeutics , Tinnitus , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To investigate the recommendations of acupuncture therapy in foreign clinical practice guidelines (CPGs) so as to understand the situation of foreign acupuncture guidelines and provide the suggestions on the development of acupuncture CPGs.</p><p><b>METHODS</b>A total of 5 website authorities were retrieved with the key words as "acupuncture" "moxibustion" "acupressure" and "electroacupuncture".</p><p><b>RESULTS</b>A total of 93 papers on CPGs had been searched, of which, the most CPGs were collected in the National Guidelines Clearinghouse (NGC). 68 papers were screened according to the requirement of CPGs, with 26 diseases and symptoms included. Since 2012, CPGs on acupuncture therapies have increased remarkably. Regarding the recommendations on acupuncture, there were 35 papers recommending acupuncture, about accounting for 51.5%. Of them, 1 paper strongly recommended and 10 papers were against recommendation. There was no CPG for moxibustion recommendation.</p><p><b>CONCLUSION</b>① The foreign recommendations are weak and brief on acupuncture. The qualities of CPGs are various among countries, which results in the limit guidance in clinical practice. The specific acupuncture CPG should be developed so as to guide the clinical strategy on acupuncture more effectively. ② There are apparent limitations on the involved diseases between those mentioned in foreign CPGs and those in the treatment in foreign countries. Being the origin of acupuncture, China should proactively develop the advantages on acupuncture treatment and participate in the development of international CPGs. ③ The recommendation on moxibustion therapy is lack. In future research, the evaluation on the safety and effectiveness should draw attention.</p>
Subject(s)
Humans , Acupuncture Therapy , China , Electroacupuncture , Internationality , Moxibustion , Practice Guidelines as TopicABSTRACT
Objective To explore the clinical significance of CT-angiography (CTA) in predicting hematoma enlargement in patients with acute hypertensive cerebral hemorrhage (HICH). Methods A prospective cohort study was performed on 50 patients with HICH. HICH and spot sign were diagnosed definitely by computerized tomography (CT) and CTA within 3 ~ 6 hours of symptom onset. Patients were dichotomized according to the presence or absence of the spot sign. CT scan was repeated immediately when patients′symptoms worsened or at 24 hours after onset of symptoms in order to find out the enlargement of hematomas. The relationship between hematoma expansion and spot sign of CTA was investigated. Results (1) Thirteen (26.0%) patients demonstrated the presence of spot sign of CTA, and 37 (74.0%) patients were without spot sign. Baseline clinical variables were similar in both groups. (2) Hematoma expansion occurred in 14 (28.0%) patients on follow-up. Eleven (84.6%) patients with and 3 (8.1%) patients without the spot sign of CTA were demonstrated hematoma expansion. The significance difference was found between the two groups (X2=24.27,P<0.05). Conclusions In acute HICH patients, CTA provided more radiological information and the CTA spot sign was associated with the presence of hematoma expansion. The spot sign will be recommended as an entry criterion for future trials of haemostatic therapy in patients with acute HICH.
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Objective To observe the clinical efficacy of Wendan decoction in the treatment of phlegm-heat accumulation type acie vulgaris.Methods 62 patients with phlegm-heat accumulation type ache vulgaris were randomly divided into a treatment group and a control group randomly,with 31 patients in each group.The control group was given dietary advice and skin cleansing techniques,while the treatment group was given oral administration of Wendan decoction on the basis of the control group.Results ①skin damage comparison:after the treatment,skin damage symptoms such as tenderness (0.71 ±0.32),redness (0.47±0.63),cyst(0.59±0.53),and tubercle (0.63±0.54) in the treatment group were significantly improved than the control group [the values were (1.12±0.32),(1.44±0.21),(1.40±0.36),(1.18±0.43),respectively] (P＜0.05).②symptoms score comparison:The symptoms score in the treatment group after the treatment (42.95±1.53) was significantly improved than that before the treatment (52.89± 1.98),(P＜0.05),and also obviously better than the control group after the treatment.③clinical efficacy comparison:Total efficacy was 96.77％ in the treatment group and 54.83％ in the control group,showing marked difference(P＜0.05).Conclusion Wendan decoction is effective in treating phlegm-heat accumulation type acne vulgaris.
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Objective To explore the value of diffusion weighted imaging (DWI) in combination with susceptibility weighted imaging (SWI) in prognosis prediction of traumatic axonal injury (TAI).Methods A retrospective study of 75 patients with TAI was performed to analyze the clinical data and the follow-up prognosis in the 6 months after injury.The detection rate of TAI lesion by DWI,SWI and conventional MRI was compared.Multiple factors analysis applied logistic regression analysis to analyze the relationship between associated factors and prognosis.Results The average detected TAI lesions were (19.92 ± 8.62) by DWI and (22.17 ± 11.72) by SWI,which had no significant differences (t=1.24,P＞0.05),but there was a significant difference bettween by conventional MRI and by DWI or SWI (all P＜0.05).DWI was more sensitive to non-hemorrhagic lesions and SWI was more sensitive to hemorrhagic lesions.However,the lesions revealed by them existed the overlap of location and pathology of lesions.Patients with poor outcomes had more number of central lesions than those patient with good outcomes (t=2.455,P＜ 0.05).Logistic regression analysis revealed that the predictive accuracy provided by the combination with imaging and clinical factors was 95.7 ％.Conclusions DWI and SWI both are sensitive to TAI lesions,and have ability to detect the lesions with different pathological characteristics,separately.Accurate prognosis prediction for patients with TAI may be provided by the combination of clinical and imaging factors.
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Objective To study the impacts of white matter ischemic lesions in various regions on the different cognitive domains of the patients. Methods 120 patients with white matter ischemic lesions were divided into subcortex,semi oval center,peri-ventricle,mixed regions according to MRI imaging (n=30 cases for each group). The 30 healthy control subjects were enrolled.Cognitive functions were evaluated by mini mental status scale (MMSE), montreal cognitive assessment (MOCA),object memory test (FOM),rapid verbal retrieve (RVR),block design (BD)and digit span (DS). Results The score of language in subcortical group (0.36±0.49) was lower than in control group (1.00±0.00) (P=0.011).There was no significant difference in RVR scores between mixed regions group and peri- ventricle group [(27.00 ± 9.22) vs. (32.30 ± 7.78) P =0.067],while RVR scores in mixed regions group (27.00± 9.22) were increased as compared with subcortex,semi oval center and control groups [(38.21±11.93),(35.94=9.53) and (37.00±3.16),respectively] (F=3.462,P=0.013).There was no difference,in BD scores between mixed regions group and semi- oval center group [(21.20± 9.21) vs.(25.63±12.10).P 0.070] but the mixed group scores were decreased as compared with subcortex, peri-ventricle, control groups [(37.14±10.43),(36.80± 14.27),(40.30±6.29),F=7.795,P=0.000].The scores of immediate verbal memory,calculation,short-term memory,visual spatial ability and executive were reduced in mixed regions group than in other groups (P=0.034,0.030,0.016,0.000).There was no difference in orientation score in MOCA and MMSE among the groups (P=0.256 and P=0.325).Conclusions Ischemic white matter lesions may lead to cognitive impairments depending on different region lesions. The obvious impact of peri-ventricle lesion is on memory, subcortex lesion on language,semi-oval center lesion on recognition and construction of images,while wide range of cognitive impairment may be attributed to the lesion in mixed regions.The scale of the MOCA is helpful and sensitive for identifying the presence of early cognitive impairment.
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Objective To discuss the value of diffusion weighted imaging (DWI) in severity assessment and prognosis prediction of diffuse axonal injury (DAI). Methods A retrospective study was performed on the clinical imaging data and the follow-up results at six months after injury in 29 patients with DAI. The detection rate of DAI lesion by DWI and conventional MRI was compared by means of one-way ANOVA. The correlation between the number of lesion in different areas with GCS and GOS was analyzed with Spearman rank correlation test. Results (1)The average detected DAI lesions were 19.24±5.72 on DWI, 14.41 ±4.50 on FLAIR, 10.58±3.79 on T2WI and 4.83 ±2. 11 on TIWI, with the highest detection number of DAI lesion on DWI (P < 0, 05). (2) There was a significant correlation of the number of central lesions (in corpus callosum, basal ganglia and brain stem) with GCS and COS (P < 0. 05), but there was no correlation of total lesion number or periphery lesion with GCS and COS (P > 0.05). Conclusions DWI is a potentially useful imaging modality in detecting DAI lesion, when the number of central lesion on DWI can be served as an objective marker in severity assessment and prognosis prediction of DAI.
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Objective To investigate the role of the extracellular signal-regulated kinases 1 and 2 (ERK1/2) in rotenone-mediated dopaminergic cell damage. Methods Neuronal rat adrenal pheochromecytoma(PC12) cells treated with rotenone were used as the cell model of Parkinson' s disease (PD). Cell viability of PC12 cells after exposure to rotenone was detected by MTT (methyl thiazolyl tetrazolium) method. Immanohistechemistry was used to detect the phosphorylation of ERK1/2 in cells exposed to rotenone. Western blotting was used to verify the phosphorylation of ERK1/2 and to observe the effect of PD98059, an inhibitor of the upstream mitogen activated protein kinase kinase (MEK) that phosphorylates and activates ERK1/2, on rotenone-induced ERK1/2 phosphorylation and cell viability.Results The viability (represented by A570 of PC12 cells exposed to 5 μmoL/L rotenone) declined with the increase of exposure time from 1 h to 24 h (%, 1 h :75.46±5.47, 2 h : 70.42±1.94, 4 h : 65.23± 0.96, 8 h : 59.04 ± 2.85, 24 h :29.64 ± 1.63, comparison between different time points(F=143.014, P=0.000) ; compared with control groups(100.00±2.89), q value: 17.07, 20.58, 24. 19, 28.50, 48.95 respectively, all P <0.01). After exposure to rotenone, phosphorylated ERK1/2 aggregated in the PC12 cells. Western blotting indicated that rotenone induced a biphasic phosphorylation of ERK1/2, which increased from 30 min after rotenone treatment, reached the peak at 1-2 h, decreased at 4 h, and increased again at 8 h, and disappeared after 16 h; PD98059 significantly inhibited ERK1/2 phosphorylation induced by rotenone, and attenuated cell injury examined at 1, 2 and 8 h. Conclusions Our study suggested that ERK1/2 activation plays a detrimental role in rotenone toxicity, and raised the possibility that abnormal patterns of ERK1/2 activation may contribute to dopaminergic neuronal cell death in PD.
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Objective To observe the changes of diffusion weighted imaging (DWI) after diffuse axonal injury (DAI) in rats. Methods Models of various degrees of DAI (mild, moderate and severe) were established in 135 SD rats by Marmarou method, and MRI examinations were performed 4, 8 and 24 h after injury. Another 8 rats were served as control group. The findings of MRI were analysed, and the apparent diffusion coefficient (ADC) values were compared among each group. Results No clear traumatic lesion was found from MRI in rats after injury. Four hours after injury, ADC values decreased in each DAI group, and there were significant differences between moderate DAI group and control group, and between severe DAI group and control group (P<0.05). Eight hours after injury, ADC values increased in each DAI group, and there was no significant difference between DAI groups and control group (P>0.05). There were significant differences in ADC values between 8 h after injury and 4 h after injury in severe DAI group (P<0.05), while there was no significant difference in moderate and mild DAI groups (P>0.05). Twenty-four hours after injury, ADC values continuously increased, especially in severe trauma group. Conclusion ADC values may reveal traumatic changes that can not be demonstrated by MRI. ADC values decrease in acute phase of DAI in rats, then increased, and the degree of variation may be related to the severity of DAI.