Comparison of Electroacupuncture and Mild-Warm Moxibustion on Brain-Gut Function in Patients with Constipation-Predominant Irritable Bowel Syndrome: A Randomized Controlled Trial / 中国结合医学杂志

<p><b>OBJECTIVE</b>To compare the effects of electroacupuncture (EA) and mild-warm moxibustion (Mox) therapies for constipation-predominant irritable bowel syndrome (C-IBS) patients.</p><p><b>METHODS</b>Sixty C-IBS patients were assigned to 2 groups by simple randomized method, i.e. EA group (30 cases) and Mox group (30 cases). Both EA and Mox treatments were performed on bilateral Tianshu (ST 25) and Shangjuxu (ST 37) for 30 min each time, 6 times per week, for 4 consecutive weeks. The gastrointestinal symptoms and psychological symptoms of the two groups were scored before and after treatment. The effects on the corresponding functional brain areas, namely the anterior cingulate cortex (ACC), insular cortex (IC) and prefrontal cortex (PFC) were observed by functional magnetic resonance imaging (fMRI) before and after treatment.</p><p><b>RESULTS</b>Compared with the Mox group, greater improvements in abdominal distension, defecation frequency, diffificulty in defecation and stool features were observed in the EA group (all P<0.01), both Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale scores were signifificantly decreased in the EA group (all P<0.01). Finally, decreased activated voxel values were observed in the ACC, right IC and PFC brain regions of EA group with 150 mL colorectal distension stimulation (P<0.05 or P<0.01).</p><p><b>CONCLUSIONS</b>Both EA and Mox could signifificantly improve some of the most intrusive symptoms of C-IBS patients, and EA was more effective than Mox. The therapeutic effect of these two therapies might through modulating of the brain-gut axis function. (Registration No. ChiCTRTRC-11001349).</p>

Comparison of electroacupuncture and moxibustion on brain-gut function in patients with diarrhea-predominant irritable bowel syndrome: A randomized controlled trial / 中国结合医学杂志

<p><b>OBJECTIVE</b>To compare the effects of electroacupuncture (EA) and moxibustion therapies on patients with diarrhea-predominant irritable bowel syndrome (D-IBS).</p><p><b>METHODS</b>A total of 60 D-IBS patients were randomly allocated to the EA group (30 cases) and moxibustion group (30 cases). Before and after treatment, the gastrointestinal symptoms and psychological symptoms were scored by Visual Analogue Scale, Bristol Stool Form Scale, Hamilton Anxiety Rating Scale (HAMA), and Hamilton Depression Rating Scale (HAMD); the expressions of 5-hydroxytryptamine (5-HT), 5-HT3 receptor (5-HT3R), and 5-HT4 receptor (5-HT4R) in the sigmoid mucosal tissue were measured by immunohistochemical staining. Additionally, the effects on the functional brain areas of the anterior cingulate cortex (ACC), insular cortex (IC) and prefrontal cortex (PFC) were observed by functional magnetic resonance imaging.</p><p><b>RESULTS</b>Compared with before treatment, both EA and moxibustion groups reported significant improvements in abdominal pain and abdominal bloating after treatment (P<0.01 or P<0.05). The moxibustion group reported greater improvements in defecation emergency, defecation frequency, and stool feature than the EA group (P<0.01). Both HAMA and HAMD scores were significantly decreased in the moxibustion group than in the EA group (P<0.01). Both groups demonstrated significantly reduced expressions of 5-HT, 5-HT3R and 5-HT4R in the colonic mucosa after treatment (P<0.01), with a greater reduction of 5-HT in the moxibustion group (P<0.05). Finally, decreased activated voxel values were observed in the left IC, right IC and PFC brain regions of patients in the moxibustion group under stimulation with 150 mL colorectal distension after treatment (P<0.05 or P<0.01), while in the EA group only PFC area demonstrated a reduction (P<0.05).</p><p><b>CONCLUSION</b>Moxibustion can significantly improve the symptoms of D-IBS, suggesting that moxibustion may be a more effective therapy than EA for D-IBS patients.</p>

Preoperative surgical planning for intracranial meningioma resection by virtual reality / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The Dextroscope system by Volume Interactions (Singapore) had been applied to minimally invasive neurosurgery in many units. This system enables the neurosurgeon to interact intuitively with the three-dimensional graphics in a direct manner resembling the way one communicates with the real objects. In the paper, we explored its values in pre-operation surgical planning for intracranial meningiomas resection.</p><p><b>METHODS</b>Brain computed tomography (CT), magnetic resonance imaging (MRI), and magnetic resonance venography (MRV) were performed on 10 patients with parasagittal and falcine meningiomas located on central groove area; brain CT, MRI and magnetic resonance angiography (MRA) were performed on 10 patients with anterior skull base meningiomas and 10 patients with sphenoid ridge meningiomas. All these data were transferred to Dextroscope virtual reality system, and reconstructed. Then meningiomas, skull base, brain tissue, drainage vein and cerebral arteries were displayed within the system, and their anatomic relationships were evaluated. Also, the simulation operations were performed.</p><p><b>RESULTS</b>For parasagittal and falcine meningiomas, the relationships of tumor with drainage vein and superior sagittal sinus were clearly displayed in the Dextroscope system. For anterior skull base and sphenoid ridge meningiomas, the relationships of tumor with bilateral internal carotid arteries, anterior cerebral arteries, middle cerebral arteries and skull base were vividly displayed within the virtual reality system. Surgical planning and simulation operation of all cases were performed as well. The real operations of all patients were conducted according to the simulation with well outcomes.</p><p><b>CONCLUSIONS</b>According to the virtual reality planning, neurosurgeons could get more anatomic information about meningioma and its surrounding structures, especially important vessels, and choose the best approach for tumor resection, which would lead to better prognosis for patients.</p>

Association between clinical ischemic events and carotid calcification evaluated by 64 slices CT angiography / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the relationship between clinical ischemic events and carotid calcification detected by 64 slices CT angiography.</p><p><b>METHODS</b>We retrospectively analyzed the carotid calcified plaques in 116 patients underwent the 64 slices CT angiography. The relationship between the carotid calcification and the clinical ischemic events was analyzed.</p><p><b>RESULTS</b>A total of 377 plaques were detected and the incidence of carotid plaque calcification was 63.40%. Incidence of plaque calcification was significantly lower in patients with ages < 50 years than that in patients with ages 51 - 59 years, 60 - 69 years and higher than 70 years (P = 0.003, P = 0.002, P = 0.000, respectively). The incidence of plaque calcification in the common carotid artery was significantly lower than the carotid bifurcation (P = 0.000) and the internal carotid artery (P = 0.000). The incidences of calcification in the mild, moderate and severe degree of stenosis and occlusion were 46.54%, 33.33%, 26.67% and 0% respectively. The distribution of intraplaque calcium was similar between patients with ischemic event and non-ischemic event group. However, the incidence of calcification was significantly lower patients with ischemic event than that in patients without ischemic event (30.34% vs. 43.10%, P = 0.013). Calcified plaque was negatively associated with ischemic event (beta = -0.688, P = 0.006).</p><p><b>CONCLUSION</b>64 slices CT angiography can analyze the characterization of carotid plaque calcium.</p>

Coregistration of three dimensional DSA and MR angiography in neuronavigation for neurosurgery / 中华放射学杂志

Objective To assess the accuracy of neuronavigation of 3D DSA and to evaluate the feasibility of 3D DSA neuronavigational neurosurgery through the coregistration of 3D DSA and MRI(A). Methods A Peg-Board Phantom was used in our study.The phantom consisted of 32 rods which were used for target localization;the height and the location of the rods were in normal distribution.For 3D DSA (Infinix NS/VC,Toshiba),the raw data was reconstructed to 3D images on the DSA workstation,and transferred to a online PC workstation where it was converted to standard 2D DICOM image data using WFU DICOM_Toolkit software.For MRI(A),the phantom was scanned with FSPGR sequence on the MRI scanner(GE SigMa VH/i 3.0 T),and the DICOM images were also transferred to the online PC workstation.Using the software 3D Slicer registration was performed on the PC workstation by using the location and shape of the rods in the phantom.The localization error of the rods was measured in image space as the Euclidean distance between targets defined in image space and those detected in the physical space. Paired t test was used to evaluate the difference between the accuracy of neuronaviagtion of 3D DSA and that of MRI(A).Results Through the coregistration of the rods in the phantom from different modality,all the images were better coregistrated.The mean localization error was(0.38?0.24)mm(3D DSA)and (0.31?0.12)mm[MRI(A)].There was no significant statistical difference between the accuracy of neuronavigation of 3D DSA and MRI(A)(t=-0.601,P=0.55).Conclusion 3D DSA images can be used in the neuronavigation system through the coregistration of 3D DSA and MRI(A).