Therapeutic Observation of Acupoint Injection at Fenglong (ST 40) with Promethazine for Posterior Circulation Ischemic Vertigo Due to Turbid Phlegm Obstructing the Middle / 上海针灸杂志

Objective To observe the clinical efficacy of acupoint injection at Fenglong (ST 40) with Promethazine in treating posterior circulation ischemic vertigo (PCIV) due to turbid phlegm obstructing the middle.Method Sixty-two patients with PCIV due to turbid phlegm obstructing the middle were randomized into a treatment group and a control group, 31 cases each. The two groups both received intravenous infusion of Vinpocetine injection, based on which, the treatment group was intervened by injection at Fenglong (ST 40) with Promethazine, while the control group was given gluteal intramuscular injection of Promethazine. The traditional Chinese medicine (TCM) syndrome score and Dizziness Handicap Inventory (DHI) were observed for the two groups before and after the treatment, and the clinical efficacies were also compared.Result The TCM syndrome and DHI scores were significant changed after the intervention in both groups (P<0.05). After the treatment, the TCM syndrome and DHI scores in the treatment group were significantly different from those in the control group (P<0.05). The total effective rate was 93.5％ in the treatment group versus 80.6％ in the control group, and the between-group difference was statistically significant (P<0.05).Conclusion Injection at Fenglong (ST 40) with Promethazine is an effective method in treating PCIV due to turbid phlegm obstructing the middle.

Exploration of whole brain networks modulated by acupuncture at analgesia acupoint ST36 using scale-specific wavelet correlation analysis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Previous studies have demonstrated that acupuncture could modulate various brain systems in the resting brain networks. Graph theoretical analysis offers a novel way to investigate the functional organization of the large-scale cortical networks modulated by acupuncture at whole brain level. In this study, we used wavelets correlation analysis to estimate the pairwise correlations between 90 cortical and subcortical human brain regions in normal human volunteers scanned during the post-stimulus resting state.</p><p><b>METHODS</b>Thirty-two college students, all right-handed and acupuncture naïve, participated in this study. Every participant received only one acupoint stimulation, resulting in 16 subjects in one group. Both structural functional magnetic resonance imaging (fMRI) data (3D sequence with a voxel size of 1 mm(3) for anatomical localization) and functional fMRI data (TR = 1500 ms, TE = 30 ms, flip angle = 90°) were collected for each subject. After thresholding the resulting scale-specific wavelet correlation matrices to generate undirected binary graphs, we compared graph metrics of brain organization following verum manual acupuncture (ACU) and sham acupuncture (SHAM) groups.</p><p><b>RESULTS</b>The topological parameters of the large-scale brain networks in ACU group were different from those of the SHAM group at multiple scales. There existed distinct modularity functional brain networks during the post-stimulus resting state following ACU and SHAM at multiple scales.</p><p><b>CONCLUSIONS</b>The distinct modulation patterns of the resting brain attributed to the specific effects evoked by acupuncture. In addition, we also identified that there existed frequency-specific modulation in the post-stimulus resting brain following ACU and SHAM. The modulation may be related to the effects of verum acupuncture on modulating special disorder treatment. This preliminary finding may provide a new clue to understand the relatively function-oriented specificity of acupuncture effects.</p>

Effect of transcutaneous acupoint electric stimulation on perioperative intravenous anesthesia in patients of transsphenoidal pituitary tumor resection / 中国针灸

<p><b>OBJECTIVE</b>To observe the impacts of transcutaneous acupoint electric stimulation on hemodynamics, anesthetic and relevant complications in patients of transsphenoidal pituitary tumor resection (TPTR).</p><p><b>METHODS</b>Ninety cases of the selective TPTR were randomized into a transcutaneous acupoint electric stimulation group (group T), a sham-acupoint group (group S) and a control group (group C); 30 cases in each one. In group T, the transcutaneous acupoint electric stimulation at Hegu (LI 4), Waiguan (TE 5), Jinmen (BL 63), Taichong (LR 3), Zusanli (ST 36) and Qiuxu (GB 40). In group S, the transcutaneous acupoint electric stimulation was applied to the sham-acupoints. In group C, the acupoints selected were same as those in group T, but the electrode pads were just attached on the related points with no-electric stimulation. The electric stimulation lasted from analgesic induction till the end of the operation. The endotracheal intubation was done under the induction by propofol, fentanyl and vecuronium bromide. Propofol and remifentanil were maintained till the end of operation. Blood pressure, heart rate, bispectral index (BIS) value, anesthetic and postoperative recovery situation were recorded.</p><p><b>RESULTS</b>The hemodynamics maintained stably in each group. In group T, the mean arterial pressure 1 min after intubation, after extubation and during directional force recovery was all lower than the other two groups respectively (all P<0.05). In group T, the effect-site concentration of fentaryl in the exposure saddle area and tumor removal stage was lower than the other two groups (all P<0.05). In 24 h after operation, 2 cases presented nausea and vomiting in group C. There were no relevant complications in the rest groups.</p><p><b>CONCLUSION</b>The transcutaneous acupoint electric stimulation improves the stability of hemodynamics in perioperative stage, reduces the intraoperative opi oids dosages and improves the quality of anesthetic recovery.</p>

Regional homogeneity analysis on acupoint specificity with resting-state functional magnetic resonance imaging / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The mechanism of acupuncture analgesia in craniotomy has been widely studied. However, the theoretical basis for selection of acupoints has not been examined. In this study, we used the regional homogeneity method blood oxygen level-dependent (BOLD) signals to determine changes in brain activity in response to transcutaneous electrical stimulation on acupoints and non-acupoints in resting state functional magnetic resonance imaging (fMRI).</p><p><b>METHODS</b>Twelve healthy volunteers were enrolled in this study. BOLD fMRI scanning of the brain was performed for 306 seconds before and 30 minutes after transcutaneous electrical stimulation on acupoints UB63 (Jinmen), LV3 (Tai chong), ST36 (Zusanli), and GB40 (Qiuxu). The procedure was repeated after one week with stimulation on non-acupoints (one was 9 above BL67, the second was 12 above BL67 (Kunlun), the third was 7 above KI3, and the fourth was 10 above KI3 (Taixi)).</p><p><b>RESULTS</b>The regional homogeneity in the acupoint group was increased in the left thalamus, caudate, putamen, lentiform nucleus (BA19, 30, 39), postcentral gyrus, precentral gyrus (BA3, 4, 30, 32), calcarine fissure, middle temporal gyrus (BA30), right superior temporal gyrus, inferior temporal gyrus (BA38), cuneus, and precuneus (BA7, 19) when compared to the non-acupoint group. The regional homogeneity of the acupoint group was decreased in the left cerebellum posterior lobe, middle frontal gyrus (BA10), double-side precuneus (BA7), and the postcentral gyrus (BA40).</p><p><b>CONCLUSIONS</b>The brain region activated following acupoint stimulation is the ipsilateral pain-related brain region, which may relate to the therapeutic effect of acupuncture on pain relief. Further acupoint stimulation causes different central nervous responses compared to non-acupoint stimulation.</p>

Differential temporal neural responses of pain-related regions by acupuncture at acupoint ST36: a magnetoencephalography study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Previous neuroimaging studies primarily focused on the spatial distribution of acupuncture needling stimulation. However, a salient feature of acupuncture was its long-lasting effect. This study attempted to detect the spatial-temporal neural responses evoked by acupuncture at an analgesia acupoint ST36 by using magnetoencephalography. To further verify its functional specificity, we also adopted acupuncture at Pericardium 6 and nonacupoint as separated controls.</p><p><b>METHODS</b>Forty-two college students, all right-handed and acupuncture naïve, participated in this study. Every participant received only one acupoint stimulation, resulting in 14 subjects in one group. Both magnetoencephalography data (151-channel whole-head system) and structural functional magnetic resonance imaging data (3D sequence with a voxel size of 1 mm(3) for anatomical localization) were collected for each subject. All processing procedures were performed in BrainStorm Toolbox.</p><p><b>RESULTS</b>Acupuncture at ST36 showed a significantly time-varied brain activities with different onset time. Our results presented that acupuncture at different acupoints (or comparing with nonacupoint) can specifically induce neural responses in different brain areas-acupuncture at ST36 can specifically induce the neural responses of pain-inhibition areas, while acupuncture at PC6 can specifically induce the activities of the insula and amygdala.</p><p><b>CONCLUSIONS</b>In the present study, we attempted to detect the temporal neural responses underlying the functional specificity of acupuncture at ST36, using acupoint belonging to different meridians and non-acupoint with efficacy-irreverent as separate controls. The specific neural substrates involving acupuncture at different acupoints may be related to its functional specificity in clinical settings.</p>

Comparison of the ability of wavelet index and bispectral index for reflecting regain of consciousness in patients undergone surgery / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Wavelet index (WLI) is a new parameter for monitoring depth of anesthesia based on Wavelet analysis. We observed the change of WLI and bispectral index (BIS) in patients regain of consciousness (ROC) in the absence of frontalis electromyographic (EMG) interference. The aim of this study was to compare the ability of WLI and BIS for reflecting ROC in patients undergone surgery.</p><p><b>METHODS</b>Twelve patients who were scheduled for maxillofacial surgeries were enrolled in the study. BIS and WLI values were monitored continually. After being given midazolam and remifentanil, patients were asked to squeeze the investigator's hand ever 30 seconds. Patients were continuously given propofol until loss of consciousness (LOC1). Tunstall's isolated forearm technique was used to test the surgical consciousness in patients. After total muscle relaxation, endotracheal intubations were performed, and the patients were connected to a ventilator. Then, propofol was withdrawn until the patients showed regain of consciousness (ROC1) and an awareness reaction. After the command test, patients were readministered with propofol until loss of consciousness (LOC2). After surgery, all of the sedatives were withdrawn, and the patients were let to regain consciousness (ROC2).</p><p><b>RESULTS</b>The BIS values of twelve patients at ROC1 after using muscle relaxant were much lower than those at LOC1 and ROC2 without using muscle relaxant, showing statistical significance (P < 0.05). Meanwhile, the WLI values of twelve patients at ROC1 after using muscle relaxant were much higher than those at LOC1 and equal to ROC2 without using muscle relaxant, showing statistical significances (P < 0.05) between ROC1 and LOC1.</p><p><b>CONCLUSIONS</b>This study showed that under muscle relaxation or facial paralysis, when there is no EMG signal, BIS can not accurately reflect regain of consciousness in surgical patients, but WLI can reflect it accurately. So WLI may have advantages for reflecting state of consciousness in surgical patients.</p>

Effect of electroacupuncture on Sevoflurane anesthesia in patients undergoing resection of supratentorial tumor / 中国针灸

<p><b>OBJECTIVE</b>To observe the supplementary analgesic effect of electroacupuncture and its influence on the maintenance of anesthesia and the speed of recovery of patients undergoing craniotomy.</p><p><b>METHODS</b>Eighty cases of supratentorial tumor resection were randomly divided into group A and group S, 40 cases in each group. All the patients were anesthetized with 2% Sevoflurane. The patients in group A received electroacupuncture at Hegu (LI 4) and Waiguan (TE 5), Jinmen (BL 63) and Taichong (LR 3), Zusanli (ST 36) and Qiuxu (GB 40) from anesthesia beginning to the end of operation, and in group S without electroacupuncture. The end-tidal Sevoflurane concentration, minimum alveolar concentration (MAC), bispectral index (BIS) and the information during anesthesia recovery stage were recorded, respectively.</p><p><b>RESULTS</b>The end-tidal concentration and MAC of Sevoflurane in group A at all times were significant lower than those in group S (P<0.05, P<0.01) with a Sevoflurane saving of 9.62% on average. The BIS in group A during a few phases were higher than that in group S (all P<0.05). During anesthesia recovery stage, the time of each phase in group A was significantly shorter than that in group S (all P<0.01). No dysphoria and one case with nausea and vomiting were shown in group A, but in group S, 2 patients had dysphoria and 3 patients had nausea and vomiting.</p><p><b>CONCLUSION</b>Electroacupuncture combined with Sevoflurane anesthesia can decrease the dosage of Sevoflurane, shorten the recovery time of anesthesia and improve the quality of anesthesia recovery of the patients undergoing resection of supratentorial tumor.</p>

Transient Neurologic Syndrome after Spinal Anaesthesia / 中国康复理论与实践

@#A number of reports have appeared implicating neurotoxicity of local anesthetics as a possible cause of neurologic complications after spinal anesthesia. Transient neurologic syndrome is one of neurologic complications. This article reviews the etiology, occurred mechanism, clinical symptoms, risk factors, prevention and treatment of transient neurologic syndrome.

Application of Lornoxicam during Craniotomy / 中国康复理论与实践

@#ObjectiveTo evaluate the effect of lornoxicam used for craniotomy. Methods60 neurosugical patients, ASA physical I～II, were randomly allocated into three groups to receive normal saline in controlled group (GroupⅠ), lornoxicam 8 mg (Group Ⅱ) and lornoxicam 24 mg (Group Ⅲ) intravenously 10～15 min before anesthesia. The end-tidal concentration of isoflurane was measured. The volumes of bleeding, transfusion, fluid infusion and urine were recorded. The time of consciousness, psychomotor and cognitive recoveries from general anesthesia were observed. The VAS scores of pain were evaluated 48 h after operation.ResultsThe concentrations of end-tidal isoflurane in the controlled group were significantly higher than other groups (P<0.01). There was no difference among the three groups in the volume of bleeding, transfusion, infusion and urine. The recovery time of conscious, psychomotor and cognitive from general anesthesia were shorter in group Ⅱ and Ⅲ (P<0.01). The total dose of tramadol and VAS score after the operation were no difference among the three groups.ConclusionThe preoperative application of lornoxicam can reduce the concentrations of end-tidal isoflurane significantly, smooth the recovery from anesthesia.

A case control study on the impact of CYP450 MSPI and GST-M1 polymorphisms on the risk of lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the correlation of polymorphisms of CYP1A1 MSPI and glutathiones S-transferase (GST-M1) independently and in combination with the risk of lung cancer.</p><p><b>METHODS</b>A case control study which included 91 cases of lung cancer and 138 controls collected from the First Affiliated Hospital of Sun Yat-sen University of Medical Sciences, Guangzhou Tumor Hospital and The Red Cross Hospital of Guangzhou or conmunity area. All subjects were investigated with a uniform questionnaire. Blood samples were collected from all cases and controls for detecting CYP1A1 MSPI and GST-M1 polymorphisms which were analyzed by PCR and RFLP.</p><p><b>RESULTS</b>It showed that there was no significant difference in frequencies of this genotypes of CYP1A1 MSPI between the two groups. The frequency of GST-M1 null (0/0) genotype was higher in the case group than in the control group, with an OR of 1.38 (95% CI 0.81 - 2.38), but there was no statistical significance. However, combination of several genotypes was strongly associated with lung cancer. There was a synergistic interaction between the m2m2 genotype of CYP1A1 MSPI and GST-M1 (0/0) genotype, with an OR of 2.47 (95% CI 1.03 - 5.90).</p><p><b>CONCLUSION</b>The combination of two genetic polymorphisms significantly increases the risk of lung cancer.</p>

The effect of intraoperative continuous nimodipine infusion on cerebral vasospasm during intracranial aneurysm surgery / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the effect of intraoperative continuous nimodipine infusion on cerebral vasospasm during intracranial aneurysm surgery.</p><p><b>METHODS</b>Thirty consecutive patients under-going intracranial aneurysmal surgery were prospectively randomized into two groups: Isoflurane (group A, n = 15) and nimodipine (group B, n = 15). The patients in group A were maintained with 1 minimum alveolar concentration (MAC) isoflurane anesthesia during the whole procedure. The patients in group B were given nimodipine infusion continuously (20 microg.kg(-1).h(-1)) after induction of anesthesia and anesthetized with 1 MAC isoflurane. S100B levels in cerebrospinal fluid were determined before aneurysm clipping and 0, 2, 4 h after aneurysm clipping by enzyme linked immunosorbent assay. Assessment of mean blood flow velocity of parent arterial and arterial branches were performed before and after aneurysm clipping.</p><p><b>RESULTS</b>(1) S100B in cerebrospinal fluid was increased significantly at 4 h after aneurysm was clipped in group A (F = 4.11, P < 0.05). However, S100B in cerebrospinal fluid was stable in group B in the whole procedure. (2) Mean arterial flow velocity of parent vessels in group B was lower significantly than that in group A (t = 2.08, P < 0.05). However, mean arterial flow velocity of distal vessels in both groups has no significant difference.</p><p><b>CONCLUSION</b>Intraoperative nimodipine infusion may prevent cerebral vasospasm during intracranial aneurysm surgery.</p>

Controlled clinical study on 49 patients of SARS treated by integrative Chinese and Western medicine / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy of Integrative Chinese and western medicine (ICWM) in treating SARS.</p><p><b>METHODS</b>By controlled paralled design, 49 patients of SARS were studied, they were divided into the control group (n = 29) and the ICWM group (n = 20). The former was treated according to the "Recommended Program for Treatment of SARS" provided by Health Ministry, by administering of such drugs as Ribavirin, Levofloxacin, Thymopentin, Azithromycin, etc, the latter was treated with the ICWM protocol for SARS of "Special Technological Action to Prevent and Treat SARS" provided by Science and Technology Ministry.</p><p><b>RESULTS</b>(1) The time for improving symptom in the ICWM group was 5.10 days and that in the control group was 7.62 days, the difference between them was significant (P < 0.05); (2) The days and amount for use hormone before subtract in the two group were similar, with insignificant difference (P > 0.05); (3) The days and amount for use hormone after subtract in the two groups were significantly different (P < 0.05); (4) The time for improving peripheral WBC count and absolute value of lymphocyte, as well as for absorption time of shadow in chest film were not different significantly between the two groups (P > 0.05).</p><p><b>CONCLUSION</b>In treating SARS, ICWM was superior to the treatment with western medicine alone in aspects of improving clinical symptom, promoting recovery of immune function and absorption of lung inflammation, decreasing the dosage of hormone used and shortening the therapeutic course.</p>

Damage to the brachial plexus produced by pulsed radiofrequency and radiofrequency thermocoagulation in rats / 中华麻醉学杂志

Objective To evaluate the damage to the brochial plexus produced by pulsed radiofrequency (PRF)and radiofrequency thermocoagulation(RFTC).Methods Fifty-five male Wistar rats weighing 250-300 g were randomly divided into 3 groups:groupⅠPRF(n=25):groupⅡRFTC(n=25)and groupⅢnormal control(n=5).The animals were anesthetized with intraperitoneal chloral hydrate.The left brochial plexus was exposed and PRF or RFTC was applied to the left brochial plexus.The voltage and current of the minimal stimulation which elecited muscle twitching and the impedance before and after operation were recorded in group PRF and RFTC.The nerve function was scored according to Tarloo(0=flaccid paresis,5=normal gait)before and at 3d after operation.The animals were killed and the left brachial plexus was removed immediately and at 1, 7,14,30 d after operation(n=5 at each time point)for determination of histopathological changes using microscope.Results The impedance and Tarlov score were significantly decreased after operation as compared to the baseline values before operation in group RFTC and were also significantly lower than in group PRF. Microscopic examination showed that the myelinated nerve fibers exhibited Wallerian degeneration and axon regeneration and the cytochondria in cylindraxile were severely injured or disappeared in group RFTC.The myelinated nerve fibers and the cytochondria in cylindraxile were significantly less injured after operation in group PRF than in group RFTC and returned to normal at 7 d and 30 d respectively.Conclusion The injury to brachial plexus produced by PRF is slighter than that produced by RFTC.