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Objective:To evaluate the prognostic efficacy of the Chinese Group on the Study of Severe Hepatitis B (COSSH) acute-on-chronic liver failure (ACLF) II score (COSSH ACLF IIs) and associated risk stratification in predicting short-term prognosis of patients with hepatitis B virus-related ACLF (HBV-ACLF).Methods:Clinical data of 224 patients with HBV-ACLF admitted to the First Affiliated Hospital of Wannan Medical College and the First Hospital of Quanzhou, Fujian Medical University from January 2018 to December 2021 were retrospectively analyzed. The patients were divided into survival group ( n=171) and fatal group ( n=53) according to 28-day survival status. The values of the COSSH ACLF IIs, the Chronic Liver Failure-Consortium (CLIF-C) ACLF score (CLIF-C ACLFs), the CLIF-C organ failure score (CLIF-C OFs), the Model of End-stage Liver Disease (MELD) score (MELDs), the MELD-sodium score (MELD-Nas), and the Child-Turcotte-Pugh score (CTPs) for 28-day mortality prediction were compared using the area under the receiver operating characteristic curve (AUC). The patients were divided into groups according to COSSH ACLF classification and COSSH ACLF IIs risk stratification, respectively. The differences in 28-day mortality between groups were compared by Kaplan-Meir method, and the consistency of the two ACLF classification systems was compared by Kappa consistency test. Results:The AUC, sensitivity, and specificity of the COSSH ACLF IIs in 28-day mortality prediction were 0.885, 0.981 and 0.731, respectively. For predicting 28-day mortality, the COSSH ACLF IIs achieved a higher AUC than the CLIF-C OFs, the MELDs, the MELD-Nas, and the CTPs ( P<0.01), while there was no significant difference in AUC between the COSSH ACLF IIs and the CLIF-C ACLFs ( Z=1.696, P=0.090). The cumulative 28-day mortality rates significantly increased with the ascending of COSSH ACLF grade and risk strata of the COSSH ACLF IIs (11.7%, 43.5% and 93.3%, P<0.001; 14.2%, 41.0% and 81.3%, P<0.001). The two ACLF grading systems showed a consistency in severity stratification of HBV-ACLF patients (Kappa=0.478, P<0.001). Conclusion:The COSSH ACLF IIs shows an excellent prognostic performance in predicting short-term mortality of HBV-ACLF patients. Using the new risk stratification scale can simplify the severity stratification of HBV-ACLF patients.
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OBJECTIVE@#To observe the effectiveness of acupuncture on claustrophobia, and to explore the effects of acupoint specificity on claustrophobia.@*METHODS@#This was an evaluator-blinded randomized controlled trial. One hundred and sixty patients who presented with claustrophobia during magnetic resonance imaging examination were randomized into an acupoint group, a non-acupoint group, a sham-acupoint group and a blank group, 40 cases in each one. The patients in the acupoint group were treated with acupuncture at Zhaohai (KI 6), Taichong (LR 3), Lingdao (HT 4), Neiguan (PC 6), Shenmen (HT 7), Danzhong (CV 17), Baihui (GV 20) and Fengchi (GB 20). The patients in the non-acupoint group were treated with acupuncture at points 0.5 next to the acupoints above. The patients in the sham-acupoint group were treated with acupuncture at acupoints not closely correlated to claustrophobia in corresponding segment. All the acupuncture was given once. No treatment was used in the blank group. The state anxiety questionnaire (S-AI) was observed in all the patients at the end of MRI examination before and after treatment. The clinical therapeutic effects were compared among four groups.@*RESULTS@#Compared before treatment, the S-AI score was reduced in the acupoint group, non-acupoint group and sham-acupoint group after treatment (0.05). After treatment, the S-AI scores in the acupoint group, non-acupoint group and sham-acupoint group was lower than that in the blank group (<0.05, <0.01), and the differences of S-AI score were higher than that in the blank group (<0.01). The S-AI score in the acupoint group was lower than that in the non-acupoint group and sham-acupoint group (<0.05), and the difference of S-AI score was higher than those in the non-acupoint group and sham-acupoint group (<0.05). The difference of S-AI score in the non-acupoint group was higher than that in sham-acupoint group (<0.05). The total effective rate was 92.5% (37/40) in the acupoint group, which was significantly superior to 25.0% (10/40) in the non- acupoint group, 17.5% (7/40) in the sham-acupoint group and 5.0% (2/40) in the blank group (<0.05, <0.01).@*CONCLUSION@#Acupuncture showes superior effect on claustrophobia, and its tranquilizing effect may be related with acupoint specificity.
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Humans , Acupuncture Points , Anxiety , Phobic Disorders , Therapeutics , Surveys and QuestionnairesABSTRACT
OBJECTIVE@#To compare the clinical curative effect of muscle tension staged acupuncture and conventional acupuncture in the treatment of stroke hemiplegia.@*METHODS@#Sixty-two patients with stroke hemiplegia were randomly divided into an observation group and a control group, 31 cases in each one. In the observation group, the muscle tension staged acupuncture was given, the six stages of Brunnstrom were classified as relaxation period and spasmodic period. The (consciousness-restoring resuscitation) combined with the hand and foot meridian acupuncture were applied at Shuigou (GV 26), Jianyu (LI 15), Quchi (LI 11), Shousanli (LI 10), Hegu (LI 4), Liangqiu (ST 34), Zusanli (ST 36), Shangjuxu (ST 37), Jiexi (ST 41) during relaxation period; mainly by hand and foot meridian and meridian, the acupoints were Jianliao (TE 14), Tianjing (TE 10), Waiguan (TE 5), Yangchi (TE 4), Houxi (SI 3), Huantiao (GB 30), Yanglingquan (GB 34), Chengshan (BL 57), Xuanzhong (GB 39), Shenmai (BL 62), Qiuxu (GB 40) during spasmodic period. In the control group, referring to 's , mainly by hand meridian, the governor vessel and foot meridian, phasing was not considered in the acupuncture treatment plan. Both groups were treated one time a day for 4 weeks. The neurological deficit scores were observed before and after treatment of the two groups and the efficacy was evaluated.@*RESULTS@#There was one case dropped in each group. After treatment, the neurological deficit scores of the two groups was lower than those before treatment (both <0.05), and the observation group was lower than the control group (<0.05). The cured and markedly effective rate was 66.7% (20/30) in the observation group, which was higher than 36.7% (11/30) in the control group, the difference between the two groups was statistically significant (<0.05).@*CONCLUSION@#The muscle tension staged acupuncture is better than the conventional acupuncture for the treatment of stroke hemiplegia.
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Humans , Acupuncture Points , Acupuncture Therapy , Hemiplegia , Therapeutics , Muscle Tonus , Stroke , Treatment OutcomeABSTRACT
Toutianliang manipulation is the most representative compound needling technique of traditional reinforcing and reducing and has the remarkable efficacy on heat syndrome with muscle and bone involved for example. Professor ZHANG Jin is one of the famous acupuncture master in China and has contributed his lifelong to the research of acupuncture manipulation techniques. He has summarized 24 single-type manipulations and has given the comprehensive explanation of the manipulations for meridian conduction, reinforcing or reducing techniques for the excess or deficiency. In the paper, Toutianliang manipulation was introduced briefly and the key operation steps had been discussed.
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Humans , Acupuncture Therapy , History , Methods , China , History, 20th Century , History, 21st CenturyABSTRACT
ObjectiveTo investigate the clinical efficacy of acupuncture in treating Tourette's syndrome.MethodEighty patients were allocated, using a random number table, to a treatment group of 40 cases and a control group of 40 cases. The treatment group received acupuncture and the control group, Western drug treatment.ResultThe YGTSS score decreased significantly in the two groups of patients after treatment(P<0.01). After treatment, the range of decrease in the YGTSS tic score was larger in the treatment group than in the control group; there was a statistically significant difference (P<0.05). The total efficacy rate was higher in the treatment group than in the control group (P<0.05). The incidences of adverse reactions were significantly lower in the treatment group than in the control group.ConclusionThe effect and safety of treatment for Tourette's syndrome are higher in the treatment group than in the control group.
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Objective To observe the clinical efficacy ofTiao Du Tong Ren (regulating the Governor Vessel and Unblocking the Conception Vessel) needling in treating post-stroke depression.Method Sixty patients with post-stroke depression were randomized into a treatment group and a control group, 30 cases in each group. The treatment group was intervened byTiao Du Tong Ren needling, while the control group was by ordinary acupuncture. The Hamilton Depression Scale (HAMD) was observed before and after intervention, and the clinical efficacies were compared between the two groups.Result The total effective rate was 93.3% in the treatment group versus 80.0% in the control group, and the difference was statistically significant (P<0.05). The HAMD scores were significantly changed in both groups after intervention (P<0.05). The change of HAMD score after intervention in the treatment group was markedly different from that in the control group (P<0.05).ConclusionTiao Du Tong Ren needling method is an effective approach in treating post-stroke depression.
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Objective To investigate the clinical efficacy of mother-child reinforcing-reducing acupoint combination in treating migraine of liver yang hyperactivity type.Methods Forty patients with migraine of liver yang hyperactivity type were randomly allocated to treatment and control groups, 20 cases each. The treatment group received acupuncture by mother-child reinforcing-reducing acupoint combination and the control group, acupuncture with conventional acupoint combination. Headache symptoms were scored in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups.Results There was a statistically significant pre-/post-treatment difference in the headache symptom score in the two groups (P<0.05). There was a statistically significant difference in pre-/post-treatment headache symptom score difference value between the treatment and control groups (P<0.05). The total efficacy rate and the cure and marked efficacy rate were 90.0% and 75.0%, respectively, in the treatment group and 85.0% and 35.0%, respectively, in the control group. There was a statistically significant difference in the cure and marked efficacy rate between the two groups (P<0.05).Conclusion Mother-child reinforcing-reducing acupoint combination is an effective way to treat migraine of liver yang hyperactivity type.
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Objective To observe the clinical efficacy of skin needling plus flash cupping for hemifacial spasm. Method Forty patients were randomized into a treatment group and a control group, 20 in each group. For both groups, the following acupoints were selected: Baihui (GV20), Sishencong (EX-HN1), Yifeng (TE17), Xiaguan (ST7), Cuanzhu (BL2), Yangbai (GB14), Taiyang (EX-HN5), Quanliao (SI18), Jiache (ST6), Dicang (ST4), Hegu (LI4), and Waiguan (TE5). Skin needling plus flash cupping was used for the treatment group, while even reducing-reinforcing needling method was used for the control group. Seven-day treatments were considered as a treatment course, and the therapeutic efficacy was analyzed after 3 courses. Result The cure rate was 65.0%in the treatment group versus 45.0% in the control group, and the difference was statistically significant (P<0.05). Conclusion Skin needling plus flash cupping can produce a significant efficacy in treating hemifacial spasm, better than ordinary needling method.
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Objective To observe the clinical efficacy of Tiao Shen Ding Zhi (mind-regulating) needling method in treating anxious neurosis. Method Fifty-eight patients with anxious neurosis were randomized into a treatment group and a control group, 29 in each group. The treatment group was intervened by Tiao Shen Ding Zhi needling method, while the control group was by conventional needling. The total effective rates of the two groups were observed. Result The total effective rate was 96.5% (28/29) in the treatment group versus 82.8% (24/29) in the control group, and the difference was statistically significant (P<0.05). Conclusion Tiao Shen Ding Zhi needling method can produce a higher total effective rate than conventional acupuncture in treating anxious neurosis.
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<p><b>OBJECTIVE</b>To explore the changes in HBsAg titer and HBV DNA load and their correlation in patients with chronic hepatitis B (CHB) and HBV-related liver cirrhosis (HBV-LC).</p><p><b>METHODS</b>Forty-six patients with mild to moderate CHB (CHB-LM), 24 patients with severe CHB (CHB-S), and 28 patients with HBV-LC at admission, and 51 patients with HBV-LC at 4.08 ± 3.06 months during antiviral treatment were tested for serum HBsAg titer and HBV DNA load using Abbott chemiluminescence and fluorescence quantitative PCR, respectively.</p><p><b>RESULTS</b>The serum HBsAg titer and HBV DNA load gradually decreased with increased disease severity (from CHB-LM, CHB-S to HBV-LC; χ(2)=12.537 and 8.381, respectively, P<0.05). HBsAg titer and HBV DNA load were significantly higher in CHB-LM and CHB-S groups than in HBV-LC group (P<0.05), but comparable between CHB-LM and CHB-S groups (Z=-0.649 and 0.032, respectively, P>0.05). Among HBeAg-positive patients, HBsAg titer and HBV DNA load tended to decrease with increased disease severity (from CHB-LM, CHB-S to HBV-LC; χ(2)=6.146, P=0.046 and χ(2)=1.017, P>0.05; respectively), and CHB-LM group had significantly higher HBsAg titer than HBV-LC group (Z=-2.247, P=0.025). Among the HBeAg-negative patients, serum HBsAg and HBV DNA load gradually declined with the disease severity (χ(2)=8.660 and 13.581, respectively, P<0.05), and were obviously higher in CHB-LM and CHB-S groups than in HBV-LC group (P<0.05). Positive correlations were found between serum HBsAg and HBV DNA levels in CHB-LM (r=0.389, P=0.009) and HBV-LC groups (r=0.431, P=0.022), but not in CHB-S group (r=0.348, P=0.104). After antiviral therapy, the serum HBsAg titer was slightly decreased (Z=-1.050, P=0.294) while HBV DNA load markedly reduced (Z=-5.415, P<0.001), showing no correlation between them (r=0.241, P=0.111) or between the measurements before and after treatment (r=0.257, P=0.085).</p><p><b>CONCLUSION</b>Serum HBsAg titer and HBV DNA load decreases progressively from CHB-LM to CHB-S and HBV-LC in both HBeAg- positive and -negative patients. The serum HBsAg titer is positively correlated with HBV DNA load, but their levels are not consistently parallel.</p>
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Humans , Antiviral Agents , Therapeutic Uses , DNA, Viral , Blood , Hepatitis B Surface Antigens , Blood , Hepatitis B, Chronic , Blood , Liver Cirrhosis , Blood , Virology , Viral LoadABSTRACT
<p><b>OBJECTIVE</b>To compare the efficacy differences in the treatment of somatoform pain disorder between resuscitation and tranquilization acupuncture technique and oral administration of deanxit.</p><p><b>METHODS</b>Forty cases of somatoform pain disorder (complicated with mild and moderate depression) were randomized into an acupuncture group and a western medication group, 20 cases in each one. In the acupuncture group. acupuncture was applied to Shenting (GV 24). Shuigou (V 26). Sishencong (EX HN I) to Baihui ((V 20) (penetrating technique). Feng-chi (GB 20). etc. The treatment was given once every day. 6 times a week. In the western medication group. the anti depression drug. deanxit was prescribed for oral administration, 1 tablet in every morning and lunchtime each day. In 8 weeks of continuous treatment, the visual analogue scale (VAS) and Hamilton depression scale 17 items (HAMD) were used to evaluate the efficacy in the patients of the two groups, the adverse reactions were observed and the recurrence rate was followed up in 3 months.</p><p><b>RESULTS</b>After treatment. VAS and HIIAMD scores were all apparently reduced as compared with those before treatment in the patients of the two groups (all P<0.05). The reducing amplitude of VAS score in the acupuncture group was greater than that in the western medication group (P<0.05) and that of HAM) score was not different significantly as compared with that in the western mnedica tion group (P > 0.05). There was no adverse reaction in the acupuncture group and were 3 cases as dizziness, trembling. dry mouth and constipation in the western medication group. The curative and remarkably effective rate was 50.0 (10(20)) in the acupuncture group, better than 15.0% (3/20) in the western medication group (P<0.05). The recurrence rate was 10.0 (2/20) in the acupuncture group. lower than 35.0% (7/20) in the western medication group (P<0.05).</p><p><b>CONCLUSION</b>The resuscitation and tranquilization acupuncture technique achieves the definite efficacy on somatoform pain disorder, relieves depression symptoms of patients, especially pain and reduces adverse reactions and recurrence rate. The effects of this therapy are advanced as compared with deanxit.</p>