BSD method for three treatments randomly allocated with equal proportion in clinical trials / 中国临床药理学与治疗学

AIM: Previous studies have suggested that big stick design (BSD) method can only be used in clinical trials of two treatments with equal proportion, which has good statistical performance and has become the recommended choice of randomized methods. This study expands BSD method, so that it can be applied to three groups, and provides more randomized methods for clinical trials. METHODS: On the basis of BSD method used in two treatments with equal proportion, the derivation conditional allocation probability of BSD method used in three treatments with equal proportion was carried out. BSD method was compared with simple randomization (SR) method, permuted block design (PBD) method and block urn design (BUD) method by Monte-Carlo simulation in balance and randomness. RESULTS: In terms of balance, PBD method was the best, followed by BUD method, BSD method, and SR method was the worst. In terms of randomness, SR method was the best, followed by BSD method, BUD method and PBD method. The comprehensive performance showed that BSD method was better than BUD method, PBD method and SR method. CONCLUSION: The expanded BSD method used in three treatments with equal proportion has good comprehensive performance, and it can be the recommended randomization method for clinical trials of three treatments with equal proportion.

Effect of mild moxibustion with moxa stick and infrared mild moxibustion on skin blood perfusion at Waiguan (TE 5) / 中国针灸

OBJECTIVES@#To observe the changes of skin blood flow perfusion at Waiguan (TE 5) caused by mild moxibustion with moxa stick and infrared mild moxibustion using laser speckle contrast imaging technology, and to compare the microcirculatory effect during and after both moxibustion methods and explore the dose-response relationship of moxibustion.@*METHODS@#Twenty-four healthy participants were treated with mild moxibustion with moxa stick and infrared mild moxibustion at left Waiguan (TE 5). The record started when the skin temperature reached (44±1) °C, and both moxibustion methods were provided within this temperature range. The 20-minute moxibustion process was divided into four stages (5, 10, 15, and 20 min) using interpolation method, and each participant completed eight interventions with a minimum 24-hour interval between different interventions. The skin surface temperature of the left Waiguan (TE 5) was monitored when both moxibustion interventions were given for 10 min using a TES1306 thermocouple thermometer. The skin microcirculatory blood perfusion units (MBPU) of left Waiguan (TE 5) was measured using a PSIN-01087 laser speckle blood flow imager 1 min before moxibustion, at 5, 10, 15, 20 min during moxibustion and continuously for 20 min after moxibustion in each intervention.@*RESULTS@#The skin surface temperature of the left Waiguan (TE 5) remained within the range of (44±1) °C during both moxibustion methods, with no statistically significant difference (P>0.05). Compared with that before moxibustion, the MBPU of the left Waiguan (TE 5) was increased significantly at 5, 10, 15, and 20 min of both moxibustion methods (P<0.05, P<0.01). Compared with moxibustion for 10, 15 and 20 min, the MBPU of the left Waiguan (TE 5) of moxibustion for 5 min was lower in both moxibustion methods (P<0.01). For both moxibustion methods with the same moxibustion course, the MBPU of the left Waiguan (TE 5) 20 min after intervention was significantly higher than that at 1 min before moxibustion (P<0.001), and there was no significant difference in MBPU between 1 min before moxibustion and 20 min after moxibustion among different groups (P>0.05). Within the same moxibustion method, the MBPU of the left Waiguan (TE 5) 20 min after moxibustion with the intervention of 5 min was lower compared to that of 10, 15, and 20 min of moxibustion (P<0.001), with no significant differences between 10, 15, and 20 min of moxibustion (P>0.05).@*CONCLUSIONS@#When controlling the skin temperature at Waiguan (TE 5) within (44±1) °C, infrared mild moxibustion has similar effects on skin microcirculatory blood perfusion as traditional mild moxibustion with moxa sticks. From a dose-response perspective, microcirculation reached a stable state after 10 min of moxibustion, and moxibustion interventions lasting for more than 10 min shows better therapeutic effects.

Effects of herbal cake separated moxibustion on Tim-4 and ubiquitination of PD-1 in rabbits with immunosuppression / 中国针灸

OBJECTIVE@#To observe the effects of herbal cake separated moxibustion on macrophage effector molecule T-cell immunoglobulin and mucin-domain containing-4 (Tim-4) and ubiquitination of programmed cell death protein 1 (PD-1) in rabbits with immunosuppression, and to explore the possible mechanism on herbal cake separated moxibustion in improving immunosuppression.@*METHODS@#Thirty-two big-ear white rabbits were randomly divided into a normal group, a model group, a moxa stick moxibustion group and a herbal cake separated moxibustion group, 8 rabbits in each group. Except the normal group, the immunosuppression model was established by intraperitoneal injection of cyclophosphamide of60 mg/kg in the other 3 groups. "Shenque" (CV 8), "Shenshu" (BL 23), "Zusanli" (ST 36), etc. were selected in both the moxa stick moxibustion group and the herbal cake separated moxibustion group. Moxa stick moxibustion was applied in the moxa stick moxibustion group, one cone at each acupoint; herbal cake separated moxibustion was applied in the herbal cake separated moxibustion group, 5 cones at each acupoint. The intervention was given once every other day for 10 times in both groups. Leukocyte content in peripheral blood was detected by blood cell analyzer; the positive expression of PD-1 in CD+4 T lymphocytes, CD+8T lymphocytes and CD+68 macrophages in peripheral blood was measured by flow cytometry, the serum levels of interleukin 2 (IL-2), CD8, CD68 and Tim-4 were detected by ELISA, and the expression of Tim-4 and F-box only protein 38 (FBXO38) in the liver and spleen tissues was measured by immunohistochemistry.@*RESULTS@#Compared with the normal group, in the model group, white blood cell count (WBC) and percentage of neutrophils (NEU%) were decreased while percentage of lymphocyte (LYM%) was increased (P<0.01) in peripheral blood; the positive expression rates of PD-1 in CD+4 T lymphocytes, CD+8T lymphocytes and CD+68 macrophages in peripheral blood were increased (P<0.01); the serum levels of IL-2, CD68 and Tim-4 were increased (P<0.01), the serum level of CD8 was decreased (P<0.01); the average optical density (AOD) of Tim-4 in the liver tissue and FBXO38 in the liver and spleen tissues was increased (P<0.01). Compared with the model group, in the moxa stick moxibustion group and the herbal cake separated moxibustion group, WBC and NEU% were increased (P<0.01); the positive expression rates of PD-1 in CD+4 T lymphocytes, CD+8T lymphocytes and CD+68 macrophages in peripheral blood were decreased (P<0.01); the serum levels of IL-2, CD68 and Tim-4 were decreased (P<0.01), the serum levels of CD8 were increased (P<0.01); the AOD of Tim-4 and FBXO38 in the liver tissue and FBXO38 in the spleen tissue was decreased (P<0.01, P<0.05). Compared with the moxa stick moxibustion group, in the herbal cake separated moxibustion group, the positive expression rate of PD-1 in CD+68 macrophages in peripheral blood was increased (P<0.05); serum level of Tim-4 was increased (P<0.01); AOD of Tim-4 in the liver tissue was decreased (P<0.05).@*CONCLUSION@#Herbal cake separated moxibustion can improve immunosuppression by regulating the expression of macrophage effector molecule Tim-4 and the FBXO38 mediated ubiquitination of PD-1, Tim-4 may be one of the specific indexes of immunomodulation involving with herbal cake separated moxibustion.

NEEDLE STICK INJURY AND POST EXPOSURE PROPHYLAXIS FOR HIV AND HBV – A KAP STUDY AMONG HEALTH CARE WORKERS

Needle stick injuries (NSI) are occupational injuries in Health Care Workers (HCWs) on using sharps. Though there are more than 20 pathogens transmitted through NSI, human immune de?ciency virus (HIV), hepatitis B & C virus (HBV&HCV)[1] are of signi?cance due to grave complications and minimum available preventive measures. According to WHO, nearly 40% of HBV and 2.5% of HIV infections among HCWs is attributed to NSI[2]. The occurrence of NSI can be reduced if Standard Work Precautions are strictly adhered by all HCWs at all times and also by taking Post Exposure Prophylaxis for HIV & HBV within the golden period of 2 hour. This study is done to assess the knowledge, attitude and practice of HCWs of various categories on NSI and PEP. A Self structured questionnaire was administered to the study population (n=307) including Post graduates, Interns, Staff nurses, Nursing students , Lab technicians, Lab technical students. There was 10 questions under three sections.1) KNOWLEDGE 2) ATTITUDE 3) PRACTICE . This study revealed that knowledge regarding transmission of all three viruses (HIV,HBV,HCV) was less among paramedics compared to medicos, but the practice of HBV vaccination is the same. 53.1% of HCWs had NSI in our study. Majority incurred NSI during recapping needles. Attitude of HCW after being exposed to report NSI is very low (30.7%). Though 37.5% of the respondents not aware of golden hour of PEP, most of them aware of initiating PEP within 72 hours of exposure . Applying disinfectants/pressure over exposed area (38.9%) & recapping (31.6%) is still prevalent among study population. And 20 % of the HCWs were not vaccinated against Hepatitis B yet.

Occupational Exposure to Needle Stick Injuries among Health Care Workers in a Tertiary care hospital: A KAP study

Background: Needle stick injuries (NSIs) are serious occupational health problem related to accidental exposure of health care workers (HCWs) while involved in patient care services. The percutaneous exposure to potentially contaminated blood and body fluids with blood borne pathogens are responsible for significant prevalence of Hepatitis B, C & HIV infections amongst HCWs. Methods: This is a descriptive cross sectional study conducted in hospital settings over a period of one year. 178 HCWs were selected for study using systematic random sampling after proportional allocation for each professional category in the hospital. Collected data was processed on SPSS ver 24. The association between needle stick and associated factors were measured using the odds ratio at a 95% confidence interval. The statistical significance was made at a p-value of less than 0.05. Results Total of 62 incidences of sustaining a needle stick injury in a year was recorded amongst 178 HCWs. In this study, statistically significant results with p value less than 0.05 was obtained with association with variables like gender [AOR=1.36 (0.64 - 2.68)], experience in years as HCWs [AOR=1.23 (0.32 - 2.12)], profession [AOR=0.063 (0.001- 0.43)], observance of universal precautions as wearing gloves [AOR=0.33 (0.169 – 0.631)] or any training on PEP or universal precautions [AOR=2.29 (1.320 - 4.696)]. Conclusion: NSIs have the potential to affect the health system both directly and indirectly. To lessen the dangers and impacts of NSIs stringent training should coordinate the endeavors toward preparing of health care workers, utilization of wellbeing designed gadgets, and diminishing patient burden per health care workers.

Prevalence of needle stick injuries, its associated factors and awareness among nursing staff at tertiary care hospital of North India

Background: Needle Stick Injuries (NSIs) are defined as accidental skin penetrating injuries caused by needles. It is the single greatest occupational hazard to a medical personnel. In developing countries, needle stick injury is associated with the highest global prevalence of HIV, Hepatitis B, and Hepatitis C. Aim & Objectives: To estimate the prevalence of needle stick injuries, its associated risk factors and assess the awareness regarding needle stick injuries among nursing staff. Material & Methods: A cross-sectional study was conducted among nursing staff who were working at a tertiary care hospital in Northern India during June 2019 to November 2019. The study commenced after taking prior approval from institutional ethics committee. A census method was used to include the participants. Results: Around 66.7% of the nursing staff was exposed to NSIs during their working hours at the hospital. There was significant association of needle stick injuries with place of working and education of nursing staff in multivariate binary logistic regression. About 26% of the nurses were unaware that recapping should be done or not for used needle, and 35% of staff nurses recapped the needle after the use. Conclusion: Needle stick injuries can be prevented by continued education, effective training, providing better safety devices, a positive work environment.

Needle Stick and Sharp Injuries among Health Care Workers in Kelantan: A Retrospective Six-Year Cohort Study

@#Introduction: The prevalence of needle stick and sharp injuries (NSSIs) still high among healthcare workers and many of them, without reason had defaulted the post management follow up. Thus, the aim of the study was to determine factors associated with default follow up among healthcare workers sustained NSSIs in Kelantan. Method: A retrospective cohort study using secondary data from Sharp Injury Surveillance notification system within period of six years started from January 2010 was done. Data were collected using proforma and analysed using SPSS version 22.0. Two hundred and seventy cases were selected by using multistage random selection method. Binary logistic regression analysis was used to determine the factors. Result: Majority of reported NSSIs involved female, with the mean age of 33 years. Most of them were intern that had less than ten years’ experience. Most of the accident occurred during office hours at tertiary healthcare setting during venepuncture for blood or intravenous fluid management. The workers with age less than 40 years and those who work at hospital setting have higher possibility to default the follow up with (Adj. OR 2.80; 95% CI: 1.12,7.00; p = 0.027) and (Adj. OR 4.65; 95% CI: 1.77,12.33; p = 0.002) respectively. Conclusion: NSSIs can occur at all level of occupational setting particularly among those who has less experience and work at tertiary healthcare setting. Thus, an intensive precaution action should focus on them since they are also the group that has higher odd to default the post management follow up.

Meta analysis of real psychological experience of needle stick injury exposure between nursing students and clinical nurses / 中国实用护理杂志

Objective:To systematically summarize the real experience of nursing students and clinical nurses after needle stick injury exposure, so as to provide the basis for the subsequent development of intervention strategies.Methods:Databases including PubMed, The Cochrane Library, Web of science, Science direct and EBSCO host, PsychINFO, Scopus, CNKI, Wanfang, VIP and CBM were searched about the qualitative research on the real experience of needle stick injury exposure of nursing students and clinical nurses from the establishment of the database to September 2020. The qualitative research quality evaluation standard of Australia JBI evidence-based health care center was used for evaluation, and the result integration method was used for integration.Results:A total of 19 literatures were included, 16 literatures related to interns and junior nurses were included, and 79 research results were extracted. 11 literatures related to senior nurses were included, and 57 research results were extracted. The similar research results were summarized into six new categories, which were summarized into three integrated results, namely, the psychological experience of nurses with needle stick injuries; the impact of needle stick injuries on family life and personal value; and the need for support.Conclusions:We should pay attention to the emotional and emotional experience of interns and clinical nurses after needle stick injury, provide professional psychological counseling, improve the occupational exposure monitoring and security system, and give full social support.

Evaluation of brain injury caused by stick type blunt instruments based on convolutional neural network and finite element method / 生物医学工程学杂志

The finite element method is a new method to study the mechanism of brain injury caused by blunt instruments. But it is not easy to be applied because of its technology barrier of time-consuming and strong professionalism. In this study, a rapid and quantitative evaluation method was investigated to analyze the craniocerebral injury induced by blunt sticks based on convolutional neural network and finite element method. The velocity curve of stick struck and the maximum principal strain of brain tissue (cerebrum, corpus callosum, cerebellum and brainstem) from the finite element simulation were used as the input and output parameters of the convolutional neural network The convolutional neural network was trained and optimized by using the 10-fold cross-validation method. The Mean Absolute Error (MAE), Mean Square Error (MSE), and Goodness of Fit ( R 2) of the finally selected convolutional neural network model for the prediction of the maximum principal strain of the cerebrum were 0.084, 0.014, and 0.92, respectively. The predicted results of the maximum principal strain of the corpus callosum were 0.062, 0.007, 0.90, respectively. The predicted results of the maximum principal strain of the cerebellum and brainstem were 0.075, 0.011, and 0.94, respectively. These results show that the research and development of the deep convolutional neural network can quickly and accurately assess the local brain injury caused by the sticks blow, and have important application value for understanding the quantitative evaluation and the brain injury caused by the sticks struck. At the same time, this technology improves the computational efficiency and can provide a basis reference for transforming the current acceleration-based brain injury research into a focus on local brain injury research.

Consideration on development of the national standard: Pure Moxa Stick / 中国针灸

The paper gives a consideration on the development of the national standard, Pure Moxa Stick. It is proposed that the principle and requirements for the development of product standard should be adhered to, while focusing on the applicability and safety of pure moxa stick. In terms of quality, the specific requirements should be developed on the ratio of moxa floss, wrapping paper and adhesives. Regarding the specifications, either the market demands or the resource waste prevention should be considered. In safety, the combustion temperature and moxa smoke control are the key issues.

Investigating the influence of moxibustion on colonic mucosal barrier in rats with dextran sulfate sodium-induced ulcerative colitis / 针灸推拿医学（英文版）

Objective: To observe the effect of moxibustion on the colonic mucosal barrier of rats with ulcerative colitis (UC) induced by dextran sulfate sodium (DSS). Methods: Forty male Sprague-Dawley rats were randomly divided into a normal group and a modeling group, with 20 rats in each group. Rats in the modeling group were subjected to preparing experimental UC models by drinking 4％ DSS for seven consecutive days. Two modeled rats and two normal rats were randomly selected for model identification. After the success of UC model was confirmed, the remaining 18 modeled rats were randomly divided into three groups, a model group, a model + herbal cake-partitioned moxibustion group, and a model + mild moxibustion group, with six rats in each group; the remaining normal rats were randomly divided into three groups, a normal group, a normal + herbal cake-partitioned moxibustion group, and a normal + mild moxibustion group, with six rats in each group. After 7 d of intervention with the herbal cake-partitioned moxibustion or the mild moxibustion, hematoxylin-eosin (HE) staining technique was used to observe the pathological changes of colon tissue under a light microscope; Western blotting and/or immunohistochemical techniques were used to detect the protein expression levels of Occludin, Claudin, junction adhesion molecular 1 (JAM1), mucin 2 (MUC2), and transforming growth factor beta1 (TGF-β1) in rat colon tissue. Results: Compared with the normal group, the colon tissue was severely damaged, the pathological score was significantly increased, and the protein expression levels of Occludin, Claudin, JAM1, MUC2, and TGF-β1 were significantly decreased in the model group (P<0.01); while there were no significant differences in the colonic histopathological score, protein expression levels of Occludin, Claudin, JAM1, MUC2, and TGF-β1 in the normal + herbal cake-partitioned moxibustion group and the normal + mild moxibustion group (P>0.05). Compared with the model group, the model + herbal cake-partitioned moxibustion group and the model + mild moxibustion group showed repaired colon tissue, ulcer healing, significantly reduced pathological score, and significantly increased protein expression levels of JAM1, MUC2, and TGF-β1 (P<0.05); the Occludin protein expression level in the colon tissue of the model + mild moxibustion group was increased (P<0.01). Conclusion: Neither herbal cake-partitioned moxibustion nor mild moxibustion influences the colonic histopathology and intestinal mucosal barrier-related protein expression in the normal rats; both herbal cake-partitioned moxibustion and mild moxibustion can up-regulate the protein expression levels of JAM1, MUC2, and TGF-β1 in the colon tissue of UC rats. Mild moxibustion can up-regulate Occludin protein expression. This may be a mechanism of moxibustion in reducing colonic mucosa inflammation in UC.

Efficacy of mild moxibustion combined with surgery for meniscal injury and its effect on TGF-β1 and PDGF levels in the fluid of knee joint / 针灸推拿医学（英文版）

Objective: To observe the efficacy of mild moxibustion combined with arthroscopic meniscal repair in the treatment of meniscal injury and to explore its action mechanism. Methods: Ninety-eight patients with meniscal injury were divided into a surgery group and a moxibustion plus surgery group by the random number table method, with 49 cases in each group. Both groups received arthroscopic meniscal repair, and the moxibustion plus surgery group was treated with add-on mild moxibustion. The Lysholm score, visual analog scale (VAS) score, and mobility of the affected knee were measured before and after treatment, and transforming growth factor (TGF)-β1 and platelet-derived growth factor (PDGF) levels were measured in the fluid of the affected knee joint. The healing of the meniscus was recorded at a follow-up visit 3 months after the surgery. Results: After treatment, the Lysholm score increased, the VAS score decreased in both groups, and the intra-group differences in both groups were statistically significant (P<0.05). The Lysholm score was higher in the moxibustion plus surgery group than in the surgery group, and the VAS score was lower in the moxibustion plus surgery group than in the surgery group. The differences between groups in both scores were statistically significant (P<0.05). The mobility of the affected knee joint increased in both groups (P<0.05), and it was greater in the moxibustion plus surgery group than in the surgery group (P<0.05). When compared with pretreatment, the levels of TGF-β1 and PDGF in the fluid of the knee joint increased in both groups (P<0.05), and the levels of TGF-β1 and PDGF in the fluid of the affected knee joint were higher in the moxibustion plus surgery group than in the surgery group (P<0.05). The healing of the meniscus in the moxibustion plus surgery group was significantly better than that in the surgery group at the follow-up visit 3 months after the surgery (P<0.05). Conclusion: The effect of mild moxibustion combined with arthroscopic meniscal repair is better than the surgery alone in improving knee function, relieving pain, increasing mobility of the affected knee, and promoting meniscal healing, which may be related to the up-regulation of TGF-β1 and PDGF levels in the fluid of knee joint.

Effect of moxibustion on N-methyl-D-aspartate receptor subtype 2B expression in hippocampus of rheumatoid arthritis model rats / 针灸推拿医学（英文版）

Objective: To observe the effect of moxibustion on the expression of N-methyl-D-aspartic acid (NMDA) receptor subtype 2B (NR2B) in the hippocampus of rheumatoid arthritis (RA) rats, and to explore the analgesic mechanisms of moxibustion in RA treatment. Methods: Sixty male Sprague-Dawley rats were randomly divided into a normal group, a model group, a moxibustion group, a moxibustion + NMDA receptor antagonist (AP-5) group, and a moxibustion + NMDA receptor agonist (NMDA) group, with 12 rats in each group. Except for the normal group, rats in the other four groups were treated with complete Freund's adjuvant in a windy, cold, and damp environment to replicate RA models. Rats in the moxibustion group received suspended moxibustion with moxa sticks at Shenshu (BL23) and Zusanli (ST36), and the two points were used alternately. After intraperitoneal injection of AP-5 or NMDA, rats in the moxibustion + AP-5 group and the moxibustion + NMDA group received the same moxibustion intervention as in the moxibustion group, once a day for 15 d. The thermal withdrawal latency (TWL) of rats in each group was detected before and after modeling and after the 15-day intervention. After the 15-day intervention, hematoxylin-eosin staining was performed to observe the pathological changes in knee joints. The real-time fluorescence quantitative polymerase chain reaction method was used to detect the mRNA expression of NR2B in the hippocampus; Western blotting assay was used to detect the protein and the phosphorylated protein expression of hippocampal NR2B. Results: The synovial tissue was proliferated, the synovial lining was significantly thickened, the pannus was formed, and the cartilage and bone tissues were significantly damaged in the model group. After intervention, the pathological morphology of the knee joints in the moxibustion group, the moxibustion + AP-5 group, and the moxibustion + NMDA group was significantly improved, and the improvement in the moxibustion + AP-5 group was more notable than that in the moxibustion + NMDA group. Compared with the normal group, the TWL was significantly decreased (P<0.01), and the mRNA, protein, and phosphorylated protein expression levels of hippocampal NR2B were significantly increased in the model group (P<0.01). Compared with the model group, the TWL of each intervention group was significantly increased (P<0.01 or P<0.05), and the mRNA, protein, and phosphorylated protein expression levels of hippocampal NR2B were significantly decreased (P<0.01). Compared with the moxibustion group, the TWL was significantly increased (P<0.01), and the mRNA, protein, and phosphorylated protein expression levels of hippocampal NR2B were significantly decreased in the moxibustion + AP-5 group (P<0.01); the TWL was significantly decreased (P<0.01), and the mRNA, protein, and phosphorylated protein expression levels of hippocampal NR2B were significantly increased in the moxibustion + NMDA group (P<0.01). Conclusion: Moxibustion reduces hyperalgesia in RA inflammatory rats. The analgesic effect may be related to the decrease in the expression and phosphorylation levels of NR2B in the hippocampus.

Mild moxibustion plus loratadine tablets for children with allergic rhinitis: a randomized controlled trial / 针灸推拿医学（英文版）

Objective: To explore the efficacy of mild moxibustion plus loratadine tablets for children with allergic rhinitis (AR).Methods: A total of 80 children were randomized into a control group and an observation group, with 40 cases in each group. The control group was treated with loratadine tablets, and the observation group was treated with mild moxibustion plus loratadine tablets. Before and after treatment, the total nasal symptom score (TNSS) was evaluated, and the serum eosinophils (EOS) count, and the interleukin (IL)-27 and macrophage migration inhibitory factor (MIF) levels were measured. Clinical efficacy was evaluated after treatment. Results: The total effective rate of the observation group was higher than that of the control group (P<0.05). After treatment, the TNSS in both groups decreased (P<0.05), and the TNSS in the observation group was lower than that in the control group (P<0.05); the serum EOS count in both groups decreased (P<0.05), and the serum EOS count in the observation group was lower than that in the control group (P<0.05). The serum IL-27 level in the control group had no statistical difference compared with the same group before treatment (P>0.05), and the serum MIF level decreased after treatment (P<0.05). The serum IL-27 level in the observation group increased after treatment (P<0.05), and the serum MIF level decreased after treatment (P<0.05), and were both statistically different from those in the control group (P<0.05). Conclusion: Mild moxibustion plus loratadine tablets is effective in treating children with AR. It can significantly improve the nasal symptoms and reduce the serum EOS count, which may be related to the regulation of the serum IL-27 and MIF levels.

Efficacy and effect on serum VEGF-C of mild moxibustion plus functional exercise for upper-limb lymphedema after breast cancer surgery / 针灸推拿医学（英文版）

Objective: To observe the efficacy of mild moxibustion combined with functional exercise in the treatment of upper-limb lymphedema after breast cancer surgery and its effect on serum vascular endothelial growth factor C (VEGF-C). Methods: Seventy-eight patients were divided into a control group and an observation group by the random number table method, with 39 cases in each group. The control group received functional exercise and the observation group received mild moxibustion plus functional exercise. The differences in circumference between the two upper limbs, the lymphatic flow of the affected upper limb, the disability of arm, shoulder and hand (DASH) score, the functional assessment of cancer therapy-breast (FACT-B) score and serum VEGF-C level between the two groups were compared before and after treatment. Efficacy was evaluated after treatment. Results: The total effective rate was significantly higher in the observation group than in the control group (P<0.05). The difference in circumference between the two upper limbs of the two groups decreased significantly after treatment (both P<0.05), but it was significantly lower in the observation group than in the control group (P<0.05). The lymphatic flow of the affected upper limb of the two groups increased significantly after treatment (both P<0.05), but it was significantly greater in the observation group than in the control group (P<0.05). The DASH scores of the two groups decreased significantly after treatment (both P<0.05), but it was significantly lower in the observation group than in the control group (P<0.05). The FACT-B scores of the two groups increased significantly after treatment (both P<0.05), but it was significantly higher in the observation group than in the control group (P<0.05). After treatment, the serum VEGF-C level increased significantly in the observation group (P<0.05), whereas the control group did not show significant change (P>0.05). The post-treatment serum VEGF-C level was significantly higher in the observation group than in the control group (P<0.05). Conclusion: The efficacy of mild moxibustion combined with functional exercise for upper-limb lymphedema after breast cancer surgery is certain, which can reduce the difference in circumference between the two upper limbs, increase the lymphatic flow of the affected upper limb, improve the limb function and the quality of life, and regulate the serum VEGF-C level.

Effect of moxibustion at Shenque (CV 8) on myocardial remodeling and function in exercise-induced fatigue rats / 针灸推拿医学（英文版）

Objective: To explore the effect of moxibustion at Shenque (CV 8) on myocardial structure and function in exercise-induced fatigue rats. Methods: A 12-week treadmill running training was performed to create an exercise-induced fatigue rat model. Sixty eligible male specific-pathogen-free grade Sprague-Dawley rats were randomly divided into a blank group, a control group, a model group, a non-meridian non-acupoint group, a Zusanli (ST 36) group and a Shenque (CV 8) group, with 10 rats in each group. Rats in the blank group did not receive treadmill running training or moxibustion. Rats in the control group did not receive treadmill running training but received mild moxibustion at Shenque (CV 8). Rats in the model group received treadmill running training but no moxibustion. Rats in the non-meridian non-acupoint group, the Zusanli (ST 36) group and the Shenque (CV 8) group received moxibustion at the non-meridian non-acupoint points, Zusanli (ST 36) or Shenque (CV 8) immediately after each treadmill running training, 15 min each time, once a day for 5 consecutive days a week at a 2-day interval, 60 times of moxibustion in total. Left ventricular end-diastolic diameter (LVEDd), left ventricular end-systolic diameter (LVESd), left ventricular diastolic volume (LVDv), left ventricular systolic volume (LVSv), ejection fraction (EF), stroke volume (SV), early diastolic peak flow velocity of mitral valve (E) and late diastolic peak flow velocity of mitral valve (A) of each group before and after the last treadmill running training were measured. Blood was collected 6 h after the last treadmill running training, and serum C-reactive protein (CRP), myoglobin (Mb), creatine kinase-myocardial band (CK-MB), cardiac troponin I (cTnI) and cardiac troponin T (cTnT) levels were detected. Finally, the heart was separated, the heart mass (HM) was measured, the cTnT level of the myocardial tissue was detected, the ultrastructural changes of the left ventricular myocardium were observed by transmission electron microscope, the left ventricular fraction shortening (LVFS), E/A and heart mass index (HMI) were calculated. Results: Compared with the same group before treatment, the rat cardiac LVEDd, LVESd, LVDv, LVSv, SV, E and A were significantly increased (all P<0.01), and the rat LVFS, E/A and EF were significantly decreased (all P<0.01) in the model group and the non-meridian non-acupoint group after treatment; the rat cardiac SV, LVDv, LVSv, E and A were all increased (all P<0.01), while E/A and EF were decreased (all P<0.01) in the Zusanli (ST 36) group after treatment; the rat cardiac LVDv, E and A were significantly increased (P<0.01 or P<0.05), and E/A was significantly decreased (P<0.01) in the Shenque (CV 8) group after treatment. After treatment, compared with the blank group, the rat cardiac LVEDd, LVESd, SV, LVDv, LVSv, E, A, the serum CRP, Mb, CK-MB, cTnI, cTnT and HMI, and the myocardial cTnT were increased (all P<0.01), and the LVFS, E/A and EF were all reduced (all P<0.01) in the model group; compared with the model group and the non-meridian non-acupoint group, rats in the Zusanli (ST 36) group and the Shenque (CV 8) group showed decreased LVEDd, LVESd, SV, LVDv, LVSv, E, A, serum CRP, Mb, CK-MB, cTnI, cTnT and HMI, and myocardial cTnT (P<0.01 or P<0.05), along with increased LVFS, E/A and EF (all P<0.01); compared with the Zusanli (ST 36) group, Mb and A of the Shenque (CV 8) group were decreased (both P<0.01), while both E/A and EF were increased (P<0.01, P<0.05). Transmission electron microscopy examination showed that myofibrils in the blank group and the control group were neatly arranged with clear light and dark bands; the model group and the non-meridian non-acupoint group showed different degrees of myofibril disintegration and breakage, increased and aggregated mitochondria of different sizes, and increased electron density. The myofibrils in the Shenque (CV 8) group and Zusanli (ST 36) group were arranged neatly with clear light and dark bands, and compensatory hyperplasia of mitochondria. Conclusion: Moxibustion at Shenque (CV 8) and Zusanli (ST 36) both can effectively improve the occurrence of myocardial remodeling in exercise-induced fatigue rats, and the effect of moxibustion at Shenque (CV 8) is better in improving cardiac function.

Regulatory effect of mild moxibustion on P2X3 receptors in spinal cord, anterior cingulate cortex and thalamic ventral posterolateral nucleus of rats with IBS visceral hyperalgesia / 针灸推拿医学（英文版）

Objective: To observe the therapeutic effect of mild moxibustion on irritable bowel syndrome (IBS) visceral hyperalgesiamodel rats and its regulatory effect on P2X3 receptors in the spinal cord, anterior cingutate cortex (ACC) and thalamic ventral posterolateral nucleus (VPL). Methods: Thirty 8-day-old newborn rats were randomly divided into a normal group (n=6) and a modeling group (n=24) according to the completely random number table method. Rats in the normal group were bred routinely, and those in the modeling group were subjected to preparing IBS chronic visceral hyperalgesia model using colorectal distention (CRD) in stimulation method. Rats successfully modelled were re-divided into a model group, a mild moxibustion group, a P2X3 receptor antagonist group, and a normal saline group according to the completely random number table method with 6 rats in each group. Rats in each group received corresponding interventions from the 37-day old, once a day for 7 consecutive days. Immunohistochemistry and Western blot assays were used to detect P2X3 protein expressions in the spinal cord, ACC and VPL of rats. Results: Under different intensities of CRD stimulation, the abdominal withdrawal reflex (AWR) scores of the model group were significantly increased versus the normal group (all P<0.05); the AWR scores of the mild moxibustion group and the P2X3 receptor antagonist group were significantly reduced versus the model group (all P<0.01). The P2X3 protein expressions in rat spinal cord, ACC and VPL tissues of the model group were significantly increased versus the normal group (all P<0.01); the P2X3 protein expressions in rat spinal cord, ACC and VPL tissues of the mild moxibustion group and the P2X3 receptor antagonist group were significantly reduced versus the model group (all P<0.01). Conclusion: Mild moxibustion can inhibit the P2X3 receptor expressions in the spinal cord, ACC, and VPL tissues of IBS visceral hyperalgesia model rats, which may be the mechanism of mild moxibustion in relieving the central sensitization of rats with IBS visceral hyperalgesia.

Effect of mild moxibustion on cancer-related fatigue, serum ghrelin and adiponectin in patients undergoing chemotherapy after colorectal cancer surgery / 针灸推拿医学（英文版）

Objective: To observe the effect of mild moxibustion on cancer-related fatigue, serum ghrelin and adiponectin in patients undergoing chemotherapy after colorectal cancer surgery. Methods: Seventy patients were divided into a control group and an observation group according to the random number table method, with 35 cases in each group. Patients in both groups were treated with conventional FOLFOX4 chemotherapy regimen. Patients in the control group also received routine treatments such as symptomatic treatment of complications, health education, nutritional support, and exercise intervention. Patients in the observation group received mild moxibustion on the basis of interventions used in the control group. The Piper fatigue scale-revision (PFS-R), Karnofsky performance status (KPS) and spleen and kidney yang deficiency syndrome were scored, and serum ghrelin and adiponectin levels were measured before and after treatment. Results: After treatment, total score of PFS-R in the control group did not change significantly (P>0.05), while in the observation group it was significantly reduced (P<0.05) and lower than that in the control group (P<0.05); KPS scores in both groups were increased (both P<0.05), and it was significantly higher in the observation group than in the control group (P<0.05); total score of spleen and kidney yang deficiency syndrome in the control group did not change significantly (P>0.05), while it was significantly reduced in the observation group (P<0.05) and lower than that in the control group (P<0.05); serum ghrelin and adiponectin levels in the control group had no significant changes (both P>0.05), but the levels were significantly increased in the observation group (both P<0.05) and higher than those in the control group (both P<0.05). Conclusion: Based on the routine treatments, mild moxibustion can relieve fatigue, improve quality of life, and improve the symptoms of spleen and kidney yang deficiency in patients undergoing chemotherapy after colorectal cancer surgery, which may be related to the regulation of serum ghrelin and adiponectin levels.

Clinical observation of heat-sensitive moxibustion for acute ischemic stroke / 针灸推拿医学（英文版）

Objective: To observe the clinical efficacy of heat-sensitive moxibustion in intervening acute ischemic stroke. Methods: A total of 112 patients were divided into a control group and an observation group by the random number table method, with 56 cases in each group. The control group was treated with conventional treatment, and the observation group was treated with heat-sensitive moxibustion on the basis of the treatment in the control group. The National Institute of Health stroke scale (NIHSS) and modified Barthel index (MBI) were evaluated, and the intracranial hemodynamic indicators including mean velocity (Vm), pulsatility index (PI) and resistance index (RI) were recorded, and the serum levels of superoxide dismutase (SOD) and homocysteine (HCY) were measured before and after treatment. Clinical efficacy was evaluated after treatment. Results: The total effective rate of the observation group was significantly higher than that of the control group (P<0.05). After treatment, the NIHSS scores in both groups decreased significantly (both P<0.05), and the MBI scores increased significantly (both P<0.05). The improvements of NIHSS and MBI scores in the observation group were superior to those in the control group (both P<0.05). Vm in both groups increased significantly (both P<0.05), PI and RI decreased (all P<0.05), and Vm, PI and RI in the observation group were superior to those in the control group (all P<0.05). The serum levels of SOD and HCY in the observation group were significantly improved, and were statistically different from those in the control group (both P<0.05). Conclusion: Conventional treatment plus heat-sensitive moxibustion is effective in intervening acute ischemic stroke. It can promote the recovery of neurological function, improve daily activities, and improve intracranial blood flow, which may be related to the regulation of serum SOD and HCY levels.

Stick supporting reposition used to treat irreducible intertrochanteric fractures / 中华创伤骨科杂志

Objective:To evaluate our self-designed stick supporting reposition which was used to treat irreducible intertrochanteric fractures.Methods:A retrospective study was conducted of the 138 patients with irreducible intertrochanteric fracture (an observational group) who had been treated by stick supporting reposition followed by intramedullary nailing at Department of Orthopaedics, Beijing Hospital between April 2015 and December 2019. They were 45 males and 93 females with an age of (79.9±8.2) years; by AO classification, there were 25 cases of type 31-A1, 98 cases of type 31-A2 and 15 cases of type 31-A3. The other 142 patients with irreducible intertrochanteric fracture were included as a control group who had been treated by open or limited open reduction and intramedullary nailing between January 2010 and March 2015. The 2 groups were compared in terms of reduction time, operation time, intraoperative blood loss, reduction quality, fracture union time and complications.Results:The 2 groups were comparable because there was no significant difference between them in preoperative general data or follow-up time ( P>0.05). The reduction time [(12.0±3.4) min], operation time [(64.1±6.5) min], and intraoperative blood loss [(228.0±40.0) mL] in the observational group were significantly less than those in the control group [(18.3±8.9) min, (72.3±11.2) min and (319.1±95.0) mL] ( P<0.05). The reduction quality in the observational group (82 excellent and 56 acceptable cases) was significantly better than that in the control group (63 excellent, 65 acceptable and 14 poor cases) ( P<0.05). The fracture union time for the observational group [(3.8±0.9) months] was significantly shorter than that for the control group [(4.0±0.9) months] ( P>0.05). There were 6 cases of internal fixation failure and 8 cases of hip varus deformity in the control group, but no such complications occurred in the observational group. Conclusion:In the treatment of irreducible intertrochanteric fractures, compared with open or limited open reduction, our stick supporting reposition may shorten operation time, reduce intraoperative blood loss and improve quality of fracture reduction.