Laparoscopic surgery contributes to a decrease in short-term complications in surgical ulcerative colitis patients during 2008–2017: a multicenter retrospective study in China

Background/Aims@#The aim of this study was to analyze the chronological changes in postoperative complications in surgical ulcerative colitis patients over the past decade in China and to investigate the potential parameters that contributed to the changes. @*Methods@#Ulcerative colitis patients who underwent surgery during 2008–2017 were retrospectively enrolled from 13 hospitals in China. Postoperative complications were compared among different operation years. Risk factors for complications were identified by logistic regression analysis. @*Results@#A total of 446 surgical ulcerative colitis patients were analyzed. Fewer short-term complications (24.8% vs. 41.0%, P=0.001) and more laparoscopic surgeries (66.4% vs. 25.0%, P<0.001) were found among patients who received surgery during 2014–2017 than 2008–2013. Logistic regression suggested that independent protective factors against short-term complications were a higher preoperative body mass index (odds ratio [OR], 0.870; 95% confidence interval [CI], 0.785–0.964; P=0.008), laparoscopic surgery (OR, 0.391; 95% CI, 0.217–0.705; P=0.002) and elective surgery (OR, 0.213; 95% CI, 0.067–0.675; P=0.009). The chronological decrease in short-term complications was associated with an increase in laparoscopic surgery. @*Conclusions@#Our data revealed a downward trend of short-term postoperative complications among surgical ulcerative colitis patients in China during the past decade, which may be due to the promotion of minimally invasive techniques among Chinese surgeons.

Effect of epalrestat combined with calcium dobesilate on diabetes peripheral neuropathy and oxidative stress / 中华内分泌外科杂志

Objective:To explore the effect of epalrestat combined with calcium dobesilate on cardiovascular and cerebrovascular diseases and oxidative stress in diabetes patients with peripheral neuropathy.Methods:In a retrospective analysis, 92 patients with diabetic peripheral neuropathy were admitted to the Department of Endocrinology and Metabolism Hospital of Bozhou People’s Hospital from Jun. 2018 to Jun. 2021, which were divided into observation group and control group according to the different treatment methods, with 46 cases in each group. The control group were treated with epalrestat. On this basis, the observation group were given calcium dobesilate combined treatment. The two groups were compared in terms of the Michigan diabetes neuropathy score (MDNS) Michigan neuropathy screening instrument (MNSI) score, oxidative stress reaction [serum superoxide dismutase (SOD), reduced glutathione (GSH) ], clinical efficacy, complications and adverse reactions Using t-test and chi square test.Result:After treatment, the MDNS and MNSI scores of both groups decreased, and the observation group [ (23.49±3.73), (8.49±1.97) ] were lower than the control group [ (28.49±3.85), (11.53±2.28) ] ( t=8.337, 6.843, P<0.05) ; After treatment, the levels of SOD and GSH in both groups increased compared to those before treatment, and the observation group [ (38.96±4.89), (89.79±6.92) ] were higher than the control group those [ (36.42±4.61), (86.74±6.20) ] ( t=2.563, 2.226, P=0.012, 0.028) ; The clinical efficacy of the observation group was higher than that of the control group ( Z=1.592, P=0.042) ; The incidence of complications in the observation group after 1 year was significantly lower than that in the control group ( χ2=4.389, P=0.036) ; The incidence of adverse reactions in the observation group was slightly lower than that in the control group ( χ2=0.155, P=0.694) . Conclusion:Epalrestat combined with calcium dobesilate is effective in the treatment of diabetes peripheral neuropathy, can effectively reduce complications, and has high treatment safety, which is worthy of clinical application.

Survey on the overlapping prevalence of gastroesophageal reflux disease, functional dyspepsia and irritable bowel syndrome among rural adults in Shaanxi Province / 中华消化杂志

Objective:To investigate the overlapping prevalence and risk factors of gastroesophageal reflux disease (GERD), functional dyspepsia (FD) and irritable bowel syndrome (IBS) among rural adults in Shaanxi Province.Methods:From February 1 to October 31 in 2019, 12 villages in Shaanxi Province were randomly selected for household questionnaire survey through multistage stratified cluster sampling. A total of 2 423 subjects were enrolled, including 1 037 males and 1 386 females, with age of (45.3±16.9) years old. GERD was diagnosed according to the Montreal criteria, FD and IBS were diagnosed according to the Rome Ⅳ criteria. The overlapping prevalence of the three diseases were calculated. The risk factors for the overlapping of GERD, FD and IBS were analyzed. Multivariate logistic regression was used for statistical analysis.Results:Among the 2 423 subjects, 624 cases had GERD (302 cases), FD (377 cases) or IBS (167 cases), of which 30.77% (192/624) patients had overlap of ≥two diseases. The overlap rates of GERD and FD, GERD and IBS, FD and IBS, GERD, FD and IBS were 2.56% (62/2 423), 1.61% (39/2 423), 2.52% (61/2 423) and 1.24% (30/2 423), respectively. The results of Multivariate analysis showed that female and migraine without aura were positively correlated with the overlap of GERD and FD, FD and IBS, and GERD and IBS (odds ratio ( OR)=3.08, 2.68, 3.66, 7.37, 5.91 and 4.46, 95% confidence interval ( CI) 1.35 to 7.01, 1.35 to 5.30, 1.52 to 8.83, 3.97 to 13.69, 1.78 to 19.60 and 2.01 to 9.92; all P<0.05). Heavy drinking (alcohol intake≥50 g/d (male) or≥30 g/d (female)) was positively correlated with the overlap of FD and IBS, GERD and IBS, and GERD, FD and IBS ( OR=3.69, 4.20 and 4.91, 95% CI 1.19 to 11.48, 1.01 to 17.50 and 1.23 to 19.52; all P<0.05). Heavy smoking (smoking≥20 cigarettes per day) was positively correlated with the overlap of GERD and FD, FD and IBS, GERD and IBS, and GERD, FD and IBS ( OR=3.44, 6.25, 8.27 and 7.04, 95% CI 1.07 to 11.01, 1.60 to 24.44, 1.80 to 38.07 and 1.76 to 28.12; all P<0.05). The educational level of junior or senior high school and age≥60 years old were negatively correlated with the overlap of GERD and FD, FD and IBS, GERD and IBS, and GERD, FD and IBS ( OR=0.47, 0.29, 0.20, 0.05, 0.23, 0.10, 0.37 and 0.16, 95% CI 0.23 to 0.93, 0.09 to 0.95, 0.09 to 0.42, 0.01 to 0.19, 0.09 to 0.60, 0.02 to 0.65, 0.15 to 0.87 and 0.03 to 0.81; all P<0.05). Conclusions:The overlap of GERD, FD and IBS is common and affected by many factors. Female, age≥60 years old, heavy smoking, heavy drinking, low education level and history of migraine without aura are associated with multiple overlaps of GERD, FD and IBS.

Indoor simulation training system for brain-controlled wheelchair based on steady-state visual evoked potentials / 生物医学工程学杂志

Brain-controlled wheelchair (BCW) is one of the important applications of brain-computer interface (BCI) technology. The present research shows that simulation control training is of great significance for the application of BCW. In order to improve the BCW control ability of users and promote the application of BCW under the condition of safety, this paper builds an indoor simulation training system based on the steady-state visual evoked potentials for BCW. The system includes visual stimulus paradigm design and implementation, electroencephalogram acquisition and processing, indoor simulation environment modeling, path planning, and simulation wheelchair control, etc. To test the performance of the system, a training experiment involving three kinds of indoor path-control tasks is designed and 10 subjects were recruited for the 5-day training experiment. By comparing the results before and after the training experiment, it was found that the average number of commands in Task 1, Task 2, and Task 3 decreased by 29.5%, 21.4%, and 25.4%, respectively ( < 0.001). And the average number of commands used by the subjects to complete all tasks decreased by 25.4% ( < 0.001). The experimental results show that the training of subjects through the indoor simulation training system built in this paper can improve their proficiency and efficiency of BCW control to a certain extent, which verifies the practicability of the system and provides an effective assistant method to promote the indoor application of BCW.

The research of sleep staging based on single-lead electrocardiogram and deep neural network

The polysomnogram (PSG) analysis is considered the golden standard for sleep staging under the clinical environment. The electroencephalogram (EEG) signal is the most important signal for classification of sleep stages. However, in-vivo signal recording and analysis of EEG signal presents us with a few technical challenges. Electrocardiogram signals on the other hand, are easier to record, and can provide an attractive alternative for home sleep monitoring. In this paper we describe a method based on deep neural network (DNN), which can be used for the classification of the sleep stages into Wake (W), rapid-eye-movement (REM) and non-rapid-eye-movement (NREM) sleep stage. We apply the sleep stage stacked autoencoder to constitute a 4-layer DNN model. In order to test the accuracy of our method, eighteen PSGs from the MIT-BIH Polysomnographic Database were used. A total of 11 features were extracted from each electrocardiogram recording The experimental design employs cross-validation across subjects, ensuring the independence of the training and the test data. We obtained an accuracy of 77% and a Cohen's kappa coefficient of about 0.56 for the classification of Wake, REM and NREM.

Effects of 32P intracavitary irradiation on scar formation in benign esophageal strictures / 西安交通大学学报(医学版)

Objective To establish a benign esophageal stricture model and observe the effect of 32P radioactive isotopes on benign esophageal stricture scarring with intracavitary irradiation so as to provide experimental evidence for inhibiting scar hyperplasia and preventing esophageal restenosis after endoscopic dilation for benign esophageal stricture.Methods Benign esophageal stricture models were established in 18 healthy adult rabbits by annular incision and anastomosis.Then the rabbits were randomly divided into control group,hormone group and irradiation group,with six rabbits in each group.On day 2 after surgery,we measured inner diameter of the anastomotic stoma;then the control group received saline intervention,the hormone group was given dexamethasone,and the irradiation group was given 32P radioactive isotopes.The rabbits were observed for two weeks for their general condition and weight.After the intervention,we measured inner diameter of the anastomotic stoma.Liver functions (ALT and AST) were tested again before modeling and after intervention.Then the rabbits were put to death and had tissue in the esophageal stricture area removed for pathological examination and esophageal HE staining.We determined hydroxyproline (HYP) content of esophageal tissue around the anastomotic stoma.Restlts Benign esophageal stricture model was established successfully.After 2 weeks,the rabbits' appetite was obviously diminished in control group and relatively poor in hormone group;obviously improved in irradiation group.The rabbits' weight increased in radiation group compared with the other two groups (P＜0.05).The esophageal inner diameter in irradiation group widened obviously compared with the other two groups (P ＜ 0.05).In irradiation group,the number of fibroblasts decreased obviously,collagen fiber and granulation tissue were not obvious;HYP content was lower than that in the other two groups,and was close to that in a normal esophagus (P＞0.05).ALT and AST did not differ before and after intervention in all groups (P＞0.05).Conclusion ① We can establish benign esophageal stricture model successfully through the surgery.② 32Pradioactive isotopes radiation therapy can be used to prevent early scar formation in esophageal benign stricture,and is superior to dexamethasone therapy.

Application and effect evaluation of stoma skin care powder combined with skin protective membrane in postoperative nursing of anal fistula / 中华护理杂志

Objective To investigate the effect of stoma skin care powde combined with skin protective mem-brane in prevention and treatment of secondary eczema after anal fistula surgery. Methods Eighty-three patients after anal fistula operation were divided into test group and control group. On the basis of routine treatment,the pa-tients in test group were used stoma skin care powder combined with skin protective membrane to protect the peri-anal skin. While the patients in control group were treated routinely. The degree of pruritus,the onset time,the number of skin lesions,the area of eczema and the healing time of eczema were observed in two groups 4 d,14 d and 24 d post-operation. Results Patients in test group had lowerdegree of pruritus,later onset time after dressing, less skin lesions,samller area of eczemaand shorter healing time of eczema than patients in control group in the 3 time nodes (all P<0.05). Conclusion Stoma skin care powder combined with skin protective membrane could effec-tively isolatepostoperative wound secretions and anus polyrrhea,and have preventive and therapeutic effects on sec-ondary perianal eczema after anal fistula surgery.

Effect of transparent cap-assisted endoscopic esophageal foreign body removal / 中国内镜杂志

Objective To compare the operation effect of esophageal foreign body removal with transparent cap-assisted endoscopic technique and traditional method. Methods Ninety-six patients with foreign body incarcerated in esophageal were randomly divided into two groups, and they were underwent transparent cap-assisted endoscopic esophageal foreign body removal or traditional endoscopic esophageal foreign body removal respectively. The clinical data of the two groups were collected, and the success rate, the operation time, the endoscopic vision clarity and the complication rate of the two groups were all recorded and analyzed. Results The success rate in transparent cap-assisted endoscopic technique group was 100% compared with 95.83% in traditional method group, and two cases of failure were transferred to transparent cap-assisted endoscopic technique and finally succeed. The mean operation time were (8.58±3.21) min in transparent cap-assisted endoscopic technique group, and (10.64 ± 5.45) min in traditional method group, and there was no significant difference in two groups (P > 0.05). Forty-five cases got A level and three got B in transparent cap-assisted endoscopic technique group in endoscopic vision clarity, in contrast to 35 A, 11 B and two C in traditional method group. The difference between the two groups was statistically significant (P = 0.020). There was no case with serious complications such as bleeding, perforation or death in two groups. Conclusions Transparent cap-assisted endoscopic technique for body removal is safety and efficacy, and this technique can provide better endoscopic operation field of vision and help improve the success rate of esophageal foreign body removal.

Effects of Heat-reinforcing Needling on Synovial Tissues of Rheumatoid Arthritis Rabbits ;with Cold Syndrome / 中国中医药信息杂志

Objective To measure the endogenous metabolites in synovial tissues of rheumatoid arthritis (RA) rabbits with cold syndrome;To investigate the specificity mechanisms of heat-reinforcing needling for RA. Methods A total of forty healthy purple blue rabbits were randomly allocated to normal group, model group, reinforcing-reducing needling group (RRN), twirling-reinforcing needling group (TRN) and heat-reinforcing needling group (HRN) 8 rabbits in each group. Arthritis rabbits cold model was made with ovalbumin and freezing. Except for normal groupand model group, RRN was given acupuncture of reinforcing-reducing needling at Zusanli (ST36), TRN was given acupuncture of twirling-reinforcing needling at Zusanli (ST36), HRN was administrated acupuncture of heat-reinforcing needling at Zusanli (ST36), once a day and retaining 30 min, a total of seven days. Fresh synovial tissues of rabbits knee joints were extracted after the intervention, then GC-Q/TOF-MS technology were employed to evaluate metabolic profiles. Results The synovial tissues metabolites of TCA cycle, carbohydrate and fatty acid metabolism in model group mainly increased compared with normal group (P<0.05); The synovial tissues metabolites of various kinds above-mentioned decreased compared with model group in all intervention of acupuncture group (P<0.05), and the metabolites of TCA cycle and carbohydrate metabolism in HRN were obviously less than that of RRN and TRN (P<0.05). Conclusion The specificity of heat-reinforcing needling for RA manifests in regulation of TCA cycle and carbohydrate metabolism.

Effect of Gastrodin on Gastric Sensitivity and Anxiety-like Behavior in FD Rats With Anxiety-like Gastric Hypersensitivity / 胃肠病学

Background:Functional dyspepsia (FD)with anxiety and gastric hypersensitivity is still one of the therapeutic difficulties in clinic. Gastrodin (Gas)may have dual effects of modulating gastric sensitivity and anxiety. Aims:To investigate the effect of Gas on gastric sensitivity and anxiety-like behavior in FD with anxiety-like gastric hypersensitivity in rats. Methods:Forty rats were randomly divided into control group,model group,buspirone group,low-dose Gas group and high-dose Gas group. Maternal separation,acute gastric irritation and restraint stress were sequentially performed to induce FD model with anxiety-like gastric hypersensitivity. At the 8th week,rats in control group and model group were intraperitoneally injected with 0. 9% NaCl solution 2. 0 mL/ kg,rats in buspirone group were given buspirone 3. 125 mg/kg,and rats in low- and high-dose Gas groups were given 62. 5,125. 0 mg/ kg Gas,respectively. The course was 7 days. Then elevated plus maze (EPM),open field test,abdominal withdrawal reflex (AWR)and electromyography (EMG) were performed. Results:Compared with control group,EPM test showed that proportions of open arms entries and duration were significantly decreased (P < 0. 01);open field test showed that virtual central grids duration (P < 0. 05),number of virtual grids climbed and times of lifting were significantly decreased (P < 0. 01);when gastric balloon dilatation pressure was equal or greater than 40 mm Hg,AWR score,area under ROC curve (AUC)of EMG was significantly increased in model group (P < 0. 05). Compared with model group,above-mentioned indices in low- and high-dose Gas groups were significantly ameliorated (P < 0. 05). Conclusions:Gas could influence the gastric sensitivity and anxiety-like behavior of the brain-stomach axis regulated anxiety-like gastric hypersensitivity in FD rat model.

Effects of heat-reinforcing acupuncture on urine metabolites in rheumatoid arthritis rabbits / 中国针灸

<p><b>OBJECTIVE</b>To compare the effects of different acupuncture methods on urine metabolites in rheumatoid arthritis (RA) rabbits, and to explore the specificity mechanism of heat-reinforcing acupuncture for RA.</p><p><b>METHODS</b>A total of 40 clean purple-blue rabbits were randomly allocated to a normal group, a model group, a mild reinforcing-reducing needling (MRRN) group, a twirling-reinforcing needling (TRN) group and a heat-reinforcing needling (HRN) group, 8 rabbits in each one. Except the normal group, the rabbits in the remaining groups were treated with ovalbumin and freezing to establish RA model. The rabbits in the MRRN group, TRN group and HRN group were treated with MRRN, TRN and HRN at "Zusanli" (ST 36), respectively, 30 min per treatment, once a day for seven days. After treatment, 24-h urine was collected. The rabbits were sacrificed to collect synovial tissues of knee to perform morphology observation; the liquid chromatography quadrupole time-of-flight mass spectrometry (LC-Q/TOF-MS) was applied to measure urine metabolites. All the data were analyzed by principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA).</p><p><b>RESULTS</b>Compared with the normal group, the leucine-related metabolites, as main urine metabolites, were decreased in the model group (<0.05), while the purine-related metabolites and tryptophane-related metabolites were increased (<0.05). Compared with the model group, the leucine-related metabolites, as main urine metabolites, were increased in the three needling groups after treatment (<0.05), while the tryptophan-related metabolites andpurine-related metabolites were decreased (<0.05), moreover, the leucine-related metabolites in the HRN group were obviously higher than those in the MRRN group and TRN gruop (<0.05).</p><p><b>CONCLUSIONS</b>MRRN, TRN and HRN can regulate the pathway of leucine metabolism (energy metabolism), purine metabolism (oxidative damage) and tryptophane metabolism (immune regulation) for RA, The specificity of HRN for RA focuses on regulation of leucine metabolism (energy metabolism).</p>

Effect of heat-reinforcing needling on serum metabolite profiles in rheumatoid arthritis rabbits with cold syndrome / 中国针灸

<p><b>OBJECTIVE</b>To explore heat-reinforcing needling for the metabolite profiling changes in serum of rheumatoid arthritis (RA) rabbits with liquid chromatograph-mass spectrometer (LC-MS) technique, and to investigate its mechanisms.</p><p><b>METHODS</b>Forty clean purple blue rabbits were randomized into a normal group, a model group, a reinforcing-reducing needling (RRN) group, a twirling-reinforcing needling (TRN) group, and a heat-reinforcing needling (HRN) group, 8 cases in each group. RA rabbits with cold syndrome were made with ovalbumin and freezing except those in the normal group. No treatment was given in the normal and model groups. The corresponding manipulations for 7 days were applied at "Zusanli" (ST 36) in the three acupuncture groups, 30 min a time, once a day. After intervention the pain threshold and the local skin temperature of each group were observed. Fresh serum from heart was collected for metabonomics detection. Principal component analysis (PCA) and partial least squares-discriminant analysis (PLS-DA) were adopted. Several metabolites were screened by the variable importance in the projection values (VIP>1) andvalue (<0.05).</p><p><b>RESULTS</b>The pain threshold and the local skin temperature in the model group were lower than those in the normal group (both<0.05). The pain threshold and the local skin temperature in the three acupuncture groups were higher than those in the model group after intervention (all<0.05), which were better in the HRN group than those in the RRN and TRN groups (all<0.05). The serum metabolites of carnitine, LysoPC (14∶0), LysoPC (18∶3), LysoPE (0∶0/20∶5), LysoPE (0∶0/22∶1), decylic acid, stearic acid and lactic acid in the model group increased compared with those in the normal group, and other metabolites decreased, including leucine, valine, glutamine, pyroglutamic acid, α-ketoglutaric acid, succinic acid, fumaric acid, malic acid, galactose, mannose. Those metabolites were correlated fatty acid, amino acid, citric acid cycle, and glucose metabolism. The metabolites above-mentioned in the three acupuncture groups were regulated in various degrees (all<0.05). Lactic acid decreased and succinic acid, fumaric acid, malic acid, galactose, mannose increased more obviously in the HRN group than those in the RRN and TRN groups.</p><p><b>CONCLUSION</b>The specificity of heat-reinforcing needling for RA presents the regulation for citric acid cycle and glucose metabolism.</p>

The heat-reinforcing needling for Kashin-Beck disease with cold-dampness blocking collaterals syndrome / 中国针灸

<p><b>OBJECTIVE</b>To compare the efficacy differences between heat-reinforcing needling and conventional treatment of western medicine on Kashin-Beck disease (KBD) with cold-dampness blocking collaterals syndrome.</p><p><b>METHODS</b>Sixty KBD patients of cold-dampness blocking collaterals syndrome were randomly assigned into a heat-reinforcing needling group and a western medication group, 30 cases in each one. In the heat-reinforcing needling group, the heat-reinforcing needling was applied at local painful sites, combined with the acupoints based on the syndrome differentiation and the distal acupoints on the affected meridians. Acupuncture was given 30 min per time, once a day, the treatment of 5 days made 1 session; there was an interval of 2 days between two sessions. In the western medication group, sodium selenite tablets were prescribed for oral administration after meals, 2 tablets each time, once a day; ibuprofen sustained release capsules were prescribed for oral administration, 1 capsule each time, twice a day; vitamin C tablets were prescribed for oral administration, 2 tablets each time, three times a day. Four-week treatment was given in the two groups. The Western Ontaraio and Mcmaster Universities Osteoarthritis Index (WOMAC) was adopted to assess the involved joints; the safety was assessed in the process of treatment; the efficacy was analyzed, and the follow-up visit was conducted 3 months and 6 months after treatment, respectively.</p><p><b>RESULTS</b>After 4-week treatment, the total effective rate was 96.7%(29/30) in the western medication group, which was superior to 90.0% (27/30) in the heat-reinforcing needling group (<0.05). However, the safety in the heat-reinforcing needling group was superior to that in the western medication group (<0.05). The improvements of joint function in 3-month and 6-month follow-up visits in heat-reinforcing needling group were superior to those in western medication group (both<0.05).</p><p><b>CONCLUSIONS</b>The heat-reinforcing needling for KBD is safe and effective with less adverse reactions. The short-term effect of heat-reinforcing needling isinferior to western medication, but the long-term efficacy is remarkably superior to western medication.</p>

Water-infusion technique improved the bowel cleanliness during withdrawing the colonscopy：a randomized controlled study / 中国内镜杂志

Objective To compare the effect of water-infusion colonoscopy and conventional air-infusion colonoscopy on the bowel cleanliness during withdrawing.Methods A single blind randomized controlled trial was conducted. 222 patients were randomly divided into water-infusion group (group A, 112 cases) and air-infusion group (group B, 110 cases). The cleanliness scores, scores improvement, pain scores, time of reaching cecum, depth of colonoscopy, rate of whole colon examination, adenoma detection rate (ADR), operator’s dififculty and complications were compared between the two groups.Results The cleanliness score during withdrawing was higher in group A [M(8)/IQR(1) vs M(8)/IQR(2),P = 0.000], the improvement was higher in group A [(0.53 ± 0.74) vs (0.23 ± 0.55), P = 0.000], the abdominal pain score was signiifcantly lower in group A [M(2)/IQR(1) vs M(4)/IQR(2),P = 0.000] and the ADR was higher in group A (36.61 % vs 23.64 %,P = 0.041). The operator’s dififculty evaluation score was signiifcantly lower in group A [M(1)/IQR(1) vs M(2)/IQR(1),P = 0.005]. There were no signiifcant differences at the time of reaching cecum, the depth of colonoscopy and the whole colon examination rate between the two groups.Conclusion Water-infusion colonoscopy could signiifcantly improve the bowel cleanliness during withdrawing scope, improve the ADR and reduce abdominal pain of patients, without increasing the time to reach cecum.

Clinical effect of surgical treatment of stricturing Crohn's disease / 中华消化外科杂志

Objective To explore the clinical effect of surgical treatment of stricturing Crohn's disease (CD).Methods The retrospective cross-sectional study was conducted.The clinical data of 28 patients with stricturing CD who were admitted to the First Affiliated Hospital of Zhejiang University School of Medicine between June 2013 and April 2016 were collected.After improving the patients' nutritional status by preoperative corresponding treatment and optimizing the risk factors of complications,patients received individualized therapy according to their conditions.The intestinal one-stage resection and anastomosis or ostomy were performed at the stenotic locus causing sypmtoms,and no treatment or angioplasty for stenosis was performed at the gentle stenotic locus.Patients received regularly postoperative outpatient reexaminations.The medication was used to prevent recurrence according to the individual conditions.Observation indicators:surgical procedures (open or laparoscopic surgery),operation time,volume of intraoperative blood loss,number of patients with intraoperative blood transfusion,length of intestine resected,anastomosis methods,angioplasty for stenosis,duration of postoperative hospital stay,postoperative complications and follow-up.Follow-up using outpatient examination,telephone interview and wechat was performed to detect the abdominal pain,diarrhea,symptoms of clinical recurrence and endoscopic recurrence situations up to July 2016.Results All the 28 patients with stricturing CD underwent the selective operations,including 8 undergoing laparoscopic surgery (3 receiving conversion to open surgery) and 20 undergoing open surgery.Of 28 patients,2 underwent partial upper jejunum resection,10 underwent partial terminal ileum resection,15 underwent right hemicolectomy and 1 underwent colectomy.Operation time and volume of intraoperative blood loss were 33-288 minutes with an average time of 122 minutes and 50-650 mL with an average volume of 200 mL,respectively.One patient had intraoperative blood transfusion.Length of intestine resected of 28 patients was 10-150 cm,with an average of 54 cm and a total length of 1 510 cm.Of 28 patients,26 received the side-to-side anastomosis using linear closures (1 received the end-to-side anastomosis using pipe stapler,1 with multiple lesions and rectovaginal fistula received colectomy and ileostomy).Two patients with multiple stenosis of the small intestine underwent intestinal resection combined with angioplasty for stenosis in 3 loci.Duration of postoperative hospital stay was 7-45 days,with an average duration of 15 days.No patient died of surgery.Three patients had postoperative complications,including wound infection,incisional hernia and anastomotic leakage.Twenty-one patients were followed up for 3 months to 2 years,with a median time of 11 months,and there was no recurrence during the follow-up.Conclusions Surgical treatment should be performed to the patients with non-symptom,chronic and fibrous stricturing CD and anastomotic stenosis after ineffective medical treatment,with a satisfactory outcome.Meanwhile,it need follow the principle of minimally invasive.And optimizing high risk factors of complications before operation is a key point for preventing postoperative complications.

Immediate effects of twirling reinforcing-reducing manipulation at head acupoints on muscle force in patients with acute ischemic stroke: a randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To observe differences of immediate effect of twirling reinforcing-reducing manipulation at head acupoints on muscle force in patients with acute ischemic stroke.</p><p><b>METHODS</b>A total of 126 patients who met the inclusive criteria were randomly divided into a twirling reinforcing group, a mild reinforcing-reducing group and a twirling reducing group, 42 cases in each one. The lines between Baihui (GV 20) and bilateral Taiyang (EX-HN 5) were selected and treated with successive insertion of three needles. The twirling reinforcing method was used in the twirling reinforcing group, and mild reinforcing-reducing method was used in the mild reinforcing- reducing group, and twirling reducing method was used in the twirling reducing group. Each needle was manipulated for 1 min, which was repeated once every 10 min. The needles were retained for 30 min. Muscle force was evaluated immediately after treatment.</p><p><b>RESULTS</b>(1) Muscle force of upper limb: after acupuncture, the muscle force of proximal and remote ends were all improved significantly in three groups (all P < 0.05), which was more obvious in proximal end (all P < 0.05). The improvement of the muscle force of proximal end in the twirling reinforcing group was superior to those in the mild reinforcing-reducing group and twirling reducing group (both P < 0.05); the differences of the muscle force of remote end were not significant among three groups (all P > 0.05). (2) Muscle force of lower limb: after acupuncture, the muscle force of proximal and remote ends was all improved significantly in the three groups (all P < 0.05). The improvement of the muscle force of proximal end was superior to that of remote end in the twirling reinforcing group and mild reinforcing-reducing group (both P < 0.05).</p><p><b>CONCLUSION</b>The twirling reinforcing manipulation at head acupoints is superior to mild reinforcing-reducing and twirling reducing manipulation for muscle force in patients with acute ischemic stroke, which is more significant in proximal end of limbs.</p>

Comparative study on the effects between manual acupuncture and electroacupuncture for hemiplegia after acute ischemic stroke / 中国针灸

<p><b>OBJECTIVE</b>To compare the efficacy differences between manual acupuncture (MA) and electroacupuncture (EA) in the treatment of hemiplegia after acute ischemic stroke.</p><p><b>METHODS</b>Sixty-eight patients of hemiplegia after acute ischemic stroke were randomized into a MA group (34 cases) and an EA group (34 cases). The routine western medication and bilateral Dingnieqianxiexian (MS 6) were adopted in the two groups. The needles were retained for 30 min. In the MA group, the even-needling technique was used for 3 times during the needle retaining, 1 min each time. In the EA group, on the basis of manual stimulation, EA therapy was added, with disperse-dense wave, 5 Hz/20 Hz. The treatment was given once every day, 6 treatments a week, totally for 2 weeks. US National Institutes of Health stroke scale (NIHSS) score, the simplified Fugl-Meyer motor function (FMA) score and Barthel index (BI) were observed before and after treatment in the two groups. The clinical efficacy was compared between the two groups.</p><p><b>RESULTS</b>NIHSS score was reduced apparently after treatment in the two groups (both<0.01). The score in the EA group was lower than that in the MA group (<0.05). After treatment, FMA score and BI score were all increased apparently in the two groups (all<0.01) and the scores in the EA group were higher than those in the MA group (both<0.01). The total effective rate was 94.1% (32/34) in the EA group and was 85.3% (29/34) in the MA group. The efficacy in the EA group was better than that in the MA group (<0.05).</p><p><b>CONCLUSIONS</b>EA acts on the rehabilitative effect on nerve defect function in the patients of hemiplegia after acute ischemic stroke. It improves limb motor function and the ability ofdaily life activity. The efficacy is better than that of MA.</p>

Effect of Heat Reinforcing Acupuncture Manipulation on Articular Synovium LDH, SDH and CCO in Rheumatoid Arthritis ;Rabbits / 上海针灸杂志

Objective To investigate the regulating effect of heat reinforcing acupuncture manipulation on body energy metabolism enzymes in rheumatoid arthritis (RA) and preliminarily explain the mechanism of heat-producing action of heat reinforcing acupuncture manipulation. Method Forty chinchilla rabbits were randomized into normal, model, equal reinforcement and reduction, twirling reinforcement, and heat reinforcing acupuncture manipulation groups. A model of cold syndrome-type RA was made by ovalbumin induction and exposure to low temperature in the other four groups not including the normal group. From two days after successful model making, the normal and model groups were grabbed and fastened (bound) by the same way as for the acupuncture groups, 30 min once daily. The equal reinforcement and reduction group received even reinforcing-reducing method;the twirling reinforcement group, twirling reinforcement method;the heat reinforcing group, heat reinforcing acupuncture manipulation. The needle was manipulated for 1 min and retained for 30 min once daily, for a total of seven days. The RA rabbit knee joint circumference was measured and the inflammation score was recorded according to synovial histopathological sections before and after treatment. After the completion of intervention, the rabbits were sacrificed and the articular synovium was rapidly separated for frozen sections. Articular synovium lactate dehydrogenase (LDH), succinate dehydrogenase (SDH) and cytochrome oxidase (CCO) activities were measured by histochemical staining. Result After acupuncture intervention, the RA rabbit knee joint circumference was shortened in all the equal reinforcement and reduction, twirling reinforcement, and heat reinforcing acupuncture manipulation groups, but the shortening effect on the RA rabbit knee joint circumference was better in the heat reinforcing acupuncture manipulation group than in the equal reinforcement and reduction and twirling reinforcement method groups (P<0.05);the inflammation score recorded according to the RA rabbit synovial histopathological sections was also decreased more in the heat reinforcing acupuncture manipulation group than in the equal reinforcement and reduction and twirling reinforcement method groups (P<0.05). Synovial LDH integral optical density, total positive area and area percentage were significantly higher in the model group than in the normal group (P<0.05), and significantly lower in the equal reinforcement and reduction, twirling reinforcement, and heat reinforcing acupuncture manipulation groups than in the model group(P<0.05) and also in the heat reinforcing acupuncture manipulation group than in the equal reinforcement and reduction and twirling reinforcement method groups (P<0.05). Rabbit synovial SDH and CCO activities were significantly higher in the model group than in the normal group (P<0.05). Rabbit synovial SDH and CCO integral optical density, total positive area and area percentage were significantly higher in the equal reinforcement and reduction, twirling reinforcement, and heat reinforcing acupuncture manipulation groups than in the model group (P<0.05) and also in the heat reinforcing acupuncture manipulation group than in the equal reinforcement and reduction and twirling reinforcement method groups (P<0.05). Conclusion Heat reinforcing acupuncture manipulation has a definite therapeutic effect on RA and can increase SDH and CCO activities to enhance aerobic metabolism and produce more local energy in a rabbit model of RA. That may be the mechanism by which heat reinforcing acupuncture manipulation produces heat.

Comparative Study on Immediate Effect of Twirling Reinforcing-reducing Manipulation on Acute Ischemic Stroke / 中国中医药信息杂志

Objective To investigate the immediate effect of twirling reinforcing manipulation, twirling reducing manipulation and mild reinforcing-reducing manipulation on motor functions for patients with acute ischemic stroke. Methods Totally 116 patients with ischemic stroke were randomly divided into twirling reinforcing manipulation group (TRFM, n=39), mild reinforcing-reducing manipulation group (TRRM, n=37), and twirling reducing manipulation group (TRDM, n=40) by stratified blocked randomization. Each group was treated in Baihui-Taiyang acupoint area accordingly with twirling reinforcing manipulation, mild reinforcing-reducing manipulation and twirling reducing manipulation once. The operation time for each needle was 1 minute. Interval time between every 2 needles was 10 minutes, and each needle was retained for 30 minutes. Neurological deficit score (NDS) and simplified Fugl-Meyer assessment (FMA) were evaluated before and immediate time, 1 h, 2 h and 3 h after treatment. Results FMA in TRFM was higher than that of TRDM and TRRM at immediate time, 1 h and 2 h after treatment (P0.05). DNS in TRFM decreased sharply at immediate time, 1 h, 2 h and 3 h compared with TRDM and TRRM (P0.05). Conclusion TRFM has an advantage over TRDM and TRRM in immediate effect of motor functions for patients with acute ischemic stroke.

Effects of Three-in-one Acupuncture on Hemiplegia after Ischemic Stroke / 中国康复理论与实践

Objective To observe the effects of Three-in-one Acupuncture on hemiplegia after ischemic stroke. Methods 146 patients with hemiplegia after ischemic stroke were randomly allocated into trial group (n=73) and control group (n=73). The trial group accepted Three-in-one Acupuncture, while the control group accepted rehabilitation, for 4 weeks. They were assessed with Neurological Deficit Score (NDS), Functional Comprehensive Assessment (FCA) and Barthel Index (BI) before and 7, 14, 21 and 28 days after treatment. They were followed up for a year. Results The NDS decreased since 7 days after treatment in the trial group (P0.05). The rate of improvement was 87.9%in the trial group, similar with 84.1%in the control group (P>0.05). The recurrence rate was 11.54%in the trial group, less than 25.49%in the control group in a year (P<0.05). Conclusion Three-in-one Acupuncture is as effective as rehabilitation on hemiplegia after ischemic stroke, more quickly and with less recurrence.