Clinical effect of acupoint application with turmeric blistering moxibustion plaster on post-stroke hemiplegic shoulder pain. / 姜黄天灸膏穴位贴敷治疗脑卒中偏瘫肩痛临床疗效观察.

OBJECTIVES: To observe the effects of acupoint application with turmeric blistering moxibustion plaster on pain, shoulder range of motion (ROM) and upper limb motor function in the patients with post-stroke hemiplegic shoulder pain (PSHSP). METHODS: Eighty-two patients with PSHSP were randomly divided into an observation group (41 cases, 1 case was eliminated, 4 cases dropped out) and a control group (41 cases, 2 cases were eliminated and 2 cases dropped out). The routine treatment, nursing care and rehabilitation training were performed in the control group. On the basis of the intervention as the control group, in the observation group, the turmeric blistering moxibustion plaster was applied to bilateral ashi points, Jianyu (LI 15), Jianliao (TE 14), Binao (LI 14), Shousanli (LI 10) and Hegu (LI 4), once a day, remained for 6 hours each time. This moxibustion therapy was operated 5 times weekly, one course of treatment consisted of 2 weeks and 2 courses were required. Separately, before treatment and after 2 and 4 weeks of treatment, the score of visual analogue scale (VAS), shoulder ROM and the score of upper limbs in Fugl-Meyer assessment (U-FMA) were observed in the two groups. RESULTS: VAS scores were lower (P<0.05), ROM in shoulder flexion, abduction, internal rotation and external rotation was larger (P<0.05), and U-FMA scores were higher (P<0.05) after 2 and 4 weeks of treatment when compared with those before treatment in the two groups. After 4 weeks of treatment, VAS score decreased (P<0.05), and ROM in shoulder flexion, abduction, internal rotation, external rotation and U-FMA score increased (P<0.05) in comparison with those after 2 weeks of treatment in either group. In the observation group, VAS scores were dropped (P<0.05) after 2 and 4 weeks of treatment respectively, and ROM of shoulder flexion and abduction enlarged after 2 weeks of treatment (P<0.05) when compared with those in the control group. After 4 weeks of treatment, ROM in shoulder flexion, abduction, internal rotation and external rotation in the observation group was larger (P<0.05) and U-FMA score was higher (P<0.05) than those in the control group. CONCLUSIONS: Acupoint application with turmeric blistering moxibustion plaster may effectively reduce the degree of shoulder pain and improve the shoulder range of motion and the upper limb motor function in the patients with post-stroke hemiplegic shoulder pain.

Moxibustion for post-stroke urinary incontinence in adults: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND AND PURPOSE: Urinary incontinence (UI) is a frequently identified complication among stroke survivors. Moxibustion is commonly used to treat post-stroke UI in Asian countries. This study aimed to synthesize the evidence of using moxibustion for post-stroke UI management. METHODS: Twelve databases were searched to identify randomized controlled trials (RCTs) using moxibustion to improve post-stroke UI management. Four Chinese journals were also manually screened for potentially eligible articles. RESULTS: Ten studies with a total of 719 participants and one completed trial without published results were included. Compared with "routine methods of treatment and/or care," the meta-analyses revealed that moxibustion had superior effects in improving UI symptoms and alleviating the severity of UI. CONCLUSION: This systematic review identified preliminary research evidence that moxibustion may be effective in managing the symptoms of post-stroke UI. More rigorously designed, large-scale RCTs are warranted to provide more robust evidence in this area.

Effects of motor imagery on walking function and balance in patients after stroke: A quantitative synthesis of randomized controlled trials.

OBJECTIVE: This study aimed to evaluate the effects of motor imagery (MI) on walking function and balance in patients after stroke. METHODS: Related randomized controlled trials (RCTs) were searched in 12 electronic databases (Cochrane Central Register of Controlled Trials, PubMed, Science Direct, Web of Science, Allied and Complementary Medicine, Embase, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, WanFang, and VIP) from inception to November 30, 2016, and Review Manager 5.3 was used for meta-analysis. References listed in included papers and other related systematic reviews on MI were also screened for further consideration. RESULTS: A total of 17 studies were included. When compared with "routine methods of treatment or training", meta-analyses showed that MI was more effective in improving walking abilities (standardized mean difference [SMD] = 0.69, random effect model, 95% confidence interval [CI] = 0.38 to 1.00, P < 0.0001) and motor function in stroke patients (SMD = 0.84, random effect model, 95% CI = 0.45 to 1.22, P < 0.0001), but no statistical difference was noted in balance (SMD = 0.81, random effect model, 95% CI = -0.03 to 1.65, P = 0.06). Statistically significant improvement in walking abilities was noted at short-term (0 to < six weeks) (SMD = 0.83, fixed effect model, 95% CI = 0.24 to 1.42, P = 0.006) and long-term (≥six weeks) assessments (SMD = 0.45, fixed effect model, 95% CI = 0.25 to 0.64, P < 0.00001). Subgroup analyses suggested that MI had a positive effect on balance with short-term duration (0 to < six weeks) (SMD = 4.67, fixed effect model, 95% CI = 2.89 to 6.46, P < 0.00001), but failed to improve balance (SMD = 0.82, random effect model, 95% CI = -0.27 to 1.90, P = 0.14) with long-term (≥six weeks) duration. CONCLUSION: MI appears to be a beneficial intervention for stroke rehabilitation. Nonetheless, existing evidence regarding the effects of MI in patients after stroke remains inconclusive because of significantly statistical heterogeneity and methodological flaws identified in the included studies. More large-scale and rigorously designed RCTs in future research with sufficient follow-up periods are needed to provide more reliable evidence on the effects of MI in post-stroke patients.

A meta-analysis of acupuncture use in the treatment of cognitive impairment after stroke.

OBJECTIVE: This meta-analysis was conducted to evaluate the efficacy of acupuncture on cognitive impairment (function) after a stroke. DESIGN: Randomized controlled trials (RCTs) comparing acupuncture with no acupuncture in addition to medicine or rehabilitation were identified from databases (PubMed, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure, VIP Chinese Periodical Database, Wangfang Chinese Periodical Database, Chinese Bio-medicine Database, Cochrane Library, and Chinese medical literature databases) and two relevant journals (Chinese Acupuncture and Moxibustion and the Journal of Shanghai Acupuncture and Moxibustion). Meta-analyses were conducted for the eligible RCTs. RESULTS: Twenty-one trials with a total of 1421 patients met inclusion criteria. Pooled random-effects estimates of the change in the Mini-Mental State Examination were calculated for the comparison of acupuncture with no acupuncture in addition to medicine or rehabilitation. Following 4 weeks and 8 weeks of intervention with acupuncture, the merged mean difference was 3.14 (95% confidence interval [CI], 2.06-4.21; p<.00001) and 2.03 (95% CI, 0.26-3.80; p=0.02), respectively. For the comparison of 3-4 weeks of acupuncture with no acupuncture in addition to medicine or rehabilitation groups, the merged MD in Neurobehavioral Cognitive State Examination total scores was 5.63 (95% CI, 3.95-7.31; p<.00001). For the comparison of 8-12 weeks of acupuncture with no acupuncture in addition to medicine or rehabilitation groups, the P300 latency merged MD was -12.80 (95% CI, -21.08 to -4.51; p<.00001), while the P300 amplitude merged MD was 1.38 (95% CI, 0.93-1.82; p<.00001). Overall, the study quality was rated as moderate on the basis of the Cochrane Handbook for Systematic Reviews of Interventions (part 2: 8.5). CONCLUSIONS: This meta-analysis suggests that acupuncture had positive effects on cognitive function after stroke and supports the need for additional research on the potential benefits of this therapeutic approach.

Comparing three methods of estimating concentration of worksite benzene / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>benzene; Air pollution; Risk assessment in the air of workshop and validate the methods.</p><p><b>METHODS</b>Expert-reference, BAYES statistics and expert-measurement were separately used to estimate benzene concentration in a slurry-applying workshop and modeling workshop of a rubber factory. The estimations were compared with current newly monitored data.</p><p><b>RESULTS</b>The estimated averages of expert-reference, BAYES statistics and expert-measurement were 100.0, 16.9, 33.2 mg/m3 respectively for the slurry-applying workshop and 100, 156, 115 mg/m3 for the modeling workshop. No significant difference was observed between the estimations and validating sample except to that of the expert-reference for the former.</p><p><b>CONCLUSION</b>BAYES statistics and expert-measurement were precise and expert-reference was candidate if no measurements in spite of its subjectivity.</p>

Effect of low benzene exposure on workers' peripheral blood parameters of different similar exposure groups / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To study the relationship between low benzene exposure doses with workers' peripheral blood parameters of different similar exposure groups (SEG).</p><p><b>METHODS</b>The workers were from a shoe factory and divided into different SEG, according to the observation method and sampling method. Exposure levels, blood samples and job histories were collected. The relationship between benzene level and blood routine were analyzed using multiple regression method.</p><p><b>RESULTS</b>Five SEGs were defined. No significant differences were found among different SEG in length of service, smoking, drinking, blood routine and symptoms except for ages. Significant negative correlation (r = -0.36, P < 0.05) between benzene exposure levels and white blood cell counts were found by multiple regression analysis. Similar negative correlation was also found between length of benzene exposure and red blood cell counts (r = -0.29, P < 0.05). No significantly statistical relationships were found between benzene exposure and red blood cell counts or platelet count.</p><p><b>CONCLUSION</b>SEGs method is sensitive for determining the relationship between benzene exposure levels and white blood cell counts. Further study is needed by increasing the number of workers to study the relationship between low benzene exposure and peripheral blood parameters.</p>