Acupuncture for patients with chronic functional constipation: A randomized controlled trial.

BACKGROUND: Acupuncture is used to treat chronic functional constipation (CFC) in China, despite limited evidence. We aim to assess the effectiveness and safety of acupuncture in managing CFC. METHODS: A multicenter randomized controlled trial was performed involving 684 patients with CFC; the patients were randomly allocated to receive He acupuncture (n = 172), Shu-mu acupuncture (n = 171), He-shu-mu acupuncture (n = 171), or oral administration of mosapride (n = 170). Sixteen sessions of acupuncture were given in the treatment duration of 4 weeks. The primary outcome was the change in spontaneous bowel movements (SBMs) at week 4 (at the end of treatment) compared to baseline. The secondary outcomes included stool consistency (Bristol scale), the degree of straining during defecation, and adverse events. KEY RESULTS: The SBMs increased in all the four groups at week 4, and the magnitude of increase was equivalent in the four groups (He acupuncture, 2.7 [95% CI, 2.3-3.1]; Shu-mu acupuncture, 2.7 [95% CI, 2.3-3.0]; He-shu-mu acupuncture, 2.2 [95% CI, 1.9-2.5]; and mosapride, 2.4 [95% CI, 2.0-2.9]; P = .226). However, the change in SBMs at week 8 was significantly smaller in mosapride group (1.4 [95% CI, 1.0-1.8]) than the three acupuncture groups (2.4 [95% CI, 2.1-2.7], 2.3 [95% CI, 1.9-2.7], 2.1 [95% CI, 1.7-2.5] in He, Shu-mu, and He-shu-mu group, respectively, P = .005). CONCLUSIONS & INTERFERENCES: The three acupuncture treatments were as effective as mosapride in improving stool frequency and stool consistency in CFC, but the magnitude of the treatment effect is unknown due to the lack of sham acupuncture control.

Research on the nutrition and cognition of high-risk stroke groups in community and the relevant factors.

OBJECTIVE: To investigate the prevalence rate of nutritional risk in high-risk stroke groups in community, analyze its influencing factors, and analyze and compare the relationship between nutritional risk or malnutrition assessed by different nutritional evaluation methods and cognitive function, so as to provide the basis and guidance for clinical nutritional assessment and support. PATIENTS AND METHODS: A cross-sectional survey was performed for 1196 cases in high-risk stroke groups in community from December 2015 to January 2017. At the same time, the nutritional status of patients was evaluated using the mini nutritional assessment (MNA) and MNA-short form (MNA-SF), and the cognitive status of patients was evaluated using the mini-mental state examination (MMSE). Moreover, the relevant influencing factors of nutritional risk and MMSE score were analyzed and compared. RESULTS: High-risk stroke groups in community suffered from a high risk of malnutrition. MNA-SF had a higher specificity and lower false positive rate than MNA. Nutritional risk occurred more easily in high-risk stroke groups in community with a history of diabetes mellitus, less physical exercise or light manual labor, daily use of multiple drugs, and higher age. Those with a higher nutritional risk were more prone to cognitive impairment. High-risk stroke groups in community, complicated with hyperhomocysteinemia, daily use of three or more kinds of prescription drugs, and a previous history of stroke, were accompanied by cognitive impairment easily. CONCLUSIONS: MNA-SF can be used for the nutritional screening of high-risk stroke groups in community. For the high-risk stroke groups in community, the rational nutritional diet should be publicized, blood sugar should be controlled in a scientific manner and physical exercise should be moderately increased.

Cloning and prokaryotic expression of rat homolog of Serpina3n and its expression change during liver regeneration.

A strikingly upregulated expressed sequence tag was screened from regenerating rat liver at 8 h in a 0-4-8-12 h short-interval successive partial hepatectomy model from a previous study. In the present study, a full-length open reading frame (ORF) corresponding to this expressed sequence tag was predicted through electronic cloning and was subsequently cloned from an 8-h rat regenerating liver and deposited in GenBank (accession No. HM448398). Sequence analysis of HM448398 and the predicted ORF revealed that the two ORFs may be different transcripts of a gene. The sequence of HM448398 was highly homologous to that of rat Serpina3n, suggesting that it may be a homolog of Serpina3n. The pGEX-2TK prokaryotic expression vector for this ORF was constructed, and the result of sodium dodecyl sulfate polyacrylamide gel electrophoresis manifested that the recombinant expression vector could express the glutathione-S-transferase-fused rat homolog of Serpina3n in an insoluble form in BL21. The target fusion protein was purified with affinity chromatography and was used as antigen to immunize rabbits for the production of polyclonal antibodies. Immunohistochemistry and real-time reverse transcription polymerase chain reaction analysis revealed that the gene was highly expressed in the priming and termination phases of liver regeneration. These findings lay a solid foundation for further study of roles of HM448398 using knock-in and RNA interference methods during liver regeneration.

The incidence of renal artery stenosis in the patients referred for coronary artery bypass grafting.

Multivessel coronary disease or peripheral arterial disease is the clinical clue to diagnosis of renal artery stenosis (RAS). RAS is considered equivalent to coronary artery disease in terms of cardiovascular risk. In this study, we evaluated the incidence of RAS in the patients who were proposed to undergo coronary artery bypass grafting (CABG). Diagnostic evaluations of coronary arteriography and renal artery angiography were performed during the same procedure; the patients who were proposed for CABG in terms of CAD anatomy and clinical manifestation were enrolled. RAS was evaluated and a diameter stenosis of ≥50% was considered as significant RAS; significant RAS patients were divided into five groups. The five groups of RAS were as follows: (1) unilateral RAS ≥50-70%, (2) unilateral RAS ≥70%, (3) bilateral RAS ≥50-70%, (4) one-renal-artery stenosis ≥50-70%, contralateral RAS ≥70%, and (5) bilateral renal artery stenosis ≥70%. A total of 151 patients were enrolled, and RAS (≥50% stenosis in either or both renal arteries) was identified in 47.02% (71/151) patients. Unilateral RAS ≥50-70% was identified in 16.6% (25/151) patients, unilateral RAS ≥70% in 4.6% (7/151) patients, bilateral RAS ≥50-70% in 7.9% (12/151) patients, one-renal-artery stenosis ≥50-70% and contralateral RAS ≥70% in 7.9% (12/151) patients, and bilateral RAS ≥70% was in 9.9%(15/151) patients. The incidence of RAS was 29.03% (18/62) in patients aged ≤60 years, 60% (36/60) in patients aged >60 and ≤70 years, and 58.62% (17/29) in patients aged >70 years. The incidence of RAS was significantly higher in patients aged >60 - ≤70, and >70 years than patients aged ≤60 years (P = 0.001 and P = 0.007, respectively). There was a trend that the incidence of RAS in patients with hypertension [HTN, 50.40% (64/127)] was higher than those without HTN (29.17%, 7/24), with P = 0.056. The incidence of RAS was 47.02% in patients who were proposed for CABG; bilateral RAS of ≥70% was 9.9%. Older age and HTN were associated with RAS in patients who were referred for CABG. This study indicates that the incidence of RAS was high in the patients referred for CABG, and the renal function should be taken care of.

[Retrospective analysis of argon laser for treating retinal periphlebitis].

OBJECTIVES: This article was to investigate the curative effect of argon laser photocoagulation for retinal periphlebitis treatment, and then to discuss the stage of the treatment. METHODS: According to the condition of vitreous hemorrhage and the range of retinal neovascularization, 31 cases (34 eyes) were divided into the light group and the heavy group, and the therapeutic effective rate, the condition of visual acuity and vitreous hemorrhage were compared. RESULTS: The therapeutic effective rate was 64.71%, there was significant difference in effective rate and prognosis of visual acuity between two groups (P < 0.01). After laser treatment, the morbidity of vitreous hemorrhage in heavy group decreased from 100% to 18.70%. CONCLUSION: Argon laser photocoagulation is an effective method for treating retinal periphlebitis and early treatment is recommended.

[Effect of Panax notoginseng saponins combined isovolumic haemodilution on the retinal microcirculation of patients with retinal vein occlusion].

OBJECTIVE: To study the effect of Panax notoginseng saponins (PNS) or isovolumic haemodilution (IHD) and combination of PNS with IHD on retinal microcirculation of patients with retinal vein occlusion (RVO). METHOD: Seventy three patients with RVO were allocated at random to three groups which were treated with PNS, IHD, or PNS + IHD respectively. The retinal circulation time (RCT) and retinal hemorrhage, edema, leakage of capillary, cystoid macular edema (CME), and nonperfusion area of capillary in retina were observed before and after treatment. RESULT: RCT of patients with RVO was shortened by three treating methods. RCT in the patients who treated by PNS + IHD was the shortest, especially in the patients with nonischemic RVO and branch retinal vein occlusion(BRVO). The retinal hemorrhage, edema, leakage of capillary, and CME in the patients treated by PNS + IHD disappeared quicker than those treated by PNS or IHD. At the same time, the incidence of nonperfusion area in patients whose course of disease was shorter than fourteen days was decreased. The perfusion of capillaries was increased at the edge of nonperfusion area which existed before the treatment. But the effect for nonperfusion area which existed before the treatment in the type of ischemic RVO was not obvious. CONCLUSION: The treatment of PNS + IHD can both shorten RCT of patients with RVO, and promote absorption of retinal hemorrhage, edema, leakage of capillary, and CME. It is possible that PNS + IHD treatment also has an effect to decrease the forming of nonperfusion area in patients whose course of disease is at early stage.

[Investigation of mandibular movement tracing in anterior crossbite malocclusion before and after orthodontic treatment]

OBJECTIVE: The investigation was conducted to record the border movement tracings of 13 patients in early permanent anterior crossbite malocclusion before and after orthodontic treatment.These records were made by a K5AR mandibular kinsiograph.The result indicated that the ranges and tracings of mandibular border movement were improved significantly.