A cross-sectional study of appropriateness evaluation of anticoagulation therapy for inpatients with nonvalvular atrial fibrillation.

Background: Oral anticoagulants (OACs) are essential for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF). However, the appropriateness of anticoagulation treatment in locally practice remains unclear. This study evaluated compliance with anticoagulation therapy concerning the guidelines and drug labels in patients with NVAF. Methods: Hospitalized patients diagnosed with NVAF between 1 November 2020, and 31 December 2021, were retrospectively enrolled. The appropriateness of anticoagulation regimens at discharge was evaluated based on a flowchart designed according to atrial fibrillation (AF) guidelines and medication labels. Furthermore, we explored factors potentially influencing the "no-use of OACs" using binary logistic regression and verified anticoagulation-related issues through a physician questionnaire. Results: A total of 536 patients were enrolled in this study, including 254 patients (47.4%) with inappropriate anticoagulation regimens. 112 patients (20.9%) were categorized as "underdosing-use of OACs," 134 (25%) who needed anticoagulation therapy were "no-use of OACs" and eight (1.5%) were "over-use of OACs." The results of a binary logistic regression analysis showed that paroxysmal AF (odds ratio [OR], 7.74; 95% confidence interval [CI], 4.57-13.10), increased blood creatinine levels (OR, 1.88; 95% CI, 1.11-3.16), hospitalized pacemaker implantation (OR, 6.76; 95% CI, 2.67-17.11), percutaneous coronary intervention (OR, 3.35; 95% CI, 1.44-7.80), and an increased HAS-BLED score (OR, 1.62; 95% CI, 1.11-2.35) were associated with "no-use of OACs" in patients with NVAF who had indications for anticoagulation therapy. Conclusion: For patients with NVAF with severe renal dysfunction and paroxysmal AF, anticoagulation therapy was inadequate. The underdosing-use of OACs in patients with NVAF was frequently observed. We recommend an anticoagulation management team to tailor anticoagulation regimens to suit each patient's needs.

[Effects of needle knife relaxing therapy on tension of local soft tissue and pain of osteoarthritis of knee].

OBJECTIVE: To probe into the mechanism and methods of needle knife relaxing therapy for treatment of osteoarthritis of knee from biomechanical view. METHODS: Needle knife relaxing therapy was given to 92 pain points around the knee joint in 14 cases of osteoarthritis of knee, and the displacement of the local pain point under the stress of 500 g (L500 g) was measured and the VAS scores were recorded before and after treatment. RESULTS: L500 g of the pain point was (4.72+/-1.03) mm before treatment and (5.39+/-1.01) mm after treatment with a very significant difference before and after treatment (P<0.01), and VAS score was (7.10+/-1.49) points before treatment and (1.49+/-1.24) points after treatment with a very significant difference before and after treatment (P<0.01), and there was a linear correlation between the changes of L500 g and VAS scores. CONCLUSION: There was close connection between the local pain and tension of local soft tissue in knee osteoarthritis. The needle knife relaxing therapy can relieve the neurovascular compression or traction syndrome by relaxing the local contracted, adhesive soft tissue, so as to relieve tension pain and finally recover internal force equilibrium of the knee joint.

[Evaluation on clinical therapeutic effect of needle-knife therapy on cervical spondylosis].

OBJECTIVE: To compare therapeutic effects of needle-knife therapy and acupuncture on cervical spondylosis. METHODS: Multi-central clinical randomized controlled trial was adopted. The patients were divided into a needle-knife treatment group treated with needle-knife therapy at the upper and lower interspinal ligaments of the affected vertebral body and bilateral posterior joint capsules; and the acupuncture control group were treated with acupuncture at Laozhen, Ashi points and cervical Jiaji points, etc. The short-term and the long-term therapeutic effects were observed at the end of the therapeutic course and 6 months after the end of the therapeutic course. RESULTS: The short-term therapeutic effect and the long-term therapeutic effect were 91.3% and 94.7% in the needle-knife treatment group and 59.4% and 56.6% in the acupuncture control group, respectively, with a very significant difference between the two groups (P < 0.01). CONCLUSION: The needle-knife treatment in the therapeutic effect on cervical spondylosis is superior to acupuncture treatment.