Case report: A rare case of hereditary hemochromatosis caused by a mutation in the HAMP gene in Fuyang, China.

Hemochromatosis, also known as siderosis, is a disease caused by excessive iron deposition in human organs and tissues, resulting from iron metabolism disorders. It is clinically characterized by skin pigmentation (bronze color), liver cirrhosis, diabetes, weakness, and fatigue. Additional symptoms may include arthritis, hypothyroidism, heart failure, and sexual hypofunction. Clinical manifestations can vary from person to person, with a few patients showing no clinical manifestations, which makes the diagnosis difficult for clinicians. In this case report, we described hereditary hemochromatosis related to a mutation in the HAMP gene in Fuyang City, China, as a reference for clinicians. Hereditary hemochromatosis is rarely reported in China. Clinicians in China have relatively insufficient knowledge of this disease, which leads to frequent misdiagnosis. In this case report, we describe hereditary hemochromatosis related to HAMP gene mutation in Fuyang City, China, for the clinician's reference.

Fifteenth century Florentine mural investigated in situ with VNIR Hyperspectral Imaging and NIR Photography supports interpretation as a bloodletting scene.

This study provides new data which suggest a novel interpretative hypothesis not only on the specific painting, but on the use of bloodletting as medical practice in the Florentine Quattrocento. As a part of a cycle of frescoes devoted to the Seven Corporal Works of Mercy, the examined lunette depicts the "Visit to the sick" in a domestic interior, but it has never been considered as an historical document of precise medical practices. The scene's definitive interpretation is still unresolved because of the uncertainty of some iconographic details. A campaign of in-situ and non-invasive technical investigations was performed to retrieve possible traces of previous details today concealed. The technical solutions adopted to implement the measurements campaign are illustrated, as an experimental example for remote sensing inspection of mural paintings in-situ. The position of the painting high up on a wall of an historical venue led to opting for stand-alone optical imaging techniques which could operate in remote sensing mode. By combining the use of portable Hyperspectral Imaging with Near Infrared photography a set of detailed images could be obtained that highlighted details not otherwise detectable. Focused on the objects held by the persons present, the analysis of the mural of Visit of the Buonomini in her Lying in Bed, the gift of swaddling cloth could be a tourniquet, shadows of folds of a blanket a thumb lancet, and an object held a blood collection bowl, supported the hypothesis that it could be a medieval bloodletting scene.

Successful Pharmacologic Treatment of Self-Bloodletting with Factitious Chronic Anemia (Lasthénie de Ferjol Syndrome) with High-Dose Serotonergic Medication: A Case Report.

Self-induced bloodletting (SBL) is a very rare form of self-injury (SI) seen primarily in adolescents and young adults with personality and eating disorders. It can result in complications like malaise, fatigue, or iron-deficiency anemia (Lasthénie de Ferjol syndrome, LFS), and poses a risk of accidental death or suicide. The condition often goes undetected due to patient concealment. There is no specific treatment established, and pharmacological strategies remain uncertain. We discuss the case of a 22-year-old female patient treated at our Psychiatry and Psychotherapy Department following a suicide attempt via SBL. She self-administered a venous cannula, losing 1.5 L of blood. Diagnosed with iron-deficiency anemia (LFS), she was initially treated with mirtazapine, risperidone, lithium, and later off-label high-dose clomipramine (300 mg/d). Clomipramine significantly reduced her SBL and suicidal thoughts, and her hemoglobin levels re-normalized under iron-substitution therapy. Despite improvement and later discharge, she attempted suicide by SBL again three months later, having stopped clomipramine due to adverse side effects. High-dose escitalopram was administered, leading to a decrease and eventual cessation of her SBL urges. This case demonstrates that patients with SBL/LFS can benefit from high-dose clomipramine or escitalopram. Despite its rarity, the consideration of high-dose serotonergic antidepressants is crucial in psychiatric diagnostics and treatment for patients affected by SBL/LFS.

Auricular acupressure combined with Tongtian oral liquid for acute attacks of migraine without aura: a single-center, retrospective study.

OBJECTIVE: To observe the effect of auricular acupressure combined with Tongtian Oral Liquid for immediate pain relief in patients with acute migraine without aura, and to analyze the risk factors that affect the number of acute attacks of migraine without aura. METHODS: This retrospective study analyzed data of 180 patients diagnosed with acute migraine without aura who were admitted to Affiliated Hospital of Nanjing University of Chinese Medicine (Jiangsu Province Hospital of Chinese Medicine). The patients were divided into an intervention group 1 (n=60), an intervention group 2 (n=60), and a control group (n=60) according to different treatment methods. The intervention group 1 received auricular acupressure + Tongtian oral liquid, the intervention group 2 received Jing point bloodletting + Tongtian oral liquid, and the control group received ibuprofen + flunarizine. Before treatment, 60 minutes and 120 minutes after treatment, the visual analogue scale (VAS) and the short-form McGill pain questionnaire (SF-MPQ) were used to score the pain in the three groups to evaluate the efficacy of immediate analgesia. Symptoms including fatigue, drowsiness, nausea, and vomiting after 2 hours of treatment were observed. The amount of ibuprofen used within 24 hours was calculated. The drug treatment was continued for one month. The frequency of migraine attacks was compared among the three groups. The relevant factors affecting the number of migraine attacks were analyzed. RESULTS: The VAS and SF-MPQ scores of the three groups were all decreased 120 minutes after treatment as compared with those before treatment (P<0.01). The decline rate in the intervention group 1 > that in intervention group 2 > that in control group (P<0.01). The immediate analgesic efficiency at 60 minutes, intervention group 1 > intervention group 2 > control group (100% vs. 76.67% vs. 56.67%, P<0.001). After 2 hours of treatment, more cases of fatigue and lethargy occurred in the control group (P<0.05). There was no significant difference in nausea and vomiting among the three groups (P>0.05). The 24-hour ibuprofen dosage and headache recurrence ratio, control group > intervention group 2 > intervention group 1 (P<0.05). The number of headache attacks within 30 days was significantly higher in the control group than in the intervention groups (P=0.012). There was no significant statistical difference between the two intervention groups (P=0.568). Regression analysis found that age (OR=1.036, 1.006-1.068), body mass index (OR=1.101, 1.008-1.201), hypertension (OR=2.879, 1.187-6.986), chronic gastritis (OR=2.839, 1.213-6.647), children with educational problems (OR=0.333, 0.164-0.676), and residual fatigue symptoms (OR=4.539, 1.828-11.271) affected the number of headache attacks within the one month of treatment. CONCLUSIONS: Auricular acupressure combined with Tongtian Oral Liquid can relieve the acute pain of migraine without aura and reduce the number of pain episodes. The curative effect of this combination is better than that of western medicine alone.

Diversity, Equity, and Inclusion Lessons From Developing Stroke Education Programs for West Michigan Asian Communities.

BACKGROUND: Asians in the United States, facing health care disparities, have increased stroke risk. Multiple subgroups, with distinct cultures and languages, add complexity to caring for Asian American (AsA) communities. We developed a tailored stroke education program for underserved West Michigan AsA communities. Methodology, lessons learned, and diversity, equity, and inclusion insights are described. METHODS: Neurology residents and faculty, in collaboration with trained community-specific navigators, developed culturally resonant stroke education that was tailored to meet the needs of specific self-identified West Michigan AsA communities. Educational and debriefing sessions were delivered over 6 months, following the Plan-Do-Study-Act model, to elucidate diversity, equity, and inclusion insights and improve materials and delivery methods. RESULTS: Eighty-six non-English-speaking participants from 5 self-identified AsA communities (Burmese, Buddhist Vietnamese, Catholic Vietnamese, Chinese, and Nepali) attended educational stroke sessions. The average age of attendees was 57.6±13.2 years; most were females (70%). Diversity, equity, and inclusion insights included identification of Asian cultural beliefs about acute stroke treatment (eg, bloodletting), investigator insights (eg, need for kitchen-table programs), systemic barriers (eg, language), and mitigation strategies. CONCLUSIONS: Institutions should consider the integration of equity-focused, trainee-influenced quality improvement projects, such as this culturally resonant stroke educational program for AsA, to enhance stroke care in these vulnerable communities.

An overview of headache treatments during the tenth century.

Although the history of treating headaches spans thousands of years, scientists during the tenth century made unique and significant contributions to understanding, treating, and preventing the development of headaches. In fact, the tenth century saw the ability to differentiate between types of headache and treatments for the first time. This article looks at the contributions of Persian, Anglo-Saxon, and Chinese medicine to the diagnosis and treatment of different types of headaches in the tenth century. It does so with reference to a range of herbal, surgical, and pharmacological methods of treating this ailment. The article also uncovers how tenth-century herbal remedies were effective at explaining the properties of their ingredients in modern terms and concepts including analgesia, anti-inflammation, and antinociception, and explores the way tenth-century treatments relieved painful headaches and prevented their recurrence.

Efficacy and safety of bloodletting puncture and cupping in postherpetic neuralgia: A systematic review and meta­analysis.

The present study aimed to evaluate the efficacy and safety of bloodletting puncture and cupping (BLP-C) in postherpetic neuralgia (PHN) and to provide guidance for clinical treatment. Randomized controlled trials (RCTs) of BLP-C therapy in PHN were systematically searched in eight databases from inception to September 2022. Literature screening, data extraction and quality assessment were performed by two independent researchers. Dichotomous and continuous variables were pooled using the risk ratio (RR) and weighted mean difference (WMD), respectively. A total of 13 studies involving 1,129 patients with PHN (571 in the experimental group and 558 in the control group) were included in the present meta-analysis. Overall efficacy (RR=1.21, 95% CI: 1.15 to 1.28, P<0.00001), VAS score (WMD=-1.10, 95% CI: -1.31 to -0.90, P<0.00001) and PSQI score (WMD=-2.42, 95% CI: -2.87 to -1.96, P<0.0001) were significantly different between the BLP-C group and Western medicine group. Furthermore, subgroup analysis demonstrated that BLP-C alone or combined with other traditional Chinese medicines was more effective than Western medicine in PHN. A total of four RCTs mentioned adverse reactions, most of which were in the Western medicine group and were relieved after treatment discontinuation. In conclusion, BLP-C is superior to Western medicine in relieving pain and improving the sleep quality of patients with PHN with a lower incidence of adverse effects.

New interpretation of "Miu Ci". / "缪刺"新识.

Based on the record of Miu Ci theory from Huangdi Neijing (The Yellow Emperor's Internal Classic), and incorporating the relevant discussions of medical scholars from various dynasties, this article interprets and analyzes the Miu Ci technique, the points to be needled, and the diseases can be treated. The following innovative understandings are proposed： 1) The original meaning of "Miu" in Miu Ci is "to prick in a different way from the meridians (needle the major collaterals)", not "needle left and right interchangeably". Needle left and right interchangeably is not a necessary operation in Miu Ci. 2) The stimulation sites of Miu Ci are the "four extremities" of the human body, referred to as the "major collaterals of qi", and the nail bed of the four extremities is not equivalent to the commonly reco-gnized "Jing-well points". 3) Miu Ci can treat critical illnesses, not just limited to musculoskeletal pain or mild conditions at the early stage of a disease. 4) Miu Ci is not equivalent to Luo Ci needling (pricking bloodletting therapy).

Medical aspects of the tour by Martin Martin (c 1660-1719) of the Western and Northern Islands of Scotland, Circa 1695.

This review is based investigations on the Western Isles, Scotland, by Martin Martin, a notable Scottish Highlander, academic and medical doctor, of the 17th-18th century. His extensive observations of the geography and peoples of these Isles were recorded in his books, "On the Description of the Western Islands of Scotland Circa 1695" and "A Late Voyage to St Kilda". In these books and subsequent papers there were some noteworthy observations on the occurrence (and as he says non-occurrence) of "epidemical" diseases and conditions afflicting the peoples of The Isle of Skye and the Western Isles of Scotland in this period, and these are discussed in this review. Martin also gives details of a wide variety of remedies that were observed or reported by inhabitants around that time. Some of these remedies are interesting for their relevance to the period but others are of doubtful merit. These are reviewed here more for their significance in the understanding of the diseases and conditions of humans and even in some cases animals at that time. Introductions by Charles Withers and R.W. Munro, 11 and re-assessments of the contributions of Martin and colleagues of that time have given insight into the health and condition of peoples of the Western Isles of Scotland(the Occidental) (Martin 1695; Martin 1716).

As funções, a formação e a extinção dos sangradores em Portugal / The functions, training, and extinction of bloodletters in Portugal / Las funciones, la formación y la extinción de los sangradores en Portugal

Resumo Enquadramento: O século XIX caracteriza-se por profunda alteração no campo assistencial. O higienismo, a bacteriologia, impulsionam a reorganização dos serviços de saúde. Os sangradores, ofício que subsistiu regulado ao longo de quase quatro séculos é oficialmente extinto em 1870. Objetivos: Compreender de que forma os sangradores estiveram presentes na sociedade e instituições assistenciais e como o seu lento desaparecimento foi acompanhado pelo desenvolvimento do processo de profissionalização dos enfermeiros em Portugal. Metodologia: Inferência histórica com base no levantamento e análise crítica de fontes primárias, como seja um manual coevo e atas dos debates parlamentares; e de fontes secundárias, nomeadamente material editado (artigos, livros, teses), que no seu conjunto levem à produção de uma síntese final interpretativa. Resultados: Enquanto perdurou a teoria dos humores, sangrar era remédio para tudo. Com o despertar da nova medicina assiste-se ao ocaso progressivo dos sangradores a partir do final do séc. XVIII. Conclusão: O desaparecimento oficial dos sangradores coincide com o acentuar da profissionalização dos enfermeiros, nomeadamente com o surgimento de formação estruturada.

Abstract Background: The 19th century was characterized by profound changes in health care. The development of hygiene standards and bacteriology reorganized health services. In Portugal, the job of bloodletters, regulated for almost four centuries, officially became extinct in 1870. Objectives: To understand bloodletters' presence in society and healthcare institutions and how their gradual disappearance accompanied the professionalization process of nursing in Portugal. Methodology: Historical inference based on the survey and critical analysis of primary sources, such as a contemporary manual and the minutes of parliamentary sessions, and secondary sources, such as articles, books, and theses. Analyzing the data collected from these sources produced a final interpretative synthesis. Results: While the humoral theory persisted, bloodletting was considered a remedy for everything. However, from the end of the 18th century, the development of modern medicine led to the progressive decline of this health-related practice. Conclusion: The official disappearance of bloodletters coincided with the intensification of nurses' professionalization process, particularly with the emergence of formal nursing training.

Resumen Marco contextual: El siglo XIX se caracteriza por un profundo cambio en el campo de la salud, con el higienismo, la bacteriología y la reorganización de los servicios de salud. Los sangradores fueron uno de los oficios que permaneció reglamentado oficialmente durante casi cuatro siglos hasta su extinción oficial en 1870. Objetivos: Comprender cómo las hemorragias estuvieron presentes en la sociedad y en las instituciones asistenciales y cómo su lenta desaparición fue concomitante con el desarrollo del proceso de profesionalización de los enfermeros en Portugal. Metodología: Inferencia histórica basada en el levantamiento y análisis crítico de fuentes primarias, tales como uno manual antiguo y debates parlamentarios, y fuentes secundarias, a saber, material editado, artículos, libros, tesis que en conjunto conducen a la producción de una síntesis interpretativa final. Resultados: mientras duró la teoría de los humores, sangrar fue una cura para todo. Con el despertar de la nueva medicina asistimos al progresivo declive de los sangradores a partir de finales del siglo XVIII. Conclusión: La desaparición oficial de los sangradores coincide con el acentuar de la profesionalización de los enfermeros, es decir, con el surgimiento de la formación estructurada.

Big business: The private sector market for image and performance enhancing drug harm reduction in the UK.

This article draws on three mutually independent ethnographic studies to explore the private sector market for image and performance enhancing drug (IPED) harm reduction in the UK, specifically examining (1) steroid accessory supplements; (2) blood testing services; and (3) bloodletting services. After contextualising the work with a discussion of IPED use and harm reduction and the substantial growth of the global health and fitness industry, each private sector provision is critically interrogated with the following questions in mind: what is the role and utility of these services compared to public sector provision? Why has the private sector begun to deliver IPED harm reduction products and services in the UK? And how does this provision relate to the health and fitness industry more broadly? The paper concludes with some reflections about the future direction of IPED harm reduction, the importance of community-led services, and the need to think innovatively if we are to best protect users' health and wellbeing.

Bloodletting puncture in the treatment of acute ischemic stroke: protocol for a mixed-method study of a multi-center randomized controlled trial and focus group.

This study is to investigate the effectiveness and safety of bloodletting puncture (BP) for acute ischemic stroke (AIS) when used in combination with standard treatment, as well as the patients' feelings and attitudes toward the treatment. This is a mixed method research which includes a multi-center, superiority, randomized controlled clinical trial, and focus group interview. A total of 360 AIS participants will be enrolled. They will be randomized into one of the following two groups for 7 d: (a) BP with standard treatment group (n = 180); (b) standard treatment group (n = 180). The primary outcome will be National Institute of Health stroke scale (NIHSS) score at day 7 after treatment. Secondary outcomes will be changes of Glasgow Coma Scale score, NIHSS score, mRS and Traditional Chinese Medicine syndrome score from baseline to 7, 14, and 30 d after treatment, recurrence rate and all-cause mortality rate within 30 d, and the safety assessments. The focus group will be conducted with a purposive sample of 1-2 acupuncturists and 1-2 patients respectively at each center at 7 and 30 d after treatment. We designed a mixed method study to evaluate the effect of BP, an acupuncture therapy for patients with AIS. If the findings of this study confirm the effectiveness of BP to reduce the NIHSS score and other related outcomes and patients are willing to accept the therapy, we believe this study will help the implementation of this therapy in clinical practice, and provide new evidence for the treatment of AIS.

Blood-letting therapy combined with Master Tung's Five-tiger Point Scraping (Gua Sha) for patients with hematological malignancy and chemotherapy-induced peripheral neuritis.

OBJECTIVE: To investigate the clinical efficacy of Shixuan and Qiduan blood-letting therapy combined with Master Tung's Five-tiger Point (11.27) Scraping for patients with hematological malignancy and peripheral neuritis. METHODS: A total of 70 patients with hematological malignancy who were admitted to Langfang TCM Hospital between January 2020 and December 2022 for treating chemotherapy-induced peripheral neuritis were enrolled retrospectively. The patients were divided into a single treatment group that received western nutritional interventions alone, and a combined treatment group that underwent additional Traditional Chinese Medicine (TCM) Shixuan and Qiduan blood-letting therapy, along with Master Tung's Five-tiger Point (11.27) Scraping. Statistical analyses were carried out to compare the clinical efficacy of the two treatment plans in the patients. Scores of sensory disturbance rating (SDR), numeric rating scale (NRS) for pain, nail fold microcirculation (NFM) of the infected extremity, and the quality of life (QoL), as well as the motor nerve conduction velocity (MNCV) and sensory nerve conduction velocity (SNCV) of the median and peroneal nerves of patients in both groups were recorded and compared before and after treatment. The incidence rate of adverse events was compared between the two groups. Furthermore, the clinical outcomes of patients in the two groups were followed up and analyzed for correlated factors using univariate and multivariate analyses. RESULTS: The clinical efficacy rate achieved by the combined therapy was 88.57%, significantly higher than 68.57% for patients undergoing single therapy (P=0.041). Moreover, the scores of SDR, pain NRS, QoL, and NFM of the affected extremity, as well as the MNCV and SNCV of patients in the two groups were all improved after treatment, with better improvements in the combined treatment group than in the single treatment group. The incidence rate of adverse events was higher in the single treatment group compared to that of the combined treatment group (17.14% vs. 11.42%) (P=0.466). In addition, during the six-month follow-up period, a total of 27 patients in both groups developed chronic neural disorders. Logistic regression analysis revealed that the MNCV and SNCV of the median and peroneal nerves, together with the duration of chemotherapy, served as independent influencing factors. CONCLUSION: Shixuan and Qiduan blood-letting therapy combined with Master Tung's Five-tiger Point (11.27) Scraping could improve the SDR and pain NRS scores, facilitate the recovery of neural functions, and advance the QoL of patients with chemotherapy-induced peripheral neuritis without increasing the risk of adverse reactions.

[Application of "eliminating stagnation and bloodletting/fire needling" in treatment of jingjin diseases].

Based on the development of conditions, the etiology and pathogenesis of jingjin (muscle region of meridian) diseases are summarized as 3 stages, i.e. stagnation due to over-exertion at early stage, manifested by tendon-muscle contracture and tenderness; cold condition due to stagnation, interaction of stasis and cold, resulting in clustered nodules at the middle stage; prolonged illness and missed/delayed treatment, leading to tendon-muscle contracture and impairment of joint function at the late stage. It is proposed that the treatment of jingjin diseases should be combined with the characteristic advantages of fire needling and bloodletting technique, on the base of "eliminating stagnation and bloodletting/fire needling". This combined therapy warming yang to resolve stasis and dispels cold to remove nodules, in which, eliminating the stagnation is conductive to the tissue regeneration, and the staging treatment is delivered in terms of the condition development at different phases.

Bloodletting Acupuncture at Jing-Well Points on Hand Induced Autophagy to Alleviate Brain Injury in Acute Altitude Hypoxic Rats by Activating PINK1/Parkin Pathway.

OBJECTIVE: To explore the protective effect of bloodletting acupuncture at twelve Jing-well points on hand (BAJP) on acute hypobaric hypoxia (AHH)-induced brain injury in rats and its possible mechanisms. METHODS: Seventy-five Sprague Dawley rats were divided into 5 groups by a random number table (n=15), including control, model, BAJP, BAJP+3-methyladenine (3-MA), and bloodletting acupuncture at non-acupoint (BANA, tail tip blooding) groups. After 7-day pre-treatment, AHH models were established using hypobaric oxygen chambers. The levels of S100B, glial fibrillary acidic protein (GFAP), superoxide dismutase (SOD), and malondialdehyde (MDA) in serum were measured by enzyme-linked immunosorbent assay. Hematoxylin-eosin staining and the terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling method were used to assess hippocampal histopathology and apoptosis. Transmission electron microscopy assay was used to observe mitochondrial damage and autophagosomes in hippocampal tissues. Flow cytometry was used to detect mitochondrial membrane potential (MMP). The mitochondrial respiratory chain complexes I, III and IV activities and ATPase in hippocampal tissue were evaluated, respectively. Western blot analysis was used to detect the protein expressions of Beclin1, autophagy protein 5 (ATG5), microtubule-associated protein 1 light chain 3 beta (LC3B), phosphatase and tensin homolog induced kinase 1 (PINK1), and Parkin in hippocampal tissues. The mRNA expressions of Beclin1, ATG5 and LC3-II were analyzed by quantitative real-time polymerase chain reaction. RESULTS: BAJP treatment reduced hippocampal tissue injury and inhibited hippocampal cell apoptosis in AHH rats. BAJP reduced oxidative stress by decreasing S100B, GFAP and MDA levels and increasing SOD level in the serum of AHH rats (P<0.05 or P<0.01). Then, BAJP increased MMP, the mitochondrial respiratory chain complexes I, III and IV activities, and the mitochondrial ATPase activity in AHH rats (all P<0.01). BAJP improved mitochondrial swelling and increased the autophagosome number in hippocampal tissue of AHH rats. Moreover, BAJP treatment increased the protein and mRNA expressions of Beclin1 and ATG5 and LC3-II/LC3-I ratio in AHH rats (all P<0.01) and activated the PINK1/Parkin pathway (P<0.01). Finally, 3-MA attenuated the therapeutic effect of BAJP on AHH rats (P<0.05 or P<0.01). CONCLUSION: BAJP was an effective treatment for AHH-induced brain injury, and the mechanism might be through reducing hippocampal tissue injury via increasing the PINK1/Parkin pathway and enhancement of mitochondrial autophagy.

[Bloodletting at auricular dorsal vein combined with auricular point sticking for menstrual migraine of qi stagnation and blood stasis and its effect on serum levels of E2 and 5-HT].

OBJECTIVE: To observe the clinical effect of bloodletting at auricular dorsal vein combined with auricular point sticking on menstrual migraine (MM) of qi stagnation and blood stasis, and explore its possible mechanism. METHODS: A total of 102 cases of MM with qi stagnation and blood stasis were randomly divided into an observation group (51 cases, 3 cases dropped off) and a control group (51 cases, 2 cases dropped off). The patients in the observation group were treated with bloodletting at auricular dorsal vein combined with auricular point sticking. The bloodletting was performed at vein at upper 1/3 of the dorsalis near the ear helix; the auricular point sticking was performed at Pizhixia (AT4), Neifenmi (CO18), Jiaogan (AH6a), Nie (AT2), Zhen (AT3), Shenmen (TF4) and Yidan (CO11). The auricular points of both ears were alternate used. From 7 days before the onset of menstruation, bloodletting at auricular dorsal vein was given once every 7 days, 3 times were taken as a course of treatment, and 1 course of treatment was given; the auricular point sticking was given once every 3 days, and 6 times of treatment were given. The patients in the control group were treated with oral administration of flunarizine hydrochloride capsules. From 7 days before the onset of menstruation, flunarizine hydrochloride was given 2 capsules per time, once a day for 3 weeks. The menstrual headache index and visual analogue scale (VAS) score of the two groups were observed before treatment, one menstrual cycle into treatment and the first and the second menstrual cycle after treatment; the migraine-specific quality of life questionnaire (MSQ) score and the serum levels of estradiol (E2) and 5-hydroxytryptamine (5-HT) were compared before treatment and one menstrual cycle into treatment; the clinical efficacy was evaluated at one menstrual cycle into treatment. RESULTS: Compared before treatment, the menstrual headache index and VAS scores were reduced at one menstrual cycle into treatment and the first and second menstrual cycle after treatment in the two groups (P<0.05), and those in the observation group were lower than the control group (P<0.05). Compared before treatment, the MSQ scores and the serum levels of E2 and 5-HT in the two groups were increased at one menstrual cycle into treatment (P<0.05), and those in the observation group were higher than the control group (P<0.05). The total effective rate was 95.8% (46/48) in the observation group, which was higher than 73.5% (36/49) in the control group (P<0.05). CONCLUSION: Bloodletting at auricular dorsal vein combined with auricular point sticking could relieve headache intensity, improve the quality of life in patients with MM of qi stagnation and blood stasis, which may be achieved by raising the serum levels of E2 and 5-HT to improve the level of hormone in the body.

Bloodletting cupping combined with conventional measures therapy for psoriasis: A systematic review and meta-analysis of randomized controlled trials.

Background: Psoriasis is an immune-mediated inflammatory disease prone to recurrence. Some studies indicated that bloodletting cupping combined with conventional measures therapy had been proposed as a treatment strategy for psoriasis. Therefore, we performed a systematic review and meta-analysis to assess the effectiveness of this combination therapy in reducing the severity of disease in patients with psoriasis. Methods: The following electronic databases were searched for articles from January 1, 2000 to March 1, 2022: PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Chinese Biomedical Literature Database (CBM), Chinese Scientific Journal Database (VIP database), Wan-Fang Database, and China National Knowledge Infrastructure (CNKI). The language was not restricted while performing the search. The quality of articles was evaluated using Rev. Man 5.4 software (provided by the Cochrane Collaboration), comparing bloodletting cupping combined with conventional measures therapy to conventional measures treatments. The studies obtained randomized controlled trials (RCTs) of bloodletting cupping combined with conventional standard treatment for treating psoriasis. Two trained researchers (Xiaoyu Ma and Jiaming He) independently reviewed the literature, extracted data based on exclusion and inclusion criteria, and assessed the quality of the included studies. We estimated the aggregate data using a random effects model. Findings: We identified 164 studies. Ten studies met the inclusion criteria for the meta-analysis. The primary outcome indicator was the total number of effective individuals. Secondary outcomes included the Psoriasis Area and Severity Index (PASI), adverse effects, and the Dermatology Life Quality Index (DLQI). Compared with conventional treatments, bloodletting cupping combined with conventional medicine yielded an improved total effective number of persons (RR = 1.15, 95%CI: 1.07 to 1.22, p < 0.00001), PASI (MD = -1.11, 95%CI: -1.40 to -0.82, p < 0.00001) and DLQI scores (MD = -0.99, 95%CI: -1.40 to -0.59, p < 0.0001). We found no significant difference in adverse reactions (RR = 0.93, 95%CI: 0.46 to 1.90, p = 0.85). The heterogeneity test showed the total effective numbers (p < 0.00001, I 2 = 43%) and PASI (p < 0.00001, I 2 = 44%) and DLQI scores (p < 0.00001, I 2 = 0%). Interpretation: Bloodletting cupping combined with conventional treatment can achieve the ideal treatment for psoriasis. However, the combined treatment in psoriasis needs to be further evaluated in high-quality RCTs with large sample sizes to enable future studies in clinical use.

Do different wiping techniques in phlebotomy have an effect on vessel visibility, procedural success, and phlebotomy-related complications?

BACKGROUND: This study was conducted to evaluate the effects of different wiping techniques used in phlebotomy on vein visibility, procedural success, and phlebotomy-related complications. MATERIALS AND METHODS: This single-center, comparative, randomized study was conducted with 90 patients in the internal medicine clinic of a tertiary hospital. During the phlebotomy procedure, the phlebotomy site was wiped with circular technique in the Group-I, vertical technique in the Group-II, and vertical + circular technique in the Group-III. RESULTS: There was a significant difference between the three groups in terms of vein visibility after wiping of the phlebotomy site (p < 0.05). The time spent for blood sampling was shorter in the Groups I and II (p > 0.05). In the 3-day follow-up after the blood sample was taken, the ecchymosis and hematoma rates of the groups were similar (p > 0.05). CONCLUSIONS: Vertical wiping and vertical + circular wiping techniques used in the cleaning of the phlebotomy site increased the visibility of the vein compared to only circular wiping. The time spent for blood sampling was shorter in the vertical wiping and vertical + circular wiping groups.