ObjectiveTo investigate the clinical efficacy of wrist-ankle acupuncture plus continuous exercise therapy for post-stroke shoulder pain.MethodsEighty patients with post-stroke shoulder pain were randomly allocated to treatment and control groups, 40 cases each. The control group received continuous exercise training with an upper limb multi-joint rehabilitation training instrument and the treatment group, wrist-ankle acupuncture in addition. The affected limb SEP N9 and N13 latency values, shoulder pain severity (the VAS score) and the upper limb motor function score were observed in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups.ResultsThe total efficacy rate was 90.0% in the treatment group and 75.0% in the control group; there was a statistically significant difference between the two groups (P<0.05). There was a statistically significant pre-/post-treatment difference in SEP N9-N13 wave interval on the affected side in the two groups (P<0.01). There was a statistically significant post-treatment difference in SEP N9-N13 wave interval on the affected side between the treatment and control groups (P<0.05). There were statistically significant pre-/post-treatment differences in the VAS score and the Fugl-Meyer score in the two groups (P<0.01). There were statistically significant post-treatment differences in the VAS score and the Fugl-Meyer score between the treatment and control groups (P<0.01).ConclusionsWrist-ankle acupuncture plus continuous exercise therapy is an effective way to treat post-stroke shoulder pain.

Objective To summarize our clinical experience of surgical treatment for pediatric patients with ventricular septal defect(VSD) and mitral regurgitation(MR).Methods A retrospective study was performed including consecutive 84 patients with VSD and MR receiving mitral valvuloplasty(MVP) and VSD closure from January 2006 to January 2012 in Shanghai Xinhua Hospital.All patients were associated with pulmonary hypertension(PH,32-85 mm Hg).The diameters of ventricular septal defects were between 0.7 and 1.6 cm.Echocardiography showed that trivial MR (+) in 9 cases,mild MR (++)in 18 cases,moderate MR(+++) in 33 cases,and severe MR(++++) in 24 cases.VSD closure and MVP were performed with cardiopulmonary bypass under moderate systemic hypothermia.The results of repair were evaluated by transesophageal echocardiography (TEE) during operation.Results Intra-operative TEE results: no residual shunt of VSD,none MR in 80 cases,residual trivial MR in 4 cases.Mean Cardiopulmonary bypass (CPB) time was (84.6 ± 18.5) mins.Mean Aortic clump time was(50.8 ± 11.5) mins.Mean postoperative ventilation time was (38.7 ± 30.2) hours,and mean postoperative inhosptial time was(10.5 ±4.6) days.The in-hospital mortality was 1.2％ (1 case died).78 cases were fully followed up.There was no late death.Echocardiography showed that none MR in 62 cases,trivial MR in 10 cases,mild MR in 4 cases,moderate MR in 2 patients.The overall freedom from reoperation at 5 years was (97.4 ± 1.8) ％.Conclusion Ventricular septal defect with pulmonary hypertension need early surgical repair.MR was treated at the same time of VSD closure could effectively improve the surgical outcome of pediatric patients with ventricular septal defect and mitral regurgitation.