Objective To compare the therapeutic effect of auricular acupuncture with that of hormone substitution on perimenopause syndrome patients to study the mechanism of auricular therapy.Methods Totally 68 female cases were randomized into the auricular acupuncture group and hormone group,34 cases in each.The auricular acupuncture group was given electro-acupuncture on Neifenmi(CD18),Ovarium,and Uterus;and the hormone group was given Tibolone.Before and after treatment,record Kupperman score and determine serum estradiol(E2),follicle-stimulating hormone(FSH)and luteotropic hormone(LH)respectively.Results After treatment,the Kupperman scores of both groups were decreased,the level of E2 increased obviously,FSH and LH decreased,the difference was significant(P0.05).Conclusion The auricular therapy can effectively relieve the perimenopause syndrome and improve the reproductive endocrine function of perimenopause females.

Objective To investigate the clinical efficacy of acupuncture intervention in muscle, bone and joint pain caused by aromatase inhibitors in the treatment of breast cancer. Method One hundred and forty breast cancer patients with aromatase inhibitors-caused muscle, bone and joint pain were randomly allocated to groups A, B, C and D, 35 cases each. group A received ear acupuncture plus the intravenous drip of zoledronic acid;group B, ear acupuncture alone;group C, the intravenous drip of zoledronic acid alone;group D, oral administration of calcium carbonate and vitamin D3 chewable tablets and alfacalcidol soft capsules. The Brief Pain Inventory score was observed in every group before and after treatment. Bone mineral densities of the lumbar vertebrae were compared between the groups before and after treatment. Result In groups a and B, there was a statistically significant difference in the pain interference score at three, six and twelve weeks of treatment and at six weeks after the end of treatment compared with before treatment (P<0.01). At three, six and twelve weeks of treatment and at six weeks after the end of treatment, there was a statistically significant difference in the pain interference score between group A or B and group C or D (P<0.01). In groups a and B, there was a statistically significant difference in the pain score during the most severe pain at three, six and twelve weeks of treatment compared with before treatment (P<0.05). At three, six and twelve weeks of treatment, there was a statistically significant difference in the pain score during the most severe pain between group A or B and group C or D (P<0.05). At three weeks of treatment, there was a statistically significant difference in the pain score during the most severe pain between group B and group C or D (P<0.05). In every group, there was no statistically significant difference in BMD T-score at twelve weeks of treatment and at six weeks after the end of treatment compared with before treatment (P>0.05). Conclusion Ear acupuncture can significantly relieve muscle, bone and joint pain caused by aromatase inhibitors and the pain relief is not related to bone mineral density, but muscle, bone and joint pain recurs in the patients after the treatment is discontinued. Zoledronic acid can not relieve the pain. Ear acupuncture plus zoledronic acid is not more effective than ear acupunctura alone in relieving the pain.

OBJECTIVETo observe the efficacy of catgut implantation at back-shu points in treatment of mild perimenopausal depression of kidney, deficiency and liver stagnation syndrome and analyze its essential function on target symptoms.

METHODSForty-five cases were randomized into a catgut implantation group (23 cases) and atid acupuncture group (22 cases). In the catgut implantation group, catguts were implanted at Shenshu (BL 23), Ganshu (BL 18), Xinshu (BL 15), Pishu (BL 20), etc., once every week. In the acupuncture group, the conventional acupuncture was applied to the same acupoints as the catgut implantation group, once every two days. The: treatment of 4 weeks made one session, and continuous 2 sessions were required. The efficacy was evaluated in, 2 sessions. The follow-up started in the 12th week. Before treatment, after treatment and in the follow-up period, Kupperman score and the total score in Hamilton depression scale (HAMD), as well as the factor score were observed in the patients separately.

RESULTSKupperman score, the total HAMD score and the scores in the items of anxiety/somatization, retardation, sleep disorder and cognitive disorder after treatment were all reduced significantly as compared with those before treatment in the two groups (P<0.01, P<0.05). In the follow-up period, the difference in Kupperman was not significant in comparison with that after treatment in the catgut implantation: group (P>0.05). The total HAMD score and sleep disorder were reduced significantly as compared with those after treatment in the catgut implantation group (both P<0.01); in the acupuncture group, Kupperman score, the total HAMD score and sleep disorder were all increased as compared with those after treatment (all P<0.05). In; the catgut implantation group, the total HAMD score was lower than that in the acupuncture group (P<0. 05), and the scores in the items of retardation and sleep disorder were reduced significantly as compared with those in the acupuncture group (both P<0.01).

CONCLUSIONThe catgut implantation at back-shu points alleviates perimenopasual sympton is in patients of mild perimenopausal depression of kidney deficiency and liver stagnation syndrome. This therapy effectively relieves depressive disorders by regulating the target symptoms such as anxiety/ somatization, retardation, sleep disorder and cognitive' disorder. The long-term efficacy of this therapy is better than the conventional acupuncture.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Catgut ; Depressive Disorder ; physiopathology ; therapy ; Female ; Humans ; Kidney ; physiopathology ; Liver ; physiopathology ; Middle Aged ; Perimenopause ; psychology ; Treatment Outcome

Objective: To observe the effects of minimally invasive tangential excision in treating deep partial-thickness burn wounds on trunk and limbs in pediatric patients in the early stage post burn. Methods: Clinical data of 40 children with deep partial-thickness burn wounds on trunk and limbs, admitted to our burn ward from January 2016 to June 2017, conforming to the study criteria, were retrospectively analyzed. They were divided into conventional treatment group (CT, n=19) and minimally invasive tangential excision group (MITE, n=21) according to the different treatments. The patients in group CT were treated with eschar-reserving therapy firstly. When tangential excision was performed, the roller knife was used, and no necrotic tissue left on the wound bed was considered the proper depth of excision. Razor-thickness skin grafting was performed to cover the wound when adipose tissue exposed markedly after tangential excision. Dressing change was performed within 48 h after the operation and repeated every 2 days. Unhealed wounds were covered by razor-thickness skin grafting. The patients in group MITE were treated with tangential excision in the early stage post burn. The tangential excision was operated with electric dermatome, and the thickness was set at 0.1 mm to excise the surface of eschar until the sporadic punctate hemorrhage on wound surface was observed and some necrotic tissue was left on the wound bed. Porcine acellular dermal matrix was applied after tangential excision. The first dressing change was often performed about 1 week after the operation. Razor-thickness skin grafting was performed to cover the unhealed wounds. The length of wound healing, high fever, antibiotic usage, and hospital stay, times of later operation, and hospitalization expenses of patients in the 2 groups were recorded. The excisional eschar and wound bed tissue of patients in group MITE were harvested for pathological observation. Data were processed with t test and Fisher′s exact probability test. Results: (1) There were no statistically significant differences in length of high fever and length of hospital stay and hospitalization expenses between patients in the 2 groups (t=-1.67, -1.93, 0.31, P>0.05). The lengths of wound healing [(24.8±2.5) d] and antibiotic usage [(4.4±0.7) d] of patients in group MITE were significantly shorter than those in group CT [(33.3±2.5) and (7.0±0.7) d, t=-2.44, -2.44, P<0.05], and times of later operation of patients in group MITE [(0.29±0.14) times] were significantly less than those in group CT [(0.79±0.21) times, t=-2.03, P<0.05]. (2) The thickness of the excisional eschar of patients in group MITE was about 150 μm. The eschar has epidermis and upper dermis. Some necrotic tissue was left on the wound bed. Conclusions The treatment for pediatric deep partial-thickness burn wounds on trunk and limbs with minimally invasive tangential excision using electric dermatome in the early stage post burn can accelerate wound healing, shorten length of antibiotic usage, and reduce times of later operations.

Objective: To observe the clinical effects of stage-Ⅱ Meek skin grafting on adipose tissue after tangential excision in patients with extensive deep burns, and to explore the functional mechanism. Methods: The medical records of 26 extensively burned patients who met the inclusion criteria and were admitted to the Department of Burns and Plastic Surgery of the Fourth Medical Center of PLA General Hospital from May 2015 to December 2017 were retrospectively analyzed. According to the treatment methods, 14 patients were enrolled in stage-Ⅰ skin grafting group (10 males and 4 females, aged 27 to 75 years), and 12 patients were enrolled in stage-Ⅱ skin grafting group (10 males and 2 females, aged 31 to 76 years). Patients in the 2 groups all underwent debridement of tangential excision, and their healthy adipose tissue was preserved. Meek skin grafting was performed just after tangential excision in patients in stage-Ⅰ skin grafting group. In patients in stage-Ⅱ skin grafting group, porcine acellular dermal matrix (ADM) was applied to cover the wound after tangential excision, and 3 days later, it was removed and Meek skin grafting was performed. The times of complement skin grafting and the wound basic healing time of patients in the 2 groups were observed and recorded. In the stage-Ⅱ skin grafting group, the adipose tissue of patients were taken from the wound center immediately after tangential excision and immediately after the removal of porcine ADM, for the observation of structure of the fault surface of adipose tissue through hematoxylin and eosin staining and microvessel density (MVD) through immunohistochemical staining. Data were processed with independent sample t test and Fisher′s exact probability test. Results: (1) The times of complement skin grafting of patients in stage-Ⅱ skin grafting group was (1.83±0.17) times, which was obviously less than (3.36±0.63) times in stage-Ⅰ skin grafting group (t=2.19, P<0.05). The wound basic healing time of patients in stage-Ⅱ skin grafting group was (35.1±2.3) d, which was obviously shorter than (48.8±4.9) d in stage-Ⅰ skin grafting group (t=2.27, P<0.05). (2) Immediately after tangential excision, the intercellular substance was few between the adipose cells in adipose tissue of patients in stage-Ⅱ skin grafting group. Immediately after the removal of porcine ADM, there was regenerated granulation tissue in the intercellular space of adipose cells of adipose tissue of patients in stage-Ⅱ skin grafting group. Immediately after tangential excision, the MVD of adipose tissue of patients in stage-Ⅱ skin grafting group was 20.2±1.3 under per 400-time field, which was obviously less than 32.2±1.9 under per 400-time field immediately after the removal of porcine ADM (t=-5.38, P<0.01). Conclusions Meek skin grafting on the adipose tissue in stage-Ⅱ surgery after tangential excision could reduce the times of complement skin grafting and shorten wound healing time of patients with extensive deep burns. The mechanism may be related to the improvement of the recipient condition of adipose tissue.