Objective To compare the clinical efficacies between warm needling and Ibuprofen sustained release capsules (a nonsteroidal anti-inflammatory drug, NSAID) in treating patients with dysmenorrhea in adenomyosis. MethodSixty-five patients with dysmenorrhea induced by adenomyosis were randomized into a treatment group of 33 cases and a control group of 32 cases. The control group was intervened by oral administration of Ibuprofen sustained release capsules, while the treatment group was intervened by warm needling.The intervention lasted 3 menstrual cycles and a 3-month follow-up was studied. The Visual Analogue Scale (VAS), dysmenorrhea symptoms scores and clinical efficacy were compared between the two groups.ResultThe VAS scores after the intervention and inthe first and second months of the follow-up study were significantly different from the pre-treatment score in the two groups (P<0.01); the VAS score of the 3-month follow-up was significantly different from the score before the intervention in the treatment group (P<0.01). There were significant differences in comparing the VAS score after the intervention and in the follow-up study between the two groups (P<0.01), and the treatment group was superior to the control group. The dysmenorrhea symptoms scoresdeclined significantly after the intervention and in the first and second months of the follow-up study in both groups (P<0.01); the dysmenorrhea symptoms score of the 3-month follow-up study decreased in the treatment group and was significantly different from the pre-treatment score (P<0.01). There were significant differences in comparing the dysmenorrhea symptoms scores in the second and third months of the follow-up study between the two groups (P<0.01). The total effective rate was 93.9% in the treatment group, significantly better than 62.5% in the control group (P<0.01).ConclusionWarm needling is effective in easing pain and improving the symptoms of dysmenorrhea in adenomyosis, and can produce a consistent efficacy after the termination of thetreatment; it's superior to NSAIDs in comparing both short-term and long-term treatment efficacies.

Objective To investigate the clinical characteristics and mechanism of cavernous sinus dural arteriovenous fistula (CSDAVF). Methods The clinical data of 17 CSDAVF patients, including clinical manifestations, characteristics of cerebrospinal fluid (CSF)and neuroimaging,were analyzed.The interventional catheter embolization of CSDAVF and postoperative follow-up were performed. Results Of the 17 subjects with CSDAVF, 5 (29.4%) were men and 12 (70.6%)were women (sex ratio=1:2.4).The average age of onset was (58.12±14.61)years old. Older CSDAVF patients were prone to be complicated with hypertension than general population at the same age. Onset symptoms included headache in 6 cases,eye symptoms in 5 cases,intracranial murmur in 2 cases,diplopia in 2 cases, dizziness in 1 case and slurred speech in 1 case. Digital subtraction angiography (DSA) was performed in all 17 patients. Further embolization was applied in 14 patients and had satisfactory outcome. In CSDAVF patients with headache, 2 patients showed orthostatic headache as initial symptom. One of them with intracranial hypotension reported exophthalmos 3 months after the onset. Those two patients remained asymptomatic during 3-year and 2-year follow-up after receiving interventional catheter embolization for CSDAVF. Conclusions CSDAVF usually occurs in middle-aged and older women, especially in those with hypertension. CSDAVF varies in clinical manifestations. A special attention should be given to orthostatic headache which can be presented as the initial symptom in few patients with CSDAVF. CTA or DSA should be considered in patients with clinically suspected CSDAVF to rule out the possibility of CSDAVF. The interventional catheter embolization is the primary treatment of CSDAVF.