Aged ; Carcinoma, Squamous Cell ; pathology ; surgery ; Cholecystectomy ; Gallbladder Neoplasms ; pathology ; surgery ; Humans ; Male

OBJECTIVETo explore the best intervention time of acupuncture and moxibustion for peripheral facial palsy (Bell's palsy) and the clinical advantage program of selective treatment with acupuncture and moxibustion.

METHODSMulti-central large-sample randomized controlled trial was carried out. Nine hundreds cases of Bell's palsy were randomized into 5 treatment groups, named selective filiform needle group (group A), selective acupuncture + moxibustion group (group B), selective acupuncture + electroacupuncture (group C), selective acupuncture + line-up needling on muscle region of meridian group (group D) and non-selective filiform needle group (group E). Four sessions of treatment were required in each group. Separately, during the enrollment, after 4 sessions of treatment, in 1 month and 3 months of follow-up after treatment, House-Brackmann Scale, Facial Disability Index Scale and Degree of Facial Nerve Paralysis (NFNP) were adopted for efficacy assessment. And the efficacy systematic analysis was provided in view of the intervention time and nerve localization of disease separately.

RESULTSThe curative rates of intervention in acute stage and resting stage were 50.1% (223/445) and 52.1% (162/311), which were superior to recovery stage (25.9%, 35/135) separately. There were no statistical significant differences in efficacy in comparison among 5 treatment programs at the same stage (all P > 0.05). The efficacy of intervention of group A and group E in acute stage was superior to that in recovery stage (both P < 0.01). The difference was significant statistically between the efficacy on the localization above chorda tympani nerve and that on the localization below the nerve in group D (P < 0.01). The efficacy on the localization below chorda tympani nerve was superior to the localization above the nerve.

CONCLUSIONThe best intervention time for the treatment of Bell's palsy is in acute stage and resting stage, meaning 1 to 3 weeks after occurrence. All of the 5 treatment programs are advantageous to Bell's palsy. In the condition of the limited medical sources, the simple filiform needle therapy is recommended in acute stage. For the patients with the disorder above chorda tympani nerve, the line-up needling on muscle region of meridian is not recommended.

Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Combined Modality Therapy ; Disease Progression ; Facial Paralysis ; pathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Treatment Outcome ; Young Adult

Objective To investigate the mental health status and sleep quality in elderly inpatients, and probe into the relationship between them. Methods A total of 300 elderly inpatients were selected from the Fourth Affiliated Hospital of Harbin Medical University from October 2005 to October 2007. Pittsburgh sleep quality index (PSQI) was used to assess the sleep quality, and Pittsburgh sleep quality index more than 8 was used as the judging standard of sleep disorder. The 300 patients were divided into the group of PSQI less than 5 (n = 70), the group of PSQI from 5 to 8 (n = 80), and the group of PSQI more than 8 (n = 146) according to their PSQI index. The symptom checklist 90 (SCL-90) was used to assess the influence of mental status. The objective and significance were explained to the patients before the test. The patients were asked to finish the questionnaires within 1 to 2 hours independently. The analysis of variance (ANOVA) was made to compare the means of scores for SCL-90, and correlation analysis based on Spearman was used to make the correlation test between the mental health status and sleep quality. Results According to the intention, all the 300 patients were analyzed in the result.① The scores of somatization, compulsion, depression, anxiety and psychoticism and the total score in the group of PSQI more than 8 were significantly higher than those in the groups of PSQI from 5 to 8 and less than 4. The higher the score of PSQI was, the higher the score of factors and the total score of SCL-90 were. ② The scores of somatization, compulsion, depression, anxiety and psychoticism and the total score were in a highly positive correlation with the sleep quality, wherein the scores of others, somatization and compulsion were in a significantly positive correlation with the scores of sleep, time for falling asleep, time of sleep and efficiency of sleep. The scores of depression and anxiety and the total score of SCL-90 were in a highly positive correlation with the score of efficiency of sleep. Conclusions The poorer the sleep quality in eider inpatients is, the higher the scores of depression and anxiety are, so they axe in a remarkable positive correlation. The poor sleep quality causes the emotional disorder such as depression and anxiety. Our results indicate that sleeplessness is not only a kind of physical order, but also a kind of mental order.