Objective To observe the efficacy of ginger-partitioned moxibustion plus Chinese medication enema in treating diarrhea caused by antibiotics. Method Forty patients with antibiotics-induced diarrhea were randomized into an observation group and a control group. Twenty cases in the control group were treated by Metronidazole and Live Combined Bifidobacterium and Lactobacillus tablets; twenty cases in the observation group were given ginger-partitioned moxibustion plus Chinese medication enema. The total effective rate and the change of abdominal pain index were observed after successive 7-day treatment. Result The total effective rate in the observation group (90.0%) was significantly higher than that in the control group (70.0%) (P<0.05); the diarrhea score was significantly lower in the observation group than in the control group (P<0.05). Conclusion Ginger-partitioned moxibustion plus Chinese medication enema can promote the recovery of antibiotics-induced diarrhea, mitigate abdominal symptoms and signs, and enhance the quality of life of patients.

OBJECTIVETo explore the relationship between the needling sensation of catgut embedding therapy and the depth of embedded catgut so as to improve the safety of the needle insertion and catgut implantation of the therapy.

METHODSTwenty healthy adults were selected. Under the ultrasound, the structure of the cervical Jiaji (EX-B 2) was observed. In the ultrasound guidance, the catgut was embedded. The two-dimensional imaging method was adopted to observe the anatomic structure and the procedure of needle insertion at the cervical Jiaji (EX-B 2). The high-frequency ultrasound was used to collect the images at Jiaji (EX-B 2) of C5 and determine the depths from the skin surface to the different layers of the point. Additionally, the visual analogue scale (VAS) was adopted to score the needling sensations when the needle inserted at different layers. The persistent sensation duration in the local area was followed continuously.

RESULTSUnder the ultrasound, the anatomic structure and tissue layers of cervical Jiaji (EX-B 2) were displayed clearly. The difference was significant in the average depth from the skin surface to the subcutaneous tissue, trapezius, splenius capitis, semispinalis capitis, semipinalis cervicis, multifidus and vertebral arch between the males and females (all P<0. 01). During the needle insertion, the sensations were apparently different when the implantation went to different layers. The qi arrival presented when the catgut was embedded to the trapezius, splenius capitis, semispinalis capitis, semipinalis cervicis and multifidus. But the distending pain was the most significant when in the myofascial. Commonly, the embedded catgut 2. 5 cm in length may be implanted deeply to the multifidus and the local needling sensation lasted averagely for (72. 0 ± 10. 2) h. Conclusion Under the ultrasound guidance, the depth of embedded catgut is clearly displayed at cervical Jiaji (EX-B 2). The needle insertion and the implanted material are visible, and the relationship between qi arrival and the layer of needle insertion is determined. The accuracy and safety of minimally invasive catgut embedding therapy is improved in the treatment of cervical spondylosis.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Catgut ; utilization ; Female ; Humans ; Male ; Middle Aged ; Neck Muscles ; anatomy & histology ; diagnostic imaging ; Qi ; Sensation ; Spondylosis ; diagnostic imaging ; therapy ; Ultrasonography

Objective To explore thc clinical manifestation of secondary generalized myasthenia gravis(GMG) and analyze the factors affecting the progression from ocular myasthenia gravis(OMG) to GMG.Methods This research constitutes a single-center,retrospectively-collected prospective cohort study.We comprehensively reviewed our self-managed myasthenia gravis (MG) database drawn from personal clinical experience from January 2000 to Junc 2013.Patients underwent series of examination including repetitive nerve stimulation (RNS) tests,measurement of serum acetylcholine receptors antibody and serum muscle-specific tyrosine kinase antibodies,thymus computer tomography scan etc.Patients were treated with pyridostigmine bromide,corticosteroid therapy and (or) thymectomy based on a nonrandomization pattern and they were documented for their respective symptoms of OMG and GMG and date of GMG conversion.Logistic regression analysis was adopted to determine the influencing factors correlated with the development of GMG during the follow-up.Results Totally 770 patients initially diagnosed with OMG were included,among whom 573 (74％) patients remained with OMG (R-OMG group) and 197(26％) patients developed into GMG (GMG group) during the follow-up.(1) In comparison with their R-OMG counterparts,patients with secondary GMG were older at onset; Displayed more frequent RNS abnormality of facial nerve,accessory nerve and ulnar nerve ; Showed higher incidence of thymoma and were less treated by early corticosteroids.(2) For GMG group,81％ (160/197) of them displayed bulbar MG; 67％ (132/197) of GMG conversion occurred within 2 years,and 84％ (166/197) within 5 years.In comparison with the patients with onset of≤ 14-year-old,both of patients with15-49-year-old and≥ 50-year-old displayed higher conversion rate and shorter conversion duration (median:10 years versus 1 year and 6.5 months).(3) RNS abnormality of accessory nerve(OR =6.650,95％ CI 3.547-12.471 ; P ＜ 0.05) and thymoma(OR =7.924,95％ CI 2.554-24.585 ; P ＜ 0.05) were prognostic factors for the development of GMG,while early corticosteroid(OR =0.232,95％ CI 0.119-0.452 ; P ＜ 0.05) predicted the reduction of the risk of generalization.Conclusions Multiple factors including abnormal RNS of proximal limb muscles,thymoma,early corticosteroids therapy and possibly even onset age of over 15-year-old may involve the generalization in patients with OMG at onset.

OBJECTIVETo explore the relationship between the therapeutic effect of minimally invasive embedding therapy and the implanted depth for cervical spondylosis.

METHODSNinety patients of cervical spondylosis of nerve root type were randomized into a shallow-layer embedding group (subcutaneous layer), a middle-layer embedding group (semispinalis capitis muscle layer) and a deep-layer embedding group (multifidus muscle layer), 30 cases in each one. Jiaji (EX-B 2) of C5 and C6 on the affected side and Dazhui (GV 14) were selected. Under the guide of ultrasound, the catgut was implanted to the corresponding tissue layers. The treatment was given once a week, continuously for 3 weeks in the three groups. The symptoms and physical signs were observed before and after treatment. The pain rating index (PRI), visual analogue scale (VAS) and present pain index (PPI) were assessed. The neck disability index (NDI) was compared.

RESULTSThe score of symptoms and function after treatment was increased apparently in the deep-layer embedding group (P < 0.05), which was increased more apparently as compared with those in the shallow-layer embedding group and the middle-layer embedding group (both P < 0.05). PRI, VAS and PPI after treatment were all reduced apparently as compared with those before treatment in the deep-layer embedding group and the middle-layer embedding group (all P < 0.05), which were reduced more remarkably than the shallow-layer embedding group (all P < 0.05). After treatment, the scores of NDI in the deep-layer embedding group and the middle-layer embedding group, were reduced apparently as compared with those before treatment (both P < 0.05), and that in the deep-layer embedding group was reduced more remarkably as compared with the shallow-layer embedding group and the middle-layer embedding group after treatment (both P < 0.05).

CONCLUSIONIn the acupoint embedding treatment of cervical spondylosis of nerve root type, the efficacy is different apparently in terms of the implantation depth. The deep-layer implantation, meaning to the multifidus muscle layer is more conductive to the treatment of cervical spondylosis.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Catgut ; Female ; Humans ; Male ; Middle Aged ; Pain Measurement ; Spondylosis ; diagnostic imaging ; therapy ; Treatment Outcome ; Ultrasonography

Objective To study the angle and articular facet curvature of lumbar zygapophyseal joints in adults.Methods The lumbar zygapophyseal joints in 120 healthy subjects without lumbar diseases were detected using spiral CT and mutiple planner re-construction.The angle and articular facet curvature of zygapophyseal joints were measured.The differences in the measured param-eters between male and female or different age groups were compared.Results ①There were no significant differences in the angle of the same lumbar zygapophyseal joints between males and females or different age groups (P >0.05);however,the significant differences in the angle between different lumbar segments were found (P <0.05).②There were no significant differences in articu-lar facet curvature of the same lumbar zygapophyseal joints between males and females or different age groups (P >0.05);however, there were significant differences in the curvature between different lumbar segments (P <0.05).The maximum articular facet cur-vature of L3-L4 was 22.1°±6.0°.Conclusion The angle and articular facet curvature of lumbar zygapophyseal joints varies from different lumbar segments with different contributions for the lumbar stability.

Objective To observe the analgesic and anti-inflammatory effects of the water extract of Glycosmis citrifolia (Willd.) Lindl.on mice and explore the mechanism. Methods The analgesic and anti-inflammatory effects were evaluated by 0.7% acetic acid-induced writhing test,the hot plate test,tests of dimethylbenzene-induced ear swelling,1% carrageenan-induced paw edema,determination of PGE2 in inflammatory feet,0.6% acetic acid-induced increase in peritoneal capillary permeability and cotton ball granuloma. Results The water extract of Glycosmis citrifolia (Willd.) Lindl.at low,medium and high doses can reduce the acetic acid-induced writhing times (P<0.01 or P<0.05),increase the pain threshold of mice (P<0.01 or P<0.05), inhibit dimethylbenzene-induced ear swelling (P<0.01 or P<0.05),1% carrageenan-induced paw edema (P<0.01 or P<0.05) and PGE2 production (P<0.01),0.6% acetic acid-induced increase of peritoneal capillary permeability (P<0.05),and the de-velopment of cotton ball granuloma (P<0.01 or P<0.05). Conclusion The water extract of Glycosmis citrifolia (Willd.) Lindl.shows analgesic and anti-inflammatory effects on mice.

Objective To analyze the short-term results of endovascular aortic repair (EVAR)for patients with acute type B aortic dissection and chronic renal insufficiency (CRI ).Methods Between February 2009 and December 2012,EVAR was performed in 30 patients with acute type B aortic dissection and CRI (CRI group).Consecutive 30 patients with acute type B aortic dissection whose renal function was normal during the same period was chosen as the control group (non-CRI group).All patients were within 14 days after onset,in which Marfan syndrome was excluded and diagnosis made by computed tomographic angiography (CTA) before the procedure.In 57 patients,EVAR was performed under looal anesthesia and associated procedures included insertion of a chimney stent in the left subclavian artery in 2 case and a bare metal stent in the renl artery in 2,In 3 patients,EVAR was done following right axillary artery-to-left axillary and left subclavian artery bypass with a Y-shaped graft under general anesthesia.Follow-up regimen included renal function and CTA at I month and 1 year postoperatively.Results Compared to the non-CRI group,patients in the CRI grup was significantly younger [ (44.7±13.2) years versus (53.7±16.2)years,P ＜0.05)and had a higher rate of perioperative complications (cerebrospinal ischemia,deterioration of renal dysfunction,and gastroenteral dysfunction) (16.7％ versus 3.3％,P ＜0.05 ),all of which resolved after surgical or medical treatment.One patient in CRI group was readmitted at 6 months for a redo EVAR to treat a new tear distal to the stent.At 1 month and I year postoperatively,no patients suffered from deterioration ofthe renal function,and their CTAs detected no apparent device deformation,alteration and endoleak,with remsrkable improvement in the blood supply of the aortic trie lumen and branches.Conchusion Satisfactory short-term results can be achieved with EVAR for patients with acute type B aortic dissection and CRI.At I month and 1 year postoperatively,no mortality or morbidity occumed such as endoleak,aortic rupture,neurologic and abdominal ischermia.

ObjectiveTo assess the differences of short- and long-term postintervention status on ocular and systemic symptoms for patients with ocular myasthenia gravis (OMG) after pyridostigmine bromide, corticosteroid, thymectomy, or thymectomy-corticosteroid combination therapy ( combination ).MethodsThis retrospective plus prospective study included 180 OMG patients, whose age of onset ≥ 15 years, treated non-randomly with above therapies separately: thymectomy group (60 cases ), corticosteroid group (39 cases), combination group ( 31 cases ), symptomatic group ( 50 cases ). Postintervention status complying with Myasthenia Gravis Foundation of America (MGFA)complete stable remission ,pharmacologic remission, or minimal manifestations was considered as desirable response, which was used as statistical indicator. Results ①Corticosteroid group showed higher desirable response rates on ptosis, ophthalmoplegia and general weakness at 3-6 months after treatment than other groups, and 42. 1％( 16/38 ) of them at 3 months achieved the desired state of ptosis, higher than the symptomatic group (7/48,14. 6％, ×2 = 8. 200, P = 0. 004 ). ② Ascending ideal rates had been presented in both combination and thymectomy groups since 1 year after treatments, while a little bit higher rate was presented in the former. At the end of observation, 21.7％ ( 13/60 )of patients in thymectomy group achieved complete stable remission.By paired longitudinal comparisons,thymectomy group showed higher ideal rates on ptosis (22/40,55.0％ ), ophthalmoplegia ( 16/27,59. 3％ ) and general weakness (20/40,50. 0％ ) at 2 years than that at 3 months( 11/59,18.6％ ;11/44,25.0％ ;9/60,15.0％ ;P =0. 002, 0. 031,0.000). ③For those patients by symptomatic treatment, the average age of onset was (51.9 ± 18.0) years, higher than that by other 3 therapies (F = 10. 563 ,P =0. 000). ④OMG patients with ophthalmoplegia more likely select corticosteroid or combined therapy. Ophthalmoplegia in combination group was higher than that in symptomatic and surgery groups( ×2 = 12. 939,14. 380, P =0. 000 in both). Ophthalmoplegia in corticosteroid group was higher than that in surgery group ( ×2 = 8. 017, P = 0. 005 ).Conclusions Corticosteroid appears to early overcome ptosis, ocular motor dysfunction and general weakness for patient with OMG in early-to-middle adulthood.Thymectomy andsurgery-corticosteroid combinationtherapies bothshowlong-term effectonthem.

Objective To evaluate different detection methods in the diagnosis of severe fever with thrombocytopenia syndrome (SFTS), and find the most quick and accurate one for the identification of new bunyavirus infection. Methods Real-time PCR and ELISA-IgM were used to detect serum samples of 158 patients with acute phase of SFTS, which were collected from the special monitoring system of SFTS in Henan Province in 2014. IgM and IgG antibodies were detected by ELISA in 109 acute and convalescent paired serum specimens. The differences of the positive rates were compared between the three methods, and the influence of the collected interval time on the detection results was analyzed. Results For 158 acute phase serum samples of SFTS patients, the positive rate detected by real-time PCR (76.58%) was higher than that of ELISA-IgM (47.47%), and the difference was statistically significant (χ2=34.13, P < 0.05). For 109 cases with acute and convalescent paired serum samples, there was no significant difference in the positive rates between ELISA-IgG ( 75.23%) and real-time PCR (72.48%) detections (χ2=0.18, P>0.05). In both the acute phase and convalescent phase, the positive rate of IgM was higher than that of IgG, and the difference was statistically significant (χ2=41.68 and 6.25, P<0.05). With the extension of collected interral time, the positive rates of IgM and IgG antibodies were both increased ( Z=6.42 and 10.08, P < 0.05). Conclusion Real-time PCR is the most sensitive method for the early diagnosis of the SFTS. ELISA-IgG is suitable for the detection of SFTS at recovery period. ELISA-IgM can be used as an assistant method to guide clinical diagnosis.

Objective:To analyze the characteristics of nerve injury in patients with diabetic peripheral neuropathy (DPN) and explore the diagnostic value of current perception threshold (CPT) and nerve conduction velocity (NCV) for DPN.Methods:One hundred and thirty-six DPN patients admitted to Beijing Puren Hospital from June 2017 to December 2019 were selected, and 130 diabetic non-DPN patients admitted during the same period were used as controls. All the subjects were tested by CPT and NCV. Among them, the detection of NCV included sensory nerve conduction velocity (SCV) and motor nerve conduction velocity (MCV). Statistical analysis was performed on the relevant indicators of the two groups of subjects.Results:The CPT values of the upper limb median nerve and ulnar nerve at 2 000 Hz, 250 Hz, and 5 Hz, the superficial peroneal nerves at 250 Hz, and 5 Hz, and the CPT values of the sural nerve at 2 000 Hz and 250 Hz were higher than those of non-DPN patients, DPN injury mainly occurred in myelinated nerve fibers in the lower extremities [60.29%(82/136)], and the difference were statistically significant ( P<0.05). The SCV and MCV of the median nerve, ulnar nerve, and common peroneal nerve in the DPN group were lower than those in the non-DPN group, the SCV abnormal rate was higher than the MCV: 55.88%(76/136) vs. 37.50%(51/136); 58.82%(80/136) vs. 41.18% (56/136); 67.65%(92/136) vs. 50.00%(68/136), and the differences were statistically significant ( P<0.05). The area under the predictive value curve (AUC) of CPT for DPN was 0.815 (95% CI 0.735 ~ 0.895). The AUC of NCV for DPN was 0.875 (95% CI 0.813 ~ 0.944). The AUC of CPT and NCV for DPN was 0.923 (95% CI 0.876 ~ 0.970). Conclusions:DPT patients have abnormal CPT and NCV, and nerve damage occurs mostly in myelinated nerve fibers and SCV. Diagnosing DPN by combining CPT and NCV is helpful to improve the detection rate of DPN.