OBJECTIVETo explore the impacts on the life quality and the effect mechanism in the patients of allergic rhinitis (AR) treated with warm acupuncture in winter and summer.

METHODSTwo hundred and forty patients of AR were randomized into a summer and winter acupuncture group, a non-summer and winter acupuncture group and a western medication group, 80 cases in each one. In the two acupuncture groups, Dazhui (GV 14), Fengmen (BL 12), Feishu (BL 13), Pishu (BL 20) and Shenshu (BL 23) were selected. In the summer and winter acupuncture group, the warm acupuncture started at the first day of the three periods of hot season and the first day of the third nine-day period after the winter solstice. The treatment was given once every two days, continuously for 15 times. Totally, 30 treatments were required a year. In the non-summer and winter acupuncture group, the warm acupuncture was applied out of the three periods of the hot season and the third nine-day period after the winter solstice. The treatment was given once every two days and 30 treatments for a year. In the western medication group, cetirizine was taken orally, continuously for 30 days as one session. In the three groups, the treatment for 1 year was taken as one session. The second session started in the next year. Totally, 2 sessions were required. The score of rhinoconjunctivitis quality of life questionnaire (RQLQ) and the level of serum immunoglobulin E (IgE) were compared in the patients' of each group before treatment and in 1 and 2 sessions of treatment.

RESULTSAfter treatment, the scores of 7 domains, named activities, common complaints, practical problems, sleep, ocular symptoms, nasal symptoms and emotions were all improved as compared with those before treatment, in the patients of the three groups (all P < 0.05). After 2 sessions treatment, the results in the summer and winter acupuncture group were better than those in the other two groups (all P < 0.05), and the results in the non-summer and winter acupuncture group were better than those in the western medication group (all P < 0.05). After treatment, serum IgE level was lower averagely than that before treatment in the three groups (all P < 0.05). After 2 sessions treatment, the result in the summer and winter acupuncture group was lower than that in the other two groups (both P < 0.05), and the result in the non-summer and winter acupuncture group was lower than that in the western medication group (P < 0.05). After treatment, the total effective rate was 92.3% (72/78) in the summer and winter acupuncture group, better than 80.5% (62/77) in the non-summer and winter acupuncture group and 69.7% (53/76) in the western medication group (both P < 0.05).

CONCLUSIONThe warm acupuncture in both summer and winter achieves the definite efficacy on AR and the effect mechanism is relevant with reducing serum IgE level.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; methods ; Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Quality of Life ; Rhinitis, Allergic ; therapy ; Seasons ; Treatment Outcome ; Young Adult

Objective To investigate the effects of sequential pulmonary resuscitation maneuver (RM) with pulmonary protective ventilation on hemodynamics and arterial blood gas in patients with acute respiratory distress syndrome (ARDS) caused by severe chest trauma. Methods Ninety-six ARDS patients caused by severe chest trauma admitted to Dongguan People's Hospital from January 2017 to December 2018 were enrolled, and they were divided into a RM group and a mechanical ventilation group according to different ventilation modes, 48 cases being in each group. The mechanical ventilation group was given low tidal volume ventilation combined with the best positive end-expiratory pressure (PEEP); while the RM group was given sequential lung RM therapy on the basis of treatment in the mechanical ventilation group. The heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP), cardiac output (CO), cardiac output index (CI), systemic circulation resistance index (SVRI) arterial blood gas were monitored before and after treatment in the two groups, and oxygenation index(PaO2/FiO2) was calculated; The mechanical ventilation time, intensive care unit (ICU) hospitalization time, incidence of ventilator associated pneumonia (VAP), mortality and incidence of adverse reaction were observed between the two groups. Results After treatment, the pH value and arterial partial pressure of carbon dioxide (PaCO2) of the two groups had no significant change; with the prolongation of treatment, the arterial partial pressure of oxygen (PaO2) and arterial blood oxygen saturation (SaO2);PaO2/FiO2 were increased significantly, total carbon dioxide (TCO2) was decreased significantly, after 72 hours of treatment, the degree of change in the RM group were more remarkable greater than those in the mechanical ventilation group [PaO2 (mmHg, 1 mmHg = 0.133 kPa): 91.02±9.03 vs. 80.34±7.66, SaO2: 0.96±0.04 vs. 0.94±0.04, TCO2 (mmol/L): 24.72±2.83 vs. 23.54±2.76, PaO2/FiO2 (mmHg): 238.47±19.83 vs. 185.34±17.37, all P < 0.05]. The ICU hospitalization time and mechanical ventilation time in the RM group were significantly lower than those in the mechanical ventilation group [ICU hospitalization time (days): 22.03±3.39 vs. 26.75±4.04,mechanical ventilation time (days): 13.38±4.04 vs. 19.33±5.02], and the incidence of VAP and mortality in the RM group were significantly lower than those in the mechanical ventilation group[incidence of VAP: 25.00% (12/48) vs. 8.33% (4/48), mortality: 18.75% (9/48) vs. 22.92% (11/48), both P < 0.05]. With the extension of time, CVP, MAP, CO, CI and SVRI in RM group all showed a trend of first decreasing and then increasing, while HR showed a trend of increasing and then decreasing, and the above indicators in 5 minutes after pulmonary re-opening, gradually returned to normal, showing no statistical significances compared with those before treatment [HR (bpm): 97.88±6.22 vs. 98.20±8.37, CVP (mmHg): 6.33±1.35 vs. 6.32±1.36, MAP (mmHg): 94.56±5.96 vs. 95.03±9.82, CO (L/min): 6.34±1.42 vs. 6.40±1.23, CI (L·min-1·s-1):2.08±0.32 vs. 2.17±0.53, SVRI: 2 404.34±31.34 vs. 2 474.34±29.73, all P > 0.05]. No adverse reactions occurred in the two groups. Conclusion Pulmonary protective ventilation sequential lung recruitment maneuver can significantly improve the oxygenation of ARDS caused by severe chest trauma, shorten the durations of mechanical ventilation and hospitalization in ICU, reduce the incidence of VAP, improve pulmonary inflammation, and in the mean time it has no serious adverse effects on hemodynamics.

Objective:To explore the potential genetic causes of unexplained neonatal encephalopathy.Methods:This retrospective study enrolled 113 infants diagnosed with unexplained neonatal encephalopathy and underwent genetic testing in the Children's Hospital of Hunan Province from January 2019 to May 2021. Perinatal data, clinical manifestations, electroencephalograph, brain MRI findings, genetic information, and prognosis of those patients were analyzed. T-test or Chi-square test were used for data analysis. Results:Of the 113 infants enrolled, 74 (65.5%) were males. The gestational age at birth was (38.6±1.5) weeks, and the birth weight was (2 957±561) g. The most common clinical manifestation was the disturbance of consciousness (83/113, 73.5%), followed by seizures (39/113, 34.5%). There were 38.2% (34/89) of the patients with abnormal brain MRI, and 80.4% (74/92) presented abnormal electroencephalography. Among the 113 infants, 60 (53.1%) had genetic abnormalities, including 48 with single nucleotide variations, eight with copy number variations, and four with chromosome abnormalities. Single nucleotide variations in the 48 patients were classified into syndromic ( n=18, 37.5%), metabolic ( n=16, 33.3%), epileptic ( n=11, 22.9%) and mitochondrial-related genes ( n=3, 6.3%), of which 14 were not included in any database. Among the 103 cases which were successfully followed up until December 31, 2021, 75 (72.8%) had a poor prognosis, including 52 (50.5%) death cases and 23 (22.3%) cases of development retardation. Birth weight and the incidence of seizures in the poor prognosis group were both lower than those in the non-poor prognosis group [(2 876±536) vs (3 254±554) g, t=3.15; 29.3% (22/75) vs 53.6% (15/28), χ2=5.20; both P<0.05], while the incidence of disturbance of consciousness was higher [80.0% (60/75) vs 53.6% (15/28), χ2=7.19, P<0.05]. The proportion of infants with genetic abnormalities in the poor prognosis group was higher than that in the non-poor prognosis group, but the difference was not statistically significant [53.3% (40/75) vs 46.4% (13/28), χ2=0.39, P=0.533]. Conclusions:Genetic abnormality is one of the leading causes of unexplained neonatal encephalopathy. Nucleotide variation is the most common genetic type. Syndromic, metabolic, and epileptic variants are frequently detected in these patients.