Objective To investigate the clinical efficacy of auricular point therapy for chronic fatigue syndrome.Methods Eighty patients with chronic fatigue syndrome were randomly allocated to treatment and control groups, 40 cases each. The treatment group received ear acupuncture plus auricular plaster therapy and the control group, conventional acupuncture. The overall symptom was scored, the Fatigue Assessment Instrument (FAI) score was recorded and immunoglobulins (IgA, IgG and IgM) were measured in the two groups before treatment and after four courses.Results There were statistically significant pre-/post-treatment differences in the overall symptom score, the FAI score and immunoglobulins in the two groups (P<0.05). There were statistically significant post-treatment differences in the FAI score, and IgA and IgG between the treatment and control groups (P<0.05). Conclusion Auricular point therapy is an effective way to treat chronic fatigue syndrome.

Plasma exchange (PE) is a therapeutic blood component replacement method. The blood of patients is first separated into plasma and blood cell components using a blood cell separator in vitro, the plasma containing harmful pathogenic substances is then discarded and replaced with the same volume of exchange solution. Finally the separated blood cells together with the exchange solution are returned back to the blood circulation of patients. By reducing the circulating antibodies, abnormal plasma proteins or cytokines and other pathogenic molecules, PE can block the disease process. PE has a good therapeutic effect on neuromyelitis optica-related optic neuritis (NMO-ON), which shows resistant to glucocorticoid therapy for the first onset. The American Society for Apheresis guideline evaluates PE for acute optic neuritis as a recommended grade 1B, type II indication. In the implementation of PE treatment for NMO-ON and other diseases, indications and contraindications should be strictly adhered to the guideline, treatment procedures and protocols should be optimized, common adverse events and its prevention and management should be known and alerted. It is important to conduct multi-center clinical cooperation and a high standard clinical randomized controlled study, to find out the optimal time window, the best protocol, and the associated factors for the efficacy and prognosis of PE in NMO-ON.

OBJECTIVETo investigate whether A118G single nucleotide polymorphisms of the µ-opioid receptor (OPRM1) affects epidural patient-controlled analgesia with fentanyl after caesarean section.

METHODSA total of 100 pregnant women (ASA class I or II) scheduled for elective caesarean section were enrolled in this study. All the patients received spinal-epidural anesthesia and were screened for blood A118G polymorphism. Epidural patient-controlled analgesia with fentanyl was provided postoperatively. The pain scores, incidence of nausea and vomiting, and total self-administered epidural fentanyl dose within 48 h postoperatively were recorded.

RESULTSNinety-six patients were finally included in this study. The percentages of the genotypes AA, AG, and GG were 36.5% (35 cases), 46.9% (45 cases), and 16.7% (16 cases), respectively. At 12 and 24 h postoperatively, the pain scores and the total fentanyl dose administered were significantly higher in group GG than in groups AA and AG.

CONCLUSIONA118G single nucleotide polymorphism affects pain relief and total fentanyl dose administered in epidural patient-controlled analgesia after caesarean section. G118 homozygotes have a poorer response to fentanyl than A118 homozygotes or heterozygotes.

Adult ; Analgesia, Epidural ; Cesarean Section ; Female ; Fentanyl ; administration & dosage ; Genotype ; Humans ; Pain Measurement ; Pain, Postoperative ; Polymorphism, Single Nucleotide ; Pregnancy ; Receptors, Opioid, mu ; genetics ; Young Adult

Objective To evaluate the visual improvement of therapeutic plasma exchange (TPE) for refractory optic neuritis (ON) patients in acute phase.Methods Seventy-five affected eyes from 44 refractory ON patients with severe visual defect or resistance to high-dose intravenous methylprednisolone (IVMP) therapy,who were admitted to The Chinese PLA General Hospital between January 2015 and August 2016,were recruited and received TPE therapy.Among these patients,11 were male and 33 were female;the average age was 39.1 ± 13.9;31 patients had two affected eyes,13 patients had one affected eye.The course of the disease on the group of patients were more than 2 weeks,and the visual acuity worsened for more than 10 days and continued to deteriorate.TPE treatment was performed on all of the patients.BCVA was recorded before and 24 h after treatment,and the visual function was scored using visual outcome scale (VOS).At the same time,the adverse reactions of TPE treatment were observed.The paired t-test was used to compare the VOS before and after treatment.The correlation between VOS before and after treatment was analyzed by Linear-by-Linear correlation analysis.Results Among 75 affected eyes,the post-therapy VOS 3.89 ±2.13 was significantly improved from pre-therapy VOS 5.56± 1.69 (t=6.77,P＜0.001).Forty-eight of 75 eyes were improved at lease 1 score of VOS,the overall rate of visual improvement was 64.0％.Especially among the eyes with initial vision of light perception,an improved rate of 82.4％ was presented.75.0％ in those eyes with initial vision of count fingers and 67.7％ in no light perception.Linear-by-Linear correlation analysis showed a significant linear correlation between the scores of VOS before and after TPE treatment (r=0.398,P=0.01).During the course of TPE treatment,5 patients had mild adverse reactions such as low calcium reaction and allergic reaction and were well controlled after treatment.Conclusion Using TPE to treat refractory ON in acute phased can improve the visual function of patients.