OBJECTIVETo assess the impacts on postoperative nausea and vomiting of the patients with laparoscopic surgery undergoing the general anesthesia by electroacupuncture (EA) at different frequencies at bilateral Neiguan (PC 6).

METHODSOne hundred and twenty female patients with laparoscopic surgery undergoing the general anesthesia were randomized into 4 groups: 2 Hz EA treatment group (group A), 2 Hz/100 Hz EA treatment group (group B), 100 Hz EA treatment group (group C) and a control group (group D), 30 cases in each one. The same anesthetic program was adopted in each group. For the patients in A, B and C groups, in the first half a hour undergoing the conventional drug anesthesia, acupuncture was applied to bilateral Neiguan (PC 6). After arrival of qi, HANS-200A electroacupuncture apparatus was connected, at the frequency as 2 Hz, 2 Hz/100 Hz and 100 Hz separately. The electric stimulation was discontinued at the end of surgery. The life physical signs after surgery, the occurrence of postoperative nausea and vomiting and the severity grades of postoperative nausea and vomiting were observed and recorded for the patients in each group.

RESULTSThe differences in the postoperative 1 h heart rate, mean arterial pressure (MAP), finger pulse oxygen saturation and respiratory frequency were not significant statistically in comparison of the patients among groups (all P > 0.05). The incidence of postoperative nausea and vomiting of the patients in group B was lower apparently than that in A, C and D groups [10.0% (3/30) vs 30.0% (9/30), 36.7% (11/30), 53.3% (16/30), all P < 0.01]. The severity of postoperative nausea and vomiting of the patients in group B was lower apparently than that in the rest three groups (all P < 0.01).

CONCLUSIONThe electroacupuncture at 2 Hz/100 Hz reduces effectively the incidence and the severity of postopera tive nausea and vomiting of the patients with laparoscopic surgery undergoing the general anesthesia.

Acupuncture Points ; Adolescent ; Adult ; Aged ; Electroacupuncture ; Female ; Humans ; Laparoscopy ; adverse effects ; Male ; Middle Aged ; Postoperative Complications ; etiology ; therapy ; Postoperative Nausea and Vomiting ; therapy ; Vomiting ; etiology ; therapy ; Young Adult

OBJECTIVETo understand the clinical features of gastrointestinal cow's milk allergy in children, and to assess the importance of cow's milk challenge.

METHODAn analysis was performed on the clinical manifestations and the challenge results of 50 children who received cow's milk challenges after admission to the department of gastroenterology, Children' s Hospital of Zhejiang University School of Medicine from January,2009 to December, 2012. The value of immunoglobulin E antibody was also analyzed among the 50 children, 25 cases were male and the other 25 were female. The youngest subject was 1. 6 months old, and the oldest was 20 months, most of the cases were younger than 6 months (36 cases).

RESULT(1) Diarrhea (27 cases, 54%) and hematochezia (25 cases, 50%) were the most common clinical features, vomiting, hematemesis and abdominal distention were rare. (2) Cow's milk challenges failed in 58% of the cases, 90% of whom showed delayed allergy. Diarrhea (19 cases, 73%) was the major later presentation, whereas the immediate hypersensitivity showed angio-edema, gastrointestinal symptom and rash. (3) The neutrophil count ((3.8 ± 2.8) x 10(9)/L vs. (2.5 ± 1.3) x 10(9)/L) was higher after challenge among children who failed the challenge. The change in the count of blood cell, neutrophil and platelet was studied, however, there were no statistical differences between the challenge-failed children and the passed ones. (4) Forty-seven cases had milk specific immunoglobulin E antibody test, and 5 showed positive results, 4 of whom were seen among the challenge-failed children.

CONCLUSIONDiarrhea and hematochezia was the most common clinical manifestation, and cow's milk protein induced proctocolitis was the most common disease in practice. It is important and necessary to perform cow's milk challenge.

Animals ; Female ; Gastrointestinal Diseases ; etiology ; Gastrointestinal Hemorrhage ; etiology ; Hematemesis ; etiology ; Humans ; Hypersensitivity, Immediate ; immunology ; Infant ; Infant, Newborn ; Male ; Milk ; Milk Hypersensitivity ; immunology ; Vomiting ; etiology

Abdomen, Acute ; etiology ; Child ; Family Health ; Female ; Gastrointestinal Diseases ; etiology ; Genes, Dominant ; genetics ; Humans ; Male ; Nausea ; etiology ; Pedigree ; Telangiectasia, Hereditary Hemorrhagic ; complications ; genetics ; pathology ; Time Factors ; Vomiting ; etiology

OBJECTIVETo analyze the clinical characteristics of children with cyclic vomiting syndrome (CVS), summarize the experience for twelve years, and improve awareness, diagnosis and treatment level of CVS.

METHODSThe clinical data and results of long-term follow-up of the children with CVS seen from 1994 to 2007 in our department were analyzed.

RESULTSForty-one children were enrolled in the study, 21 were male, and 20 female, mean age was 8 years, mean age of onset was 4 years, mean interval from onset to proper diagnosis was 4 years; 13/41 and 20/41 patients had family history of migraine and motion sickness, 20/41 patients had triggers, such as upper respiratory tract infection, diet, and mental/emotional factor. Vomiting lasted for days, during the periods between the episodes of vomiting the children were completely healthy. The intervals of most patients were 2 to 8 weeks, and in 12/41 patients the episodes started at early morning. The peak number of emesis per hour exceeded six in 23/41 children. The episodes were characterized by a pattern of sudden onset and sudden ending. All patients showed depressed, social withdrawal, intractable nausea and anorexia. Associated symptoms and signs include pallor, excess salivation, hypertension, headache, photophobia, and abdominal pain. Electroencephalogram of 13/33 patients were slightly abnormal. Electrogastrogram showed dysrhythmia and gastrointestinal motility were abnormal during the period of onset and normal during complete remission. Eleven of the 41 of patients were treated as epilepsy, and 9 patients were diagnosed as esophageal hiatal hernia and 4 superior mesenteric artery compression syndrome and had surgery before the diagnosis was made. Eight patients diagnosed from 1994 to 2000 were followed up for ten years in average, 3 patients were treated with doxepin and alprazolanic, and were cured after 2.2 (1.0 - 4.0) years; and five patients who did not use any medicine recovered 7.7 (4 - 10) years later. Fourteen children diagnosed from 2001 to 2007 were followed up for longer than one year, 9 patients were treated with valproate, doxepin, cyproheptadine, and recovered 2.3 (1 - 4) years later; 5 patients without treatment recovered 1.9 (1 - 3) years later.

CONCLUSIONSThe diagnosis must be based on the special manifestation of CVS, including intervals during which the patients are completely healthy, and the systemic diseases which can cause CV should be excluded. Most patients get better as they grow up. Therapeutic strategies may include combined use of neuroleptics, thymoleptics and anti-migraine when the episodes occur frequently and when there is growth retardation. Supportive care includes intravenous fluids and symptomatic treatment during an episode.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Periodicity ; Recurrence ; Syndrome ; Vomiting ; diagnosis ; etiology ; therapy

Child, Preschool ; Female ; Humans ; Infant ; Male ; Rotavirus Infections ; diagnosis ; therapy ; Vomiting ; etiology

OBJECTIVE: To observe the effect of ginger-partitioned moxibustion on digestive tract reaction, quality of life and white blood cell count after chemotherapy in advanced malignant bone tumors patients. METHODS: A total of 64 patients were randomly divided into an observation group and a control group, 32 cases in each group. Both groups were treated with adriamycin combined with cisplatin (AP) chemotherapy. The patients in the control group were treated by tropisetron hydrochloride intravenous on preventing the vomiting 1 h before receiving chemotherapy. On the basis of the control group, the patients in the observation group were treated with ginger-partitioned moxibustion at Neiguan (PC 6), Zusanli (ST 36), Shenque (CV 8), and Zhongwan (CV 12) 2 h after chemotherapy, once a day, 30 min each time. The course of chemotherapy, ginger-partitioned moxibustion and tropisetron hydrochloride intravenous was 5 days. The digestive tract reaction rating, quality of life score and white blood cell count were compared 1 d before chemotherapy, 2 d after chemotherapy and 7 d after chemotherapy between the two groups. RESULTS: The number of 0 grade in digestive tract reaction 2 d and 7 d after chemotherapy in the observation group was significantly higher than that in the control group ( CONCLUSION Ginger-partitioned moxibustion can prevent and treat vomiting after chemotherapy in advanced malignant bone tumors, and improve the quality of life and white blood cell count of patients.
Acupuncture Points ; Bone Neoplasms/drug therapy* ; Ginger ; Humans ; Moxibustion ; Quality of Life ; Vomiting/etiology*

OBJECTIVE: To describe the sonographic (US) and clinical features of spontaneously reduced small bowel intussusception, and to discuss the management options for small bowel intussusception based on US findings with clinical correlation. MATERIALS AND METHODS: During a five years of period, 34 small bowel intussusceptions were diagnosed on US in 32 infants and children. The clinical presentations and imaging findings of the patients were reviewed. RESULTS: The clinical presentations included abdominal pain or irritability (n = 25), vomiting (n = 5), diarrhea (n = 3), bloody stool (n = 1), and abdominal distension (n = 1), in combination or alone. US showed multi-layered round masses of small (mean, 1.5+/-0.3 cm) diameters and with thin (mean, 3.5+/-1 mm) outer rims along the course of the small bowel. The mean length was 1.8+/-0.5 cm and peristalsis was seen on the video records. There were no visible lead points. The vascular flow signal appeared on color Doppler images in all 21 patients examined. Spontaneous reduction was confirmed by combinations of US (n = 28), small bowel series (n = 6), CT scan (n = 3), and surgical exploration (n = 2). All patients discharged with improved condition. CONCLUSION: Typical US findings of the transient small bowel intussusception included 1) small size without wall swelling, 2) short segment, 3) preserved wall motion, and 4) absence of the lead point. Conservative management with US monitoring rather than an immediate operation is recommended for those patient with typical transient small bowel intussusceptions. Atypical US findings or clinical deterioration of the patient with persistent intussusception warrant surgical exploration.
Abdomen/physiopathology ; Abdominal Pain/etiology ; Child ; Child, Preschool ; Diarrhea/etiology ; Female ; Humans ; Infant ; Intestine, Small/*ultrasonography ; Intussusception/*ultrasonography ; Irritable Mood ; Male ; Occult Blood ; Ultrasonography, Doppler, Color ; Vomiting/etiology

Adolescent ; Child ; Child, Preschool ; Female ; Gastroesophageal Reflux ; complications ; Humans ; Infant ; Male ; Retrospective Studies ; Superior Mesenteric Artery Syndrome ; complications ; Vomiting ; etiology

OBJECTIVETo compare the clinical effects between electroacupuncture at Zusanli (ST 36) combined with intravenous drip of Granisetron and intravenous drip of Granisetron only for treatment of nausea and vomiting caused by the chemotherapy of the malignant tumor.

METHODSThe methods of multicentral, randomized controlled trial were used, the observation group (127 cases) was treated with electroacupuncture at Zusanli (ST 36) combined with intravenous drip of Granisetron, and the control group (119 cases) was treated with intravenous drip of Granisetron only.

RESULTSThe total effective rate of 90.5% in observation group was superior to that of 84.0% in control group (P < 0.01); the nausea and vomiting scores of two groups were obviously decreased after treatment (both P < 0.001), and the decreased degree of the observation group was superior to that of control group (P < 0.001).

CONCLUSIONElectroacupuncture at Zusanli (ST 36) can significantly alleviate the symptoms such as nausea and vomiting caused by the chemotherapy of the patients.

Acupuncture Points ; Adolescent ; Adult ; Aged ; Antineoplastic Agents ; adverse effects ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Nausea ; etiology ; therapy ; Neoplasms ; complications ; drug therapy ; pathology ; Vomiting ; etiology ; therapy ; Young Adult

OBJECTIVETo observe the influence of auricular point sticking on incidence of nausea and vomiting and analgesia effect after gynecological laparoscopy, and provide evidence for clinical application of auricular point sticking.

METHODSOne hundred and twenty cases of selective gynecological laparoscopy under general anesthesia were randomly divided into an auricular point sticking group and a placebo group, 60 cases in each group. In the auricular point sticking group, the auricular point sticking with vaccaria seeds was applied at Shenmen (TF 4), Wei (CO 4) and Jiaogan (AH 6a) before the operation and 1, 5, 9, 23 h after the operation, which were pressed 5 min each point each time. The two ears were proceeded at the same time. In the placebo group, the same point selection, sticking paste was used as the auricular point sticking group, but no sticking or pressing with vaccaria seeds was adopted. The incidence of nausea and vomiting, the usage rate of tropisetron and morphine within 24 hours of the operation, as well as the score of visual analogue scale (VAS) and other adverse reactions at 2, 6, 10, 24 h after the operation were observed respectively.

RESULTSCompared with the placebo group, the incidence of nausea and vomiting [31.7% (19/60), 16.7% (10/60) vs 58.3% (35/60), 35.0% (21/60)], the usage rate of tropisetron [21.7% (13/60) vs 48.3% (29/60)] and morphine [18.3% (11/60) vs 38.3% (23/60)], the VAS scores at all different time points in the auricular point sticking group were all decreased (all P < 0.05), and no adverse reaction was observed.

CONCLUSIONThe auricular point sticking could significantly decrease the incidence of nausea and vomiting in patients of gynecological laparoscopy and has positive analgesic effect.

Acupuncture Analgesia ; Acupuncture Points ; Acupuncture, Ear ; Adult ; Female ; Genital Diseases, Female ; surgery ; Gynecology ; Humans ; Laparoscopy ; adverse effects ; Middle Aged ; Nausea ; etiology ; therapy ; Vomiting ; etiology ; therapy ; Young Adult