Objective:To observe the clinical efficacy of back-Shu and front-Mu points combination needling on balance and walking function in patients after stroke and its mechanism. Methods:A total of 79 patients with post-stroke balance and walking dysfunction were randomly divided into a control group and an observation group.Both groups received conventional treatments such as dietary guidance and oral medications as well as rehabilitation training.On this basis,the control group was treated with additional conventional acupuncture,and the observation group was treated with additional back-Shu and front-Mu points combination needling.Both groups were treated for 4 consecutive weeks.The thickness of abdominal muscle group(transverse abdominal muscle,rectus abdominis,obliquus internus abdominis,and obliquus externus abdominis),the scores of Berg balance scale(BBS),Fugl-Meyer assessment(FMA),and functional ambulation categories(FAC),and walking velocity and stride were compared between the two groups. Results:During the trial,there was 1 dropout case in the control group and 4 dropout cases in the observation group.Before treatment,there were no statistical differences in the abdominal muscle group thickness,scores of BBS,FMA,and FAC,and walking velocity and stride between the two groups(P>0.05).After 4 weeks of treatment,the thickness of abdominal muscle groups,scores of BBS,FMA,and FAC,and walking velocity and stride in both groups were improved(P<0.01),and the observation group was superior to the control group(P<0.05). Conclusion:Both conventional acupuncture and back-Shu and front-Mu points combination needling are conducive to the improvement of balance and walking function in patients after stroke.The back-Shu and front-Mu points combination needling method has better curative efficacy.Strengthening the core muscle group strength may be one of the mechanisms of back-Shu and front-Mu points combination needling treatment.

Objective To evaluate the cost-utility of tiotropium/olodaterol in treating Chinese patients with moderate to very severe chronic obstructive pulmonary disease(COPD)and to provide references for selecting more economical inhaled preparations in clinical practice.Methods A four-state lifetime Markov model was established with a 3-month cycle.The health outcomes included life years and quality-adjusted life years.Costs,including direct medical costs,were calculated from the perspective of the Chinese health system.Discontinuation rates were derived from the discontinuation curve using GetData Graph Digitizer.The main output indicator of the model was the incremental cost-utility ratio,which was calculated from the queue simulation results to judge the economy of tiotropium bromide/odataterol.The scenario analysis and sensitivity analyses were carried out to detect the robustness of the base case result.Results Compared with tiotropium bromide,the patient treated with tiotropium bromide/odataterol gained an additional 0.0846 life years,an additional cost of ￥3 201.50,and additional 0.029 6 QALY.The incremental cost-utility ratio was 108 140.11 yuan/QALY,lower than the willingness-to-pay threshold of three times China's per capita GDP in 2021.The costs of tiotropium bromide and tiotropium bromide/odataterol had the greatest impact on the result in the one-way sensitivity analysis.93.8%of the Chinese COPD population was willing to pay for tiotropium bromide/odataterol under the threshold in the probability sensitivity analysis.Conclusion Tiotropium/olodaterol is a cost-effective alternative compared to tiotropium for patients with moderate to very severe COPD in China and the results were robust in the sensitivity analyses.