OBJECTIVE: To observe the efficacy and safety of Tiaowei Jiannao acupuncture (acupuncture for regulating defensive qi and nourishing brain) for post-ischemic stroke insomnia (PISI). METHODS: A total of 96 patients with PISI were randomized into an acupuncture group (32 cases, 1 case was excluded), a medication group (32 cases, 1 case dropped out, 1 case was excluded) and a sham-acupuncture group (32 cases, 1 case dropped out, 1 case was excluded). In the acupuncture group, Tiaowei Jiannao acupuncture was applied at bilateral Shenmai (BL62), Zhaohai (KI6), Hegu (LI4), Taichong (LR3), and Baihui (GV20), Sishencong (EX-HN1), Yintang (GV24⁺), Shenting (GV24), once a day, 1-day interval was taken after 6-day treatment, for 3 weeks totally. In the medication group, eszopiclone tablet was given orally, 1-3 mg a time, once a day for 3 weeks. In the sham-acupuncture group, non-invasive sham acupuncture was applied, the acupoint selection, frequency and course of treatment were the same as the acupuncture group. Before treatment, after 2,3 weeks of treatment, the scores of Pittsburgh sleep quality index (PSQI), self-rating sleep scale (SRSS), National Institutes of Health Stroke scale (NIHSS), Hamilton depression scale-17 (HAMD-17) were observed; before and after treatment, the sleep parameters were recorded using polysomnography (PSG); and the efficacy and safety were evaluated after treatment in the 3 groups. RESULTS: After 2,3 weeks of treatment, the scores of PSQI, HAMD-17 and SRSS in the acupuncture group and the medication group, as well as the SRSS scores in the sham-acupuncture group were decreased compared with those before treatment (P<0.05); after 2 weeks of treatment, the NIHSS score in the acupuncture group was decreased compared with that before treatment (P<0.05); after 3 weeks of treatment, the NIHSS scores in the acupuncture group, the medication group and the sham-acupuncture group were decreased compared with those before treatment (P<0.05). After 3 weeks of treatment, the scores of PSQI, SRSS, HAMD-17 and NIHSS in the acupuncture group and the medication group, as well as the NIHSS score in the sham-acupuncture group were decreased compared with those after 2 weeks of treatment (P<0.05). After 2,3 weeks of treatment, the scores of PSQI, SRSS and HAMD-17 in the acupuncture group and the medication group were lower than those in the sham-acupuncture group (P<0.05), the NIHSS scores in the acupuncture group were lower than those in the medication group and the sham-acupuncture group (P<0.05); after 3 weeks of treatment, HAMD-17 score in the acupuncture group was lower than that in the medication group (P<0.05), the NIHSS score in the medication group was lower than that in the sham-acupuncture group (P<0.05). Compared before treatment, after treatment, the total sleep time was prolonged (P<0.05), the wake after sleep onset, sleep latency, and non-rapid eye movement (NREM) sleep latency were shortened (P<0.05), the sleep efficiency was improved (P<0.05), the number of awakenings was reduced (P<0.05), the percentage of rapid eye movement (REM%) and the percentage of NREM stage 1 (N1%) were decreased (P<0.05), the percentage of NREM stage 2 (N2%) and the percentage of NREM stage 3 (N3%) were increased (P<0.05) in the acupuncture group and the medication group; the sleep latency was shortened in the sham-acupuncture group (P<0.05). After treatment, the PSG indexes in the acupuncture group and the medication group were superior to those in the sham-acupuncture group (P<0.05); in the acupuncture group, the number of awakenings was less than that in the medication group (P<0.05), the REM% and N1% were lower than those in the medication group (P<0.05), the N2% and N3% were higher than those in the medication group (P<0.05). The total effective rate were 93.5% (29/31) and 90.0% (27/30) in the acupuncture group and the medication group respectively, which were higher than 10.0% (3/30) in the sham-acupuncture group (P<0.05). There was no serious adverse events in any of the 3 groups. CONCLUSION Tiaowei Jiannao acupuncture improves the insomnia symptoms in patients with ischemic stroke, improves the quality of sleep, increases the deep sleep, promotes the recovery of neurological function, and relieves the depression. It is effective and safe for the treatment of PISI.
Humans ; Acupuncture Therapy ; Male ; Sleep Initiation and Maintenance Disorders/physiopathology* ; Female ; Middle Aged ; Aged ; Acupuncture Points ; Treatment Outcome ; Adult ; Ischemic Stroke/complications* ; Stroke/complications* ; Sleep

This article reported the clinical features of a rare patient with anti-metabotropic glutamate receptor 5 （mGluR5） encephalitis with mental disorders as the initial symptom， so as to provide references for clinical diagnosis and treatment. The patient was a 38-year-old male， developed pharyngeal pain as prodromal symptoms， and the main clinical manifestations included rapidly progressive memory loss， anxiety and depression， and psychomotor excitement symptoms including irritability and impulsive behaviors. The disease had a progressive deterioration. In the most severe state， the patient became unconscious in a shallow coma， with further cognitive decline， hallucinations and delusions， and lack of self-awareness. Both cerebrospinal fluid and serum anti-mGluR5 antibody were strongly positive （1∶100）. After two sessions of hormone shock therapy， the patient showed significantly improvement in consciousness， cognitive， emotional and psychiatric dimensions.

Objective To investigate the combination of Oxycodone and Morphine Hydrochloride Injec-tion in cancer pain and breakthrough cancer pain (BtCP).Methods This study included 78 patients with moder-ate or severe cancer pain ,which was titration with Oxycodone and Morphine Hydrochloride Injection .All data were obtained from diagnosed malignant tumors and followed up in the people ′s hospital of Jiangmen city between Jan 2011 and Dec 2015.Results The first 5 days of the titration with a total Morphine Equivalent Dose (MED)be-tween 156~1 491 mg(426.46 ±286.00 mg),and a total dose of IV morphine hydrochloride injection between 2~57 mg(20.96 ±13.25 mg).The mean dose used in the treatment of BtCP was 2.23 ±2.50 mg in Phase B(8 pm~8 am)and 1.96 ±2.14 mg in Phase A(P<0.05).When the treatment begun Numerical Rating Scale (NRS)showed a significant decrease .All the patients were less likely to experience any severe side -effects. Conclusion The titration by Oxycodone and Morphine Hydrochloride Injection is a simple , safe and efficient method,with less side-effect,significantly improve the living quality .It′s a good choice in the titration of moder-ate or severe cancer pain .

Objective To investigate the autistic symptoms or autistic trait in the children with attention deficit hyperactivity disorder(ADHD) for facilitating the development of appropriate interventions.Methods Sixty-two 6-12-year-old high-functioned autism spectrum disorder (ASD),ADHD and typically developing (TD) children were assessed respectively using Chinese-version social responsiveness scale (SRS),and ADHD core symptoms were assessed in the ADHD children at the same time.Results ASD group＞ADHD group＞ TD group on the SRS total raw score and the five dimensions scores as well(P＜0.01).ASD,ADHD and TD group scored respectively 92.43±19.17,65.66±19.86 and 38.40±10.68 on the SRS total scale.The SRS total raw score of ADHD group exceeded the TD group for 2.55 standard deviant (SD) and with social communication (2.00 SD) and autistic mannerism (2.71 SD) deviating the most.22.58％ (14 out of 62) children with ADHD scored above the threshold on the SRS total raw score which was significantly higher than that in the TD group(P＜0.01).There were nonsignificant differences in the ADHD core symptoms between ADHD± children (with the SRS total raw score ≥85)and ADHD-children(with the SRS total raw score＜85) (P＞0.01).Conclusion Children with ADHD appear more ASD symptoms than the TD children and a considerable proportion of them reach the SRS diagnostic cut-off point.

Objective To compare the efficacy and safety of intravenous injection and oral taken of morphine in the treatment of severe cancer pain.Methods 35 patients with severe cancer pain were randomly divided into oral group (n =16)and IV group (n =19).Results The time from start of treatment to achievement of CR /PR in the oral group was significantly longer than that in the IV group,and there was no significant difference of incidence rate of complications be-tween two groups.Conclusion Both oral taken and intravenous injection of morphine can effec-tively alleviate severe cancer pain,and compared with oral take,the intravenous injection of mor-phine is even more effective,so it is worthy of popularization.

Objective To compare the efficacy and safety of intravenous injection and oral taken of morphine in the treatment of severe cancer pain.Methods 35 patients with severe cancer pain were randomly divided into oral group (n =16)and IV group (n =19).Results The time from start of treatment to achievement of CR /PR in the oral group was significantly longer than that in the IV group,and there was no significant difference of incidence rate of complications be-tween two groups.Conclusion Both oral taken and intravenous injection of morphine can effec-tively alleviate severe cancer pain,and compared with oral take,the intravenous injection of mor-phine is even more effective,so it is worthy of popularization.

Objective: To investigate the effect of chronic intermittent hypoxia (CIH) on liver injury and the expression of fractalkine in rats and explore its possible mechanism.
Methods: A CIH murine model was established to mimic the pathophysiology of obstructive sleep apnea-hypopnea syndrome (OSAHS) in humans. Thirty healthy male Spraque-Dawley rats were randomly assigned to 3 groups: a 5% CIH group, a 5% CIH+RH (removal of hypoxia) group and a control group ( 10 rats in each group). The 5% CIH and 5% CIH+RH groups were exposed to CIH for 3 weeks, 8 h/d, and the frequency of hypoxia was 20 times/h. The 5% CIH+RH group was then exposed to normal gaseous environment for another 3 weeks. After the experiment, liver sections were stained with hematoxylin-eosin (HE) and the liver pathology was observed. The expression of fractalkine in the liver tissues was detected by immunohistochemical method.
Results: 1) Compared with the control group, the hepatic steatosis and inflammatory activities in the 5% CIH and 5% CIH+RH groups were more severe (allP<0.01 ); compared with the 5% CIH group, the hepatic steatosis and inflammatory activity in the 5% CIH+RH group were dramatically reduced (P<0.01 ). 2) Compared with the control group, the fractalkine expression in the 5%CIH and 5% CIH+RH groups was increased (bothP<0.01). The fractalkine expression in the 5% CIH+RH group was dramatically downregulated compared with that in the 5% CIH group (P<0.01).
Conclusion: CIH can induce liver injury and high fractalkine expression in rat liver tissues.

Objective To observe the therapeutic effect of therapy of dispelling wind,cooling blood and tonifying kidney for refractory idiopathic thrombocytopenic purpura(RITP).Methods Fifteen RITP patients received therapy of dispelling wind,cooling blood and tonifying kidney.After treatment for 3 courses(18 weeks in total),the changes of platelet count and megakaryocyte maturation were observed.Results Of 15 RITP patiens,8 were clinically cured,4 markedly effective,2 effective,1 ineffective and the total effective rate was 93.3%.After treatment,the platelet count was increased(P

Objective To observe the influence of wind-dispelling therapy on therapeutic effect of blood-cooling and kidney-tonifying herbs for chronic idiopathic thrombocytopenic purpura(CITP),and to investigate its immunoregulatory effect.Methods Forty-two CITP patients were randomized into 2 groups:the treatment group(N=22) received therapy of dispelling wind,cooling blood and tonifying kidney,and the control group(N=20) received therapy of cooling blood and tonifying kidney.Six weeks constituted one treatment course,and the treatment lasted 3 courses.Serum interleukin 2(IL-2),soluble IL-2 receptor(sIL-2R),Fas protein,Fas-L protein,and platelet-associated immunoglobulin G(PAIgG) levels and lymphocyte subtypes were compared before and after treatment.Results In the treatment group,14 patients were clinically cured,5 markedly effective,2 effective,1 ineffective and the total effective rate was 95.5%;in the control group,8 patients were clinically cured,4 markedly effective,3 effective,5 ineffective and the total effective rate was 75.0%.The therapeutic effect in the treatment group was superior to that in the control group(P