OBJECTIVE: To observe the effects of thumbtack-needle embedding therapy of auricular acupuncture on gastrointestinal function and intestinal microflora in the patients with gastric cancer after operation, and to explore its mechanism. METHODS: A total of 80 patients with gastric cancer after radical operation were randomly divided into an observation group (40 cases, 3 cases discontinued) and a control group (40 cases, 3 cases discontinued). The patients of both groups received the perioperative care for accelerating recovery. Additionally, in the observation group, the thumbtack-needle embedding therapy of auricular acupuncture was delivered at the auricular points of unilateral side, including Wei (CO₄), Pi (CO₁₃), Dachang (CO₇), Xiaochang (CO₆), Yuanzhong (AT_2,3,4i), Erzhong (HX₁), Sanjiao (CO₁₇) and Jiaowozhong (TF₃), and the needles were embedded and retained for 72 h. The postoperative recovery time of gastrointestinal function (the postoperative bowel sound recovery time, the first exhaust time, the first defecation time), the postoperative hospital stay and pain visual analogue scale (VAS) score were observed in the two groups. Before operation and on day 5 after operation, the serum gastrin level was detected in the two groups. The third-generation 16S rRNA sequencing technology was used to detect the composition and relative abundance of intestinal flora in the two groups before and after operation. RESULTS: Compared with the control group, the postoperative bowel sound recovery time, the first exhaust time and the first defecation time were shortened in the observation group (P<0.05). In the observation group, the VAS scores at 24 h, 48 h, and 72 h after surgery were lower than those of the control group, respectively (P<0.05). There was no significant differences in postoperative hospital stay and serum gastrin level between the two groups (P>0.05). The alpha diversity analysis showed that the differences in Shannon index, Simpson index, Pielou_J index and Pd_fath index were not significant statistically after intervention between the two groups (P>0.05). After intervention, the community structure of the fecal sample was similar at each taxonomic level between the two groups, and although the proportion between species was various, the difference was not significant (P>0.05). After intervention, there were 55 species with the differences between the two groups, 17 species of them presented significant difference in relative abundance in the observation group and 38 species in the control group. Regarding the level of genus, the levels of Klebsiell and Enterobacter increased (P<0.05) and the level of Streptococcus decreased (P<0.05) in the observation group. The main microbial groups that played an important role were Coprobacillaceae, Sutterellaceae and Yersiniaceae in the observation group. KEGG function prediction indicated that the function of intestinal microflora was mainly associated with the cofactor and vitamin metabolism, carbohydrate metabolism, and amino acid metabolism. CONCLUSION The thumbtack-needle embedding therapy of auricular acupuncture improves the postoperative gastrointestinal function of the patients with gastric cancer probably through regulating the structure and relative abundance of intestinal microflora and affecting the energy metabolism.
Humans ; Male ; Female ; Middle Aged ; Acupuncture, Ear/instrumentation* ; Gastrointestinal Microbiome ; Aged ; Stomach Neoplasms/therapy* ; Adult ; Acupuncture Points ; Gastrointestinal Tract/microbiology* ; Intestines/physiopathology* ; Postoperative Period ; Acupuncture Therapy

OBJECTIVE: To observe the clinical efficacy of auricular electroacupuncture for post-stroke dysphagia in the pharyngeal phase. METHODS: Eighty-two patients with post-stroke dysphagia in the pharyngeal phase were randomized into an auricular electroacupuncture group (41 cases) and a swallowing electrical stimulation group (41 cases, 1 case dropped out). In the auricular electroacupuncture group, electroacupuncture was applied at auricular points, i.e. Xin (CO₁₅) and Yanhou (TG₃), using disperse-dense wave, in frequency of 2 Hz/10 Hz, 30 min a time. In the swallowing electrical stimulation group, swallowing electrical stimulation was delivered for 30 min a time. Both groups were treated once daily for 4 weeks. The functional oral intake scale (FOIS) grade, as well as the hyolaryngeal complex displacement, the pharyngeal constriction rate (PCR) and the pharyngeal delay time (PDT) under video fluoroscopic study of swallowing (VFSS) were observed before and after treatment, and the clinical efficacy was evaluated in the two groups. RESULTS: Compared before treatment, the FOIS grade was improved (P<0.01), the forward and upward displacement amplitude of hyoid bone and thyroid cartilage was increased (P<0.05), and the PCR and PDT were decreased (P<0.05) after treatment in the two groups. After treatment, compared with the swallowing electrical stimulation group, the FOIS grade was superior (P<0.01), the upward displacement amplitude of hyoid bone and thyroid cartilage was larger (P<0.05) and the PCR and PDT were lower (P<0.05) in the auricular electroacupuncture group. The total effective rate was 85.4% (35/41) in the auricular electroacupuncture group, which was higher than 62.5% (25/40) in the swallowing electrical stimulation group (P<0.05). CONCLUSION Auricular electroacupuncture can effectively trigger pharyngeal initiation and improve post-stroke dysphagia in the pharyngeal phase.
Humans ; Electroacupuncture ; Male ; Deglutition Disorders/etiology* ; Female ; Middle Aged ; Aged ; Stroke/physiopathology* ; Pharynx/physiopathology* ; Acupuncture, Ear ; Acupuncture Points ; Deglutition ; Treatment Outcome ; Adult

Objective:To compare the changes in distortion product otoacoustic emission （DPOAE） test results in clinical patients with negative middle ear pressure after equalizing the pressure in the external canal and the middle ear cavity. This study aims to analyze the effect of negative middle ear pressure on otoacoustic emissions and investigate the correlation between the degree of negative middle ear pressure and the changes in amplitude and signal-to-noise ratio of DPOAE. Methods:Twenty-seven clinical patients were included, with 34 ears exhibiting negative middle ear pressure. Acoustic conductance tests, pure tone hearing threshold tests, and DPOAE tests were conducted under ambient pressure and peak pressure after equalizing the middle ear pressure for all tested ears. The amplitude and signal-to-noise ratio of DPOAE before and after compensating for middle ear pressure were recorded and statistically analyzed. Results:At 1.0 k Hz, 1.5 k Hz, and 8.0 k Hz, the DPOAE amplitude under ambient pressure was significantly higher than that under negative pressure （P<0.05）. A significant difference in the DPOAE signal-to-noise ratio was observed at 1.0 k Hz and 8.0 k Hz （P<0.05）. The difference in both amplitude and signal-to-noise ratio between these two test conditions was more pronounced at 1.0 k Hz （P<0.01）. There was no correlation between the negative pressure value from the tympanogram and the change in amplitude, with a weak negative correlation trend observed only at 0.75 k Hz （r=-0.328, P=0.054）. However, a significant negative correlation was found between the negative pressure value from the tympanogram and the change in signal-to-noise ratio at 0.75 k Hz （r=-0.366, P<0.05）. Conclusion:Compensating for middle ear pressure significantly improves the amplitude and signal-to-noise ratio of DPOAE in cases of negative middle ear pressure, particularly in the medium-frequency range. The smaller the degree of negative pressure in the middle ear, the weaker the effect of equalizing middle ear pressure is, especially in the low-frequency range.
Humans ; Ear, Middle/physiopathology* ; Male ; Female ; Adult ; Otoacoustic Emissions, Spontaneous ; Young Adult ; Middle Aged ; Pressure ; Adolescent ; Aged ; Signal-To-Noise Ratio

Objective:To explore of auditory-vestibular function and inner ear imaging features of patients with Meniere's disease（MD） at different clinical stages. Methods:The clinical data of 110 patients with unilateral MD who were admitted from January 2023 to March 2024 were collected, and all patients were staged according to the results of pure tone hearing threshold test, including 13 patients with stage Ⅰ, 18 cases with stage Ⅱ, 65 cases with stage Ⅲ, and 14 cases with stage Ⅳ. All patients were tested for vestibular function, including caloric tests, vestibular evoked myogenic potentials（VEMPs）, vHIT and sensory integration tests（SOT）. The sites of endolymphatic hydrops were evaluated by intravenous endotogidolinium-based MRI, twenty-seven patients completed electrocochleography. Results:①The disease course time of patients with different stages was different, and the disease course time of stage Ⅰ and Ⅱ was shorter than that of stage Ⅲ and Ⅳpatients（P<0.05）. ②No statistical differences were found in clinical data or vestibular function between normal and abnormal ECochG groups（P>0.05）. ③The results of caloric tests showed that the UW% values of stage Ⅲ（45.5±14.79） and stage Ⅳ （51.57±22.44） were higher than those of stageⅠ（31.2±14.9） and stage Ⅱ（33.5±13.31）, there were statistically significant differences between stage Ⅰ and stage Ⅱ with stage Ⅲ and Ⅳ groups（P<0.05）, the total abnormal rate of cVEMP was 62.72%, there was a statistically significant difference between stageⅠand stage Ⅲ with the stage Ⅳ group（P<0.05）, the total abnormal rate of oVEMP was 71.82%, the difference between stage Ⅰ and stage Ⅳ group was statistically significant（P<0.05）. The total score of SOT comprehensive balance gradually decreased with the increase of clinical stage, and there was a significant difference between the stage Ⅰ and Ⅳ groups（H=26.08, P<0.01）, and there was a statistically significant difference in the rate of vestibular dysfunction of SOT between the two groups（χ²=6.7, P<0.05）. ④Patients with vestibular and cochlear endolymphatic hydrops, and patients with simple cochlear or vestibular had significantly differences in disease course time, clinical stages, UW% value of caloric test, abnormal rate of cVEMP and oVEMP, total SOT balance score, the rate of vestibular abnormality（P<0.01）. Among them, when the vestibular and cochlear endolymphatic hydrops are at the same time, the clinical stage of the patient is mainly stage Ⅲand Ⅳ. Conclusion:Auditory-vestibular and inner ear gadolinium-contrasted MRI examinations in clinical practice provide a supplementary reference for judging vestibular function and the type of endolymphatic hydrops.
Humans ; Meniere Disease/diagnostic imaging* ; Ear, Inner/physiopathology* ; Male ; Magnetic Resonance Imaging ; Female ; Middle Aged ; Vestibule, Labyrinth/diagnostic imaging* ; Adult ; Vestibular Evoked Myogenic Potentials ; Aged ; Audiometry, Pure-Tone ; Caloric Tests ; Vestibular Function Tests

OBJECTIVES: To evaluate the efficacy of balloon Eustachian tuboplasty (BET) combined with grommet insertion in the treatment of chronic dilation Eustachian tube dysfunction (CDETD). METHODS: A retrospective study was performed in 19 patients with CDETD who underwent BET at the Department of Otolaryngology-Head and Neck Surgery, Xinhua Hospital Affiliated with Shanghai Jiaotong University School of Medicine, from October, 2014 to September, 2016. The ages of these patients ranged from 10 to 67 years. All the patients underwent the preoperative assessment of oto-endoscope, tympanometry, pure tone audiometry, fiber nasopharyngeal endoscopy, Eustachian tube pressure measurement (TMM), CT and MRI. These patients had failed to respond to medicine, multiple tympanic membrane puncture and at least 2 times grommet insertion before our study. BET was performed in 5 patients (5 ears), and BET+grommet insertionwas performed in other 14 patients (23 ears). The changes of Eustachian tube function in these patients was assessed using the Eustachian tube score (ETS) and Eustachian tube dysfunction questionnaire-7 (ETDQ-7) preoperatively and 1, 3, 6, 9 and 12 months after surgery, respectively. In addition, subjective symptoms including the difficulty level of valsalva, aural fullness and earache were assessed by visual rating scale (VAS score) preoperatively and at 1, 6, and 12 months after surgery. The mean scores before surgery were compared with that at 1, 3, 6, 9 and 12 months. Postoperative adverse reactions and complications were recorded, such as earache, nosebleeding and so on. RESULTS: Valsalva score and VAS score for aural fullness before surgery were 8.286±0.189 and 8.571±0.221, respectively. Valsalva score and VAS score for aural fullness were 3.714±0.317, 2.393±0.434, respectively, at one month after surgery, which were decreased significantly, as compared with the scores before surgery (<0.05). VAS score at 6 months and 12 months after surgery were statistically significant compared with those before surgery (<0.05). ETS score after surgery was significantly higher than that before surgery (<0.05). ETDQ-7 score after surgery was significantly lower than that before surgery (<0.05). The subjective satisfaction in these patients was 84.2%. CONCLUSIONS BET is simple and safe, with fewer complications, and effective for the treatment of CDETD combined with grommet insertion.
Adolescent ; Adult ; Aged ; Child ; China ; Dilatation ; Ear Diseases ; Eustachian Tube ; physiopathology ; surgery ; Humans ; Middle Aged ; Middle Ear Ventilation ; Retrospective Studies ; Treatment Outcome ; Young Adult

Child ; Cholesteatoma, Middle Ear ; diagnosis ; pathology ; Ear, Middle ; physiopathology ; Humans ; Otitis Media with Effusion ; diagnosis ; pathology

OBJECTIVETo explore the efficacy on obesity of spleen deficiency and damp blockage pattern and hyperlipemia treated with warm needling therapy and auricular acupuncture and the effect mechanism of the combined treatment.

METHODSOne hundred and ten patients of obesity of spleen deficiency and damp blockage pattern and hyperlipemia were randomized into an observation group and a control group, 55 cases in each one. Additionally, a healthy group (52 cases) was set up as the control. In the control group, the warm needling therapy was applied to Taibai (SP 3), Chongyang (ST 42), Yinlingquan (SP 9), Zusanli (ST 36), etc., once every two days. In the observation group, on the basic treatment as the control group, the auricular acupuncture was applied to Pi (CO₁₃), Wei (CO₄), Fei (CO₁₄), Shen (CO₁₀), etc., once every 2 to 3 days. The efficacy was evaluated after 3-month, treatment in the two groups. The observation was conducted on the obesity outcomes [body mass, obesity degree (A), body mass index (BMI), body fat percentage (F%)], blood-lipoids indicators [such as serum total cholesterol (TC), triacylglycerol (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C)], fat-islet endocrine axis outcomes [such as fasting plasma glucose (FPG) , fasting leptin (FLP), fasting insulin (FINS), insulin sensitivity index (ISI), insulin resistance index (Homa-IR) and insulin β cell function index (Homa-β)], as well as autonomic nerve function index (Y) before and after treatment in the patients of the two groups. The efficacy was assessed in the two groups.

RESULTSThe total effective rate was 96.4% (53/55) in the observation group, better than 87.3% (48/55, P < 0.01) in the control group. For the improvements of the obesity indices, the differences were not significant between the two groups (all P > 0.05). Before treatment, the levels of TC, TG, LDL-C, FLP, FPG, FINS and Homa-IR in the two groups were all significantly higher than those in the healthy group (all P < 0.01), and the levels of HDL, ISI, Homa-β and Y were significantly lower than those in the healthy group (all P < 0.01). After treatment, except Homa-β, the other indices were all improved significantly (all P < 0.01). The results in the observation group were better than those in the control group (all P < 0.01).

CONCLUSIONThe patients of obesity of spleen deficiency and damp blockage pattern and hyperlipemia have the disturbances of lipid metabolism, "fat-islet endocrinal axis" function and automatic nerve function. The combined treatment of warm needling therapy and auricular acupuncture or simple warm needling therapy present the effects of weight reducing and lipid reducing. The effect of the combined treatment is better than simple warm needling therapy. The efficacy mechanism is probably relevant to the positive regulation of blood glucose, lipid metabolism, fat-islet endocrinal axis and automatic nerve function.

Acupuncture Points ; Acupuncture Therapy ; Acupuncture, Ear ; Adolescent ; Adult ; Blood Glucose ; Female ; Humans ; Hyperlipidemias ; metabolism ; physiopathology ; therapy ; Lipids ; blood ; Male ; Middle Aged ; Obesity ; metabolism ; therapy ; Spleen ; physiopathology ; Treatment Outcome ; Triglycerides ; blood ; Young Adult

OBJECTIVETo compare the differences of clinical effects in female patients with obesity and hyperlipidemia of yang deficiency of spleen and kidney syndrome between warm acupuncture combined with auricular acupuncture and simple warm acupuncture.

METHODSOne hundred and thirty patients were randomly divided into an observation group and a control group, 65 cases in each one. In the control group, acupuncture was used at Pishu (BL 20), Zhongwan(CV 12), Shenshu(BL 23), Zhongji(CV 3), Guanyuan(CV 4), Mingmen(GV 4), Taibai(SP 3), Fenglong(ST 40), etc.; warm acupuncture was applied at Pishu(BL 20), Zhongwan(CV 12), Shenshu(BL 23) and Zhongji(CV 3); the treatment was required once every two days and for 3 months continuously. In the observation group, based on the treatment in the control group, thumbtack intradermal needles were embedded at auricular points, including pi(CO13), shen(CO10), pangguang(CO9), sanjiao(CO17), neifenmi(CO18), neishengzhiqi(TF2), etc. Obesity indices [body mass(W), obesity degree(A), body mass index(BMI), body fat percentage(F%)] blood lipid indices [serum total cholesterol(TC), triglyceride(TG), low density lipoprotein(LDL-C), high density lipoprotein(HDL-C)] and clinical efficacy were observed before and after treatment in the two groups. Results After treatment in the two groups, the obesity indices of W, A, BMI, F% and the blood lipid levels of TC, TG, LDL-C were obviously decreased compared with those before treatment (all P<0. 01) and the HDL-C levels were apparently increased than those before treatment (both P<0. 01). After treatment, the improvement of TC and HDL-C in the observation group was superior to that in the control group (both P<0. 01). The difference was not statistically significant in the aspect of improving every obesity index between two groups (all P>. 05). The comprehensive total effective rate of the observation group was 95.4% (62/65), which was better than 84. 6% (55/65) of the control group (P<0. 001).

CONCLUSIONWarm acupuncture combined with auricular acupuncture and simple warm acupuncture can both benignly adjust abnormal lipid metabolism of obesity patients with hyperlipidemia, and warm acupuncture combined with auricular acupuncture are superior to simple warm acupuncture treatment on antiobesity action and improving the TC and HDL-C levels.

Acupuncture Points ; Acupuncture Therapy ; Acupuncture, Ear ; Adult ; Blood Glucose ; metabolism ; Female ; Humans ; Hyperlipidemias ; metabolism ; physiopathology ; therapy ; Kidney ; physiopathology ; Middle Aged ; Obesity ; metabolism ; physiopathology ; therapy ; Spleen ; physiopathology ; Triglycerides ; metabolism ; Yang Deficiency ; metabolism ; physiopathology ; therapy ; Young Adult

OBJECTIVETo compare the differences of clinical effects on primary hypertension between acupuncture combined with auricular point sticking and western medicine.

METHODSNinety patients with primary hypertension were randomly divided into a medication group and a combination group, 45 cases in each group. In the medication group, captopril tablets were treated with oral administration, 12.5 mg each time, twice a day; in the combination group, acupuncture and auricular point sticking were used, and acupuncture was applied at Renying (ST 9), Fengchi (GB 20) and Baihui (GV 20), while auricular point sticking was adopted at Shenmen (TF4), Xin (CO15), Jiangyagou and Jiaogan (AH6a), once a day for continuous 4 weeks. After treatment, the changes of 24 h ambulatory blood pressure, angiotensin II (Ang II) level, creatinine level and syndrome scores were observed and the clinical efficacy was assessed in the two groups.

RESULTSAfter 4 weeks' treatment, the 24 h ambulatory blood pressure was both improved compared with that before treatment in the two groups (P<0.01, P<0.05). The reducing of 24 h ambulatory blood pressure in the combination group was superior to that in the medication group (P<0.05). There were reducing tendencies about coefficients of variation (CVs) of the two groups, and in the combination group, the CVs of 24 h ambulatory blood pressure and systolic pressure acquired more obvious reducing range compared with the medication group (both P<0.05). Serum Ang II level and plasma creatinine level of the patients in the two groups after treatment were both decreased (both P<0.05) and the reducing of Ang II level and creatinine level of the combination group was more obvious than that of the medication group (both P<0.05). The syndrome scores of the two groups after treatment were both remarkably decreased (both P<0.05), and the reducing of the syndrome scores of the combination group was more marked than that of the medication group (P<0.05). The total effective rate of the combination group was 95.6% (43/45), which was superior to 71.1% (32/45) of the medication group (P<0.05).

CONCLUSIONAcupuncture combined with auricular point sticking for primary hypertension has reliable effect. It is better than captopril for the improvement of 24 h ambulatory blood pressure, AngII level and creatinine level, and can improve dizzy, palpitation and other clinical symptoms.

Acupuncture Points ; Acupuncture Therapy ; Acupuncture, Ear ; Adult ; Aged ; Blood Pressure ; Female ; Humans ; Hypertension ; physiopathology ; therapy ; Male ; Middle Aged ; Treatment Outcome

OBJECTIVETo compare the effective differences between deep needling and shallow needling at three acupoints around ear for subjective tinnitus.

METHODSFifty patients with subjective tinnitus were randomized divided into a deep needling group and a shallow needling group, 25 cases in each group. Twenty-two patients in the deep needling group and 20 patients in the shallow needling group were brought into statistic in the end. In the two groups, the three acupoints around ear and distal acupoints were both selected. The acupoints of the affected side such as Yifeng (TE 17), Tinghui (GB 2), Ermen (TE 21), Zhigou (TE 6), Zhongzhu (TE 3) and Hegu (LI 4) were adopted. Yifeng (TE 17), Tinghui (GB 2) and Ermen (TE 21) were acupunctured 30-38 mm in the deep needling group and 15-20 mm in the shallow needling group. The other acupoints were conventionally acupunctured in the two groups. The needles were retained for 30 min,once a day and five times a week for all patients. The treatment was continuously for 4 weeks in the two groups. Tinnitus handicap inventory (THI) scores, tinnitus grades and visual analogue scale (VAS) for tinnitus sound levels were observed before and after treatment, and the effects of the two groups were compared.

RESULTSThe total effective rate in the deep needling group was 59.1% (13/22), and it was better than 20.0% (4/20) in the shallow needling group (P < 0.05). In the deep needling, group, the THI score, tinnitus grade and the VAS score were improved than those before treatment (all P < 0.05). In the shallow needling group, the three above indices before and after treatment were not different in statistical significance (all P > 0.05). After treatment, all the three indices in the deep needling group were superior to those in the shallow needling group (all P < 0.05).

CONCLUSIONAcupuncture at the three acupoints around ear deeply could apparently improve tinnitus, and reduce tinnitus sound levels for subjective tinnitus. The effect is better than that by shallow needling at the three acupoints.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; Adult ; Aged ; Ear ; physiopathology ; Female ; Hearing ; Humans ; Male ; Middle Aged ; Tinnitus ; physiopathology ; therapy ; Treatment Outcome ; Young Adult