OBJECTIVES

To evaluate and compare ectasia and pseudoectasia in post-myopic LASIK patients presenting with corneal topographic changes indicative of ectasia using the Ectasia Risk Factor Score System (ERFSS).

Single-center retrospective comparative case series of a consecutive chart review of cases in 18 years who underwent bilateral myopic-LASIK and showed topographic changes indicative of ectasia.

Four patients were included. Group 1: pseudoectasia eyes, consisting of two patients with bilateral pseudoectasia, and Group 2: ectasia eyes, consisting of two patients with unilateral ectasia. The clinical course of the cases was discussed and compared based on the ERFSS parameters: topography pattern, residual stromal bed thickness, age, preop thinnest cornea, and pre-operative spherical equivalent (SE) manifest refraction (MR). Group 1 scored zero to low risk for developing ectasia while Group 2-eyes with ectasia scored moderate risk. The predictive value of the ERFSS was 1 in this study.

The ERFSS is a good measure in deciding the suited treatment plan for patient undergoing refractive procedure. Knowing the clinical course of ectasia and pseudoectasia is helpful in the therapeutic approach since pseudoectasia is reversible when identified and managed early as seen in this study.

Presented here is a cases of a 12-year old female patient who was ran over by a reaper. After a comprehensive evaluation, she was advised to undergo transvesical subtrigonal buccal mucosa graft inlay for her almost completely obliterated bladder neck contracture. Such a procedure proved to be a viable option for the patient’s bladder neck reconstruction.

OBJECTIVE

This study compared the proportion of dry eye disease (DED) diagnosed using the Philippine criteria with that diagnosed using the Asia Dry Eye Society (ADES) criteria among participants, and characterized DED features using clinical tests and the OCULUS Keratograph® 5M (K5M; OCULUS Optikgeräte GmbH, Wetzlar, Germany).

This multicenter, cross-sectional study included participants with and without DED. Participants completed the Ocular Surface Disease Index (OSDI) questionnaire and underwent fluorescein tear breakup time (FTBUT) measurement, fluorescein staining of the cornea, lissamine green staining of the conjunctiva, Schirmer 1 test without anesthesia, and basal tear secretion test (BST). The OCULUS K5M was used to measure noninvasive tear breakup time (NIKBUT) and tear meniscus height (TMH), and to perform meibography.

The analysis included 344 eyes from 172 patients with DED and 44 eyes from 22 normal participants. Patients with DED were mostly female (66.3%). Compared to normal participants, patients with DED were older (42.7 ± 14.6 years) and had higher OSDI scores (28.6 ± 21.0). Among those diagnosed with DED using the Philippine criteria, 53.2% met the ADES criteria. Evaporative DED was the predominant type (53.2%). DED eyes had lower FTBUT (5.0 ± 3.3 seconds) and NIKBUT (12.3 ± 5.9 seconds) than controls (p CONCLUSION

There were disparities between the Philippine and ADES criteria for DED diagnosis and differences in tear measurements using clinical tests and the OCULUS Keratograph, indicating the need to harmonize diagnostic standards.

INTRODUCTION: Oral cancer is a major public health concern in India. Both conventional and altered fractionation radiotherapy schedules have been used in curative treatment of oral cancer. This study aimed to retrospectively evaluate the clinical profile and treatment outcomes of patients with carcinoma buccal mucosa who underwent treatment with definitive hypofractionated accelerated radiotherapy. METHODS: A total of 517 patients treated from January 2011 to December 2016 were eligible for the analysis. All patients were treated with definitive hypofractionated accelerated radiotherapy schedule of 5,250 cGy in 15 fractions over 3 weeks. Survival estimates were generated using the Kaplan-Meier method. RESULTS: At a median follow-up of 77.4 months, 473 (91.5%) patients attained complete remission with radiation therapy. The 5-year disease-free survival (DFS) and overall survival (OS) rates were 69% and 80.5%, respectively. The 5-year OS for stage I, II, III and IVa tumours was 80.3%, 84.4%, 81.4% and 73.7%, respectively, and the DFS was 75.7%, 73.2%, 69.6% and 60.2%, respectively. Age >50 years was found to be a significant factor affecting DFS ( P = 0.026) and OS ( P = 0.048) in multivariate analysis. Fifty-three (10.3%) patients developed osteoradionecrosis of the mandible. CONCLUSION Excellent outcome could be achieved in less-aggressive, low-volume carcinoma of the buccal mucosa with radical accelerated hypofractionated radiotherapy. A radiotherapy schedule over a 3-week period is useful in high-volume centres.
Humans ; Retrospective Studies ; Male ; Female ; Middle Aged ; Mouth Neoplasms/mortality* ; Mouth Mucosa/radiation effects* ; Treatment Outcome ; Aged ; Adult ; Radiation Dose Hypofractionation ; Disease-Free Survival ; India ; Kaplan-Meier Estimate ; Dose Fractionation, Radiation ; Aged, 80 and over

OBJECTIVE: To observe the clinical efficacy of stuck acupuncture combined with facial acupuncture for facial cosmetology. METHODS: A total of 22 female patients with symptoms of facial aging were treated with stuck acupuncture combined with facial acupuncture. Stuck acupuncture was applied at bilateral Taiyang (EX-HN5) through Xiaguan (ST7), Jiache (ST6) through Daying (ST5) and Yingxiang (LI20)，once a week. Facial acupuncture was applied at Yintang (GV24⁺), ashi points (nasolabial fold) and bilateral Yangbai (GB14), Quanliao (SI18), Sibai (ST2), Xiaguan (ST7), Dicang (ST4), Jiache (ST6), Daying (ST5), Renying (ST9), twice a week. Four weeks were required. The global aesthetic improvement scale (GAIS) score after treatment, wrinkle severity rating scale (WSRS) score before and after treatment were observed. The quantitative analysis of skin characteristics was performed before and after treatment. RESULTS: After treatment, of the 22 patients, 3 cases had complete improvement, 15 cases had obvious improvement, 4 cases had partial improvement, 0 case had no improvement. The WSRS score and scores of wrinkles, textures and pores were decreased compared with those before treatment (P<0.01). CONCLUSION Stuck acupuncture combined with facial acupuncture could effectively improve the symptoms of facial aging.
Humans ; Female ; Acupuncture Therapy ; Middle Aged ; Adult ; Face ; Acupuncture Points ; Skin Aging ; Treatment Outcome ; Aged

OBJECTIVE: To construct a prediction model for the clinical effect of eye acupuncture combined with rehabilitation therapy on ischemic stroke based on interpretable machine learning. METHODS: From January 1st, 2020 to October 1st, 2024, the clinical data of 470 patients with ischemic stroke were collected in the the Second Department of Encephalopathy Rehabilitation of the Affiliated Hospital of Liaoning University of TCM. The modified Barthel index (MBI) score before and after treatment was used to divide the patients into an effect group (291 cases) and a non-effect group (179 cases). Random forest and recursive feature elimination with cross-validation were combined to screen the predictors of the therapeutic effect of patients. Seven representative machine learning models with different principles were established according to the screening results. The predictive effect of the best model was evaluated by receiver operating characteristics (ROC), calibration, and clinical decision-making (DCA) curves. Finally, the Shapley additive explanation (SHAP) framework was used to interpret the prediction results of the best model. RESULT: ①All the machine learning models presented the area under curve (AUC) to be above 85%. Of these models, the random forest model showed the best prediction ability, with AUC of 0.96 and the precision of 0.87. ②The prediction probability of calibration curve and the actual probability showed a good prediction consistency. ③The net benefit rate of DCA curve in the range of 0.1 to 1.0 was higher than the risk threshold, indicating a good effect of model. ④SHAP explained the characteristic values of variables that affected the prediction effect of the model, meaning, more days of treatment, lower MBI score before treatment, lower level of fibrinogen, shorter days of onset and younger age. These values demonstrated the better effect of eye acupuncture rehabilitation therapy. CONCLUSION The rehabilitation effect prediction model constructed in this study presents a good performance, which is conductive to assisting doctors in formulating targeted personalized rehabilitation programs, and identifying the benefit groups of eye acupuncture combined with rehabilitation therapy and finding the advantageous groups with clinical effect. It provides more ideas for the treatment of ischemic stroke with eye acupuncture combined with rehabilitation therapy.
Humans ; Acupuncture Therapy ; Machine Learning ; Male ; Female ; Middle Aged ; Ischemic Stroke/rehabilitation* ; Aged ; Stroke Rehabilitation ; Adult ; Eye

OBJECTIVE: To compare the clinical efficacy between penetrating needling of three eye acupoints combined with sodium hyaluronate eye drops and sodium hyaluronate eye drops alone for the treatment of dry eye. METHODS: A total of 156 patients (312 eyes) with dry eye were randomly assigned to an observation group and a control group, with 78 patients (156 eyes) in each group. The control group was treated with sodium hyaluronate eye drops, one drop per eye, four times daily, for 4 weeks. In addition to the sodium hyaluronate treatment, the observation group received penetrating needling of three eye acupoints. Acupoints included bilateral Cuanzhu (BL2), Sizhukong (TE23), Sibai (ST2), and Jingming (BL1). Needling was performed once daily, four times a week, for 4 weeks. The subjective ocular symptom scores, neuropathic pain symptom inventory-eye (NPSI-Eye) scores, ocular surface disease index (OSDI) scores, corneal fluorescein staining (FL) scores, tear break-up time (BUT), SchirmerⅠtest (SⅠT), central tear meniscus height (TMH), and tear levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were evaluated before and after treatment in the two groups. Clinical efficacy was also compared between the two groups. RESULTS: After treatment, both groups showed significant improvements in subjective ocular symptom scores, NPSI-Eye scores, OSDI scores, FL scores, and reductions in tear IL-6 and TNF-α levels (P<0.01). Additionally, BUT, SⅠT, and TMH were increased significantly in both groups (P<0.01). After treatment, the subjective ocular symptom scores, NPSI-Eye score, OSDI score, FL score, and tear levels of IL-6 and TNF-α in the observation group were lower than those in the control group (P<0.01, P<0.05), while BUT, SⅠT, and TMH were significantly improved compared to the control group (P<0.01). The markedly effective rate and total effective rate in the observation group were 83.3% (65/78) and 100.0% (78/78), respectively, which were higher than 52.6% (41/78, P<0.01) and 92.3% (72/78, P<0.05) in the control group. CONCLUSION The penetrating needling of three eye acupoints combined with sodium hyaluronate eye drops can effectively alleviate symptoms of dry eye, reduce inflammatory response, and has superior efficacy to sodium hyaluronate eye drops alone.
Humans ; Hyaluronic Acid/administration & dosage* ; Male ; Female ; Dry Eye Syndromes/genetics* ; Middle Aged ; Acupuncture Points ; Ophthalmic Solutions/administration & dosage* ; Adult ; Aged ; Treatment Outcome ; Acupuncture Therapy ; Interleukin-6/genetics* ; Young Adult ; Tumor Necrosis Factor-alpha/metabolism*

Based on the theory of the five-body constituents from Huangdi Neijing (Yellow Emperor's Internal Classic), the approach and methods of acupuncture for facial aging are explored. Acupuncture for facial aging can be guided by the concept of the five-body constituents, targeting the facial "skin, flesh, vessels, tendons, and bones", and utilizing five different types of needles-facial needles, needle knives, filiform needles, retaining needles, and elongated needles and filiform needles-to maximize their respective advantages in treating facial aging. Facial needles are applied to the "skin" by selecting facial acupoints or local ashi points (at wrinkle or pigmentation sites). Needle knives are used for the "flesh" to perform longitudinal dredging and transverse dissection of the facial muscle layers. Filiform needles target the "vessels" with needling at Renying (ST9) to improve facial complexion. Retaining needles act on the "tendons" with needling from Taiyang (EX-HN5) to Xiaguan (ST7), and Jiache (ST6) to Daying (ST5), using clockwise twisting to generate a retaining needle sensation and lifting to achieve an overall facial lifting effect.
Humans ; Acupuncture Therapy/methods* ; Face ; Skin Aging ; Acupuncture Points ; Aging

This paper introduces the academic characteristics of Professor ZHANG Ren in treatment with acupuncture for refractory eye diseases in modern times, guided by "homotherapy for heteropathy" (same therapy for different diseases sharing the same pathogenesis). The refractory eye diseases in modern times include a variety of conditions such as glaucoma, macular degeneration, diabetic retinopathy, high myopia and its complications, dry eye, cortical visual impairment and genetic eye diseases. The same therapy is used because these diseases share the similar location and pathogenesis. Professor ZHANG optimizes the methods of acupoint selection and provides the comprehensive prescriptions, "basic prescription, prescription based on disease differentiation, and supplementary prescription". A variety of acupuncture manipulation techniques are operated in clinical practice, such as compound needling methods, penetration needling, manipulations for promoting qi movement and conducting qi flow. "Early, regular and persistent" treatment is the common requirement with "the same acupoints, the same prescription and the same acupuncture method" as well as at "the same time". It is also proposed that the treatment should be provided flexibly according to the different symptoms, "identifying the differences within similarities".
Acupuncture Therapy/methods* ; Humans ; Eye Diseases/history* ; Acupuncture Points ; History, 20th Century ; China ; History, 21st Century

This paper reports a case of head-facial herpes zoster in perimenopausal woman treated with Zheng's cold reducing acupuncture. The patient presented with a syndrome of yin deficiency and internal heat, the treatment principles focused on clearing heat and toxins, nourishing yin and promoting fluid production, achieved through acupuncture. Local surrounding needling was applied around the lesions, supplemented by Zheng's cold reducing acupuncture at head and facial acupoints (including bilateral Fengchi [GB20], Tianzhu [BL10], and Shangxing [GV23], Baihui [GV20], as well as Shuaigu [GB8], Touwei [ST8] on the affected-side) and limb acupoints (including bilateral Lieque [LU7], Neiguan [PC6], Hegu [LI4], Diwuhui [GB42]). Each session lasted 20 min, administered once daily for 8 consecutive days, followed by a 3-day break. An additional session was performed post-break to consolidate efficacy, totally 9 sessions. After treatment, the herpes lesions subsided, and perimenopausal symptoms significantly improved. A 2-month follow-up revealed no residual complications, with the patient in good condition.
Humans ; Female ; Acupuncture Therapy ; Herpes Zoster/therapy* ; Middle Aged ; Perimenopause ; Acupuncture Points ; Head/virology* ; Face/virology*