OBJECTIVE: To compare the therapeutic effect of Fu's subcutaneous needling combined with scalp acupuncture and simple scalp acupuncture for shoulder-hand syndrome phase Ⅰ after cerebral infarction. METHODS: A total of 68 patients with shoulder-hand syndrome phase Ⅰ after cerebral infarction were randomized into a combination group (34 cases, 1 case dropped out) and a scalp acupuncture group (34 cases). Internal medicine treatment and conventional rehabilitation training were adopted in both groups. In the scalp acupuncture group, acupuncture was applied at parietal area and anterior parietal area of Yu's scalp acupuncture, electroacupuncture was connected for 30 min, with disperse-dense wave, in frequency of 2 Hz/100 Hz and in electric current of 1 mA, and the needles were retained for 6 h, once a day for continuous 14 days. On the basis of the treatment in the scalp acupuncture group, Fu's subcutaneous needling was applied at the affected muscles during needle retaining in the combination group, once a day in the first 3 days, once every other day in left days, 2-day interval was taken after 4-time treatment, for 14 days totally. Before and after treatment, the scores of the short form of McGill pain questionnaire (SF-MPQ), edema degree, guides to evaluation of permanent impairment (GEPI), and disabilities of the arm, shoulder and hand (DASH) were observed in the two groups, respectively, and the therapeutic effect was evaluated after treatment. RESULTS: After treatment, the scores of pain rating index (PRI), visual analogue scale (VAS) and present pain intensity (PPI), as well as the total scores of SF-MPQ were decreased compared with those before treatment in the two groups (P<0.05), and the above indexes in the combination group were lower than those in the scalp acupuncture group (P<0.05). After treatment, the scores of edema degree and DASH were decreased compared with those before treatment (P<0.05), while the GEPI scores were increased compared with those before treatment (P<0.05) in the two groups; in the combination group, the scores of edema degree and DASH were lower (P<0.05) while the GEPI score was higher (P<0.05) than those in the scalp acupuncture group. The total effective rate was 97.0% (32/33) in the combination group, which was superior to 91.2% (31/34) in the scalp acupuncture group (P<0.05). CONCLUSION Both Fu's subcutaneous needling combined with scalp acupuncture and simple scalp acupuncture can effectively relieve the shoulder joint pain and edema degree of hand, improve the upper limb function in patients with shoulder-hand syndrome phase Ⅰ after cerebral infarction, and the combination therapy has better therapeutic effect than simple scalp acupuncture.
Humans ; Male ; Female ; Acupuncture Therapy/instrumentation* ; Middle Aged ; Cerebral Infarction/therapy* ; Aged ; Treatment Outcome ; Scalp ; Reflex Sympathetic Dystrophy/therapy* ; Acupuncture Points ; Adult

Background: Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. Methods: Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. Results: The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. Conclusion The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.

Background: Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. Methods: Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. Results: The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. Conclusion The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.

Objective:To evaluate the monitoring value of amplitude-integrated electroencephalography (aEEG) in brain injury among neonates with severe hyperbilirubinemia.Methods:This study retrospectively recruited 223 full-term infants with severe hyperbilirubinemia who underwent aEEG in the Department of Neonatology of Guangzhou Women and Children Medical Center from October 2018 to June 2020. Differences in serum bilirubin level and the incidence of acute bilirubin encephalopathy (ABE) between the normal group ( n=180) and abnormal aEEG group ( n=43) were compared. The monitoring value of aEEG in ABE, and its association with brain stem auditory evoked potential (BAEP) and MRI were studied. Two-independent sample t-test, Mann-Whitney U test and Chi-square test were used for comparing the differences between groups. Goodman-Kruskal Gamma was used for correlation analysis. Results:The total serum bilirubin level [(536.2±154.6) vs (422.1±103.0) μmol/L, t=-5.109, P<0.001] and the incidence of ABE [62.8% (27/43) vs 9.4% (17/180), χ2=62.366, P<0.001] in the abnormal aEEG group were significantly higher than those in the normal aEEG group. The sensitivity and specificity of aEEG in the diagnosis of ABE were 61.3% and 91.1%, respectively. With the progression of ABE from warning period to spasmodic stage, more severe voltage suppression (Gamma=0.847, P=0.003), more disordered sleep-wake cycles (Gamma=0.941, P<0.001) and a more frequent epileptic discharge (Gamma=0.976, P<0.001) were observed. Out of the 223 cases, 148 underwent BAEP. The abnormal rate of aEEG in abnormal BAEP group was significantly higher than that in normal BAEP group [32.7% (33/101) vs 6.4% (3/47), χ2=12.040, P=0.001]. The incidence of abnormal voltage in severe abnormal BAEP group was significantly higher than that in mild abnormal BAEP group [20.6% (7/34) vs 2.6% (1/38), χ2=5.858, P=0.016]. The incidence of epileptic discharge in severe abnormal BAEP group was significantly higher than that in mild abnormal BAEP group [32.4% (11/34) vs 2.6% (1/38), χ2=11.413, P=0.001] and moderate abnormal BAEP group [32.4% (11/34) vs 3.5% (1/29), χ2=8.480, P=0.004]. Among the 223 cases, 108 received MRI examination. The incidence of epileptic discharge in the cases with bilirubin brain injury image was significantly higher than those with normal MRI images [28.6% (10/35) vs 2.6% (1/39), χ2=9.864, P=0.002] and those with other abnormal images [28.6% (10/35) vs 2.9% (1/34), χ2=8.451, P=0.004]. Conclusions:aEEG monitoring is helpful in the diagnosis of ABE and can reflect disease severity. Severe hyperbilirubinemia-induced brain injury in neonates mainly manifests as increased and more frequent epileptic discharge on aEEG. There is a correlation between aEEG monitoring with BAEP and MRI findings.

Objective To investigate the relationship of high sensitivity C reactive protein (hs-CRP), interleukin-6 (IL-6)and soluble IL-6 receptor (sIL-6R)with the severity of clinical symptoms and coronary artery lesions in coronary heart disease (CHD)patients.Methods A total of 522 CHD patients were recruited and divided into three groups:stable angina pectoris (SAP),unstable angina pectoris (UAP)and acute myocardial infarction (AMI)groups.Another 102 healthy individuals served as normal controls (NCs).We calculated Gensini score according to the result of coronary angiography (CAG),collected clinical data and compared the groups. Multiple linear regression analysis was used to investigate the relationship of hs-CRP,IL-6 and sIL-6 R with Gensini score.Results The plasma hs-CRP,IL-6 levels were significantly higher and sIL-6R level was signficantly lower in SAP,UAP and AMI groups than in NC group (P<0 .0 5 ).There was a positive correlation between IL-6 level and Gensini score but a negative correlation between sIL-6 R and Gensini score presented by multiple linear regression analysis (P<0.05 ).Conclusion In CHD patients,plasma hs-CRP,IL-6 and sIL-6R levels are significantly related to the severity of clinical manifestations and coronary artery stenosis.These indicators may help predict the severity of CHD.

Objective To investigate the clinical significance of soluble CD40 ligand (sCD40L ) and lipoprotein associated phospholipase A2 (Lp-PLA2 ) in the assessment of coronary artery severity and risk classification in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS).Methods Of the 9 6 patients with coronary heart disease diagnosed by coronary angiography,2 8 patients had stable angina pectoris (SAP),38 patients unstable angina pectoris (UAP)and 30 patients acute non-ST-segment elevation myocardial infarction (NSTEMI).Another 30 patients with non-coronary heart disease (NC)served as controls.The sCD40L and Lp-PLA2 levels were determined by enzyme-linked immune sorbent assay (ELISA)method.The Gensini score was used to assess the severity of coronary artery and analyze the correlation with sCD40L and Lp-PLA2.The correlation of sCD40L and Lp-PLA2 with GRACE risk score was analyzed too.Results ① sCD40L was significantly higher in NSTEMI and UAP groups than in SAP and NC groups (P<0 .0 5 ),but there was no significant difference between NSTEMI and UAP groups (P>0 .0 5 )or SAP and NC groups (P>0 .0 5 ).Lp-PLA2 was significantly higher in NSTEMI group than in UAP,SAP and NC groups (P<0.05).Lp-PLA2 was significantly higher in UAP group than in SAP and NC groups (P<0.05).② We found that sCD40L had obvious correlation with Lp-PLA2 (r=0.284, P<0.01),Gensini score (r=0.213,P<0.05),and GRACE (r=0.224,P<0.05).Lp-PLA2 was significantly correlated with Gensini score (r=0.270,P<0.05),and GRACE (r=0.323,P<0.01).③ Multivariate logistic regression analysis showed that Lp-PLA2 was independently associated with NSTE-ACS (P<0.05).Conclusion The sCD40L and Lp-PLA2 which were significantly elevated in NSTE-ACS are correlated with the severity of coronary artery disease.The two indexes indicate the instability of atherosclerotic plaque;thus they can be used as predictors of risk assessment in coronary heart disease.

Objective To investigate the expression of serum angiopoietin-2 (Ang-2 ) and its clinical significance in patients with chronic heart failure (CHF).Methods The levels of serum Ang-2,N-terminal pro-B-type natriuretic peptide (NT-proBNP)and left ventricular ejection fraction (LVEF)were detected in 1 1 3 patients with CHF,who were divided into four groups according to New York Heart Association (NYHA:class Ⅰ,n=3 2;Ⅱ,n=30;Ⅲ,n=26;Ⅳ,n=25).Another 20 healthy volunteers for physical check-up were chosen as the control group.Results With the change of cardiac function (from Ⅰ to Ⅳ),the levels of plasma Ang-2 and NT-proBNP were increased significantly (P<0.05 ).The level of serum Ang-2 was positively correlated with NT-proBNP (r=0.774,P<0.001),but negatively correlated with left ventricular ejection fraction (r=-0.725,P<0.001).Conclusion The level of serum Ang-2 has a significant correlation with the severity of heart failure.Ang-2 is expected to be used to predict and evaluate the severity of CHF.