BACKGROUND: China is seeing a growing demand for rehabilitation treatments for post-stroke upper limb spastic paresis (PSSP-UL). Although acupuncture is known to be effective for PSSP-UL, there is room to enhance its efficacy. OBJECTIVE: This study explored a semi-personalized acupuncture approach for PSSP-UL that used three-dimensional kinematic analysis (3DKA) results to select additional acupoints, and investigated the feasibility, efficacy and safety of this approach. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: This single-blind, single-center, randomized, controlled trial involved 74 participants who experienced a first-ever ischemic or hemorrhagic stroke with spastic upper limb paresis. The participants were then randomly assigned to the intervention group or the control group in a 1:1 ratio. Both groups received conventional treatments and acupuncture treatment 5 days a week for 4 weeks. The main acupoints in both groups were the same, while participants in the intervention group received additional acupoints selected on the basis of 3DKA results. Follow-up assessments were conducted for 8 weeks after the treatment. MAIN OUTCOME MEASURES: The primary outcome was the Fugl-Meyer Assessment for Upper Extremity (FMA-UE) response rate (≥ 6-point change) at week 4. Secondary outcomes included changes in motor function (FMA-UE), Brunnstrom recovery stage (BRS), manual muscle test (MMT), spasticity (Modified Ashworth Scale, MAS), and activities of daily life (Modified Barthel Index, MBI) at week 4 and week 12. RESULTS: Sixty-four participants completed the trial and underwent analyses. Compared with control group, the intervention group exhibited a significantly higher FMA-UE response rate at week 4 (χ² = 5.479, P = 0.019) and greater improvements in FMA-UE at both week 4 and week 12 (both P < 0.001). The intervention group also showed bigger improvements from baseline in the MMT grades for shoulder adduction and elbow flexion at weeks 4 and 12 as well as thumb adduction at week 4 (P = 0.007, P = 0.049, P = 0.019, P = 0.008, P = 0.029, respectively). The intervention group showed a better change in the MBI at both week 4 and week 12 (P = 0.004 and P = 0.010, respectively). Although the intervention group had a higher BRS for the hand at week 12 (P = 0.041), no intergroup differences were observed at week 4 (all P > 0.05). The two groups showed no differences in MAS grades as well as in BRS for the arm at weeks 4 and 12 (all P > 0.05). CONCLUSION: Semi-personalized acupuncture prescription based on 3DKA results significantly improved motor function, muscle strength, and activities of daily living in patients with PSSP-UL. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2200056216. Please cite this article as: Huang XY, Liao OP, Jiang SY, Tao JM, Li Y, Lu XY, Li YY, Wang C, Li J, Ma XP. Three-dimensional kinematic analysis can improve the efficacy of acupoint selection for post-stroke patients with upper limb spastic paresis: A randomized controlled trial. J Integr Med. 2025; 23(1): 15-24.
Humans ; Male ; Female ; Middle Aged ; Acupuncture Points ; Upper Extremity/physiopathology* ; Biomechanical Phenomena ; Single-Blind Method ; Aged ; Stroke/therapy* ; Acupuncture Therapy/methods* ; Stroke Rehabilitation/methods* ; Adult ; Muscle Spasticity/therapy* ; Paresis/physiopathology* ; Treatment Outcome

OBJECTIVE To investigate the relationship between clinical features and human papillomavirus(HPV)infection and the expression of hypoxia-inducible factor(HIF)and vascular endothelial growth factor(VEGF)in patients with pharyngeal and laryngeal papilloma.METHODS Adult patients with pharyngeal and laryngeal papilloma admitted to Beijing Tongren Hospital Affiliated to Capital Medical University from October 2022 to February 2024 were selected as the test group,and adult patients with non-inflammatory non-tumor throat lesions were selected as the control group.Clinical data and pathological tissue samples were collected.The differences of pharyngeal and laryngeal papilloma patients in symptoms,age,gender,smoking,drinking,the number of lesion involved sites and the number of operations were compared.Real-time fluorescence quantitative PCR was used to detect the expression of HPV DNA,HIF cDNA and VEGF cDNA in the pathological tissues.RESULTS The symptoms of pharyngeal papilloma are less severe than those of laryngeal papilloma.There were no statistically significant differences between the two groups in terms of gender and alcohol consumption(P>0.05),but there were statistically significant differences in terms of age,smoking,the number of lesions involved and the number of operations(P<0.05).The number of lesion involved sites was positively correlated with the expression of HIF and VEGF(r=0.3553、r=0.2693,P<0.05).The number of operations was positively correlated with the expression of VEGF(r=0.2515,P<0.05).The expression levels of HIF and VEGF in laryngeal papilloma were higher than those in pharyngeal papilloma and control group(F=9.174,H=23.737,P<0.001).The expression levels of HIF and VEGF in HPV-positive tissue were higher than those in HPV-negative tissue(t=3.899,t=6.463,P<0.001).The HPV positive rate of laryngeal papilloma(97.9%,46/47)was higher than that in pharyngeal papilloma(21.7%,10/46)and control group(13.6%,3/22)(χ2=53.114、χ2=46.647,P<0.001).CONCLUSION HPV infection is one of the important causes of pharyngeal papilloma.The low infection status of pharyngeal papilloma may lead to low expression of HIF and VEGF in the tumor,which makes its clinical features different from laryngeal papilloma.

OBJECTIVE To investigate the improved anesthesia method of arytenoid cartilage reduction under general anesthesia in the treatment of arytenoid dislocation.METHODS The clinical data of 12 patients who underwent modified arytenoid cartilage reduction under general anesthesia in Beijing Tongren Hospital from July 2020 to March 2024 were retrospectively analyzed.To evaluate and analyze the modified anesthesia method of maintaining low degree of neuromuscular block during operation,the recovery of arytenoid cartilage movement and sound after operation.RESULTS All the 12 patients successfully completed arytenoid cartilage reduction.The articulation,arytenoid movement and glottis closure were improved significantly.Compared with the total voice handicap index(VHI),physical scores,functional scores and emotional scores before reduction,the scores at 1 month after surgery were significantly lower[83.5(75-91)vs.13(7-19),30.5(26.5-33)vs.5.5(3-7),25.5(22.5-29)vs.4(2-6),26(23.5-30)vs.4(1.5-6),P<0.001].No complications such as laryngeal spasm and laryngeal edema occurred during perioperative period.CONCLUSION Arytenoid cartilage reduction under modified general anesthesia has high safety,good patient cooperation and high reduction success rate.It provides a new option for the treatment of arytenoid dislocation.

Objective To explore the guiding value of thromboelastography(TEG)in blood transfusion therapy for patients undergoing liver rupture repair.Methods A total of 106 patients who underwent liver rupture repair and were admitted to the hospital from June 2021 to June 2024 were selected.According to the random number table method,the patients were divided into 53 patients who underwent liver rupture repair with TEG detection blood transfusion(study group)and 53 patients who underwent liver rupture repair with conventional coagulation function detection blood transfusion(control group).General information of patients was collected.The levels of coagulation function indicators,the dosage of blood products and intraoperative complications of patients in the study group and the control group before blood transfusion and 24 hours after blood transfusion were compared.Results 24 hours after blood transfusion,the fibrinogen level in the study group was higher than that in the control group,while the prothrombin time,activated partial thromboplastin time and thrombin time were shorter than those in the control group,and the differences were statistically sig-nificant(P<0.05).The dosages of red blood cells,frozen plasma,platelets and cryoprecipitate in the study group were all lower than those in the control group,and the differences were statistically significant(P<0.05).The total incidence of intraoperative complications in the study group was lower than that in the con-trol group,and the difference was statistically significant(P<0.05).Conclusion TEG has significant guiding value in blood transfusion therapy for patients undergoing liver rupture repair.

Objective:To analyze the relevant studies on fertility concerns intervention programs for breast cancer survivors of childbearing age, and identify the specific content, outcome indicators and intervention effects of intervention, in order to provide reference for clinical staff to implement relevant intervention.Methods:According to the research method of scope review, the studies on the fertility concerns with breast cancer patients of childbearing age in China National Knowledge Infrastructure, WanFang, VIP, China Biomedical Literature Database, CINAHL, PubMed, Cochrane Library, Web of Science etc. were searched. The search period was from database establishment to May 9, 2024. The included literature was classified and analyzed.Results:A total of 12 articles were included, 9 were randomized controlled trials, 2 were self-controlled before and after studies, and 1 was a prospective cohort study. Fertility concerns intervention programs included group fertility counseling centered on couples, fertility support based on a multidisciplinary team collaboration model, and fertility management based on "Internet + reproductive health". The duration of intervention was usually 4 or 24 weeks. The intervention had different effects on the level of fertility concerns, psychological state and marital status.Conclusions:At present, the intervention programs for fertility concerns of breast cancer survivors of childbearing age reflect the importance, professionalism, immediacy and interactivity, but China is in the initial stage, and there are still shortcomings in multidisciplinary teams, fertility referral system, and Internet platform construction. Future research should build a breast cancer fertility intervention program suitable for our country, and promote its application through the Internet.

Objective:To analyze the relevant studies on fertility concerns intervention programs for breast cancer survivors of childbearing age, and identify the specific content, outcome indicators and intervention effects of intervention, in order to provide reference for clinical staff to implement relevant intervention.Methods:According to the research method of scope review, the studies on the fertility concerns with breast cancer patients of childbearing age in China National Knowledge Infrastructure, WanFang, VIP, China Biomedical Literature Database, CINAHL, PubMed, Cochrane Library, Web of Science etc. were searched. The search period was from database establishment to May 9, 2024. The included literature was classified and analyzed.Results:A total of 12 articles were included, 9 were randomized controlled trials, 2 were self-controlled before and after studies, and 1 was a prospective cohort study. Fertility concerns intervention programs included group fertility counseling centered on couples, fertility support based on a multidisciplinary team collaboration model, and fertility management based on "Internet + reproductive health". The duration of intervention was usually 4 or 24 weeks. The intervention had different effects on the level of fertility concerns, psychological state and marital status.Conclusions:At present, the intervention programs for fertility concerns of breast cancer survivors of childbearing age reflect the importance, professionalism, immediacy and interactivity, but China is in the initial stage, and there are still shortcomings in multidisciplinary teams, fertility referral system, and Internet platform construction. Future research should build a breast cancer fertility intervention program suitable for our country, and promote its application through the Internet.

OBJECTIVE Exploring the effects of juvenile-onset recurrent respiratory papillomatosis on growth and development,intellectual level,and psychological status.METHODS The clinical data of 40 patients with JORRP who attended Beijing Tongren Hospital of Capital Medical University from January to December 2023(observation group)and 40 healthy adolescents who had medical checkups at the hospital during the same period(control group)were retrospectively analyzed.The body mass index(BMI),Raven's standard progressive matrices(SPM),and the feelings of inadequacy scale(FIS)were used to evaluate the growth and development,intelligence level,and psychological status of the enrolled population.RESULTS BMI was(21.320±3.609)kg/m2 in the observation group and(22.250±2.685)kg/m2 in the control group.The difference between the two groups was not statistically significant(U=668.000,P>0.05).According to the standard conversion of SPM scores,the proportion of observation group with good intelligence level was 5%(2/40),average level was 55%(22/40),below average level was 35%(14/40),and low level was 5%(2/40),while 5%(2/40)of the control group had good intelligence,90%(36/40)had average intelligence,and 5%(2/40)had below average intelligence.The differences in SPM total scores and scores of perceptual discrimination ability in group A,series relationship ability in group D and abstract reasoning ability in group E between the two groups were statistically significant(P<0.05).The intelligence levels of both groups were related to their living areas(|r|>0.3,P<0.05).The difference in FIS scores between the observation group and the control group was statistically significant(86.650±21.680 vs.62.250±9.446,U=270.000,P<0.001).The age of first onset in the observation group was negatively correlated with its sense of inferiority(|r|>0.3,P<0.05).There was no correlation between the number of surgeries in the observation group and their intelligence level and FIS scores(|r|<0.3,P>0.05).CONCLUSION JORRP does not affect the growth and development of patients,but can increase their sense of inferiority to a certain extent,which has a negative impact on their mental health.

OBJECTIVE To observe the long-term efficacy of type-Ⅰ thyroplasty under general anesthesia in the treatment of glottal insufficiency caused by unilateral vocal cord paralysis.METHODS A total of 52 patients with unilateral vocal cord paralysis who underwent type-Ⅰ thyroplasty under general anesthesia at Beijing Tongren Hospital from January 2017 to June 2023 were followed up for more than one year to analyze their efficacy.RESULTS All 52 patients underwent surgery successfully under general anesthesia,and hoarseness improved after operation.Coughing caused by drinking water was reduced or disappeared,and the vocal cords moved inward with improved glottal closure.One year after operation,there was no significant change in the position of the affected vocal cords compared to one week after surgery.The visual analog scale(VAS)scores of all patients with voice disorders decreased sequentially before surgery,one week after surgery,and one year after surgery(80.28±13.49 vs.37.78±19.15 vs.26.26±21.29,P<0.05).The preoperative and one-year postoperative voice perception assessment(GRBAS)showed statistically differences in grade(G),rough(R),breathy(B),and asthenia(A)scores(2.70±0.47 vs.1.09±0.66,2.52±0.54 vs.0.85±0.67,2.85±0.36 vs.0.67±0.65,2.74±0.44 vs.0.61±0.80,P<0.05)except for strain(S).Compared with preoperative results,one-year postoperatively showed a significant decrease in jitter and shimmer(4.61±2.61 vs.3.05±2.37,9.52±3.91 vs.7.11±2.78,P<0.05),and a significant prolongation of maximum phonation time(MPT)[(5.87±2.70)s vs.(14.50±4.30)s,P<0.05].No patients experienced perioperative adverse events.CONCLUSION Type-Ⅰ thyroplasty is an effective surgical method for treatment of vocal cord paralysis.The type-Ⅰ thyroplasty under general anesthesia is safe and effective,which not only significantly improves the symptoms of hoarseness in patients,but also has stable therapeutic effects and can maintain the results for a long time.At the same time,the patient has no pain during the procedure.

Objective:To systematically review, assess, extract, and summarize the most effective evidence on non-pharmacological traditional Chinese medicine interventions for promoting pulmonary rehabilitation in stable patients with chronic obstructive pulmonary disease, aiming to provide a theoretical foundation for clinical nurses to implement traditional Chinese medicine nursing interventions.Methods:According to the "6S" evidence model, relevant evidence on non-pharmacological traditional Chinese medicine interventions for stable chronic obstructive pulmonary disease was retrieved from domestic and foreign databases, guideline websites and professional society websites, including clinical decisions, guidelines, evidence summaries, systematic reviews, expert consensus, etc. The retrieval time was from January 1, 2018 to August 10, 2023. Two researchers evaluated the quality of the included literature, and extracted data and summarized evidence.Results:A total of 23 articles were included, including 6 guideline, 1 evidence summary, 7 systematic reviews, 8 Meta analysis and 1 expert consensus. The 37 evidences were summarized from 11 aspects, including target population, intervention focus, moxibustion therapy, acupoint sticking therapy, transcutaneous electrical acupoint stimulation, acupuncture therapy, acupoint injection therapy, traditional Chinese exercises, diet therapy, follow-up procedures, safety considerations.Conclusions:This study summarizes the evidences of traditional Chinese medicine non-drug pulmonary rehabilitation in the stable stage of chronic obstructive pulmonary disease. When applying the evidence in clinical practice, the traditional Chinese medicine nursing ability of nurses and the actual situation of patients should be fully considered to formulate an individualized traditional Chinese medicine nursing plan.

Cardiomyopathy is a group of heterogeneous myocardial diseases with a variety of specific phenotypes that can lead to cardiovascular death or progressive heart failure in severe cases.Because of the severity and complexity of these diseases,the search for new regulatory mechanisms to prevent and treat cardiomyopathy is particularly urgent.Iron death is a form of programmed cell death that differs from other forms of iron dependence and is characterized by the accumulation of iron-dependent lipid peroxides.Studies have shown that iron death can be involved in the occurrence and progression of cardiomyopathy through different signaling pathways.Therefore,targeted regulation of iron death is a new strategy to prevent cardiomyopathy.In this paper,the mechanism of iron death and its important role in cardiomyopathy were reviewed to find the potential relationship between iron death and cardiomyopathy and provide more ideas for the treatment of various cardiomyopathies in the future.