[Objective]To analyze the application and compatibility rules of acupoints and reflex areas in foot massage for the treatment of insomnia through data mining technology,thereby providing an evidence-based basis for the clinical treatment of foot massage in patients with insomnia.[Methods]The literatures associated with the treatment of insomnia through foot massage were retrieved by computer from The Cochrane Library,Web of Science,Embase,PubMed,China National Knowledge Infrastructure,Wanfang,VIP,Chinese Biomedical Literature and other databases.The search period was set until January 1,2025.Excel 2016 software was employed to establish the database for the treatment of insomnia with foot massage,and SPSS 25.0 software was utilized to calculate the frequency of acupoints and reflection areas in the database.Association rules were analyzed by the Apriori module of SPSS Modeler 18.0 software.The association rules of acupoints,reflection areas and their compatibility were described.The association rules were visualized by using Cytoscape 3.9.1 and cluster analysis was visualized with Origin 2022,respectively.[Results]Finally,124 effective literatures were incorporated including 35 for massage treatment of the foot reflex area alone,42 for massage treatment of the foot point alone,and 47 for massage treatment of the combined area and point.The most frequently utilized foot reflex areas of foot massage were the brain,the abdominal nerve plexus,the kidney,the heart,etc.,and the foot points were Yongquan,insomnia points,Taixi,etc.,among which the foot points were mainly characterized by the foot Shaoyin kidney channel and the foot Jueyin liver channel.The five transport points were the most prevalent specific points.The statistical results indicated that the effect of multi-point and/or multi-zone compatibility treatment was superior.Compatibility analysis revealed that the efficacy of multi-point and/or multi-zone compatibility treatments was superior.Analysis result of 124 articles on insomnia treatment through foot massage demonstrated that the most supportive compatibitily for the treatment of insomnia by foot massage was brain-abdominal nerve plexus,which was consistent with the analysis results of 35 literatures on the treatment of insomnia by foot reflex area massage alone.Furthermore,an analysis of 42 articles on insomnia treatment through massage of foot acupoints indicated that Yongquan-Taixi was the most supportive foot acupoint combination.[Conclusion]The combination of Chinese and western medicine theories for guiding foot massage in the treatment of insomnia is highly recommended.Selecting points such as Yongquan,Taixi,insomnia points,brain,abdominal nerve plexus,kidney,heart,and others for the compatibility treatment effect of these areas is better.

Objective To explore the application effect of foot massage based on the brain-gut axis theory in patients with spleen-kidney yang deficiency syndrome undergoing maintenance hemodialysis and suffering from insomnia,and to provide references for improving patients' sleep quality and gastrointestinal symptoms.Methods A total of 88 patients with spleen-kidney yang deficiency syndrome undergoing maintenance hemodialysis and suffering from insomnia,who were treated at a Blood Purification Center of a tertiary-A general hospital in Hangzhou,Zhejiang Province from April to September 2024,were selected as a study subjects.They were randomly divided into an experimental group and a control group using the random number table method,with 44 cases in each group.The experimental group received foot massage based on the guidance of the brain-gut axis theory in addition to conventional treatment and nursing care,while the control group received conventional treatment and nursing care only.The intervention lasted for 3 months.The differences in the Pittsburgh Sleep Quality Index(PSQI)scores,Gastrointestinal Symptom Rating Scale(GSRS)scores,traditional Chinese medicine(TCM)syndrome scores,and serum 5-hydroxytryptamine and melatonin levels between the 2 groups before and after the intervention were compared.Results During the study period,no cases were lost in the experimental group,while 5 cases were lost in the control group.Ultimately,44 cases were included in the experimental group and 39 cases in the control group.After the intervention,the PSQI scores,GSRS scores,and TCM syndrome scores in both groups were lower than those before the intervention,and those in the experimental group were lower than those in the control group.The serum 5-hydroxytryptamine and melatonin levels were higher than those before the intervention,and the levels in the experimental group were higher than those in the control group,with statistically significant differences(all P＜0.001).Conclusion Foot massage based on the brain-gut axis theory can improve gastrointestinal symptoms and TCM syndromes in patients with spleen-kidney yang deficiency syndrome undergoing maintenance hemodialysis and suffering from insomnia,and enhance their sleep quality.

Objective To explore the application effect of foot massage based on the brain-gut axis theory in patients with spleen-kidney yang deficiency syndrome undergoing maintenance hemodialysis and suffering from insomnia,and to provide references for improving patients' sleep quality and gastrointestinal symptoms.Methods A total of 88 patients with spleen-kidney yang deficiency syndrome undergoing maintenance hemodialysis and suffering from insomnia,who were treated at a Blood Purification Center of a tertiary-A general hospital in Hangzhou,Zhejiang Province from April to September 2024,were selected as a study subjects.They were randomly divided into an experimental group and a control group using the random number table method,with 44 cases in each group.The experimental group received foot massage based on the guidance of the brain-gut axis theory in addition to conventional treatment and nursing care,while the control group received conventional treatment and nursing care only.The intervention lasted for 3 months.The differences in the Pittsburgh Sleep Quality Index(PSQI)scores,Gastrointestinal Symptom Rating Scale(GSRS)scores,traditional Chinese medicine(TCM)syndrome scores,and serum 5-hydroxytryptamine and melatonin levels between the 2 groups before and after the intervention were compared.Results During the study period,no cases were lost in the experimental group,while 5 cases were lost in the control group.Ultimately,44 cases were included in the experimental group and 39 cases in the control group.After the intervention,the PSQI scores,GSRS scores,and TCM syndrome scores in both groups were lower than those before the intervention,and those in the experimental group were lower than those in the control group.The serum 5-hydroxytryptamine and melatonin levels were higher than those before the intervention,and the levels in the experimental group were higher than those in the control group,with statistically significant differences(all P＜0.001).Conclusion Foot massage based on the brain-gut axis theory can improve gastrointestinal symptoms and TCM syndromes in patients with spleen-kidney yang deficiency syndrome undergoing maintenance hemodialysis and suffering from insomnia,and enhance their sleep quality.

[Objective]To analyze the application and compatibility rules of acupoints and reflex areas in foot massage for the treatment of insomnia through data mining technology,thereby providing an evidence-based basis for the clinical treatment of foot massage in patients with insomnia.[Methods]The literatures associated with the treatment of insomnia through foot massage were retrieved by computer from The Cochrane Library,Web of Science,Embase,PubMed,China National Knowledge Infrastructure,Wanfang,VIP,Chinese Biomedical Literature and other databases.The search period was set until January 1,2025.Excel 2016 software was employed to establish the database for the treatment of insomnia with foot massage,and SPSS 25.0 software was utilized to calculate the frequency of acupoints and reflection areas in the database.Association rules were analyzed by the Apriori module of SPSS Modeler 18.0 software.The association rules of acupoints,reflection areas and their compatibility were described.The association rules were visualized by using Cytoscape 3.9.1 and cluster analysis was visualized with Origin 2022,respectively.[Results]Finally,124 effective literatures were incorporated including 35 for massage treatment of the foot reflex area alone,42 for massage treatment of the foot point alone,and 47 for massage treatment of the combined area and point.The most frequently utilized foot reflex areas of foot massage were the brain,the abdominal nerve plexus,the kidney,the heart,etc.,and the foot points were Yongquan,insomnia points,Taixi,etc.,among which the foot points were mainly characterized by the foot Shaoyin kidney channel and the foot Jueyin liver channel.The five transport points were the most prevalent specific points.The statistical results indicated that the effect of multi-point and/or multi-zone compatibility treatment was superior.Compatibility analysis revealed that the efficacy of multi-point and/or multi-zone compatibility treatments was superior.Analysis result of 124 articles on insomnia treatment through foot massage demonstrated that the most supportive compatibitily for the treatment of insomnia by foot massage was brain-abdominal nerve plexus,which was consistent with the analysis results of 35 literatures on the treatment of insomnia by foot reflex area massage alone.Furthermore,an analysis of 42 articles on insomnia treatment through massage of foot acupoints indicated that Yongquan-Taixi was the most supportive foot acupoint combination.[Conclusion]The combination of Chinese and western medicine theories for guiding foot massage in the treatment of insomnia is highly recommended.Selecting points such as Yongquan,Taixi,insomnia points,brain,abdominal nerve plexus,kidney,heart,and others for the compatibility treatment effect of these areas is better.

Objective:To explore the commonly used ear acupoints and their selection and compatibility rules for the treatment of primary hypertension with auricular acupressure.Methods:Systematic research was conducted on China Biology Medicine disc, VIP Information Chinese Journal Service Platform, Wanfang Data Knowledge Service Platform, CNKI, PubMed, Embase, Web of Science and Cochrane Library, and the search period was from establishment of the databases until December 31, 2022. Excel 2021 was used to establish the database, and R Studio software was used to analyze the principles of ear acupoint compatibility correlation.Results:A total of 165 articles were included, of which 136 articles were solely treated with auricular acupressure for primary hypertension and 29 articles were treated with other intervention measures. The common syndrome types were hyperactivity of liver fire, stagnation of phlegm, Yin deficiency and Yang hyperactivity, and deficiency of both Yin and Yang. The common acupoints were Shenmen (15.1%, 135/894) , Jiangya Gou (14.09%, 126/894) , Sympathetic (10.63%, 95/894) , Liver (10.29%, 92/894) , Heart (9.73%, 87/894) , Kidney (9.06%, 81/894) , and Subcortical (6.94%, 62/894) .Common acupoint combinations included Shenmen-Jiangya Gou-Sympathetic-Liver-Kidney, Shenmen-Jiangya Gou-Liver-Kidney, Shenmen-Jiangya Gou-Sympathetic, and Shenmen-Jiangya Gou.Conclusions:The treatment of primary hypertension with auricular acupressure has a certain regularity, which can provide reliable references for selecting acupoints for clinical treatment of primary hypertension.

Nutrition therapy is considered as the basis for prevention and management of chronic kidney disease (CKD), throughout the three-tier prevention strategies of CKD. The primary objective is to delay the disease progression, correct metabolic disorders, and improve the outcomes of CKD. Low protein diet has been recognized as an important therapeutic measure in CKD, but the quantity, quality and source of protein are always the points of contention. Recently, both domestic and foreign guidelines have been updated on the amount of protein intake. In addition to quantity, attention has been paid to the type and diversity of proteins. With the rise of plant-based food consumption and the concept of vegetarian diet, the scientific community began to review the benefits of plant protein again, and a plant-based diet is recommend extensively. Whether the plant-based dietary pattern is also suitable for CKD patients who need a low-protein diet, and whether it could meet the nutritional needs of CKD patients are hot topics, this article reviews the recent progress of these research hotspots.

Objective:We compare the consistency, similarities and differences of operating procedures, data and conclusions of air-charged catheters(ACC) and water-filled catheters(WFC), as simultaneously using ACC and WFC in pressure-flow study(PFS).Methods:This study was a prospective, synchronously controlled study, including eligible patients who underwent PFS in the Department of Urology, Beijing Chaoyang Hospital from January 2021 to March 2021. Inclusion criteria: ① Patients need PFS for lower urinary tract symptoms like frequency of urination, urgent urination, urinary incontinence and dysuria; ② Age over 18 years old. Exclusion criteria: ① Unable to complete or cooperate during the urodynamic test; ② Patients with severe urethral stricture or acute stage urinary tract infection; ③ Pregnant women. The bladder pressure was measured continuously by using a 7FDR T-DOC ?AC three-chamber bladder pressure tube, which linked to ACC sensor and improved WFC pressure conduction module. At the same time, 7FA T-DOC ?AC single-lumen rectal pressure tube and 7F Labori-CAT411 double-lumen water sac abdominal pressure tube was used to measure the ACC and WFC rectum pressure, respectively. We recorded the Pdet, Pves and Pabd measured by ACC and WFC, at the point of initial sitting position, bladder filling at 100 ml, 150 ml, 200 ml, cough, Q max, maximum Pdet and the end of urination, and compared the mean values, differences, and consistencies of our data. Result:A total of 63 patients (26 female, 37 male) were included in this study, with an average age of 59.19 years (25-86 years old). During bladder filling phase, the mean values of Pves measured by ACC and WFC were 30.78/24.67cmH 2O (initial sitting position), 29.79/25.13cmH 2O (100 ml), 30.87/25.90cmH 2O (150 ml) and 30.95/26.17cmH 2O(200 ml), respectively, the mean value of Pabd were 30.03/24.17cmH 2O (initial sitting position), 28.81/21.78cmH 2O (100ml), 28.89/21.38cmH 2O (150ml), 28.44/21.60cmH 2O (200ml), respectively, and were significantly different at each sampling point ( P<0.01). During urination period, no significant differences were found in data( P>0.05), and the data measured with ACC and WFC system have good consistency. There were significant differences in Pves(mean 57.30/49.95 cmH 2O, respectively) and Pdet(mean 54.21/43.10 cmH 2O, respectively) between ACC and WFC in cough ( P<0.01), but there was a strong linear correlation between these data between two systems(R 2=0.792 in Pves and 0.756 in Pabd). Bland-Altman analysis showed that detrusor pressure at the maximum urine flow rate maintained good consistency between ACC and WFC, which 95% CI was -13.9 cmH 2O to 15.8 cmH 2O. Conclusions:In PFS, although the ACC measurement values (Pves and Pabd) during the filling phase are higher than those WFC readings, but the absolute measurement difference is small, so there is no practical meaning in clinical practice. There was no significant difference in detrusor pressure measured during voiding phase, which indicated that the urodynamic judgment and clinical conclusions of the two systems are highly consistent in judgment of the detrusor contractility and the bladder outlet obstruction.

Objective:To summarize long-term outcome of sacral neuromodulation (SNM) for refractory interstitial cystitis/bladder pain syndrome (IC/BPS).Methods:Between January 2013 and October 2020, 28 patients with IC / BPS who received SNM in Beijing Chaoyang Hospital and Hebei Yanda Hospital were retrospectively analyzed. There were 5 males and 23 females, with median age 63.00 (47.50, 66.75) years old. The urgency score was 4 (3, 4) points, 24-hour micturition frequency was 26 (20.50, 32.50) times, nocturia was 9 (7, 12) times, single urine volume was 59.00 (41.25, 79.50) ml, VAS score was 9.0 (8.0, 9.0) points, O′Leary-Sant score was 31.00 (20.25, 33.00) points, and single maximum urine volume was 100.0 (80.0, 127.5) ml. The improvement of symptoms before operation, test period and last follow-up were compared.Results:The urgency score was 2 (1, 3), the 24-hour micturition frequency was 17.00 (15.00, 22.75), the frequency of nocturia was 5.5 (4.0, 7.0), the single urine volume was 87.50 (70.25, 110.00) ml, the VAS score was 4.0 (3.0, 6.0) and the O′Leary-Sant score was 20.00 (17.00, 23.00) in 28 patients during the test period, which were significantly improved compared with those before operation ( P < 0.05). There was no significant difference in the single maximum urine volume of 135.0 (102.5, 160.0) ml between the two groups ( P > 0.05). 28 patients received SNM Ⅱ permanent stimulator implantation. The median follow-up time was 29.5 (21.25, 61.75) months. Among the 28 patients, 3 patients underwent cystectomy and ileal conduit after removal of the complete SNM system due to the unsatisfied results. Twenty-five cases (89.3%) were still treated with SNM. Among them, 6 cases accepted combinative therapy of oral medicine (antihistamines, sodium pentose polysulfate, hormones, immunosuppressants, etc.). Two cases accepted combinative therapy of intravesical instillation, including heparin in one case and sodium hyaluronate in the other one. Three cases accepted combinative therapy of botulinum toxin injection.One case accepted combinative therapy of bladder augmentation. Two cases accepted combinative therapy of traditional Chinese medicine (TCM). One case accepted combinative therapy of oral medicine and TCM. The remaining 10 cases didn't accept any treatment. Among them, 3 cases were still treated with SNM even though they were not satisfied with the effect, including 1 case due to electrode displacement. At the last follow-up of 25 patients, the urgency score was 2 (1, 3), the 24-hour micturition frequency was 16.50 (13.00, 19.75), the frequency of nocturia was 5.5 (4.0, 9.0), the single urine volume was 105.0 (72.5, 120.0) ml, the VAS score was 4.5 (3.0, 6.0) and the O'Leary Sant score was 16.00 (14.00, 22.50), which were significantly improved compared with those before operation ( P < 0.05), but no difference with those during test period ( P>0.05). There was no significant difference in the single maximum urine volume of 125.0 (102.5, 150.0) ml at the last follow-up compared with preoperative and test period ( P>0.05). Conclusions:As a treatment option for refractory IC / BPS, SNM can improve the symptoms of most patients and maintain good long-term efficacy combined with other.

OBJECTIVE: To analyze the current status of diagnosis and management of acute appendicitis (AA) in China. METHODS: Questionnaire survey was used to retrospectively collect data of hospitalized patients with AA from 43 medical centers nationwide in 2017 (Sort by number of cases provided: Jinling Hospital of Medical School of Nanjing University, The First Affiliated Hospital of Xinjiang Medical University, Lu'an People's Hospital, Tengzhou Central People's Hospital, Dalian Central Hospital, The Affiliated Hospital of Xuzhou Medical University, Dongying People's Hospital, Jinjiang Hospital of Traditional Chinese Medicine, Huangshan Shoukang Hospital, Xuyi People's Hospital, Nanjing Jiangbei People's Hospital, Lanzhou 940th Hospital of PLA, Heze Municipal Hospital, The First College of Clinical Medical Science of China Three Gorges University, Affiliated Jiujiang Hospital of Nanchang University, The Second People's Hospital of Hefei, Affiliated Central Hospital of Shandong Zaozhuang Mining Group, The Third People's Hospital of Kunshan City, Xuzhou First People's Hospital, The 81st Group Army Hospital of PLA, Linyi Central Hospital, The General Hospital of Huainan Eastern Hospital Group, The 908th Hospital of PLA, Liyang People's Hospital, The 901th Hospital of Joint Logistic Support Force, The Third Affiliated Hospital of Chongqing Medical University, The Fourth Hospital of Jilin University, Harbin Acheng District People's Hospital, The First Affiliated Hospital of Zhengzhou University, Nanjing Luhe People's Hospital, Taixing Municipal People's Hospital, Baotou Central Hospital, The Affiliated Hospital of Nantong University, Linyi People's Hospital, The 72st Group Army Hospital of PLA, Zaozhuang Municipal Hospital, People's Hospital of Dayu County, Taixing City Hospital of Traditional Chinese Medicine, Suzhou Municipal Hospital, Beijing Guang'anmen Hospital, Langxi County Hospital of Traditional Chinese Medicine, Nanyang Central Hospital, The Affiliated People's Hospital of Inner Mongolia Medical University).The diagnosis and management of AA were analyzed through unified summary. Different centers collected and summarized their data in 2017 and sent back the questionnaires for summary. RESULTS: A total of 8 766 AA patients were enrolled from 43 medical centers, including 4 711 males (53.7%) with median age of 39 years and 958 (10.9%) patients over 65 years old. Of 8 776 patients, 5 677 cases (64.6%) received one or more imaging examinations, and the other 3 099 (35.4%) did not receive any imaging examination. A total of 1 858 (21.2%) cases received medical treatment, mainly a combination of nitroimidazoles (1 107 cases, 59.8%) doublet regimen, followed by a single-agent regimen of non-nitroimidazoles (451 cases, 24.4%), a nitroimidazole-free doublet regimen (134 cases, 7.2%), a triple regimen of combined nitroimidazoles (116 cases, 6.3%), nitroimidazole alone (39 cases, 2.1%) and nitroimidazole-free triple regimen (3 cases, 0.2%). Of the 6 908 patients (78.8%) who underwent surgery, 4 319 (62.5%) underwent laparoscopic appendectomy and 2589 (37.5%) underwent open surgery. Ratio of laparotomy was higher in those patients under 16 years old (392 cases) or over 65 years old (258 cases) [15.1%(392/2 589) and 10.0%(258/2 589), respectively, compared with 8.5%(367/4 316) and 8.0%(347/4 316) in the same age group for laparoscopic surgery, χ²=91.415, P<0.001; χ²=15.915,P<0.001]. Patients with complicated appendicitis had higher ratio of undergoing open surgery as compared to those undergoing laparoscopic surgery [26.7%(692/2 589) vs. 15.6%(672/4 316), χ²=125.726, P<0.001].The cure rates of laparoscopic and open surgery were 100.0% and 99.8%(2 585/2 589) respectively without significant difference (P=0.206). Postoperative complication rates were 4.5%(121/2 589) and 4.7%(196/4 316) respectively, and the difference was not statistically significant (χ²=0.065, P=0.799). The incidence of surgical site infection was lower (0.6% vs. 1.7%, χ²=17.315, P<0.001), and hospital stay was shorter [6(4-7) days vs. 6(5-8) days, U=4 384 348.0, P<0.001] in the laparoscopic surgery group, while hospitalization cost was higher (median 12 527 yuan vs. 9 342 yuan, U=2 586 809.0, P<0.001). CONCLUSIONS The diagnosis of acute appendicitis is still clinically based, supplemented by imaging examination. Appendectomy is still the most effective treatment at present. Laparoscopic appendectomy has become the main treatment strategy, but anti-infective drugs are also very effective.
Acute Disease ; Adolescent ; Adult ; Aged ; Anti-Bacterial Agents ; therapeutic use ; Appendectomy ; Appendicitis ; diagnosis ; therapy ; China ; Female ; Health Care Surveys ; Humans ; Laparoscopy ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

Objective To investigate the clinical value of CT spectral imaging parameters in evaluating the liver function in patients with different types of Budd-Chiari syndrome (BCS),by comparing the normalized iodine concentration (NIC) and the slope of spectral curve in liver segment Ⅰ-Ⅷ,portal vein (PV),hepatic vein (HV),inferior vena cava (IVC) and spleen.Methods Eighty-one patients with BCS underwent spectral CT angiography.NIC,spectral decay curve and the slope of spectral curve of liver segment Ⅰ-Ⅷ in portal venous phase,PV,HV,IVC and spleen were measured and calculated.Clinical indicators of liver function including prothrombin time (PT),albumin (ALB),total bilirubin (TBIL),aspartate transaminase (AST),alanine transaminase (ALT) were recorded.Quantitative data were analyzed using One-way ANOVA.Pearson correlation analysis was used to evaluate the correlation of liver NIC and clinical liver function indexes.Results PT and TBIL were negatively correlated with liver NIC and there was a positive correlation between ALB and liver NIC (P＜0.05).The differences of NIC among the three types of BCS in liver segment Ⅱ-Ⅵ,HV,IVC and spleen were statistically significant (P＜0.05) and the difference of slopes of the spectral curves among three types of BCS in liver segment Ⅱ-V and spleen was statistically significant (P＜0.05).Conclusion Combined use of spectral CT multi-site and multi-parameter imaging may be useful in the evaluation of liver function in patients with BCS.