Objective:To explore the healing effects of internal heat needle and electroacupuncture on post-stroke shoulder pain and their impacts on serum interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α).Methods:From January 2023 to March 2025, 94 patients with post-stroke shoulder pain admitted to the Affiliated Hospital of Hangzhou Normal University were included and separated into two groups according to a random number table. The 47 cases in the electroacupuncture group adopted electroacupuncture, while 47 cases in the internal heat needle group adopted internal heat needle. The pre- and post-treatment limb function, quality of life, healing effect, visual analogue scale (VAS), and serum IL-6, IL-1β, and TNF-α were compared.Results:After treatment, the Constant-Murley Shoulder Scale (CMS) score, shoulder range of motion (flexion, outward rotation, extension), Fugl-Meyer Assessment-Upper Extremity (FMA-UE) score, and Modified Barthel Index (MBI) in the internal heat acupuncture group were all better than those in the electroacupuncture group:(63.45 ± 10.31) points vs. (56.51 ± 9.15) points, (136.67 ± 32.44)° vs. (109.32 ± 25.01)°, (51.64 ± 12.84)° vs. (42.95 ± 11.72)°, (34.35 ± 10.15)° vs. (29.53 ± 9.82)°, (45.63 ± 10.25) points vs. (39.16 ± 10.43) points, (83.42 ± 16.09) points vs. (74.55 ± 15.83) points, there were statistical differences ( P<0.05). While the levels of serum IL-1β, IL-6, TNF-α, and VAS score in the internal heat needle group were decreased in the electroacupuncture group: (7.39 ± 3.68) ng/L vs. (9.28 ± 4.10) ng/L, (19.25 ± 2.12) ng/L vs. (28.50 ± 2.43) ng/L, (9.55 ± 3.54) ng/L vs. (11.17 ± 3.77) ng/L,(1.69 ± 0.45) points vs. (2.13 ± 0.56) points, there were statistical differences ( P<0.05). The therapeutic effect in the internal heat needle group was significantly higher than that in the electroacupuncture group:93.62% (44/47) vs. 78.72% (37/47), there was statistical difference ( P<0.05). Conclusions:For post-stroke shoulder pain, internal heat needle therapy has a clear healing effect than electroacupuncture, and can effectively reduce the levels of inflammatory factors such as IL-1β, IL-6, and TNF-α in serum.

Objective:To explore the healing effects of internal heat needle and electroacupuncture on post-stroke shoulder pain and their impacts on serum interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α).Methods:From January 2023 to March 2025, 94 patients with post-stroke shoulder pain admitted to the Affiliated Hospital of Hangzhou Normal University were included and separated into two groups according to a random number table. The 47 cases in the electroacupuncture group adopted electroacupuncture, while 47 cases in the internal heat needle group adopted internal heat needle. The pre- and post-treatment limb function, quality of life, healing effect, visual analogue scale (VAS), and serum IL-6, IL-1β, and TNF-α were compared.Results:After treatment, the Constant-Murley Shoulder Scale (CMS) score, shoulder range of motion (flexion, outward rotation, extension), Fugl-Meyer Assessment-Upper Extremity (FMA-UE) score, and Modified Barthel Index (MBI) in the internal heat acupuncture group were all better than those in the electroacupuncture group:(63.45 ± 10.31) points vs. (56.51 ± 9.15) points, (136.67 ± 32.44)° vs. (109.32 ± 25.01)°, (51.64 ± 12.84)° vs. (42.95 ± 11.72)°, (34.35 ± 10.15)° vs. (29.53 ± 9.82)°, (45.63 ± 10.25) points vs. (39.16 ± 10.43) points, (83.42 ± 16.09) points vs. (74.55 ± 15.83) points, there were statistical differences ( P<0.05). While the levels of serum IL-1β, IL-6, TNF-α, and VAS score in the internal heat needle group were decreased in the electroacupuncture group: (7.39 ± 3.68) ng/L vs. (9.28 ± 4.10) ng/L, (19.25 ± 2.12) ng/L vs. (28.50 ± 2.43) ng/L, (9.55 ± 3.54) ng/L vs. (11.17 ± 3.77) ng/L,(1.69 ± 0.45) points vs. (2.13 ± 0.56) points, there were statistical differences ( P<0.05). The therapeutic effect in the internal heat needle group was significantly higher than that in the electroacupuncture group:93.62% (44/47) vs. 78.72% (37/47), there was statistical difference ( P<0.05). Conclusions:For post-stroke shoulder pain, internal heat needle therapy has a clear healing effect than electroacupuncture, and can effectively reduce the levels of inflammatory factors such as IL-1β, IL-6, and TNF-α in serum.

Objective:To evaluate the efficacy and outcomes of early removal of lumen-apposing metal stent (LAMS) in the treatment of pancreatic wall-off necrosis (WON).Methods:A retrospective analysis was performed on 51 patients with WON who underwent endoscopic ultrasound (EUS)-guided transluminal drainage (ETD) and direct endoscopic necrosectomy (DEN) using LAMS at Nanjing Drum Tower Hospital from January 2018 to December 2022. Patients were divided into the early removal group (within two weeks, n=24) and the traditional removal group (after two weeks, n=27) based on the timing of LAMS removal. The short-term effects, safety and long-term outcomes of WON were compared between the two groups. Results:The technical success rate of LAMS placement in 51 patients reached 100%, and all patients underwent ETD and DEN. The median number of necrosectomy sessions in the early removal group was significantly lower than in the traditional removal group, 2.0 sessions vs 3.0 sessions and the difference was statistically significant ( P<0.05). Postoperatively, 15.7% of patients required percutaneous catheter drainage (PCD) and 5.9% required surgery, with no significant difference between the two groups. The clinical success rate and mortality rate in the early removal group were 79.2% and 8.3%, respectively, compared to 81.5% and 3.7% in the traditional removal group, with no statistically significant difference. In terms of safety, the early removal group exhibited a significantly lower rate of adverse events during stent retention with statistically significant difference (12.5% vs 37.0%, P<0.05) compared to the traditional removal group. A total of 46 patients were followed up for six months. In the early removal group, the rates of disease recurrence, need for endoscopic reintervention and occurrence of long-term complications were 20.0%, 10.0% and 20.0%, respectively. These rates did not show a significant increase compared to the traditional removal group, which were 7.7%, 3.8% and 38.5%, respectively, without significant differences between the groups. Conclusions:In the treatment of WON, early removal of LAMS is safe and effective to a certain extent. In comparison to the traditional practice of removing LAMS after two weeks, early removal does not reduce clinical success rates, nor does it increase the rates of disease-related mortality, recurrence, or long-term complications. On the contrary, it may reduce the occurrence of adverse events during stent retention and decrease the number of necrosectomy procedures subsequently.