Acquired paralytic strabismus is a common neuromuscular disorder in adults,characterized by diplopia, visual confusion, impaired ocular motility, and ocular deviation, which severely affects the patient's quality of life and overall health. The disease has a complex etiology, encompassing multiple pathological mechanisms such as vascular pathologies, trauma, inflammation, neoplasms, and immune-related disorders. Treatment primarily focuses on addressing the underlying cause. While conventional Western approaches, such as medication and surgery, can alleviate symptoms, some carry the risk of adverse effects, and their long-term recurrence rates warrant careful consideration. Traditional Chinese medicine utilizes distinctive therapies such as herbal medicine, acupuncture, and other adjunctive therapies, which have shown promising therapeutic effects but are constrained by a lack of high-quality evidence from large-scale randomized controlled trials. This review systematically summarizes recent advances in the etiological classification and traditional Chinese and Western medical treatments of acquired paralytic strabismus. It innovatively summarizes the clinical features associated with different causes, analyzes current therapeutic strategies and research landscape, aiming to inform clinical practice and suggest future research directions.

OBJECTIVE: To observe the difference for vascular dementia among flipping moxibustion of medicine at acupoints in governor vessel combined with acupuncture, simple medicine and simple acupuncture. METHODS: A total of 120 patients with vascular dementia were randomly assigned into a combination group, a flipping moxibustion group and an acupuncture group, 40 cases in each one, with 2 patients dropping respectively. Flipping moxibustion was used at the acupoints of group A on Monday and at the acupoints of group B on Friday in the flipping moxibustion group. The acupoints of group A were Baihui (GV 20), Dazhui (GV 14), Shenzhu (GV 12), Zhiyang (GV 9), Jizhong (GV 6), Mingmen (GV 4), Yaoyangguan (GV 3), and the acupoints of group B were Fengfu (GV 16), Taodao (GV 13), Shendao (GV 11), Jinsuo (GV 8), Xuanshu (GV 5), Changqiang (GV 1). Acupuncture was used in the acupuncture group at the main acupoints of Baihui (GV 20), Sishencong (EX-HN 1), Neiguan (PC 6), Zusanli (ST 36), Taixi (KI 3) and Xuanzhong (GB 39), matched with the acupoints based on syndrome differentiation, 30 min a time, once a day, continuous 5 times a week. The above two methods were applied in the combination group. All the treaments were for 4 weeks. The indexes were observed before and after treatment, including syndrome differentiationof TCM scale for vascular dementia (SDSVD), simple mental state scale (MMSE), self-care ability of daily life scale (ADL). The clinical effects and safety were evaluated. RESULTS: After treatment, the total effective rate in the combination group was 89.5% (34/38); the rate in the flipping moxibustion group was 65.8% (25/38); the rate in the acupuncture group was 63.2% (24/38). The difference among groups was statistically significant (<0.05). The effect in the combination group was better than those in the flipping moxibustion group and in the acupuncture group (both <0.05). There was no statistically significant difference between the flipping moxibustion group and the acupuncture group (>0.05). The SDSVD scores after treatment were lower and the MMSE and ADL scores after treatment were higher than those before treatment in the three groups (all <0.01), with better results on the above three scores in the combination group than those in the other two groups (<0.05, <0.01), and the differences on the three scores between the flipping moxibustion group and the acupuncture group were not statiatically significant (all >0.05). The treatment in the three groups was safe, without stastical significance (>0.05). CONCLUSION The effect of flipping moxibustion combined with acupuncture for vascular dementia is better than those of simple flipping moxibustion and simple acupuncture. The combination treatment achieves better effect on TCM syndrome, cognitive function and daily activity ability than the other two simple treatment.
Activities of Daily Living ; Acupuncture Points ; Dementia, Vascular ; Humans ; Moxibustion

Background:A recent perspective European study has shown that Chronic Liver Failure-Consortium Organ Failure score(CLIF-C OFs)is an effective diagnostic criteria for acute-on-chronic liver failure(ACLF)in alcoholic or hepatitis C virus patients with acute decompensation(AD). Aims:To assess the efficacy of CLIF-C OFs for distinguishing ACLF in non-hepatitis B virus(HBV)-related chronic liver disease patients with AD. Methods:A total of 274 consecutive non-HBV-related chronic liver disease patients with AD from Jan. 2005 to Dec. 2010 at Shanghai Ren Ji Hospital were enrolled. Patients were divided into three groups:ACLF at admission,ACLF developed within 28-day and non-ACLF according to CLIF-C OFs criteria. Clinical and biochemistry characteristics,severity of the disease and 28-day and 90-day mortality data between ACLF and non-ACLF groups were analyzed. Results:Of the patients assessed,40 had ACLF at admission,27 had ACLF developed within 28-day,207 remained not having ACLF. Patients in ACLF group had higher TB,Cr,INR,ALT,AST,ALB,WBC,score of Child-Pugh,CTP,MELD,MELD-Na than non-ACLF patients(P <0. 05),and were younger in age(P < 0. 01). Incidences of hepatic,renal,cerebral,coagulation,circulation and lung failure,28-day mortality,90-day mortality were significantly higher in ACLF group than in non-ACLF patients( P <0. 01). However,no significant differences were seen in the characteristics mentioned above between ACLF at admission group and ACLF developed at 28-day group(P > 0. 05). TB level at admission and infection occurred within 28-day were the risk factors for developing ACLF(P < 0. 05). Conclusions:ACLF constitutes a more severe subgroup in non-HBV-related chronic liver disease patients with AD,and CLIF-C OFs could help to distinguish ACLF patients out from non-HBV-related chronic liver disease patients with AD.