This paper reviews the published articles of recent years on the application of deep learning methods in automatic localization of acupoint, and summarizes it from 3 key links, i.e. the dataset construction, the neural network model design, and the accuracy evaluation of acupoint localization. The significant progress has been obtained in the field of deep learning for acupoint localization, but the scale of acupoint detection needs to be expanded and the precision, the generalization ability, and the real-time performance of the model be advanced. The future research should focus on the support of standardized datasets, and the integration of 3D modeling and multimodal data fusion, so as to increase the accuracy and strengthen the personalization of acupoint localization.
Deep Learning ; Acupuncture Points ; Humans ; Neural Networks, Computer

This paper presents an automatic acquisition and analytic procedure of acupuncture manipulation based on optical navigation, aiming at solving the shortcomings of existing acquisition methods of acupuncture manipulation. An acquisition holder installed at the handle tail of filiform needle was designed to display the movement trajectory of the needle during acupuncture delivery by collecting the movement trajectory of holder. The 3-month old male Bama miniature pig was selected as the experimental subject, and 6 points, "Bojian" "Qiangfeng" "Housanli" "Xiaokua" "Huiyang" (BL35) and "Baihui" (GV20), were selected during acupuncture manipulation. The optical navigation system was used to collect the real-time data, and these data were per-processed and analyzed using mean filtering and Fourier transform. The acupuncture procedure was divided into 3 stages, inserting, lifting-thrusting, and twisting. The results showed that the accuracy was 96.3% at lifting-thrusting stage, and that was 100.0% at twisting stage. The decomposition effect of the entire procedure was satisfactory. This study provides a new approach to the quantitative analysis of acupuncture manipulation. In the future, it needs to further optimize the algorithm and expand the sample size so as to improve the accuracy of this analytic technique.
Acupuncture Therapy/methods* ; Male ; Animals ; Swine ; Acupuncture Points ; Humans ; Swine, Miniature ; Needles

Objective This study aimed to develop an experimental animal platform for evaluating the feasibility and safety of intelligent acupuncture robots and to lay the foundation for further research.Methods Six 2-month-old Guangxi Bama miniature pigs were used as experimental subjects for acupuncture verification after anesthesia.First,manual acupuncture verification was carried out.Six acupoints were selected for each experimental animal and the needles were left for 20 min after the lifting,inserting,and twisting manipulation.Before and after controls were included.The experiment was carried out for 28 days,and each experiment was conducted once every 2 days for a total of 10 times.After verification of manual acupuncture,a point 10 mm from each of the six selected acupoints was selected,with a total of 12 points,and acupuncture operations were carried out on the experimental animals using the intelligent acupuncture module of the acupuncture robot at different frequencies and angles,to further verify the stability and feasibility of the animal platform.Results Routine safety-related blood indicators and blood biochemistry indicators after the procedure were normal and stable compared with those before the procedure.The average heart rate of the animals was 124 beats/min,the average blood pressure was 87/36 mmHg,and the average body temperature of was 36℃at a room temperature of 25℃,with no significant change in body temperature during and after the experiment.On the basis of this experimental platform,acupuncture manipulation using the intelligent acupuncture module of the acupuncture robot was completed successfully,with no abnormalities related to acupuncture such as bending,breaking,or stagnation of needles during the experimental process,and the experimental animals showed no obvious abnormalities.Conclusions This study established a stable experimental animal platform for evaluating the feasibility and safety of acupuncture carried out by intelligent acupuncture robots,based on the existing experimental method of miniature pigs.These result lay a foundation for further research related to the use of intelligent acupuncture robots.

OBJECTIVE: To evaluate the performance of a newly developed intelligent acupuncture robot that simulates human manual acupuncture techniques through an animal experiment using miniature pigs. METHODS: Two 3-month-old Bama miniature pigs were selected. One pig was used for the manual needling techniques of the practitioner, and the other pig was used for the intelligent acupuncture robot. The acupoints selected were "Qiangfeng" "Bojian" "Xiaokua" "Huiyang" (BL 35) and "Baihui" (GV 20), with a straight insertion depth of 25-35 mm. The manipulation techniques, including lifting-thrusting and twisting at a frequency of 90 times/min, were applied for 1 min, with 30 s each for lifting-thrusting (10 mm amplitude) and twisting (180° angle). The practitioner's needling techniques were captured using an optical motion capture system, and the collected data were input into the intelligent acupuncture robot for replication on the second miniature pig. A complete needling session of five acupoints was considered one round, and three rounds were performed per session, every other day, for a total of five sessions, completing 15 rounds. The Fréchet distance method was used to compare the robot's replicated needling data with the practitioner's data, and curve fitting analysis was conducted to evaluate the robot's performance and precision. RESULTS: The intelligent acupuncture robot achieved a total completion rate of 96.00% for 75 needling operations, with a non-completion rate of 4.00%. The robot's replication of the practitioner's needling techniques showed a good fit, with many characteristic points overlapping. The average Fréchet distance was 18.67. The Fréchet distance for the lifting-thrusting and twisting techniques at Baihui (GV 20) and "Huiyang" (BL 35) acupoints was smaller than that at "Xiaokua" and "Qiangfeng" points (P<0.01). The accuracy of the lifting-thrusting technique at "Xiaokua" and "Qiangfeng" acupoints was lower than the twisting technique (P<0.01). CONCLUSION The intelligent acupuncture robot is able to replicate the pre-recorded manual needling parameters with a high degree of accuracy.
Animals ; Swine ; Swine, Miniature ; Acupuncture Therapy/methods* ; Robotics/instrumentation* ; Humans ; Acupuncture Points ; Female ; Male

Objective:To analyze the intervention effect of rehabilitation platform-based online psycho-education on patients with bipolar disorder (BD) in remission stage.Methods:In this randomized controlled study, 91 patients with BD in remission stage who attended the community health center in Xicheng District, Beijing from July to August 2021 were randomly divided into a test group (46 cases) and a control group (45 cases) according to a 1∶1 ratio using the random number table. Baseline data were collected from both groups, and the control group received conventional medication and community telephone follow-up, while the test group was given online mental health education in the form of a WeChat subscription number on this basis, including BD mental health education course push (twice a week) and disease self-management (daily recording of mood, sleep, medication, exercise and gratitude diary), and the intervention period was 6 months in both groups. During the intervention, one patient in the test group was admitted to hospital due to exacerbation of mental illness and the trial was terminated. A total of 90 cases were included in the study. The scores of Medication Adherence Rating Scale (MARS), Hamilton Depression Scale (HAMD), Young Mania Rating Scale (YMRS) and Perceived Devaluation-Discrimination Scale (PDD) were assessed at baseline, after 3 months and 6 months of intervention in both groups, respectively. And the differences in baseline data between the two groups were compared using two independent samples t test and χ2 test, and the repeated-measures ANOVA was used to compare the differences in MARS, HAMD, YMRS, and PDD scores between the two groups before and after the intervention, and to analyze the intervention effects of network mental health education based on the rehabilitation platform on patients in remission stage of BD. Results:After 6 months of intervention, MARS scores in the test group was significantly higher than that in the control group [(8.47±1.75) vs (7.47±1.85)], and was significantly higher than that at baseline (7.36±2.13) and after 3 months of intervention (8.04±1.68) (all P<0.05). YMRS and PDD scores in the test group were significantly lower than those at baseline after 3 and 6 months of intervention [YMRS, 2.0(1.0,4.0),2.0(0,3.0) vs 3.0(1.0,5.5); PDD, (31.18±4.65), (30.13±4.76) vs (32.51±4.51)] (all P<0.05); the differences in YMRS and PDD scores in the control group were not statistically significant (all P>0.05). There was no statistically significant difference in HAMD scores between the two groups before and after the intervention (all P>0.05). Conclusion:Combining mental health education based on rehabilitation platform with conventional medication and community management can significantly improve the medication compliance of patients with BD in remission stage, and improve their manic symptoms and reduce the stigma of the disease.

The research on risk factors for stroke is of great significance for the early identification of high-risk groups and the improvement of prognosis. Studies have confirmed that insulin resistance （IR） is an independent risk factor for cerebrovascular diseases. Triglyceride-glucose （TyG） index has a great potential value as a simple and reliable alternative index for IR. A relatively high TyG index is associated with increases in atherosclerosis， carotid intima-media thickness， carotid plaque instability， and the incidence rate of cardiovascular diseases. A large number of evidence has proved that TyG index can predict the risk of ischemic stroke. TyG index is independently associated with the adverse clinical outcomes of ischemic stroke， which can aggravate the deterioration of the nervous system during hospitalization and cause the recurrence of ischemic stroke. Individuals with a high TyG index are more likely to develop cerebrovascular diseases， and a potential linear dose-response relationship is observed. This article systematically summarizes the evidence for the association between TyG index and stroke and discusses the value of TyG in optimizing the risk stratification of ischemic stroke.

Objective:To evaluate the visibility of intracranial deep medullary vein (DMV) by sensitivity weighted imaging (SWI), and explore its correlation with recent small subcortical infarct (RSSI).Methods:From March 2021 to May 2022, 277 patients with cerebral small vascular disease (CSVD) confirmed by cranial MRI in Department of Neurology, Third Hospital of Hebei Medical University, were consecutively enrolled. These patients were divided into RSSI group ( n=128) and non-RSSI group ( n=149) according to RSSI presence or not within one week of onset. According to the DMV scores, these patients were divided into mild-moderate DMV group (0-12 scores, n=199) and severe DMV group (13-18 scores, n=78). The clinical and imaging data of these groups were analyzed retrospectively and compared. Multivariate Logistic regression analysis was used to determine the correlation between DMV and RSSI, as well as the independent influencing factors for DMV grading. Results:The cerebral microbleed (CMB), periventricular white matter hyperintensity (WMH) scores, deep WMH scores, total WMH scores, total CSVD burden scores, and DMV scores in patients of the RSSI group were significantly higher than those in the non-RSSI group ( P<0.05); and patients in the RSSI group had significantly younger age and significantly lower high density lipoprotein cholesterol (HDL-C) level than those in the non-RSSI group ( P<0.05). Multivariate Logistic regression analysis showed that DMV score ( OR=1.142, 95%CI: 1.026-1.271, P=0.016) was an independent influencing factor for RSSI after adjusting for HDL-C and deep WMH scores. The severe DMV group had significantly older age, statistically higher percentages of patients having history of hypertension, CMB, lacuna and moderate to severe EPVS in basal ganglia, and significantly higher periventricular WMH scores, deep WMH scores, total WMH scores, and total CSVD burden scores as compared with the mild-moderate DMV group ( P<0.05). Multivariate Logistic regression analysis showed that age ( OR=1.101, 95%CI: 1.060-1.143, P<0.001) and total CSVD burden scores ( OR=3.589, 95%CI: 2.506-5.141, P<0.001) were independent influencing factors for DMV scores. Conclusion:DMV is involved in the mechanism of RSSI, and DMV visibility can be used as an indicator to diagnose RSSI and evaluate RSSI progression.

Objective:To compare the effectiveness and recurrence rate of different types of mesh or without mesh in laparoscopic hiatal hernia repair.Methods:From Jan 2016 to Mar 2022 at the three hospital 90 patients with hiatal hernia, including 26 cases without mesh, 29 cases using synthetic mesh, and 35 cases using biological mesh underwent laparoscopic hiatal hernia repair.Results:The surgical procedures was successful in all the 90 cases without conversion to open surgeny. There were no statistically significant differences in operative time, intraoperative blood loss and postoperative hospital stay among the three groups ( P>0.05), and there were statistically significant differences in hospital cost between the group without mesh and synthetic mesh and biological mesh ( P<0.05). Long-term follow-up was achieved in 87 patients, with a follow-up rate of 96.7% (87/90), and a median follow-up time of 44 months. There were no significant differences in the incidence of postoperative complications (diarrhea, dysphagia, abdominal distension, chest pain), recurrence rate of symptoms (acid reflux, heartburn) and patient satisfaction among the three groups ( P>0.05). Conclusion:In laparoscopic hiatal hernia repair, the mesh should be carefully selected according to the specific intraoperative situation for a satisfactory clinical efficacy.

Objective:To explore the clinical efficacy and safety of repetitive transcranial magnetic stimulation (rTMS) combined with selective serotonin reuptake inhibitors (SSRIs) in the treatment of first-episode late-life depression.Methods:From June 2019 to January 2020, first-episode elderly patients with depression in Beijing Anding Hospital affiliated to Capital Medical University were screened and randomly divided into test group (true rTMS+SSRIs, n=26) and control group (rTMS sham+SSRIs, n=25) according to the random number table method. All the patients were treated for 4 weeks and followed up for 4 weeks after treatment. The test group received 20 sessions (5 sessions per week) of 10 Hz rTMS (120% of motor threshold). Hamilton Depression Scale (HAMD 17) and The Patient Health Questionnaire-9 (PHQ-9) were used to assess the clinical symptoms at the end of the 1st, 2nd, 3rd and 4th week of treatment and at the end of the 4th week of the follow-up after treatment, and the response rate and the rate of recovery were compared between the two groups,analyzed by the χ 2 test and repeated measurement analysis of variance. Results:(1) At the end of the 4th week of treatment 69.23% (18/26) subjects in the test group and 36.00% (9/25) in the control group significantly improved their depressive condition, which was defined as a more than 50% HAMD 17 reduction (χ 2=5.649, P=0.017). However, there was no significant difference between the two groups when compared the rate of recovery,which was defined as a HAMD 17 ≤7 ( P>0.05). (2) At the end of the 4th week of the follow-up, there was no significant difference in the response rate nor the rate of recovery between the two groups ( P>0.05). (3) During the entire observation period, there was an interaction between the time point and the group in HAMD 17 total score and PHQ-9 total score ( F=66.313, P=0.008; F=8.571, P<0.01). Conclusion:There might be potential advantages in the combination treatments by rTMS at 120% MT and SSRIs antidepressants for the elderly depressive patients, and the onset of efficacy is faster than that of pharmacotherapy alone, while the large sample clinical studies are still needed to confirm the benefits.

Objective:To explore the clinical efficacy and safety of repetitive transcranial magnetic stimulation (rTMS) combined with selective serotonin reuptake inhibitors (SSRIs) in the treatment of first-episode late-life depression.Methods:From June 2019 to January 2020, first-episode elderly patients with depression in Beijing Anding Hospital affiliated to Capital Medical University were screened and randomly divided into test group (true rTMS+SSRIs, n=26) and control group (rTMS sham+SSRIs, n=25) according to the random number table method. All the patients were treated for 4 weeks and followed up for 4 weeks after treatment. The test group received 20 sessions (5 sessions per week) of 10 Hz rTMS (120% of motor threshold). Hamilton Depression Scale (HAMD 17) and The Patient Health Questionnaire-9 (PHQ-9) were used to assess the clinical symptoms at the end of the 1st, 2nd, 3rd and 4th week of treatment and at the end of the 4th week of the follow-up after treatment, and the response rate and the rate of recovery were compared between the two groups,analyzed by the χ 2 test and repeated measurement analysis of variance. Results:(1) At the end of the 4th week of treatment 69.23% (18/26) subjects in the test group and 36.00% (9/25) in the control group significantly improved their depressive condition, which was defined as a more than 50% HAMD 17 reduction (χ 2=5.649, P=0.017). However, there was no significant difference between the two groups when compared the rate of recovery,which was defined as a HAMD 17 ≤7 ( P>0.05). (2) At the end of the 4th week of the follow-up, there was no significant difference in the response rate nor the rate of recovery between the two groups ( P>0.05). (3) During the entire observation period, there was an interaction between the time point and the group in HAMD 17 total score and PHQ-9 total score ( F=66.313, P=0.008; F=8.571, P<0.01). Conclusion:There might be potential advantages in the combination treatments by rTMS at 120% MT and SSRIs antidepressants for the elderly depressive patients, and the onset of efficacy is faster than that of pharmacotherapy alone, while the large sample clinical studies are still needed to confirm the benefits.