Objective:To explore the clinical efficacy of targeted epidural space block combined with acupotomy in the treatment for lumbar disc herniation(LDH)under the monitor of X-ray image,and to analyze the safety of its operation.Methods:A total of 60 LDH patients who admitted to Department of Pain,Jiangyin Affiliated Hospital of Nanjing University of Chinese Medicine from January 2022 to September 2023 were selected,and they were randomly divided into observation group and control group as random number table,with 30 cases in each group.The observation group adopted targeted epidural space block combined with acupotomy under monitor with X-ray for anterior epidural space,while the control group adopted conventionally epidural block,all of which were treated only once.The Visual Analogue Scale(VAS)scores and Oswestry Disability Index(ODI)scores of two groups before treatment and at the 3rd day,7th day and 30th day after treatment were compared.At the 30th day after treatment,the curative effects of two groups were evaluated according to ODI scores,at the same time,the safe distance between puncture and acupotomy in patients of observation group was analyzed.Results:The effective rates of the treatment of observation group and control group were respectively 96.67%and 70%,and the difference of that between the two groups was statistically significant(x2=7.680,P<0.05).The VAS scores of the two groups at the 3rd day,7th day and 30th day after treatment were lower than those before treatment,and the observation group(2.30±0.87),(1.53±0.86)and(1.47±0.81)were lower than the control group(4.43±0.89),(2.23±0.89)and(4.27±0.82),the difference was statistically significant(t=9.374,3.098,13.306,P<0.05).The ODI scores of the two groups were at the 3rd day,7th day and 30th day after treatment were lower than those before treatment,and the differences of them between two groups were statistically significant(t=7.112,10.690,10.151,P<0.05).In 30 patients of observation group,the gap between the dural sac and the inner edge of facet joint on the affected side was larger than 4.0mm in 25 cases,and all of them can safely conduct puncture with targeting.Conclusion:The targeted epidural space block combined with acupotomy by adopting monitor with X-ray image can effectively improve the symptom of pain,and activities of daily life of LDH patients,which treatment is safe and effective.

From the natural-philosophical model of medicine in ancient Greece to the modern bio-psycho-social par-adigm,the evolution of medical models has always been shaped by philosophy.In classical antiquity,medicine and philosophy were closely intertwined;the natural-philosophical model,exemplified by Hippocrates,emphasized the human body as an integrated whole.During the Renaissance,the rise of experimental science challenged traditional philosophical systems and pushed medicine toward empirical investigation.In the late twentieth century,the bio-psycho-social model emerged to address the limitations of the purely biomedical approach.In the twenty-first centu-ry,the advent of artificial intelligence is driving a new transformation in medicine and continually prompting reflec-tion on the future direction of medical models and their underlying philosophical significance.

Objective To investigate the efficacy and safety of blank microspheres combined with microcoils in treating hemopty-sis due to arteriae bronchiales(BA)malformation during bronchial arterial embolization(BAE).Methods A retrospective analysis was conducted on the preoperative data,embolization materials,technical success rate,clinical success rate,postoperative recurrence rate,and complications of 87 patients who underwent BAE using blank microspheres for hemoptysis due to BA malformation.Results There were 87 patients in this study,and BA computed tomography angiography(CTA)classification was as follows:32 cases(36.78％)of type Ⅰ,23 cases(26.44％)of type Ⅱ,19 cases(21.84％)of type Ⅲ,and 13 cases(14.94％)of other types(Ⅳ-Ⅸ).A total of 171 blood vessels were embolized in 87 patients,including 16 ectopic BA,and 130 embolized microspheres,including 104 microspheres of 500-700 μm and 26 of 700-900 μm.There were 265 microcoils,with a technical success rate of 100％,a 24 h clinical success rate of 100％,and a 30 d clinical success rate of 98.85％.The recurrence rate was 3.45％ at 6 months,5.75％ at 12 months,and 8.05％ at 24 months.Postopera-tive complications(Clavien-Dindo classification):complications of grade Ⅰ,embolic syndrome recurrence rate was 8.05％,chest pain incidence was 3.45％,dysphagia incidence was 2.30％,BA injury incidence was 3.45％;complications of grade Ⅳ,paraplegia inci-dence was 1.15％.Conclusion The use of blank microspheres combined with microcoils in the treatment of hemoptysis caused by BA malformation has high safety and clear efficacy.

OBJECTIVE: To observe the effects of acupoint catgut embedding (ACE) on gut microbiota and fecal short-chain fatty acids (SCFAs) levels in patients with Parkinson's disease (PD) with constipation. METHODS: A total of 80 PD patients with constipation were randomly divided into an observation group and a control group, 40 cases in each group. Additionally, 40 healthy individuals were recruited as a healthy control group. The control group received conventional Western medical treatment for PD combined with polyethylene glycol (PEG), once daily for eight weeks. The observation group received additional ACE treatment at bilateral Tianshu (ST25), Zusanli (ST36), and Shangjuxu (ST37), once every two weeks for eight weeks. The healthy control group received no intervention. The spontaneous bowel movements (SBMs) per week and patient assessment of constipation quality of life (PAC-QOL) scores were assessed at baseline and after treatment in the two groups. Fecal samples were collected at the end of treatment for the observation and the control groups and at baseline for the healthy control group. Gut microbiota composition and diversity were analyzed using 16S rRNA method, and SCFA levels were measured using high-performance liquid chromatography (HPLC). RESULTS: Compared before treatment, the observation group showed a significant increase in SBMs (P<0.01), and PAC-QOL scores including physical discomfort, psychosocial discomfort, worry and concern, and total score were significantly reduced (P<0.01) after treatment; the control group also showed a reduction in PAC-QOL total score after treatment (P<0.01). After treatment, the observation group had significantly more SBMs (P<0.01), and lower PAC-QOL physical discomfort, psychosocial discomfort, worry and concern scores, and total score (P<0.01), and higher PAC-QOL satisfaction score (P<0.01) than the control group. Compared with the healthy control group, the control group showed decreased Chao1 and Ace indices (P<0.01). Compared with the healthy control group, the relative abundance of Prevotella and Roseburia was increased (P<0.05), while that of Enterobacter and Ruminococcus torques (six species in total) was decreased (P<0.05) in the control group. Compared with the control group, the observation group had increased relative abundance of Dialister, Parabacteroides, and Ruminococcus torques (P<0.05), and decreased relative abundance of Prevotella and Eubacterium ruminantium (P<0.05). Compared with the healthy control group, the control group had increased fecal SCFA levels (P<0.05); compared with the control group, the observation group had reduced fecal SCFA levels (P<0.05). Compared with the healthy control group, acetic acid, propionic acid, and butyric acid levels were elevated in the control group (P<0.05); compared with the control group, acetic acid, propionic acid, and butyric acid levels were decreased in the observation group (P<0.05). CONCLUSION ACE could increase spontaneous bowel movements and improve the quality of life in PD patients with constipation, which may be related to the regulation of gut microbiota composition and SCFA levels.
Humans ; Constipation/metabolism* ; Male ; Gastrointestinal Microbiome ; Acupuncture Points ; Female ; Middle Aged ; Parkinson Disease/complications* ; Aged ; Fatty Acids, Volatile/metabolism* ; Catgut ; Feces/microbiology* ; Acupuncture Therapy ; Quality of Life ; Adult

Objective To investigate the efficacy and safety of blank microspheres combined with microcoils in treating hemopty-sis due to arteriae bronchiales(BA)malformation during bronchial arterial embolization(BAE).Methods A retrospective analysis was conducted on the preoperative data,embolization materials,technical success rate,clinical success rate,postoperative recurrence rate,and complications of 87 patients who underwent BAE using blank microspheres for hemoptysis due to BA malformation.Results There were 87 patients in this study,and BA computed tomography angiography(CTA)classification was as follows:32 cases(36.78％)of type Ⅰ,23 cases(26.44％)of type Ⅱ,19 cases(21.84％)of type Ⅲ,and 13 cases(14.94％)of other types(Ⅳ-Ⅸ).A total of 171 blood vessels were embolized in 87 patients,including 16 ectopic BA,and 130 embolized microspheres,including 104 microspheres of 500-700 μm and 26 of 700-900 μm.There were 265 microcoils,with a technical success rate of 100％,a 24 h clinical success rate of 100％,and a 30 d clinical success rate of 98.85％.The recurrence rate was 3.45％ at 6 months,5.75％ at 12 months,and 8.05％ at 24 months.Postopera-tive complications(Clavien-Dindo classification):complications of grade Ⅰ,embolic syndrome recurrence rate was 8.05％,chest pain incidence was 3.45％,dysphagia incidence was 2.30％,BA injury incidence was 3.45％;complications of grade Ⅳ,paraplegia inci-dence was 1.15％.Conclusion The use of blank microspheres combined with microcoils in the treatment of hemoptysis caused by BA malformation has high safety and clear efficacy.

Objective:To explore the clinical efficacy of targeted epidural space block combined with acupotomy in the treatment for lumbar disc herniation(LDH)under the monitor of X-ray image,and to analyze the safety of its operation.Methods:A total of 60 LDH patients who admitted to Department of Pain,Jiangyin Affiliated Hospital of Nanjing University of Chinese Medicine from January 2022 to September 2023 were selected,and they were randomly divided into observation group and control group as random number table,with 30 cases in each group.The observation group adopted targeted epidural space block combined with acupotomy under monitor with X-ray for anterior epidural space,while the control group adopted conventionally epidural block,all of which were treated only once.The Visual Analogue Scale(VAS)scores and Oswestry Disability Index(ODI)scores of two groups before treatment and at the 3rd day,7th day and 30th day after treatment were compared.At the 30th day after treatment,the curative effects of two groups were evaluated according to ODI scores,at the same time,the safe distance between puncture and acupotomy in patients of observation group was analyzed.Results:The effective rates of the treatment of observation group and control group were respectively 96.67%and 70%,and the difference of that between the two groups was statistically significant(x2=7.680,P<0.05).The VAS scores of the two groups at the 3rd day,7th day and 30th day after treatment were lower than those before treatment,and the observation group(2.30±0.87),(1.53±0.86)and(1.47±0.81)were lower than the control group(4.43±0.89),(2.23±0.89)and(4.27±0.82),the difference was statistically significant(t=9.374,3.098,13.306,P<0.05).The ODI scores of the two groups were at the 3rd day,7th day and 30th day after treatment were lower than those before treatment,and the differences of them between two groups were statistically significant(t=7.112,10.690,10.151,P<0.05).In 30 patients of observation group,the gap between the dural sac and the inner edge of facet joint on the affected side was larger than 4.0mm in 25 cases,and all of them can safely conduct puncture with targeting.Conclusion:The targeted epidural space block combined with acupotomy by adopting monitor with X-ray image can effectively improve the symptom of pain,and activities of daily life of LDH patients,which treatment is safe and effective.

Objective To observe the value of shear wave elastography(SWE)for evaluating hepatic iron overload in children with β-thalassemia major(β-TM),as well as the correlations of relative parameters with MR T2*value and serum ferritin.Methods Totally 96 children with β-TM and 100 healthy children(control group)were retrospectively enrolled.Children with β-TM were divided into hematopoietic stem cell transplantation(HSCT)group(n=41)or non-HSCT group(n=55)according to underwent HSCT or not.SWE parameters were compared among groups.Spearman correlation was performed to observe the correlations of liver shear wave velocity with MR T2*value and serum ferritin,as well as Young's modulus with MR T2*value and serum ferritin in children with β-TM.Results Liver shear wave velocity(LSWV)and Young's modulus in HSCT group and non-HSCT group were all higher than those in control group(all P＜0.001).No significant difference of LSWV nor Young's modulus was found between HSCT group and non-HSCT group(both P＞0.05).SWE parameters of children with β-TM were moderately and negatively correlated with MR T2*value(r=-0.501,P＜0.05;r=-0.514,P＜0.05),while weakly and positively correlated with serum ferritin(r=0.488,P＜0.05;r=0.470,P＜0.05).Conclusion SWE was helpful for evaluating hepatic iron overload in children with β-TM,with parameters being negatively correlated with MR T2*value and positively correlated with serum ferritin.

Irritable bowel syndrome(IBS)is accompanied by impaired intestinal mucosal barrier,and there is currently no ideal drug therapy.Acupuncture has obvious advantages in protecting intestinal mucosal barrier of IBS,but the molecular biological mechanism needs to be further studied.Based on the overall intestinal homeostasis in the"flora-intestinal epithelial dialogue"study to repair damaged intestinal mucosal barrier has become a hot research in this field.Therefore,based on the frontier basis,this paper discusses the feasibility mechanism of acupuncture in repairing IBS intestinal mucosal barrier injury from the perspective of intestinal flora-short-chain fatty acid-intestinal PPAR γ pathway-mediated intestinal epithelial cell metabolic reprogramming,in order to interpret the scientific connotation of acupuncture in repairing intestinal mucosal barrier injury,and provide a scientific basis for acupuncture therapy to play a greater role in public health care and for the modernization of traditional Chinese medicine.

Irritable bowel syndrome(IBS)is accompanied by impaired intestinal mucosal barrier,and there is currently no ideal drug therapy.Acupuncture has obvious advantages in protecting intestinal mucosal barrier of IBS,but the molecular biological mechanism needs to be further studied.Based on the overall intestinal homeostasis in the"flora-intestinal epithelial dialogue"study to repair damaged intestinal mucosal barrier has become a hot research in this field.Therefore,based on the frontier basis,this paper discusses the feasibility mechanism of acupuncture in repairing IBS intestinal mucosal barrier injury from the perspective of intestinal flora-short-chain fatty acid-intestinal PPAR γ pathway-mediated intestinal epithelial cell metabolic reprogramming,in order to interpret the scientific connotation of acupuncture in repairing intestinal mucosal barrier injury,and provide a scientific basis for acupuncture therapy to play a greater role in public health care and for the modernization of traditional Chinese medicine.

Objective To observe the effect of moxibustion of"Zusanli"and"Ganshu"on the intestinal flora of colorectal cancer cells liver metastasis in nude mice and its possible mechanism was explored.Methods HCT116-GFP colon cancer cells were inoculated by spleen injection,sixty SPF BALB/c male nude mice were divided into model control group,Pre-Mox group,Post-Mox group,Pre-Post-Mox group.Bilateral"Ganshu(BL18)"and"Zusanli(ST36)"acupoints were selected for moxibustion intervention for once a day for 10 minutes each time.the tumor formation rate,liver metastasis rate and the number of tumor of each group were calculated.Furthermore,16S rRNA analysis was used to assess their microbial diversity.Results Moxibustion intervention can significantly reduce the rate of liver metastasis,reduce the number of metastatic foci.Compared with the model control group,Lactobacillus_reuteri and Robinsoniella_peoriensis were significantly lower in Pre-Mox group(P<0.05).Lactobacillus_gasseri decreased significantly,Clostridium_cocleatum and Erysipelatoclostrdum_ramosum multiplex increased significantly in the Post-Mox group(P<0.01).Pre-Post-Mox mice had significantly decreased levels of Lactobacillus_gasseri,and Clostridium_cocleatum,Akkermansia_muciniphila and Clostridium_cocleatum were significantly increased(P<0.05).LEfSe Difference analysis showed that the Pre-Mox group was mainly changed by Coprobacillus;the Post-Mox group was marked by Muribaculaceae and erysipelas;the Pre-Post-Mox group took Verrucomicrobia,Akkermansia_muciniphila and erysipelas as signs.Conclusion Moxibustion could exert an inhibitory effect on CRC liver metastasis,especially the 5-week Pre-PostMox treatment showed the best inhibitory.The potential mechanism might rely on the alteration of microbiota diversity and composition.