Emotional blunting is primarily characterized by a lack of emotional response to positive and negative stimuli, manifesting as a disinterest in surroundings or a cessation of caring about things used to matter. It can significantly and negatively impact patients′ work, social interactions, and family life, consequently leading to declined quality of life and fewer social responsibilities. While emotional blunting gradually attracted researchers′ interest, there is still a lack of clinical knowledge and relevant studies to date. The terms of apathy and emotional blunting have been interchangeably used when describing similar symptoms of affective disorders in previous studies. This article reviews studies on emotional blunting in various mental disorders, including assessment tools, neurobiological mechanisms, and treatment strategies, to provide a more thorough understanding and reference for clinical treatment.

Emotional blunting is primarily characterized by a lack of emotional response to positive and negative stimuli, manifesting as a disinterest in surroundings or a cessation of caring about things used to matter. It can significantly and negatively impact patients′ work, social interactions, and family life, consequently leading to declined quality of life and fewer social responsibilities. While emotional blunting gradually attracted researchers′ interest, there is still a lack of clinical knowledge and relevant studies to date. The terms of apathy and emotional blunting have been interchangeably used when describing similar symptoms of affective disorders in previous studies. This article reviews studies on emotional blunting in various mental disorders, including assessment tools, neurobiological mechanisms, and treatment strategies, to provide a more thorough understanding and reference for clinical treatment.

OBJECTIVETo compare the difference in the clinical therapeutic effects on mild and moderate lumbar disc herniation (LDH) of blood stagnation syndrome between-conducting needling technique at the governor vessel acupoints combined with electroacupuncture (EA) and conventional EA.

METHODSTwo hundred and one patients of LDH at the mild and moderate stage, differentiated as blood stagnation syndrome were randomized into an observation group (101 cases) and a control group (100 cases). In the observation group, the-conducting needling technique at the governor vessel acupoints and EA were used. The acupoints were Yaoyangguan (GV 3), Shiqizhui (EX-B 8), Huantiao (GB 30) and Yanglingquan (GB 34). Afterarrival, the-conducting needling technique was used at Yaoyangguan (GV 3) and Shiqizhui (EX-B 8); the EA was at Huantiao (GB 30) and Yanglingquan (GB 34). The treatment was given once every two days, 3 times a week. The treatment for 12 times was as one session. The observation lasted for 1 session. In the control group, the acupoints were the same as the observation group and stimulated with EA. The EA parameters, treatment frequency and duration were all the same as the observation group. The lumbar back pain score of Japanese Orthopedics Association (JOA) score before treatment, after treatment and in 3-month follow-up visit in the two groups, the infrared thermogram temperature in lumbar region and the relaxation area under curve (RAUC) before and after treatment as well as the short-term and the long-term therapeutic effects were compared between the two groups.

RESULTSThe total short-term effective rate was 89.11% (90/101) and the total long-term effective rate was 91.11% (82/90) in the observation group, and those were 86.00% (86/100) and 89.53% (77/86) in the control group respectively, without significant differences between the groups (both>0.05). The short-term clinical curative rate was 52.48% (53/101) and the long-term clinical curative rate was 55.56% (50/90) in the observation group, better than 36.00% (36/100) and 34.88% (30/86) in the control group (both<0.05). Compared with those before treatment, JOA scores were all improved after treatment and in follow-up visit in the two groups (all<0.01), without statistical significance at each time point between the two groups (all>0.05). The infrared thermogram temperature was improved after treatment in the two groups (both<0.01). The increasing amplitude in the observation group was higher than that in the control group (<0.01). The lumbar RAUC after treatment was increased apparently as compared with that before treatment in the observation group (<0.01) and larger than that in the control group (<0.01).

CONCLUSIONSThe-conducting needling technique at the governor vessel acupoints combined with EA achieve the better clinical therapeutic effects than regular EA in the treatment of mild and moderate LDH of blood stagnation sydrome.

Objective: To investigate the community promotion feasibility of superficial needling plus club swing for post-stroke motion impairment of the shoulder joint. Methods:A total of 180 cases (duration <1.5 years) with post-stroke motion impairment of the shoulder joint were recruited from three community health centers in Changning District, 60 from each community. They were randomly allocated into an observation group (n=90) and a control group (n=90). Patients in both groups received standard internal and rehabilitation care. Patients in the observation group received additional superficial needling plus club swing. The visual analogue scale (VAS) was conducted before and 60 d after the treatment to evaluate the severity of shoulder pain. The active movement of the shoulder joint and activities of daily living (ADL) were also observed. Results:There were no between-group statistical differences before the treatment (allP>0.05). After a 60-day treatment, the shoulder pain severity, active range of motion of the shoulder joint and ADL in the observation group were significantly improved than those in the control group (allP<0.01). In addition, no adverse events were reported by participants in the observation group. Conclusion:Superficial needling plus club swing plays a positive role in improving post-stroke motion impairment of the shoulder joint. This safe, reliable and economical therapy has good patient compliance and is suitable for community promotion.

Objective To investigate the efficacy of modified electrical superficial surround acupuncture in treating postherpetic neuralgia. Method One hundred and eighty-six patients with postherpetic neuralgia were randomly allocated to electrical acupuncture, superficial acupuncture and electrical superficial acupuncture groups, 62 cases each. All the three groups were given acupuncture at ashi points around the painful region. The electrical acupuncture group received electroacupuncture alone. The superficial acupuncture group received sweeping-dispersing manipulation and following 24-hour retention of the soft tube. The electrical superficial acupuncture group received sweeping-dispersing manipulation based on modified superficial acupuncture and following electroacupuncture, without retention of the soft tube after the completion of treatment. The therapeutic effects were evaluated and compared after one course of treatment. Result There was a statistically significant pre-/post-treatment difference in the VAS score in the three groups (P<0.01). There was a statistically significant post-treatment difference in the VAS score between the electrical superficial acupuncture group and the electrical acupuncture or superficial acupuncture group (P<0.01) but no between the electrical acupuncture and superficial acupuncture groups (P>0.05). The evaluation of the therapeutic effects according to WHO pain rating showed that the marked efficacy rate and the total efficacy rate were 45.2% and 82.3%, respectively, in the electrical acupuncture group, 52.3% and 88.7%, respectively, in the superficial acupuncture group and 62.9% and 91.9%, respectively, in the electrical superficial acupuncture group. There was no statistically significant difference in the total efficacy rate between the three groups (P>0.05). There was a statistically significant difference in the marked efficacy rate between the electrical acupuncture and electrical superficial acupuncture groups (P<0.05)but no between the electrical acupuncture and superficial acupuncture groups (P>0.05) and between the superficial acupuncture and electrical superficial acupuncture groups(P>0.05). Conclusion The therapeutic effect of electrical superficial acupuncture is better than that of superficial acupuncture and electrical acupuncture. Electrical superficial acupuncture is characterized by selection of few points, small number of treatments and meanwhile, avoidance of potential medical risks.

Objective To observe the clinical efficacy of qi-guiding needling plus electroacupuncture in treating intractable low back pain after lumbar disc herniation surgery and the change of infrared thermal image.Method Totally 172 patients with intractable low back pain after lumbar disc herniation surgery were randomized into a treatment group and a control group, 86 cases in each group. The treatment group was intervened by qi-guiding needling plus electroacupuncture, while the control group was by electroacupuncture alone. The infrared thermal image of the affected low back area was observed before and after intervention, and the clinical efficacies were compared between the two groups.Result The change of infrared thermal image of the affected low back area in the treatment group after intervention was significantly different from that in the control group (P<0.01). The total effective rate and the recovery-markedly-effective rate were respectively 87.2% and 66.3% in the treatment group, versus 74.4% and 37.2% in the control group, and the differences were statistically significant (P<0.05,P<0.01).Conclusion Qi-guiding needling plus electroacupuncture can mitigate the intractable low back pain after lumbar disc herniation surgery.

Objective To investigate the clinical efficacy of neck point Bailao injection as main therapy plus acupuncture for cervical spondylotic radiculopathy. Method Two hundred patients with cervical spondylotic radiculopathy were randomly allocated to treatment (neck point Bailao injection as main therapy plus acupuncture) and control (oral administration of Western medicines, e.g. nonsteroid diclofenac sodium as a main drug and meanwhile, mecobalamin tablets) groups. The therapeutic effects and pre-/post-treatment changes in clinical symptoms and signs, TCM syndrome, pains and numbness were observed in the two groups. Result The total efficacy rate was 86.0%in the treatment group and 75.0%in the control group;there was a statistically significant difference between the two groups (P<0.05). The total efficacy rate was higher in the treatment group than in the control group. There were statistically significant differences in pre-/post-treatment clinical symptom and sign score difference values between the treatment and control groups (P<0.01), indicating that the symptoms and signs improved more in the treatment group than in control group. Conclusion Both treatments can improve the clinical symptoms and signs and relieve pains in cervical spondylotic radiculopathy, but neck point Bailao injection as main therapy plus acupuncture is more effective than oral administration of Western medicines.

BACKGROUND: Matrix metal oproteinase inhibitor 1 plays an important role in the inhibition of articular cartilage degeneration and destruction.
OBJECTIVE: To observe the changes of matrix metal oproteinase inhibitor 1 expression level in synovium of knee osteoarthritis rats after treated with penetration needling of long needle.
METHODS: A total of 40 Sprague-Dawley rats were randomly assigned into normal group, penetration needling group, drug group and model group, with 10 rats in every group. 1.6% papain solution was injected into knee joint cavity of Sprague-Dawley rats. 2 weeks later, knee osteoarthritis models were established. Rats in the normal and model groups did not receive any intervention. In the penetration needling group, rats were treated by penetration needling with 0.3 mm×125.0 mm filiform needle. Rats in the drug group were intraarticularly injected with sodium hyaluronate.
RESULTS AND CONCLUSION: (1) Enzyme linked immunosorbent assay: at 4 weeks after treatment, matrix metal oproteinase inhibitor 1 expression in synovial membrane was higher in the normal group than in the model group (P < 0.05). Matrix metal oproteinase inhibitor 1 expression in synovial membrane was higher in the penetration needling group and drug group than in the model group (P < 0.05). (2) Results verified that long needle penetration therapy can effectively increase matrix metal oproteinase inhibitor 1 expression in synovial membrane of knee osteoarthritis model rats.

Objective To evaluate the short-term and long-term therapeutic efficacies of LU’s heat-producing needling (Shao Shan Huo) in treating cervical spondylotic radiculopathy (CSR). MethodTwo hundred patients with CSR were randomized into a treatment group and a control group, 100 in each group. The treatment group was intervened by using heat-producing needling method, while the control group was by regular acupuncture technique with even reinforcing-reducing manipulations. For both groups, the treatment was given once a day, 10 sessions as a treatment course. The Pain Rating Index (PRI), Present Pain Intensity (PPI), and Visual Analogue Scale (VAS) were adopted for observation before intervention and after two treatment courses. The clinical efficacies were compared between the two groups.Result Right after the intervention and in the 3-month follow-up, the VAS, PPI, and PRI scores were significantly different from that before intervention in both groups (P<0.01). There were significant differences in comparing the VAS, PPI, and PRI scores between the two groups after intervention and in the 3-month follow-up (P<0.01). The VAS, PPI, and PRI scores in the treatment group right after intervention were markedly different from that in the 3-month follow-up (P<0.01). The total effective rate was 98.0% in the treatment group versus 79.0% in the control group, and the difference was statistically significant (P<0.01).Conclusion LU’s heat-producing needling is an effective way in treating CSR, as it can significantly reduce pain intensity, and improve other symptoms and body signs.

Objective:To observe the clinical efficacy of combining tuina and Chinese herbal fumigation for chronic ankle sprain.
Methods:A total of 93 cases were randomly allocated into an observation group (n=47) and a control group (n=46) according to the table of random number. Cases in the observation group received tuina combining with Chinese herbal fumigation, whereas cases in the control group received oral blood-circulating and pain-alleviating capsules combining with Chinese herbal fumigation. Both tuina and Chinese herbal fumigation were done once every other day and 10 times made up a course of treatment. The Baird-Jackson ankle scoring system and clinical efficacy were observed after 1 course of treatment.
Results:After treatment, except for radiographic findings, there were significant intra-group differences in individual item scores of Baird-Jackson (P<0.05,P<0.01); except for ankle joint range of motion (ROM), there were significant between- group differences in individual item scores and total score (P<0.01). The excellence and good rate was 76.6% in the observation group, versus 54.4% in the control group, showing a statistical significance (P<0.05).
Conclusion:Combining Chinese herbal fumigation and tuina based on the muscle region theory can obtain better effect than combining oral blood-circulating and pain-alleviating capsules and Chinese herbal fumigation for chronic ankle sprain.