OBJECTIVE: To compare the clinical efficacy of acupuncture with Neiguan (PC6)-to-Waiguan (TE5) and esmolol on hemodynamics during anesthesia induction and postoperative nausea and vomiting. METHODS: A total of 100 patients undergoing elective laparoscopic hernia repair or gynecological surgery under general anesthesia were randomly divided into an acupuncture group (50 cases, 3 cases were eliminated) and an esmolol group (50 cases, 2 cases were eliminated). In the acupuncture group, before anesthesia induction, patients were applied to acupuncture with Neiguan (PC6)-to-Waiguan (TE5), and the needles were retained for 15 min on the right side and 30 min on the left side. Patients in the esmolol group were intravenously injected with 20 mg esmolol hydrochloride injection 5 min before anesthesia induction. The systolic blood pressure (SBP) and heart rate (HR) of the two groups were recorded at 5 min after entering the operating room (T₀), before anesthesia induction (T₁), after anesthesia induction (T₂), before tracheal intubation (T₃) and 1 min after tracheal intubation (T₄). The visual analogue scale (VAS) scores of pain and the incidence of nausea and vomiting in the two groups were observed at the time of entering postanesthesia care unit (PACU) (T₅), leaving PACU (T₆), 6 h after operation (T₇) and 24 h after operation (T₈). The dosage of anesthesia-related drugs in the two groups was counted. RESULTS: The SBP and HR of the two groups at T₂, T₃ and T₄ were lower than those at T₁ (P<0.05). SBP and HR at T₃ in the acupuncture group were higher than those in the esmolol group (P<0.05). Compared with the esmolol group, in the acupuncture group, the VAS scores of pain at T₆ and T₇ were decreased (P<0.05), the incidence of nausea and vomiting at T₇ and T₈ and the nausea and vomiting visual analogue scale (NVAS) scores were decreased (P<0.05). Compared with the esmolol group, the dosage of propofol in the acupuncture group was decreased (P<0.05). CONCLUSION Acupuncture with Neiguan (PC6)-to-Waiguan (TE5) can relieve hemodynamic fluctuations during anesthesia induction, reduce postoperative pain and nausea and vomiting, and reduce the dosage of propofol. The curative effect is better than that of esmolol.
Humans ; Female ; Adult ; Middle Aged ; Acupuncture Points ; Male ; Hemodynamics ; Propanolamines/administration & dosage* ; Postoperative Nausea and Vomiting/drug therapy* ; Young Adult ; Heart Rate ; Aged ; Blood Pressure ; Acupuncture Therapy

OBJECTIVE: To observe the clinical efficacy of herb-spreading moxibustion as an adjuvant treatment for chemotherapy-induced nausea and vomiting (CINV) of spleen and stomach deficiency cold in gastric cancer. METHODS: Seventy-six patients with CINV of spleen and stomach deficiency cold in gastric cancer were randomly divided into an observation group (38 cases, 1 case was discontinued, 1 case dropped out) and a control group (38 cases, 1 case was discontinued). The patients in both groups were treated with cisplatin+tigio regimen chemotherapy, and were treated with basic anti-nausea drugs on the 1st to 3rd day of chemotherapy. The observation group was treated with herb-spreading moxibustion at Zhongwan (CV12) acupoint area (covering from Shangwan [CV13] to Shenque [CV8] of the conception vessel, and from both sides to the kidney meridian of foot-shaoyin). The herb was selected as Fuzi Lizhong decoction, once a day, about 50 min each time, with 3 consecutive days as one treatment course, with an interval of 1 day between each course, for a total of 3 treatment courses. The grading of nausea and vomiting degree in the two groups were recorded on the 1st, 3rd, 7th and 14th days of chemotherapy. Karnofsky performance status (KPS) score in the two groups was observed before treatment and on the 1st, 3rd, 7th and 14th days of chemotherapy. The TCM symptom grading and TCM syndrome score of the two groups before and after treatment were compared, and the clinical efficacy and safety of the two groups were evaluated. RESULTS: On the 7th and 14th days of chemotherapy, the grading of nausea degree in the observation group was lower than that in the control group (P<0.05). On the 3rd, 7th and 14th days of chemotherapy, the grading of vomiting degree in the observation group was lower than that in the control group (P<0.05, P<0.01). Compared before treatment, the KPS scores of the two groups on the 1st day of chemotherapy and the control group on the 7th day of chemotherapy were decreased (P<0.05, P<0.01), and the KPS scores of the observation group on the 7th day of chemotherapy and the two groups on the 14th day of chemotherapy were increased (P<0.01). On the 7th and 14th days of chemotherapy, the KPS scores of the observation group were higher than those of the control group (P<0.01). After treatment, the each item grading of TCM symptom in the two groups was better than that before treatment (P<0.01), except for loose stool, the each item grading of TCM symptom in the observation group was better than that in the control group (P<0.05, P<0.01). After treatment, the scores of TCM syndrome in the two groups were lower than those before treatment (P<0.01), and the score in the observation group was lower than that in the control group (P<0.01). The obvious effective rate of the observation group was 58.3% (21/36), which was higher than 24.3% (9/37) of the control group (P<0.01). No adverse events occurred in both groups. CONCLUSION Herb-spreading moxibustion as an adjuvant treatment for CINV of spleen and stomach deficiency cold in gastric cancer can effectively relieve nausea and vomiting, and improve the symptoms of TCM, and improve the quality of life of patients. The clinical efficacy is satisfactory and the safety is good.
Humans ; Moxibustion ; Male ; Female ; Middle Aged ; Stomach Neoplasms/drug therapy* ; Nausea/physiopathology* ; Vomiting/physiopathology* ; Aged ; Adult ; Acupuncture Points ; Antineoplastic Agents/therapeutic use* ; Drugs, Chinese Herbal/administration & dosage* ; Spleen/drug effects* ; Stomach/drug effects*

Chemotherapy-induced nausea and vomiting (CINV) is common in patients receiving moderately or highly emetogenic chemotherapy and is caused by the activation of peripheral and central nervous system pathways, with the neurokinin-1 receptor playing a central role in delayed CINV. Neurokinin-1 receptor antagonists (NK1RAs) in combination with other antiemetic agents are recommended in international and Chinese guidelines for the prevention of acute and delayed CINV. Therefore, a summary of current data for NK1RAs would be of great clinical utility. This article summarizes the available clinical and real-world data on the use of NK1RAs in CINV prophylaxis, with a focus on evidence from China, where three NK1RAs, aprepitant, fosaprepitant and netupitant, are currently approved. NK1RAs have demonstrated efficacy and favorable safety in the prevention of acute and delayed CINV. Further research is required to determine the optimal use of these drugs and to identify strategies for CINV management in specific patient populations.
Humans ; Vomiting/prevention & control* ; Neurokinin-1 Receptor Antagonists/therapeutic use* ; Nausea/prevention & control* ; Antiemetics/therapeutic use* ; Antineoplastic Agents/adverse effects* ; Aprepitant/therapeutic use* ; Morpholines/therapeutic use*

Postoperative nausea and vomiting (PONV) are common complications that mainly occur within 24 h after orthognathic surgery. The incidence of nausea and vomiting after orthognathic surgery remains high and is a difficult problem for patients and surgeons. These complications not only affect wound healing and increase the risk of postoperative bleeding. Vomit and blood may also cause nausea and vomiting, which results in a vicious cycle. Frequent nausea and vomiting are a painful experience and more serious than postoperative pain. They are one of the main reasons for postoperative infection, delayed discharge, and increased hospitalization costs and affect patient satisfaction. In this review, the author combined literature review and clinical experience and summarized and analyzed the causes of orthognathic nausea and vomiting and prevention and treatment strategies to improving the related clinical process.
Humans ; Postoperative Nausea and Vomiting/etiology* ; Orthognathic Surgical Procedures/adverse effects*

Objective: To investigate the misdiagnosis of area postrema syndrome (APS) manifesting as intractable nausea, vomiting and hiccups in neuromyelitis optic spectrum disease (NMOSD) and reduce the risk of misdiagnosis. Methods: We retrospectively analyzed data from NMOSD patients attending the Department of Neurology at the First Medical Center of PLA General Hospital between January 2019 and July 2021. SPSS25.0 was then used to analyze the manifestations, misdiagnosis, and mistreatment of APS. Results: A total of 207 patients with NMOSD were included, including 21 males and 186 females. The mean age of onset was 39±15 years (range: 5-72 years). The proportion of patients who were positive for serum aquaporin 4 antibody was 82.6% (171/207). In total, 35.7% (74/207) of the NMOSD patients experienced APS during the disease course; of these patients, 70.3% (52/74) had APS as the first symptom and 29.7% (22/74) had APS as a secondary symptom. The misdiagnosis rates for these conditions were 90.4% (47/52) and 50.0% (11/22), respectively. As the first symptom, 19.2% (10/52) of patients during APS presented only with intractable nausea, vomiting and hiccups; 80.8% (42/52) of patients experienced other neurological symptoms. The Departments of Gastroenterology and General Medicine were the departments that most frequently made the first diagnosis of APS, accounting for 54.1% and 17.6% of patients, respectively. The most common misdiagnoses related to diseases of the digestive system and the median duration of misdiagnosis was 37 days. Conclusions: APS is a common symptom of NMOSD and is associated with a high rate of misdiagnosis. Other concomitant symptoms often occur with APS. Gaining an increased awareness of this disease/syndrome, obtaining a detailed patient history, and performing physical examinations are essential if we are to reduce and avoid misdiagnosis.
Male ; Female ; Humans ; Child, Preschool ; Child ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Aged ; Neuromyelitis Optica/diagnosis* ; Area Postrema ; Retrospective Studies ; Hiccup/complications* ; Vomiting/etiology* ; Nausea/etiology* ; Inflammation ; Syndrome ; Autoantibodies ; Diagnostic Errors ; Aquaporin 4

Objective: To investigate the clinical characteristics and related factors of corticosteroid induced adrenal crisis (AC) in children with primary nephrotic syndrome (NS). Methods: Case control study. The case group included 7 children aged 1 to 18 years with NS combined with AC hospitalized in Peking University First Hospital from January 2016 to May 2021 (AC group). According to the ratio of case group: control group 1: 4, 28 children aged 1 to 18 years who were diagnosed with NS without AC during the same period were matched as controls (non-AC group). Clinical data were collected. The clinical characteristics of AC were described. The clinical parameters were compared between the 2 groups by t test, Mann-Whitney U test or Fisher's test. Receiver operating characteristic (ROC) curve was used to analyze the cutoff values of clinical parameters for prediction of AC. Results: The AC group included 4 boys and 3 girls aged 6.9 (4.6, 10.8) years. The non-AC group included 20 boys and 8 girls aged 5.2 (3.3, 8.4) years. All AC events occurred during the relapse of NS with infection. Seven children had gastrointestinal symptoms such as nausea, vomiting and abdominal pain. Six children had poor mental state or impaired consciousness. No significant differences in NS course, corticosteroid treatment course, corticosteroid type, steroid dosage, steroid medication interval, the proportion of gastroenteritis and fever existed between the two groups (all P>0.05). Compared with the non-AC group, the duration from the onset of the relapse of NS until hospitalization in the AC group was significantly shorter (0.2 (0.1, 0.6) vs. 1.0 (0.4, 5.0) month,U=25.50, P=0.005). The 24 h urinary total protein (UTP) level was significantly higher in the AC group (193 (135, 429) vs. 81 (17, 200) mg/kg, U=27.00,P=0.036) than the non-AC group. The serum albumin level in the AC group was significantly lower((13.1±2.1) vs. (24.5±8.7) g/L,t=-6.22,P<0.001) than the non-AC group. There were significantly higher total white blood cell counts ((26±9)×10⁹ vs. (11±5)×10⁹/L,t=4.26,P=0.004), percentage of neutrophils (0.71±0.08 vs. 0.60±0.19,t=2.56,P=0.017) and the proportion of children with C reactive protein level≥8 mg/L (3/7 vs. 0,P=0.005) in the AC group than in the non-AC group. ROC curve analysis showed that the cutoff value of 24 h UTP was 122 mg/(kg·d) with a sensitivity of 100.0% and specificity of 70.4%. The cutoff value of serum albumin was 17.0 g/L with a sensitivity of 100.0% and specificity of 82.1%. Conclusions: Gastrointestinal symptoms and poor mental state were prominent manifestations of AC in children with NS. High 24 h UTP level, low serum albumin level, high peripheral white blood cell counts, high neutrophils percentage, and high C-reactive protein level during the early stage of NS relapse may be related to the occurrence of AC in children with NS.
Nephrotic Syndrome/drug therapy* ; Humans ; Child ; Adolescent ; Male ; Female ; Gastrointestinal Diseases/diagnosis* ; Adrenal Cortex Hormones/therapeutic use* ; Nausea/chemically induced* ; Vomiting/chemically induced* ; Abdominal Pain/chemically induced* ; Mental Processes/drug effects* ; China

OBJECTIVE: To investigate the correlation between aldehyde dehydrogenase 2 (ALDH2) rs671 polymorphisms and chemotherapy-induced nausea and vomiting (CINV). METHODS: A total of 90 Chinese patients with malignant tumors receiving chemotherapy for the first time were recruited in this study. The occurrence of CINV was observed within 120 h after treatment with docetaxel and cis-platinum chemotherapy (DP regimen). The data of the patients (including age, gender, tumor stage, habitual alcohol consumption, motion sickness, morning sickness, and average sleep time prior to chemotherapy) were collected through a questionnaire. ALDH2 rs671 polymorphisms of the patients were analyzed using a multiple single nucleotide polymorphism genotyping, and the Hardy-Weinberg equation was used for genetic linkage analysis. The correlations between the factors including ALDH2 rs671 polymorphisms and the occurrence of CINV were analyzed. RESULTS: The incidence of CINV was 48.9% among the patients receiving their first chemotherapy with DP regimen. Univariate analysis indicated that the genetic polymorphisms of ALDH2 rs671 were significantly correlated with the occurrence of CINV (P < 0.05). Multivariate logistic analysis indicated that ALDH2 rs671 mutation (OR: 3.019, 95% CI: 1.056-8.628, P < 0.05) and average sleep time prior to chemotherapy no longer than 6 h (OR: 2.807, 95% CI: 1.033-7.628, P < 0.05) were risk factors for CINV in patients with malignant tumors receiving the first chemotherapy with DP regimen. CONCLUSION ALDH2 gene mutation at rs671 is a risk factor contributing to the occurrence of CINV, and understanding of the underlying mechanism may help to more effectively control the occurrence of CINV.
Humans ; Aldehyde Dehydrogenase, Mitochondrial/genetics* ; Antineoplastic Agents/adverse effects* ; Nausea/genetics* ; Polymorphism, Single Nucleotide ; Vomiting/genetics* ; Neoplasms/drug therapy*

OBJECTIVE: To observe the effect of preoperative, intraoperative and postoperative electroacupuncture (EA) intervention on postoperative urination function in patients with mixed hemorrhoid surgery. METHODS: A total of 240 patients with mixed hemorrhoid surgery under lumbar anesthesia were randomly divided into an EA preconditioning group (group A, 60 cases, 9 cases dropped off), an intraoperative EA group (group B, 60 cases, 4 cases dropped off), a postoperative EA group (group C, 60 cases, 6 cases dropped off), and a non-acupuncture group (group D, 60 cases, 3 cases dropped off). In the groups A, B and C, EA was exerted at Zhongliao (BL 33) and Huiyang (BL 35) , with disperse-dense wave, 4 Hz/20 Hz in frequency, and lasting 30 min, at 30 min before lumbar anesthesia, immediately after lumbar anesthesia and 6 h after surgery, respectively. No EA intervention was performed in the group D. The postoperative urination smoothness score in each group was observed 24 h after surgery. The first urination time, first urination volume, urine residual volume after first urination were recorded, and incidence of indwelling catheterization, postoperative visual analogue scale (VAS) score, number of remedial analgesia, and the incidence of postoperative nausea and vomiting were observed in each group. RESULTS: In the groups A, B and C, the postoperative urination smoothness scores were superior to the group D (P<0.05), and the time of first urination was earlier than the group D (P<0.05). In the group C, the time of first urination was earlier than the group A and the group B (P<0.05), the first urination volume was higher than the group D (P<0.05), and the urine residual volume after first urination was lower than the group D (P<0.05). There was no significant difference in the incidence of indwelling catheterization and postoperative nausea and vomiting among the 4 groups (P>0.05). The VAS scores of the group A, B and C were lower than that in the group D (P<0.05), and the number of remedial analgesia cases was lower than that in the group D (P<0.05). CONCLUSION EA intervention could promote the recovery of urination function and relieve postoperative pain in patients with mixed hemorrhoids surgery. Early postoperative EA intervention is more conducive to the recovery of urination function.
Humans ; Electroacupuncture ; Hemorrhoids/surgery* ; Urination ; Postoperative Nausea and Vomiting ; Acupuncture Points

OBJECTIVE: To observe the effect of buccal acupuncture on pain after lumbar spinal fusion. METHODS: Sixty patients undergoing lumbar spinal fusion were randomly divided into an observation group (30 cases, 1 case dropped off) and a control group (30 cases, 1 case was eliminated). The patients in the control group were treated with routine anesthesia. On the basis of the control group, the patients in the observation group were treated with buccal acupuncture at bilateral back point, waist point, and sacral point for 30 min per treatment. The first acupuncture was given before anesthesia induction, and then once a day postoperation for two days, totally 3 treatments. The dosage of sufentanil, the number of remedial analgesia, and the incidence of nausea and vomiting within 48 h after surgery were compared between the two groups; rest and motion visual analogue scale (VAS) scores at 2 (T1), 8 (T2), 12 (T3), 24 (T4), and 48 (T5) h after surgery were observed; the quality of recovery-15 scale (QoR-15) at 24 and 48 h after surgery were evaluated. RESULTS: The dosage of sufentanil and the number of remedial analgesia within 48 h after surgery in the observation group were lower than those in the control group (P<0.01). There was no significant statistically difference in rest and motion VAS scores between the two groups in T1, T2, T3, T4 and T5 (P>0.05). The QoR-15 scores in the observation group at 24 and 48 h after surgery were higher than those in the control group (P<0.01). The incidence of nausea in the observation group was lower than that in the control group (P<0.05). CONCLUSION Buccal acupuncture could reduce the amount of postoperative analgesic drugs of patients after lumbar spinal fusion, and promote early postoperative recovery.
Humans ; Spinal Fusion/adverse effects* ; Sufentanil ; Acupuncture Therapy ; Pain Management ; Pain ; Nausea

Humans ; East Asian People ; Nausea/drug therapy* ; Vomiting/drug therapy* ; Antineoplastic Agents/adverse effects* ; Neoplasms/drug therapy*