In recent years,as living standards have continued to improve,the number of diabetes patients in China,along with the incidence of complications associated with the disease,has been increasing.Among these complication...In recent years,as living standards have continued to improve,the number of diabetes patients in China,along with the incidence of complications associated with the disease,has been increasing.Among these complications,diabetic foot disease is one of the main causes of disability and death in diabetic patients.Due to the differences in economy,culture,religion and level of medical care available across different regions,preventive and treatment methods and curative results for diabetic foot vary greatly.In multidisciplinary models built around diabetic foot,the timely assessment and diagnosis of wounds and appropriate methods of prevention and treatment with internal and external surgery are key to clinical practice for this pathology.In 2019,under the leadership of the Jiangsu Medical Association and Chinese Diabetes Society,the writing group for the Guidelines on multidisciplinary approaches for the prevention and management of diabetic foot disease(2020 edition)was established with the participation of scholars from the specialist areas of endocrinology,burn injury,vascular surgery,orthopedics,foot and ankle surgery and cardiology.Drawing lessons from diabetic foot guidelines from other countries,this guide analyses clinical practices for diabetic foot,queries the theoretical basis and grades and gives recommendations based on the characteristics of the pathology in China.This paper begins with assessments and diagnoses of diabetic foot,then describes treatments for diabetic foot in detail,and ends with protections for high-risk feet and the prevention of ulcers.This manuscript covers the disciplines of internal medicine,surgical,nursing and rehabilitation and describes a total of 50 recommendations that we hope will provide procedures and protocols for clinicians dealing with diabetic foot.展开更多
Abstract： With the rapid development of assisted reproductive technology, various reproductive disorders have been effectively addressed. Acupuncture-like therapies, including electroacupuncture （EA） and transcutan...Abstract： With the rapid development of assisted reproductive technology, various reproductive disorders have been effectively addressed. Acupuncture-like therapies, including electroacupuncture （EA） and transcutaneous electrical acupoint stimulation （TEAS）, become more popular world-wide. Increasing evidence has demonstrated that EA and TEAS are effective in treating gynecological disorders, especially infertility. This present paper describes how to select acupoints for the treatment of infertility from the view of theories of traditional Chinese medicine and how to determine critical parameters of electric pulses of ENTEAS based on results from animal and clinical studies. It summarizes the principles of clinical application of EA/rEAS in treating various kinds of reproductive disorders, such as polycystic ovary syndrome （PCOS）, pain induced by oocyte retrieval, diminished ovarian reserve, embryo transfer, and oligosperrnia/ asthenospermia. The possible underlying mechanisms mediating the therapeutic effects of EA/TEAS in reproductive medicine are also examined.展开更多
Whether in the West or the East,the connection between the ear and the rest of the body has been explored for a long time.Especially in the past century or more,the relevant theoretical and applied research on the ear...Whether in the West or the East,the connection between the ear and the rest of the body has been explored for a long time.Especially in the past century or more,the relevant theoretical and applied research on the ear has greatly promoted the development of ear therapy,and finally the concept of transcutaneous auricular vagus nerve stimulation(taVNS)has been proposed.The purpose of taVNS is to treat a disease non-invasively by applying electrical current to the cutaneous receptive field formed by the auricular branch of the vagus nerve in the outer ear.In the past two decades,taVNS has been a topic of basic,clinical,and transformation research.It has been applied as an alternative to drug treatment for a variety of diseases.Based on the rapid understanding of the application of taVNS to human health and disease,some limitations in the development of this field have also been gradually exposed.Here,we comprehensively review the origin and research status of the field.展开更多
Background:Postoperative gastrointestinal dysfunction(PGD)is one of the most common complications in patients undergoing major abdominal surgery.Acupuncture has been used widely in gastrointestinal diseases due to its...Background:Postoperative gastrointestinal dysfunction(PGD)is one of the most common complications in patients undergoing major abdominal surgery.Acupuncture has been used widely in gastrointestinal diseases due to its effectiveness and minimally invasive nature.Objective:This study evaluated the efficacy of using transcutaneous electrical acupoint stimulation(TEAS)during the surgery and postoperative recovery in patients with gastric and colorectal surgery for improving postoperative gastrointestinal function.Design,setting,participants and interventions:A total of 280 patients undergoing abdominal surgery were stratified by type of surgery(i.e.,gastric or colorectal surgery)and randomly allocated into the TEAS group(group T)or the sham group(group S).Patients in group T received TEAS at LI4,PC6,ST36 and ST37.Patients in group S received pseudo-TEAS at sham acupoints.The stimulation was given from 30 min before anesthesia until the end of surgery.The same treatment was performed at 9 am on the 1st,2nd and 3rd days after surgery,until the recovery of flatus in patients.Main outcome measures:The primary outcome was the time to the first bowel motion,as detected by auscultation.The secondary outcomes included the first flatus and ambulation time,changes of perioperative substance P(SP),incidence of PGD,postoperative pain,postoperative nausea and vomiting(PONV)and some economic indicators.Results:The time to first bowel motion,first flatus and first ambulation in group T was much shorter than that in group S(P<0.01).In patients undergoing colorectal surgery,the concentration of SP was lower in group T than in group S on the third day after the operation(P<0.05).The average incidence of PGD in all patients was 25%,and the frequency of PGD was significantly lower in group T than in group S(18.6%vs.31.4%,respectively;P<0.05).TEAS treatment(odds ratio=0.498;95%confidence interval:0.232–0.786)and type of surgery were relevant factors for the development of PGD.Postoperative pain score and PONV occurrence were significan展开更多
BACKGROUND:This study aimed to observe the effect of early goal directed therapy(EGDT)on tissue perfusion,microcirculation and tissue oxygenation in patients with septic shock.METHODS:Patients with early septic shock(...BACKGROUND:This study aimed to observe the effect of early goal directed therapy(EGDT)on tissue perfusion,microcirculation and tissue oxygenation in patients with septic shock.METHODS:Patients with early septic shock(<24 hours) who had been admitted to the ICU of Zhongda Hospital Affiliated to Southeast University from September 2009 through May 2011 were enrolled(research time:12 months),and they didn't meet the criteria of EGDT.Patients who had one of the following were excluded:stroke,brain injury,other types of shock,severe heart failure,acute myocardial infarction,age below 18 years,pregnancy,end-stage disease,cardiac arrest,extensive burns,oral bleeding,difficulty in opening the mouth,and the onset of septic shock beyond 24 hours.Patients treated with the standard protocol of EGDT were included.Transcutaneous pressure of oxygen and carbon dioxide(PtcO_2,PtcCO_2) were monitored and hemodynamic measurements were obtained.Side-stream dark field(SDF) imaging device was applied to obtain sublingual microcirculation.Hemodynamics,tissue oxygen,and sublingual microcirculation were compared before and after EGDT.If the variable meets the normal distribution,Student's t test was applied.Otherwise,Wilcoxon's rank-sum test was used.Correlation between variables was analyzed with Pearson's product-moment correlation coefficient method.RESULTS:Twenty patients were involved,but one patient wasn't analyzed because he didn't meet the EGDT criteria.PtcO_2 and PtcCO_2 were monitored in 19 patients,of whom sublingual microcirculation was obtained.After EGDT,PtcO_2 increased from 62.7+24.0 mmHg to 78.0±30.9mmHg(P<0.05) and tissue oxygenation index(PtcO_2/FiO_2) was 110.7+60.4 mmHg before EGDT and 141.6±78.2 mmHg after EGDT(P<0.05).The difference between PtcCO_2 and PCO_2 decreased significantly after EGDT(P<0.05).The density of perfused small vessels(PPV) and microcirculatory flow index of small vessels(MFI) tended to increase,but there were no significant differences between them(P>0.05).PtcO_2,PtcO_2/FiO_2,and PtcCO_2 were 展开更多
OBJECTIVE:To investigate the effect of transcutaneous electrical acupoint stimulation (TEAS) on enhanced recovery after surgery (ERAS) in laparoscopic colorectal cancer resection and its clinical significance.METHODS:...OBJECTIVE:To investigate the effect of transcutaneous electrical acupoint stimulation (TEAS) on enhanced recovery after surgery (ERAS) in laparoscopic colorectal cancer resection and its clinical significance.METHODS:Sixty-four patients undergoing laparoscopic colorectal resection were randomly divided into two groups,the control group (group A) and the TEAS group (group B).Patients in the TEAS group received electroacupuncture stimulation of bilateral Zusanli (ST 36) at 30 min before anesthesia to the end of surgery.The patients in the control group were not given the stimulation.Perioperative anesthesia management of the two groups were performed according to the ERAS guidelines,and postoperative patient-controlled intravenous analgesia (PCIA) was used.The amount of remifentanil used in the two groups was observed and recorded,and the visual analogue scale (VAS) of the 4,12,24 and 48 h after surgery in the two groups was recorded.Moreover,postoperative anal exhaust time,postoperative feeding time,postoperative first ambulation time and postoperative hospital stay length were compared between the two groups.RESULTS:Compared with group A,the VAS score of group B decreased significantly at 48 h after operation (P < 0.05).The postoperative anal exhaust time in group B was significantly shorter than that of group A (P < 0.05).There was no significant difference between the two groups with regards to remifentanil consumption,postoperative feeding time,postoperative first ambulation time and postoperative hospital stay (all P > 0.05).CONCLUSION:TEAS can promote the recovery of postoperative gastrointestinal function and reduce the pain intensity 48 h after surgery,thus satisfying the need of early postoperative analgesia.展开更多
Background: Chemotherapy?induced nausea and vomiting adversely affects the quality of life of patients who receive chemotherapy via intravenous infusion or transcatheter arterial chemoembolization(TACE). This study ai...Background: Chemotherapy?induced nausea and vomiting adversely affects the quality of life of patients who receive chemotherapy via intravenous infusion or transcatheter arterial chemoembolization(TACE). This study aimed to investigate the clinical effects of transcutaneous electrical acupoint stimulation(TEAS) on nausea and vomiting after TACE.Methods: A total of 142 patients who received TACE with cisplatin for primary or metastatic liver cancer were assigned to the active?acupuncture(n = 72) or placebo?acupuncture(n Hegu(LI4), Neiguan(P6), an= 70) groups using a covariate?adaptive randomization at a ratio of 1:1. The acupointsd Zusanli(ST36) were stimulated twice daily for 6 days. The effects of TEAS on nausea and vomiting were assessed by using occurrence rate and severity of these symptoms. Anorexia scale and M. D. Anderson Symptom Inventory(MDASI) scores were secondary endpoints and were used to assess the effect of TEAS on patient appetite and quality of life. The safety of the treatments was also monitored.Results: Between the two groups, the differences in occurrence rates and severities of nausea and vomiting after TACE were not significant(all P > 0.05). From the second day after TACE, anorexia scores were significantly lower in the active?acupuncture group than in the placebo?acupuncture group and continued to decrease over time with treat?ment(all P values less than 0.01). On days 0, 1, and 2, the mean MDASI scores for the active?acupuncture group were slightly lower than those for the placebo?acupuncture group, but the differences were not statistically significant(all P > 0.05). No significant differences were found between the two groups in the occurrence rate of any adverse event(P > 0.05).Conclusion: TEAS appears to be a safe and effective therapy to relieve patients' gastrointestinal discomfort after chemotherapy.展开更多
Objective：To investigate the efficacy of transcutaneous electrical nerve stimulation（TENS）on four specific acupuncture points Hegu（LI4）,Neiguan（PC6）,Danshu（BL19）and Weishu（BL21）for reducing pain in labor.Me...Objective：To investigate the efficacy of transcutaneous electrical nerve stimulation（TENS）on four specific acupuncture points Hegu（LI4）,Neiguan（PC6）,Danshu（BL19）and Weishu（BL21）for reducing pain in labor.Methods：A total of 160 voluntary nulliparous women who were willing to receive TENS for analgesia were assigned to the treatment group after cervical dilation of more than 2 cm.Another 145 matched nullipara were recruited as the control group.Visual analogue scale（VAS）was used to assess the pain before and 0.5 h after the application of TENS.Then,VAS was assessed every one hour until delivery.Percentage of VAS score decreased by〉25%was the primary outcome,the delivery mode and neonatal outcome were measured as secondary outcomes.Adverse reactions were also recorded during TENS.Results：The percentage of VAS score decreased by〉25%was 68.6%in the TENS treatment group.Maternal delivery mode and neonatal outcomes were not significantly different between the two groups.In addition,the incidence of postpartum hemorrhage in the TENS treatment group was less than the control group（P〈0.05）.There was no adverse reaction recorded with TENS on acupoints.Conclusion：As a novel and non-invasive approach,TENS on specific acupoints including Hegu（LI4）,Neiguan（PC6）,Danshu（BL19）and Weishu（BL21）was an effective method for analgesia in labor.展开更多
背景:一般情况下经皮氧分压测定有氧能力水平越高,安静状态时值越高,训练过程中呈下降趋势,提示机体疲劳加深,肌肉缺氧程度加大,机能状态下降,经皮二氧化碳分压则反之。目的:分析6周高原训练期间优秀男子赛艇运动员肱二头肌经皮氧分压...背景:一般情况下经皮氧分压测定有氧能力水平越高,安静状态时值越高,训练过程中呈下降趋势,提示机体疲劳加深,肌肉缺氧程度加大,机能状态下降,经皮二氧化碳分压则反之。目的:分析6周高原训练期间优秀男子赛艇运动员肱二头肌经皮氧分压、经皮二氧化碳分压变化特点与其训练负荷之间的关系。方法:将整个高原训练板块分为高原前、高原训练、高原后3个阶段,每周运动员休息时早晨空腹状态下使用PeriFlux System 5000激光多普勒血流监测仪对10名男子赛艇运动员进行无创测试,测试指标包括经皮氧分压、经皮二氧化碳分压及乳酸值的变化;同时在上高原前1周及下高原后2周分别对运动员进行测功仪6 km及6级负荷测试。结果与结论:(1)高原训练中经皮氧分压、经皮氧分压/经皮二氧化碳分压呈现出"W"型变化趋势,经皮二氧化碳分压呈现"V"型变化趋势。(2)结果说明:高原训练"平原阶段储备体能、高原训练前期加量后期加度"的训练模式较为合理,可为今后高原训练提供一个较好的范式;经皮氧分压、经皮二氧化碳尤其是二者比值对评价运动负荷对运动员的刺激程度有着重要参考作用;经皮氧分压测定还量化了高原训练中运动员毛细血管的含氧量;建议将经皮氧分压作为一种无创性指标应用于运动员有氧能力变化的监测。展开更多
Background The mechanism of acupuncture analgesia in craniotomy has been widely studied. However, the theoretical basis for selection of acupoints has not been examined. In this study, we used the regional homogeneit...Background The mechanism of acupuncture analgesia in craniotomy has been widely studied. However, the theoretical basis for selection of acupoints has not been examined. In this study, we used the regional homogeneity method blood oxygen level-dependent （BOLD） signals to determine changes in brain activity in response to transcutaneous electrical stimulation on acupoints and non-acupoints in resting state functional magnetic resonance imaging （fMRI）.Methods Twelve healthy volunteers were enrolled in this study. BOLD fMRI scanning of the brain was performed for 306 seconds before and 30 minutes after transcutaneous electrical stimulation on acupoints UB63 （Jinmen）, LV3 （Tai chong）, ST36 （Zusanli）, and GB40 （Qiuxu）. The procedure was repeated after one week with stimulation on non-acupoints （one was 9 above BL67, the second was 12 above BL67 （Kunlun）, the third was 7 above KI3, and the fourth was 10 above KI3 （Taixi））.Results The regional homogeneity in the acupoint group was increased in the left thalamus, caudate, putamen, lentiform nucleus （BA19, 30, 39）, postcentral gyrus, precentral gyrus （BA3, 4, 30, 32）, calcarine fissure, middle temporal gyrus （BA30）, right superior temporal gyrus, inferior temporal gyrus （BA38）, cuneus, and precuneus （BA7, 19） when compared to the non-acupoint group. The regional homogeneity of the acupoint group was decreased in the left cerebellum posterior lobe, middle frontal gyrus （BA10）, double-side precuneus （BA7）, and the postcentral gyrus （BA40）.Conclusions The brain region activated following acupoint stimulation is the ipsilateral pain-related brain region, which may relate to the therapeutic effect of acupuncture on pain relief. Further acupoint stimulation causes different central nervous responses compared to non-acupoint stimulation.展开更多
基金The National Natural Science Foundation of China(grant number:81770810)。
文摘In recent years,as living standards have continued to improve,the number of diabetes patients in China,along with the incidence of complications associated with the disease,has been increasing.Among these complications,diabetic foot disease is one of the main causes of disability and death in diabetic patients.Due to the differences in economy,culture,religion and level of medical care available across different regions,preventive and treatment methods and curative results for diabetic foot vary greatly.In multidisciplinary models built around diabetic foot,the timely assessment and diagnosis of wounds and appropriate methods of prevention and treatment with internal and external surgery are key to clinical practice for this pathology.In 2019,under the leadership of the Jiangsu Medical Association and Chinese Diabetes Society,the writing group for the Guidelines on multidisciplinary approaches for the prevention and management of diabetic foot disease(2020 edition)was established with the participation of scholars from the specialist areas of endocrinology,burn injury,vascular surgery,orthopedics,foot and ankle surgery and cardiology.Drawing lessons from diabetic foot guidelines from other countries,this guide analyses clinical practices for diabetic foot,queries the theoretical basis and grades and gives recommendations based on the characteristics of the pathology in China.This paper begins with assessments and diagnoses of diabetic foot,then describes treatments for diabetic foot in detail,and ends with protections for high-risk feet and the prevention of ulcers.This manuscript covers the disciplines of internal medicine,surgical,nursing and rehabilitation and describes a total of 50 recommendations that we hope will provide procedures and protocols for clinicians dealing with diabetic foot.
基金Project supported by the Special Research Fund for the Public Welfare Industry of Health of China(No.201302013)
文摘Abstract： With the rapid development of assisted reproductive technology, various reproductive disorders have been effectively addressed. Acupuncture-like therapies, including electroacupuncture （EA） and transcutaneous electrical acupoint stimulation （TEAS）, become more popular world-wide. Increasing evidence has demonstrated that EA and TEAS are effective in treating gynecological disorders, especially infertility. This present paper describes how to select acupoints for the treatment of infertility from the view of theories of traditional Chinese medicine and how to determine critical parameters of electric pulses of ENTEAS based on results from animal and clinical studies. It summarizes the principles of clinical application of EA/rEAS in treating various kinds of reproductive disorders, such as polycystic ovary syndrome （PCOS）, pain induced by oocyte retrieval, diminished ovarian reserve, embryo transfer, and oligosperrnia/ asthenospermia. The possible underlying mechanisms mediating the therapeutic effects of EA/TEAS in reproductive medicine are also examined.
基金This review was supported by the National Key R&D Program of China(2018YFC1705800)the National Natural Science Foundation of China(81803872,81674072)+1 种基金the Joint Sino-German Research Project(GZ1236)the Fundamental Research Funds for the Central Public Welfare Research Institutes(ZZ201813006).
文摘Whether in the West or the East,the connection between the ear and the rest of the body has been explored for a long time.Especially in the past century or more,the relevant theoretical and applied research on the ear has greatly promoted the development of ear therapy,and finally the concept of transcutaneous auricular vagus nerve stimulation(taVNS)has been proposed.The purpose of taVNS is to treat a disease non-invasively by applying electrical current to the cutaneous receptive field formed by the auricular branch of the vagus nerve in the outer ear.In the past two decades,taVNS has been a topic of basic,clinical,and transformation research.It has been applied as an alternative to drug treatment for a variety of diseases.Based on the rapid understanding of the application of taVNS to human health and disease,some limitations in the development of this field have also been gradually exposed.Here,we comprehensively review the origin and research status of the field.
基金supported by the Beijing Administration of Traditional Chinese Medicine,PR China(Grant No.JJ-2020-62)。
文摘Background:Postoperative gastrointestinal dysfunction(PGD)is one of the most common complications in patients undergoing major abdominal surgery.Acupuncture has been used widely in gastrointestinal diseases due to its effectiveness and minimally invasive nature.Objective:This study evaluated the efficacy of using transcutaneous electrical acupoint stimulation(TEAS)during the surgery and postoperative recovery in patients with gastric and colorectal surgery for improving postoperative gastrointestinal function.Design,setting,participants and interventions:A total of 280 patients undergoing abdominal surgery were stratified by type of surgery(i.e.,gastric or colorectal surgery)and randomly allocated into the TEAS group(group T)or the sham group(group S).Patients in group T received TEAS at LI4,PC6,ST36 and ST37.Patients in group S received pseudo-TEAS at sham acupoints.The stimulation was given from 30 min before anesthesia until the end of surgery.The same treatment was performed at 9 am on the 1st,2nd and 3rd days after surgery,until the recovery of flatus in patients.Main outcome measures:The primary outcome was the time to the first bowel motion,as detected by auscultation.The secondary outcomes included the first flatus and ambulation time,changes of perioperative substance P(SP),incidence of PGD,postoperative pain,postoperative nausea and vomiting(PONV)and some economic indicators.Results:The time to first bowel motion,first flatus and first ambulation in group T was much shorter than that in group S(P<0.01).In patients undergoing colorectal surgery,the concentration of SP was lower in group T than in group S on the third day after the operation(P<0.05).The average incidence of PGD in all patients was 25%,and the frequency of PGD was significantly lower in group T than in group S(18.6%vs.31.4%,respectively;P<0.05).TEAS treatment(odds ratio=0.498;95%confidence interval:0.232–0.786)and type of surgery were relevant factors for the development of PGD.Postoperative pain score and PONV occurrence were significan
文摘BACKGROUND:This study aimed to observe the effect of early goal directed therapy(EGDT)on tissue perfusion,microcirculation and tissue oxygenation in patients with septic shock.METHODS:Patients with early septic shock(<24 hours) who had been admitted to the ICU of Zhongda Hospital Affiliated to Southeast University from September 2009 through May 2011 were enrolled(research time:12 months),and they didn't meet the criteria of EGDT.Patients who had one of the following were excluded:stroke,brain injury,other types of shock,severe heart failure,acute myocardial infarction,age below 18 years,pregnancy,end-stage disease,cardiac arrest,extensive burns,oral bleeding,difficulty in opening the mouth,and the onset of septic shock beyond 24 hours.Patients treated with the standard protocol of EGDT were included.Transcutaneous pressure of oxygen and carbon dioxide(PtcO_2,PtcCO_2) were monitored and hemodynamic measurements were obtained.Side-stream dark field(SDF) imaging device was applied to obtain sublingual microcirculation.Hemodynamics,tissue oxygen,and sublingual microcirculation were compared before and after EGDT.If the variable meets the normal distribution,Student's t test was applied.Otherwise,Wilcoxon's rank-sum test was used.Correlation between variables was analyzed with Pearson's product-moment correlation coefficient method.RESULTS:Twenty patients were involved,but one patient wasn't analyzed because he didn't meet the EGDT criteria.PtcO_2 and PtcCO_2 were monitored in 19 patients,of whom sublingual microcirculation was obtained.After EGDT,PtcO_2 increased from 62.7+24.0 mmHg to 78.0±30.9mmHg(P<0.05) and tissue oxygenation index(PtcO_2/FiO_2) was 110.7+60.4 mmHg before EGDT and 141.6±78.2 mmHg after EGDT(P<0.05).The difference between PtcCO_2 and PCO_2 decreased significantly after EGDT(P<0.05).The density of perfused small vessels(PPV) and microcirculatory flow index of small vessels(MFI) tended to increase,but there were no significant differences between them(P>0.05).PtcO_2,PtcO_2/FiO_2,and PtcCO_2 were
文摘OBJECTIVE:To investigate the effect of transcutaneous electrical acupoint stimulation (TEAS) on enhanced recovery after surgery (ERAS) in laparoscopic colorectal cancer resection and its clinical significance.METHODS:Sixty-four patients undergoing laparoscopic colorectal resection were randomly divided into two groups,the control group (group A) and the TEAS group (group B).Patients in the TEAS group received electroacupuncture stimulation of bilateral Zusanli (ST 36) at 30 min before anesthesia to the end of surgery.The patients in the control group were not given the stimulation.Perioperative anesthesia management of the two groups were performed according to the ERAS guidelines,and postoperative patient-controlled intravenous analgesia (PCIA) was used.The amount of remifentanil used in the two groups was observed and recorded,and the visual analogue scale (VAS) of the 4,12,24 and 48 h after surgery in the two groups was recorded.Moreover,postoperative anal exhaust time,postoperative feeding time,postoperative first ambulation time and postoperative hospital stay length were compared between the two groups.RESULTS:Compared with group A,the VAS score of group B decreased significantly at 48 h after operation (P < 0.05).The postoperative anal exhaust time in group B was significantly shorter than that of group A (P < 0.05).There was no significant difference between the two groups with regards to remifentanil consumption,postoperative feeding time,postoperative first ambulation time and postoperative hospital stay (all P > 0.05).CONCLUSION:TEAS can promote the recovery of postoperative gastrointestinal function and reduce the pain intensity 48 h after surgery,thus satisfying the need of early postoperative analgesia.
基金supported by grants from the Shanghai Municipal Health Bureau Programs (No.2010L058A)the National Natural Science Foundation of China (No.81403248, No.81273955)
文摘Background: Chemotherapy?induced nausea and vomiting adversely affects the quality of life of patients who receive chemotherapy via intravenous infusion or transcatheter arterial chemoembolization(TACE). This study aimed to investigate the clinical effects of transcutaneous electrical acupoint stimulation(TEAS) on nausea and vomiting after TACE.Methods: A total of 142 patients who received TACE with cisplatin for primary or metastatic liver cancer were assigned to the active?acupuncture(n = 72) or placebo?acupuncture(n Hegu(LI4), Neiguan(P6), an= 70) groups using a covariate?adaptive randomization at a ratio of 1:1. The acupointsd Zusanli(ST36) were stimulated twice daily for 6 days. The effects of TEAS on nausea and vomiting were assessed by using occurrence rate and severity of these symptoms. Anorexia scale and M. D. Anderson Symptom Inventory(MDASI) scores were secondary endpoints and were used to assess the effect of TEAS on patient appetite and quality of life. The safety of the treatments was also monitored.Results: Between the two groups, the differences in occurrence rates and severities of nausea and vomiting after TACE were not significant(all P > 0.05). From the second day after TACE, anorexia scores were significantly lower in the active?acupuncture group than in the placebo?acupuncture group and continued to decrease over time with treat?ment(all P values less than 0.01). On days 0, 1, and 2, the mean MDASI scores for the active?acupuncture group were slightly lower than those for the placebo?acupuncture group, but the differences were not statistically significant(all P > 0.05). No significant differences were found between the two groups in the occurrence rate of any adverse event(P > 0.05).Conclusion: TEAS appears to be a safe and effective therapy to relieve patients' gastrointestinal discomfort after chemotherapy.
基金Supported by the National Natural Science Foundation of China(No.30471820)the Foundation of Shanghai for Key Medical Subjects(No.05-Ⅲ016)
文摘Objective：To investigate the efficacy of transcutaneous electrical nerve stimulation（TENS）on four specific acupuncture points Hegu（LI4）,Neiguan（PC6）,Danshu（BL19）and Weishu（BL21）for reducing pain in labor.Methods：A total of 160 voluntary nulliparous women who were willing to receive TENS for analgesia were assigned to the treatment group after cervical dilation of more than 2 cm.Another 145 matched nullipara were recruited as the control group.Visual analogue scale（VAS）was used to assess the pain before and 0.5 h after the application of TENS.Then,VAS was assessed every one hour until delivery.Percentage of VAS score decreased by〉25%was the primary outcome,the delivery mode and neonatal outcome were measured as secondary outcomes.Adverse reactions were also recorded during TENS.Results：The percentage of VAS score decreased by〉25%was 68.6%in the TENS treatment group.Maternal delivery mode and neonatal outcomes were not significantly different between the two groups.In addition,the incidence of postpartum hemorrhage in the TENS treatment group was less than the control group（P〈0.05）.There was no adverse reaction recorded with TENS on acupoints.Conclusion：As a novel and non-invasive approach,TENS on specific acupoints including Hegu（LI4）,Neiguan（PC6）,Danshu（BL19）and Weishu（BL21）was an effective method for analgesia in labor.
文摘背景:一般情况下经皮氧分压测定有氧能力水平越高,安静状态时值越高,训练过程中呈下降趋势,提示机体疲劳加深,肌肉缺氧程度加大,机能状态下降,经皮二氧化碳分压则反之。目的:分析6周高原训练期间优秀男子赛艇运动员肱二头肌经皮氧分压、经皮二氧化碳分压变化特点与其训练负荷之间的关系。方法:将整个高原训练板块分为高原前、高原训练、高原后3个阶段,每周运动员休息时早晨空腹状态下使用PeriFlux System 5000激光多普勒血流监测仪对10名男子赛艇运动员进行无创测试,测试指标包括经皮氧分压、经皮二氧化碳分压及乳酸值的变化;同时在上高原前1周及下高原后2周分别对运动员进行测功仪6 km及6级负荷测试。结果与结论:(1)高原训练中经皮氧分压、经皮氧分压/经皮二氧化碳分压呈现出"W"型变化趋势,经皮二氧化碳分压呈现"V"型变化趋势。(2)结果说明:高原训练"平原阶段储备体能、高原训练前期加量后期加度"的训练模式较为合理,可为今后高原训练提供一个较好的范式;经皮氧分压、经皮二氧化碳尤其是二者比值对评价运动负荷对运动员的刺激程度有着重要参考作用;经皮氧分压测定还量化了高原训练中运动员毛细血管的含氧量;建议将经皮氧分压作为一种无创性指标应用于运动员有氧能力变化的监测。
基金This work was supported by the grants from the National Key Basic Research and Development Program ＂973＂ Project （No. 2007CB512503）, and the China Postdoctoral Science Foundation （No. 20070420403）.Acknowledgements： The authors are highly grateful to Professor ZANG Yu-feng （State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University） for software support.
文摘Background The mechanism of acupuncture analgesia in craniotomy has been widely studied. However, the theoretical basis for selection of acupoints has not been examined. In this study, we used the regional homogeneity method blood oxygen level-dependent （BOLD） signals to determine changes in brain activity in response to transcutaneous electrical stimulation on acupoints and non-acupoints in resting state functional magnetic resonance imaging （fMRI）.Methods Twelve healthy volunteers were enrolled in this study. BOLD fMRI scanning of the brain was performed for 306 seconds before and 30 minutes after transcutaneous electrical stimulation on acupoints UB63 （Jinmen）, LV3 （Tai chong）, ST36 （Zusanli）, and GB40 （Qiuxu）. The procedure was repeated after one week with stimulation on non-acupoints （one was 9 above BL67, the second was 12 above BL67 （Kunlun）, the third was 7 above KI3, and the fourth was 10 above KI3 （Taixi））.Results The regional homogeneity in the acupoint group was increased in the left thalamus, caudate, putamen, lentiform nucleus （BA19, 30, 39）, postcentral gyrus, precentral gyrus （BA3, 4, 30, 32）, calcarine fissure, middle temporal gyrus （BA30）, right superior temporal gyrus, inferior temporal gyrus （BA38）, cuneus, and precuneus （BA7, 19） when compared to the non-acupoint group. The regional homogeneity of the acupoint group was decreased in the left cerebellum posterior lobe, middle frontal gyrus （BA10）, double-side precuneus （BA7）, and the postcentral gyrus （BA40）.Conclusions The brain region activated following acupoint stimulation is the ipsilateral pain-related brain region, which may relate to the therapeutic effect of acupuncture on pain relief. Further acupoint stimulation causes different central nervous responses compared to non-acupoint stimulation.
