The evolution of acupuncture anesthesia(AA)has spanned six decades.Cardiothoracic surgery serves as a representative case study to illustrate this evolution.Reflecting on its historical development,the use of AA in ca...The evolution of acupuncture anesthesia(AA)has spanned six decades.Cardiothoracic surgery serves as a representative case study to illustrate this evolution.Reflecting on its historical development,the use of AA in cardiothoracic surgery has advanced from basic AA procedures in the 1960s to combined acupuncture and drug anesthesia techniques in the early 1980s.Since 2005,the innovative use of non-intubation AA combined anesthesia has been implemented extensively in cardiothoracic surgery.As the medical industry continues to evolve,the techniques applied in AA have expanded to encompass the entire perioperative period in cardiothoracic surgery,leading to the introduction of the concept of modern AA.The use of AA in cardiothoracic surgery exemplifies the ongoing advances and integration of traditional Chinese and Western medicine.Moving forward,it is imperative to enhance the theoretical framework of AA through the execution of rigorous multicenter clinical trials,to further strengthen the body of evidence supporting evidence-based medicine,and to finally explore the underlying mechanisms of AA.展开更多
AIM:To investigate usefulness of adherence to gastroesophageal reflux disease(GERD) guideline established by the Spanish Association of Gastroenterology.METHODS:Prospective,observational and multicentre study of 301 p...AIM:To investigate usefulness of adherence to gastroesophageal reflux disease(GERD) guideline established by the Spanish Association of Gastroenterology.METHODS:Prospective,observational and multicentre study of 301 patients with typical symptoms of GERD who should be managed in accordance with guidelines and were attended by gastroenterologists in daily practice.Patients(aged > 18 years) were eligible for inclusion if they had typical symptoms of GERD(heartburn and/or acid regurgitation) as the major complaint in the presence or absence of accompanying atypical symptoms,such as dyspeptic symptoms and/or supraesophageal symptoms.Diagnostic and therapeutic decisions should be made based on specific recommendations of the Spanish clinical practice guideline for GERD which is a widely disseminated and well known instrument among Spanish in digestive disease specialists.RESULTS:Endoscopy was indicated in 123(41%) patients:50 with alarm symptoms,32 with age > 50 years without alarm symptom.Seventy-two patients(58.5%) had esophagitis(grade A,23,grade B,28,grade C,18,grade D,3).In the presence of alarm symptoms,endoscopy was indicated consistently with recommendations in 98% of cases.However,in the absence of alarm symptoms,endoscopy was indicated in 33% of patients > 50 years(not recommended by the guideline).Adherence for proton pump inhibitors(PPIs) therapy was 80%,but doses prescribed were lower(half) in 5% of cases and higher(double) in 15%.Adherence regarding duration of PPI therapy was 69%;duration was shorter than recommended in 1%(4 wk in esophagitis grades C-D) or longer in 30%(8 wk in esophagitis grades A-B or in patients without endoscopy).Treatment response was higher when PPI doses were consistent with guidelines,although differences were not significant(95% vs 85%).CONCLUSION:GERD guideline compliance was quite good although endoscopy was over indicated in patients > 50 years without alarm symptoms;PPIs were prescribed at higher doses and longer duration.展开更多
Tang Shulan is president of Shulan College of Chinese Medicine,in Manchester,the United Kingdom,and president of the China-UK Center of Chinese Medicine.Since 1993,the year she founded the college,Tang has dedicated h...Tang Shulan is president of Shulan College of Chinese Medicine,in Manchester,the United Kingdom,and president of the China-UK Center of Chinese Medicine.Since 1993,the year she founded the college,Tang has dedicated herself to both the clinical practice of traditional Chinese medicine(TCM)and the promotion of TCM education and culture in the UK,and around the world.展开更多
基金the Shanghai Acupuncture Clinical Medical Research Center project(No.20MC1920500)National Key Disciplines Construction Project of High-level Traditional Chinese Medicine of China(No.zyyzdxk-2023068)+1 种基金National Natural Science Foundation of China(No.82074163)Shanghai Science and Technology Commission Project(No.21Y31920100)。
文摘The evolution of acupuncture anesthesia(AA)has spanned six decades.Cardiothoracic surgery serves as a representative case study to illustrate this evolution.Reflecting on its historical development,the use of AA in cardiothoracic surgery has advanced from basic AA procedures in the 1960s to combined acupuncture and drug anesthesia techniques in the early 1980s.Since 2005,the innovative use of non-intubation AA combined anesthesia has been implemented extensively in cardiothoracic surgery.As the medical industry continues to evolve,the techniques applied in AA have expanded to encompass the entire perioperative period in cardiothoracic surgery,leading to the introduction of the concept of modern AA.The use of AA in cardiothoracic surgery exemplifies the ongoing advances and integration of traditional Chinese and Western medicine.Moving forward,it is imperative to enhance the theoretical framework of AA through the execution of rigorous multicenter clinical trials,to further strengthen the body of evidence supporting evidence-based medicine,and to finally explore the underlying mechanisms of AA.
文摘AIM:To investigate usefulness of adherence to gastroesophageal reflux disease(GERD) guideline established by the Spanish Association of Gastroenterology.METHODS:Prospective,observational and multicentre study of 301 patients with typical symptoms of GERD who should be managed in accordance with guidelines and were attended by gastroenterologists in daily practice.Patients(aged > 18 years) were eligible for inclusion if they had typical symptoms of GERD(heartburn and/or acid regurgitation) as the major complaint in the presence or absence of accompanying atypical symptoms,such as dyspeptic symptoms and/or supraesophageal symptoms.Diagnostic and therapeutic decisions should be made based on specific recommendations of the Spanish clinical practice guideline for GERD which is a widely disseminated and well known instrument among Spanish in digestive disease specialists.RESULTS:Endoscopy was indicated in 123(41%) patients:50 with alarm symptoms,32 with age > 50 years without alarm symptom.Seventy-two patients(58.5%) had esophagitis(grade A,23,grade B,28,grade C,18,grade D,3).In the presence of alarm symptoms,endoscopy was indicated consistently with recommendations in 98% of cases.However,in the absence of alarm symptoms,endoscopy was indicated in 33% of patients > 50 years(not recommended by the guideline).Adherence for proton pump inhibitors(PPIs) therapy was 80%,but doses prescribed were lower(half) in 5% of cases and higher(double) in 15%.Adherence regarding duration of PPI therapy was 69%;duration was shorter than recommended in 1%(4 wk in esophagitis grades C-D) or longer in 30%(8 wk in esophagitis grades A-B or in patients without endoscopy).Treatment response was higher when PPI doses were consistent with guidelines,although differences were not significant(95% vs 85%).CONCLUSION:GERD guideline compliance was quite good although endoscopy was over indicated in patients > 50 years without alarm symptoms;PPIs were prescribed at higher doses and longer duration.
文摘Tang Shulan is president of Shulan College of Chinese Medicine,in Manchester,the United Kingdom,and president of the China-UK Center of Chinese Medicine.Since 1993,the year she founded the college,Tang has dedicated herself to both the clinical practice of traditional Chinese medicine(TCM)and the promotion of TCM education and culture in the UK,and around the world.
