We report about a successful heart failure therapy with carvedilol in two children with neonatal Marfan syndrome (nMFS). As shown in Case 1, double valve replacement in an infant with neonatal Marfan syndrome is feasi...We report about a successful heart failure therapy with carvedilol in two children with neonatal Marfan syndrome (nMFS). As shown in Case 1, double valve replacement in an infant with neonatal Marfan syndrome is feasible but its benefit on long term is uncertain. Excluding our patient, 3 infants with nMFS from the literature died early after cardiac surgery. Our second case is a unique patient who survives nMFS despite diaphragmatic herniae, dilated neonatal cisterna magna and severe atrioventricular valve insufficiencies. Treated with 0.7 mg/kg/day Carvedilol since his seventh month of life, he never developed severe heart failure. However despite his good health status at the age of 9 years, a progressive aortic root dilatation and left conornary aneurysm are still waiting for surgical repair.展开更多
1) Introduction: Ventilation disorders of the middle ear play a major role in everyday clinical ENT-practice and sometimes represent a major therapeutic challenge. In addition to the conventional therapy of tympanosto...1) Introduction: Ventilation disorders of the middle ear play a major role in everyday clinical ENT-practice and sometimes represent a major therapeutic challenge. In addition to the conventional therapy of tympanostomy tube insertion, tuboplasty (TP) offers a less invasive option for treating this problem. The study should examine whether TP can be performed in a rural setting. 2) Material and methods: This is a prospective, monocentric study of patients scheduled for TP because of tubal ventilation disorder (TVD) in a rural region of Germany. The diagnosis was established after a thorough clinical examination and by assessing the possibility of performing the Valsalva maneuver, the tympanogram type, recording the middle ear pressure and air-bone gap. The subjective impairment caused by the TVD was evaluated using the EDTQ-7 questionnaire pre- and approximately 3 months postoperatively. 3) Results: Sixty-two patients with 92 TP were included with a mean age of 44.1 years. The EDTQ-7 score decreased highly significantly from 3.6 to 1.7 (p < 0.0001) without correlating with parameters such as age, sex, BMI, allergies or smoking. Middle ear pressure fell in average by −87 daPa, resulting in an improvement of the tympanogram type. The preoperative air-bone gap of 10.2 dB also was reduced significantly in most patients to 8.0 dB after the procedure. No notable complications occurred beside a sore throat due to the use of a laryngeal mask for ventilation during anesthesia in two cases. 4) Conclusion: In our experience, TP represents a less invasive and, in many cases, successful alternative to the established tympanostomy tube insertion with the advantage of an intact eardrum. It can also be offered and successfully performed in a rural setting.展开更多
Depression is a prevalent neuropsychiatric disorder characterized by persistent sadness,anhedonia,guilt,fatigue,and impaired concentration.Although pharmacotherapy and psychotherapy can be effective,their utility is l...Depression is a prevalent neuropsychiatric disorder characterized by persistent sadness,anhedonia,guilt,fatigue,and impaired concentration.Although pharmacotherapy and psychotherapy can be effective,their utility is limited by adverse effects and significant inter-individual variability.Non-pharmacological therapies from traditional medicine have emerged as promising adjuncts owing to their favorable safety profiles,minimal side effects,and high patient compliance.These therapies,including acupoint stimulation,meditation,and yoga,produce antidepressant effects by reducing neuroinflammation,modulating neurotransmitter release,enhancing neuroplasticity,and regulating the gut-brain axis.This review summarizes clinical applications and mechanistic insights of traditional medicine’s non-pharmacological therapies for depression,providing a scientific rationale for their integration into comprehensive management.展开更多
BACKGROUND Electroacupuncture(EA)has been recognized for its beneficial effects on glucolipid metabolism,potentially through the regulation of sensory nerve coordination.The expandability of peripancreatic adipose tis...BACKGROUND Electroacupuncture(EA)has been recognized for its beneficial effects on glucolipid metabolism,potentially through the regulation of sensory nerve coordination.The expandability of peripancreatic adipose tissue(PAT)is implicated in the transition from obesity to type 2 diabetes mellitus(T2DM).However,the specific pancreatic responses to EA require further elucidation.AIM To investigate the influence of EA on pancreatic glucolipid reduction level in a high-fat diet(HFD)rat model.METHODS To delineate the precise pathway through which EA mediates interactions bet ween PAT and islets,we assessed the expression levels of NGF,TRPV1,insulin,as well as other proteins in the pancreas and PAT.This approach enabled us to identify the acupoints that are most conducive to optimizing glycolipid metabolism.RESULTS The ST25,LI11 and ST37 groups attenuated HFD-induced obesity and insulin resistance(IR)to distinct degrees,with ST25 group having the greatest effect.EA at ST25 was found to modify the local regulatory influence of PAT on the pancreatic intrinsic nervous system.Specifically,EA at ST25 obviously activated the TRPV1-CGRP-islet beta cell pathway,contributing to the relief of glucolipid metabolic stress.The beneficial effects were abrogated following the chemical silencing of TRPV1 sensory afferents,confirming their indispensable role in EA-mediated regulation of islet and PAT function.Furthermore,in TRPV1 knockout mice,a reduction in PAT inflammation was observed,along with the recovery of islet beta cell function.EA at LI11 and ST37 demonstrated anti-inflammatory properties and helped ameliorate IR.CONCLUSION The PAT ecological niche influenced the progression from obesity to T2DM through various immunometabolic pathways.EA at ST25 could regulate glucolipid metabolism via the TRPV1-CGRP-islet beta cell pathway.展开更多
Background:Acupuncture therapy provides a complementary and alternative approach to treating major depressive disorder(MDD),but its efficacy and safety have still not been comprehensively assessed.Recently published s...Background:Acupuncture therapy provides a complementary and alternative approach to treating major depressive disorder(MDD),but its efficacy and safety have still not been comprehensively assessed.Recently published systematic reviews remain confusing and inconclusive.Objective:This systematic review evaluated the efficacy and safety of acupuncture therapy alone or combined with antidepressants for adult patients with mild and moderate MDD.Search strategy:Chinese Biomedical Literature Database,China National Knowledge Infrastructure Database,Wanfang Database,Chinese Science and Technology Journal Database,Pub Med,Embase,and Cochrane Library were searched from their inceptions to March 2025.Inclusion criteria:Randomized controlled trials that compared acupuncture therapy with antidepressants,or acupuncture therapy plus antidepressants with acupuncture therapy or antidepressants for adult patients with mild and moderate MDD were included.Data extraction and analysis:Five reviewers independently extracted data from original literature using a standardized form,and the data were verified by two reviewers to ensure accuracy.Statistical meta-analyses,publication bias analyses,and subgroup analyses were performed by using Review Manager 5.3 software.The Grading of Recommendations Assessment,Development,and Evaluation approach was used to assess the certainty of the evidence.Results:A total of 60 eligible studies including 4675 participants were included.Low-certainty evidence showed that compared with antidepressants,acupuncture therapy(standardized mean difference[SMD]=-0.57;95%confidence interval[CI]=[-0.87,-0.27];I^(2)=86%;P=0.006)or acupuncture therapy plus antidepressants(SMD=-1.00;95%CI=[-1.18,-0.81];I^(2)=77%;P<0.00001)may reduce the severity of depression at the end of treatment.Low-certainty evidence indicated that compared with acupuncture therapy alone,acupuncture therapy plus antidepressants slightly reduced the severity of depression at the end of treatment(SMD=-0.38;95%CI=[-0.61,-0.14];I^(2)=18%;P=0.002).Similar results were also found for acupuncture's relief of insomnia.The reported adverse effects of acupuncture therapy were mild and transient.For most of the subgroup analyses,acupuncture type,scale type,and the course of treatment did not show a significant relative effect.Conclusion:Acupuncture therapy may provide antidepressant effects and relieve insomnia with mild adverse effects for adult patients with mild and moderate MDD.But the certainty of evidence was very low.More high-quality,well designed,large-scale studies with long-term follow-up are needed in the future.展开更多
目的:观察针刺推拿结合治疗Sudeck骨萎缩的临床疗效。方法:将92例Sudeck骨萎缩患者随机分为治疗组和对照组各46例,治疗组采用针刺加推拿手法,对照组采用单纯针刺法,以临床疗效、评定疼痛的视觉模拟评分(visual analogue scale VAS)及腕...目的:观察针刺推拿结合治疗Sudeck骨萎缩的临床疗效。方法:将92例Sudeck骨萎缩患者随机分为治疗组和对照组各46例,治疗组采用针刺加推拿手法,对照组采用单纯针刺法,以临床疗效、评定疼痛的视觉模拟评分(visual analogue scale VAS)及腕关节功能Dienst分级评分为观察指标。结果:两组均取得明显的疗效,且治疗组明显优于对照组(P<0.01);与对照组相比,VAS评分(cm,2.01±2.03 vs 3.16±2.22)及Dienst评分(优21 vs 11例;良15 vs 12例;可6 vs 14例;差4 vs 9例)均有显著性差异(P<0.01)。结论:针刺、推拿疗法治疗Sudeck骨萎缩疗效确切,针刺推拿结合法的疗效明显优于单纯针刺法,尤其在消肿止痛、改善腕关节功能方面具有显著的优势,值得推广应用。展开更多
文摘We report about a successful heart failure therapy with carvedilol in two children with neonatal Marfan syndrome (nMFS). As shown in Case 1, double valve replacement in an infant with neonatal Marfan syndrome is feasible but its benefit on long term is uncertain. Excluding our patient, 3 infants with nMFS from the literature died early after cardiac surgery. Our second case is a unique patient who survives nMFS despite diaphragmatic herniae, dilated neonatal cisterna magna and severe atrioventricular valve insufficiencies. Treated with 0.7 mg/kg/day Carvedilol since his seventh month of life, he never developed severe heart failure. However despite his good health status at the age of 9 years, a progressive aortic root dilatation and left conornary aneurysm are still waiting for surgical repair.
文摘患者报告结局(patient reported outcome,PRO)直接来源于患者对其健康状态及治疗的直接报告,在肾脏病学尤其是血液透析(hemodialysis,HD)中具有重要价值,可反映患者身心状态并辅助治疗策略调整。2018年启动的高剂量血液透析滤过与高通量血液透析的比较(comparison of highdose hemodiafiltration with high-flux hemodialysis,CONVINCE)研究首次纳入PRO。本文系统梳理PRO及其在血液透析滤过研究中的应用,并展望其临床实践前景,为相关研究和实践提供参考。
文摘1) Introduction: Ventilation disorders of the middle ear play a major role in everyday clinical ENT-practice and sometimes represent a major therapeutic challenge. In addition to the conventional therapy of tympanostomy tube insertion, tuboplasty (TP) offers a less invasive option for treating this problem. The study should examine whether TP can be performed in a rural setting. 2) Material and methods: This is a prospective, monocentric study of patients scheduled for TP because of tubal ventilation disorder (TVD) in a rural region of Germany. The diagnosis was established after a thorough clinical examination and by assessing the possibility of performing the Valsalva maneuver, the tympanogram type, recording the middle ear pressure and air-bone gap. The subjective impairment caused by the TVD was evaluated using the EDTQ-7 questionnaire pre- and approximately 3 months postoperatively. 3) Results: Sixty-two patients with 92 TP were included with a mean age of 44.1 years. The EDTQ-7 score decreased highly significantly from 3.6 to 1.7 (p < 0.0001) without correlating with parameters such as age, sex, BMI, allergies or smoking. Middle ear pressure fell in average by −87 daPa, resulting in an improvement of the tympanogram type. The preoperative air-bone gap of 10.2 dB also was reduced significantly in most patients to 8.0 dB after the procedure. No notable complications occurred beside a sore throat due to the use of a laryngeal mask for ventilation during anesthesia in two cases. 4) Conclusion: In our experience, TP represents a less invasive and, in many cases, successful alternative to the established tympanostomy tube insertion with the advantage of an intact eardrum. It can also be offered and successfully performed in a rural setting.
基金supported by the Beijing Natural Science Foundation(7244491)Beijing TCM Science and Technology Development Fund Project(BJZYON-2023-05)+2 种基金Fundamental Research Funds for the Central Public Welfare Research Institutes(ZZ15-YQ-048,ZZ-YQ2023006)Innovation Team and Talents Cultivation Program of National Administration of Traditional Chinese Medicine(ZYYCXTD-D-202409)Science and Technology Innovation Project of the Institute of Acupuncture and Moxibustion,China Academy of Chinese Medical Sciences(CIZJS2025023).
文摘Depression is a prevalent neuropsychiatric disorder characterized by persistent sadness,anhedonia,guilt,fatigue,and impaired concentration.Although pharmacotherapy and psychotherapy can be effective,their utility is limited by adverse effects and significant inter-individual variability.Non-pharmacological therapies from traditional medicine have emerged as promising adjuncts owing to their favorable safety profiles,minimal side effects,and high patient compliance.These therapies,including acupoint stimulation,meditation,and yoga,produce antidepressant effects by reducing neuroinflammation,modulating neurotransmitter release,enhancing neuroplasticity,and regulating the gut-brain axis.This review summarizes clinical applications and mechanistic insights of traditional medicine’s non-pharmacological therapies for depression,providing a scientific rationale for their integration into comprehensive management.
基金Supported by National Natural Science Foundation of China,No.82305376,No.82374577,No.82305375,No.82074532,and No.82405567The Priority Academic Program Development of Jiangsu Higher Education Institutions(PAPD).
文摘BACKGROUND Electroacupuncture(EA)has been recognized for its beneficial effects on glucolipid metabolism,potentially through the regulation of sensory nerve coordination.The expandability of peripancreatic adipose tissue(PAT)is implicated in the transition from obesity to type 2 diabetes mellitus(T2DM).However,the specific pancreatic responses to EA require further elucidation.AIM To investigate the influence of EA on pancreatic glucolipid reduction level in a high-fat diet(HFD)rat model.METHODS To delineate the precise pathway through which EA mediates interactions bet ween PAT and islets,we assessed the expression levels of NGF,TRPV1,insulin,as well as other proteins in the pancreas and PAT.This approach enabled us to identify the acupoints that are most conducive to optimizing glycolipid metabolism.RESULTS The ST25,LI11 and ST37 groups attenuated HFD-induced obesity and insulin resistance(IR)to distinct degrees,with ST25 group having the greatest effect.EA at ST25 was found to modify the local regulatory influence of PAT on the pancreatic intrinsic nervous system.Specifically,EA at ST25 obviously activated the TRPV1-CGRP-islet beta cell pathway,contributing to the relief of glucolipid metabolic stress.The beneficial effects were abrogated following the chemical silencing of TRPV1 sensory afferents,confirming their indispensable role in EA-mediated regulation of islet and PAT function.Furthermore,in TRPV1 knockout mice,a reduction in PAT inflammation was observed,along with the recovery of islet beta cell function.EA at LI11 and ST37 demonstrated anti-inflammatory properties and helped ameliorate IR.CONCLUSION The PAT ecological niche influenced the progression from obesity to T2DM through various immunometabolic pathways.EA at ST25 could regulate glucolipid metabolism via the TRPV1-CGRP-islet beta cell pathway.
基金supported by the National Natural Science Foundation of China(No.82474644)the National Key R&D Foundation of China(No.2017YFC1703600)+1 种基金the Shenzhen“Sanming Project”(No.202101007)the Shenzhen Science and Technology Program(No.JCYJ2022081810080300)。
文摘Background:Acupuncture therapy provides a complementary and alternative approach to treating major depressive disorder(MDD),but its efficacy and safety have still not been comprehensively assessed.Recently published systematic reviews remain confusing and inconclusive.Objective:This systematic review evaluated the efficacy and safety of acupuncture therapy alone or combined with antidepressants for adult patients with mild and moderate MDD.Search strategy:Chinese Biomedical Literature Database,China National Knowledge Infrastructure Database,Wanfang Database,Chinese Science and Technology Journal Database,Pub Med,Embase,and Cochrane Library were searched from their inceptions to March 2025.Inclusion criteria:Randomized controlled trials that compared acupuncture therapy with antidepressants,or acupuncture therapy plus antidepressants with acupuncture therapy or antidepressants for adult patients with mild and moderate MDD were included.Data extraction and analysis:Five reviewers independently extracted data from original literature using a standardized form,and the data were verified by two reviewers to ensure accuracy.Statistical meta-analyses,publication bias analyses,and subgroup analyses were performed by using Review Manager 5.3 software.The Grading of Recommendations Assessment,Development,and Evaluation approach was used to assess the certainty of the evidence.Results:A total of 60 eligible studies including 4675 participants were included.Low-certainty evidence showed that compared with antidepressants,acupuncture therapy(standardized mean difference[SMD]=-0.57;95%confidence interval[CI]=[-0.87,-0.27];I^(2)=86%;P=0.006)or acupuncture therapy plus antidepressants(SMD=-1.00;95%CI=[-1.18,-0.81];I^(2)=77%;P<0.00001)may reduce the severity of depression at the end of treatment.Low-certainty evidence indicated that compared with acupuncture therapy alone,acupuncture therapy plus antidepressants slightly reduced the severity of depression at the end of treatment(SMD=-0.38;95%CI=[-0.61,-0.14];I^(2)=18%;P=0.002).Similar results were also found for acupuncture's relief of insomnia.The reported adverse effects of acupuncture therapy were mild and transient.For most of the subgroup analyses,acupuncture type,scale type,and the course of treatment did not show a significant relative effect.Conclusion:Acupuncture therapy may provide antidepressant effects and relieve insomnia with mild adverse effects for adult patients with mild and moderate MDD.But the certainty of evidence was very low.More high-quality,well designed,large-scale studies with long-term follow-up are needed in the future.
文摘目的:观察针刺推拿结合治疗Sudeck骨萎缩的临床疗效。方法:将92例Sudeck骨萎缩患者随机分为治疗组和对照组各46例,治疗组采用针刺加推拿手法,对照组采用单纯针刺法,以临床疗效、评定疼痛的视觉模拟评分(visual analogue scale VAS)及腕关节功能Dienst分级评分为观察指标。结果:两组均取得明显的疗效,且治疗组明显优于对照组(P<0.01);与对照组相比,VAS评分(cm,2.01±2.03 vs 3.16±2.22)及Dienst评分(优21 vs 11例;良15 vs 12例;可6 vs 14例;差4 vs 9例)均有显著性差异(P<0.01)。结论:针刺、推拿疗法治疗Sudeck骨萎缩疗效确切,针刺推拿结合法的疗效明显优于单纯针刺法,尤其在消肿止痛、改善腕关节功能方面具有显著的优势,值得推广应用。
