Polysomnographically determined sleep and body mass index in patients with insomnia

We assessed associations between polysomnographically determined sleep, especially the amount of slow-wave sleep (SWS), and body mass index (BMI) in patients with insomnia. One hundred and forty-one insomniacs and 55 healthy volunteers completed overnight polysomnographic recordings, and we measured height and body weight. No significant correlations were obtained between total sleep time and BMI among insomniacs. Compared with normal volunteers, insomnia patients exhibited longer sleep latency and shorter total sleep duration. While the two groups had no significant differences in BMI, insomniacs presented with more N1 but less time spend in SWS and rapid eye movement sleep (REMS). Based on their SWS time, we divided insomnia patients into three groups: short (26.99±13.88), intermediate (59.24±8.12), and long (102.21±26.17) SWS groups. The short-SWS group had significantly greater BMI than the long-SWS group. Further analyses with multiple linear regression showed a significant negative correlation between the amount of SWS and BMI scores in insomniacs, whereas no such correlation was found in healthy volunteers after controlling for potential confounds (e.g., age, sex and AHI). Our study suggests that low amounts of SWS may be associated with higher BMI in patients with insomnia.     

减重步行训练对卒中后遗症期偏瘫患者的康复疗效

目的 探讨减重步行训练对卒中后遗症期偏瘫患者步行功能、下肢运动功能、日常生活能力及生活质量的影响.方法 将广州医学院第二附属医院康复科自2009年5月至2011年6月收治的58例卒中后遗症期偏瘫患者按随机数字表法分为减重步行训练组30例及对照组28例,对照组接受常规康复治疗,减重步行训练组除接受常规康复训练外另接受减重步行训练.在治疗前后采用功能性步行量表(FAC)、FugI-Meyer量表(FMA)、Barthel指数(BI)及生活质量量表(SF-36)分别评价患者步行功能、下肢运动功能、日常生活能力及生活质量.结果 治疗前2组患者FAC、FMA、BI、SF-36评分比较差异均无统计学意义(P＞0.05).治疗后2组患者FAC、FMA、BI、SF-36评分均较治疗前明显提高,差异有统计学意义(P＜0.05),其中减重步行训练组FAC、FMA、BI、SF-36评分改善情况均明显优于对照组,差异有统计学意义(P＜0.05).结论 减重步行训练较常规康复治疗能显著提高卒中后遗症期偏瘫患者的步行功能、下肢运动能力、日常生活能力及生活质量.     

针刺对照激素治疗贝尔麻痹急性期疗效比较系统评价

目的：比较针刺与激素治疗贝尔麻痹急性期临床疗效及安全性。方法：检索PubMed、Cochrane图书馆、CBM数据库、CNKI数据库等收集针灸治疗贝尔麻痹急性期的临床随机对照试验,以Cochrane系统评价手册4.26结合Jadad进行质量评价,统计学分析采用RevMan 4.2.6。结果：4篇文献符合纳入标准,共316例患者。Meta分析显示针刺治疗贝尔麻痹急性期对照激素为主治疗,组间比较差异无统计学意义。合并RR[随机效应模型]=1.11,95%CI（0.99,1.25）,Z=1.80,P=0.07。结论：针刺较激素予贝尔麻痹急性期治疗治愈率尚无差异,但可能有缩短疗程的趋势,需要高质量的证据进一步证明。     

针灸治疗压力性尿失禁的临床研究进展

目的了解针灸治疗压力性尿失禁的现状和存在的问题。方法总结和分析近十五年来针灸治疗压力性尿失禁的文献。结果针灸治疗压力性尿失禁疗效确切．但辨证和疗效评价的标准不一致。结论今后应运用循证医学的方法,建立完善的针灸治疗压力性尿失禁规范化诊疗体系。     

不同刺激量针刺关元穴对寒凝类痛经模型大鼠的影响

目的：观察不同的针刺刺激量施于关元穴对寒凝类痛经模型大鼠子宫组织中收缩素受体（ OTR）及肌球蛋白轻链激酶（ MLCK）含量的影响。方法将处于动情间期3月龄的SD雌性大鼠32只,随机分为盐水组、寒凝类痛经模型组24只,造模成功后将寒凝类痛经模型组又分为模型组、刺激量A组和刺激量B组,每组8只。除盐水组外,模型组、刺激量A组和刺激量B组均采用全身冷冻法结合苯甲酸雌二醇注射法造模。盐水组和模型组不予针刺,刺激量A组予以粗针、深刺、行手法;刺激量B组予以细针、浅刺、不施手法。采用荧光定量PCR方法检测大鼠子宫组织中缩宫素受体（ OTR）的含量。采用ELISA（酶联免疫法）测量大鼠子宫组织中MLCK的含量。结果与盐水组比较,模型组的子宫收缩波个数、波峰峰值、活动度及MLCK水平均升高（ P﹤0.01）;与模型组比较,刺激量A组的子宫收缩波个数明显减少（ P﹤0.05）、MLCK含量明显降低（ P﹤0.01）,刺激量B组的OTR mRNA相对表达量降低（ P﹤0.05）;与刺激量A组比较,刺激量B组收缩波个数增多（ P﹤0.05）、OTR mRNA相对表达量降低（ P﹤0.01）。结论不同刺激量针刺关元穴对寒凝类痛经模型大鼠的效应有所不同,粗针、深刺、行手法的效应较强于细针、浅刺、不行手法的针刺效应,提示针刺的刺激量也是决定针刺疗效的因素之一。     

Differential temporal neural responses of pain-related regions by acupuncture at acupoint ST36: a magnetoencephalography study

Background  Previous neuroimaging studies primarily focused on the spatial distribution of acupuncture needling stimulation. However, a salient feature of acupuncture was its long-lasting effect. This study attempted to detect the spatial-temporal neural responses evoked by acupuncture at an analgesia acupoint ST36 by using magnetoencephalography. To further verify its functional specificity, we also adopted acupuncture at Pericardium 6 and nonacupoint as separated controls.

Methods  Forty-two college students, all right-handed and acupuncture naïve, participated in this study. Every participant received only one acupoint stimulation, resulting in 14 subjects in one group. Both magnetoencephalography data (151-channel whole-head system) and structural functional magnetic resonance imaging data (3D sequence with a voxel size of 1 mm³ for anatomical localization) were collected for each subject. All processing procedures were performed in BrainStorm Toolbox.

Results  Acupuncture at ST36 showed a significantly time-varied brain activities with different onset time. Our results presented that acupuncture at different acupoints (or comparing with nonacupoint) can specifically induce neural responses in different brain areas—acupuncture at ST36 can specifically induce the neural responses of pain-inhibition areas, while acupuncture at PC6 can specifically induce the activities of the insula and amygdala.

Conclusions  In the present study, we attempted to detect the temporal neural responses underlying the functional specificity of acupuncture at ST36, using acupoint belonging to different meridians and non-acupoint with efficacy-irreverent as separate controls. The specific neural substrates involving acupuncture at different acupoints may be related to its functional specificity in clinical settings.

     

开窍通络针刺联合小续命汤加减用于脑卒中恢复期疗效观察

目的探讨开窍通络针刺联合小续命汤加减用于脑卒中恢复期的临床疗效。方法选取医院2018年3月至2019年3月收治的脑卒中恢复期患者82例,按随机数字表法分为对照组和试验组,各41例。两组患者均予常规治疗,并予开窍通络针刺,试验组患者加用小续命汤加减治疗。两组均治疗30 d,随访1个月。结果试验组总有效率为95.12%,显著高于对照组的78.05%(P <0.05);试验组患者治疗后的美国国立卫生研究院卒中量表及纤维蛋白原水平、血沉和血浆黏度均显著低于对照组,Fugl-Meyer评定量表和改良Barthel指数均显著高于对照组(P <0.05);治疗期间两组患者均未出现明显不良反应。结论开窍通络针刺联合小续命汤加减能改善脑卒中恢复期患者的神经功能和肢体运动功能,提高其日常生活能力,改善血液动力学。     

Predictive factors for surgical complications of laparoscopy-assisted distal gastrectomy for gastric cancer

Background  Some studies have found high incidences of intraoperative and postoperative complications for patients with gastric cancer. To determine the predictive factors for the surgical complications of laparoscopic gastric surgery, surgical outcomes were evaluated. Methods  Between April 2002 and December 2007, 152 patients with preoperatively diagnosed early gastric cancer who underwent laparoscopy-assisted distal gastrectomy (LADG) were enrolled. Visceral (VFA) and subcutaneous fat areas (SFA) were assessed by Fat Scan software. The predictive factors for surgical complications of LADG were evaluated by univariate and logistic regression analyses. Results  Of 152 patients, conversion to open surgery due to uncontrollable bleeding was observed in nine male patients, and postoperative complications were detected in seven male and one female patient (four anastomotic leakage, two intraabdominal abscess, one pancreatic fistula, and one lymphorrhea). High body mass index (BMI) and high VFA independently predicted conversion to open surgery and postoperative complications. VFA was significantly higher, operation time was longer, blood loss was greater, and SFA was lower in male than in female patients, whereas no significant difference was observed in BMI between male and female patients. Conclusions  High BMI and high VFA can predict technical difficulties during laparoscopic gastric surgery and postoperative complications. Particularly, LADG should be performed cautiously to prevent surgical complications for male patients with high VFA. Predictive impact of VFA should be further determined in a larger set of patients.     

金纳多联合针灸治疗感音性耳鸣的疗效观察

目的：观察金纳多联合针灸治疗感音性耳鸣的临床疗效。方法将81例患者随机单盲法分成两组,观察组（A组）41人,采用金纳多联合针灸耳穴治疗;对照组（B组）40人,血栓通联合针灸耳穴治疗,均以2周为1疗程,效差时连续下1疗程,共3个疗程,每疗程间隔3~4d。结果 A组：痊愈22例,显效7例,有效6例,显效率70.7%,总有效率87.5%;B组：治愈16例,显效6例,有效5例,显效率55.0%,总有效率为67.5%. A组总有效率明显高于B组（P〈0.01）。结论 A组治疗感音性耳鸣疗效优于B组,金纳多联合针灸治疗感音性耳鸣能有效提高有效率,值得推广应用。     

Yoga Training Improves Metabolic Parameters in Obese Boys

Yoga has been known to have stimulatory or inhibitory effects on the metabolic parameters and to be uncomplicated therapy for obesity. The purpose of the present study was to test the effect of an 8-week of yoga-asana training on body composition, lipid profile, and insulin resistance (IR) in obese adolescent boys. Twenty volunteers with body mass index (BMI) greater than the 95th percentile were randomly assigned to yoga (age 14.7±0.5 years, n=10) and control groups (age 14.6±1.0 years, n=10). The yoga group performed exercises three times per week at 40~60% of heart-rate reserve (HRR) for 8 weeks. IR was determined with the homeostasis model assessment of insulin resistance (HOMA-IR). After yoga training, body weight, BMI, fat mass (FM), and body fat % (BF %) were significantly decreased, and fat-free mass and basal metabolic rate were significantly increased than baseline values. FM and BF % were significantly improved in the yoga group compared with the control group (p<0.05). Total cholesterol (TC) was significantly decreased in the yoga group (p<0.01). HDL-cholesterol was decreased in both groups (p<0.05). No significant changes were observed between or within groups for triglycerides, LDL-cholesterol, glucose, insulin, and HOMA-IR. Our findings show that an 8-week of yoga training improves body composition and TC levels in obese adolescent boys, suggesting that yoga training may be effective in controlling some metabolic syndrome factors in obese adolescent boys.