Kaufmanhein5759
Aortic stenosis (AS) causes left ventricular outflow obstruction. Severe AS has major haemodynamic implications in critically ill patients, in whom increased cardiac output and oxygen delivery are often required. Transthoracic echocardiography (TTE) plays a key role in the AS severity grading. In this review, we will give an overview of how to use the simplified Bernoulli equation to convert the echo Doppler measured velocities (cm s-1) to AS peak and mean gra-dient (mm Hg) and how to calculate the aortic valve area (AVA), using the continuity equation, based on the principle of preservation of flow. TTE allows quantification of compensatory left ventricular (LV) hypertrophy, assessment of LV systolic function, and determination of LV diastolic function and LV loading. Subsequently, the obtained results from the TTE study need to be integrated to establish the AS severity grading. The pitfalls of echocardiographic AS severity assessment are explained, and how to deal with inconsistency between AVA and mean gradient. The contribution of transoesophageal echocardiography, low-dose dobutamine stress echo (in case of low-flow low-gradient AS), echocardiography strain imaging, cardiac magnetic resonance imaging, cardiac multidetector computed tomography and the relatively new concept of Flow Pressure Gradient Classification to the work-up for aortic stenosis is discussed. Finally, the treatment of AS is overviewed. Elective aortic valve replacement is indicated in patients with severe symptomatic AS. In the ICU, afterload reduction by vasodilator therapy and treatment of pulmonary and venous congestion by diuretics could be considered.The relationship between adenosine receptor (AdoR) and myocardial ischemia (MI), effect of acupuncture for MI and action mechanism of acupuncture improving MI by regulating AdoR are summarized. The existing researches have preliminarily reflected that the improvement of MI treated with acupuncture may be achieved by influencing the expression of AdoR. However, there are still some limitations, e.g. most of the research regimens are single-acupoint, the research results are not entirely consistent and the interaction of AdoRs are ignored, all these need to be further verified and supplemented.
To analyze the rules of acupoint selection in the acupuncture treatment of cervical spondylotic radiculopathy by data mining.
The randomized controlled trials (RCTs) regarding acupuncture for cervical spondylotic radiculopathy published from July 15 of 2009 to July 15 of 2019 were retrieved from databases of CNKI, VIP, Wanfang, SinoMed, PubMed and EMbase. A database was established with Microsoft Excel 2016. The frequency and total effective rate of high-frequency acupoints, meridians and acupoint combinations were analyzed, and the association rules of acupoints and meridians were analyzed by Apriori algorithm.
A total of 87 RCTs were included, involving 104 acupoints with a total frequency of 921. Among them, the high-frequency acupoints were cervical Jiaji (EX-B 2, 87 times), Fengchi (GB 20, 70 times), Houxi (SI 3, 54 times), etc. The frequently-used acupoints were mainly distributed in the hand
large intestine meridian, the foot
gallbladder meridian and hand
small intestine meridian. The frequently-used acupoint combination was Fengchi (GB 20)-cervical Jiaji (EX-B 2), and most of the combinations were acupoints at the proximal end and acupoints at the far and near end. With the analysis of association rules, 15 groups of acupoint association rules and meridian association rules were obtained.
It is feasible to explore the acupoint selection and compatibility rules of acupuncture for cervical spondylotic radiculopathy by data mining. This study could provide corresponding reference for clinical treatment.
It is feasible to explore the acupoint selection and compatibility rules of acupuncture for cervical spondylotic radiculopathy by data mining. This study could provide corresponding reference for clinical treatment.
By defining the inclusion criteria of the lost acupuncture technique and sorting out the content of lost acupuncture technique (possibly lost acupuncture technique), this article aimed to provide ideas and methods of the inheritance of acupuncture technique.
The whole entries of
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were searched. The items of acupuncture technique were screened and used as the key terms to retrieve the literature from the database of CNKI, Wanfang, VIP and SinoMed. After that, the lost acupuncture technique and the possibly lost technique were selected from included items, and the terminologies of acupuncture technique were standardized.
A total of 364 items of acupuncture technique were retrieved, including 17 items of lost acupuncture technique and 12 items of possibly lost acupuncture technique.
The lost acupuncture technique is defined as the acupuncture technique recorded in ancient classics but can not be retrieved in modern literature of clinical application or expert's experience. The change of government or alternation of dynasty, the evolution of acupuncture-moxibustion theories and education are the related causes of lost acupuncture technique.
The lost acupuncture technique is defined as the acupuncture technique recorded in ancient classics but can not be retrieved in modern literature of clinical application or expert's experience. The change of government or alternation of dynasty, the evolution of acupuncture-moxibustion theories and education are the related causes of lost acupuncture technique.From the view of location, through the longitudinal comparison of the meridian name references of "moxibustion on a meridian" from the records in Zubi Shiyimai Jiujing (Moxibustion Classic of Eleven Yin-Yang Meridians) to the works in the Tang dynasty. The connotation and significance are analyzed on the occurrence and disappearance of the substitution of meridian terms for the indications so as to better understand the connotation of ancient "meridian (mai )" and the relevant content of the evolution of meridians and acupoints and to deepen the recognition of acupuncture therapy at the early era.Through analyzing the differences in the clinical questions of Guideline for Clinical Practice of Acupuncture- Moxibustion Migraine (Guideline) between the domestic standard and international standard (under development), the specific issues are determined in the transformation from domestic standard to international one. Taking acupuncture practitioners as investigation object, by means of the survey, the basic information and clinical questions were investigated. The survey results show that the following aspects should be supplemented in terms of the international requirements during the development of this international Guideline suitable patient population, applicable types of disease, the optimal intervention time of acupuncture for migraine, common methods in treatment as well as the other involved health problems. selleck chemicals llc Moreover, it needs to update the key clinical questions, recommended regimens for the newly supplemented types of disease, as well as the more specified assessment on therapeutic effect. The ultimate solution of these questions relies on the quality of clinical evidence.Through sorting out the development of meridian points and the standardization of extraordinary points in dynasties, two objectives are discovered in the standardization of extraordinary points starting from the Tang Dynasty. The points with extraordinary effect are selected points and transferred to meridian points and the commonly-used key points are selected and developed to be standardized acupoints. Hence, 3 approaches are summarized. Approach No.1 a large number of "meridian-outside" points that are the potential supplementation but not included yet in meridian points are supplemented to meridian points. Approach No.2 based on the specified requirement, the key points are selected from the acupoints with determined locations and names, which is developed to be the standard of acupoints. Approach No.3 the acupoints with extraordinary effect are selected from the "meridian-outside" points and these points are collected for the formulation of the standard of extraordinary points. The latter two approaches provide for the development direction of teaching and standardization in the future.The classic acupuncture theory is an important component of the basic theory of TCM. Due to clinical disciplinary division and other factors, the relationship of acupuncture theory with each division of "Chinese herbal formula and pulse" has been gradually alienated. In this paper, by taking the progress of syndrome/pattern differentiation and treatment of 3 medical cases as the examples, the feasibility of clinical application of classical formulas guided by the classic acupuncture theory and clinical effect are explained. It shows that the accuracy of syndrome/pattern differentiation and the therapeutic effect can be obviously improved if the classic acupuncture theory is correctly applied to the syndrome/pattern differentiation and treatment with classical Chinese herbal formulas. It also proves the inner communication and high complementarity in terms of the theory between acupuncture and classical Chinese herbal formula. It is anticipated to provide the references for the theoretic integration among academic disciplines and for the mutual reference as well as for the application of the characteristic theories among specialties.Professor LIN Guo-hua's clinical experience of acupuncture for oculomotor nerve palsy was summarized and one typical case was introduced. Professor LIN skillfully applied traditional acupuncture theory and classical acupuncture method, and proposed a diagnosis and treatment system combining meridian syndrome differentiation and specific acupuncture techniques. In addition, Professor LIN combined the yuan-primary and luo-connecting acupoints combination method, theory of "removing the stagnation of blood and qi " and theory of root-stem and origin-end, etc. into the treatment of oculomotor nerve palsy, and achieved good results.On the base of the theory on "the subtlety of acupuncture relying on the quick or slow needle insertion by the timing" recorded in the Chapter One of Lingshu (Miraculous Pivot) and the clinical application, professor GAO Zhen-wu created three core factors of "quick and slow needling technique" of acupuncture and summarized in the paper. The speed of deqi after needle insertion indicates the rising and falling of vital qi and pathogen in the body, which guides the selection of corresponding reinforcing or reducing needling techniques. At the stage of needle manipulation and the regulation of qi activity, the quick or slow insertion and withdrawal of needle and needle manipulation, as well as the duration of needle retaining may control the speed of qi arrival. At the stage of the change in qi transformation after needling, the speed of qi activity should be observed carefully before and after needling so as to determine the effect of reinforcing and reducing technique of acupuncture. Gao 's idea on "quick and slow needling technique" of acupuncture runs through the whole process of acupuncture. It takes the speed of deqi as the core of reinforcing or reducing effect of acupuncture. This technique of acupuncture simplifies the operation of reinforcing and reducing procedure and is more applicable in clinical practice.
