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Low-level laser acupuncture reduces postoperative pain and morphine consumption in older patients with total knee arthroplasty: A randomized placebo-controlled trial

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Journal of Integrative Medicine 2022年第4期20卷 321-328页

作者： Chiung-Hui Huang mei-ling yeh Fang-Pey Chen Daphne Wu Department of Nursing Taipei Veterans General HospitalTaipei City 11217TaiwanChina School of Nursing National Taipei University of Nursing and Health SciencesTaipei City 11219TaiwanChina Center for Traditional Medicine Taipei Veterans General HospitalTaipei City 11217TaiwanChina Scool of Nursing National Taipei University of Nursing and Health Sciences and School of MedicineTaipei City 11217TaiwanChina

Background: Patients commonly develop postoperative pain after total knee arthroplasty(TKA).Acupuncture-related techniques and low-level laser therapy could be beneficial for pain management for older individuals.Objective: To examine the effect of low-level laser acupuncture(LA) in reducing postoperative pain, painrelated interference in daily life, morphine consumption, and morphine-related side effects in older patients with knee osteoarthritis who underwent TKA.Design, setting, participants and intervention: A single-blind randomized placebo-controlled trial was conducted. Patients(N = 82) were recruited and randomly assigned via a computer-generated list to the LA group or a placebo group. The LA group received low-level laser therapy at Sanyinjiao(SP6), Taixi(KI3),Kunlun(BL60), Fengshi(GB31), Futu(ST32) and Neiguan(PC6) after TKA, while the placebo acupuncture group received the same treatment procedure without laser energy output.Main outcome measures: The primary outcome was postoperative pain intensity, and it was measured at baseline and hours 2, 6, 10, 24, 48 and 72 after TKA. The secondary outcomes, including relative pain,postoperative pain-related interference in daily life and morphine consumption, were measured at hours24, 48 and 72 after TKA.Results: Generalized estimating equations revealed significant between-group differences in pain intensity(P = 0.01), and trend differences in pain intensity for the LA group starting at hours 10 to 72(P < 0.05)and morphine consumption at hours 48 and 72(P < 0.05). The changes in pain-related interference in daily life were significant(P < 0.05) at 72 h, with the exception of the parameters for worst pain, mood,and sleep. Nausea and vomiting side effects from morphine had significant between-group differences at hours 10 and 24(P < 0.05).Conclusion: Low-level LA gradually reduced older patients’ postoperative pain intensity and morphine consumption within the first 72 h after their TKA for osteoarthritis. Low-level LA may have benefits as an adjuvant pain man

关键词： Acupuncture Morphine Low-level laser Older patients Osteoarthritis Pain Total knee arthroplasty Randomized controlled trial

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Laser acupuncture combined with auricular acupressure improves low-back pain and quality of life in nurses:A randomized controlled trial

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Journal of Integrative Medicine 2023年第1期21卷 26-33页

作者： Hsueh-Hua Yang Yu-Chu Chung Pai-Pei Szeto mei-ling yeh Jaung-Geng Lin School of Nursing National Taipei University of Nursing and Health SciencesTaipei 11219TaiwanChina Nursing Department En Chu Kong HospitalNew Taipei 23702TaiwanChina Department of Nursing Yuanpei University of Medical TechnologyHsinchu 30015TaiwanChina Cochrane Taiwan Taipei Medical UniversityTaipei 11031TaiwanChina School of Chinese Medicine China Medical UniversityTaichung 40402TaiwanChina

Background Low-back pain(LBP)in nurses is a major health concern that affects their quality of life and ability to work,with consequences for their economic status.Objective This study evaluates the effect of low-level laser acupuncture combined with auricular acupressure(LAA)on pain intensity,pain interference and quality of life in nurses with LBP.Design,setting,participants and interventions This randomized controlled trial recruited a convenience sample of hospital-based nurses from one teaching hospital in Taiwan,China.Participants were randomly assigned to the LAA group(n=38)receiving low-level laser acupuncture and auricular acupressure for 4 weeks,and the control group(n=38)receiving only sham laser acupuncture treatment without laser energy output.Main outcome measures Data were collected for the primary pain outcome using the Short Form of the Brief Pain Inventory,while the secondary outcome,quality of life,was evaluated using the Roland-Morris Disability Questionnaire.Both primary and secondary outcomes were scored before the intervention,and after 2-week and 4-week intervention.The rate of LBP recurrence was evaluated at the 4th week and 8th week after the end of intervention.Results After controlling for prior pain,the result of linear mixed model analysis showed trends in significant between-group differences in the level of current pain occurring in week 4(P<0.001),worst pain in week 2(P<0.001)and week 4(P<0.001),least pain in week 2(P=0.032)and week 4(P<0.001),pain interference in week 2(P=0.009)and week 4(P<0.001),and in the life dysfunction in week 2(P<0.001)and week 4(P<0.001).Recurrence rates of LBP at the 4th and 8th weeks after the end of intervention were 0%and 36.89%in the LAA group,and 69.44%and 36.11%in the control group.Conclusion This study shows that 4-week LAA intervention reduced pain intensity and pain interference,and improved quality of life for hospital-based nurses with LBP.These effects were maintained continuously for at least 4 weeks after the intervention.The nonpharmacolog

关键词： Acupuncture Acupressure Low-backpain Low-level laser Qualityof life Randomized controlled trial

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Respiratory training interventions improve health status of heart failure patients: A systematic review and network meta-analysis of randomized controlled trials

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World Journal of Clinical Cases 2019年第18期7卷 2760-2775页

作者： mei-Hua Wang mei-ling yeh School of Nursing National Taipei University of Nursing and Health Sciences

BACKGROUND Prior studies indicate that doing breathing exercises improves physical performance and quality of life (QoL) in heart failure patients. However, these effects remain unclear and contradictory. AIM To determine the effects of machine-assisted and non-machine-assisted respiratory training on physical performance and QoL in heart failure patients. METHODS This was a systematic review and network meta-analysis study. A literature search of electronic databases was conducted for randomized controlled trials (RCTs) on heart failure. Respiratory training interventions were grouped as seven categories: IMT_Pn (inspiratory muscle training without pressure or < 10% maximal inspiratory pressure, MIP), IMT_Pl (inspiratory muscle training with low pressure, 10%-15% MIP), IMT_Pm (inspiratory muscle training with medium pressure, 30%-40% MIP), IMT_Ph (inspiratory muscle training with high pressure, 60% MIP or MIP plus aerobics), Aerobics (aerobic exercise or weight training), Qi_Ex (tai chi, yoga, and breathing exercise), and none. The four outcomes were heart rate, peak oxygen uptake (VO2 peak), 6-min walking distance test (6MWT), and Minnesota Living with Heart Failure QoL. The random-effects model, side-splitting model, and the surface under the cumulative ranking curve (SUCRA) were used to test and analyze the data. RESULTS A total of 1499 subjects from 31 RCT studies were included. IMT_Ph had the highest effect sizes for VO2 peak and 6MWT, IMT_Pm highest for QoL, and Qi_Ex highest for heart rate. Aerobics had the second highest for VO2 peak, Qi_Ex second highest for 6MWT, and IMT_Ph second highest for heart rate and QoL.CONCLUSION This study supports that high- and medium-intensity machine-assisted training improves exercise capacity and QoL in hospital-based heart failure patients. After hospital discharge, non-machine-assisted training continuously improves cardiac function.

关键词： Heart failure Network meta-analysis Respiratory training Cardiac function Exercise capacity Quality of life

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A Dual-Mode Step-up DC/DC Converter IC with Current-Limiting and EMI Reduction Techniques

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Journal of Electronic Science and Technology of China 2008年第3期6卷 279-283页

作者： Wan-Rone Liou Ping-Hsing Chen Marynelle L. Z. Rosales yeh Chun-Ting Kuo mei-ling yeh the Graduate Institute of Electrical Engineering National Taipei University San Shia Taipei 23741 Taiwan China the Department of Electrical Engineering National Taiwan Ocean University Keelung Taiwan China

This paper presents a novel dual-mode step-up （boost） DC/DC converter. Pulse-frequency modulation （PFM） is used to improve the efficiency at light load. This converter can operate between pulse-width modulation （PWM） and pulse-frequency modulation. The converter will operate in PFM mode at light load and in PWM mode at heavy load. The maximum conversion efficiency of this converter is 96%. The conversion efficiency is greatly improved when load current is below 100 mA. Additionally, a soft-start circuit and a variable-sawtooth frequency circuit are proposed in this paper. The former is used to avoid the large switching current at the start up of the converter and the latter is utilized to reduce the EMI of the converter.

关键词： Boost converter dual-mode converter integrated power management pulse-frequency modulation （PFM） pulse-width modulation （PWM）

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The Optimization Design of the Nozzle Section for theWater Jet Propulsion System Applied in Jet Skis

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Computer Modeling in Engineering & Sciences 2024年第3期138卷 2277-2304页

作者： Cheng-yeh Li Jui-Hsiang Kao Department of Systems Engineering and Naval Architecture Taiwan Ocean UniversityKeelungTaiwanChina

The performance of a water jet propulsion system is related to the inlet duct,rotor,stator,and nozzle.Generally,the flow inlet design must fit the bottom line of the hull,and the design of the inlet duct is often limited by stern space.The entire section,from the rotor to the nozzle through the stator,must be designed based on system integration in that the individual performance of these three components will influence each other.Particularly,the section from the rotor to the nozzle significantly impacts the performance of a water jet propulsion system.This study focused on nozzle design and established referable analysis results to facilitate subsequent integrated studies on the design parameters regarding nozzle contour.Most existing studies concentrate on discussions on rotor design and the tip leakage flow of rotors or have replaced the existing complex computational domain with a simple flow field.However,research has yet to implement an integrated,optimal design of the section from the rotor to the nozzle.Given the above,our program conducted preliminary research on this system integration design issue,discussed the optimal nozzle for this section in-depth,and proposed design suggestions based on the findings.This program used an existing model as the design case.This study referred to the actual trial data as the design conditions for the proposed model.Unlike prior references’simple flow field form,this study added a jet ski geometry and free surface to the computational domain.After the linear hull shape was considered,the inflow in the inlet duct would be closer to the actual condition.Based on the numerical calculation result,this study recommends that the optimal nozzle outlet area should be 37%of the inlet area and that the nozzle contour should be linear.Furthermore,for the pump head,static pressure had a more significant impact than dynamic pressure.

关键词： Water jet propulsion system rotor nozzle outlet area nozzle contour

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Impact of microplastics and nanoplastics on liver health:Current understanding and future research directions

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World Journal of Gastroenterology 2024年第9期30卷 1011-1017页

作者： Chun-Cheng Chiang Hsuan yeh Ruei-Feng Shiu Wei-Chun Chin Tzung-Hai Yen School of Medicine University of PittsburghPittsburghPA 15213United States Pittsburgh Liver Research Center University of PittsburghPittsburghPA 15213United States Division of Experimental Pathology Department of PathologyUniversity of PittsburghPittsburghPA 15213United States Division of Endocrinology Department of PediatricsUniversity of PittsburghPittsburghPA 15213United States Center of Excellence for The Oceans National Taiwan Ocean UniversityKeelung 20224Taiwan Institute of Marine Environment and Ecology National Taiwan Ocean UniversityKeelung 20224TaiwanChina Department of Materials Science and Engineering University of California MercedMercedCA 95343United States Department of Nephrology Clinical Poison CenterChang Gung Memorial HospitalTaoyuan 333TaiwanChina College of Medicine Chang Gung UniversityTaoyuan 333TaiwanChina

With continuous population and economic growth in the 21st century,plastic pollution is a major global issue.However,the health concern of microplastics/nanoplastics(MPs/NPs)decomposed from plastic wastes has drawn public attention only in the recent decade.This article summarizes recent works dedicated to understanding the impact of MPs/NPs on the liver-the largest digestive organ,which is one of the primary routes that MPs/NPs enter human bodies.The interrelated mechanisms including oxidative stress,hepatocyte energy re-distribution,cell death and autophagy,as well as immune responses and inflammation,were also featured.In addition,the disturbance of microbiome and gut-liver axis,and the association with clinical diseases such as metabolic dysfunction-associated fatty liver disease,steatohepatitis,liver fibrosis,and cirrhosis were briefly discussed.Finally,we discussed potential directions in regard to this trending topic,highlighted current challenges in research,and proposed possible solutions.

关键词： Microplastics Nanoplastics Liver Reactive oxidative species Cell death Autophagy Innate immunity Metabolic dysfunction-associated fatty liver disease Gut-liver axis

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Severe dengue in the intensive care unit

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Journal of Intensive Medicine 2024年第1期4卷 16-33页

作者： Alexandre Mestre Tejo Debora Toshie Hamasaki Letícia Mattos Menezes yeh-Li Ho Intensive Care Unit Department of Intensive Medicine of the Cancer Institute of the State of São PauloHospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSão PauloBrazil Transfusion Medicine and Cell Therapy Department A.C.Camargo Cancer CenterSão PauloBrazil Intensive Care Unit of Infectious Disease Department Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSão PauloBrazil

Dengue fever is considered the most prolific vector-borne disease in the world,with its transmission rate increasing more than eight times in the last two decades.While most cases present mild to moderate symptoms,5%of patients can develop severe disease.Although the mechanisms are yet not fully comprehended,immune-mediated activation leading to excessive cytokine expression is suggested as a cause of the two main findings in critical patients:increased vascular permeability that may shock and thrombocytopenia,and coagulopathy that can induce hemorrhage.The risk factors of severe disease include previous infection by a different serotype,specific genotypes associated with more efficient replication,certain genetic polymorphisms,and comorbidities such as diabetes,obesity,and cardiovascular disease.The World Health Organization recommends careful monitoring and prompt hospitalization of patients with warning signs or propensity for severe disease to reduce mortality.This review aims to update the diagnosis and management of patients with severe dengue in the intensive care unit.

关键词： Severe dengue Intensive care units Shock Pathogenesis Diagnosis Management

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Subsequent bilateral acute carpal tunnel syndrome due to tophaceous infiltration:A case report

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World Journal of Clinical Cases 2024年第2期12卷 418-424页

作者： Soon-Chin Yeoh Wen-Tien Wu Jui-Tien Shih Wen-Chin Su Kuang-Ting yeh School of Medicine Tzu Chi UniversityHualien 970374TaiwanChina Department of Orthopedics Hualien Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationHualien 970473TaiwanChina Department of Orthopaedic Surgery Taoyuan Armed Forces General HospitalTaoyuan 325208TaiwanChina Department of Clinical Education Hualien Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationHualien 970473TaiwanChina Graduate Institute of Clinical Pharmacy Tzu Chi UniversityHualien 970374TaiwanChina

BACKGROUND Acute carpal tunnel syndrome(ACTS)is commonly caused by repetitive strain,trauma,or inflammatory conditions.However,ACTS due to tophaceous gout is a clinical event that remains poorly understood and underreported.This rare manifestation necessitates prompt diagnosis and intervention to prevent irreversible complications.CASE SUMMARY A 51-year-old man who had poorly controlled hyperuricemia presented with ACTS secondary to tophaceous gout.Because of rapid symptom progression symptoms and severe median nerve compression within 3 mo,the patient underwent emergency decompression surgery for both wrists at different time points.Postoperatively,he exhibited complete recovery of sensory and motor functions,with no recurrence at long-term follow-up.Favorable outcomes were achieved through immediate decompression surgery,anti-inflammatory medications,postoperative active and passive range-of-motion exercises,and intermittent wrist splinting.Prompt diagnosis and surgical intervention,when necessary,are crucial for preventing long-term complications and obtaining favorable outcomes in patients with ACTS.An optimal gout management strategy involving pharmacologic therapy and lifestyle modifications may help minimize ACTS recurrence and improve clinical outcomes.CONCLUSION Prompt surgical intervention and optimal gout management are crucial for preventing irreversible nerve damage and ACTS recurrence.

关键词： Acute carpal tunnel syndrome Gout Surgical decompression Range-of-motion exercises Case report

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Outcomes of combined mitochondria and mesenchymal stem cellsderived exosome therapy in rat acute respiratory distress syndrome and sepsis

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World Journal of Stem Cells 2024年第6期16卷 690-707页

作者： Kun-Chen Lin Wen-Feng Fang Jui-Ning yeh John Y Chiang Hsin-Ju Chiang Pei-Lin Shao Pei-Hsun Sung Hon-Kan Yip Department of Anesthesiology Kaohsiung Chang Gung Memorial HospitalKaohsiung 83301TaiwanChina Division of Pulmonary and Critical Care Medicine Department of Internal MedicineKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiung 83301TaiwanChina Department of Cardiology The First Affiliated Hospital of Jinan UniversityGuangzhou 510630Guangdong ProvinceChina Department of Computer Science and Engineering National Sun Yat-sen UniversityKaohsiung 804201TaiwanChina Department of Healthcare Administration and Medical Informatics Kaohsiung Medical UniversityKaohsiung 80708TaiwanChina School of Medicine Chung Shan Medical UniversityTaichung 40201TaiwanChina Department of Nursing Asia UniversityTaichung 41354TaiwanChina Division of Cardiology Department of Internal MedicineKaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiung 83301TaiwanChina Institute for Translational Research in Biomedicine Kaohsiung Chang Gung Memorial HospitalKaohsiung 83301TaiwanChina Center for Shockwave Medicine and Tissue Engineering Kaohsiung Chang Gung Memorial HospitalKaohsiung 83301TaiwanChina Department of Medical Research China Medical University HospitalChina Medical UniversityTaichung 40402TaiwanChina School of Medicine College of MedicineChang Gung UniversityTaoyuan 33302TaiwanChina

BACKGROUND The treatment of acute respiratory distress syndrome(ARDS)complicated by sepsis syndrome(SS)remains challenging.AIM To investigate whether combined adipose-derived mesenchymal-stem-cells(ADMSCs)-derived exosome(EXAD)and exogenous mitochondria(mitoEx)protect the lung from ARDS complicated by SS.METHODS In vitro study,including L2 cells treated with lipopolysaccharide(LPS)and in vivo study including male-adult-SD rats categorized into groups 1(sham-operated-control),2(ARDS-SS),3(ARDS-SS+EXAD),4(ARDS-SS+mitoEx),and 5(ARDS-SS+EXAD+mitoEx),were included in the present study.RESULTS In vitro study showed an abundance of mitoEx found in recipient-L2 cells,resulting in significantly higher mitochondrial-cytochrome-C,adenosine triphosphate and relative mitochondrial DNA levels(P<0.001).The protein levels of inflammation[interleukin(IL)-1β/tumor necrosis factor(TNF)-α/nuclear factor-κB/toll-like receptor(TLR)-4/matrix-metalloproteinase(MMP)-9/oxidative-stress(NOX-1/NOX-2)/apoptosis(cleaved-caspase3/cleaved-poly(ADP-ribose)polymerase)]were significantly attenuated in lipopolysaccharide(LPS)-treated L2 cells with EXAD treatment than without EXAD treatment,whereas the protein expressions of cellular junctions[occluding/β-catenin/zonula occludens(ZO)-1/E-cadherin]exhibited an opposite pattern of inflam-mation(all P<0.001).Animals were euthanized by 72 h post-48 h-ARDS induction,and lung tissues were harvested.By 72 h,flow cytometric analysis of bronchoalveolar lavage fluid demonstrated that the levels of inflam-matory cells(Ly6G+/CD14+/CD68+/CD11b/c+/myeloperoxidase+)and albumin were lowest in group 1,highest in group 2,and significantly higher in groups 3 and 4 than in group 5(all P<0.0001),whereas arterial oxygen-saturation(SaO2%)displayed an opposite pattern of albumin among the groups.Histopathological findings of lung injury/fibrosis area and inflammatory/DNA-damaged markers(CD68+/γ-H2AX)displayed an identical pattern of SaO2%among the groups(all P<0.0001).The protein expressions of inflammatory(TLR-4/MMP-9/IL-

关键词： Acute respiratory distress syndrome Sepsis syndrome Exosomes Mitochondria Adipose tissue-derived mesenchymal stem cells Inflammation

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Parathyroidectomy restored bone mineral density in a neglected femoral neck fracture with renal osteodystrophy:A case report

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World Journal of Clinical Cases 2024年第25期12卷 5761-5768页

作者： Tzu-Ching Lin Shih-Wei Lin Kuang-Ting yeh Department of Education Hualien Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationHualien 970473Taiwan ProvinceChina Department of Orthopedics Ten-Chan Medical GroupTaoyuan 320003Taiwan ProvinceChina Department of Orthopedics Hualien Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationHualien 970473Taiwan ProvinceChina Department of Graduate Institute of Clinical Pharmacy Tzu Chi UniversityHualien 970374Taiwan ProvinceChina

BACKGROUND This case report contributes to the medical literature by highlighting the successful management of a neglected femoral neck fracture in a patient with renal osteodystrophy and secondary hyperparathyroidism(SHPTH)who was on dialysis due to end-stage renal disease(ESRD).It underscores the efficacy of parathyroidectomy(PTX)in restoring bone mineral density(BMD)and promoting fracture healing,addressing a significant complication in ESRD patients.CASE SUMMARY A 36-year-old female with renal osteodystrophy and on dialysis due to ESRD presented with a history of left patellar tendon rupture and later,a right achilles tendon avulsion fracture.Persistent right hip pain led to the discovery of a neglected right femoral neck fracture,which was initially overlooked due to the patient’s complex medical history.Two months post-achilles tendon repair,the patient underwent PTX to manage the refractory SHPTH.The postoperative course included rehabilitation and weight-bearing exercises.Remarkably,2 years after osteosynthesis,radiographic assessments indicated a solid union of the periprothesis fracture and significant improvement in BMD,showcasing the efficacy of the treatment approach.CONCLUSION PTX,combined with appropriate rehabilitation,is crucial for improving BMD and fracture healing in ESRD patients with SHPTH.

关键词： Secondary hyperparathyroidism Parathyroidectomy Fracture Renal osteodystrophy Case report

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