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Reappraisal of endoscopic papillary balloon dilation for the management of common bile duct stones

World Journal of Gastrointestinal Endoscopy 2015年第2期7卷 77-86页

作者： Kwok-Hung Lai Hoi-Hung Chan tzung-jiun tsai Jin-Shiung Cheng Ping-I Hsu Division of Gastroenterology Department of Internal Medicine Kaohsiung Veterans General Hospital School of Medicine National Yang-Ming University

Although endoscopic sphincterotomy(EST) is still considered as a gold standard treatment for common bile duct(CBD) stones in western guideline, endoscopic papillary balloon dilation(EPBD) is commonly used by the endoscopists in Asia as the first-line treatment for CBD stones. Besides the advantages of a technical easy procedure, endoscopic papillary large balloon dilation(EPLBD) can facilitate the removal of large CBD *** indication of EPBD is now extended from removal of the small stones by using traditional balloon, to removal of large stones and avoidance of lithotripsy by using large balloon alone or after EST. According to the reports of antegrade papillary balloon dilatation, balloon dilation itself is not the cause of pancreatitis. On the contrary, adequate dilation of papillary orifice can reduce the trauma to the papilla and pancreas by the basket or lithotripter during the procedure of stone extraction. EPLBD alone is as effective as EPLBD with limited EST. Longer ballooning time may be beneficial in EPLBD alone to achieve adequate loosening of papillary orifice. The longer ballooning time does not increase the risk of pancreatitis but may reduce the bleeding episodes in patients with coagulopathy. Slowly inflation of the balloon, but not exceed the diameter of bile duct and tolerance of the patients are important to prevent the complication of perforation. EPBLD alone or with EST are not the sphincter preserved procedures, regular follow up is necessary for early detection and management of CBD stones recurrence.

关键词： Common bile duct stones Complications Endoscopic balloon dilation Endoscopic large balloondilation Endoscopic sphincterotomy

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Anti-hepatitis C virus therapy in chronic kidney disease patients improves long-term renal and patient survivals

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World Journal of Clinical Cases 2019年第11期7卷 1270-1281页

作者： Yi-Chun Chen Chung-Yi Li Shiang-jiun tsai Yen-Chun Chen Division of Nephrology Department of Internal Medicine Dalin Tzu Chi Hospital Buddhist Tzu Chi Medical Foundation Chiayi County 622 Taiwan School of Medicine Tzu Chi University Hualien 970 Taiwan Department and Graduate Institute of Public Health College of Medicine National Cheng Kung University Tainan 701 Taiwan Department of Public Health College of Public Health China Medical University Taichung 404 Taiwan Department of Medical Research Dalin Tzu Chi Hospital Buddhist Tzu Chi Medical Foundation Chiayi County 622 Taiwan Division of Hepato-Gastroenterology Department of Internal Medicine Dalin Tzu Chi Hospital Buddhist Tzu Chi Medical Foundation Chiayi County 622 Taiwan

BACKGROUND Hepatitis C virus (HCV) infection is a documented risk factor for chronic kidney disease (CKD) and progression to end-stage renal disease (ESRD). However, to date there are no reports on the long-term hard endpoints (ESRD and death) of anti-HCV therapy [interferon-based therapy (IBT) or new direct-acting antivirals] in CKD patients. Direct-acting antivirals are not available in Taiwan’s singlepayer national health insurance database currently released for research. Therefore, we hypothesized that a retrospective analysis of the long-term outcomes of IBT in CKD patients will serve as a proxy for direct-acting antivirals to increase our understanding of progression to ESRD following HCV infection. AIM To evaluate the long-term outcomes (ESRD and death) of anti-HCV therapy, especially IBT, in HCV-infected patients with stage 1-5 CKD. METHODS We analyzed 93894 Taiwan Residents adults diagnosed with CKD and without HBV infection. Of these, 4.9% were infected with HCV. Of the 4582 HCV-infected CKD patients, 482 (10.5%) received IBT (treated cohort). They were matched 1:4 with 1928 untreated HCV-infected CKD patients (untreated cohort) by propensity scores and year, which further matched 1:2 by propensity scores with 3856 CKD patients without HCV infection (uninfected cohort). All participants were followed until the occurrence of ESRD, death, or the end of 2012. The association between HCV infection, IBT use, and risks of ESRD and death was analyzed using competing risk analysis. RESULTS Taking the uninfected cohort as a reference, the adjusted hazard ratios for ESRD, after adjusting for competing mortality, were 0.34 (0.14-0.84, P = 0.019) and 1.28 (1.03-1.60, P = 0.029) in the treated and untreated cohorts, respectively. The treated cohort had a 29%(0.54-0.92, P = 0.011) decrease in mortality compared to the untreated cohort, in which the mortality was 31%(1.18-1.45, P < 0.001) higher than in the uninfected cohort. The reduced risks of ESRD (0.14, 0.03–0.58,

关键词： Hepatitis C virus Chronic kidney disease End-stage renal disease Antihepatitis C virus therapy Cohort study

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Nationwide cohort study suggests that nucleos(t)ide analogue therapy decreases dialysis risk in Taiwan Residents chronic kidney disease patients acquiring hepatitis B virus infection

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World Journal of Gastroenterology 2018年第8期24卷 917-928页

作者： Yi-Chun Chen Chung-Yi Li Shiang-jiun tsai Yen-Chun Chen Department of Internal Medicine Dalin Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationChiayi County 622Taiwan School of Medicine Tzu Chi UniversityHualien 970Taiwan Department and Graduate Institute of Public Health College of MedicineNational Cheng Hung UniversityTainan 701Taiwan Department of Public Health College of Public HealthChina Medical UniversityTaichung 404Taiwan Department of Medical Research Dalin Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationChiayi County 622Taiwan Division of Hepato-Gastroenterology Department of Internal MedicineDalin Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationChiayi County 622Taiwan

AIM To investigate the risk of end-stage renal disease(ESRD) in hepatitis B virus(HBV)-infected patients with chronic kidney disease(CKD) with and without nucleos(t)ide analogue(NA) *** This nationwide cohort study included 103444 Taiwan Residents CKD adults without hepatitis C virus infection from the Taiwan Longitudinal Health Insurance Database 2005 between 1997 and 2012. We identified 2916 CKD patients who acquired HBV infection and did not receive NAs(untreated cohort), and they were propensitymatched 1:4 with 11664 uninfected counterparts. We also identified 442 CKD patients who acquired HBV infection and received NAs(treated cohort), and they were propensity-matched 1:3 with 1326 untreated counterparts. The association between HBV infection, NA use, and ESRD was analyzed using competing risk *** Multivariable Cox regression analysis showed a 1.67-fold higher risk(P < 0.0001) of ESRD in the untreated cohort(16-year cumulative incidence, 10.1%) than in the matched uninfected cohort(16-year cumulative incidence, 6.6%), which was independent of cirrhosis or diabetes. The treated cohort(16-year cumulative incidence, 2.2%) had an 87% lower ESRD risk(P < 0.0001) compared with the matched untreated cohort(16-year cumulative incidence, 11.9%). The number needed to treat for one fewer ESRD after NA use at 12 years was 12. Multivariable stratified analyses verified these associations in all *** This study suggests that untreated HBV infection and NA therapy are associated with increased and decreased risk of ESRD, respectively, in CKD patients. Identification of HBV status and targeted monitoring for ESRD development are important in CKD patients living in HBV-endemic areas.

关键词： hepatitis B virus chronic kidney disease end-stage renal disease nucleos(t)ide analogue cohort study

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Comparison between the therapeutic effects of differentiated and undifferentiated Wharton’s jelly mesenchymal stem cells in rats with streptozotocin-induced diabetes

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World Journal of Stem Cells 2020年第2期12卷 139-151页

作者： Chen-Yuan Hsiao Tien-Hua Chen Ben-Shian Huang Po-Han Chen Cheng-Hsi Su Jia-Fwu Shyu Pei-jiun tsai Graduate Institute of Medical Sciences National Defense Medical CenterTaipei 114Taiwan Department of Surgery Landseed International HospitalTaoyuan 324Taiwan Institute of Anatomy and Cell Biology School of MedicineNational Yang Ming UniversityTaipei 112Taiwan Trauma Center Department of SurgeryVeterans General HospitalTaipei 112Taiwan Division of General Surgery Department of SurgeryVeterans General HospitalTaipei 112Taiwan Department of Obstetrics and Gynecology Veterans General HospitalTaipei 112Taiwan Department of Surgery Cheng Hsin General HospitalTaipei 112Taiwan Department of Biology and Anatomy National Defense Medical CenterTaipei 114Taiwan Department of Critical Care Medicine Veterans General HospitalTaipei 112Taiwan

BACKGROUND Despite the availability of current therapies,including oral antidiabetic drugs and insulin,for controlling the symptoms caused by high blood glucose,it is difficult to cure diabetes mellitus,especially type 1 diabetes *** Cell therapies using mesenchymal stem cells(MSCs)may be a promising ***,the therapeutic mechanisms by which MSCs exert their effects,such as whether they can differentiate into insulin-producing cells (IPCs) beforetransplantation, are *** this study, we used three types of differentiation media over 10 d to generateIPCs from human Wharton’s jelly MSCs (hWJ-MSCs). We further transplantedthe undifferentiated hWJ-MSCs and differentiated IPCs derived from them intothe portal vein of rats with streptozotocin-induced diabetes, and recorded thephysiological and pathological *** fluorescent staining and C-peptide enzyme-linked immunoassay, we wereable to successfully induce the differentiation of hWJ-MSCs into *** of both IPCs derived from hWJ-MSCs and undifferentiated hWJMSCshad the therapeutic effect of ameliorating blood glucose levels andimproving intraperitoneal glucose tolerance tests. The transplanted IPCs homedto the pancreas and functionally survived for at least 8 wk after transplantation,whereas the undifferentiated hWJ-MSCs were able to improve the insulitis andameliorate the serum inflammatory cytokine in streptozotocin-induced *** IPCs can significantly improve blood glucose levels in diabetic ratsdue to the continuous secretion of insulin by transplanted cells that survive in theislets of diabetic rats. Transplantation of undifferentiated hWJ-MSCs cansignificantly improve insulitis and re-balance the inflammatory condition indiabetic rats with only a slight improvement in blood glucose levels.

关键词： Human Wharton’s jelly mesenchymal stem cell Insulin-producing cells Diabetes mellitus Differentiation Regeneration therapy Anti-inflammatory

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Reduced risk of dementia in patients with type 2 diabetes mellitus using Chinese herbal medicine:A nested case-control study

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World Journal of Diabetes 2023年第11期14卷 1632-1642页

作者： Hou-Hsun Liao Hanoch Livneh Hua-Lung Huang Jui-Yu Hung Ming-Chi Lu How-Ran Guo tzung-Yi tsai Department of Chinese Medicine Dalin Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationChiayi 62247TaiwanChina Graduate Institute of Chinese Medicine School of Chinese MedicineCollege of Chinese MedicineChina Medical UniversityTaichung 404333TaiwanChina Department of Nursing Tzu Chi University of Science and TechnologyHualien 62247TaiwanChina Department of Special and Counselor Education Portland State UniversityPortlandOR 97207United States Department of Rehabilitation Dalin Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationChiayi 62247TaiwanChina Department of Nursing Dalin Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationChiayi 62247TaiwanChina Division of Allergy Immunology and RheumatologyDalin Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationChiayi 62247TaiwanChina Department of Environmental and Occupational Health College of MedicineNational Cheng Kung UniversityTainan 70428TaiwanChina Department of Occupational and Environmental Medicine National Cheng Kung University HospitalTainan 70428TaiwanChina Occupational Safety Healthand Medicine Research CenterNational Cheng Kung UniversityTainan 70428TaiwanChina Department of Medical Research Dalin Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationChiayi 62247TaiwanChina

BACKGROUND Dementia is a prevalent condition in type 2 diabetes mellitus(T2DM)*** Chinese herbal medicine(CHM)is often employed as complementary therapy for glycemic control,its effect in controlling likelihood of dementia has not yet been fully *** To compare the risk of dementia between T2DM patients with and without CHM *** We undertook a nested case-control study and obtained data on patients 20-70 years of age who received medical care for T2DM between 2001 and 2010 from the National Health Insurance Research database in ***,defined as those with dementia that occurred at least one year after the diagnosis of T2DM,were randomly matched to controls without dementia from the study cohort at a 1:1 *** applied conditional logistic regression to explore the associations between CHM treatment and *** A total of 11699 dementia cases were matched to 11699 non-dementia *** found that adding CHM to conventional care was related to a lower risk of dementia[adjusted odds ratio(OR)=0.51],and high-intensity CHM treatment was associated with an adjusted OR of *** This study shows that the cumulative CHM exposure was inversely associated with dementia risk in an exposureresponse manner,implying that CHM treatment may be embraced as a disease management approach for diabetic patients to prevent dementia.

关键词： Type 2 diabetes mellitus Dementia Chinese herbal medicine Nested case-control study Odds ratio

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Drive and Control of Electromagnetic Drive Module on Reciprocally Rotating Disc Used for Micro-Gyroscope

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Journal of Electromagnetic Analysis and Applications 2010年第6期2卷 362-371页

作者： Nan-Chyuan tsai jiun-Sheng Liou Chih-Che Lin Tuan Li 不详

An innovative 3-phase AC (Alternative Current) drive circuit for the seismic disc in micro-gyroscopes is designed and verified by computer simulations and experiments. The in-plane dynamic model of the seismic disc with mass eccentricity and air gap against the centre bearing and the mathematic expression of two sinusoidal magnetic fields are developed respectively. In order to prevent the seismic disc from collision with the centre bearing and the EM (Electromagnetic) poles, an anti-collision controller is established by employing two Look-up tables which define the intensity of the applied current to the EM poles. Self-sensing technique is included to measure the real-time offset of the disc by two orthogonal pairs of EM poles, without any additional sensors. The drive circuit under SPWM (Sinusoidal Pulse Width Modulation) operation and the anti-collision strategy are verified by intensive computer simulations via commercial software, OrCAD 9, and experiments.

关键词： Micro-Gyroscope Electromagnetic Pole Anti-Collision Drive Circuit

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Comparison of NO-scavenging and NO-Suppressing Activities of Several Herbal Teas with those of Green Tea

Comparison of NO-scavenging and NO-Suppressing Activities of...

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第四届海峡两岸茶业学术研讨会

作者： Po-Jung tsai tzung-Hsun tsai Chun-Hsien Yu Su-Chen Ho Department of Food Science Yuanpei UniversityHsinchuTaiwan Department of Dentistry Keelung Chang-Gung Memorial HospitalKeelungTaiwan Department of Paediatrics Buddist Xindian Tzu Chi General HospitalTaipeiTaiwan Department of Food Science Yuanpei UniversityHsinchuTaiwan

＜正＞Oxidative stress caused by the production of excess nitric oxide （NO） during infection or inflammation has been implicated in the pathogenesis of several diseases, including cancer, diabetes and renal disease. Accordingly, the scavenging of NO radical or/and suppression of NO production by mitogen-activated cells may be promising indicators in screening healthy food. In this work, the NO-scavenging and NO-suppressing activities of numerous herbal teas were determined, and compared with those of green tea. All of the tested herbal teas revealed NO-scavenging and NO-suppressing activities. The NO-scavenging activity of herbal teas can be ranked by the IC50, the concentration of the tested herbal tea required to quench 50% of NO radicals released by sodium nitroprusside. The activities follow the order of green tea ＞ rosemary, sweet osmanthus, rose and lavender ＞ jasmine, lemongrass and daisy. The NO-suppressing activity was evaluated based on the suppressing effect of herbal teas on the production of NO by LPS-activated RAW 264.7 macrophages. Experimental results indicated that green tea and rosemary had IC50 values of lower than 500 g/mL, and was proven to be a good NO-suppressor, whereas lavender;sweet osmanthus;lemongrass;rose;daisy, and jasmine had IC50 values that exceeded 500 g/mL, and were classified as rather poor NO-suppressors. In conclusion, consumption of herbal teas promotes the NO-scavenging and NO-suppressing activities of one’s diet, even though their activities were weaker than that of green tea.

关键词： Nitric oxide Antioxidant Phenolics Herbal tea

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Primary small cell carcinoma of kidney after renal transplantation:a case report and literature review

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Chinese Journal of Cancer Research 2013年第5期25卷 608-611页

作者： Hsiang-Ying Lee Wen-Jeng Wu Kun-Bow tsai Jung-Tsung Shen Mei-Yu Jang Hsun-Shuan Wang Shu-Fang Chang Li-jiun tsai Department of Urology Department of PathologyKaohsiung Medical University Hospital Department of Urology Kaohsiung Municipal Hsiao-Kang Hospital Department of Urology College of MedicineKaohsiung Medical University

Extrapulmonary small cell carcinoma （EPSCC） is a rare neoplasm comprising 2.5％ to 5％ of small cell carcinomas （SCCs）.Bladder SCC is the most common site of genitourinary *** renal SCC is extremely *** report a case of primary SCC of the kidney which is rarely reported in the urinary tract and presents an aggressive clinical picture.A 59-year-old female visited a urologic clinic with complaint of persistent left flank soreness 10 years after undergoing renal *** computed tomography showed a left renal pelvis *** the patient received left nephroureterectomy with bladder cuff resection,her pathology results showed *** surgery,she received adjuvant systemic chemotherapy,and her recovery has been uneventful as of 8 *** renal SCC presents with an advanced tumor stage and a short median survival period,therefore early intervention and close follow-up are recommended.

关键词： Kidney small cell carcinoma (SCC) extrapulmonary renal pelvis carcinoma

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Xenografting of human umbilical mesenchymal stem cells from Wharton’s jelly ameliorates mouse spinocerebellar ataxia type 1

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Translational Neurodegeneration 2019年第1期8卷 359-371页

作者： Pei-jiun tsai Chang-Ching Yeh Wan-Jhen Huang Ming-Yuan Min Tzu-Hao Huang Tsui-Ling Ko Pei-Yu Huang Tien-Hua Chen Sanford P.C.Hsu Bing-Wen Soong Yu-Show Fu Institute of Anatomy and Cell Biology School of MedicineNational Yang-Ming UniversityTaipeiTaiwanRepublic of China Trauma Center Department of SurgeryVeterans General HospitalTaipeiTaiwanRepublic of China Department of Critical Care Medicine Veterans General HospitalTaipeiTaiwanRepublic of China Department of Obstetrics and Gynecology Veterans General HospitalTaipeiTaiwanRepublic of China Institute of Clinical Medicine National Yang-Ming UniversityTaipeiTaiwanRepublic of China Department of Obstetrics and Gynecology National Yang-Ming UniversityTaipeiTaiwanRepublic of China Department of Life Science National Taiwan UniversityTaipeiTaiwanRepublic of China School of Medicine I-Shou UniversityKaohsiungTaiwanRepublic of China Institute of Physiology School of MedicineNational Yang-Ming UniversityTaipeiTaiwanRepublic of China Division of General Surgery Department of SurgeryVeterans General HospitalTaipeiTaiwanRepublic of China Department of Neurosurgery Neurological InstituteTaipei Veterans General HospitalTaipeiTaiwanRepublic of China School of Medicine National Yang-Ming UniversityTaipeiTaiwanRepublic of China Department of Neurology Shuang Ho Hospitaland Taipei Neuroscience InstituteTaipei Medical UniversityTaipeiTaiwanRepublic of China Department of Neurology Taipei Veterans General HospitalTaipeiTaiwanRepublic of China Brain Research Center National Yang-Ming UniversityTaipeiTaiwanRepublic of China Department of Anatomy and Cell Biology School of MedicineNational Yang-Ming UniversityNo.155Sec.2Li-Nung StreetTaipei 112TaiwanRepublic of China

Background:Spinocerebellar ataxia type 1(SCA1)is an autosomal dominant neurodegenerative disorder caused by the expansion of CAG repeats in ATXN1 gene resulting in an expansion of polyglutamine repeats in the ATXN1 ***,there has yet been any effective treatment so far for *** study investigated the feasibility of transplanting human umbilical mesenchymal stem cells(HUMSCs)into transgenic SCA1 mice containing an expanded uninterrupted allele with 82 repeats in the ATXN1-coding ***:106 human umbilical mesenchymal stem cells were transplanted into the cerebella at 1 month of ***:HUMSCs displayed significant ameliorating effects in SCA1 mice in terms of motor behaviors in balance beam test and open field test as compared with the untransplanted SCA1 *** transplantation effectively reduced the cerebellar atrophy,salvaged Purkinje cell death,and alleviated molecular layer *** studies showed higher amplitudes of compound motor action potentials as indicated by increasing neuronal-muscular response strength to stimuli after stem cell *** 5 months after transplantation,HUMSCs scattering in the mice cerebella remained viable and secreted cytokines without differentiating into neuronal or glia ***:Our findings provide hope for a new therapeutic direction for the treatment of SCA1.

关键词： Umbilical mesenchymal stem cells Cell transplantation SCA1

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Using a consensus acupoints regimen to explore the relationship between acupuncture sensation and lumbar spinal postoperative analgesia: A retrospective analysis of prospective clinical cooperation

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Journal of Integrative Medicine 2022年第4期20卷 329-337页

作者： Yen-Lin Chao Yi-Ai Rau Hong-Sheng Shiue jiun-Lin Yan Yuan-Yun Tang Shao-Wen Yu Bo-Yan Yeh Yen-Lung Chen Tsung-Hsien Yang Shu-Chen Cheng Yi-Wen Hsieh Hsin-Chia Huang Fu-Kuang tsai Yu-Sheng Chen Geng-Hao Liu Division of Acupuncture and Moxibustion Department of Traditional Chinese MedicineChang Gung Memorial HospitalTaoyuan 333TaiwanChina School of Traditional Chinese Medicine College of MedicineChang Gung UniversityTaoyuan 333TaiwanChina Department of Neurosurgery Keelung Chang Gung Memorial HospitalKeelung 204TaiwanChina Department of Traditional Chinese Medicine New Taipei Municipal TuCheng HospitalChang Gung Memorial HospitalNew Taipei 236TaiwanChina Sleep Center Chang Gung Memorial HospitalTaoyuan 333TaiwanChina

Objective: This study evaluated the effectiveness of acupuncture treatment on postoperative pain in patients with degenerative lumbar spine disease, and explored the relationship between the postoperative analgesic effect of acupuncture and the sensation of acupuncture experienced by the ***: This retrospective study analyzed the medical records of 97 patients who had undergone an operation by the same surgeon due to degenerative lumbar disease. These patients were divided into acupuncture group(n = 32), patient-controlled analgesia(PCA) group(n = 27), and oral analgesia group(n = 38) according to the different postoperative analgesic methods. During their hospitalization, patients completed daily evaluations of their pain using a visual analogue scale(VAS), and injection times of supplemental meperidine were recorded. Also, the Chinese version of the Massachusetts General Hospital Acupuncture Sensation Scale(C-MASS) was used in the acupuncture ***: Each of the three treatment groups showed significant reductions in postoperative pain, as shown by reduced VAS scores. The acupuncture group, however, had less rebound pain(P < 0.05) than the other two groups. Both the acupuncture and PCA groups experienced acute analgesic effects that were superior to those in the oral analgesia group. In addition, the higher the C-MASS index on the second day after surgery, the lower the VAS score on the fourth day after surgery. There was also a significant difference in the“dull pain” in the acupuncture ***: The results demonstrated that acupuncture was beneficial for postoperative pain and discomfort after simple surgery for degenerative spinal disease. It is worth noting that there was a disproportionate relevance between the patient’s acupuncture sensation and the improvement of pain VAS score.

关键词： Acupuncture analgesia Postoperative period Neurodegenerative diseases Lumbosacral region Acupuncture sensation De-qi

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