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clinical values of Barcelona clinic Liver Cancer subgroup and up-to-7 criteria in intermediate stage hepatocellular carcinoma with transcatheter arterial chemoembolization

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World Journal of clinical Cases 2022年第21期10卷 7275-7284页

作者： Shou-Wu Lee Yen-Chun Peng Han-Chung Lien Chung-Wang Ko Chun-Fang Tung Chi-Sen chang Division of Gastroenterology and Hepatology Department of Internal MedicineTaichung Veterans General HospitalTaichung 40705Taiwan Department of Internal Medicine Yang Ming Chiao Tung UniversityTaipei 112304Taiwan Department of Post-Baccalaureate Medicine College of MedicineChung Hsing UniversityTaichung 40227Taiwan Department of Internal Medicine Chung Shan Medical UniversityTaichung 40201Taiwan

BACKGROUND Transarterial chemoembolization(TACE)is a recommended treatment for patients with intermediate stage hepatocellular carcinoma(HCC)but with variable treatment *** To determine factors for predicting outcomes of TACE in patients with intermediate stage B *** Patients with Barcelona clinic Liver Cancer(BCLC)stage B HCC who underwent TACE as the primary treatment were enrolled at Taichung Veterans general Hospital from January 2005 to December *** were assigned to either the objective responder(OR)group or the non-OR group according to mRECIST *** and radiological characteristics were compared between the 2 *** overall survival of enrolled subjects was *** In 128 enrolled patients,66(51.6%)were in the OR group and 62(48.4%)in the non-OR *** with the non-OR group,the OR group had a significantly smaller HCC size(6.55 cm vs 9.50 cm,P=0.001)and was within the up-to-7 criteria(50%vs 26.7%,P=0.001).After multivariable analyses,these significant associations still *** survival rate of all the subjects averaged 20.65±13.26 *** survival rate at 1-year was 64.8%,2-year was 46.9%,and 3-year was 31.2%.For those patients with OR to TACE,smaller tumor size and within up-to-7 criteria were associated with significantly better overall *** patients with subgroup B1 had the highest OR ratio(75%)and better overall survival(26.70±12.07 mo)after *** BCLC stage B HCC patients with smaller tumor size or within up-to-7 criteria had better survival outcomes to *** stage B subgroup is useful to predict refractoriness to TACE.

关键词： Hepatocellular carcinoma Objective response Overall survival Transcatheter arterial chemoembolization Barcelona clinic Liver Cancer

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World Journal of Gastroenterology 2005年第47期11卷 7494-7498页

作者： Shih-Chao Kang Shinn-Jang Hwang Shiang-Ho Lee Full-Young chang Shou-Dong Lee Division of Family Medicine I-Lan HospitalDepartment of HealthI-LanTaiwanChina Department of Family Medicine Taipei Veterans General Hospital and National Yang-Ming University School of MedicineTaipeiTaiwanChina Shiang-Ho clinic TaipeiTaiwanChina Division of Gastroenterology Department of MedicineTaipei Veterans General Hospital and National Yang-Ming University School of MedicineTaipeiTaiwanChina

AIM: To evaluate health-related quality of life (HRQOL) in Chinese patients with chronic hepatitis C (CH-C), and the impact of antiviral ***: Short Form 36 (SF-36) Health-related Quality of Life Questionnaires to interview CH-C patients, and age- and sex-matched control subjects at outpatient clinics of a medical center in Taiwan were used. Data were transformed to scores for comparisons of eight major SF-36 domains. We also enrolled consecutive CH-C patients who completed one course of antiviral treatment(interferon α with ribavirin), and measured the HRQOLbefore, at the 12th wk of treatment, at the end of treatment, and at mo 6, after stopping the treatment to evaluate the impact of antiviral ***: A total of 371 outpatients were enrolled, including 182 with CH-C and 189 age- and sex-matched subjects without CH-C. CH-C subjects had obviously lower educational status (P＜0.01). Mean scores of domains in general health, physical functioning, role-physical,role-emotional, vitality, and mental health of the SF-36 were significantly lower in subjects with CH-C than those without CH-C (P＜0.05). In an analysis of 47 CH-C patients who received and completed the whole course of antiviral treatment, mean scores of all domains were significantly lower at wk 12 of treatment compared to baseline. The scores returned to pretreatment values by the end of treatment, but were significantly increased at mo 6 after stopping the treatment. Among the 47 CH-C patients, 21 had sustained responses and 26 had nonsustained responses to antiviral treatment. Compared to pretreatment values, subjects with sustained responses had significantly lower social functioning scores at wk 12 of treatment, and scores for all SF-36 domains returned to pretreatment values, and increased significantly at mo 6 after stopping the treatment. For non-sustained virological responders, scores of all SF-36 domains significantly decreased at wk 12 of treatment, and did not increase signi

关键词：身体健康生活质量慢性丙型肝炎中国

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A nomogram to preoperatively predict 1-year disease-specific survival in resected pancreatic cancer following neoadjuvant chemoradiation therapy

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Chinese Journal of Cancer Research 2020年第1期32卷 105-114页

作者： Ho Kyoung Hwang Keita Wada Ha Yan Kim Yuichi Nagakawa Yosuke Hijikata Yota Kawasaki Yoshiharu Nakamura Lip Seng Lee Dong Sup Yoon Woo Jung Lee chang Moo Kang Division of HBP Surgery Department of SurgeryYonsei University College of MedicineSeoul 03722Korea Pancreatobiliary Cancer clinic Yonsei Cancer CenterSeverance HospitalSeoul 03722Korea Department of Surgery Teikyo University School of MedicineTokyo 173-8605Japan Biostatistician Biostatistics Collaboration UnitDepartment of Biomedical Systems InformaticsYonsei University College of MedicineSeoul 03722Korea Department of Gastrointestinal and Pediatric Surgery Tokyo Medical UniversityTokyo 160-8402Japan Department of Digestive Surgery Breastand Thyroid SurgeryGraduate School of Medical SciencesKagoshima UniversityKagoshima 890-0065Japan Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery Nippon Medical SchoolTokyo 890-0065Japan Department of general Surgery Changi General HospitalSingapore 529889Singapore

Objective: This study aimed to develop a nomogram to predict the 1-year survival of patients with pancreatic cancer who underwent pancreatectomy following neoadjuvant treatment with preoperatively detectable clinical parameters. Extended pancreatectomy is necessary to achieve complete tumor removal in borderline resectable and locally advanced pancreatic cancer. However, it increases postoperative morbidity and mortality rates, and should be balanced with potential benefit of long-term ***: The medical records of patients who underwent pancreatectomy following neoadjuvant treatment from January 2005 to December 2016 at Severance Hospital were retrospectively reviewed. Medical records were collected from five international institutions from Japan and Singapore for external ***: A total of 113 patients were enrolled. The nomogram for predicting 1-year disease-specific survival was created based on 5 clinically detectable preoperative parameters as follows: age(year), symptom(no/yes), tumor size at initial diagnostic stage(cm), preoperative serum carbohydrate antigen(CA) 19-9 level after neoadjuvant treatment(tients were used for external validation. When correlating actual disease-specific survival and calculated 1-year disease-specific survival, there were significance differences according to the calculated probability of 1-year survival among the three groups(P=0.044).Conclusions: The developed nomogram had quite acceptable accuracy and clinical feasibility in the decision-making process for the management of p

关键词： Pancreatic cancer neoadjuvant treatment pancreatectomy survival nomogram

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Hemorrhagic blisters in fulminant Aeromonas hydrophila bacteremia: Case report and literature review

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Asian Pacific Journal of Tropical Medicine 2019年第2期12卷 91-94页

作者： Yao-tien chang Sung-Yuan Hu Che-An Tsai Department of Emergency Medicine Taichung Veterans General Hospital Department of Nursing College of Health National Taichung University of Science and Technology School of Medicine Chung Shan Medical University Institute of Medicine Chung Shan Medical University Department of Nursing College of Nursing Central Taiwan University of Science and Technology Division of Infectious Disease Department of Internal Medicine Taichung Veterans General Hospital

The Aeromonas species, belonging to the family Aeromonadaceae, are opportunistic pathogens found in humans with an incidence rate of 76 cases per million inhabitants in Southern *** incidence of Aeromonas septicemia is relatively low, accounting for less than 15% of *** diagnosed with Aeromonas hydrophila bacteremia who were presented with skin blisters and septic shock have been reported to have a mortality rate of 100%.Aeromonas infection must be considered in the differential diagnosis of gangrene-like tissue damage or skin lesions in patients with end-stage renal disease, due to the potential sources of infections.A 49-year-old Taiwan Residents diabetic woman with end-stage renal disease had underwent regular *** was referred to our hospital due to a one-day course of fever, dyspnea, hypotension, and fulminant hemorrhagic blisters covering her whole body.A physical examination uncovered multiple hemorrhagic blisters, along with a ruptured blister over the lower left *** tests revealed an elevation of liver enzymes, impaired renal function, lactatemia, and high anion-gap metabolic *** of both blood and hemorrhagic blister fluid grew Aeromonas ***, she experienced persistent shock despite aggressive intravenous fluid, empiric antibiotics, and inotropic agents with norepinephrine and *** diagnosis and prompt management using intravenous fluids, antibiotics and surgical debridement is recommended in order to improve a patient's survival rate.

关键词： Aeromonas hydrophila Bacteremia End-stage renal disease Hemorrhagic blister

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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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Endoscopic management of post-bariatric surgery complications

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World Journal of Gastrointestinal Endoscopy 2016年第17期8卷 591-599页

作者： Mena Boules Julietta chang Ivy N Haskins Gautam Sharma Dvir Froylich Kevin El-Hayek John Rodriguez Matthew Kroh Department of general Surgery Digestive Disease InstituteCleveland Clinic

Understanding the technical constructs of bariatric surgery is important to the treating endoscopist to maximize effective endoluminal therapy. Post-operative complication rates vary widely based on the complication of interest, and have been reported to be as high as 68% following adjustable gastric banding. Similarly, there is a wide range of presenting symptoms for post-operative bariatric complications, including abdominal pain, nausea and vomiting, dysphagia, gastrointestinal hemorrhage, and weight regain, all of which may provoke an endoscopic assessment. Bleeding and anastomotic leak are considered to be early( 30 d) complications. Treatment of complications in the immediate post-operative period may require unique considerations. Endoluminal therapies serve as adjuncts to surgical and radiographic procedures. This review aims to summarize the spectrum and efficacy of endoscopic management of post-operative bariatric complications.

关键词： Bariatric surgery Weight loss surgery Bariatric complications Endoscopy Bariatrics

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Rapid Synthesis of Piezoelectric ZnO-Nanostructures for Micro Power-Generators

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Journal of Materials Science & Technology 2013年第10期29卷 893-897页

作者： Nai-Feng Hsu tien-Kan Chung Ming chang Hong-Jun Chen Department of general Education Army Academy Department of Mechanical Engineering National Chiao Tung University Department of Mechanical Engineering Chung Yuan Christian University State Key Laboratory of Digital Manufacturing Equipment and Technology Huazhong University of Science and Technology

In this paper, we report a rapid synthesis of piezoelectric ZnO-nanostructures and fabrication of the nanostructures- based power-generators demonstrating an energy conversion from an environmental mechanical/ultrasonic energy to an electrical energy. The ZnO nanostructures are grown on a silicon wafer by a modified chemical solution method （CSD, chemical-solution-deposition） with a two-step thermal-oxidation approach. The synthesis process can be completed within 1 h. By varying the mixture-ratio of Zn micro-particles in an oxalic acid solution with 0.75 mol/l concentration in the CSD process, the growth mechanism is well-controlled to synthesize three different types of ZnO-nanostructures （i.e., dandelion-like nanostructures, columnar nanostructures, and nanowires）. Furthermore, through oxidizing at different temperatures in the thermal-oxidation process, the featured geometry of the nanostructures （e.g., the length and diameter of a nanowire） is modified. The geometry, size, morphology, crystallization, and material phase of the modified nanostructures are characterized by scanning electron microscopy and X-ray diffraction. Finally, the nanostructures are used to fabricate several micro power-generators. Through the piezoelectric effect, a maximum current density output of 0.28 μA cm-2 generated by a power-generator under an ultrasonic wave is observed.

关键词： Piezoelectric ZnO nanostructures Chemical solution method Thermal-oxidation Power-generator

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Gene expression profile of peripheral blood in colorectal cancer

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World Journal of Gastroenterology 2014年第39期20卷 14463-14471页

作者： Yu-tien chang Chi-Shuan Huang Chung-Tay Yao Sui-Lung Su Harn-Jing Terng Hsiu-Ling Chou Yu-Ching Chou Kang-Hua Chen Yun-Wen Shih Chian-Yu Lu Ching-Huang Lai Chen-En Jian Chiao-Huang Lin Chien-Ting Chen Yi-Syuan Wu Ke-Shin Lin Thomas Wetter Chi-Wen chang Chi-Ming Chu Division of Biomedical Statistics and Informatics School of Public Health National Defense Medical Center Division of Colorectal Surgery Cheng Hsin Rehabilitation Medical Center Department of Surgery Cathay General Hospital Department of Epidemiology School of Public Health National Defense Medical Center Advpharma Inc. Department of Nursing Far Eastern Memorial Hospital and Oriental Institute of Technology Department of Nursing School of Medicine Chang Gung University Air Force Combatant Command National Defense Ministry Institute of Medical Biometry and Informatics Heidelberg University Germany Department of Biomedical Informatics and Medical Education University of Washington Seattle United States

AIM:Optimal molecular markers for detecting colorectal cancer(CRC)in a blood-based assay were ***:A matched(by variables of age and sex)case-control design(111 CRC and 227 non-cancer samples)was *** RNAs isolated from the338 blood samples were reverse-transcribed,and the relative transcript levels of candidate genes were *** training set was made of 162 random samples of the total 338 samples.A logistic regression analysis was performed,and odds ratios for each gene were determined between CRC and *** samples(n=176)in the testing set were used to validate the logistic model,and an inferred performance(generality)was *** pooling 12 public microarray datasets(GSE 4107,4183,8671,9348,10961,13067,13294,13471,14333,15960,17538,and 18105),which included 519 cases of adenocarcinoma and 88 controls of normal mucosa,we were able to verify the selected genes from logistic models and estimate their external ***:The logistic regression analysis resulted in the selection of five significant genes(P<0.05;MDM2,DUSP6,CPEB4,MMD,and EIF2S3),with odds ratios of 2.978,6.029,3.776,0.538 and 0.138,*** five-gene model performed stably for the discrimination of CRC cases from controls in the training set,with accuracies ranging from 73.9%to 87.0%,a sensitivity of 95%and a specificity of 95%.In addition,a good performance in the test set was obtained using the discrimination model,providing 83.5%ac-curacy,66.0%sensitivity,92.0%specificity,a positive predictive value of 89.2%and a negative predictive value of 73.0%.Multivariate logistic regressions analyzed 12 pooled public microarray data sets as an external *** that provided similar expected and observed event rates in subgroups were termed well calibrated.A model in which MDM2,DUSP6,CPEB4,MMD,and EIF2S3 were selected showed the result in logistic regression analysis(H-L P=0.460,R2=0.853,AUC=0.978,accuracy=0.949,specificity=0.818 and sensitivity=0

关键词： Colorectal cancer Gene expression Micro-array Inte

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Simple instruments facilitating achievement of transanal total mesorectal excision in male patients

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World Journal of Gastroenterology 2017年第31期23卷 5798-5808页

作者： chang Xu Hua-Yu Song Shao-Liang Han Shi-chang Ni Hu-Xiang Zhang Chun-Gen Xing Department of general Surgery the Second Affiliated Hospital of Soochow University Department of Colorectal Surgery the First Affiliated Hospital of Wenzhou Medical University Department of Pathology the First Affiliated Hospital of Wenzhou Medical University

AIM To assess the efficacy of a modified approach with transanal total mesorectal excision(ta TME) using simple customized instruments in male patients with low rectal *** A total of 115 male patients with low rectal cancer from December 2006 to August 2015 were retrospectively studied. All patients had a bulky tumor(tumor diameter ≥ 40 mm). Forty-one patients(group A) underwent a classical approach of transabdominal total mesorectal excision(TME) and transanal intersphincteric resection(ISR), and the other 74 patients(group B) underwent a modified approach with transabdominal TME,transanal ISR, and ta TME. Some simple instruments including modified retractors and an anal dilator with a papilionaceous fixture were used to perform ta TME. The operative time, quality of mesorectal excision, circumferential resection margin, local recurrence, and postoperative survival were *** All 115 patients had successful sphincter preservation. The operative time in group B(240 min, range: 160-330 min) was significantly shorter than that in group A(280 min, range: 200-360 min; P = 0.000). Co m pa r e d w it h g r o up A, m o r e c o m p le t e d is t a l mesorectum and total mesorectum were achieved in group B(100% vs 75.6%, P = 0.000; 90.5% vs 70.7%, P = 0.008, respectively). After 46.1 ± 25.6 mo followup, group B had a lower local recurrence rate and higher disease-free survival rate compared with group A, but these differences were not statistically significant(5.4% vs 14.6%, P = 0.093; 79.5% vs 65.1%, P = 0.130). CONCLUSION Retrograde ta TME with simple customized instruments can achieve high-quality TME, and it might be an effective and economical alternative for male patients with bulky tumors.

关键词： Rectal neoplasm Total mesorectal excision Transanal approach Intersphincteric resection Longterm outcome Local recurrence

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Effects of acupuncture on post-cesarean section pain

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Chinese Medical Journal 2009年第15期122卷 1743-1748页

作者： WU Hung-chien LIU Yu-chi OU Keng-liang chang Yung-hsien HSIEH Ching-liang TSAI Angela Hsin-chieh TSAI Hong-te CHIU Tsan-hung HUNG Chih-jen LEE Chien-chung LIN Jaung-geng College of Dental Medicine Kaohsiung Medical University Taiwan China School of Post Baccalaureate Chinese Medicine China Medical University Taiwan China Research Center for Biomedical Implants and Microsurgery Devices College of Oral Medicine Taipei Medical University Taiwan China China Medical University Hospital China Medical University Taiwan China Meridian Medical Centre Australia Department of Obstetrics and Gynecology Changhua Christian Hospital Taiwan China Department of Obstetrics and Gynecology China Medical University Hospital Taiwan China Department of Anesthesiology Taichung Veterans General Hospital Taiwan China Mei-Tsung Obstetrics and Gynecology clinic Taiwan China Graduate Institute of Acupuncture Science China Medical University Taiwan China

Background Post-operation pain is a very subjective phenomenon. The aim of this study was to find out the effects of acupuncture or electro-acupuncture on post-cesarean pain. Methods Sixty women, who had had spinal anesthesia during cesarean section at the Department of Obstetrics of China Medical University Hospital, were randomly assigned to the control group, the acupuncture group, and the electro-acupuncture group. After the operation, we applied subjects with acupuncture or electro-acupuncture on the bilateral acupuncture point, San Yin Jiao （Sp6）, and the patient controlled analgesia （PCA）. The first time of requesting morphine, the frequency of PCA demands in 24 hours, and the doses of PCA used were recorded double blindly. In addition, monitoring the subjects＇ vital signs, the opioid-related side effects, and the pain scores was done. Results The results showed that the acupuncture group and the electro-acupuncture group could delay the time of requesting morphine up to 10-11 minutes when compared with the control group. The total dose of PCA used within the first 24 hours was 30%-35% less in the acupuncture group and the electro-acupuncture group when compared with the control group, which was indicated in statistical significance. However, there was no significant difference between the acupuncture group and the electro-acupuncture group. The electro-acupuncture group＇s and the acupuncture group＇s pain scores were lower than the control group＇s within the first 2 hours. Both were statistically significant. However, two hours later, there were no significant differences of the visual analogue scale （VAS） scores between either of the treatment groups and the control group. Finally, the incidence of opioid-related side effects, such as dizziness, was less in the acupuncture group and electro-acupuncture group than in the control group. Conclusions This study shows that the application of acupuncture and electro-acupuncture could definitely delay the time of r

关键词： cesarean-section childbirth, acupuncture electro-acupuncture pain

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