Systematic review of the therapeutic effect of fire acupuncture on psoriasis vulgaris based on"releasing stagnated fire"theory

Background:To systematically evaluate the clinical efficacy of fire acupuncture(or needle)in the treatment of psoriasis vulgaris.Methods:The following electronic databases were retrieved by calculator:PubMed,Embase,Cochrane Library,CNKI,Wanfang Academic Journal Database,VIP Chinese Journal Database,etc.All the randomized controlled trials using fire needles in the treatment of psoriasis vulgaris from the self-established database to August 2021 were included,and the qualified literatures were included.Review manager 5.3 software was used for the combined analysis of the included literatures,TSA v0.9 Beta for sequential analysis,and GRADE pro V3.6 for evidence quality evaluation.Results:A total of 14 studies with 1,440 patients were included in this study.Meta analysis results showed:effective rate[RR=1.15,95%CI(1.10,1.19),P<0.00001,very low quality evidence];Psoriasis Area and Severity Index[PASI score,WMD=-2.15,95%CI(-2.40,-1.90),P<0.00001,evidence of low quality],Dermatology Life Quality Index scale[DLQI score,WMD=-3.56,95%CI(-4.86,-2.26),P<0.00001,very low quality evidence],the experimental group was better than the control group(P<0.05).Sequential analysis further showed that the use of fire needle as the primary treatment could significantly reduce PASI score.The adverse reactions rate of the experimental group was 6%,and that of the control group was 11%,P<0.05.Conclusion:Fire acupuncture as the main treatment can reduce PASI and QLDI scores of patients with psoriasis vulgaris,improve the treatment efficiency,and fewer adverse reactions.

Management of orthostatic intolerance in children: the state of the art

Orthostatic intolerance(OI)is characterized by symptoms and signs of dizziness,headache,visual difficulties,a loss of consciousness,nausea,abdominal discomfort,pallor,tachycardia or hypotension;and OI is primarily elicited by a rapid postural change from supine to standing or prolonged quiet standing which can be resolved by lying down[1,2].About 15%of children and adolescents are affected by OI,with the median peak age of the first OI onset at 15 years[3].OI accounts for a noticeable proportion of emergency department visits.Deliberately or indeliberately,the injection of normal saline always plays a role,which“rescues”the patients.Single or occasional episodes of OI are often overlooked by some patients;and children with recurrent OI symptoms often experience depression,and have diminished quality of life。

Body mass index is a promising predictor of response to oral rehydration saline in children with vasovagal syncope

Background:Vasovagal syncope(VVS)greatly impairs quality of life.The therapeutic efficacy of oral rehydration saline(ORS)for unselected VVS patients is not satisfactory due to the diverse mechanisms of the disease.Body mass index(BMI)was demonstrated to reflect blood volume to a certain extent.Therefore,the present study explored the capability of BMI to predict the therapeutic response of children with VVS to ORS treatment.Methods:Seventy-four children with VVS who visited the Syncope Unit of Pediatrics at Peking University First Hospital from November 2010 to June 2019 receiving ORS treatment were enrolled for this retrospective case-control study.A comparison of demographic,clinical,and hemodynamic characteristics was performed between responders and non-responders.The correlation between baseline BMI and response time was analyzed.To determine the value of baseline BMI in predicting the therapeutic efficacy of ORS in children with VVS,a receiver operating characteristic curve analysis was performed.Results:Fifty-two children were identified as responders,and the remaining 22 children were identified as non-responders.The baseline BMI of the responders was much lower than that of the non-responders(16.4[15.5,17.8]kg/m2vs.20.7±3.6 kg/m2,P<0.001),and baseline BMI was positively correlated with response time in the head-up tilt test after adjusting for sex(r=0.256,95%confidence interval[CI]:0.067-0.439,P=0.029).The area under the receiver operating characteristic curve of baseline BMI was 0.818(95%CI:0.704-0.932,P<0.001),and an optimal cut-off value of 18.9 kg/m2 yielded a sensitivity of 83%and a specificity of 73%to predict the efficacy of ORS in VVS.Conclusion:Prior to treatment,baseline BMI is a promising predictor of response to ORS in children with VVS.