Study and Discussion on Acupuncture Treatment of Urticaria

OBJECTIVE:To explore the etiology and pathogenesis of urticaria and its characteristics,advantages of acupuncture and moxibustion treatment of it and the commonly used acupoints,with a prospect of providing clinical guidance for other doctors.METHODS:Methods and views of urticaria treatment with acupuncture and moxibustion were summarized and the representative acupoints were found out by retrieving related literatures in recent years.RESULTS:Traditional Chinese medicine holds that urticaria is caused by weakness and leads to the wind stroke knot on the skin,which fights against qi and blood and generates wheal..Acupuncture therapy has its unique advantages in treating,which is worth clinical reference and promotion,however,there are still some problems in its clinical study.CONCLUSION:Acupuncture therapy should be combined with reinforcing qi and nourishing blood,detoxification dehumidification,dispelling wind and arresting itching as the principle,as according to the the principle that different symptomsmatch with the corresponding points after selecting the main point.Physiciansshould treat patients by choosing acupuncture point according to the law of syndrome differentiation in selecting,tired to choose acupuncture point,local pick acupuncture point and choosing particular points.As urticaria may attack in any season,in any place and on any person.Therefore,the prevention and treatment of urticariais a protracted war,and needs to strengthen the nursing in the treatmentto achieve the desired effect.

Septal collateral distal tip injection during retrograde percutaneous coronary intervention for chronic total occlusion

Background The use of collateral channels(CCs)in crossing the occlusion plays a pivotal role in the retrograde PCI approach,but the impact of septal collateral distal tip injection(DTI)on contemporary septal collateral channels(CCs)crossing is still unknown.Methods 264 chronic total occlusion(CTO)cases in which the retrograde approach via septal collateral channels were enrolled after reviewing the coronary angiograms of 1300 patients from Jan 2014 to Dec 2019.This study collected the clinical and angiography data of those patents for analyzing the usefulness of this technology.In addition,a forward multivariable logistic-regression model was applied to identify the independent predictors of CC crossing failure.Results A total of 264 retrograde cases were divided into successful CCs crossing group(n=233,88.3%)and failure group(n=31,11.7%).Univariate statistics showed successful cases had low proportion of collateral channel tortuosity(42.1%vs.67.7%,P=0.011)and JCTO≥3 lesions(68.7%vs.90.3%,P=0.002)while had higher proportion of Werner CC2 collateral(52.8%vs.16.1%,P<0.001).Multivariate statistics found that the use of DTI was not significantly associated with increasing CCs crossing success rate.Twenty cases in success group performed DTI after CCs crossing failure.Conclusions Successful CTO PCI via septal CCs was not enhanced by the use of DTI before CCs attempt.

Usefulness of coronary epicardial collaterals for the retrograde approach treatment of coronary chronic total occlusions

Background The retrograde approach allows to significantly increase the success rate of coronary chronic total occlusion（CTO） percutaneous intervention（PCI）. Epicardial collateral channels（CCs） remain an essential channel for retro-recanalization. But paucity of data in this area limits the use of epicardial CCs for retrograde canalization. The present study was to explore the feasibility and significance of coronary epicardial collaterals for the retrograde approach treatment of coronary CTO. Methods We retrospectively analyzed 347 CTO cases which the retrograde approach was attempted after reviewing the coronary angiograms of 1290 patients. And there were 89 retrograde approach PCI cases applying epicardial CCs. We collected the clinical and angiography data of those patents for analyzing the safety and usefulness of this technology. Results The study consisted of347 CTO PCI. Mean age was 60.8±10.4 and 60.3±10.2 years in epicardial CCs and septal CCs groups respectively. The total retrograde success rate was 79.8%. The success rate of retrograde approach applying epicardial CCs was not lower（82.0% vs. 79.1%, P=0.646） than that in cases applying septal CCs. There were 8 epicardial CCs injury cases（9.0%） and 3 cases resulted in cardiac tamponade and required emergency pericardiocentesis. Coils were used for all of them with success. No patients were dead in retrograde approach applying epicardial CCS.Conclusions Coronary epicardial collaterals can be used as an access for the retrograde approach in the percutaneous treatment of CTO, which is relative feasible, and has a high success rate. Epicardial CCs injury can be safety as long as it is treated timely.