Name: press needle: a traditional chinese medicine therapy for myopia patients with dry eye
Uploaded: 2024-04-12T14:35:00.000+00:00
Duration: 5 min 26 s
Description: Read this Scientific Article Protocol about Author Spotlight: Exploring Press Needle Efficacy and Underlying Molecular Pathways at JoVE.com

这项工作得到了成都中医药大学杏林学者研究促进项目 （MPRC2022012 和 QJJJ2023004） 的支持。

该方案已在成都中医药大学附属医院眼科批准用于临床试验伦理（伦理记录编号:KY2023001）。确保环境清洁无污染，光线充足，环境安静。获得患者的知情同意以使用和发布本文所示的数据。
1. 医生准备
<ol><li>检查患者的基本信息。确保患者符合《 近视防治指南 》中近视的诊断标准，且患有干眼症: （1） 确保患者远距离视力模糊，近视力良好，早期远视力经常波动，看远处物体时眯眼;（2） 通过屈光确定近视并确定程度。</li>
	<li>排除具有以下情况的患者: （1） 晕动病患者;（2） 皮肤溃疡;（3） 血糖控制不佳、血压控制不佳、头晕患者;（4） 凝血功能障碍和严重心功能不全患者;（5） 风湿性心脏病、先天性心脏病、肾衰竭、肝衰竭等;（6） 不配合治疗的患者。</li>
	<li>佩戴医用口罩和医用帽</li>
	<li>用肥皂水和七步洗手法洗手，保持双手干燥，并在取针前使用免洗手消毒液。 注意:手部消毒后避免触摸其他物品。手术前后必须洗手，双手必须保持清洁。</li>
</ol>2. 患者检查
<ol><li>获取患者基本信息:询问患者的姓名、性别、年龄、医生编号、身高、体重、既往病史、主诉等基本信息。</li>
	<li>测试患者的肉眼视力。<ol><li>要求患者距离视力表 5 m;遮盖眼睛的一侧。</li>
		<li>识别视力表上的"E"并检查它，直到它不再可识别。保持标签的方向从上到下。</li>
		<li>阅读视力表左侧的十进制记数法，根据视力表的读数判断患者的视力。</li>
		<li>然后使用相同的方法评估另一只眼睛。与通用视力表 （UCVA） 相比，低于 1.0 的分数被认为是近视。</li>
	</ol></li>
	<li>测试患者的干眼症评分。<ol><li>确保患者有眼睛干涩、异物感、烧灼感、疲劳、不适、眼睛发红和视力波动等主观症状之一。</li>
		<li>对照眼表疾病指数量表 （OSDI） 检查相应的情况:您在过去一周内是否出现过畏光、异物感、眼痛、眼睛刺激、视力模糊或视力丧失？ 总是出现 是 4 分， 经常出现 是 3 分， 一半时间出现 是 2 分， 有时出现 是 1 分， 没有出现 是 0 分。</li>
		<li>使用等式计算分数:0-12 是正常的;13-22 被归类为轻度干眼症;23-32 为中度干眼症;33-100 为重度干眼症。 最终比分 =<img alt="Equation 1" src="/files/ftp_upload/66727/66727eq01.jpg" style="margin: auto;"></li>
		<li>如果患者的 UCVA 评分为 <1.0 且 OSDI 为 ≥13 分，则进行下一步针刺治疗;否则，暂停针头给药。确保皮肤没有受损和溃疡。</li>
	</ol></li>
	<li>测量患者的血压。<ol><li>测量前让患者放松并安静休息 5-10 分钟。</li>
		<li>准备水银血压计;让患者坐着，双脚平放，肘部和前臂舒适地与心脏大致平行。</li>
		<li>打开血压计，将水银柱降至零。</li>
		<li>将血压计袖带系在患者上臂肘关节上方;确保一根手指仍然可以插入袖带和皮肤之间。</li>
		<li>将听诊器放在有动脉搏动的肘关节处，然后慢慢提高血压计内的压力，直到听诊器听不到血管的脉搏为止。现在慢慢放气:收缩压是听到血管脉搏的第一声，而舒张压是听不到声音的时候。</li>
		<li>如果血压正常（收缩压低于 90-140 mmHg，舒张压高于 60-90 mmHg），进行下一步针疗;否则，暂停针头应用。</li>
	</ol></li>
	<li>检测患者的脉搏率和血氧饱和度。<ol><li>准备一个夹式血氧仪，将左手或右手的食指放入夹式血氧仪的夹式中，检查夹式血氧仪中的红外灯是否开启。</li>
		<li>保持手指与夹持式血氧仪完全接触，在显示屏上显示测试进度。进入检测状态后，请保持手指稳定。</li>
		<li>显示屏上显示测试结果后，请伸出手指。显示屏顶部的 %SpO2 是血氧指数，屏幕上的 Min 是脉搏率。</li>
		<li>如果脉率正常（60-100 bpm（次/分钟）），进行下一步的针头治疗;否则，暂停针头应用。</li>
	</ol></li>
	<li>测量患者的呼吸频率。<ol><li>让患者保持安静、坐着或平躺，以保持平静的呼吸。</li>
		<li>观察患者的呼吸模式（胸式呼吸或腹式呼吸），并将手放在胸部或腹部。</li>
		<li>用手表或时钟计数，并通过观察胸部或腹腔的起伏来判断每分钟的呼吸频率。</li>
		<li>如果呼吸频率正常（12-20 次/分钟），进行下一步针刺治疗;否则，暂停针头应用。</li>
	</ol></li>
</ol>3. 穴位的识别和消毒
<ol><li>将患者平躺在治疗床上，仰卧位。摘下眼镜（如果有）以露出面部。让医生站在患者的右侧。</li>
	<li>遵循穴位定位:根据标准化穴位定位，穗竹（BL2）、余瑶（Ex-HN04）、四白（ST2）（见 图2）。<ol><li>BL2:定位在脸上，取眉毛内缘（眉毛中间，眶上切迹）的凹陷处。</li>
		<li>Ex-HN04:位于额头上，直视，瞳孔笔直向上;取眉毛的中间。</li>
		<li>ST2:定位于面部，眼睛方正，瞳孔垂直向下;以眶下孔的凹陷为例。 注意: 消毒前询问患者是否对酒精过敏。对酒精和不锈钢过敏的人不应使用它。</li>
	</ol></li>
	<li>取 75% 医用消毒酒精，在穴位喷洒 2-3 次，用一次性医用消毒棉签由内向外、从上到下擦拭;消毒部分的直径约为 2-3 厘米。等待酒精蒸发并确保操作部件干燥。</li>
</ol>4. 针灸手术
<ol><li>检查压针，确保其在保质期内，打开包装，检查压针是否完整，无损坏或变形。</li>
	<li>针灸BL2穴位:用左手拇指和食指固定皮肤，右手用镊子拿起针带，保持针头无菌，将针尖对准穴位，以45°进入皮肤，将针尖完全压入皮肤，左手按压固定带（见 图3）。<ol><li>如果接触血管，请减小针头与皮肤之间的角度，以避免针头进一步插入血管。</li>
	</ol></li>
	<li>针灸 Ex-HN04 穴位:按照步骤 4.2 中概述的程序进行操作（见 图 4）。</li>
	<li>针灸 ST2 穴位:按照步骤 4.2 中概述的程序进行操作（见 图 5）。</li>
	<li>询问患者感觉如何:轻轻按压手指 3 次以应用针头，并询问患者是否有任何酸涩、麻木、肿胀、疼痛和其他刺激。如果有任何感觉，请留下针头;如果没有感觉，调整针灸的方向，直到有感觉，然后离开针头。</li>
	<li>2 天后拔针，休息 1 天，再次涂抹上述穴位。一个疗程持续 2 周;总共进行 2 个疗程的治疗。在保留期内大约每 3 小时进行一次按压，每天 3 次，一次 ~1 分钟。</li>
	<li>取针:用左手的拇指和食指固定皮肤，右手用镊子拿起针带，取出垂直于皮肤的针头，取下后用无菌棉签按压针孔，用酒精棉签局部消毒。</li>
	<li>拔针后，将患者留在治疗室 30 分钟后再离开。</li>
	<li>疗效评价:1 个疗程（2 周）后，根据国际通用视力表 （UCVA） 测量患者的肉眼视力，并在下一个疗程前评估患者干眼评分的改善情况。</li>
</ol>

Standardizing Press Needle Treatment for Myopia with Dry Eye

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针灸作为我国古老的传统治疗方法，其疗效在漫长的发展历史中得到了验证，近年来的各种研究成果进一步证明了针灸在改善近视患者视力和干眼症状方面的有效性。这种疗法的有效性主要取决于所选择的穴位。高辉14 等人的研究证实，针灸疗法可以显着改善干眼症的症状，增加泪液分泌量。至于针灸治疗干眼症近视患者的疗效，国内已有大量临床报道得到证实。根据中医经典?...

近视是一种屈光不正;当眼睛处于放松的调整状态时，平行光线穿过屈光视网膜后聚焦在视网膜前方，从而在视网膜上产生清晰的图像，这称为近视。这种疾病的主要表现是近处物体的清晰视力和远处物体的模糊视力1。当正常的眼睛适应到松弛状态时，来自 5 m 外的平行光线穿过眼睛的屈光系统，焦点落在视网膜上，形成清晰的图像。但是，当近视患者看到 5 m 外的远处物体时，平行光线穿过眼球的屈光系统后会聚焦在视网膜前方，因此视力会变得模糊。如果观察 5 m 以内的近处物体，平行光线穿过眼球的屈光系统后会聚焦在视网膜上，效果会更清晰。由于近年来社会经济环境的快速变化，电子屏幕的广泛使用，以及精细化的眼睛使用方法的增加，近视的发病率迅速增加，并呈现年轻化的趋势，对社会健康产生了严重影响。
据统计，到 2050 年，全球近视人数将达到近 50 亿。随着电脑和智能手机的普及，加上之前新型冠状病毒爆发的影响，越来越多的近视患者开始出现干眼症状2。中国有近 4 亿人患有干眼症，近视干眼症的患病率明显高于正视和远视，近视青少年干眼症的发生率约为 20%。泪液不足和泪膜不稳定是导致干眼症的关键因素，近视患者眼睛伸长过程中角膜的变化和眼睑空间的增加会导致泪膜分布不均匀，导致泪膜稳定性下降，从而增加干眼症的风险。
干眼症的特征是泪膜不平衡和眼睛不适。是角膜结膜干燥的慢性炎症反应，主要表现为对外界环境敏感、泪液不足、眼感异物。可导致角膜结膜病变和视力障碍，进而影响患者的生活质量和视力3。干眼症的病因很复杂;主要原因是泪液的质量、数量和动力学异常，导致泪膜不稳定或眼表微环境失衡。疾病的具体起病与患者的眼表泪膜渗透压变化、免疫炎症反应、泪膜过度氧化、感觉神经麻痹和细胞凋亡有关，病理过程涉及 MAPK、NF-κB、Wnt、TLR、PI3K/AKT 等信号通路 4,5。
中医认为，近视患者干眼症的主要发病机制是肝肾功能不全。在 黄帝的内经苏温中记载"五脏六腑渗入眼内"，由此可见内脏功能障碍、滋润眼睛的液体产生不足或输液不良是重要的病原。 银海精微 明确指出:"泪水少负责肝肾虚"——肝脏的主要血液是眼睛的外部，肝血充足，肝气调理，将细微物质注入眼表以产生泪水。肾脏的主要水是体液的源头，肾充足，肾气充盈，全身源头充足。肝肾精华和血液是同源且相互关联的，因此肝肾功能不全是一个重要的发病机制6。目前，干眼症的临床治疗主要以人工泪液、维生素、神经生长因子和热脉冲疗法为主，短期效果良好，但长期效果仍然有限。中医治疗以中医内服为主，针灸、热敷熏蒸、耳压丸等。疗效持久性好，但手术较复杂，患者依从性不强。
压针是一种皮内针灸，在临床上应用广泛，主要用于治疗面瘫、失眠、痛经等疾病，近年来逐渐扩展到眼科疾病，具有疗效持久、操作简便、成本低、患者依从性好等特点7.具体来说，将一根特殊的小针（0.2-0.3 厘米长）插入并固定在穴位区域或皮下进行长时间埋葬。埋针时无需立即产生空气感，只有埋针后才能调节空气。本疗法结合了穴位理论和中医皮肤理论，采用"久静不动"的古老理念，结合传统针灸和埋线的优点，对皮肤进行长时间的持续刺激，达到防病的目的。
压针可以改善肉眼远视力，改善视觉疲劳状态，减少屈光，延缓近视患者的轴向生长，这已被临床研究证实 8,9,10。按压针可以改善干眼症，在改善干眼症患者泪膜稳定性、泪液分泌和角膜上皮损伤程度方面优于单独使用透明质酸钠滴眼液 11,12,13。按压针联合耳压豆、中医雾化熏蒸、按摩治疗干眼症的效果更为显著，这可能与调控MAPK、NF-kB、Wnt、TLR、PI3K/AKT等多条信号通路有关。
基于中医穴位和皮肤虫理论，本研究采用压针治疗（图 1），旨在改善干眼症症状、改善视觉功能和生活质量。按压针是一种持久、易于操作且价格低廉的中医治疗方法。综上所述，有必要提出一个关于如何正确操作针灸治疗干眼症近视的标准方案。本文介绍了如何正确使用压针治疗近视患者的干眼症。

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press needle: a traditional chinese medicine therapy for myopia patients with dry eye

大多数近视患者患有干眼症，这已被证明会对近视患者的眼部症状、近视进展和生活质量产生不利影响。针刺已被证明可有效缓解近视和干眼症患者的症状。压针是一种持久、易于操作且价格低廉的中医治疗方法。针头插入的标准做法对于治疗近视和干眼症非常重要。具体步骤包括选择合适的穴位，用合适的针刺穿，固定在穴位皮肤或皮下，埋 2 天，休息 1 天;治疗过程持续 2 周。具体来说，评估了以下指标: 未矫正视力和眼表疾病指数。本文将解释如何规范按压针在治疗近视和干眼症中的操作。

在本研究中，共有 8 名符合标准的患者参加并完成了试验，在此过程中没有一人出院或被排除在外。OSDI 和 UCVA 评分用作该试验的主要评价指标，数据来自患者在治疗前后完成的量表评分。使用配对 t 检验比较治疗前后的自我控制。
表 1 比较了患者治疗前后的 OSDI 评分。将 OSDI 评分分为轻度症状≤ 21~45 分为中度症状，≥46 分为重度症状。治疗后患者 OSDI 评...

Read this Scientific Article Protocol about Author Spotlight: Exploring Press Needle Efficacy and Underlying Molecular Pathways at JoVE.com

Author Spotlight: Exploring Press Needle Efficacy and Underlying Molecular Pathways

在这里，我们提出了一种方案，以标准化针灸治疗干眼症近视的操作。

压针:干眼症近视患者的中医疗法

Most patients with myopia have dry eye, which has been shown to adversely affect ocular symptoms, myopia progression, and quality of life in patients with ...

我们的研究重点是使用中医预防和治疗眼病。具体来说，我们正在制定治疗近视和干眼症的标准手术计划。按压针可以提高干眼症患者泪膜、泪液分泌和角膜雅典损伤的稳定性，比单独使用钠、高神经率滴眼液更好。可能与 MAPK、LFP、B、WNT、TLR、PI3、KAKT 和其他信号通路的调节有关。我们观察到针灸治疗后近视患者的干眼症状有显着改善，并导致某些病例的视力得到改善。

press-needle-traditional-chinese-medicine-therapy-for-myopia-patients

Research

JoVE Journal

Medicine

Press Needle: A Traditional Chinese Medicine Therapy for Myopia Patients with Dry Eye

1.2K 次观看.  Eye School of Chengdu University of Traditional Chinese Medicine. 我们的研究重点是使用中医预防和治疗眼病。具体来说，我们正在制定治疗近视和干眼症的标准手术计划。按压针可以提高干眼症患者泪膜、泪液分泌和角膜雅典损伤的稳定性，比单独使用钠、高神经率滴眼液更好。可能与 MAPK、LFP、B、WNT、TLR、PI3、KAKT 和其他信号通路的调节有关。我们观察到针灸治疗后近视患者的干眼症状有显着改善，并导致某些病例的视力得到改?...

视频: Author Spotlight: Exploring Press Needle Efficacy and Underlying Molecular Pathways

Scleral Cross-linking Using Riboflavin and Ultraviolet-A Radiation for Prevention of Axial Myopia in a Rabbit Model

Myopic individuals, especially those with severe myopia, are at higher-than-normal risk of cataract, glaucoma, retinal detachment and chorioretinal abnormalities. In addition, pathological myopia is a common irreversible cause of visual impairment and blindness1-3. Our study demonstrates the effect of scleral crosslinking using riboflavin and ultraviolet-A radiation on the development of axial myopia in a rabbit model. The axial length of the eyeball was measured by A-scan ultrasound in New Zealand white rabbits aged 13 days (male and female). The eye then underwent 360&#176; conjunctival peritomy with scleral crosslinking, followed by tarsorrhaphy. Axial elongation was induced in 13 day-old New Zealand rabbits by suturing their right eye eyelids (tarsorrhaphy). The eyes were divided into quadrants, and every quadrant had two scleral irradiation zones, each with an area of 0.2 cm&#178; and a radius of 4 mm. Crosslinking was performed by dropping 0.1% dextran-free riboflavin-5-phosphate onto the irradiation zones 20 sec before ultraviolet-A irradiation and every 20 sec during the 200 sec irradiation time. UVA radiation (370 nm) was applied perpendicular to the sclera at 57 mW/cm&#178; (total UVA light dose, 57 J/cm&#178;). Tarsorrhaphies were removed on day 55, followed by repeated axial length measurements. This study demonstrates that scleral crosslinking with riboflavin and ultraviolet-A radiation effectively prevents occlusion-induced axial elongation in a rabbit model.

We demonstrate the effect of scleral crosslinking with riboflavin and UVA on an axial elongation rabbit eye. Axial elongation was induced in 13 day-old New Zealand rabbits (male and female) by suturing their right eye eyelids (tarsorrhaphy).

巩膜交联兔模型使用核黄素和紫外辐射的轴性近视防治

Myopic individuals, especially those with severe myopia, are at higher-than-normal risk of cataract, glaucoma, retinal detachment and chorioretinal ...

科研

医学

Second Harmonic Generation Signals in Rabbit Sclera As a Tool for Evaluation of Therapeutic Tissue Cross-linking (TXL) for Myopia

Methods to strengthen tissue by introducing chemical bonds (non-enzymatic cross-linking) into structural proteins (fibrillar collagens) for therapy include photochemical cross-linking and tissue cross-linking (TXL) methods. Such methods for inducing mechanical tissue property changes are being employed to the cornea in corneal thinning (mechanically weakened) disorders such as keratoconus as well as the sclera in progressive myopia, where thinning and weakening of the posterior sclera occurs and likely contributes to axial elongation. The primary target proteins for such tissue strengthening are fibrillar collagens which constitute the great majority of dry weight proteins in the cornea and sclera. Fortuitously, fibrillar collagens are the main source of second harmonic generation signals in the tissue extracellular space. Therefore, modifications of the collagen proteins, such as those induced through cross-linking therapies, could potentially be detected and quantitated through the use of second harmonic generation microscopy (SHGM). Monitoring SHGM signals through the use of a laser scanning microscopy system coupled with an infrared excitation light source is an exciting modern imaging method that is enjoying widespread usage in the biomedical sciences. Thus, the present study was undertaken in order to evaluate the use of SHGM microscopy as a means to measure induced cross-linking effects in ex vivo rabbit sclera, following an injection of a chemical cross-linking agent into the sub-Tenon&#39;s space (sT), an injection approach that is standard practice for causing ocular anesthesia during ophthalmologic clinical procedures. The chemical cross-linking agent, sodium hydroxymethylglycinate (SMG), is from a class of cosmetic preservatives known as formaldehyde releasing agents (FARs). Scleral changes following reaction with SMG resulted in increases in SHG signals and correlated with shifts in thermal denaturation temperature, a standard method for evaluating induced tissue cross-linking effects.

Second Harmonic Generation Signals in Rabbit Sclera As a Tool for Evaluation of Therapeutic Tissue Cross-linking TXL for Myopia

This protocol describes techniques for evaluating chemical cross-linking of the rabbit sclera using&#160;second harmonic generation imaging and differential scanning calorimetry.

兔巩膜二次谐波信号作为治疗组织交叉连接 (txl-) 评价近视的工具

Methods to strengthen tissue by introducing chemical bonds (non-enzymatic cross-linking) into structural proteins (fibrillar collagens) for therapy ...

Intense Pulsed Light for the Treatment of Dry Eye Owing to Meibomian Gland Dysfunction

Dry eye disease (DED) is an increasingly common condition and one of the most common complaints of patients. The vast majority of DED is caused by the so-called &#34;evaporative&#34; subtype, that is mainly caused by meibomian gland dysfunction (MGD). Intense pulsed light (IPL) devices employ high intensity pulses of polychromatic lights with a broad range of wavelength (515-1200 nm). IPL treatment has been utilized for years in the field of dermatology, and then its use was applied to ophthalmology for the treatment of MGD. Recently, a new device employing IPL was specifically designed for the periocular application. This procedure determines the thermal selective coagulation and ablation of superficial blood vessels and telangiectasias of the eyelids skin, reducing the release of inflammatory mediators and tear cytokines levels, and improving meibomian glands outflow. IPL treatment is noninvasive and easy to perform, lasts for only a few minutes and can be conducted in an office setting. In the present study, 19 patients underwent 3 sessions of IPL treatment. After treatment, both mean noninvasive break-up time and lipid layer thickness grade significantly increased, as a result of an improvement of tear film stability and quality, respectively. Conversely, no statistically significant changes were found for meibomian gland loss and tear osmolarity. Furthermore, the vast majority of the treated patients (17/19; 89.5% of the total) perceived an improvement of their ocular discomfort symptoms after IPL treatment. Although IPL treatment provides an improvement of both ocular surface parameters and ocular discomfort symptoms after one cycle of three sessions, regular repeated treatments are usually required to maintain the persistence over the time of its beneficial effects.

Dry eye disease is an increasingly common condition, which strongly impair patients&#39; life quality. Recently, a new device employing intense pulsed light, specifically designed for the periocular area, has been shown to improve tear film stability and ocular discomfort symptoms in dry eye disease owing to meibomian gland dysfunction.

梅博米安腺体功能障碍治疗干眼症的强脉冲光

Dry eye disease (DED) is an increasingly common condition and one of the most common complaints of patients. The vast majority of DED is caused by the ...

Platelet-Rich Plasma Lysate for Treatment of Eye Surface Diseases

Various ocular surface diseases are treated with blood-derived eye drops. Their use has been introduced in clinical practice because of their metabolite and growth factor content, which promotes eye surface regeneration. Blood-based eye drops can be prepared from different sources (i.e., whole blood or platelet apheresis donation), as well as with different protocols (e.g., different dilutions and freeze/thaw cycles). This variability hampers the standardization of clinical protocols and, consequently, the evaluation of their clinical efficacy. Detailing and sharing the methodological procedures may contribute to defining common guidelines. Over the last years, allogenic products have been diffusing as an alternative to the autologous treatments since they guarantee higher efficacy standards; among them, the platelet-rich plasma lysate (PRP-L) eye drops are prepared with simple manufacturing procedures. In the transfusion medicine unit at AUSL-IRCCS di Reggio Emilia, Italy, PRP-L is obtained from platelet-apheresis donation. This product is initially diluted to 0.3 x 109 platelets/mL (starting from an average concentration of 1 x 109 platelets/mL) in 0.9% NaCl. Diluted platelets are frozen/thawed and, subsequently, centrifuged to eliminate debris. The final volume is split into 1.45 mL aliquots and stored at &#8722;80 &#176;C. Before being dispensed to patients, eye drops are tested for sterility. Patients may store platelet lysates at &#8722;15 &#176;C for up to 1 month. The growth factor composition is also assessed from randomly selected aliquots, and the mean values are reported here.

Platelet lysates represent an emerging tool for the treatment of ocular surface diseases. Here, we propose a method for the preparation, dispensation, storage, and characterization of platelet lysate collected from platelet donors.

富血小板血浆裂解物用于治疗眼表疾病

Various ocular surface diseases are treated with blood-derived eye drops. Their use has been introduced in clinical practice because of their metabolite ...

Enema of Traditional Chinese Medicine for Patients with Severe Acute Pancreatitis

Severe acute pancreatitis (SAP) is characterized by high mortality rates, numerous complications, and extreme difficulties in treatment. A traditional Chinese medicine (TCM) enema has been widely utilized in clinical and experimental studies of SAP. It has been demonstrated to have beneficial effects in protecting pancreatic function and delaying disease progression. The procedure of TCM enema is to perfuse the Chinese medicinal liquid of raw rhubarb (Rheum officinale Baill. DaHuang) from the anus into the rectum and colon. Basic steps of the procedure include boiling the herbal solution in advance, using a disposable enema kit to assist patients in taking a left lying position, raising the patient's hip 10 cm, and carefully inserting the enema 30-35 cm into the anus, with a drip speed of 60-80 drops/min. The medicine liquid temperature should be equivalent to the patient's body temperature, typically between 37-39 &#176;C. The end of the enema operation should be slow, and Tui na (massage therapy) should be administered before extubation. The medication liquid should be kept in the rectum for more than 1 h. After issuing an enema, it is essential to observe the patient's feces and abdomen, and to evaluate the remission of abdominal signs and symptoms.

An enema is a type of traditional Chinese medicine (TCM) therapy used to treat severe acute pancreatitis (SAP). The therapy involves instilling a TCM liquid into the rectum and colon through the anus to keep the liquid in the intestine, absorbing through the intestinal mucosa. This study aims to standardize the enema procedure for SAP patients.

重症急性胰腺炎患者中药灌肠

Severe acute pancreatitis (SAP) is characterized by high mortality rates, numerous complications, and extreme difficulties in treatment. A traditional ...

<meta charset="utf8"></head><body>评估眼表疾病中角膜神经的健康状况

Corneal Sensitivity Testing Procedure for Ophthalmologic and Optometric Patients

The cornea is the most densely innervated structure in the human body, making it one of the most sensitive tissues. Changes in corneal nerve sensitivity can be observed in several ocular surface diseases. Nerve sensitivity may be increased, as is often seen in patients with a neuropathic component to ocular pain, or decreased, as is seen in patients with neurotrophic keratitis. Corneal sensitivity testing involves assessing a patient's reaction to brief corneal stimulation, yields insight into the health of the corneal nerves, and provides diagnostic value for evaluating the health of the nerves and the interplay with the ocular surface. Currently, there is limited published guidance on how to conduct corneal sensitivity testing in a clinical setting. This article presents a protocol for testing corneal sensitivity using easy-to-use, low-cost materials that are readily accessible to eye care providers (either a cotton swab, a piece of dental floss, or a finely tapered tissue). This protocol allows for qualitative assessment of corneal sensitivity in which responses to corneal stimulation are rated from 0 (no response) to 3 (hypersensitive response). This test can be performed quickly (in approximately 30 s). Given its diagnostic value and accessibility, corneal sensitivity testing should be included as part of the standard eye examination for any patient undergoing an ocular surface examination.

<meta charset="utf8"></head><body> 作者聚焦:在临床环境中建立实用且经济高效的角膜敏感性检测方案

Corneal sensitivity testing provides insight into the health of the corneal nerves and helps diagnose ocular surface diseases. We present a concise protocol to qualitatively assess corneal sensitivity that can be readily used by eye care providers across clinical settings.

眼科和验光患者的角膜敏感性测试程序

The cornea is the most densely innervated structure in the human body, making it one of the most sensitive tissues. Changes in corneal nerve sensitivity ...

<meta charset="utf8"></head><body>准分子激光多焦点双非球面消融术用于老花眼矫正

Correction of Presbyopia by Monocular Bi-Aspheric Ablation Profile

The study aims to evaluate visual acuity and objective visual quality before and after the monocular bi-aspheric ablation profile for correction of presbyopia surgery. This prospective self-control study included 20 cases and 38 eyes of patients who underwent monocular bi-aspheric ablation profile correction of myopia with presbyopia at the Eye Hospital of Shandong University of Traditional Chinese Medicine from January 2023 to January 2024. These patients were selected for observation, and each patient's preoperative and postoperative uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), corrected distance visual acuity (CDVA), spherical aberration (SA) (within 6 mm), horizontal and vertical coma (within 6 mm), and corneal aspheric index (Q-value) (within 6 mm) were evaluated. Statistical data analysis was performed at different time points before and after the operation. There were statistically significant differences in UDVA between dominant and non-dominant eyes before and after surgery (Z = -3.784, p &lt; 0.001; Z = -3.817, p &lt; 0.001). Post-operatively, 90% of the non-dominant eyes achieved UNVA of J1 and above, and 95% of the bilateral eyes achieved UNVA of J1 and above. Significant differences were found in the SA of the dominant eyes, which showed a positive increase (Z= -3.784, p &lt; 0.001); however, compared with the dominant eye, the SA of the non-dominant eye was negatively increased, but the difference was not statistically significant (p = 0.08). There was a significant difference in the vertical coma of the dominant eye before and after the operation, but there was no significant difference in non-dominant eyes. There was no significant difference in the change of binocular horizontal coma before and after the operation. There were significant changes in the Q value of both eyes before and after the operation (Z = -3.923, p &lt; 0.001; Z = -3.51, p &lt; 0.001). After the monocular bi-aspheric ablation profile, the cornea of the non-dominant eye showed a prolate shape, negative SA increased, and the UDVA and UNVA improved after the operation.

<meta charset="utf8"></head><body>作者聚焦:老花眼屈光手术矫正的进展和探索术后视力

This article provides a step-by-step guide to correcting presbyopia with a monocular bi-aspheric ablation profile.

通过单眼双非球面消融剖面矫正老花眼

The study aims to evaluate visual acuity and objective visual quality before and after the monocular bi-aspheric ablation profile for correction of ...

压针:干眼症近视患者的中医疗法

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巩膜交联兔模型使用核黄素和紫外辐射的轴性近视防治

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