Rejected

Ancient acupuncture and moxibustion prescriptions are one of the sources for evidence-based acupuncture research, representing the techniques features in treatment. This paper examines and analyses the literature of ancient acupuncture and moxibustion prescriptions for headache. It was found that repeated adaption and private changes of ancient acupuncture prescriptions was common. It was also found that the literature which reported the adaption of the indications of acupoints and the annotation of acupuncture and moxibustion in the form of poetry was often confused with the clinical acupuncture prescriptions. It is essential to trace the literature sources of ancient acupuncture prescriptions and to confirm the earliest documents extant for their authenticity and inheritance. In this sense, they are the two steps for review of the literature of ancient acupuncture prescriptions.

To understand the current status of appraisal of post-concussion syndrome disability and the reasons for the changes in re-appraisal opinions.

To determine why some implants can appear to be well osseointegrated with no signs of infection and yet can remain sensitive to percussion and painful and unable to tolerate the weight of a restoration.

<b>Introduction:</b> Median arcuate ligament syndrome (MALS) is a rare cause of chronic epigastric pain. The presentation might be unclear and non-specific. Diagnosing the syndrome requires interdisciplinary methods and specialists. Treatments consist of celiac axis release performed laparoscopically or robotically, and intraluminal stenting. </br></br> <b>Aim:</b> The aim of the study was to report the medium-term postoperative follow-up results for four patients with MALS. </br></br> <b>Materials and methods:</b> We performed 5 laparoscopic celiac axis releases in patients with MALS in our department in 2018. The study included 4 patients who were admitted 16-23 months after surgery for computed tomography angiography.</br></br> <b> Results:</b> Patients constituted 4 women aged 28-63 with a mean body mass index of 22.4 kg/m2. The diagnosis of MALS was confirmed by computed tomography angiography, which showed severe (>70%) narrowing of the celiac axis. Patients underwent laparoscopic celiac axis release, and were all discharged on the first postoperative day with no postoperative complications. The patients' quality of life improved and their symptoms subsided completely. Follow-up computed tomography angiography confirmed full decompression of the celiac axis in all 4 patients, with no stenosis caused by scarification of the celiac axis.</br></br> <b> Conclusion:</b> Laparoscopy is a valuable and safe method to treat patients with MALS.

Studies comparing the utility of dexmedetomidine with other drugs for sedation during medical thoracoscopy are lacking. In this pilot study, we compared dexmedetomidine with midazolam for sedation in thoracoscopy.

Heat shock protein 90 (Hsp90) is a ubiquitously expressed integral cellular protein essential for regulating proteomic stress. Previous research has shown that Hsp90 regulates critical signaling pathways underlying chronic pain and inflammation. Recent discovery of membrane bound ectopic Hsp90 (eHsp90) on tumor cells has shown that Hsp90 induction to the plasma membrane can stabilize disease-relevant proteins. Here, we characterize eHsp90 expression in a mouse model of inflammation and demonstrate its role in nociception and pain. We found that intraplantar complete Freund adjuvant (CFA) induced robust expression of eHsp90 on the cell membranes of primary afferent nociceptors located in the L3-L5 dorsal root ganglia (DRG), bilaterally, with minimal to no expression in other tissues. Complete Freund adjuvant-induced increases in eHsp90 expression on lumbar DRG were significantly greater in females compared with males. Furthermore, exogenous Hsp90 applied to primary Pirt-GCaMP3 nociceptors induced increases in calcium responses. Responses were estrogen-dependent such that greater activity was observed in female or estrogen-primed male nociceptors compared with unprimed male nociceptors. Treatment of mice with the selective eHsp90 inhibitor HS-131 (10 nmol) significantly reversed CFA-induced mechanical pain, thermal heat pain, and hind paw edema. Notably, a higher dose (20 nmol) of HS-131 was required to achieve analgesic and anti-inflammatory effects in females. Here, we provide the first demonstration that inflammation leads to an upregulation of eHsp90 on DRG nociceptors in a sex-dependent manner and that inhibition of eHsp90 reduces nociceptor activity, pain, and inflammation. Thus, eHsp90 represents a novel therapeutic axis for the development of gender-tailored treatments for inflammatory pain.

: Economic evaluation of early surgery compared to the endoscopy-first approach in chronic pancreatitis.

This study was designed as a prospective and interventional study that evaluated LigaSure™ haemorrhoidectomies with regional anaesthesia as a daycare procedure.

Teratoma is a common type of mediastinal tumor, often located in the anterior mediastinum. Mediastinal teratomas often occur in young and middle-aged people, and account for 5-21.5% of mediastinal tumors. Mature cystic teratoma is a common type of mediastinal teratoma, its onset is slow, and most patients are asymptomatic. In a few patients, the tissue around the mediastinum is invaded or there is malignant transformation, which results in chest pain, chest tightness, a cough, and other symptoms. In this case, the patient had a giant teratoma, compressing large blood vessels and nerves, complicated by pleural and pericardial effusion. The 21-year-old female patient was misdiagnosed with tuberculous disease because of chronic cough and expectoration. Her initial symptoms improved after anti-tuberculosis treatment; however, an imaging examination showed that the lesion had enlarged some 9 months later. Surgery was performed at our hospital, as the tumor was squeezing blood vessels, and the trachea was seriously adhering to the surrounding tissue. To avoid damage to the peripheral blood vessels and nerves, many residual tissues were retained after the operation. The post-operative pathology results confirmed that the patient had a mature mediastinal cystic teratoma. One year after the operation, there was no recurrence, the peripheral blood vessels had basically returned, and the patient did not have any nerve injury. Effusion caused by mediastinal teratoma should be carefully differentiated from tuberculous diseases to avoid unnecessary damage to patients during treatment. Separation can be difficult in benign mediastinal tumors with severe adhesion. To avoid the trauma caused by the excessive separation of a tumor, it is our view that part of the residual tissue should be retained and left to be absorbed naturally.

Renal cell carcinoma (RCC) is the most common renal tumor with a high incidence in the recent decade. Generally, an RCC metastasis mainly occurs via hematogenous and lymphomatous routes. Even though RCC has a potential to metastasize to almost any site, metastasis to the pancreas and duodenal ampulla is a rare event. In this study, we describe a case of pancreatic and periampullary metastatic renal cell carcinoma, which recurred 17 years after surgery. The patient admitted to hospital for severe symptoms of jaundice and skin pruritus after removal of the primary tumor for 17 years. Computer tomography angiography (CTA) scan and endoscopy showed pancreatic and duodenal ampullary metastasis. Finally, it confirmed by histopathologic examination. After some symptomatic treatment has been given the patient remained alive. However, intermittent hematochezia along with these metastatic lesions continue to occur until now as observed during the annual follow-up appointments. This study concludes that metastatic involvement of the pancreas and other organs should be suspected in any patient with a history of an RCC who does not manifest any typical symptom even after more than 10 years of RCC resection. In the case of abnormal symptoms and examination results after several years of RCC surgery, attention should be paid to provide immediate treatment.