human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Purpose Postoperative ileus ( POI ) prolongs hospital stay and increases risk of postoperative complications . We conducted a r and omized , sham-controlled trial to evaluate whether acupuncture reduces POI more effectively than sham acupuncture . Methods Colon cancer patients undergoing elective colectomy were r and omized to receive 30 min of true or sham acupuncture twice daily during their first 3 postoperative days . GI-3 ( the later of the following two events : time that the patient first tolerated solid food , AND time that the patient first passed flatus OR a bowel movement ) and GI-2 ( the later of the following two events : time patient first tolerated solid food AND time patient first passed a bowel movement ) were determined . Pain , nausea , vomiting , and use of pain medications were evaluated daily for the first 3 postoperative days . Results Ninety patients were r and omized . Eighty-one received the allocated intervention : 39 in the true acupuncture group and 42 in the sham acupuncture group , all evaluated for the primary endpoint . The mean time to GI-3 was 149 h [ st and ard deviation ( SD ) 71 h ] and 146 ( SD 62 h ) after surgery for the acupuncture group and the sham acupuncture group ( difference between means −2 h ; 95 % confidence interval −31 , 26 ; p = 0.9 ) . No significant differences were found between groups for secondary endpoints . Conclusions True acupuncture as provided in this study did not reduce POI more significantly than sham acupuncture . The study was limited by a st and ard deviation much larger than expected , suggesting that a study with a larger sample size might be required OBJECTIVES Postoperative ileus ( POI ) is a common problem after abdominal surgery . Acupuncture is being accepted as an option for reducing POI and managing various functional gastrointestinal disorders . Therefore , this pilot study was conducted to evaluate the effect of acupuncture on reducing duration of POI and other surgical outcomes in patients who underwent gastric surgery . DESIGN A prospect i ve , r and omized , controlled pilot study was conducted on patients who underwent gastric cancer surgery from January 2013 to December 2013 . Ten patients were r and omly assigned into the  acupuncture ( A ) or nonacupuncture ( NA ) groups at a 1:1 ratio . INTERVENTIONS The acupuncture treatment was performed by Korean traditional medicine doctors ( KMDs ) . The style of acupuncture was Korean . In the A group , acupuncture treatment was given once daily for 5 consecutive days starting on postoperative day 1 . Each patient received acupuncture at 16 acupoints based on expert consensus provided by qualified and experienced KMDs . No acupuncture treatment was performed in the NA group . OUTCOME MEASURES The primary outcome measure was the number of remnant Sitz markers in the small intestine on abdominal radiography . Secondary outcome measures were time to first flatus , start of sips water , start of soft diet , hospital stay , and laboratory findings . RESULTS The A group had significantly fewer remnant Sitz markers in the small intestine on postoperative days 3 and 5 compared with those in the NA group ( p = 0.025 and 0.005 ) . A significant difference was observed in the numbers of remnant Sitz marker in the small intestine with respect to time difference by group ( p = 0.019 ) . The A group showed relatively better surgical outcomes , but without statistical significance . CONCLUSIONS Although further studies are warranted , acupuncture may reduce duration of POI after gastric surgery and could be a potential factor in enhanced recovery after surgery protocol Purpose Acupuncture has recently been accepted as a treatment option for managing postoperative ileus ( POI ) and various functional gastrointestinal disorders . Therefore , we conducted a prospect i ve r and omized study to evaluate the effect of acupuncture on POI and other surgical outcomes in patients who underwent gastric surgery . Material s and Methods Thirty-six patients who underwent distal gastrectomy for gastric cancer from March to December 2015 were r and omly assigned to acupuncture or non-acupuncture ( NA ) groups at 1:1 ratio . The acupuncture treatment was administered treatment once daily for 5 consecutive days starting at postoperative day 1 . The primary outcome measure was the number of remnant sitz markers in the small intestine on abdominal radiograph . The secondary outcome measure was the surgical outcome , including the times to first flatus , first defecation , start of water intake , and start of soft diet , as well as length of hospital stay and laboratory findings . Results The acupuncture group had significantly fewer remnant sitz markers in the small intestine on postoperative days 3 and 5 compared to those in the NA group . A significant difference was observed in the numbers of remnant sitz markers in the small intestine with respect to group differences by time ( P<0.0001 ) . The acupuncture group showed relatively better surgical outcomes than those in the NA group , but the differences were not statistically significant . Conclusions In this clinical trial , acupuncture promoted the passage of sitz markers , which may reflect the possibility of reducing POI after distal gastrectomy Background . Guidelines surrounding optimum needle retention duration in acupuncture have not been established , despite a growing evidence base for acupuncture over recent decades . This retrospective study explored the effect of varying acupuncture needle retention duration s in cancer patients . Method . Patients received either 2 ( n = 35 ) , 10 ( n = 53 ) , or 20 minutes ( n = 54 ) of acupuncture once a week for 6 weeks . Outcomes of anxiety and depression , stress , fatigue , and quality of life ( QOL ) , with the Hospital Anxiety and Depression Scale , Perceived Stress Scale , Functional Assessment of Cancer Therapy – Fatigue , and European Organization for Research and Treatment of Cancer Quality of Life , were measured at baseline and at 6 weeks following the intervention . Results . The mean age of participants was 58 years ( n = 152 ) . The majority were female , diagnosed with breast cancer . Depression , stress , fatigue , and QOL were significantly improved in all 3 groups at 6 weeks postintervention . No significant differences in all outcomes were found between the 3 groups ( ≤2 vs 10 minutes vs 20 minutes ) . There were no differences with the satisfaction of the acupuncture services and perceived efficacy  of acupuncture among the 3 groups . More than 95 % of participants indicated that they would recommend acupuncture to other cancer patients , friends , and their family members . Conclusion . The efficacy of acupuncture may not only depend on needle retention duration , but may also be associated with multiple factors . Considering the limitations of this study design , robust r and omized controlled studies are warranted to confirm the findings BACKGROUND Quality acupuncture influences the outcomes of clinical research , and issues associated with effective administration of acupuncture in r and omized controlled trials need to be addressed when appraising studies . OBJECTIVE The study objective was to achieve consensus on domains and items for inclusion in a rating scale to assess quality acupuncture administered in clinical research . STUDY DESIGN AND SUBJECTS An active group of Australian acupuncture research ers initially identified a pool of items assessing quality . The Delphi consensus process was then used to select and reduce the number of items , and an additional expert panel of 42 research ers were invited to participate . Participants initially ranked items along a five-point scale for the first Delphi round , and indicated an agree or disagree response during the second round . For an item to be retained into the second round , an item had to attain greater than 80 % agreement that the item described a dimension of quality acupuncture and related study design . RESULTS Thirty-two ( 32 ) experts agreed to participate in the study . After two rounds of the Delphi process , consensus was reached on 14 domains and 26 items relating to quality acupuncture . Domains , items , and minimum st and ards related to study design ; rationale of the intervention ; criteria relating to needling stimulation either manual or electrostimulation ; duration and frequency of treatment ; and practitioner training . CONCLUSIONS Items for inclusion in an instrument to assess quality  acupuncture in clinical research were identified . Further development of the instrument including relative weighting of items and reliability testing is under way PURPOSE / OBJECTIVES To evaluate the effectiveness of ST-36 ( Zusanli ) acupressure on recovery of postoperative gastrointestinal function in patients with colorectal cancer . DESIGN A longitudinal , r and omized , controlled trial design . SETTING An urban medical center in Taiwan . SAMPLE 60 patients with colorectal cancer who had undergone abdominal surgery . METHODS Patients were r and omly assigned to two groups , the ST-36 acupressure group ( n = 30 ) and a sham acupressure group ( n = 30 ) . Patients in the ST-36 group received an acupressure procedure in a three-minute cycle performed three times per day during the five days after surgery . Patients in the control group received routine postoperative care and sham acupressure . Generalized estimating equations ( GEEs ) were used to gauge longitudinal effects of the two groups of patients . MAIN RESEARCH VARIABLES Frequency of bowel sounds , the time to first flatus passage , first liquid intake , solid intake , and defecation . FINDINGS Patients who received acupressure had significantly earlier flatus passage and time to liquid intake as compared to patients in the control group . Other main variables , including the first time to solid intake and defecation , did not show significant difference between the two groups . The GEE method revealed that all patients had increasing bowel sounds over time , and the experimental group had greater improvement of bowel motility than the control group within the period of 2 - 3 days postoperatively . CONCLUSIONS ST-36 acupressure was able to shorten the time to first flatus passage , oral liquid intake , and improve gastrointestinal function in patients after abdominal surgery . IMPLICATION S FOR NURSING ST-36 acupressure can be integrated into postoperative adjunct nursing care to assist patients ' postoperative gastrointestinal function . KNOWLEDGE TRANSLATION Few studies have explored the effectiveness of acupressure techniques on promoting bowel sounds . Evidence from this study suggests stimulation of the ST-36 acupressure point can increase bowel sound frequency for patients with colorectal cancer in the first three days after surgery . Application of this technique may improve a patient 's comfort after surgery Postoperative ileus ( POI ) is a common complication after most abdominal surgeries including cesarean section . It is associated with longer hospitalization and increased medical costs . This study is a r and omized controlled trial investigating the effect of acupressure , and low-cost noninvasive traditional treatment , on POI symptoms after cesarean section . A total of 120 patients were r and omly divided into two groups ; the treatment group received two sessions of acupressure ( an hour after attending the women 's division ; and 3 hours after the first session ) , each lasting 20 minutes . The time of flatus and defecation , time to presence of bowel sounds , and duration of postoperative bed rest were monitored . Patients in the treatment group had a shorter time to presence of bowel sounds compared with those in the control group ( p<0.001 ) , as well as shorter time to first passage of flatus ( p<0.001 ) and shorter postoperative bed rest ( p=0.005 ) . However , the time to first defecation was not statistically significant ( p=0.311 ) . Acupressure has potential positive impacts on attenuating POI symptoms after cesarean section , and can be used as a low-cost noninvasive nursing care to reduce POI incidence and intensity after cesarean section OBJECTIVE To verify the clinical therapeutic effect of warming needle moxibustion on improvement of the gastrointestinal and immune function in patients with postoperation of colorectal cancer . METHODS One hundred and five patients with postoperation of colorectal cancer were r and omly divided into an acupuncture and moxibustion group , a Chinese medicine group and a routine treatment group , 35 cases in each group . They were all treated with gastrointestinal decompression and fluid replacement after operation . The acupuncture and moxibustion group was also treated with warming needle moxibustion on the 1st day after operation , and Zusanli ( ST 36 ) , Shangjuxu ( ST 37 ) and Xiajuxu ( ST 39 ) etc . were selected , once a day for 10 days , and the Chinese medicine group with Simo Decoction oral solution , three times daily for 10 days . The gastrointestinal function , peripheral blood components and changes of T lymphocyte and NK cells in postoperative patients were observed . RESULTS The time of the first bowel sound , exhaust and defecation in the acupuncture and moxibustion group were all shorter than those in the Chinese medicine group and the routine treatment group ( P<0.05 , P<0.01 ) . On the 10th day after operation , the percentages distribution of lymphocyte and neutrophil in the acupuncture and moxibustion group were better than those in the Chinese medicine group and the routine treatment group ( all P<0.05 ) . The acupuncture and moxibustion group was also superior to the Chinese medicine group and the routine treatment group in improving the subgroup of T lymphocyte , NK cells and the digestive system symptoms ( all P<0.05 ) . CONCLUSION Warming needle moxibustion has a good therapeutic effect on gastrointestinal function and can regulate bidirectionally peripheral blood lymphocyte and neutrophile granulocyte and improve the T lymphocyte subgroup and NK cells so as to promote the recovery of immune function in patients with colorectal cancer after operation AIM To examine whether acupuncture 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Purpose Postoperative ileus ( POI ) prolongs hospital stay and increases risk of postoperative complications . We conducted a r and omized , sham-controlled trial to evaluate whether acupuncture reduces POI more effectively than sham acupuncture . Methods Colon cancer patients undergoing elective colectomy were r and omized to receive 30 min of true or sham acupuncture twice daily during their first 3 postoperative days . GI-3 ( the later of the following two events : time that the patient first tolerated solid food , AND time that the patient first passed flatus OR a bowel movement ) and GI-2 ( the later of the following two events : time patient first tolerated solid food AND time patient first passed a bowel movement ) were determined . Pain , nausea , vomiting , and use of pain medications were evaluated daily for the first 3 postoperative days . Results Ninety patients were r and omized . Eighty-one received the allocated intervention : 39 in the true acupuncture group and 42 in the sham acupuncture group , all evaluated for the primary endpoint . The mean time to GI-3 was 149 h [ st and ard deviation ( SD ) 71 h ] and 146 ( SD 62 h ) after surgery for the acupuncture group and the sham acupuncture group ( difference between means −2 h ; 95 % confidence interval −31 , 26 ; p = 0.9 ) . No significant differences were found between groups for secondary endpoints . Conclusions True acupuncture as provided in this study did not reduce POI more significantly than sham acupuncture . The study was limited by a st and ard deviation much larger than expected , suggesting that a study with a larger sample size might be required OBJECTIVES Postoperative ileus ( POI ) is a common problem after abdominal surgery . Acupuncture is being accepted as an option for reducing POI and managing various functional gastrointestinal disorders . Therefore , this pilot study was conducted to evaluate the effect of acupuncture on reducing duration of POI and other surgical outcomes in patients who underwent gastric surgery . DESIGN A prospect i ve , r and omized , controlled pilot study was conducted on patients who underwent gastric cancer surgery from January 2013 to December 2013 . Ten patients were r and omly assigned into the  acupuncture ( A ) or nonacupuncture ( NA ) groups at a 1:1 ratio . INTERVENTIONS The acupuncture treatment was performed by Korean traditional medicine doctors ( KMDs ) . The style of acupuncture was Korean . In the A group , acupuncture treatment was given once daily for 5 consecutive days starting on postoperative day 1 . Each patient received acupuncture at 16 acupoints based on expert consensus provided by qualified and experienced KMDs . No acupuncture treatment was performed in the NA group . OUTCOME MEASURES The primary outcome measure was the number of remnant Sitz markers in the small intestine on abdominal radiography . Secondary outcome measures were time to first flatus , start of sips water , start of soft diet , hospital stay , and laboratory findings . RESULTS The A group had significantly fewer remnant Sitz markers in the small intestine on postoperative days 3 and 5 compared with those in the NA group ( p = 0.025 and 0.005 ) . A significant difference was observed in the numbers of remnant Sitz marker in the small intestine with respect to time difference by group ( p = 0.019 ) . The A group showed relatively better surgical outcomes , but without statistical significance . CONCLUSIONS Although further studies are warranted , acupuncture may reduce duration of POI after gastric surgery and could be a potential factor in enhanced recovery after surgery protocol Purpose Acupuncture has recently been accepted as a treatment option for managing postoperative ileus ( POI ) and various functional gastrointestinal disorders . Therefore , we conducted a prospect i ve r and omized study to evaluate the effect of acupuncture on POI and other surgical outcomes in patients who underwent gastric surgery . Material s and Methods Thirty-six patients who underwent distal gastrectomy for gastric cancer from March to December 2015 were r and omly assigned to acupuncture or non-acupuncture ( NA ) groups at 1:1 ratio . The acupuncture treatment was administered treatment once daily for 5 consecutive days starting at postoperative day 1 . The primary outcome measure was the number of remnant sitz markers in the small intestine on abdominal radiograph . The secondary outcome measure was the surgical outcome , including the times to first flatus , first defecation , start of water intake , and start of soft diet , as well as length of hospital stay and laboratory findings . Results The acupuncture group had significantly fewer remnant sitz markers in the small intestine on postoperative days 3 and 5 compared to those in the NA group . A significant difference was observed in the numbers of remnant sitz markers in the small intestine with respect to group differences by time ( P<0.0001 ) . The acupuncture group showed relatively better surgical outcomes than those in the NA group , but the differences were not statistically significant . Conclusions In this clinical trial , acupuncture promoted the passage of sitz markers , which may reflect the possibility of reducing POI after distal gastrectomy Background . Guidelines surrounding optimum needle retention duration in acupuncture have not been established , despite a growing evidence base for acupuncture over recent decades . This retrospective study explored the effect of varying acupuncture needle retention duration s in cancer patients . Method . Patients received either 2 ( n = 35 ) , 10 ( n = 53 ) , or 20 minutes ( n = 54 ) of acupuncture once a week for 6 weeks . Outcomes of anxiety and depression , stress , fatigue , and quality of life ( QOL ) , with the Hospital Anxiety and Depression Scale , Perceived Stress Scale , Functional Assessment of Cancer Therapy – Fatigue , and European Organization for Research and Treatment of Cancer Quality of Life , were measured at baseline and at 6 weeks following the intervention . Results . The mean age of participants was 58 years ( n = 152 ) . The majority were female , diagnosed with breast cancer . Depression , stress , fatigue , and QOL were significantly improved in all 3 groups at 6 weeks postintervention . No significant differences in all outcomes were found between the 3 groups ( ≤2 vs 10 minutes vs 20 minutes ) . There were no differences with the satisfaction of the acupuncture services and perceived efficacy  of acupuncture among the 3 groups . More than 95 % of participants indicated that they would recommend acupuncture to other cancer patients , friends , and their family members . Conclusion . The efficacy of acupuncture may not only depend on needle retention duration , but may also be associated with multiple factors . Considering the limitations of this study design , robust r and omized controlled studies are warranted to confirm the findings BACKGROUND Quality acupuncture influences the outcomes of clinical research , and issues associated with effective administration of acupuncture in r and omized controlled trials need to be addressed when appraising studies . OBJECTIVE The study objective was to achieve consensus on domains and items for inclusion in a rating scale to assess quality acupuncture administered in clinical research . STUDY DESIGN AND SUBJECTS An active group of Australian acupuncture research ers initially identified a pool of items assessing quality . The Delphi consensus process was then used to select and reduce the number of items , and an additional expert panel of 42 research ers were invited to participate . Participants initially ranked items along a five-point scale for the first Delphi round , and indicated an agree or disagree response during the second round . For an item to be retained into the second round , an item had to attain greater than 80 % agreement that the item described a dimension of quality acupuncture and related study design . RESULTS Thirty-two ( 32 ) experts agreed to participate in the study . After two rounds of the Delphi process , consensus was reached on 14 domains and 26 items relating to quality acupuncture . Domains , items , and minimum st and ards related to study design ; rationale of the intervention ; criteria relating to needling stimulation either manual or electrostimulation ; duration and frequency of treatment ; and practitioner training . CONCLUSIONS Items for inclusion in an instrument to assess quality  acupuncture in clinical research were identified . Further development of the instrument including relative weighting of items and reliability testing is under way PURPOSE / OBJECTIVES To evaluate the effectiveness of ST-36 ( Zusanli ) acupressure on recovery of postoperative gastrointestinal function in patients with colorectal cancer . DESIGN A longitudinal , r and omized , controlled trial design . SETTING An urban medical center in Taiwan . SAMPLE 60 patients with colorectal cancer who had undergone abdominal surgery . METHODS Patients were r and omly assigned to two groups , the ST-36 acupressure group ( n = 30 ) and a sham acupressure group ( n = 30 ) . Patients in the ST-36 group received an acupressure procedure in a three-minute cycle performed three times per day during the five days after surgery . Patients in the control group received routine postoperative care and sham acupressure . Generalized estimating equations ( GEEs ) were used to gauge longitudinal effects of the two groups of patients . MAIN RESEARCH VARIABLES Frequency of bowel sounds , the time to first flatus passage , first liquid intake , solid intake , and defecation . FINDINGS Patients who received acupressure had significantly earlier flatus passage and time to liquid intake as compared to patients in the control group . Other main variables , including the first time to solid intake and defecation , did not show significant difference between the two groups . The GEE method revealed that all patients had increasing bowel sounds over time , and the experimental group had greater improvement of bowel motility than the control group within the period of 2 - 3 days postoperatively . CONCLUSIONS ST-36 acupressure was able to shorten the time to first flatus passage , oral liquid intake , and improve gastrointestinal function in patients after abdominal surgery . IMPLICATION S FOR NURSING ST-36 acupressure can be integrated into postoperative adjunct nursing care to assist patients ' postoperative gastrointestinal function . KNOWLEDGE TRANSLATION Few studies have explored the effectiveness of acupressure techniques on promoting bowel sounds . Evidence from this study suggests stimulation of the ST-36 acupressure point can increase bowel sound frequency for patients with colorectal cancer in the first three days after surgery . Application of this technique may improve a patient 's comfort after surgery Postoperative ileus ( POI ) is a common complication after most abdominal surgeries including cesarean section . It is associated with longer hospitalization and increased medical costs . This study is a r and omized controlled trial investigating the effect of acupressure , and low-cost noninvasive traditional treatment , on POI symptoms after cesarean section . A total of 120 patients were r and omly divided into two groups ; the treatment group received two sessions of acupressure ( an hour after attending the women 's division ; and 3 hours after the first session ) , each lasting 20 minutes . The time of flatus and defecation , time to presence of bowel sounds , and duration of postoperative bed rest were monitored . Patients in the treatment group had a shorter time to presence of bowel sounds compared with those in the control group ( p<0.001 ) , as well as shorter time to first passage of flatus ( p<0.001 ) and shorter postoperative bed rest ( p=0.005 ) . However , the time to first defecation was not statistically significant ( p=0.311 ) . Acupressure has potential positive impacts on attenuating POI symptoms after cesarean section , and can be used as a low-cost noninvasive nursing care to reduce POI incidence and intensity after cesarean section OBJECTIVE To verify the clinical therapeutic effect of warming needle moxibustion on improvement of the gastrointestinal and immune function in patients with postoperation of colorectal cancer . METHODS One hundred and five patients with postoperation of colorectal cancer were r and omly divided into an acupuncture and moxibustion group , a Chinese medicine group and a routine treatment group , 35 cases in each group . They were all treated with gastrointestinal decompression and fluid replacement after operation . The acupuncture and moxibustion group was also treated with warming needle moxibustion on the 1st day after operation , and Zusanli ( ST 36 ) , Shangjuxu ( ST 37 ) and Xiajuxu ( ST 39 ) etc . were selected , once a day for 10 days , and the Chinese medicine group with Simo Decoction oral solution , three times daily for 10 days . The gastrointestinal function , peripheral blood components and changes of T lymphocyte and NK cells in postoperative patients were observed . RESULTS The time of the first bowel sound , exhaust and defecation in the acupuncture and moxibustion group were all shorter than those in the Chinese medicine group and the routine treatment group ( P<0.05 , P<0.01 ) . On the 10th day after operation , the percentages distribution of lymphocyte and neutrophil in the acupuncture and moxibustion group were better than those in the Chinese medicine group and the routine treatment group ( all P<0.05 ) . The acupuncture and moxibustion group was also superior to the Chinese medicine group and the routine treatment group in improving the subgroup of T lymphocyte , NK cells and the digestive system symptoms ( all P<0.05 ) . CONCLUSION Warming needle moxibustion has a good therapeutic effect on gastrointestinal function and can regulate bidirectionally peripheral blood lymphocyte and neutrophile granulocyte and improve the T lymphocyte subgroup and NK cells so as to promote the recovery of immune function in patients with colorectal cancer after operation AIM To examine whether acupuncture 
    Output:
    