Objective: To evaluate the efficacy and safety of acupuncture for the treatment of knee osteoarthritis and to provide evidence for its use in clinical practice. Methods: Eight databases were extensively searched up to March 2018. Randomized controlled trials (RCTs) comparing the efficacy of acupuncture with sham acupuncture or no acupuncture for knee osteoarthritis were included. Study selection, data extraction and quality assessment were independently conducted by two reviewers. The Cochrane Collaboration's tool was used for assessing the risk of bias. Results: A total of 18 RCTs were included, involving a total of 3522 participants. The results showed that acupuncture was superior to sham acupuncture in relieving pain (SMD=-0.34, 95％CI:-0.57 to -0.11, I2=85％, P=0.003) and improving physical function (SMD=-0.34, 95％CI: -0.57 to -0.11, I2=85％, P=0.003). In comparison to the no-acupuncture group, the acupuncture group also showed significant advantages in relieving pain (SMD=-0.79, 95％CI: -1.15 to -0.43, I2=87％, P<0.0001) and improving physical function (SMD=-0.75, 95％CI:-1.19 to -0.31, I2=91％, P=0.0008). Sensitivity analyses suggested that the results were robust, and Egger's test found no potential publication bias. Conclusion: In the treatment of knee osteoarthritis, the acupuncture group had significant advantages over sham acupuncture or no-acupuncture groups in relieving pain and improving physical function.

Hemorrhagic transformation(HT) is the most severe complication after tissue-type plasminogen activator (tPA) thrombolysis. It greatly limits the clinical application of tPA. Early blood-brain barrier ( BBB) damage may be an important mechanism for HT. Maintaining the integrity of BBB can significantly decrease the risk of HT. This article review s the roles, mechanisms, and preventive measure of early BBB damage in HT after tPA thrombolysis.

Blood-brain barrier (BBB) injury is an important pathological change of ischemic stroke.Occludin constitutes the major component of the tight junction of BBB, which plays a significant role in maintaining the BBB integrity.Cerebral ischemia initiates occludin degradation through the induction of the activation of inflammatory mediators, reactive oxygen, and matrix metalloproteinases, and causes the changes of tight junction cytoskeletal protein interaction, resulting in BBB integrity destruction and increased permeability.This article mainly elaborates the relationships of occludin with BBB, brain edema and hemorrhagic transformation, as well as the possibility of occludin as an intervention target for ischemic stroke.

BACKGROUND: Microarc oxidation (MAO) is a break-through anodyzing technology for forming oxide films on valve metal.Use of this technology allows thick, porous oxide layers to be formed on the surface of pure titanium. Few biocompatibility reports using this treatment have been found.OBJECTIVE: The blood compatibility of a novel surface modified titanium substrata biomaterial using MAO was investigated.DESIGN: Positive and negative control, contrast observation and gold standard control.SETTING: Wuhan Union Hospital.MATERIALS: A healthy male adult New-Zealand rabbit, weighing 2.5 kg and ordinary grade, was selected in this study.Pure titanium sticks TA1 (Baoji Yingnaite Non-ferrous Metal Co., Ltd.), MAO-Ti and 20 g/L potassium oxalate were also selected in this study.METHODS: The study was carried out in the Laboratory of General Surgery, Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology in May 2006. ① Materials: Titanium substrate of 10 mm in diameter and 2 mm in depth was put in an electrolyte which was quipped with deionized water, dibasic sodium phosphate, and ethanoic acid calcium for MAO treatment for 10 minutes. ② Groups: Three groups were analysed: test group, negative control group and positive control group. Test group: MAO-Ti was dipped in 10 mL saline; Positive control group: 10 mL deionized water was added in each tube; Negative control group: 10 mL saline was added in each tube. ③ Operation: Fresh whole blood was collected from rabbit and then mixed with the liquids in the three groups respectively after anti-coagulation. In addition, UV-Visible Spectrophotometer was used to evaluate the hemolytic ratio. A hemolytic ratio below or equal to 5% indicated that this novel material fitted the requirements. On the contrary, a hemolytic ratio higher than 5% proofed the existence of a hemolyzation.MAIN OUTCOME MEASURES: The hemolytic ratio of materials in three groups.RESULTS: The hemolytic ratio of the test group was 0.90%. The result indicated that this new material had no haemolysis effect.CONCLUSION: The material does not resolve red blood cells and is coincident with the international and governmental standard.

Object To study comparatively the chromatographic fingerprint of Forsythia suspensa (Thunb ) Vahl in different producing aeras Methods Pyrolysis gas chromatography (PGC) was used Results The similar fingerprint of 13 samples (PGC) appeared The chromatographic overlap of them was over 89%, RSD

Objective To comparatively study the difference between thromboelastography (TEG)and light transmission ag-gregometry (LTA)in monitoring clopidogrel effect in patients with acute coronary syndrome.Methods 68 patients with a-cute coronary syndrome,who were in hospital from February to December 2013,were enrolled in this study.They received TEG and LTA to determine platelet aggregation.Results Clopidogrel effect was (47.84±26.04)% and (45.64±20.92)%respectively by TEG and LTA.There were negative correlation between LTAADP and TEGADP(r=-0.752,P<0.001),pos-itive correlation between LTAADP and MAADP(r=0.789,P<0.001),negative correlation between TEGADP and MAADP(r=-0.820,P<0.001).Conclusion There was a good correlation between the two methods.TEG can be used to evaluate thera-peutic effect of Clopidogrel effect.

OBJECTIVETo observe the dose-effect relationship of electroacupuncture of different current intensities combined with Morphine of different dosage on alleviating the rats' tibial cancer pain, and explore the possible mechanism, which could provide the experiment basis for alleviating the tibial cancer pain by electroacupuncture combined with Morphine.

METHODSOne hundred female Wistar rats were randomly divided into a normal group, a model group and eight treatment groups, 10 cases in each group. The rats in the treatment groups were treated by combined therapies of electroacupuncture of different intensities with 2 Hz /100 Hz dense-disperse wave on "Jiaji"(EX-B 2)and different dosage Morphine in 2 factor 3 level conditions, once a day for 6 days. The pain thresholds were observed before the treatment and 0 min, 1 h, 2 h and 5 h after the first treatment as well as after 3 and 6 times of treatments. The glial fibrillary acidic protein (GFAP) expression was determined by immunohistochemical method.

RESULTSThe rats' pain thresholds were significantly increased with electroacupuncture of 2 mA and 1 mA (all P < 0.01) on the 0 min, 1 h and 2 h of the first treatment, between which there were no significant differences (all P > 0.05). The pain threshold was still increased by electroacupuncture of 2 mA on the 5 h of the treatment (P < 0.01), while that of 1 mA failed to take effect (P > 0.05). After 3 and 6 times of treatments, both electroacupuncture of 2 mA and 1 mA had the effect of increasing the pain threshold (all P < 0.01), and the effect of 2 mA was superior to that of 1 mA (P < 0.05), had the synergistic effect with 5 mg/(kg x d) Morphine (P < 0.05). After 6 times of treatments, both electroacupuncture of 2 mA and 1 mA could inhibit the expression of GFAP (both P < 0.01), and there was no significant difference between them (P > 0.05). Both of 5 mg/(kg x d) and 2.5 mg/(kg x d) of Morphine, however, didn't bring about inhibition effect (P > 0.05).

CONCLUSIONThere is a does-effect relationship on electroacupuncture of different current intensity for alleviating the tibial cancer pain in rats. The electroacupuncture with 2 mA, which is better than that with 1 mA, has the synergistic effect with 5 mg/(kg x d) of Morphine. The electroacupuncture can inhibit the expression of GFAP to cooperate with Morphine for the purpose of alleviating the rats' tibial cancer pain.

Animals ; Bone Neoplasms ; complications ; genetics ; metabolism ; Electroacupuncture ; instrumentation ; methods ; Female ; Gene Expression Regulation, Neoplastic ; Glial Fibrillary Acidic Protein ; genetics ; metabolism ; Humans ; Pain ; etiology ; genetics ; metabolism ; Pain Management ; instrumentation ; methods ; Rats ; Rats, Wistar ; Spine ; metabolism ; Tibia ; metabolism

OBJECTIVETo compare the difference in the clinical efficacy on posterior circulation ischemia between acupuncture at stellate ganglion and conventional acupuncture as well as the impacts on blood pressure.

METHODSEighty cases of posterior circulation ischemia were randomized into an observation group (40 cases) and a control group (40 cases). In the observation group, acupuncture was applied to the bilateral stellate ganglions on the neck, stimulated with reinforcing technique by rotating the needles. In the control group, the acupuncture of reducing technique was applied to Fengchi (GB 20), Baihui (GV 20), Neiguan (PC 6) and Taichong (LR 3) in the excess syndrome. The even needling or reinforcing technique was applied to Fengchi (GB 20), Baihui (GV 20), Ganshu (BL 18), Shenshu (BL 23) and Zusanli (ST 36) for the deficiency syndrome. The treatment was given once every 3 days and 4 treatments were required totally in the two groups. The changes in total syndrome score, peak Systolic blood flow velocity (Vp) of vertebral artery and basilar artery, systolic and diastolic blood pressures were compared before and after treatment in the two groups. The clinical efficacy was compared between the two groups.

RESULTSThe total syndrome score was reduced apparently after treatment compared with that before treatment in the two groups (P < 0.01), and the reducing was more obvious in the observation group as compared with that in the control group (P < 0.01). The total effective rate was 87.5% (35/40) in the observation group, higher than 67.5% (27/40, P < 0.05) in the control group. After treatment, the reduced Vp of vertebral artery was not improved apparently as compared with that before treatment in the control group, Vp in blood velocity abnormality (including vascular spasm, stenosis or reduced velocity) of vertebral artery and basilar artery was all improved as compared with that before treatment in the two groups (P < 0.01), and the improvements in the observation group were more obvious than those in the control group (P < 0.01). After treatment, the systolic and diastolic pressures were reduced as compared with those before treatment in the two groups, and the reduced systolic and diastolic pressures in the observation group were more apparent than those in the control group (P < 0.01).

CONCLUSIONAcupuncture at stellate ganglion achieves the satisfactory efficacy in the treatment of posterior circulation ischemia and the significant efficacy of reducing blood pressure, more advanced than the conventional acupuncture.

Acupuncture Points ; Acupuncture Therapy ; Aged ; Blood Pressure ; Brain Infarction ; physiopathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Stellate Ganglion ; physiopathology ; Treatment Outcome

Objective To compare anti-inflammatory and hepatoprotective effects of Bupleurum marginatum Wall. ex DC. and Bupleurum chinense DC. Methods The anti-inflammatory effect of two kinds of radix bupleuri decoction were compared using the xylene-induced ear edema mice model and the egg white-induced foot swelling rats model. Acute liver injury in mice was induced through intraperitoneal injection of peanut oil with 0. 1%carbon tetrachloride. Alanine aminotransferase ( ALT ) , aspartate aminotransferase ( AST ) , and alkaline phosphatase ( ALP ) in serum, superoxide dismutase ( SOD ) , malondialdehyde ( MDA ) , and glutathione ( GSH ) in liver tissue homogenate were detected. Histopathological changes, transforming growth factor-β ( TGF-β) and nuclear factor-κB ( NF-κB) in hepatic tissues were also observed. Results Ear swelling experiment showed that the decoction of both Bupleurum marginatum Wall. ex DC. and Bupleurum chinense DC. had equal anti-inflammatory effects (P>0. 05). Similarly,the decoction of Bupleurum marginatum Wall. ex DC. and Bupleurum chinense DC. improved levels of ALT,AST,SOD,GSH,and MDA to the same extent compared with the model control group ( P<0. 05 or P<0. 01 ). There was no significant difference among all groups in ALP levels ( P > 0. 05 ). Histopathological and immunohistochemical experiments showed that expressions of TGF-β and NF- κB were similar between the two kinds of radix bupleuri. Conclusion Bupleurum marginatum Wall. ex DC. and Bupleurum chinense DC. have similar anti-inflammatory and hepatoprotective effects.

Objective:To analyze the structure modes of general practice teams in community health care cen-ters in order to provide empirical evidence for the transformation of the community health service mode. Method:Pur-posive sampling was adopted. Twelve community health service centers in Beijing, Shanghai, Zhengzhou and Cheng-du, where the transformation of the community health service mode was piloted earlier and representative, were se-lected as the field survey sites. The qualitative method was used to collect the data accompanied by the quantitative method. Results:The structure models of general practice teams could be divided into four types:1) general practi-tioner+nurse+nurse assistant+pharmacist, 2) physician (general practitioner, herbalist physician) +nurse+com-munity volunteers, 3 ) physician ( general practitioner/herbalist physician ) +nurse +assistant +community volun-teers, and 4) general practitioner+nurse+assisting team (professionals of public health and maternal care, etc) +supportive team ( pharmacists, health technician, etc) . Conclusion:The paper verified the common sense conclusion that general practitioners should play an essential role in general practice teamwork. The four general practice team models analyzed above positively contributed to the improvement of efficiency and quality, the relationship between health professionals and patients, the promotion of community participation, and the combination between preventive care and clinical care.