Recently a number of acupuncture clinical trial projects mainly conducted by conventional scientists have generated many negative results. A large meta-analysis of patient-level acupuncture data for the treatment of chronic pain conditions have demonstrated that the effects of verum acupuncture on pain improvement have statistically significant, but small, differences compared with sham-acupuncture procedures and no difference between acupuncture points and non-points. These conclusions have puzzled the acupuncture community and made confusion for acupuncture research and practices. The purpose of this paper was to compare differences between acupuncture clinical practices and the trial studies, which include "acupuncture technical principles", "acupuncture clinical trial design", and "acupuncture practice based on the theory of traditional Chinese medicine". These factors contribute to the puzzle between the acupuncture community/practice and acupuncture clinical trials, which can be improved in future studies.
Acupuncture Points ; Acupuncture Therapy ; Chronic Disease ; Clinical Trials as Topic ; Humans ; Meta-Analysis as Topic ; Pain Management ; methods ; Research Design

[Objective] To discuss the operation and clinical results about surgical treatment of scoliosis of thoracic hemivertebra and diastematomyelia of adolescent.[Methods]From Jan 2001 to June 2007,15 patients were treated with one-stage posterior hemivertebrae and osseous divide resection combined with transpedicular instrumentation and bone graft.There were 6 males and 9 females with an average age of 21.2 years(range 16 to 24 years).All cases were segmented hemivertebrae.Hemivertebrae were located at T11(n=3)and T12(n=12).The status of the spinal fusion,correction rate and instrumentation were evaluated after surgery.[Results]All cases were followed up for 19 to 45 months with an average of 34 months.Cobb's angles of the main curve were 52.3??3.8?before surgery,10.2??1.4? after surgery.At the final follow-up there was 1.6? loss of correction.The mean height was increased by 3.76 cm.The district of bone graft showed good bone fusion.The time of vertebra fusion was 3 to 5 months(mean 3.6 months).No instrumentation,spinal fusion failure or other severe complications were noted.[Conclusion]One-stage posterior hemivertebrae and osseous divide resection combined with transpedicular instrumentation and bone graft can achieve a satisfactory result for the treatment of scoliosis of thoracic hemivertebra and diastematomyelia of adolescent.It can be recommended in clinical practice because of a good stability of fixation and fine spinal fusion.

Objective To investigate the clinical effect of Paclitaxel and Cisplatin(TP) combined with radiotherapy and clinical security in advanced local cervical cancer. Methods After informed consent,80 patients with cervical canco were studied prospectively,and divided into TP combined with radiotherapy group(40 cases,observation group) ,and surgery group(40 cases,control group). The clinical effect and adverse reactions were analyzed. Results Total effective rate in study group was 80. 0% ,50. 0% in control group,the difference showed statistical significance(x2 =3.47,P ＜0.05).The transfer rate of pelvis lymph node was 5. 0% in observation group,22. 5% in control group, the difference showed statistical significance( x2 = 4. 78 ,P ＜ 0. 05). The difference of adverse reactions between two groups showed no statistical significance( P ＞ 0. 05). Conclusion Clinical effect of Paclitaxel and Cisplatin combined with radiotherapy was obvious in advanced local cervical cancer patients,with little side effect,and could be applied to clinical practice.

BACKGROUND:The structure surrounding upper thoracic spine is complicated. Transverse diameter of pedicle was relatively smal . There were important organs in front of the vertebral body. Screws deviated from axis or screws were too long. The safety and effectiveness of screw implantation were not implemented. It is necessary to understand the key structure of surroundings. OBJECTIVE:To analyze the relationship of anatomic position between the axis of screw of pedicle of upper thoracic spine and key adjacent structure of the vertebral body. METHODS:A total of 30 healthy adult volunteers received T 1-T 4 pedicle axis paral el to CT scans. The positions of esophagus, trachea position, aortic arch, carotid and vertebral arteries were observed when the pedicle screw was implanted along the pedicle axis. The shortest distance on both sides of a vertebral pedicle axis from these structures was measured. Paired t-test was utilized for analysis. RESULTS AND CONCLUSION:240 measurement parameters were analyzed. The distance from the left pedicle axis on T 1-3 to esophagus was smal , and the left pedicle on T 2 was minimal. The distance from the right pedicle axis on T 2-4 to trachea was smal . The distance from right pedicle axis on T 3 , T 4 to right main bronchus was smal . Carotid and vertebral artery did not show the risk of injury. 62%of the patients were in the aortic arch on T 4 plane, and no risk of damage was found. These results indicated that the left pedicle screws were easy to damage the esophagus, and the right pedicle screw was easy to damage trachea. Carotid artery, vertebral artery and aortic arch were not easy to be damaged. The anatomic position of easily damaged structure could be identified by careful analysis of CT data before screw implantation in the pedicle of upper thoracic spine.

Objective To compare the value of pacemaker implantation using the subclavian vein (SCV) puncture and thecephalic vein(CV) cutdown approach.Methods One hundred and forty-six patients were randomized into SCV group (98 patients) and CV group (48 patients).We observed the success rate,surgery duration,fluoroscopy time and complications of the two groups.Results The SCV group had significantly higher success rate,shorter duration of surgery and fluoroscopy than the CV group (success rate:100％ (98/98) vs.89％ (43/48),x2 =10.5,P ＜ 0.05 ; duration of surgery:(118 ± 35) min vs.(256 ± 75)min,t =12.12,P ＜0.01 ; duration of fluoroscopy:(15 ±5) min vs.(35 ± 10) min,t =13.08,P ＜0.01).Both groups had one case who developed compilations which were pocket hematoma and wire electrode dislocation respectively.The rate of complications was not significantly different between the two groups (P ＞ 0.05).Conclusion The SCV approach should be considered a preferable access in pacemaker implantation.

ObjectiveTo study the distribution, developmental patterns, and hormonal control of androgen re- ceptors(AR) in the developing and ethane dimethane sulfonate(EDS) treated male SD rat epididymis. MethodsThe ABC technique of immunohistochemistry and image analysis were used to assess optodensity means (OPTDM) of AR, providing a measure of relative nuclear AR concentration. ResultsThe specific AR immunostaining was observed in the nuclei of epididymal epithelium, peritubular smooth muscle cells and intertubular connective tissue cells. The rela- tive AR concentrations varied with the different segments of the epididymis in the adult rat(P<0. 05 or P<0.01). AR protein was highest in the caput (0. 763--0. 026),lowest in the corpus (0. 712±0. 025) and intermediate in the cauda (0. 736±0. 008). Levels of epididymal AR changed with development. In the cauda, AR level was highest on day 21 (0. 773±0. 028),intermediate on day 35(0. 762±0. 022),and lowest on day 90～120(0. 736±0. 008). The 90～120d group was significantly different from the 21d group (P＜0. 01)and 35d group (P＜0. 05). After the adult rats were treated with EDS to eradicate Leydig cells and endogenous testosterone, it was observed that the OPTDM of AR in the epididymal cauda epithelium was significantly reduced (P＜0. 001), and was restored to the control level by using ex- ogenous testosterone replacement (P＜0. 001). Conclusion These results suggest that the epididymal corpus depends least on androgens and the AR expression in the epididymis decreases with age and is dependent on circulating andro- gens.

Objective: To study a new method of alveolar cleft bone grafting. Methods: Group A: 62 cases (74 sides) alveolar cleft patients were transplanted with self-ilium spongy bone. Group B: 26 cases (30 sides) alveolar process patients used autologous ilium combined with DDM. Anterior occlusal radiographs and panoramic oral radiogram were taken before and after the operation to observe if there was new bone formation in the bone grafting area. According to Bergland grade criterion, analyzed the X-ray results after 3 months of the operation. Results: Group A: 17cases(17 sides) in class 1 group(23%), 17 cases(20 sides) in class 2 group(27%), 13 cases(14 sides) in class 3 group (19%), 15 case(23 sides) in class 4 group(31%). The overall survival rate of ABGR was 68.9%, and the clinical success rate was 50 %;Group B:16 cases(16 sides) in class 1 group(53.3%), 7 cases(8 sides) in class 2 group(26.7%), 2 cases(4 sides) in class 3 group (13.3%), 1 case(2 sides) in class 4 group(6.7%). The overall survival rate of ABGR was 93.3%, and the clinical success rate was 80%. Conclusion: Ilium spongy bone combined with DDM is good for alveolar process cleft bone grafting. It is better to use decalcified dentinal matrix of human than autologous ilium spongy bone.

OBJECTIVE: To study the characteristics of adverse drug reactions( ADR) in our hospital. METHODS: 240 ADR cases collected between 2003 and 2006 in our hospital were analyzed retrospectively. RESULTS: Of the total ADR cases, 211( 87. 92% ) were induced by intravenous drugs, 153( 63. 75% ) were induced by antibacterials, and 118( 49. 17% ) were manifested as lesions of skin and its appendages. CONCLUSIONS: Importance should be attached to the monitor and reporting of ADR so as to lessen or avoid the occurrence of ADR.

Objective:To analyze the mean levels of skeletal muscle mass and strength in elderly patients with type 2 diabetes mellitus(T2DM), and to investigate the effects of chronic inflammatory factors and oxidative stress on them.Methods:A cross-sectional study was conducted on 120 patients with T2DM aged over 60 years and 126 elderly patients without diabetes(the control group). Skeletal muscle mass, strength and serum levels of chronic inflammatory factors interleukin-6(IL-6), tumor necrosis factor-α(TNF-α)and 8-hydroxy-2′-deoxyguanosine(8-OHdG)were determined, and their effects on skeletal muscle mass and strength in elderly patients with T2DM were analyzed.Results:Compared with the control group, grip strength decreased in elderly patients with T2DM(25.03±7.85)kg vs.(29.52±7.73)kg( P<0.01), and skeletal muscle mass decreased(21.36±5.46)kg vs.(22.01±5.22)kg with no significant difference( P>0.05). Serum levels of 8-OHdG were higher in elderly patients with T2DM than in the control group(3.08±0.26)ng/L vs.(2.59±0.16)ng/L( P<0.01). Correlation and regression analysis results showed that 8-OHdG was an influencing factor for muscle strength in elderly patients with T2DM( R2=0.457)and that height and weight could be influencing factors for skeletal muscle mass in elderly patients with T2DM( R2=0.822). Conclusions:Skeletal muscle mass and strength decline in elderly T2DM patients, probably as a result of increased levels of oxidative stress.These findings may serve as evidence for sarcopenia intervention in elderly T2DM patients.

This study aims to assess if adverse drug reactions (ADRs) to parenterally administered salvianolate are allergic in origin. Hospital information system (HIS) data from 20 hospitals in China were used to carry out a retrospective nested case control design study. Included were patients who received dexamethasone for suspected allergic reactions after receiving parenterally administered salvianolate. These were compared with non-allergic reaction people. Single factor logistic regression and multiple factor logistic regression were used to analyze data. Condition on admission, allergic history, dosage, disease status and drug combinations were taken into account in cases of suspected allergic reactions. After analysis in two subgroups we found that the condition on admission had a significant effect, P values was < 0.000 1 on suspected cases of allergic reactions in the first subgroup analysis. For the second subgroup analysis, we found condition on solvents had a significant effects, P values was 0.005 1 on suspected cases of allergic reactions. We also found that using other four injections at the same time as parenterally administered salvianolate could be risky factors in suspected cases of allergic reactions. For the second subgroup analysis combining using three injections could increase risks. However, further research for verification is required. This study can provide guidance for safe clinical practice in using parenterally administered salvianolate.
Adult ; Aged ; Aged, 80 and over ; Case-Control Studies ; Drug-Related Side Effects and Adverse Reactions ; diagnosis ; Female ; Hospital Information Systems ; Humans ; Male ; Middle Aged ; Plant Extracts ; adverse effects ; therapeutic use ; Retrospective Studies