From the perspective of efficacy evaluation based on the literatures of MEDLINE database,the study carries out a bibliometrics study on domestic and foreign acupuncture clinical trials of the past three decades.The study involves the statistical classification on different systems and diseases,as well as statistics of diseases species on RCT or non- RCT involved,which will provide ideas and directions on diseases selection for the efficacy evaluation and re-evaluation researches in the field of evidence based medicine.

Heavy-ions have the similar characteristic of depth-dose distribution with protons, but exhibit enhanced physical and radiobiological benefits. With increasing development in technical and clinical research, more facilities are being installed in the world. At the same time, many critical techniques of heavy-ion therapy facility were optimized and completed. This paper classified and reviewed the basic structure of heavy-ion system equipments, especially the accelerator, gantry, nozzle , TPS.
Cancer Care Facilities ; Heavy Ion Radiotherapy ; instrumentation ; Humans ; Neoplasms ; therapy

Based on the investigation and analysis of industry dynamics of health maintenance Applications (APP) of Traditional Chinese Medicine (TCM),the paper designs and develops health maintenance APP of TCM,and describes its architecture,operating principle,functions,innovativeness,applicability scope,etc.

Objective To investigate whether early goal-directed therapy ( EGDT ) could lower the mortality rate in patients with severe sepsis and septic shock. Methods Articles with items sepsis, severe sepsis, septic shock, EGDT were retrieved from MEDLINE, EMBASE, Cochrane, Wanfang Data and CNKI. Inclusion criteria included randomized controlled trial, subjects concerning patients with severe sepsis or septic shock, endpoints with short-term mortality [ in-hospital, intensive care unit ( ICU ) or 28-day ] and long-term mortality ( 60-day or 90-day ). Related risk ( RR ) and 95% confidence interval ( 95%CI ) were used as indices to judge the difference in mortality rate between EGDT group and standard treatment group. RevMan 5.2 software was used for Meta analysis. Results There were 8 studies meeting inclusive criteria with a total of 4 853 patients. For patients with severe sepsis and septic shock, compared with the group with routine treatment, EGDT showed a decrease in the short-term mortality ( RR = 0.74, 95%CI=0.66-0.82, P<0.000 01 ), but did not decrease the long-term mortality ( RR=0.99, 95%CI=0.92-1.06, P=0.81 ). Conclusion EGDT strategy may decrease the short-term mortality in patients with severe sepsis and septic shock, but it showed no influence on the long-term mortality.

Objectives:To analyze the clinical characteristics of patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR) and identify the risk factors for death.Methods:The clinical data of 60 patients undergoing ECPR admitted to our hospital and Hangzhou First People's Hospital from September 2014 to September 2019 were retrospectively analyzed. The patients were divided into the survival group and the death group. The clinical data of the two groups were compared to explore the risk factors related to death. COX regression analysis was used to identify the risk factors for death.Results:Sixty patients undergoing ECPR were included in our study, of them, 16 (26.7%) cases were out-of-hospital cardiac arrest (OHCA) and 44 (73.3%) cases were in-hospital cardiac arrest (IHCA). The mortality of OHCA patients was higher than that of IHCA patients (87.5% vs. 56.89%, P < 0.05), and the duration from CPR to ECMO installation in the death group was longer than that in the survival group [(105.4±105.1) min vs. (53.0±28.5) min, P < 0.05]. Compared with the survival group, patients in the death group had higher troponin and glutamic oxalacetic transaminase and lower PH and lactate ( P < 0.05). The median survival time of the 60 patients was 42 days. Out-of-hospital cardiac arrest, high SOFA score before ECMO, high-dose norepinephrine, pulmonary infection during ECMO support and long ECMO support time were independent predictors of patients’ death. Conclusions:Risk factors associated with patients’ death undergoing ECPR are out-of-hospital cardiac arrest, high SOFA score before ECMO, high-dose norepinephrine, long duration from CPR to ECMO installation, pulmonary infection during ECMO support and long ECMO support time.

This article was aimed to explore the method of traditional Chinese medicine (TCM) health maintenance knowledge base building. TCM health maintenance knowledge classification method was studied under the guidance of TCM health maintenance classification system to construct a special literature database to store TCM health maintenance knowledge. Based on TCM literature resources, TCM health maintenance knowledge service platform was designed and developed for the static display and dynamic query support of TCM health maintenance knowledge. The content of knowledge base will be accessed to the whole society. The results showed that the construction method can be a system arrangement and modern interpretation of TCM health maintenance knowledge, in order to support TCM health maintenance knowledge base and its update and service system. It was concluded that under the guidance of TCM theories, the construction of TCM health maintenance knowledge base will realize the health maintenance knowledge-sharing and service requirement of TCM.

Objective To analyze the advantages of modified retrograde endotracheal intubation and to investigate its application effect in difficult airway opening. Methods Eighteen patients with difficult airways receiving modified retrograde endotracheal intubation admitted to Jinhua Municipal Central Hospital from June 2013 to June 2017 were enrolled. The successful intubation rate, complication rate, average intubation time and typical cases were calculated and analyzed. Results The causes of airway difficulty in 18 patients: there were 7 patients with glottis exposing difficulty due to tongue body hypertrophy, 2 patients with trismus due to tetanus, 5 patients with cervical spinal cord injury and 4 patients with burns. The successful rate of modified retrograde endotracheal intubation was 100% in 18 patients with difficult airway. Only 1 patient had a little bleeding at the puncture site and it was improved after local compression, the complication rate being 5.6% (1/18), and the average intubation time was (3.6±0.8) min. Conclusion Modified retrograde endotracheal intubation is a method easy to be mastered, its material is simple and easily to be acquired, clinically, the successful rate in its application in difficult airway patients is very high and its incidence of complication is very low, so that the technique can be popularized in primary hospitals.

Objective To explore the subtype,incidence and duration of delirium in intensive care unit(ICU).Methods From October 2015 to September 2017,we prospectively collected baseline information of 516 inpatients met the inclusion criteria of ICU in Jinhua Municipal Central Hospital of Zhejiang Province.We assessed patients with the Confusion Assessment Method for the Intensive Care Unit(CAM-ICU),and analyzed subtype of delirium and compared the incidence and duration of delirium.Results Among 516 patients,there were 119 cases with delirium along with 23.06％for the incidence.There were 14 cases with delirium in the type of increased activities,61 cases with delirium in the type of decreased activities and 44 cases with delirium in the mixed type.Delirium of 79.83％of patients occurred for the first time when being admitted to ICU between the second day and fifth day with 63.87％for the incidence of delirium night.The duration of delirium was from two to three days accounting for 52.94％.There were statistical differences in the occurrence time of delirium with three subtypes(χ2=11.116,P=0.025).The differences in duration of delirium with three subtypes were also significant(H=24.728,P<0.001).Conclusions Patients' high-incidence period of delirium is from the second day to the fifth day after being admitted to ICU.The occurrence time of delirium has the volatility showing the characteristic of light daytime and heavy night.We should strengthen assessment for delirium of patients to identify and take steps early,so as to reduce the occurrence risk of ICU delirium and shorten the duration of delirium.

Objective: To investigate whether the combination of oral propranolol and topical 0.5% timolol maleate cream is more effective than oral propranolol alone for treating infantile hemangioma (IH). Methods: From September 2015 to July 2016, 14 patients with proliferative IH, visited the infantile hemangioma outpatient clinic of the Department of Plastic and Reconstructive Surgery of Shanghai 9th People′s Hospital, were enrolled in this study. All patients took oral propranolol. Half of each IH lesion was treated with 0.5% timolol maleate cream. There were 5 male patients and 9 female patients, aged from 1.5 to 5.0 months. After 4 months of treatment, the color, size, extent, volume and the overall clinical outcomes of each lesion were measured, and the side effects were recorded. The therapeutic outcomes of oral propranolol alone and the combination of propranolol and timolol were analyzed and compared using Wilcoxon matched-pair signed-rank nonparametric tests. Results: Both oral propranolol alone and oral propranolol combined with topical 0.5% timolol maleate cream were proved to effectively improve the regression of IH with minor side effects. The color VAS score of oral propranolol alone group was 6.92±2.63, while the combination group was 6.88±2.33 (Z=0.043, P=0.966). The volume VAS score of oral propranolol alone group was 6.94±2.00, while the combination group was 6.98±2.11(Z=-0.051, P=0.959). Conclusions Oral propranolol combined with topical application of 0.5% timolol maleate could not increase the efficacy in the treatment of IH, compared with oral propranolol alone in the short-term observation.

Objectives:To compare the effects of manual and mechanical chest compression on patients receiving extracorporeal cardiopulmonary resuscitation (ECPR).Methods:Patients who underwent extracorporeal cardiopulmonary resuscitation admitted to Jinhua Municipal Central Hospital, Hangzhou First People's Hospital and the First Hospital of Jiaxing from September 2014 to July 2022 were enrolled in the study. The patients were divided into the manual group and mechanical group according to the compression method, and the clinical data of the two groups were compared. To explore the effects of the two compression method on the ECPR implementation, proportion of return of spontaneous circulation (ROSC) and hospital survival.Results:A total of 108 patients who underwent ECPR were included in the study, 50 patients in the manual group and 58 patients in the mechanical group. There were no significant differences in sex, age, laboratory tests before ECPR, ROSC proportion (90.0% vs. 86.2%) and survival (34.0% vs. 39.7%) between the two groups (all P>0.05). The puncture time in the mechanical group was shorter than that in the manual group [12 (9,15) min vs. 13 (11,16) min, P<0.05]. Conclusions:Compared with manual compression, mechanical compression during ECPR neither increase the probability of ROSC nor reduce in-hospital mortality in patients with cardiac arrest. However, mechanical compression may help to shorten the puncture time.