China ; Complementary Therapies ; organization & administration ; Humans ; International Cooperation ; National Institutes of Health (U.S.) ; Research ; organization & administration ; United States

Drugs, Chinese Herbal ; therapeutic use ; Evidence-Based Medicine ; Humans ; Medicine, Chinese Traditional ; Quality of Life ; Treatment Outcome

Acupuncture Therapy ; Deglutition Disorders ; etiology ; therapy ; Humans ; Stroke ; complications

Evidence-Based Medicine ; Humans ; Medicine, Chinese Traditional ; Randomized Controlled Trials as Topic

Objective To analyze the clinical and CT manifestations of the chest and abdomen lymphangioleiomyomatosis (LAM). Methods The clinical and CT manifestations of 13 patients with LAM proved histopathologically were reviewed retrospectively.Results Twelve patients onset with intrapulmonary manifestations all had progressive dyspnea, other symptoms included pneumothorax of recurrent attacks, chest distress, hemoptysis, cough, chylothorax and so on. During the course of disease, 12 patients had no extrapulmonary symptoms, abdominal great goiter was found unintentionally in the rest one without any intrapulmonary symptoms. Pectoral CT manifestations included sporadic or asystematic cysts in pulmones with size of 2-20 mm, and most had thin and clear capsule wall. The lung parenchyma among cysts was mostly normal. Four patients had pneumatocele, 2 had pleural effusion. Abdominal CT was performed in 10 patients and 7 had abnormal findings: renal angiolipoleiomyoma (ALL) in 3 including one had retroperitoneal multiple lymphangiomyomas and effussion and seroperitoneum, another 2 had multiple liver ALL and spleen accretion. The rest 4 patients included retroperitoneal lymphadenectasis in 2, seroperitoneum in one, as well as retroperitoneal lump and spleen accretion in one patient.Conclusion Pectoral and abdominal symptoms in LAM are not specific, but the CT manifestations somehow specific, which are helpful to the identification and early diagnosis of LAM.

With the economic development and the deepening of reform in China,more attention has been paid on health.Based on literature from Chinese Journal of Health Statistics in 2008,the number and ranks of practicing doctors,occupancy of hospital beds,the disease spectrums,outpatient per year were analyzed.The results hold it is better for the doctors to practice in more medical institutions.

Objective To study the changes in the level of serum IMA in patients with cardiac arrest followed by CPR,and explore the value of serum IMA in predicting prognosis of these patients after CPR.Methods (1) A total of 36 patients (25 men and 11 women) after CPR following cardiac arrest were recruited into experimental group (group C).Of them,15 cases (11 men and 4 women) and 21 cases (14men and 7 women) were assigned into resuscitation group (group R) and non resuscitation group (group NR),respectively,according to the presence or absence of ROSC.Meanwhile,another 60 healthy subjects (39 men and 21 women) matched for age and gender were recruited into healthy control group (group H).(2) The determination of the serum IMA level and comparisons of changes in serum IMA levels among groups were carried out.Results (1) The level of serum IMA in group C was higher than that in group H (P ＜ 0.05) ; The serum IMA level in group R was lower than that in group NR and higher than that in group H (P ＜0.05 for both).(2) The area under the ROC curve for serum IMA in predicting the prognosis of patients treated with CPR after cardiac arrest was 0.73.When the cut off value was 128.25 U/mL,the sensitivity and specificity were 57.1％ and 93.3％ respectively; the positive predictive value and negative predictive value were 92.3％ and 60.9％ ; positive likelihood ratio and negative likelihood ratio were 8.5 and 0.5 ; the correct diagnosis index was 72.2％,and Youden index was 50.5％.Conclusions Serum IMA has a certain value in prediction of prognosis in patients treated with CPR following cardiac arrest.

Objective To establish a new method for measuring the 3-D kinematics of hindfoot joints in vivo by using reverse engineering software together with the theory of rigid body kinematics.Methods CT images were gathered from 9 feet of 5 healthy volunteers in both the initial position (neutral position) and the terminal position (extremely inversion-adduction-dorsiflexion position).The 3-D digital modules of hindfoot joints in the initial position and terminal position were established with MIMICS 10.01 software.The data of reconstructed digital modules was inputted into the GEOMAGIC 10.0 software in STL format for twice registration,and then their relatively displacement and changes of angle in 3-D space between the two positions were calculated Results The rotation range of the tibiotalar joint was 3.89° ±2.77° in eversion,5.29°±4.47° in abduction,10.77°+5.70° in dorsiflexion,and the relative displacement was 0.78±0.59 mm towards lateral ankle,0.18±0.75 mm towards the hindfoot,(0.65±0.71) mm towards the proximal limbs;the range of subtalar joint was 16.46°±2.94° in inversion,12.77°±1.81° in adduction,6.33°±4.32° in plantarflexion,and the relative displacement was 5.50±1.45 mm towards medial ankle,1.96±1.77 mm towards forefoot,0.43±1.18 mm towards distal limbs; the range of talonavicular joint was 38.82°±5.98° in inversion,19.71°±6.33° in adduction,5.09°±6.89° in plantarflexion,and the relative displacement was (9.77±1.73) mm towards medial ankle,3.13±1.29 mm towards hindfoot,4.64±1.42 mm towards proximal limbs.Conclusion This method measuring 3-D kinematics of hindfoot joints in vivo is non-invasive and easy to operate.

Objective To analyze the clinical and CT manifestations of lung involvement of microscopic polyangiitis (MPA). Methods The clinical manifestations,laboratory ANCA examinations and CT features of 16 patients with lung involvement of MPA were retrospectively reviewed. Results (1) Clinical manifestations: 11 cases had hemoptysis or bloody sputum. Eight cases, who first presented with lung symptoms, were misdiagnosed with other lung diseases. All cases had mulfiorgans injuries involved kidney, cardiovascular and endocrine system, etc. (2) Laboratory examinations: all cases were pANCA positive and 14 cases were MPO-ANCA positive. (3) CT examinations: all cases had interstitial changes, 15 cases were interstitial predominately and 1 case was parenchymal predominately. Eight cases had pulmonary interstitial fibrosis and 11 cases had consolidation and 6 of them had both interstitial and consolidation. Two case had accompanied multiple nodulesand one of them had multiple cavitates. Six cases had mediastinal lymphoadenopathy. Conclusions Most of MPA patients have clinical manifestations of hemoptysis and bloody sputum, the CT examination show interstitial lung disease. Middle or advanced age population presented with above-mentioned manifestations should be alert to MPA, whether or not they have kidney and other organs injury.

Traditional medicine (TM) has been practiced in China for several thousand years. To better standardize the behaviors of medical staff of TM, rapidly improve their professional level, effectively and reasonably distribute TM resources, decrease the unnecessary application of medical care and suppress the rapidly increasing medical expenses, it is necessary to urgently set clinical therapeutic guideline in TM under the direction of evidence based medicine (EBM). The article also discusses the main existing problems and their solutions in setting clinical therapeutic guideline in TM.
China ; Evidence-Based Medicine ; Medicine, Chinese Traditional ; standards ; Practice Guidelines as Topic