The reasons of bias that is caused in the design of randomized controlled trial are analyzed in this article. It is emphasized that the design of randomized controlled trial in TCM acupuncture should follow its basic concepts and cores and make clear normative standards of placebo acupuncture. The concept of real-time control is proposed and focusing on activating the nerve cells process in threshold field is advised, which will make profound influence on development of medical science of acupuncture and moxibustion.
Acupuncture Therapy ; standards ; Humans ; Placebo Effect ; Randomized Controlled Trials as Topic ; standards ; Research Design ; Treatment Outcome

The high quality literatures on acupuncture RCTs that has been published in China and the United States in recent years are retrieved. The analysis of random methods, research design and application status and social conditions is carried out. The statistical analysis of China population and the United States population is carried out to explore the reasons for publication bias in acupuncture RCTs. The results suggest that there is no significant difference between China and the United States in design and application on randomized method. Compared with the United States, the blind assessor used in acupuncture research is poorly carried out in China. The research design and application status on acupuncture is better in China than in the United States. The reasons for publication bias in acupuncture RCTs may be related to the understanding and acceptance status of acupuncture. It is impressed that blind assessor in acupuncture RCTs is a key of improving the research quality.
Acupuncture Therapy ; Humans ; Publication Bias ; Randomized Controlled Trials as Topic

Objective Familial left ventricular noncompaction( LVNC ) is quite rare.We screened for the presence of LVNC and related clinical characteristics in a 5-generation Chinese family.Methods Comprehensive medical history was obtained from 40 members in a 5-generation Chinese family.Systemic clinical investigations including echocardiography (UCG),routine and ambulatory electrocardiogram (ECG),X-rays were performed in 33 family members.Cardiovascular magnetic resonance image (MRI) was carried out in 2 family members.Results Sudden cardiac death (including 1 occurred while following-up)was reported in 7 family mcmbers( 17.5％,7/40 ).LVNC was diagnosed in 10 out of the 33 family members (30.3％ )and heart enlargement was evidenced in 3,heart failure in 2,complete left branch conductive block in 3,serious sick sinus syndrome (SSS) treated with permanent pacemaker implantation in 1 and paroxysmal supraventricular tachycardia treated with radiofrequency ablation procedure in 1 out of these 10 LVNC patients.Primary pedigree analysis revealed that offspring from female patients were at the highest risk to be affected by LVNC ( 15/18,83.3％ ) while LVNC was absent in offspring of male LVNC patients (0/8).Moreover,clinical heart failure symptoms and arrhythmias were more severe in female LVNC patients than in male LVNC patients.Conclusion Primary familial investigation reveals the matrilineal inheritauce of familial LVNC in this 5-generation Chinese family,further investigations are warranted to explore the potential mutations in the mitochondrial genome responsible for LVNC in this family.

To observe the effects of total flavones of Metasequoia glyptostroboides Hu et Cheng (TFM) on volume-overload cardiac hypertrophy and the expression of c-Fos protein in rat. Methods　Volume-overload cardiac hypertrophy of rat was induced by aortocaval shunts. The rats were given ig TFM (400, 40 and 4 mg/kg/d). c-Fos protein in the ventricles were measured by immunocytochemical study. Results　TFM at the above dosage decreased heart weight and contents of RNA and protein in the myocardium, inhibited the expression of c-Fos protein in the ventricles. Conclusion　TFM can prevent volume-overload cardiac hypertrophy in rats. The inhibitory effects on the expression of c-Fos protein may be its mechanism in the molecular level.

OBJECTIVETo investigate the nephrotoxic effects of methyl cantharidimide tablets on urinary protein and enzymes in Beagle dogs.

METHODBeagle dogs were randomly divided into negative control group(blank tablet), methyl cantharidimide tablets group (6.11,12.21, 24.42 mg x kg(-1)), continuously 30 days of oral adminiStration, once a day. The drug and control group were collected and determined fresh urine in 1, 2, 3 and 4 weeks of the administration; Serum urea nitrogen (BUN), creatinine (Crea), total protein (TP) and albumin (ALB) as well as sodium, potassium, chloride electrolyte were determined on 15 and 30 days of the administration; Urine albumin (mAlb), kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin( NGAL), N-acetyl-beta-D-glucosaminidase (NAG), clusterin, beta2-microglobulin (beta2-MG), alpha1-microglobulin (alpha1-MG), alanine aminopeptidase( AAP) and im- munoglobulins IgG were tested on 15 and 30 days of the administration.

RESULTCompared with the control group, urine protein and white blood cells was significantly increased in each dose group. On 15 days of the administration, mAlb were higher in each dose group, KIM-1, NGAL, clusterin, NAG and AAP were significantly higher in high-dose group, while the middle and low dose group had no significant difference, as well as blood SCr and BUN no obvious abnormalities. On 30 days, mAlb, KIM-1, clusterin, NAG, AAP were increased in each dose group, appearing dose-effect relationship, beta2-MG and NGAL levels were significantly increased in high-dose group. Contents above indicators were increased with significant dose and time relationship, and serum BUN, Scr were correlated, suggesting that urine mAlb, KIM-1, clusterin, NAG and AAP indicators that can sensitively respond the changes of proteins and enzymes in urine.

CONCLUSIONMethyl cantharidimide tablets has a renal toxicity, urine mAlb, KIM-1, clusterin, NAG and AAP can be used as the early nephrotoxic biomarkers of methyl cantharidimide tablets.

Animals ; Biomarkers ; urine ; Dogs ; Female ; Kidney ; drug effects ; Kidney Diseases ; chemically induced ; Male ; Proteins ; metabolism ; Tablets ; adverse effects ; Urine ; chemistry

OBJECTIVETo construct recombinant expression vectors of small interfering RNA (siRNA) targeting survivin and investigate apoptosis of glioma cell line U251 mediated by the survivin-targeting siRNA.

METHODSAccording to the sequence of the coding region of survivin gene, two strings of 19 nucleotides of inverted sequence flanking the loop sequence of two complementary 9-base oligonucleotides were designed and synthesized to form hairpin construct as the DNA templates for the target siRNA. The siRNA templates were cloned into siRNA expression vector pGenesil-1, and the resulted vector pGenesil-1/survivin was transfected into U251 cells using Metafectene following the standard protocols. Real-time PCR and Western blotting were performed to evaluate survivin gene silencing induced by siRNA transfection at the RNA and protein levels, respectively. Flow cytometry analysis with Annexin-V/PI double staining was used to determine the cell apoptosis.

RESULTSReal-time RT-PCR and Western blotting revealed significantly lowered survivin expression at both RNA and protein levels in transfected U251 cells, which exhibited a significantly higher apoptosis rate after transfection as shown by flow cytometry analysis.

CONCLUSIONRNA interference mediated by the siRNA expression vector pGenesi-l/survivin can significantly reduce survivin expression and induce remarkable apoptosis in U251 cells.

Apoptosis ; physiology ; Brain Neoplasms ; metabolism ; pathology ; Cell Division ; Cell Line, Tumor ; Genetic Therapy ; Glioma ; metabolism ; pathology ; Humans ; Inhibitor of Apoptosis Proteins ; Microtubule-Associated Proteins ; biosynthesis ; genetics ; Neoplasm Proteins ; biosynthesis ; genetics ; RNA, Antisense ; genetics ; RNA, Small Interfering ; Transfection

Objective To investigate the efficacy and safety of rivaroxa-ban in the prevention of deep vein thrombosis in patients with hip arthro-plasty.Methods Ninety-eight patients with hip arthroplasty were re-cruited in our hospital.The included 98 cases were randomized divided into rivaroxaban group ( n=46 ) with rivaroxaban 10 mg · d -1 orally with 5-week and low molecular heparin ( LMH) group with LMH 4100 U with 2-week.The risk of deep vein thrombosis between the two groups was recorded within the flowing 6 months.Results With a follow-up peri-od of 6 months, the incidence of deep vein thrombosis were 2.3%(1/44) and 14.6%(7/58) in the rivaroxaban group and LMH group re-spectively , which indicated the incidence was much lower in rivaroxaban group ( P<0.05 ).But the platelet count , coagulation function , drainage volume and subcutaneous ecchymosis were not different between the two groups ( P>0.05 ).Conclusion Rivaroxaban can significant decrease the risk of deep vein thrombosis in patients with hip arthroplasty without increasing the side effects.

Objective To investigate the on-job training mode suitable for ICU nursing staff for elderly patients,in order to improve the comprehensive treatment and nursing capabihties of ICU nursing staffs in critically ill elder patients with a variety of diseases.Methods Nurses from coronary care unit (CCU),respiratory intensive care unit (RICU),and surgery intensive care unit(SICU) were recruited to participated in the training.Every three months were considered as a training cycle,each ICU took responsibility for one-month training program for the participants in turns.Satisfaction rate and examination scores concerning the first aid theory and first aid skills of nurses were evaluate and compared before and after training.Results After receiving the training program,satisfaction rates for the first aid theory and the first aid skills of nurses in patients and their families were 96.6％ and 95.2％,and higher than that were 83.7％ and 86.3％ before the training program; 95.5％ and 93.7％ among doctors after the training were higher than 80.9％ and 84.6％ before the training program; 98.7％ and 97.6％ among nursing staffs after the training were higher than 80.9％ and 84.6％ before the training program; and these differences were statistically significant between before and after the training (x2 =8.900,4.395,5.224,4.940,12.890,7.680,respectively; P ＜0.05).The examination score of the first aid theory before the training was (59.2 ± 4.2) and lower than that was (89.7 ± 3.7) after the training,the examination score of the first aid skills of nurses before the training was (63.8 ± 4.6) and lower than that was (90.3 ± 5.3) after the training,these differences were statistically significant between before and after the training (t =-59.12,-41.06,respectively; P ＜ 0.01).Conclusions The establishment of the teaching mode of multidisciplinary collaboration on nursing training among elderly patients in ICU,which can develop the comprehensive treatment and nursing capabilities of ICU nursing staffs and improve the satisfaction rate for nursing job and the rate of successfully rescuing critically ill patients,can be used to achieve the sharing of human resources,medical instruments and information resources,and is feasible in nursing practice in ICU and more worthy of clinical promotion and application.

OBJECTIVETo investigate the efficacy and feasibility of duodenojejunal bypass(DJB)on non-severe obese patients with type 2 diabetes mellitus(T2DM).

METHODSThe body mass index (BMI), fasting plasma glucose(FPG), 2h-postprandial plasma glucose(2hPG), fasting insulin(F-ins), fasting c-peptide(F-CP), glycated hemoglobin and hypoglycemic agents dose changes were tested in 7 patients with non-severe obese T2DM undergoing DJB, preoperatively and within 24 weeks after surgery during the follow-up. Data were collected and the clinical outcomes of T2DM were analyzed.

RESULTSIn 7 cases of non-obese T2DM who underwent DJB, one patient was weaned off hypoglycemic agents with normal FPG, 2hPG and HbA1c postoperatively. Five required significantly lower dosage. No significant improvement in 1 case. Complete remission rate of hyperglycemia was 1/7, effective rate was 6/7, and effective rate of HbA1c was 5/7. No significant changes in BMI were observed between the preoperative and postoperative phases.

CONCLUSIONPlasma glucose level can be markedly reduced by duodenojejunal bypass in non-obese T2DM, independent of weight loss, and the mechanism remains unclear.

Adult ; Aged ; Bariatric Surgery ; methods ; Diabetes Mellitus, Type 2 ; surgery ; Duodenum ; surgery ; Female ; Follow-Up Studies ; Humans ; Jejunum ; surgery ; Male ; Middle Aged ; Obesity ; Treatment Outcome

Objective To establish reference intervals for serum soluble transferrin receptor(sTfR)and sTfR/log ser-um ferritin index(sTfR/lgSF)in apparently healthy adults in the Wuhan area,so as to provide reference for clinical diagno-sis and treatment of iron deficiency and iron-deficiency anemia.Methods A total of 273 individuals from the Wuhan Aisa General Hospital,including health examination participants and blood donors,were selected to measure sTfR,other iron metabolism indicators and high sensitivity C-reactive protein(hsCRP).The sTfR/lgSF values were calculated and reference intervals for sTfR and sTfR/lgSF were established using the percentile method(P2.5 to P97.5).Spearman correlation anal-ysis was used to evaluate the relationships between sTfR,sTfR/lgSF,and other iron metabolism indicators,as well as hsCRP.Results The sTfR levels(M,mg/L)between males and females(1.01 vs 1.07)were not statistically significant(P＞0.05),but the sTfR/lgSF levels if males were significantly lower than those in females(0.45 vs 0.62)(P＜0.05).There was no significant difference in sTfR(M,mg/L)and sTfR/lgSF(M)among different age groups,with values of 1.07 vs 1.02 vs 1.00 and 0.52 vs 0.53 vs 0.51,respectively(P＞0.05).The reference interval for STfR was(0.72-1.68)mg/L,the sTfR/lgSF reference interval was(0.31-0.88)for males,and(0.37-1.19)for females.Correlation analysis showed no correlation between sTfR,sTfR/lgSF and hsCRP(r=0.043,P＞0.05;r=-0.064,P＞0.05),while serum ferritin(SF),serum iron(SI),transferrin saturation(TSAT)were correlated with hsCRP(r=0.128,P＜0.05;r=-0.195,P＜0.01;r=-0.173,P＜0.01).There was no correlation between sTfR and SF(r=-0.115,P＞0.05),while sTfR/lgSF was significantly correlated with and SF(r=-0.685,P＜0.01).Conclusion Preliminary reference intervals for serum sTfR and sTfR/lgSF in apparently healthy adults in the Wuhan has been established.sTfR and sTfR/lgSF are not affected by inflammatory factors and are significant for identifying iron deficiency in anemia patients with elevated serum ferritin caused by inflammation.