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.

Objective To study the clinical features of the variants of benign childhood epilepsy with central temporal spikes (BECT).Methods The clinical data of 12 hospitalized pediatric patients with BECT from Jan 2007 to Jan 2014 were retrospectively reviewed. Results There were 7 boys and 5 girls in 12 patients. The age of onset was from 3 to 9 years old. Two cases were dizygotic twins. The atypical symptoms included atypical absence of 10 cases, negative myoclonic seizure of 8 cases, speech expression disorders and oral-pharynx apraxia of 4 cases. The electroencephalography (EEG) of all 12 patients showed abundance of spike and waves (SW) in rolandic areas during wake-up and sleep. The SW index was 50%-85% during slow sleep in all patients.Conclusions The variants of BECT are often associated with EEG deterioration. Understanding the clinical featuress and EEG characteristics can help the diagnosis of BECT variants.

Objective To study the relationship between urinary albumin excretion rate(UAER)and cardiac structure and function in type 2 diabetes mellitus(T2DM).Methods Five hundred and twenty patients with T2DM were divided into three groups by 8 h UAER:normoalbuminuria group(424 cases),microalbuminuria group(75 cases)and macroalbuminuria group(21 cases).At the same time,50 healthy people were selected as control group.The cardiac structure and function in four groups were evaluated by echocardiographic measurements.Results Left atrial dimensio[(34.39±3.46)mm],left ventricular posterior wall thickness[(10.34±1.05)mm],relative wall thickness(0.46±0.05),interventricular septal thickness[(10.49±1.07)mm],left ventricular mass[(167.37±32.12)g],left ventricular mass index[(87.62±12.16)g/m2]in macroalbuminuria group were significantly higher than those in control group[(32.59±2.71)mm,(9.30±0.77)mm,0.42±0.04,(9.75±0.81)mm,(147.33±27.23)g,(80.14±13.81)g/m2](P＜0.05),mean while the ratio of E/A(0.82±0.19)in macroalbuminuria group was significantly lower than that in control group(1.21±0.16)(P＜0.05).Conclusions In T2DM patients with albuminuria,the cardiac structure and function have changed.With the increase of UAER,the impairments are more prominent.And it may predict diabetes cardiomyopathy.

Objective The study was conducted to investigate the acute phase of convulsion related problem on the clinical manifestations,imaging and electroencephalograph (EEG) examination of purulent meningitis.Methods Cluster sampling method was employed to select children in our hospital,a total of 301 cases with purulent meningitis was analyzed retrospectively.Among them,62 cases had convulsion.The incidence of convulsion in the acute phase of the purulent meningitis,risk factors,and prognosis were analyzed.Results The convulsion incidence rate of acute purulent meningitis was 20.60％.The partial seizure was eight cases (12.90％).The secondarily generalized seizure following partial seizure was 15 cases (24.19％).The generalized seizure was 32 cases (51.61％).The convulsive status was 7 cases (11.29％).The EEG abnormality was significantly different between the convulsion group and the no convulsion group (P ＜ 0.05).The incidence of brain organic damage was significantly different between two groups (P ＜0.05).The multivariate unconditional logistic regression analysis showed,cause of disease,first symptom,disturbance of consciousness,obvious signs,and cerebrospinal fluid culture with convulsion were the relevant factors (P ＜ 0.01).Conclusions The most common seizure of purulent meningitis was the generalized seizure.Brain organic damage easily resulted in convulsion of purulent meningitis.The days of hospitalization,cause of disease,first symptom,disturbance of consciousness,obvious signs,and cerebrospinal fluid culture with convulsion were the positively relevant factors.Those positively relevant factors in combination of the clinical manifestations,imaging,and EEG examination in children would play an important role in diagnosis,treatment,and prognosis evaluation of convulsion derived from purulent meningitis.Moreover,convulsion affects the disease recovery in children with purulent meningitis.

Objective To analyze the potential etiologies and risk factors of childhood stroke. Methods This study retrospectively reviewed the clinical data of 159 children who were admitted from Jan.2006 to Jan.2014. Results The 159 children were composed of 100 boys and 59 girls , with median onset age of 1.8 years (ranged from 1 day to 12 years old) and median peak age of 0.9 years (ranged from 3 months to 2.8 years old). Their initial symptoms included limb hemiplegia,language dififculties and convulsion. The common causes included infections found in 46 cases (central nervous system infection in 32 cases, respiratory and gastrointestinal tract infection in 14 case), head injury in 42 cases, vitamin K deifciency in 29 cases, Moyamoya disease in 8 cases, heart diseases in 11 cases, spontaneous hemorrhage in 11 cases and 12 cases of unknown reason. Infectious diseases were the most common cause of children acute ischemic stroke in toddler period;and vitamin K1 deifciency were the most common cause of children hemorrhage stroke in infancy. The most common region of infarction is basal ganglia and middle cerebral artery in neuronal imaging. The median age at the time of diagnosis was 1.4 days. The median time of inhospital was 28 days. The median apex time was 4.3 days. Conclusions Among 159 cases, acute ischemic stroke is much more common than hemorrhagic stroke in children stroke, and the major risk factors are infections and head injury;Vitamin K1 deifciency is a major risk factor in infants with hemorrhagic stroke.

OBJECTIVETo observe the clinical efficacy on spastic pelvic floor syndrome (SPFS) treated with electroacupuncture (EA) at Shangliao (BL 31), Ciliao (BL 32), Zhongliao (BL 33) and Xialiao (BL 34).

METHODSThirty-six cases of SPFS were treated with EA at Shangliao (BL 31), Ciliao (BL 32), Zhongliao (BL 33) and Xialiao (BL 34), intermittent wave, 60 times/min in frequency, retained for 20 min. In general, the acupoints on one side were stimulated in each treatment. The bilateral acupoints stimulation was applied in serious cases. The treatment was given once every two days, five treatments made one session and totally three sessions were required. Before and after treatment, the clinical symptoms, anal kinetic indices defecation radiographic changes were observed. The follow-up observation was done in three months after the end of treatment.

RESULTSIn three-months follow-up after treatment, 14 cases were cured, 18 cases improved and 4 cases failed. The total effective rate was 88. 9%. After treatment, the cases of incomplete defecation, difficult defecation, anal pain and anal obstruction were reduced apparently as compared with those before treatment, indicating the statistically significant differences (all P<0.01). After treatment, rectal anal reflex threshold (ARA) was increased, anal maximal contraction pressure (AMCP) was reduced to (16.62±1.54) kPa and anal rest pressure (ARP) was significantly reduced to (7.22±0.36) kPa, indicating the statistical differences as compared with those before treatment (all P<0.01). After treatment, anorectal angle (ARA) in forceful defecation was increased to (116.55±9.42)°, the distance between the anorectal junction and the pubococcygeal line was decreased, and the impression of puborectal muscle was alleviated apparently as compared with that before treatment (P<0.01).

CONCLUSIONEA at Shangliao (BL 31), Ciliao (BL 32), Zhongliao (BL 33) and Xialiao (BL 34) achieves definite efficacy on SPFS and this therapeutic method obviously relieves the symptoms and deserves to be promoted in clinic.

Acupuncture Points ; Adult ; Aged ; Anus Diseases ; physiopathology ; therapy ; Constipation ; physiopathology ; therapy ; Defecation ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Muscle Spasticity ; physiopathology ; therapy ; Pelvic Floor ; pathology

Objective To observe the changes of antithrombin activity(AT) and D-dimer in acute leukemia(AL)children complicated with disseminated intravascular coagulation(DIC) and to explore the changes of blood coagulation and fibrinolysis function.Methods Twenty-seven AL children without DIC were selected as AL group and 25 childern complicated with DIC were selected as observe group,36 health children were as control group.Plasma level of AT,D-dimer,fibrinogen,activated partial thromboplastin time and prothrombin time were tested by color substrate,immuno-latex turbidimetry,and coagulation method.And the rusults of AL group were compared with observe group and control group by SPSS 10.0 software.Results PT was significantly prolonged and the D-dimer in AL group and observation group were significantly higher than those in control group(Pa

Objective To explore the therapeutic effect of patients with intractable by microsurgical operation.Methods All patients assisted by a 3-dimensional precise localization system of epileptic foei for epilepsy diagnosis and the epileptogenic focus and comprehensive surgical measures were taken for the treat- ment of isolated epileptic foci and their network.The outcomes of 50 patients in the following up 1～2 years were defined.A retrospective review was conducted.Results In this group,Excellent 53 cases (31.90%);good 83 cases(50.93%);moderate 10 cases(6.13%)and poor 18 cases(11.04%).The ef- fective rate was 80%.Conclusion The microsurgical management is an effective approach for treatment of refractory epilepsy.

Objective To investigate the association between peripheral white blood cell (WBC) count and the carotid intimal-medial thickness (cIMT) in middle-aged and elderly Chinese of suburban area of Shanghai.Methods A total of 2 519 subjects aged 40 years or older from Jiading District,Shanghai were recruited to undergo questionnaire interview,anthropometric measurements,fasting blood sampling,and carotid B-mode ultrasonography.After excluding subjects with biochemical index missing,WBC count ＞ 10× 109/L as well as those with known myocardial infarction,cerebral infarction,coronary heart disease,and those taking lipid-lowing agents,2 239subjects were included in this analysis.Results Increased WBC count was associated with more unfavorable metabolic risk profiles.With the increasing quartiles of WBC count,cIMT were 0.558,0.570,0.573,and 0.587mm respectively(P for trend ＜ 0.01).As compared with participants in the first WBC quartile,the risks of cIMT thickening were increased by 79％,109％ in males and 29％ in females (P＞ 0.05 in females).Multiple linear regression model showed that peripheral WBC count was an independent risk marker for cIMT thickening,especially for neutrophil and monocyte count.Conclusion A high-normal WBC count was significantly associated with cIMT thickening in middle-aged and elderly Chinese of suburban area of Shanghai,especially in males.

Objective To develop psychosocial skills training module for schizophrenic outpatients.Methods Structured psychosocial skills training program, which were made according to community rehabilitation plan for schizophrenia, featured convenience and well operability. Subjects were 96 of 204 schizorenic outpatients in remission who were randomly assigned to receive psychosocial skills training combined medicine(observation group) or medicine only(control group) and followed up by 24 months. The changes during treatment were evaluated by positive and negative syndrome scale(PANSS), Social Disability Screening Schedule(SDSS) and patients' cognition function were also evaluated longitudinally. Results Relapse rate of control group (37%) is higer than observation group (17.7%, P＜0.01). After Last Observation Carried Forward(LOCF), control group showed higer scores than observation group on positive syndrome (8.34±2.04 vs 7.66±0.97), negative syndrome(9.15±1.97 vs 813±1.15), total score (37.64±5.58 vs 34.79±3.64) and Social disability (2.81±1.90 vs 2.07±1.47) (P＜0.01); observation group also showed a significant progress on cognition function(P＜0.05). Conclusion This trial demonstrated the efficacy of the easy-operating structured psychosocial skill training grogram in preventing relapse and improving social adoptive function for schizophrenia.