Randomized controlled trials (RCT) is the source of the raw data of evidence-based medicine. Blind method is adopted in most of the high-quality RCT. Sham acupuncture is the main form of blinded in acupuncture clinical trial. In order to improve the quality of acupuncture clinical trail, based on the necessity of sham acupuncture in clinical research, the current situation as well as the existing problems of sham acupuncture, suggestions were put forward from the aspects of new way and new designation method which can be adopted as reference, and factors which have to be considered during the process of implementing. Various subjective and objective factors involving in the process of trial should be considered, and used of the current international standards, try to be quantification, and carry out strict quality monitoring.
Acupuncture Therapy ; standards ; Biomedical Research ; standards ; Evidence-Based Medicine ; Humans ; Randomized Controlled Trials as Topic ; standards

Objective To explore the surgery way of anterolateral small incision total hip replacement and evaluate the curative effect after surgery.Methods Clinical data of 41 patients(48 hips)with anterolateral small incision total hip replacement were analyzed retrospectively.The incision length,operation time,intraoperative blood loss,postoperative volume of drainage,perioperative complications,hospitalization days,X -ray performance were recorded.Results The incision length was 7-8cm,mean (7.5 ±0.5)cm.The operation time was 60-70min,mean (65 ±5)min.The intraoperative blood loss was 165 -280mL,mean (235 ±44)mL and the postoperative volume of drainage was 85 -120mL,mean (95 ±15)mL.No perioperative complications occurred.The average follow-up time was (36 ±6)months.The preoperative hip joint Harris score was (30.3 ±28.2)points,and the last follow-up score was (98.0 ±4.0)points,the difference was statistically significant(t=15.665,P=0.000),and the excellent and good rate was 100%.Conclusion The anterolateral small incision total hip replacement has small trauma,less bleed-ing,less postoperative pain,quick recovery,better joint stability,and it is suitable for clinical promotion.

Objective To investigate the effect of NaAsO2 on the binding levels of methyl CpG binding protein 2(MeCP2),DNA methyltransferase 1 (DNMT1) and histone deacetylase 1(HDAC1) to the hypermethylation promoter region of MGMT gene in HaCaT cells,in order to provide a basis to deepen the interpretation of the role of arsenic poisoning mechanism.Methods HaCaT cells were treated repeatedly and interval with different concentrations of NaAsO2(3.13,6.25,12.50,25.00 μnol/L,respectively) for 72 h.Untreated HaCaT was used as blank control group and human epidermal squamous carcinoma cell line(A431 cells) as positive control group.The binding levels to the two transcription regulatory regions(ChIP1,ChIP2) and to the coding region(ChIP3) of MGMT 8ene were detected by chromatin immuno-precipitation combined with quantitative PCR.Results The differences of binding levels of MeCP2,DNMT1 and HDAC1 to ChIP1 and ChIP2 in each group were significant (F=7.387,84.634,78.442 and 19.263,69.649,26.546,all P ＜ 0.05).The binding levels of MeCP2,DNMT1 and HDAC1 to ChIP1 and ChIP2 in each NaAsO2 exposed group[3.13 μmol/L NaAsO2 exposed group:(136.00 ±16.97)％,(145.00 ± 2.83)％,(88.50 ± 19.09)％ and (106.50 ± 37.48)％,(112.34 ± 8.73)％,(59.71 ± 8.49)％;6.25 μmol/L NaAsO2 exposed group:(130.00 ± 42.43)％,(154.50 ± 4.95)％,(101.00 ± 1.27)％ and (88.50 ±3.54)％,(134.32 ± 2.82)％,(102.75 ± 19.91)％ ; 12.50 μmol/L NaAsO2 exposed group:(141.50 ± 23.33)％,(161.50 ± 7.78)％,(125.00 ± 11.31)％ and (119.50 ± 24.75)％,(171.59 ± 3.54)％,(167.61 ± 10.61)％; 25.00μmol/L NaAsO2 exposed group:(134.50 ± 43.13)％,(472.50+ 50.20)％,(383.50 ± 30.41)％ and (180.09 ±12.73)％,(348.50 ± 27.58)％,(158.45 ± 12.02)％] were higher than that in the blank control group[(51.50 ±9.19)％,(82.00 ± 12.73)％,(25.03 ± 2.91)％ and (37.02 ± 4.24)％,(91.56 ± 26.16)％,(19.09 ± 2.90)％,all P ＜ 0.05].The differences of binding levels of MeCP2 to ChIP3 in each group were not significant(F =1.670,P ＞0.05),but the differences of binding levels of DNMT1 and HDAC1 to ChIP3 were significant (F =4.404,9.863,all P ＜ 0.05),and only the binding levels in the 25.00 μmol/L NaAsO2 exposed group [(615.85 ± 29.63)％,(306.09 ± 59.40)％] were higher than that in the blank control group[(99.70 ± 12.02)％,(92.45 ± 48.79)％,all P ＜ 0.05].Conclusions MeCP2 can bind to the methylated MGMT gene transcriptional regulatory regions which are induced by arsenic and leads to histone deacetylation by the recruitment of DNMT1 and HDAC1 and,meanwhile,DNMT1 can bind to the coding region of MGMT gene to recruit HDAC1 in a methyl DNA binding protein(MBD) independence manner and media MGMT gene silencing through the chromatin remodeling way,which might be the early molecular events of arsenic poisoning.

Objective To evaluate the release of leucine-enkephalin (L-EK) in the cerebrospinal fluid induced by intrathecal human embryonic kidney (HEK293) cells modified with human preproenkephalin (hPPE)gene and the analgesic efficacy of L-EK for bone cancer pain.Methods Forty CIBP female Sprague-Dawley rats were randomized into transplantation (CIBP+ hPPE/HEK293,n =20) and control (CIBP + HEK293,n =20)groups using a random number table.At 1 day before inoculation of cancer cells (T1,baseline) and 8,15,21,25,32 and 35 days after inoculation (T2-7),thermal paw withdrawal latency (TWL) was measured,and the number of licking/biting the claw on the transplantated side and degree of hindlimb limping during free activities were recorded.After observation at T4,10 rats were chosen from each group and sacrificed and the cerebrospinal fluid of rats was collected in an ice bath for detection of hPPE expression using radioimmunoassay.Results Compared with control group,TWL was significantly prolonged,the concentration of L-EK in the cerebrospinal fluid was increased,and the number of licking/biting the claw on the transplantated side and degree of hindlimb limping during free activities were decreased at T4-7 in transplantation group.Conclusion Intrathecal HEK293 cells modified with hPPE gene can continuously secrete L-EK and mitigate bone cancer pain.

OBJECTIVE: To investigate the effects of Liuwei Dihuang Pills (LWDHP) on expressions of apoptosis-related genes bcl-2 and Bax in pancreas of OLETF rats. METHODS: Forty male OLETF rats were randomly divided into LWDHP-treated group and untreated group. Another ten male LETO rats were included in normal control group. OLETF rats in the LWDHP-treated group were given LWDHP (2.4 g.kg(-1).d(-1)) orally since the age of 8 weeks and the rats in the other two groups were given distilled water orally. Body weights of rats were recorded weekly and blood glucose concentration was determined by oral glucose tolerance test (OGTT). Pancreas weights were recorded after rats were killed and the expression levels of bcl-2 mRNA and Bax mRNA were detected by reverse transcriptase-polymerase chain reaction (RT-PCR). RESULTS: In the LWDHP-treated group, the expression of bcl-2 mRNA in the pancreas of rats at the age of 40 weeks (1.25+/-0.07) was much higher than that in the untreated group (1.01+/-0.16), P<0.01. Bax mRNA level in the LWDHP-treated group (0.57+/-0.11) was obviously lower than that in the untreated group (1.18+/-0.28), P<0.01. There was no significant difference of pancreas-to-body weight ratios between the LWDHP-treated group and the untreated group. The ability of glucose tolerance was improved in the LWDHP-treated group. CONCLUSION: LWDHP can up-regulate the expression of bcl-2 and down-regulate the expression of Bax at transcription level, which maybe contribute to the anti-apoptosis effects of LWDHP.

Objective To assess the prognosis of patients with bladder neck (BN) involvement in radical prostatectomy specimens and compare it with patients with seminal vesicle invasion (SVI).Methods From January 2002 to December 2008,42 patients with prostate carcinoma who underwent radical prostatectomy were analyzed retrospectively.The mean age was 70.3 years (range 59-78 years).The patients were divided into two groups according to 2002 TNM system:pT4a group (bladder neck invasion) with 17 cases and pT3b group (unilateral or bilateral seminal vesicle invasion)with 25 cases.Postoperative outpatients were followed-up on a regular basis,two consecutive postoperative serums PSA greater than 0.2 μg/L defined as a biochemical recurrence.The postoperative follow-up to the time of biochemical recurrence or follow up to the deadline without biochemical recurrence were defined as biochemical recurrence free survival time.Results All patients were followed up for 50-122 months.The patients with BN involvement 17.6％ (3/17) had biochemical recurrence,whereas seminal vesicle invasion 24.0％ (6/25),there was no statistical significance between the two groups (P＞0.05).Conclusions Postoperative adjuvant therapies can improve the biochemical recurrence free survival.In this study,the prognosis of pT4a and pT3b group is similar.A conceivable down-staging of BN involvement in the TNM staging system should be considered.

OBJECTIVETo explore the effect of Qiling Decoction (QD) combined highly active antiretroviral treatment (HAART) on expression levels of peripheral blood Th17 and Treg cells in HIV/AIDS patients.

METHODSTotally 55 HIV/AIDS patients were randomly assigned to the treatment group (28 cases) and the combination group (27 cases). Besides, 21 HIV negative patients were recruited as the healthy control group. Those in the treatment group received HARRT alone, while those in the combination group received HAART combined QD. The observation lasted for 24 weeks. Meanwhile, according to peripheral blood CD4+ T cell counts before treatment, HIV/AIDS patients were assigned to three subgroups. For patients in subgroup 1, 1 cells/microL < CD4+ T cell counts < or = 100 cells/microL; For patients in subgroup 2, 101 cells/microL < CD4+ T cell counts < or = 200 cells/lL; For patients in subgroup 3, 201 cells/microL < CD4+ T cell counts < or = 350 cells/microL. Expression of peripheral blood Th17 and Treg cells, and number of CD4+ T cell counts were detected using flow cytometry (FCM)in HIV/AIDS patients at the pre-treatment baseline, week 4, 12, and 24, as well as those in the healthy control group.

RESULTSCompared with the healthy control group, CD4+ T cell counts and the baseline expression level of Th17 cells in the peripheral blood of HIV/AIDS patients significantly decreased, the expression level of Treg cells significantly increased P < 0.01). Compared with before treatment in the same group, CD4+ T cell counts all increased at week 4, 12, and 24 in the two treatment groups, showing statistical difference (P < 0.05, P < 0.01). There was no statistical difference in the effective rate at various CD4+ T cell levels between the two groups (P > 0.05). There was no statistical difference in expression levels of Th17 and Treg cells between the combination group and the treatment group at any time point (all P >0.05). The Th17/Treg ration significantly increased in the combination group after 24 weeks of treatment, showing statistical difference when compared with the treatment group (U = 2.135, P = 0.038).

CONCLUSIONQD could improve the immune balance of Th17/Treg cells, which might be one of its mechanisms for improving HIV/AIDS patients' immunity.

Acquired Immunodeficiency Syndrome ; drug therapy ; immunology ; Adult ; Antiretroviral Therapy, Highly Active ; CD4 Lymphocyte Count ; Case-Control Studies ; Drugs, Chinese Herbal ; therapeutic use ; Female ; HIV Infections ; drug therapy ; immunology ; Humans ; Male ; Middle Aged ; Phytotherapy ; T-Lymphocytes, Regulatory ; cytology ; Th17 Cells ; cytology

Objective To compare the effect of right ventricular outflow tract (RVOT) and right ventricular apex (RVA) pacing on ventricular systolic synchrony using gated blood pool SPECT (GBPS).Methods A total of 50 patients implanted with pacemaker due to high degree or complete atria-ventricular block were enrolled in the study. Twenty-three patients were RVOT paced ( Group A, n = 23) and 27 were RVA paced (Group B, n=27). Twenty-four patients with malignancy, normal echocardiographic findings and no history of cardiac diseases were scheduled for pre-chemotherapy evaluation of cardiac structure and function and were enrolled as control group ( Group C, n = 24). All patients underwent GBPS imaging and the values of phase angle (PS), mean phase of each wall, standard deviation (SD) of mean phase of each wall, lateral-septal motion delay of left ventricle ( LV Sep-Lat Delay), septal-right ventricular (RV) delay of LV ( LV Sep-RV Delay) and LV-RV Delay were acquired. The parameters of ventricular systolic synchrony among the three groups were compared using one-way ANOVA. Results The mean phase of LV lateral wall in Groups A and B were significantly higher than that in Group C: Group A (120.50 ±40.58) ms; Group B (103.23±28.34) ms; Group C (84.63 ±22.38) ms (F=7.72, P ＜0.05). There was no significant difference between Groups A and B ( t = 1.30, P ＞ 0.05 ). The mean phase of RV in Group A was significantly larger than those in Groups B and C: Group A ( 137.05 ± 39.27) ms, Group B ( 100.85 ± 23.79) ms,Group C (59. 13 ±30.52) ms (F=35.55, P＜0.05). PS, SD and LV Sep-Lat Delay in Groups A and B were significantly higher than those in Group C: (85.73 ± 12.00)°vs (89.85 ± 15.61 )°vs (58.95 ±9.87)°, (27.68±10.66) ms vs (26.15 ±13.02) ms vs (15.63 ±8.35) ms, (25.06±34.23) ms vs (2. 62 ± 60. 31 ) ms vs ( - 23.66 ± 31.39) ms, F = 41.54,8.55,6.81, all P ＜ 0.01 ), however, there was no significant difference between Groups A and B ( t = 0. 68, 0.68, 1.30, all P ＞ 0.05 ). LV Sep-RV Delay and LV-RV Delay were significantly different among the three groups ( LV Sep-RV Delay: Group A (57.60 ±56.77) ms, Group B (6.36 ±61.88) ms, Group C ( -41.89 ±35.78) ms; LV-RV Delay:Group A (47.36 ±42.59) ms, Group B ( 3.08 ± 38.81 ) ms Group C ( - 26.50 ± 20.99 ) ms, F = 20. 32,25.38, both P ＜ 0.01 ). Conclusion Both RVA and RVOT pacing increase the segmental phases detected by GBPS, causing inter- and intra- ventricular asynchrony compared with patients without pacemakers.

OBJECTIVETo observe the changing laws of TCM syndrome type in patients with coronary heart disease (CHD) before and after intervention treatment (IT) and to explore the influence of IT on TCM syndrome type.

METHODSThe TCM syndrome type of 71 patients with "Chest-Bi" was differentiated before and after percutaneous coronary intervention (PCI) treatment, of which the most common syndrome types were qi deficiency, yang deficiency, yin deficiency, qi stagnation, blood stasis, phlegm, cold coagulation, heat-syndrome, etc.

RESULTSBefore PCI treatment, syndrome types of blood stasis (53 cases, 74.6%), qi deficiency (46 cases, 64.8%), and phlegm (28 cases, 39.4%) were the commonest, while there were 12 cases of qi stagnation (16.9%) and 12 cases of cold coagulation (16.9%); One week after PCI treatment, the most commonly seen types were blood stasis (47 cases, 66.2%), qi deficiency (39 cases, 54.9%) and phlegm (23 cases, 32.4%), while qi stagnation (2 cases, 2.8%) and cold coagulation (1 case, 1.4%) were also found; One month after PCI, qi deficiency (47 cases,85.4%), blood stasis (40 cases,72.7%), phlegm (31 cases, 56.4%) were the most commonly seen types. Comparison of the syndrome types between before and after PCI showed that the syndromes of qi deficiency and phlegm were progressively aggravating, while syndromes of qi stagnation and cold coagulation were alleviated after PCI.

CONCLUSIONAlthough PCI treatment could relieve patients' symptoms of excess in superficiality, it can't radically change the pathogenetic nature of CHD, namely, the deficiency in origin and excess in superficiality, which indicates that one should pay full attention to the importance and necessity of CHD after PCI treatment.

Adult ; Aged ; Aged, 80 and over ; Angina, Unstable ; diagnosis ; therapy ; Angioplasty, Balloon, Coronary ; Coronary Disease ; diagnosis ; therapy ; Diagnosis, Differential ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Myocardial Infarction ; diagnosis ; therapy ; Stents ; Syndrome

OBJECTIVETo investigate the effects of Liuweidihuang pills (LP) on visceral fat deposition in Otsuka Long-Evans Tokushima Fatty (OLETF) rats.

METHODSForty male OLETF rats were randomly divided into LP group and control group (n=20 per group), and 10 male Long-evans Tokushima Otsuka (LETO) rats were used as normal controls. The rats in LP group were given LP(2.4 mg/kg) daily by intragastric administration since the age of 8 weeks, and those in the other two groups were given water of the same volume by intragastric administration. Blood glucose of all the rats was determined by oral glucose tolerance test (OGTT) and visceral fat deposition examined after the rats were sacrificed.

RESULTSOLETF rats had obviously greater amount of visceral fat than LETO rats (P<0.05) and administration of LP ameliorated the increment of visceral fat deposition in this type 2 diabetic model, producing significant effect at the age of 40 weeks (P<0.01).

CONCLUSIONLP may effectively decrease visceral fat deposition in OLETF rats.

Animals ; Blood Glucose ; metabolism ; Diabetes Mellitus, Type 2 ; blood ; drug therapy ; pathology ; Drugs, Chinese Herbal ; therapeutic use ; Intra-Abdominal Fat ; drug effects ; pathology ; Male ; Obesity ; pathology ; prevention & control ; Phytotherapy ; Random Allocation ; Rats ; Rats, Inbred OLETF