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 effects of application of laparoscopic simulators in teaching of plastic surgery. Methods 10 plastic surgeons and 20 standardized training surgical residents with 2 to 4 years' experience were tested about their proficiency in moving beans, pinching, suturing and tying by timing and counting. After they were trained with laparoscopic simulators 3, 6, 9 times with each time for 90 min, tests were taken. SPSS 19.0 was used to make single factor variance analysis of the related data or conduct q test. Result There was significant difference before and after the residents' training of moving beans, pinching, suturing and tying (P<0.05). Less time to finish the operation was needed after training, but after training for 6 times or 9 times, there was no significant difference in operation time (P >0.05). Conclusion Application of laparoscopic simulator training can significantly improve the operation skills of the novices with some clinical experience in the short term, which is conducive to the endoscope assisted breast augmentation surgery, and is worthy of promotion.

Objective To research application of quality control circle activity in the treatment of infantile pneumonia by aerosol inhalation. Methods Carry out the quality control circle activity with the theme of "improving the efficiency of the oxidation atomization inhalation", using the method of PDCA cycle, statistics of inhalation of children, analyze the reasons for the failure of atomization inhalation, set up the improvement target, make the countermeasure and organize the implementation. Then clinical symptoms (the time of evacuation, the time of lung rale disappearance and the time of fever suppression ), hospitalization time, Heart failure rate, nosocomial infection rate, recurrence rate, compliance, satisfaction degree, treatment effect were compared two groups of quality control circle activities before and after. Results After implementation, children with wheeze disappearance time, pulmonary rales disappeared time, cooling time, hospitalization time were significantly lower than the before implementation, the difference was statistically significant(P<0.05); Incidence of heart failure, nosocomial infection rate, recurrence rate were significantly lower than the before implementation, the difference was statistically significant(P<0.05), compliance were significantly higher than the before implementation, the difference was statistically significant(P<0.05); Nursing satisfaction were significantly higher than the before implementation, the difference was statistically significant(P<0.05); total effective rate were significantly higher than the before implementation, the difference was statistically significant(P<0.05). Conclusion Quality control circle activity can achieve satisfactory results in the treatment of children's pneumonia by aerosol inhalation, can reduce the occurrence of adverse events, is conducive to the prognosis of children, so as to improve treatment efficacy and satisfaction.

To study the transport mechanisms of drugs for transplacental treatment of fetal tachyarrhythmia, MDCKII-BCRP and MDCKII cell models was used. MDCKII-BCRP and MDCKII cell monolayer model was used to investigate the bi-direction transport of sotalol, propranolol, propafenone, procainamide and flecainide. Drug concentrations were measured by HPLC-UV or chemiluminescence. The apparent permeability coefficient (P(app)), efflux rate (R(E)) and net efflux rate (R(net)) were calculated. Drugs with R(net) greater than 1.5 were further investigated using cellular accumulation experiments with or without a BCRP inhibitor. The R(net) of sotalol, propranolol, propafenone and procainamide were less than 1.5, while R(net) of flecainide with concentrations of 20 and 5 μmol x L(-1) were 1.6 and 1.9, respectively. The results showed that the transport of flecainide on MDCKII-BCRP cell monolayer could be mediated by BCRP; and the affinity increased when the concentration of flecainide decreased. Cellular accumulation experiments further suggested that accumulation of flecainide in MDCKII-BCRP cells was significantly lower than that in MDCKII cells in a concentration-dependent manner. BCRP inhibitor quercetin (50 μmol x L(-1)) significantly increased the accumulation of flecainide in MDCKII-BCRP cells (P < 0.05). Our preliminary data showed that flecainide but not sotalol, propranolol, propafenone or procainamide can be a substrate of BCRP. Thus the effect of flecainide may be affected by the BCRP in the maternal placental trophoblast membrane layer when treating fetal tachyarrhythmia.
Animals ; Biological Transport ; Cell Membrane Permeability ; Dogs ; Female ; Flecainide ; metabolism ; Madin Darby Canine Kidney Cells ; metabolism ; Placenta ; physiology ; Pregnancy ; Tachycardia ; drug therapy

HER2, a member of epidermal growth factor receptor family proteins, is overexpressed in about 30% of human breast cancer. Increased levels of HER2 are associated with poor patient prognosis and enhanced metastasis. RNA interference (RNAi) is developed recently as a new technique which can inhibit gene expression specifically in mammalian cells. On the basis of previous study,in which two target sequences with favorable RNAi effect on HER2 were identified, a series of dual promoter siRNA-expressing vectors containing two opposing U6 and H1 promoters were constructed. After transfection of HER2-overexpressing SKBR3 breast cancer cells with the siRNA-expressing vectors, downregulation of HER2 was identified quantitatively. Subsequently, the siRNA-expressing cassettes were subcloned into lentiviral vectors by LR recombination reaction and lentivirus was prepared successfully. The results from infection of SKBR3 cells with siRNA-expressing lentivirus demonstrated that lentiviral-mediated RNAi could downregulate HER2 expression efficiently through fluorescent quantitative PCR (FQ-PCR), western blot, and FACS analysis. Furthermore, cell growth was inhibited in cell proliferation assay after treatment with siRNA lentivirus.A new tool for clarifying the function of HER2 in cancer metastasis and developing the gene therapy drug was offered.

Objective: To observe the influence of sot alol on the QT dispersion in patients with atrioventricular accessory pathways u nderwent radiofrequency catheter ablation (RFCA). Methods: Thirt y-six patients were divided into 2 groups by random. One was the drug group(18 cases) treated by RFCA， and sotalol 160 mg was orally administered and intracar diac electrophysiological study was performed every 30 min for 5 times. Th e other group(control group, 18 cases) only treated by RFCA.QTd,QTcd and QTLcd w ere measured before and after RFCA. Results: There was no signif icant difference with QT dispersion before and after RFCA in control group. When compared with before RFCA, QTd in patients administered sotalol was (30.9 ±14.3) ms vs (24.7±9.6) ms; QTcd(33.7±17.1) ms vs (25.2±10.1) ms; QT Lcd(30.8±14.1)ms vs (25.6±19.4) ms (P<0.05). Conclusion: Sotalol can slightly lower QT dispersion, which is beneficial for preventing malignant ventricular arrthythmia. It is safe in RFCA in pateints with accessory pathway.

Objective:To observe the influence of radiofrequency catheter ablation of the fat pad at the right pulmonary vein- atria junction(RPV fat pad)on Bezold-Jarisch reflex(BJR)induced by veratridine in canine.Methods:Ten mongrel dogs were anesthetized and their chest were opened through a right thoracotomy to expose the RPV fat pad.Veratridine was injected into the left ventricle at bolus doses of 10?g/kg through a catheter to induce BJR.The sinus cycle length(SCL),systolic arterial pressure(SAP),diastolic arterial pressure(DAP),mean arterial pressure(MAP),left ventricle systolic pressure(LVSP), left ventricle diastolic pressure(LVDP)and mean left ventricle pressure(MLVP)were measured under the baseline and after ablation of the RPV fat pad;the changes of the above parameters(?SCL,?SAP,?DAP,?MAP,?LVSP,?LVDP,and?MLVP)were calculated.Then the same dose of veratridine was injected under the pad after ablation and the changes of the a- bove parameters were observed.Results:BJR was successfully induced in the 8 animals;the animals has prolonged sinus cycle length(SCL)and decreased MAP and MLVP.After ablation,the prolongation of SCL after injection of veratridine was markedly reduced([229.2?92.3]ms vs[39.3?14.1]ms,P

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Coronary Disease ; therapy ; Humans ; Male ; Middle Aged

This study was aimed to detect the expression of CD4(+)CD25(+) regulatory T cells (Treg), sFas and sFasL in patients with autoimmune thrombocytopenic purpura (AITP), and to explore their roles in the pathogenesis of AITP and clinical significance, so as to provide a theoretical basis for effective treatment for AITP. The expressions of CD4(+)T, Treg, CD4(+)CD25(-)T, Treg/CD4(+)T in peripheral blood of 30 the patients with AITP and 18 controls were detected by flow cytometry, and enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of sFas and sFasL in peripheral blood of controls and the patients with AITP before and after treatment. The results indicated that the expression rate of CD4(+)T in AITP patients was lower than that in the control (p < 0.05), and the expression rates of Treg and Treg/CD4(+)T were significantly lower than those of control (p < 0.01), but the expression rate of Treg between the two group had no difference (p > 0.05). The levels of sFas and sFasL in the peripheral blood of the patients before treatment were significantly higher than that after treatment and control group (p < 0.01), and no difference between the patients after treatment and the control group (p > 0.05) was found. The expression rates of Treg, Treg/CD4(+)T were positively related with the platelet count and the level of sFas was positively related with the level of sFasL in the peripheral blood of AITP before treatment. There were no significant correlation between the levels of CD4(+)T, Treg, sFas, sFasL and the platelet count. No correlation was seen between the expression of Treg and sFas, sFasL. It is concluded that CD4(+)CD25(+) Treg play a role in the pathogenesis of AITP; the expression rate of Treg is associated with the severity of AITP; the abnormal levels of sFas and sFasL participate in the immune pathogenesis of AITP.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Case-Control Studies ; Fas Ligand Protein ; blood ; Female ; Humans ; Male ; Middle Aged ; Purpura, Thrombocytopenic, Idiopathic ; blood ; T-Lymphocytes, Regulatory ; metabolism ; Young Adult ; fas Receptor ; blood

OBJECTIVE: To investigate the occurring mechanism and clinical characteristics of severe acute pancreatitis (SAP) associated with hypoalbuminemia in early stage and its influence on prognosis of SAP and the preventive and therapeutic management of this disease. METHODS: One hundred and thirty-eight cases diagnosed as SAP complicated by hypoalbuminemia in early stage were accepted in our hospital from August 1, 2003 to December 31, 2004, and they were divided into 2 groups according to the level of plasma albumin: mild hypoalbuminemia (30 to 35 g/L) group and severe hypoalbuminemia (<30 g/L) group. The complications in the early stage, related parameters, and the incidence rate of infection and mortality in the later stage were evaluated respectively. RESULTS: The incidence rates of renal dysfunction, shock, cardiovascular failure and gastrointestinal hemorrhage, the score of acute physiology and chronic health evaluation II (APACHE II ) and the frequencies of pulse and breath in the severe hypoalbuminemia group were all higher than those in the mild hypoalbuminemia group (P<0.05 or P<0.01). The differences of incidence rate of hepatic failure and the scores of Ranson and Balthazar CT between these two groups had no statistical significance (P>0.05). The incidence rate of infection and the mortality in the severe hypoalbuminemia group were higher than those in the mild hypoalbuminemia group (P<0.01) in the later stage of SAP. CONCLUSION: Hypoalbuminemia in the early stage can accelerate the deterioration in pathophysiology of SAP. The lower level of the plasma albumin is in the early stage, the more complications and the higher incidence rate of infection and mortality will be in the later stage. To relieve the extent of systemic inflammatory response syndrome (SIRS) and abundant supplement of albumin, amino acid and lipid in time may be crucial to prevent the occurrence and deterioration of hypoalbuminemia.