BACKGROUND: The effects of acupuncture have varied in different randomized controlled trials (RCTs), and there are many factors that influence treatment effect of acupuncture in different outcomes, with conflicting results. OBJECTIVE: To identify factors and their impact on the treatment effect of acupuncture in different outcomes. METHODS: Acupuncture RCTs were searched from 7 databases including Medline (PubMed), Embase, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang Database, VIP Database, and China Biology Medicine disc between January 1st, 2015 and December 31st, 2019. Eligible studies must compare acupuncture to no acupuncture, sham acupuncture, or waiting lists, and report at least 1 patient-important outcome. A multi-level meta-regression was conducted using a 3-level robust mixed model and univariate analyses were performed for all independent variables, even those excluded from the multivariable model due to collinearities. We used thresholds of 0.2 and 0.4 for the difference of standardized mean differences (SMDs), categorising them as small (<0.2), moderate (0.2-0.4), or large (>0.4) effects. RESULTS: The pain construct analysis involved 211 effect estimates from 153 studies and 14 independent variables. High-frequency acupuncture treatment sessions produced larger effects compared to low-frequency sessions [large magnitude, the difference of adjusted SMDs 0.46, 95% confidence interval (CI) 0.07 to 0.84; P=0.02]. The non-pain symptoms construct analysis comprised 323 effect estimates from 231 studies and 15 independent variables. Penetrating acupuncture showed moderately larger effects when compared to non-penetrating acupuncture (0.30, 95% CI 0.06 to 0.53; P=0.01). The function construct analysis included 495 effect estimates from 274 studies and 14 independent variables. Penetrating acupuncture and the flexible acupuncture regimen showed moderately larger effects, compared to non-penetrating acupuncture and fixed regimen, respectively (0.40, 95% CI 0 to 0.80; P=0.05; 0.29, 95% CI 0.06 to 0.53; P=0.01). CONCLUSIONS High-frequency acupuncture sessions appear to be a more effective approach to managing painful symptoms. Penetrating acupuncture demonstrated greater effect in relieving non-painful symptoms. Both penetrating acupuncture type and flexible acupuncture regimen were linked to significant treatment effects in function outcomes. Future studies should consider the factors that are significantly associated with the effects of acupuncture in patient-important outcomes.
Humans ; Randomized Controlled Trials as Topic ; Acupuncture Therapy/methods* ; Pain ; Pain Management ; China

Objective To investigate the application efficiency and potential of CT radiomics in differentiating malignant and benign sub-centimeter solid pulmonary nodules. Methods A retrospective study was performed on the sub-centimeter ( ≤ 10 mm) solid pulmonary nodules detected by enhanced CT in our hospital from March 2020 to January 2023. Malignancy was confirmed by surgical pathology, and benignity was confirmed by surgical pathology or follow-up. Lesions were manually segmented and radiomic features were extracted. The feature dimension was reduced via feature correlation analysis and least absolute shrinkage and selection operator (LASSO). The 5-fold cross validation was used to validate the model. Support vector machine, logistic regression, linear classification support vector machine, gradient boosting, and random forest models were established for CT radiomics. Receiver operating characteristic curves were drawn. Delong test was used to compare the diagnostic performance of the five classifiers. The optimal model was selected and compared to radiologists with medium and high seniority. Results A total of 303 nodules, 136 of which were malignant, were examined. Radiomics models were established after feature extraction and selection. On test set, the areas under the receiver operating characteristic curves of support vector machine, logistic regression, linear classification support vector machine, random forest, and gradient boosting models were 0.922 (95%CI: 0.893, 0.950), 0.910 (95%CI: 0.878, 0.942), 0.905 (95%CI: 0.872, 0.938), 0.899 (95%CI: 0.865, 0.933), and 0.896 (95%CI: 0.862, 0.930), respectively. Delong test indicated no significant differences in the performance of the five radiomics models, and the support vector machine model showed the highest accuracy and F1 score. The support vector machine model showed significantly higher diagnostic accuracy as compared to radiologists (83.8% vs. 55.4%, P < 0.001). Conclusion The radiomics models achieved high diagnostic efficiency and may help to reduce the uncertainty in diagnosis of malignant and benign sub-centimeter solid nodules by radiologists.

Objective To explore the influence of organizational support on the career satisfaction of doctors in public hospitals and the mediating effect of role stress.Methods Using the survey data of 523 public hospital doctors from 9 medical institutions in 4 places in 2022,OLS linear regression model was used to analyze the influence of organizational support on career satisfaction,and Bootstrap test was used to explore the mediating effect of role stress.Results Organizational support had a positive effect on the career satisfaction of doctors in public hospitals,and for every unit increase in organizational support score,career satisfaction score will increase by 0.528 points.And role stress had a negative effect on the career satisfaction of doctors in public hospitals.Conclusion Organizational managers should take measures to promote the positive impact of organizational support on doctors'career satisfaction in public hospitals,reduce doctors'role stress,and continuously improve their career satisfaction.

ObjectiveThe detection of RNA single nucleotide polymorphism (SNP) is of great importance due to their association with protein expression related to various diseases and drug responses. At present, splintR ligase-assisted methods are important approaches for RNA direct detection, but its specificity will be limited when the fidelity of ligases is not ideal. The aim of this study was to create a method to improve the specificity of splintR ligase for RNA detection. MethodsIn this study, a dual-competitive-padlock-probe (DCPLP) assay without the need for additional enzymes or reactions is proposed to improve specificity of splintR ligase ligation. To verify the method, we employed dual competitive padlock probe-mediated rolling circle amplification (DCPLP-RCA) to genotype the CYP2C9 gene. ResultsThe specificity was well improved through the competition and strand displacement of dual padlock probe, with an 83.26% reduction in nonspecific signal. By detecting synthetic RNA samples, the method demonstrated a dynamic detection range of 10 pmol/L-1 nmol/L. Furthermore, clinical samples were applied to the method to evaluate its performance, and the genotyping results were consistent with those obtained using the qPCR method. ConclusionThis study has successfully established a highly specific direct RNA SNP detection method, and provided a novel avenue for accurate identification of various types of RNAs.

The advantages of fluorescence detection of uric acid were introduced compared to the traditional detection methods.The preparation process,detection principle and performance of organic,inorganic and organic-inorganic hybrid fluorescent probes were reviewed.The advantages and disadvantages of kinds of fluorescent probes were analyzed when used for uric acid detection,and the futural directions were pointed out for related research.[Chinese Medical Equipment Journal,2024,45(6):93-104]

Objective To develop a GIS-based 3D playback system for the flight human-plane data to realize the fusion of pilots'airborne flight data and physiological data.Methods The 3D playback system was developed with the Browser/Server(B/S)architecture,micro-server model,Java language and Spring Cloud technology framework,which was composed of three functional modules for flight process reproduction,physiological situational awareness and critical event calibration analysis.Results The system developed achieved time synchronization and data fusion of airborne flight data and physiological data with a time synchronization frequency of 1 Hz and a refresh rate of not less than 120 frames/s.Conclusion The system developed with high safety,stability,reliability and accuracy facilitates pilot in-flight physiological monitoring and fusion and simultaneous display of airborne flight data and physiological data,which can be used as an important platform for decision-making support in flight training.[Chinese Medical Equipment Journal,2024,45(10):14-19]

Background and aim:Hepatic ischemia-reperfusion injury(IRI)is a significant challenge in liver trans-plantation,trauma,hypovolemic shock,and hepatectomy,with limited effective interventions available.This study aimed to investigate the role of leukocyte cell-derived chemotaxin 2(LECT2)in hepatic IRI and assess the therapeutic potential of Lect2-short hairpin RNA(shRNA)delivered through adeno-associated virus(AAV)vectors. Materials and methods:This study analyzed human liver and serum samples from five patients under-going the Pringle maneuver.Lect2-knockout and C57BL/6J mice were used.Hepatic IRI was induced by clamping the hepatic pedicle.Treatments included recombinant human LECT2(rLECT2)and AAV-Lect2-shRNA.LECT2 expression levels and serum biomarkers including alanine aminotransferase(ALT),aspartate aminotransferase(AST),creatinine,and blood urea nitrogen(BUN)were measured.Histological analysis of liver necrosis and quantitative reverse-transcription polymerase chain reaction were performed. Results:Serum and liver LECT2 levels were elevated during hepatic IRI.Serum LECT2 protein and mRNA levels increased post reperfusion.Lect2-knockout mice had reduced weight loss;hepatic necrosis;and serum ALT,AST,creatinine,and BUN levels.rLECT2 treatment exacerbated weight loss,hepatic necrosis,and serum biomarkers(ALT,AST,creatinine,and BUN).AAV-Lect2-shRNA treatment significantly reduced weight loss,hepatic necrosis,and serum biomarkers(ALT,AST,creatinine,and BUN),indicating thera-peutic potential. Conclusions:Elevated LECT2 levels during hepatic IRI increased liver damage.Genetic knockout or shRNA-mediated knockdown of Lect2 reduced liver damage,indicating its therapeutic potential.AAV-mediated Lect2-shRNA delivery mitigated hepatic IRI,offering a potential new treatment strategy to enhance clinical outcomes for patients undergoing liver-related surgeries or trauma.

Objective To explore clinical effect of closed reduction percutaneous elastic intramedullary nail assisted by arthrography in the treatment of radial neck fracture in children.Methods A retrospective analysis was performed on 23 chil-dren with radial neck fracture treated with arthrography assisted closed reduction and percutaneous elastic intramedullary nail internal fixation(arthrography with elastic nail group)from January 2019 to December 2022,including 12 males and 11 fe-males,aged from 2 to 12 years old with an average of(7.36±1.89)years old;According to Judet fracture types,14 children were type Ⅲ and 9 children were type Ⅳ.In addition,23 children with radial neck fracture were selected from January 2015 to December 2018 who were treated with closed reduction and percutaneous elastic intramedullary nail fixation(elastic nail group),including 11 males and 12 females,aged from 2 to 14 years old with an average of(7.50±1.91)years old;Judet classi-fication included 15 children were type Ⅲ and 8 children were type Ⅳ.Operative time and intraoperative fluoroscopy times were compared between two groups.Metaizeau evaluation criteria was used to evaluate fracture reduction,and Tibone-Stoltz evaluation criteria was used to evaluate functional recovery of elbow between two groups.Results Both groups were followed up for 12 to 24 months with an average of(16.56±6.34)months.Operative time and intraoperative fluoroscopy times of elastic nail group were(56.64±19.27)min and(21.13±7.87)times,while those of joint angiography with elastic nail group were(40.33±1 1.50)min and(12.10±3.52)times;there were difference between two groups(P＜0.05).According to Metaizeau evaluation,11 patients got excellent result,9 good and 3 fair in joint angiography with elastic nail group,while in elastic nail group,5 ex-cellent,13 good,4 acceptable,and 1 poor;the difference between two groups was statistically significant(P＜0.05).According to Tibone-Stoltz criteria,14 patients got excellent result,8 good,and 1 fair in joint arthrography with elastic nail group;while in elastic nail group,12 patients got excellent result,9 good,1 fair and 1 poor;there was no significant difference between two groups(P＞0.05).Conclusion Compared to percutaneous elastic intramedullary nail fixation,closed reduction assisted by arthrography has advantages of reduced operation time,decreased intraoperative fluoroscopy frequency,and improved fracture reduction.Arthrography enables clear visualization of the anatomical structures of radius,head,neck,bone,and cartilage in children,facilitating comprehensive display of fracture reduction and brachioradial joint alignment.This technique more pre-cisely guides the depth of elastic intramedullary nail implantation in radius neck,thereby enhancing surgical efficiency and success rate.

Objective To investigate the value of optical coherence tomography(OCT)in predicting the risk of major adverse cardiovascular events(MACE)in patients of acute coronary syndrome(ACS).Methods Four hundred and forth-eight ACS patients admitted to the First Affiliated Hospital of Xinjiang Medical University who underwent percutaneous coronary intervention(PCI)and OCT from February 2015 to February 2022 were selected as the study subjects.We found 749 non-culprit coronary lesions.And follow up the patients,median follow-up was 5 years[interquartile interval(IQR):3-7 years].Kaplan-meier was used to estimate the cumulative incidence of MACE,multivariate Cox regression was used to analyze the risk of MACE with OCT parameters non-culprit coronary lesions,and receiver operating characteristic(ROC)curve was used to evaluate the predictive value of OCT parameters for MACE in non-culprit coronary lesions.Results A total of 749 non-culprit coronary lesions were detected,and 41 MACE cases were caused by non-culprit coronary lesions imaged by OCT.Compared with plaques without thin-cap fibroatheroma(TCFA)and minimal lumen area(MLA)＜3.5 mm2,the incidence of MACE was significantly associated with vulnerable plaques with TCFA and MLA＜3.5 mm2(33％vs.3％,HR 13.62,95％CI 6.71-27.65,P＜0.001).Multivariate Cox regression analysis showed that larger maximum lipid arc(HR 1.02,95％CI 1.01-1.03,P＜0.001),smaller maximum lipid cap thickness(HR 0.97,95％CI 0.96-0.99,P＜0.001)and MLA(HR 0.31,95％CI 0.18-0.55,P＜0.001)were independent risk factors for MACE.The area under ROC curve(AUC)of the thinnest fiber cap thickness for predicting MACE occurrence was 0.858(95％CI 0.802-0.913),and the optimal cutoff value was 66.5 μm.The AUC of maximum lipid arc for predicting MACE occurrence was 0.853(95％CI 0.786-0.920),and the optimal cut-off value was 180.35°.The AUC of MLA for predicting MACE was 0.821(95％CI 0.766-0.876),and the optimal cutoff was 3.575 mm2.Conclusions The non-culprit coronary lesions with TCFA and MLA＜3.5 mm2 were significantly associated with an increased risk of subsequent MACE development at the lesion level,and OCT imaging helps early identification of the risk of MACE development in non-culprit coronary lesions in patients of ACS.

Objective To objectively evaluate the clinical efficacy and safety of acupuncture in regulating the mood of patients with post-stroke depression(PSD)and explore the possible target of acupuncture intervention.Methods 76 patients with PSD were randomly divided into treatment group and control group.The control group was treated with routine treatment measures for stroke,and the treatment group was treated with acupuncture on this basis.The main acupoints were Shangxing,Baihui,Shenting,Fengchi and Dugu,supplemented by acupuncture on Taichong,Hegu,Quchi,Neiguan,Yanglingquan,Zusanli and Taixi,5 times a week,continuously treated for 4 weeks,followed up on the 90th day after treatment.The levels of serum 5-hydroxytryptamine,norepinephrine and intestinal microflora before and after treatment were compared with the 17 Hamilton Depression Scale scores(HAMD),modified Barthel Index(MBI),and the levels of serum 5-hydroxytryptamine and norepinephrine before and after treatment.Results The HAMD score and MBI index of the two groups after treatment and follow-up were lower than those before treatment.The levels of 5-hydroxytryptamine and norepinephrine in the treatment group after treatment were higher than those before treatment(P<0.01),and significantly higher than those in the control group(P<0.01).After acupuncture,the dominant bacterial groups of Bacteroides,Thick-wall bacteria and Broughter bacteria in patients showed an upward trend(P>0.05).The difference of bacteria before and after treatment was mainly concentrated in signal pathways such as ECM-receptor interaction,and the difference was statistically significant(P<0.01).Conclusion Acupuncture can help patients improve their ability of daily living,and also improve the relative abundance of intestinal flora in PSD patients to a certain extent,so as to regulate the levels of 5-HT and NE to relieve the depression of patients,which is worthy of promotion in clinical practice.