Objective To systematically evaluate the effect of occupational protection education towards needle stick injuries among nursing students in China. Methods A computerized literature searching was carried out from October 2002 to October 2012 in following databases: PubMed, CNKI, WanFang Data and VIP, so as to collect all controlled studies about the effects of preventing needle stick injuries between students who had occupational protection education and those who had not. Two reviewers independently screened the studies according to the inclusive and exclusive criteria, extracted the data, and assessed the quality. Then RevMan 5.0 software was used for meta-analysis. Results A total of 10 studies involving 2 197 nursing students were included. Ten studies indicated that protection education could reduce the incidence of needle stick injuries by 33%; 3 studies indicated that protection education could increase the awareness rate of protective knowledge by 52%; and 4 studies indicated that protection education could increase the correct treatment rate after injuries by 61%. Conclusion Occupational protection education before internship is effective to prevent needle stick injuries among nursing students. However, because of the limitation of this study, more high quality studies are needed to further confirm its effectiveness and to provide targeted advices for formulating preventive measures.
Based on the conclusion of recent clinical research conducted by foreign countries, there is no statistical difference in outcomes between real and placebo acupuncture. This paper analyzes the weaknesses of methods currently being used by foreign countries to compare the effects of real and placebo acupuncture, striving for a new way to test for the placebo effect; a way that is more scientific, more suitable for the current conditions of China, while at the same time capable of being recognized internationally. This paper describes a new acupuncture placebo-controlled method. Under the condition of complete patient trust, we may ensure an ideal placebo effect to the greatest extent by minimizing the potential curative effects in the placebo group. From the actual clinical practice, by randomized controlled trial comparing acupuncture and medicine, using the concept as the double-dummy clinical trail, this paper explores the “double-dummy – non-specific sites – random sampling” method in the clinical setting as a way to form a new acupuncture clinical research model of comparison between acupuncture and medicine.
目的:观察手法复位配合针刺治疗腰椎间盘突出症的疗效。方法:将239例确诊为腰椎间盘突出症的患者随机分为治疗组和对照组，其中治疗组120例，采用手法复位配合针刺治疗，对照组119例，采用针刺治疗。并分别观察两组患者症状评分变化和疗程。结果:治疗组总显效率85.83%，对照组72.27%（Plt;0.05）。治疗组痊愈率53.33%，对照组36.13%（Plt;0.05）。治疗组显效病例，达到显效时所需的治疗时间为12.60±3.39天，对照组为16.85±4.15天（Plt;0.05）。结论:手法复位配合针刺治疗腰椎间盘突出症优于针刺治疗。
目的 评价B超引导下核心针活检术（CNB）对不可触及的乳腺病变（NPBL）的诊断价值。方法 采用18G Tru-cut针结合活检枪对88例患者的96个NPBL行B超引导下CNB，并与切除活检病理结果比较。结果 NPBL大小4～23mm（平均13.1mm）。在CNB中，86个为良性，2个为可疑恶性，6个为恶性，2个取材不良。在切除活检中9个为恶性，87个为良性。CNB可疑恶变的2个NPBL均为恶性，1个恶性NPBL误诊为乳腺腺病，取材不良的2个NPBL均为良性。本组NPBL中恶性病变占9.38%（9/96），B超引导下CNB对NPBL的良恶性诊断正确率为98.94%（93/94），诊断乳腺癌的敏感性为88.89%（8/9），特异性为100%（8/8），良性病变的病理诊断符合率为97.70%（85/87），取材不良为2.08%（2/96）。结论 B超引导下CNB对NPBL的诊断具有较高的敏感性和特异性，结果准确可靠。
Objective To assess the quality of randomized controlled trials (RCTs) on acupuncture for treating acute migraine attacks. Methods With the searching terms of acupuncture and migraine, the Cochrane Controlled Trials Register (CCTR), PubMed, MEDLINE, EMbase, CBM, CMCC, CNKI and VIP were searched. The reports quality of the included trials, including the quality of methodology, diagnostic criteria, inclusion/exclusion criteria, acupuncture/control interventions, outcome measures, observing time, and adverse effects reports, was evaluated. Results A total 23 RCTs involving 2645 patients were included, of which only 3 RCTs were of high quality with Jadad scores equal to or more than 4. At present, only a few high quality trials on treating acute attacks of migraine with acupuncture had been reported at home and abroad. The international recognized diagnostic criteria and common evaluation methods had not been used generally, and the design of control was kind of irrational. Conclusion Based on current clinical reports, acupuncture may be effective in the management of acute migraine attacks, but some relevant proof is still required. The further domestic studies should be designed strictly following the international recommended diagnosis and evaluation criteria of migraine, and rational control methods as well.
The use of placebo controls in acupuncture trials has been an international concern for many years. We discussed some common problems in placebo controls and introduced four kinds of control methods (sham acupuncture, non-points acupuncture, minimal acupuncture and non-specific sites acupuncture). For sham acupuncture, non-points acupuncture and non-specific sites acupuncture, patients who have received acupuncture are liable to doubt the intervention they are taking. Minimal acupuncture has better reliability but is limited to use in many diseases for its physiological effect. Needling on some special parts of the body, for example, head and back side of the body, can make balance among factors as reliability, physiological effect and feasibility. This paper recommends a control method needling special parts according to the tradiontional acupuncture theory, which provides references for acupuncture clinical trials.
Objective To assess the efficacy and safety of acupuncture for patients with hiccups after stroke. Methods The randomized controlled trials (RCTs) of acupuncture for patients with hiccups after stroke were collected by searching PubMed, The Cochrane Library, CNKI, VIP, and WangFang databases. The quality of the included studies was evaluated and the data were retrieved according to the methods recommended by the Cochrane Collaboration. Meta-analyses were conducted by using RevMan software. Results Three trials involving 143 patients were included. All of them were open-label controlled without observing the effective rate and mortality rate (or dependence rate) at the end of follow-up visit lasting for at least three months. The result of meta-analyses showed that the group of acupuncture plus drug was more effective for hiccup after stroke than the drug group at the end of the treatment, and the difference was significant (OR=9.05, 95%CI 3.17 to 25.82, Plt;0.000 01). The three studies did not report any adverse reactions. Conclusion Although the acupuncture has the short-term improvement trend without adverse events for hiccups after stroke, the confirmed conclusion of long-term effectiveness has not yet been reached because both the methodological quality and the quantity of all included studies are poor, and especially the long-term outcome measures are insufficient. There is no enough evidence to recommend acupuncture as a routine treatment for hiccups after stroke. So more high-quality multi-center RCTs in large scale are required.
“针刺临床试验干预措施报告标准”（Standards，for Reporting Interventions in Clinical Trials of Acupuncture，STRICTA）于2001年和2002年在5种期刊上发表。该指南以对照试验检查清单及解释的形式供作者和期刊编辑使用，旨在提高针刺临床试验报告的质量，尤其是对其中干预措施的报告，因而有助于对这些试验的解释和重复。随后对STRICTA的应用及影响的述评都强调了STRICTA的价值，也提出了改进和修订的建议。 为使修订过程顺利进地，STRICTA工作组、CONSORT工作组和中国Cochrane中心于2008年开始合作，召集成立的包含47名成员的专家小组对清单的修改稿提出了电子版反馈意见。在后来于弗莱堡（Freiburg）召开的见面会上，由21名专家组成的工作组进一步修订了STRICTA对照检查清单，并计划如何对其进行发布。 新的STRICTA对照检查清单作为CONSORT的正式扩展版，包含6项条目及17条二级条目。这些条目为报告针刺治疗的合理性、针刺的细节、治疗方案、其他干预措施、治疗师的背景以及对照或对照干预提供了指南。而且，作为修订工作的一部分，对每一条目作了详尽解释，并针对每一条目给出了良好报告的实例。此外，STRICTA中的“对照”（controlled）一词被替换成了“临床”（clinical），以示STRICTA适用于更广泛的各类临床评价设计，包括非对照结局研究和病例报道。修订的STRICTA对照检查清单有望与CONSORT声明及其非药物治疗扩展版一起共同提高针刺临床试验的报告质量。
Objective To compare the effectiveness of P6 stimulation and sham stimulation/ drug intervention on prevention of postoperative nausea and vomiting (PONV). Methods We searched PubMed (1990 to 2010), OVID (1990 to 2010), EBSCO (1990 to 2010), The Cochrane Library (1996 to 2010), PNAI (1990 to 2010), Hight Wirepres (1990 to 2010), and Chinese Digital Hospital Library (www.chkd.cnki.net) (1999 to 2010) to identify randomized controlled trials (RCTs) about P6 stimulation and sham stimulation/drug intervention on prevention of PONV. The methodological quality of the included studies was assessed and the data was extracted according to the Cochrane Reviewer’s Handbook 4.2.2. Meta-analyses were performed using RevMan 4.2 software. Results A total of 21 studies were included. The results of meta-analyses indicated that: (1) Compared with sham stimulation, P6 stimulation could be effective in preventing postoperative nausea (beginning to termination) (Plt;0.000 01), postoperative early nausea (lt;after surgery 6 h) (P=0.000 6) and postoperative late nausea (gt;after surgery 6 h) (P=0.001). (2) Compared with sham stimulation, P6 stimulation could be effective in preventing postoperative vomiting (beginning to termination) (Plt;0.0.000 1) and postoperative early vomiting (P=0.002), but as to postoperative late vomiting (gt;after surgery 6 h), P6 stimulation had no effective preventive effect (P=0.08). (3) Compared with the drug intervention, P6 stimulation had little effect on preventing postoperative nausea (P=0.29) and vomiting (P=0.15). Conclusion Compared with sham stimulation, P6 stimulation can be effective in preventing postoperative early nausea and vomiting as well as postoperative late nausea, but not effective in preventing postoperative late vomiting. In comparison with drugs, a large number of clinical trials are needed to prove P6 stimulation can replace drugs to prevent postoperative nausea and vomiting.