Systematic evaluation and trial sequential analysis of warming acupuncture combined with joint mobilization in the treatment of scapulohumeral periarthritis

Objective:To evaluate the clinical efficacy of warming acupuncture combined with joint mobilization for the treatment of scapulohumeral periarthritis.Methods:A search for published randomized controlled trials(RCT)investigating warming acupuncture combined with joint mobilization for the treatment of scapulohumeral periarthritis was performed using the Cochrane Library,PubMed,Embase,and Web of Science databases.According to requirements of the Cochrane systematic review,all evaluations of RCT investigating warming acupuncture with joint mobilization in the treatment of scapulohumeral periarthritis were performed via method quality assessment,data extraction,and data analysis.Revman 5.3 and Stata 12.0 statistical software were used for the meta-analysis,and the trial sequential analysis(TSA)software estimated the required information size for each outcome.Results:A total of 14 articles were retrieved for meta-analysis,which included 551 cases in the treatment group and 539 cases in the control group.Meta-analysis showed that:(1)warming acupuncture combined with joint mobilization improved total efficiency[OR=6.16,95%CI(3.79,10.00),Z=7.34;P<0.001),TSA results confirmed the results of the meta-analysis;(2)warming acupuncture combined with joint mobilization improved the cure rate[OR=2.84,95%CI(2.19,3.70),P<0.001],TSA results revealed that no further tests were needed to verify;(3)warming acupuncture combined with joint mobilization reduced the number of treatments required for healing[MD=-7.49,95%CI(-9.75,-5.23),P<0.001],TSA results confirmed the results of the meta-analysis;(4)in comparing visual analog scale scores before and after treatment,meta-analysis result showed that:SMD=-2.01,95%CI(-2.37,-1.65),P<0.001,the difference was statistically significant,TSA results confirmed the results of the meta-analysis.Conclusion:Warming acupuncture combined with joint mobilization had a significant effect on the treatment of scapulohumeral periarthritis.

Practice and considerations on the integrated respiratory system course

The system-based integrated curriculum teaching is a mainstream trend of curriculum reform at medical schools both at home and abroad.Since 2009,Shanghai Jiao Tong University School of Medicine has implemented the integrated teaching reform with modules classified by organ systems.This paper takes the integrated respiratory system course as an example,reviews and explores the outcomes and existing problems during the teaching reform practice,so as to lay a foundation for comprehensive and efficient implementation of the system-based integrated teaching,improve the teaching quality,and cultivate high level excellent medical talents.