The Clinical Randomized Controlled Trial on the Safety and Efficacy of Polyethersulfone Membrane Dialyzer in the Maintenance of Hemodialysis Patients

Objective： To observe the safety and efficacy of polyethersulfone membrane dialyzer used by chronic renal failure patients in clinical maintenance hemodialysis （MHD）. Methods： From January to February 2009, 36 patients were recruited from Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. The experiment was approved by the ethnical committee of Xinhua Hospital and under permissions fronl patients. All the patients were randomized into polyethersulfone group （PES, n=18） and polysulfone group （PS, n=18）. Hemodialysis was given by using Fresenius 4008S capacity-controlled dialyser and ultra-purified bicarbonate dialysate, more than 3.5 h each time, three times per-week, followed by heparin anticoagulation for a week, three times totally. Changes in blood urea nitrogen （BUN）, serum creatinine （Set）, phosphate （p2＋）, hemoglobin and albumin levels were determined for the efficacy and safety evahlation. Results： The serum BUN, Set and p2＋ concentrations significantly reduced after hemodialysis with different dialyzers, and the decrease amplitude of two groups was equivalent（P〉0.05）. The clearance rate of the serum BUN and Scr had no significant difference among two groups（P〉O.05）. The clearance rate （ml/min） of the sermn P^2＋ was 144.57 ±27.83 v.s. 117.15 ±22.77 in two groups. The clearance rate of the serum p^2＋ in PES group was more than that in PS group, and the difference was significant between two groups （P=0.0001）. It was indicated that PES and PS membrane could efficiently eliminate serum mieromolecule solute in MHD patients, so PES membrane excelled PS membrane in eliminating serum p2＋. The hemodialysis safety index, for example serum hemoglobin, albumin and blood pressure, had no significant difference between the two groups before and after hemodialysis （P〉0.05）. Conclusion： The efficacy and safety of the PES hollow fiber membrane dialyzer is equivalent to that of the imported PS membrane dialyzer in hemodialysis for MHD patients. The PES membrane excels PS membrane in eliminating sermn p^2＋.

Observation on clinical efficacy of acupuncture combined with direct moxibustion with fine-strip moxa for 62 cases of herpes zoster

Objective To evaluate the clinical effect of acupuncture combined with direct moxibustion with fine-strip moxa for herpes zoster. Methods Sixty-two patients with herpes zoster were randomly divided into two groups according to attendance number, 32 in acupuncture group and 30 in western medicine group. The patients in the acupuncture group were treated by acupuncture at the nidus-related nerve segments Jiaji （夹脊 EX-B2） in combination with direct moxibustion with fine-strip moxa, while the patients in the western medicine group were treated by oral valaciclovir hydrochloride, vitamin B1, vitamin B12. The times of response, incrustation and decrustation were observed respectively, and pain relief degree of the two groups were compared. Results The response time, incrustation time and decrustation time of the acupuncture group were all less than those of the western medicine group [（1.74±0.43） days vs （3.86±0.58） days, （2.03±0.52） days vs （5.46±0.65） days, （5.14±0.33） days vs （8.34±0.59） days, all P〈O.05]. The pain relief degree （VAS score）, and pain duration in the acupuncture group were all higher obviously than those of the western medicine group [（10.41±12.1） vs （15.63±11.39）, （4.78±0.45） days vs （8.12±0.63） days, all P〈O.05]. The total effective rate of the acupuncture group was 96.9% （31/32）and that of the western medicine group was 90% （27/30）, thus the therapeutic effect of acupuncture group was better than that of western medicine group （P〈0.05）. Conclusion The therapeutic effect of acupuncture combined with direct moxibustion with fine-strip moxa is remarkable. It can effectively control the development of herpes zoster, alleviate pain and shorten therapy periods. It is worthy to be promoted and applied.

Acupuncture therapy for angina pectoris:a systematic review

OBJECTIVE： To assess the effectiveness and safety of acupuncture therapy for angina pectoris. METHODS： Randomized controlled trials （RCTs） concerned with acupuncture treatment of angina pectoris were identified by searching Academic Source Premier, MEDLINE, Science Citation Index Expanded, and three Chinese databases （China biol- ogy medicine database, China national knowledge infrastructure, and VlP database for Chinese techni- cal periodicals）. The valid data were extracted in ac- cordance with our inclusion and exclusion criteria. The main outcomes of the included studies were synthesized using Revman 5.1. RESULTS： Twenty-one articles on 16 individual studies were included and evaluated as having high or moderate risk of bias according to the stan- dards of the Cochrane Collaboration. Meta-analysis indicated that acupuncture combined with conven- tional drugs （ACCD） was superior to conventional drugs alone in reducing the incidence of acute myocardial infarction （AMI） [0R=0.18, 95%CI （0.04,0.84）, P=0.03]. Moreover, ACCD was superior to con- ventional drugs in the relief of angina symptoms [0R=4.23, 95%C/（2.73, 6..56）, P〈0.00001], and im- provement of electrocardiography （ECG） [0R=2.61, 95%C/（1.83, 3.73）, P〈0.00001]. Acupuncture by it- self was also superior to conventional drugs for angi- na symptoms [0R=3.59, 95%C/（1.76, 7.92）, P=0.0004] and ECG improvement [0R=3.07, 95%C/（1.54, 6.10）, P=0.001]. ACCD was superior to conventional drugs in shortening the time to onset of angina relief [WMD=-1.40, 95% CI （-1.65, -1.15）, P〈 0.00001]. However, the time to onset was signifi- cantly longer for acupuncture treatment than for conventional treatment alone [WMD=2A3, 95%O （1.63, 3.23）, P〈0.000 01]. CONCLUSION： ACCD reduced the occurrence of AMI, and both acupuncture and ACCD relieved an- gina symptoms and improved ECG. However, com- pared with conventional treatment, acupuncture showed a longer delay before its onset of action. This indicates that acupuncture is not suitable for emergency treatment of heart attack. Owing to the poor quality of the current evidence, the findings of this systematic review need to be verified by more RCTs to enhance statistical power.

Electroacupuncture in Treating Depression:A Randomized Controlled Study

Objective: To observe the clinical efficacy of electroacupuncture in treating depression. Methods: By a randomized controlled study method, sixty patients with depression were randomized into an electroacupuncture group and a medication group, 30 in each. The electroacupuncture group was treated with electroacupuncture, and the medication group was orally administrated Paroxetine tablets. They were evaluated by using Hamilton Depression Scale (HAMD) before and after treatments and the safety was also assessed. Results: The total effective rate was 83.3% in the electroacupuncture group versus 60.0% in the medication group, and the difference was statistically significant (P<0.05). The electroacupuncture group was superior to the medication group in comparing the improvement of HAMD scores after treatment (P<0.05). Conclusion: Electroacupuncture is an effective approach in treating depression.

No Additional Cholesterol-Lowering Effect Observed in the Combined Treatment of Red Yeast Rice and Lactobacillus Casei in Hyperlipidemic Patients：A Double-Blind Randomized Controlled Clinical Trial

Objective：To observe the effect of combining red yeast rice and Lactobacillus casei（L.casei）in lowering cholesterol in patients with primary hyperlipidemia,the later has also been shown to remove cholesterol in in vitro studies.Methods：A double-blind clinical trial was conducted to evaluate the cholesterol-lowering effect of the combination of red yeast rice and L.casei.Sixty patients with primary hyperlipidemia were recruited and randomized equal y to either the treatment group（red yeast rice＋L.casei）or the control group（red yeast rice＋placebo）.One red yeast rice capsule and two L.casei capsules were taken twice a day.The treatment lasted for 8 weeks,with an extended follow-up period of 4 weeks.The primary endpoint was a difference of serum low-density lipoprotein cholesterol（LDL-C）level at week 8.Results：At week 8,the LDL-C serum level in both groups was lower than that at baseline,with a decrease of 33.85±26.66 mg/dL in the treatment group and 38.11±30.90 mg/dL in the control group;however,there was no statistical difference between the two groups（P〉0.05）.The total cholesterol was also lower than the baseline in both groups,yet without a statistical difference between the two groups.The only statistical y significant difference between the two groups was the average diastolic pressure at week 12,which dropped by 2.67 mm Hg in the treatment group and increased by 4.43 mm Hg in the placebo group（P〈0.05）.The antihypertensive activity may be associated with L.casei.Red yeast rice can significantly reduce LDL-C,total cholesterol and triglyceride.Conclusion：The combination of red yeast rice and L.casei did not have an additional effect on lipid profiles.