针灸治疗类风湿关节炎的系统评价再评价

目的:对针灸治疗类风湿关节炎的Meta分析/系统评价进行再评价。方法:计算机检索中国知网(CNKI)、万方(Wanfang)、维普(VIP)、Pubmed、Cochrane Library等数据库发表的有关针灸治疗类风湿关节炎的系统评价,检索时间为数据库建立至2019年12月,并用AMSTAR量表和GRADE pro软件分别对纳入研究进行方法学质量和证据等级评价。结果:最终纳入14个研究,AMSTAR评分在5~10分,质量中等,GRADE证据等级偏低。针灸治疗类风湿关节炎总有效率优于对照组,但在晨僵、关节肿胀、视觉模拟评分法评分、类风湿因子、红细胞沉降率、C-反应蛋白等结局指标方面未见明显优势。结论:针灸治疗类风湿关节炎的Meta分析方法学质量中等以及证据等级质量偏低,但是综合近年来该方面的研究进展,推介针灸作为一种补充替代疗法改善类风湿关节炎患者的临床症状,值得尝试。

肺切除患者术后不留置导尿管安全性和可行性的Meta分析

探讨肺切除术后不留置导尿管(No Urinary Catheter ,NUC)的安全性和可行性。方法 计算机检索 PubMed、EMbase、the Cochrane Library、Web of Science、中国知网、维普和万方数据库,搜集关于肺切除术后不留置导尿管的研究,检索时限均为从建库至 2022年1月。由 2名评价员独立筛选文献、提取资料和评价纳入研究的质量,采用 RevMan 5.4 软件进行 Meta 分析。结果 最终纳入 13项研究,括7项 RCT 和6 项队列研究,共计3918 例患者,其中术后不留置导尿管组(No Urinary Catheter ,NUC)患者 1552 例、留置导尿管(Urinary Catheter Placement,UCP)组2366 例。结果 两组术后尿潴留发生率差异无统计学意义[OR=0.87,95% CI(0.70,1.08),P=0.21];NUC组的患者尿路感染发生率低于UCP组[OR=1.88,95% CI(1.47,2.41),P<0.01];NUC 组的患者尿路刺激发生率低于UCP组[OR=3.91,95% CI(2.53,6.03),P<0.01];NUC组的患者自我报告舒适度高于UCP组[OR=6.29,95% CI(4.12,9.61),P<0.01];NUC组患者早期下床时间明显短于UCP组[SMD=3.75,95% CI(2.53,4.97),P<0.01];NUC组患者住院时间明显短于UCP组[SMD=1.44,95% CI(0.37,2.51),P<0.01]。结论 对于满足条件的肺切除患者,术后不留置导尿管是可行和安全的。

Evaluation model for freeway incident management system

In order to evaluate the general situation and find special problems of the freeway incident management system, an evaluation model is proposed. First, the expert appraisal approach is used to select the primary evaluation index. As a result, 81 indices and the hierarchical structures of the index such as the object layer, the sub-object layer, the criterion layer and the index layer are determined. Then, based on the fuzzy characteristics of each index layer, the analytical hierarchy process（AHP）and the fuzzy comprehensive evaluation are applied to generate the weight and the satisfaction of the index and the criterion layers. When analyzing the relationship between the sub-object layer and the object layer, it is easy to find that the number of sub-objects is too large and sub-objects are significantly redundant. The partial least square （PLS） is proposed to solve the problems. Finally, an application example, whose result has already been accepted and employed as the indication of a new project in improving incident management, is introduced and the result verifies the feasibility and efficiency of the model.

Correlation Between Helicobacter pylori Infection and Tongue Manifestations:A Meta-analysis

Objective To analyze the relationship between Helicobacter pylori(H.pylori)infection and the manifestations of the tongue.Methods Without language restrictions,we searched databases including CAJD,CBMdisc,CDFD,CMFD,PubMed,Cochrane,and EMBASE and made meta-analysis for all literature we have collected.Results Six studies with 975 patients and 50 healthy people in total were included in the analytic pool.There were significant differences in the numbers of H.pylori infections between patients with thin and thick tongue coatings(OR=2.02,95%CI 1.32–3.07,P=0.001).In yellow tongue subgroup,there was a significant difference between patients with thick and thin coatings(OR=2.09,95%CI 1.16–3.77,P=0.01).There was a significant difference in the prevalence of H.pylori infection between patients with yellow and white coatings(OR=2.86,95%CI 2.10–3.90,P<0.001).The frequency of H.pylori infection was significantly increased in patients with red and purple tongues compared with those with pale red tongues(OR=3.42,95%CI 2.40–4.88,P<0.001;OR=7.51,95%CI 3.57–15.79,P<0.001).Conclusion Red or purple tongues and yellow tongues with thick coatings are indicators of a risk of H.pylori infection in patients with GI symptoms.Our study shows that tongue manifestations could serve as a feasible predictor of H.pylori infection in patients with GI symptoms,and determination of the exact association between tongue manifestations and H.pylori infection could enable an understanding of the objectivity of TCM.Long-term and rigorous controlled trials are needed in the future to evaluate the correlating factors.

Jinhuang powder for the treatment of diabetic foot ulcers:an updated metaanalysis with power analysis and trial sequential analysis

Background:Traditional Chinese Medicines(TCM)had been indicated to benefit for the chronic non-infectious diseases,such as cancers,hypertension,primary dysmenorrheal,etc.Although randomized controlled trials(RCTs)had been conducted,there was still the controversy on the efficacy of Jinhuang powder for diabetic foot ulcers(DFUs).Objective:This systematic review aimed to objectively evaluate the potential of Jinhuang powder for DFUs.Methods:Seven databases(CNKI,Chongqing VIP,Wanfang database,CBM,the Cochrane Library,PubMed and Web of Science)were searched to retrieve RCTs up to December,2016;and the relevant references of the eligible studies were screened.According to the eligible criteria,the literature was screened;data were extracted;and then the methodological quality was assessed.The meta-analysis,power analysis and trial sequential analysis(TSA)were performed by using Meta analyst software(version beta 3.13),Stata 12.0,Power and Precision statistical software package(Biostat)and TSA software(version0.9),respectively.Results:Finally,three RCTs with 198 participants were included.The results of meta-analysis showed that there were statistically significant differences between groups in(1)the cure rate(RR,1.25;95%CI.1.10to1.41;P=0.00)and(2)the wound healing time(SMD,-3.404;95%CI,-5.821 to -0.987;P=0.00).Three trials presented more than 80% power with 0.05α-errors in both outcomes and the power of two meta-analyses to pool different outcomes presented more than 95%.The TSA showed that the summary results were certain.Conclusion:The external application with Jinhuang powder was an effective and cost-effective therapy for DFUs.The power analysis and TSA showed that the efficacy of Jinhuang powder dressing for the treatment of DFUs is conclusive.

Effects of yiqi yangyin huoxue therapy on IgA nephropathy: a systematic review and meta-analysis of randomized controlled trials

Objective To assess the efficacy and safety of Yiqi Yangyin Huoxue therapy (YYHT) for the treatment of IgA nephropathy. Methods Databases articles about YYHT in treating IgAN patients were searched through February 2018. Comparisons were YYHT alone or YYHT in combination with western medicine as experimental intervention, and western medicine as the control. Randomized controlled trials (RCTs) were selected. Cochrane collaboration tool was used for assessing risk of bias to evaluate methodologies. RevMan 5.3 software was applied to analyze the data of included trials. Results A total of 21 studies involving 1473 patients were included. Meta-analysis results demonstrated that YYHT alone or YYHT in combination with western medicine were more efficacious than only western medicine in decreasing proteinuria [MD =-0.41, 95% CI (-0.53,-0.29), P < 0.00001] and the urine red blood cells [MD =-7.46, 95% CI (-9.28,-5.64), P < 0.00001]. There also showed improvement in the clinical total effective rate [OR = 2.78, 95% CI (2.14, 3.61), P < 0.00001] between the two groups. Some of the included trials did not report the adverse events. Conclusions Current evidence shows that YYHT can reduce proteinuria and urine red blood cells and improve the total efficacy rate. Since poor quality and publication bias of some included trials, more evidence-based medicine studies needed to define the role of YYHT in the treatment of IgAN.

Meta-analysis and systematic review of colorectal endoscopic mucosal resection

AIM:To evaluate the proportion of successful complete cure en-bloc resections of large colorectal polyps achieved by endoscopic mucosal resection(EMR). METHODS:Studies using the EMR technique to resect large colorectal polyps were selected.Successful complete cure en-bloc resection was defined as one piece margin-free polyp resection.Articles were searched for in Medline,Pubmed,and the Cochrane Control Trial Registry,among other sources. RESULTS:An initial search identified 2620 reference articles,from which 429 relevant articles were selected and reviewed.Data was extracted from 25 studies(n =5221)which met the inclusion criteria.All the studies used snares to perform EMR.Pooled proportion of en-bloc resections using a random effect model was 62.85%(95%CI:51.50-73.52).The pooled proportion for complete cure en-bloc resections using a random effect model was 58.66%(95%CI:47.14-69.71).With higher patient load(>200 patients),this complete cure en-bloc resection rate improves from 44.19%(95%CI: 24.31-65.09)to 69.17%(95%CI:51.11-84.61). CONCLUSION:EMR is an effective technique for the resection of large colorectal polyps and offers an alternative to surgery.

Effect of fast track surgery care on knee joint function in patients with knee joint replacement surgery: A systematic review

Objective: To assess the effect of fast track surgery care on knee joint function in patients with knee joint replacement surgery. Methods: Eighteen databases were searched for randomized controlled trials, focusing on evaluation of fast track surgery care on knee joint function in patients with knee joint replacement surgery. Two people independently screened literatures and extracted data according to the inclusion criteria. Then the available data were analyzed with RevMan software (version 5.3.0). Descriptive techniques were performed when no available data could be used. Results: A total of 8 studies were included, for a total sample of 635 patients. The results showed that fast track surgery care can improve Hospital for Special Surgery Knee score at 2 months, 3 months, 6 months, and 1 years after operation [after 2 months (weighted mean difference (WMD), 15.2;95%CI, 13.58 to 16.82;P < 0.01);after 3 months (WMD, 9.42;95%CI, 7.80 to 11.04;P < 0.01);after 6 months,(WMD, 11.01;95%CI, 9.73 to 12.28;P < 0.01);after 1 years (WMD, 10.78;95%CI, 9.33 to 12.24;P < 0.01)]. Fast track surgery care can improve the knee score of American Knee Society Knee Score(WMD, 9.23;95%CI,0.86 - 17.6;P < 0.05), and reduce the incidence of postoperative deep vein thrombosis, constipation, pulmonary infection, urinary tract infection and other complications. Conclusion: Fast track surgery care can promote knee joint function recovery, reduce postoperative deep venous thrombosis, constipation, pulmonary infection and urinary tract infection. However, rigorous large sample and multicenter randomized controlled trials are needed for further validation.

Efficacy of blood-letting puncture and cupping in the treatment of periarthritis of shoulder:a systematic review

Objective:To systematically evaluate the clinical efficacy and safety of blood-letting puncture and cupping in the treatment of periarthritis of shoulder.Methods:We electronically searched databases including CNKI,VIP,PubMed,WanFang Data,EMbase Cochrane Library and to collect randomized controlled trials(RCTs)and quasi-randomized controlled trials about blood-letting puncture and cupping for periarthritis of shoulder and evaluated the quality of the documents collected by the Cochrane collaboration,provided by Review Manager 5 software for statistical analysis.Then the quality of the included trials was assessed using the Jadad scale and GRADE system was used to score the quality and grade recommendation.Results:Thirty RCTs involving 2556 patients were included.The results of meta-analysis showed that:Total effective rate OR=6.21[OR=6.21,95%CI(4.69,8.21),P<0.001].The results of GRADE system evaluation showed that the level of evidence was B,and the recommendation level was weak recommendation.Conclusion:Blood-letting puncture and cupping shows better effects than other treatments and preferably security in the treatment of periarthritis of shoulder.We do not find any serious adverse reaction reports.Due to limited quality of the included studies,more high quality studies are needed to verify the above conclusion.

Effectiveness of animal-assisted therapy on pain in children:A systematic review and meta-analysis

Aims:Animal-assisted therapy(AAT)relieves pain by creating a relaxed and comfortable environment to reduce anxiety in children.Yet little is known about its effects on pain in children.This study aims to systematically evaluate the effects of AAT on pain in children.Methods:Eight databases including PubMed,Cochrane Library,Web of Science,CINAHL Complete,Chinese Biomedical Database(CBM),Weipu Database(VIP),China Knowledge Resource Integrated Database(CNKI)and Wanfang Database were retrieved,and all randomized controlled trials or controlled clinical trial using AAT on children’s pain were recruited from inception to October 2019.Two reviewers independently screened literature,extracted data and assessed the risk of bias of the included studies.RevMan 5.3 software was employed for meta-analysis.Results:Seven published studies containing 4 RCTs and 3 CCTs were included for the systematic review.The results of meta-analysis showed that AAT could reduce children’s pain when compared with the control group[MD=-0.53,95%CI(-0.77,-0.30),P<0.00001].Conclusion:Current evidence shows that AAT can relieve pain in children to some extent.Considering the limited quality and quantity of the available studies,more high quality studies should be performed to verify the above conclusion.

Chinese Herbal Medicine in Treatment of Polyhydramnios:a Meta-analysis and Systematic Review

Objective To compare the efficacy of Chinese herbal medicine （therapy A） or Chinese herbal medicine plus indomethacin （therapy B） with that of indomethacin alone （therapy C） in treating polyhydramnios. Methods Literatures published up to April 2012 were retrieved from PubMed, Embase and Cochrane library, Chinese National Knowledge Infrastructure （CNKI）, Chinese Scientific and Technological Periodical Database （VIP）, Wangfang, and Traditional Chinese Medicine online. Two researchers collected data independently. The assessment of methodological quality was based on Cochrane handbook and the materials were analyzed with software RevMan 5.1.2. The outcome measure index was relative risk or difference of mean value （95% confidence interval）. The following outcomes were evaluated： （1） general clinical improvement rate; （2） maximum vertical pocket depth; （3） amniotic fluid index （AH） value; （4） rate of fetal ductus arteriosus constriction; （5） incidence of adverse events. Results Based on the search strategy, 5 trails involving 1017 patients were finally included. Compared with therapy C, therapy A decreased the rate of fetal ductus arteriosus constriction （P〈0.01）. Therapy B was more effective than therapy C in general clinical improvement and decrease of AH for polyhydramnios （P〈 0.01 ）. No serious adverse events were reported in therapy A and therapy B. Conclusions Compared with therapy C, therapy A and therapy B may appear to be more effective for polyhydramnios. However, the exact effect needs to be confirmed with well-designed large-scale clinical trials.

The Chinese herbal Formula Tongxieyaofang for irritable bowel syndrome:a protocol for meta-analysis of randomized controlled trials

Background:Irritable bowel syndrome(IBS)is a chronic functional bowel disorder characterized by abdominal pain and altered bowel function.The TongXieYaoFang(TXYF)is a Chinese herbal formula with a long history for the management of chronic diarrhea accompanied by abdominal pain,and it is always used to relieve symptoms of IBS.Although there are some studies were published,there is no consensus on its effects.Moreover,new relevant study was published recently.Therefore,a systematic review and meta-analysis is needed to assess the safety and eff ectiveness of the Chinese herbal medicine TongXieYaoFang for IBS.Methods and analysis:PubMed,EMBASE,the Cochrane library,CNKI,WanFang,VIP and CBM databases will be searched without search date and language restrictions.We will include randomized controlled trial(RCT)comparing TXYF with another therapy method for IBS.The quality of included studies will be independently assessed using Risk of bias tool in the Cochrane Handbook 5.1.0,and be categorized as being at low,unclear or high risk of bias.The primary outcome is the disappearance and significant improvement in global symptoms,and the secondary outcomes including visual analog scale(VAS)score,adverse event,rehospitalization rate and the quality of life.The Meta-analysis will be performed using the Cochrane Collection’s tool RevMan 5.3 software.Results:This study is ongoing and will be submitted to a peerreviewed journal for publication.Conclusion:This study will provide a confirmed evidence on the safety and eff ectiveness of TXYF for IBS.Ethics and dissemination:Ethical approval and patient consent are not required because of the study is a systematic review and meta-analysis based on literatures.The results of this study will be submitted to a peer-reviewed journal for publication.

Systematic evaluation and Meta-analysis of acupuncture and collaterals cupping therapy for Knee Osteoarthritis

Objective:In order to obtain the best treatment program for Knee Osteoarthritis(KOA),to alleviate the pain of patients with KOA,and to systematically evaluate the efficacy of acupuncture cupping therapy for KOA.Methods:we used computer to search the databases of CNKI(1989-2018.10),Wanfang(1989-2018.10),VIP(1989-2018.10),PubMed(1966-2018.10),EMbase(1986-2018.10)and Cochrane Library(the 3rd issue of 2018).And the literature quality was evaluated by Jadad scale.Results:A total of 19 eligible RCT studies were included,and a total of 2,088 patients participated in the eligible clinical study.Meta-analysis results showed that the total effective rate OR combination=2.85[OR=3.98,95%CI(2.98,5.32),P<0.00001].The results showed that the curative effect of acupuncture and collaterals cupping in the treatment of KOA was superior to other therapies.Conclusion:Acupuncture and cupping therapy of traditional Chinese medicine is effective and safe in treating KOA.Due to the impact of the original study on Meta-analysis results,more large samples and high-quality clinical trials are still needed to verify.

Methodologic quality of systematic reviews and meta-analyses on the Mediterranean diet and cognitive function： a review

Background and aim： Several systematic reviews and meta-analyses published within the past years have examined the associations of Mediterranean-style diets （MedSDs） on cognitive. However, these reviews have not been evaluated for satisfying Contemporary methodologies quality standards. At the same time, due to the high demand for related care during the aging process in China, it is necessary to summarize the ex-isting system evaluation and evaluate the quality of it, so as to provide strong evidence for the development of relevant work and to standardize the research process and methods in this field. This study evaluated the quality of recent systematic reviews and meta-analyses on MedSD and cognitive outcomes by using an established methodology quality scale, and to provide some valuable references for future research and Chinese systematic review and meta-analysis developing. Methods： We used the AMSTAR Methodology Quality Assessment Scale to evaluate the quality of methodology of the existing meta-analyses and systematic review. Meta analysis and systematic review that meets our criteria must contain the following characteristics： 1） used systematic or meta-analytic procedures to review the lit-erature, and 2） had MedSD interventions independently. Results： Reviews satisfied with 5 to 9 of the AMSTAR MedSD items （mean 7.35, standard deviation： 1.27）, quality is above average with those published in higher-impact journals having a greater quality score. Conclusion： These data suggest that current meta-analyses/systematic reviews evaluating the effect of MedSD on cognitive do not fully meet contemporary methodology quality standards. The methodological quality of the literature needs to be im- proved. As a result, there are more research questions to answer to enhance our understanding of how MedSD affects cognitive. To clarify associations between MedSD and cognitive, future meta-analyses and systematic reviews should not only follow methodology quality standards but also include more statistical modeling results when data allow. And in order to make the conclusions more reliable, we expect higher quality RCTs in the future.

Conversion of One- to Two-Way Streets in Birmingham, Alabama

This paper summarizes the approach, findings and evaluation methodology for a study that investigated the feasibility and potential impacts of street conversion options on traffic operations in downtown Birmingham, Alabama. Of particular interest were issues related to conversion of grid systems from one-way to two-way operations. Recommendations on the most promising design and control configurations for implementation are also provided. A literature review was performed that threw light on the issues and challenges associated with implementation of street conversions, and the available best practices. A comprehensive traffic impact analysis that ensued employed the SYNCHRO computer simulation model to represent current and future operations so as to assess the implications of two-way conversions at and around the test sites. Detailed realistic two-way operations scenarios were developed that considered geometric and right-of-way restrictions, the location of land uses that generate and/or attract vehicular and pedestrian traffic, connectivity with the street grid, and accessibility to nearby freeway facilities, as well as practical concerns.

Acupuncture treatment for improving anxiety status in patients with primary insomnia:a systematic review and meta-analysis

Objective:To evaluate the clinical efficacy of acupuncture in the treatment of anxiety state in patients with primary insomnia(PI).Methods:Randomized controlled trials of acupuncture treatment for PI patients with an anxiety state in Web of Science,Cochrane Library,PubMed,Excerpta Medica Database(EMBASE),China National Knowledge Infrastructure(CNKI),Wanfang Data Knowledge Service Platform(Wanfang),and Chongqing VIP Database(VIP)were retrieved by computer.The retrieval time was from each database’s inception to December 30,2022.Data extraction and evaluation were performed for the included studies.The Cochrane risk of bias assessment tool was used to assess the risk of bias in each article.Meta-analysis of valid data was performed using the RevMan 5.4 software.If the outcome indicator was a categorical variable,relative risk(RR)was used as the effect size.If it was a continuous variable,mean difference(MD)was used to calculate the effect size.Each effect size was expressed as a 95%confidence interval(CI).P<0.05 was considered to indicate a statistically significant difference.Results:A total of 18 studies were included,comprising a total of 1198 patients.The findings of the meta-analysis showed that electroacupuncture had a significant advantage in improving the Hamilton anxiety scale(HAMA)score than benzodiazepines[MD=-1.61,95%CI(-2.17,-1.06),P<0.001].Acupuncture was superior to sham acupuncture[MD=-14.90,95%CI(-20.39,-9.41),P<0.001]and benzodiazepines[MD=-3.39,95%CI(-4.67,-2.12),P<0.001]in reducing the self-rating anxiety scale(SAS)score.Acupuncture was superior to sham acupuncture in reducing the insomnia severity index(ISI)score[MD=-5.61,95%CI(-6.63,-4.89),P<0.001].Acupuncture was superior to benzodiazepines[MD=0.84,95%CI(-1.42,-0.25),P=0.005]and sham acupuncture[MD=-8.39,95%CI(-8.39,-7.86),P<0.001]in improving the Pittsburgh sleep quality index(PSQI)score.Acupuncture had a better effective rate than benzodiazepines[RR=1.16,95%CI(1.08,1.25),P<0.001]and sham acupuncture[RR=8.94,95%CI(4.63,17.25),P<0.001]in treating PI.Conclusion:Acupuncture or electroacupuncture has certain therapeutic advantages over benzodiazepines and sham acupuncture in the treatment of anxiety in PI patients.However,more high-quality randomized controlled trials are needed for further verification.

Acupuncture for spastic hemiplegia after ischemic stroke: a systematic review

Objective:To systematically assess the effectiveness and safety of acupuncture for spastic hemiplegia after ischemic stroke.Methods:Randomized controlled trials(RCTs)of acupuncture treatment for spastic hemiplegia after ischemic stroke meeting the inclusion criteria in Cochrane Library,Medline,Excerpta Medica Database(EMBASE),PubMed,China National Knowledge Infrastructure(CNKI),SinoMed,Chongqing VIP Database(VIP),and Wanfang Data Knowledge Service Platform(Wanfang)published from each database’s inception to February 2023 were retrieved by computer.Two reviewers independently extracted data and evaluated the risk of bias using Cochrane’s risk of bias tool.Review Manager 5.4 was used for data analysis.Continuous data were evaluated using mean difference(MD)with a 95%confidence interval(CI),and dichotomous data were analyzed using risk ratio(RR).Results:A total of 24 trials,including 1970 participants,were included in the study.The meta-analysis of 7 trials showed that compared to the rehabilitation therapy,acupuncture therapy was more effective in improving the simplified Fugl-Meyer assessment score after 1-month treatments[MD=10.52,95%CI(7.81,13.23),P<0.001].The meta-analysis of 2 articles showed the same tendency after 6-month treatments[MD=19.18,95%CI(11.34,27.02),P<0.001],and the 6-month treatment course resulted in better outcomes than the 1-month course.The meta-analysis of 8 trials showed that acupuncture had a better improvement on the Barthel index score than rehabilitation therapy after 1-month treatments[MD=10.78,95%CI(8.91,12.64),P<0.001].The meta-analysis of 2 articles showed the same tendency after 6-month treatments[MD=19.94,95%CI(19.02,20.87),P<0.001],and the 6-month course was better than the 1-month course.The meta-analysis of 2 trials showed that the effective rate of the modified Ashworth scale score improvement was more notable in the acupuncture group after 1-month treatments[RR=1.20,95%CI(1.02,1.40),P=0.020].One trial reported no adverse event,and 1 trial reported 3 adverse events without severe influence.Conclusion:Acupuncture might be an effective and safe therapy for spastic hemiplegia after ischemic stroke,but more high-quality,large-sample objectively-evaluated RCTs are needed to validate the conclusion.

Meta-analysis on protective effect of electroacupuncture at “Nèiguān”(内关 PC 6) in rats with reperfusion injury induced myocardial ischemia

Objective To systematically evaluate the protection effect of electroacupuncture at ＂Neiguan＂（内关 PC 6） on myocardial damage by means of evidence-based medicine.Methods Databases were retrieved by computer,while dissertation compilations and conference proceedings were searched manually.Data were analyzed statistically by using RevMan5.2software.Results Twelve studies were enrolled.Compared with myocardial ischemia reperfusion injury model group,① the magnitude of ECG STⅡ segment elevation can be reduced by means of electroacupuncture at PC 6（WMD=-73.95,95%CI[-109.69,-38.20]） and the difference was statistically significant（P0.0001）;② the ATPase in myocardial cells can be increased by means of electroacupuncture at PC 6（SMD=2.28,95%Cl[1.50,3.07]） and the difference was statistically significant（P0.00001）;③ the release of cTnT can be reduced by means of electroacupuncture at PC 6（WMD=-2.69,95%CI[-3.16,-2.22]） and the difference was statistically significant（P0.00001）;④ the size of myocardial infarction can be reduced by means of electroacupuncture at PC 6（WMD=-17.99,95%Cl[-19.88,-16.09]） and the difference was statistically significant（P0.00001）;⑤ the release of CK can be reduced by means of electroacupuncture at PC 6（WMD=-0.44,95%CI[-0.61,-0.27]） and the difference was statistically significant（P0.00001）;⑥ the release of CK-MB can be reduced by means of electroacupuncture at PC 6（SMD=-2.85,95%CI[-4.46,-1.24]） and the difference was statistically significant（P0.001）;⑦ the release of LDH can be reduced by means of electroacupuncture at PC 6（SMD=-2.97,95%CI[-4.87,-1.07]） and the difference was statistically significant（P0.01）.Conclusion Based on the current experimental evidences,electroacupuncture at PC 6 has a higher protective effect on myocardium.

Efficacy of fire-needle for acne:a systematic review and meta-analysis of randomized controlled trials

Objective To evaluate the efficacy of fire-needle therapy for acne to provide an objective basis for clinical decisions.Method Pub Med,Chinese Biomedical Medicine disc（CBM）,Chinese National knowledge infrastructure（CNKI）,and Wanfang database were searched to include eligible randomized controlled trails.Bias risk was assessed and data were extracted.Meta-analysis was performed and as was subgroup analysis.Results Thirty-three RCTs involving 3362 patients were included.Most of them had a high risk or unclear risk of bias regarding allocation concealment,incomplete outcome data and selective reporting.Compared with control groups,meta-analysis revealed that fireneedle therapy had an overall higher total effectiveness rate（RR=1.19,95% CI：1.16–1.22,P0.000 01）.Subgroup analysis showed fire-needle therapy was associated with an increased total effective rate（RR=1.20,95%CI：1.14–1.28,P0.000 01）,when compared against drug therapy.Fire-Needle therapy was associated with an increased total effective rate（RR=1.18,95%CI：1.12–1.24,P0.000 01）,when fire-needle plus other TCM therapy was compared against other therapy.fire-needle therapy was associated with an increased total effective rate（RR=1.18,95%CI：1.13–1.24,P0.000 01）,when fire-needle plus Chinese herb therapy was compared against Chinese herb therapy alone.fireneedle therapy was associated with an increased total effective rate（RR=1.28,95%CI：1.18–1.39,P0.000 01）,when compared fire-needle plus Western drug therapy against western drug therapy alone.Adverse events were not reported in most articles.Conclusion Our study showed that fire-needle appears to be an effective therapy for treating acne,but the evidence is currently insufficient due to the poor quality of the studies.The safety of fire-needle therapy is also uncertain due to the small sample size and the lack of reporting in included articles.Larger sample,higher quality studies are needed.

Systematic review on the effectiveness of embedding catgut therapy for simple obesity

Objective To systematically evaluate the effect of acupoint catgut embedding therapy （ACET） for simple obesity. Methods Computer retrieval was used for randomized controlled trials on the treatment effect of simple obesity with ACET in databases of the China National Knowledge Infrastructure （CNKI）, Wanfang Data system, and the China Biology Medicine disc （CBMDisc）. The Jadad Quality Scale was used in the evaluation of included studies. The outcome indicators were analyzed with the Review Manage 5.1 software. Results A total of 16 randomized controlled trials were included finally. The meta-analysis result showed that compared with the control group, there was statistically significance on the total efficiency of using ACET for simple obesity [OR=2.51, 95% confidence interval （1.74, 3.63）, Z=4.91, P〈0.000 01]. The analysis on the literature quality showed that there was only 2 article marked as 3 points. The other 25 articles marked ≤2 points. The quality of published articles was generally low. There were publication biases and the blinding method was seldom used, the losses of follow-up / drop oup / withdraw were reported with less. There were 27 acupoints used in the treatment, which mainly included Tianshu （天枢ST 25）, Zhongwan （中脘 CV 12）, Fenglong （丰隆 ST 40）, Shufen （水分 CV 9）, Qihai （气海 CV 6）, Sanyinjiao （三阴交 SP 6）, Zusnli （足三里 ST 36）, Ashi point, Daheng （大横 SP 25）. The five kinds of catgut embedding needle were injection needles ＋ acupuncture needle, specialized catgut embedding needle, spinal needle, triangular needle, and skin suture needle. Conclusion There is definite efficiency of using ACET in the treatment of simple obesity. However, the clinical efficiency still lacks of sufficient evidences. Therefore, further clinical research should be conducted in the providing of reliable evidences in the clinical decision-making in the future.