AIM： To investigate in vitro effects of propofol, midazolam and dexmedetomidine, which are commonly used anaesthesic or sedatives, on spontaneous contractions of the ileum both in normal rats and those exposed to hyp...AIM： To investigate in vitro effects of propofol, midazolam and dexmedetomidine, which are commonly used anaesthesic or sedatives, on spontaneous contractions of the ileum both in normal rats and those exposed to hyperdynamic peritonitis.METHODS： Spontaneous contractions of isolated ileum muscle segments from sham operated rats and those exposed to peritonitis, were studied in vitro. The amplitude and the frequency of spontaneous contractions of ileum muscle segments were studied after adding dexmetetomidine, propofoi, and midazolam to the organ bath in a cumulative manner.RESULTS： Both amplitude （85.2 ± 6.6 vs 47.4 ± 7.1） and frequency （32.8 ± 4.6 vs 20.2 ± 3.9） of spontaneous contractions in ileum smooth muscle segments were decreased significantly in the peritonitis group compared to the control group （P 〈 0.05）. Dexmedetomidine significantly increased the amplitude of spontaneous contractions （85.2 ± 6.6 vs 152.0 ± 5.4, P 〈 0.05） whereas, propofol （85.2 ± 6.6 vs 49.6 ± 4.8, P 〈 0.05） and midazolam （85.2 ± 6.6 vs 39.2 ± 4.5, P 〈 0.05） decreased it in both control and peritonitis groups. The frequency of spontaneous contractions were significantly decreased by propofol in both control （32.8 ± 4.6 vs 18.2 ± 3.4, P 〈 0.05） and peritonitis groups 20.2 ± 3.9 vs 11.6 ± 3.2, P 〈 0.05）. Dexmedetomidine and midazolam did not cause significant changes in the number of spontaneous contractions in both control and the peritonitis groups （P 〉 0.05）.CONCLUSION： Propofol, midazolam and dexmede- tomidine have various in vitro effects on spontaneous contractions of the rat ileum. While dexmedetomidine augments the spontaneous contraction of the rat ileum, propofol attenuates it. However, the effects of these compounds were parallel in both control and peritonitis groups.展开更多
Over the last several years there has been a growing interest in placebo, not only as an inert control in clinical trials, but also in the placebo effect as a group effect as well as a reaction in individual subjects....Over the last several years there has been a growing interest in placebo, not only as an inert control in clinical trials, but also in the placebo effect as a group effect as well as a reaction in individual subjects. Methodological factors such as regression to the mean and natural history of the disease play a role in the evaluation of a possible placebo effect. In this report, we discuss several factors including PavIovian conditioning, beliefs outcome, expectations, and other factors as potential mediators of the placebo response. Placebo effects are common in gastrointestinal diseases and there seems to be no clear difference between placebo effects in functional gastrointestinal diseases （functional dyspepsia and irritable bowel syndrome） and organic gastrointestinal disease （duodenal ulcer and inflammatory bowel disease）.展开更多
The use of cooled dialysate temperatures first came about in the early 1980s as a way to curb the incidence of intradialytic hypotension （IDH）. IDH was then, and it remains today, the most common complication affect...The use of cooled dialysate temperatures first came about in the early 1980s as a way to curb the incidence of intradialytic hypotension （IDH）. IDH was then, and it remains today, the most common complication affecting chronic hemodialysis patients. It decreases quality of life on dialysis and is an independent risk factor for mortality. Cooling dialysate was first employed as a technique to incite peripheral vasoconstriction on dialysis and in turn reduce the incidence of intradialytic hypotension. Although it has become a common practice amongst in-center hemodialysis units, cooled dialysate results in up to 70% of patients feeling cold while on dialysis and some even experience shivering. Over the years, various studies have been performed to evaluate the safety and effcacy of cooled dialysate in comparison to a standard, more thermoneutral dialysate temperature of 37℃. Although these studies are limited by small sample size, they are promising in many aspects. They demonstrated that cooled dialysis is safe and equally efficacious as thermoneutral dialysis. Although patients report feeling cold on dialysis, they also report increased energy and an improvement in their overall health following cooled dialysis. They established that cooling dialysate temperatures improves hemodynamic tolerability during and after hemodialysis, even in patients prone to IDH, and does so without adversely affecting dialysis adequacy. Cooled dialysis also reduces the incidence of IDH and has a protective effect over major organs including the heart and brain. Finally, it is an inexpensive measure that decreases economic burden by reducing necessary nursing intervention for issues that arise on hemodialysis such as IDH. Before cooled dialysate becomes standard of care for patients on chronic hemodialysis, larger studies with longer follow-up periods will need to take place to confrm the encouraging outcomes mentioned here.展开更多
To observe the effects of closed reduction and percutaneous K wires fixation of displacd supracondylar humerus fracture in children MethodsRetrospective review of fourteen patients who s...To observe the effects of closed reduction and percutaneous K wires fixation of displacd supracondylar humerus fracture in children MethodsRetrospective review of fourteen patients who sustained displaced supracondylar fracture of distal humerus treated by closed reduction and percutaneous K wires fixation Results. All patients’ K wires were removed at 4 weeks post operation Their elbow function regained at 8 weeks The average period of followed up was 10 month (varies from 6 to 18 month), all fractures healed very well without any permanent complications Two transient nerves palsy,ulnar and radial nerve each, recovered completely at 12 weeks and 16 weeks post operation respectively Conclusion. Closed reduction and percutaneous K wires fixation is a safe and efficient treatment for displaced humerus surpracondylar fracture in children展开更多
AIM： To review the safety （infection, perforation） and efficacy （expulsion, continuation rates, pregnancy） of intrauterine device （IUD） insertion in the postpartum period. METHODS： MEDLINE, PubMed and Google S...AIM： To review the safety （infection, perforation） and efficacy （expulsion, continuation rates, pregnancy） of intrauterine device （IUD） insertion in the postpartum period. METHODS： MEDLINE, PubMed and Google Scholar were searched for randomized controlled trials and prospective cohort studies of IUD insertions at different times during the postpartum period. Time of insertion during the postpartum period was documented speci-fically, immediate post placenta period （within 10 min）, early post placenta period （10 min to 72 h）, and de-layed/interval period （greater than 6 wk）. Other study variables included mode of delivery, vaginal vs cesarean, manual vs use of ring forceps to insert the IUD. RESULTS： IUD insertion in the immediate postpartum （within 10 min of placental delivery）, early postpartum （10 min up to 72 h） and Interval/Delayed （6 wk onward） were found to be safe and effcacious. Expulsion rates were found to be highest in the immediate postpartum groups ranging from 14% to 27%. Immediate post placental insertion found to have expulsion rates that ranged from 3.6% to 16.2%. Expulsion rate was significantly higher after insertion following vaginal vs cesarean delivery. The rates of infection, perforation and unplanned pregnancy following postpartum IUD insertion are low. Method of insertion such as with ring forceps, by hand, or another placement method unique to the type of IUD did not show any signifcant difference in expulsion rates. Uterine perforations are highest in the delayed/interval IUD insertion groups.Breastfeeding duration and infant development are not affected by delayed/interval insertion of the non-hormonal （copper） IUD or the Levonorgestrel IUD. Timing of the Levonorgestrel IUD insertion may affect breastfeeding. CONCLUSION： IUD insertion is safe and efficacious during the immediate postpartum, early postpartum and delayed postpartum periods. Expulsion rates are highest after vaginal delivery and when inserted during the immediate postpartum period. IUD associated infection rates were not increased by insertion during the postpartum period over interval insertion rates. There is no evidence that breastfeeding is negatively affected by postpartum insertion of copper or hormone-secreting IUD. Although perforation rates were higher when inserted after lactation was initiated. Randomized controlled trials are needed to further elucidate the consequence of lactation on postpartum insertion. Despite the concerns regarding expulsion, perforation and breastfeeding, current evidence indicates that a favorable risk beneft ratio in support of postpartum IUD insertion. This may be particularly relevant for women for whom barriers exist in achieving desired pregnancy spacing.展开更多
AIM： To review of the efficacy and safety outcomes of different single incision slings （SIS） systems, also in comparison with traditional slings.METHODS： A literature search was conducted in PubMed/MEDLINE databas...AIM： To review of the efficacy and safety outcomes of different single incision slings （SIS） systems, also in comparison with traditional slings.METHODS： A literature search was conducted in PubMed/MEDLINE database. The research was re-stricted to randomized and/or prospective trials and retrospective studies, published after 2006, with at least 20 patients with non-neurogenic stress urinary incontinence （SUI）. The studies had to assess effcacy and/or safety of the SIS with a minimum follow-up of 12 mo. All the paper assessing the performance of tension free vaginal tape secur were excluded from this review. The fnal selection included 19 papers fulflling the aforementioned criteria. Two authors independently reviewed the selected papers.RESULTS： Four different SIS systems were analysed： Ajust , Ophira , Altis and MiniArc . The average objective cure rate was 88%. Overall no statistically significant differences were found between SIS and traditional mid-urethral slings （MUS） in terms of objective cure （all P 〉 0.005）. Only one paper showed a statistically lower success rate in MiniArc？ vs Advant-age？ slings （40% vs 90%） and higher rates of failure in the SIS group. Since there was a great variability in terms of tests performed, it was not possible to com-pare subjective cure between studies. The vast part of the studies showed no major complications after SIS surgery. We also observed very low reported pain rates in SIS patients. The RCTs on Ajust？ and MiniArc？, showed better outcomes in terms of post-operative pain compared to MUS. None of the patients reported long- term pain complains. CONCLUSION： SIS showed similar effcacy to that of traditional slings but lower short-term pain, complication and failure rates.展开更多
Promotion of a model of the criminal law of public order represents an important point of reflection in criminal law doctrine. Public order, as a juridical good, has many predispositions to be exposed to criminal acti...Promotion of a model of the criminal law of public order represents an important point of reflection in criminal law doctrine. Public order, as a juridical good, has many predispositions to be exposed to criminal activity, and in this point of view, its special protection through criminal law norms constitutes a major concern of criminal legislation objectives. Criminal legislation （as a regulatory and modifying tool within society） is an intelligent social product It is a concrete expression of the important contribution of society in ensuring qualitative and quantitative relations of the model of public order. The latter finds expression as the object of a subjective right, which cannot be divided from the affirmation made by criminal legislation as a primary juridical good. In this context, the model of public order is associated with that of protection of general interest, in the subjective sense of the right to punish （ius puniendO, implemented by state authorities. In their universal meaning, all criminal offences in one way or another affect the normal functioning of public order, but terrorist acts can violate or impinge upon public order more closely and specifically. While affecting the designated model of public order, terrorist crimes put in question the architecture of the rule of law. In response to the mechanisms of terrorist offences, two main criminalization techniques are elaborated： （1） the classical technique of criminalization; and （2] the enumerative technique of criminalization. Criminal sanctions, by which the repression of this criminal vector is carried out, aim at ensuring not only the survival of human society, but also its cardinal values and interests, as well as the technical and scientific progress.展开更多
Aiming at the conclusion that ＂there is no difference in efficacy between acupuncture and sham-acupuncture＂ in clinical research field of migraine in foreign countries in recent years, through the discussions on the...Aiming at the conclusion that ＂there is no difference in efficacy between acupuncture and sham-acupuncture＂ in clinical research field of migraine in foreign countries in recent years, through the discussions on the definition of sham acupuncture （placebo acupuncture）, the principles required to be obey in satisfactory placebo acupuncture, the definition, location, function as well as clinical results of shallow puncture, the authors probed into whether shallow puncture could be the control method of sham acupuncture （placebo acupuncture） in clinical research of acupuncture. It was demonstrated in the results that ＂acupuncture with minimal stimulation on skin superficial layer of meridian points or non-meridian points＂, the so-called control method of ＂sham acupuncture （placebo acupuncture）＂ excited holistic regulation of human body quite probably through ＂shallow puncture on cutaneous region of meridians＂ to achieve therapeutic effects. Hence, this method is not the appropriate control method of placebo acupuncture and cannot be the control method of sham acupuncture （placebo acupuncture） in clinical research of acupuncture. Therefore, it is naturally to repudiate the conclusion that ＂there is no difference in efficacy between acupuncture and sham acupuncture＂ in the research where this method is taken as the control of placebo acupuncture.展开更多
Objective： Different kinds of sham acupuncture are widely applied in randomized controlled trials （RCTs） to explore whether acupuncture has intrinsic therapeutic effects beyond the placebo effects for certain indic...Objective： Different kinds of sham acupuncture are widely applied in randomized controlled trials （RCTs） to explore whether acupuncture has intrinsic therapeutic effects beyond the placebo effects for certain indication. To make conclusions of trials more comparable and convincing, it is of great necessity to unify the sham acupuncture procedure. Methods： RCTs of acupuncture with high quality in the recent 14 years were reviewed, and the appropriateness of the sham acupuncture procedures was assessed. Results： The sham acupuncture procedures were mainly classified into five kinds according to their administered sites, penetrating, and intervention apparatus. Conclusion： Among the sham acupuncture procedures, needling near the selected acupoints, needling at a distant non-acupoints, and non-penetrating sham acupuncture are most commonly used. Sham acupuncture performed at distant site belongs to non-meridian and non-acupoint may be an ideal control for the study of the intrinsic therapeutic effects of acupuncture. Besides, the selection of controls must focus on the design and aim of RCTs, such as non-inferiority, equivalence and superiority trials.展开更多
文摘AIM： To investigate in vitro effects of propofol, midazolam and dexmedetomidine, which are commonly used anaesthesic or sedatives, on spontaneous contractions of the ileum both in normal rats and those exposed to hyperdynamic peritonitis.METHODS： Spontaneous contractions of isolated ileum muscle segments from sham operated rats and those exposed to peritonitis, were studied in vitro. The amplitude and the frequency of spontaneous contractions of ileum muscle segments were studied after adding dexmetetomidine, propofoi, and midazolam to the organ bath in a cumulative manner.RESULTS： Both amplitude （85.2 ± 6.6 vs 47.4 ± 7.1） and frequency （32.8 ± 4.6 vs 20.2 ± 3.9） of spontaneous contractions in ileum smooth muscle segments were decreased significantly in the peritonitis group compared to the control group （P 〈 0.05）. Dexmedetomidine significantly increased the amplitude of spontaneous contractions （85.2 ± 6.6 vs 152.0 ± 5.4, P 〈 0.05） whereas, propofol （85.2 ± 6.6 vs 49.6 ± 4.8, P 〈 0.05） and midazolam （85.2 ± 6.6 vs 39.2 ± 4.5, P 〈 0.05） decreased it in both control and peritonitis groups. The frequency of spontaneous contractions were significantly decreased by propofol in both control （32.8 ± 4.6 vs 18.2 ± 3.4, P 〈 0.05） and peritonitis groups 20.2 ± 3.9 vs 11.6 ± 3.2, P 〈 0.05）. Dexmedetomidine and midazolam did not cause significant changes in the number of spontaneous contractions in both control and the peritonitis groups （P 〉 0.05）.CONCLUSION： Propofol, midazolam and dexmede- tomidine have various in vitro effects on spontaneous contractions of the rat ileum. While dexmedetomidine augments the spontaneous contraction of the rat ileum, propofol attenuates it. However, the effects of these compounds were parallel in both control and peritonitis groups.
文摘Over the last several years there has been a growing interest in placebo, not only as an inert control in clinical trials, but also in the placebo effect as a group effect as well as a reaction in individual subjects. Methodological factors such as regression to the mean and natural history of the disease play a role in the evaluation of a possible placebo effect. In this report, we discuss several factors including PavIovian conditioning, beliefs outcome, expectations, and other factors as potential mediators of the placebo response. Placebo effects are common in gastrointestinal diseases and there seems to be no clear difference between placebo effects in functional gastrointestinal diseases （functional dyspepsia and irritable bowel syndrome） and organic gastrointestinal disease （duodenal ulcer and inflammatory bowel disease）.
文摘The use of cooled dialysate temperatures first came about in the early 1980s as a way to curb the incidence of intradialytic hypotension （IDH）. IDH was then, and it remains today, the most common complication affecting chronic hemodialysis patients. It decreases quality of life on dialysis and is an independent risk factor for mortality. Cooling dialysate was first employed as a technique to incite peripheral vasoconstriction on dialysis and in turn reduce the incidence of intradialytic hypotension. Although it has become a common practice amongst in-center hemodialysis units, cooled dialysate results in up to 70% of patients feeling cold while on dialysis and some even experience shivering. Over the years, various studies have been performed to evaluate the safety and effcacy of cooled dialysate in comparison to a standard, more thermoneutral dialysate temperature of 37℃. Although these studies are limited by small sample size, they are promising in many aspects. They demonstrated that cooled dialysis is safe and equally efficacious as thermoneutral dialysis. Although patients report feeling cold on dialysis, they also report increased energy and an improvement in their overall health following cooled dialysis. They established that cooling dialysate temperatures improves hemodynamic tolerability during and after hemodialysis, even in patients prone to IDH, and does so without adversely affecting dialysis adequacy. Cooled dialysis also reduces the incidence of IDH and has a protective effect over major organs including the heart and brain. Finally, it is an inexpensive measure that decreases economic burden by reducing necessary nursing intervention for issues that arise on hemodialysis such as IDH. Before cooled dialysate becomes standard of care for patients on chronic hemodialysis, larger studies with longer follow-up periods will need to take place to confrm the encouraging outcomes mentioned here.
文摘To observe the effects of closed reduction and percutaneous K wires fixation of displacd supracondylar humerus fracture in children MethodsRetrospective review of fourteen patients who sustained displaced supracondylar fracture of distal humerus treated by closed reduction and percutaneous K wires fixation Results. All patients’ K wires were removed at 4 weeks post operation Their elbow function regained at 8 weeks The average period of followed up was 10 month (varies from 6 to 18 month), all fractures healed very well without any permanent complications Two transient nerves palsy,ulnar and radial nerve each, recovered completely at 12 weeks and 16 weeks post operation respectively Conclusion. Closed reduction and percutaneous K wires fixation is a safe and efficient treatment for displaced humerus surpracondylar fracture in children
文摘AIM： To review the safety （infection, perforation） and efficacy （expulsion, continuation rates, pregnancy） of intrauterine device （IUD） insertion in the postpartum period. METHODS： MEDLINE, PubMed and Google Scholar were searched for randomized controlled trials and prospective cohort studies of IUD insertions at different times during the postpartum period. Time of insertion during the postpartum period was documented speci-fically, immediate post placenta period （within 10 min）, early post placenta period （10 min to 72 h）, and de-layed/interval period （greater than 6 wk）. Other study variables included mode of delivery, vaginal vs cesarean, manual vs use of ring forceps to insert the IUD. RESULTS： IUD insertion in the immediate postpartum （within 10 min of placental delivery）, early postpartum （10 min up to 72 h） and Interval/Delayed （6 wk onward） were found to be safe and effcacious. Expulsion rates were found to be highest in the immediate postpartum groups ranging from 14% to 27%. Immediate post placental insertion found to have expulsion rates that ranged from 3.6% to 16.2%. Expulsion rate was significantly higher after insertion following vaginal vs cesarean delivery. The rates of infection, perforation and unplanned pregnancy following postpartum IUD insertion are low. Method of insertion such as with ring forceps, by hand, or another placement method unique to the type of IUD did not show any signifcant difference in expulsion rates. Uterine perforations are highest in the delayed/interval IUD insertion groups.Breastfeeding duration and infant development are not affected by delayed/interval insertion of the non-hormonal （copper） IUD or the Levonorgestrel IUD. Timing of the Levonorgestrel IUD insertion may affect breastfeeding. CONCLUSION： IUD insertion is safe and efficacious during the immediate postpartum, early postpartum and delayed postpartum periods. Expulsion rates are highest after vaginal delivery and when inserted during the immediate postpartum period. IUD associated infection rates were not increased by insertion during the postpartum period over interval insertion rates. There is no evidence that breastfeeding is negatively affected by postpartum insertion of copper or hormone-secreting IUD. Although perforation rates were higher when inserted after lactation was initiated. Randomized controlled trials are needed to further elucidate the consequence of lactation on postpartum insertion. Despite the concerns regarding expulsion, perforation and breastfeeding, current evidence indicates that a favorable risk beneft ratio in support of postpartum IUD insertion. This may be particularly relevant for women for whom barriers exist in achieving desired pregnancy spacing.
文摘AIM： To review of the efficacy and safety outcomes of different single incision slings （SIS） systems, also in comparison with traditional slings.METHODS： A literature search was conducted in PubMed/MEDLINE database. The research was re-stricted to randomized and/or prospective trials and retrospective studies, published after 2006, with at least 20 patients with non-neurogenic stress urinary incontinence （SUI）. The studies had to assess effcacy and/or safety of the SIS with a minimum follow-up of 12 mo. All the paper assessing the performance of tension free vaginal tape secur were excluded from this review. The fnal selection included 19 papers fulflling the aforementioned criteria. Two authors independently reviewed the selected papers.RESULTS： Four different SIS systems were analysed： Ajust , Ophira , Altis and MiniArc . The average objective cure rate was 88%. Overall no statistically significant differences were found between SIS and traditional mid-urethral slings （MUS） in terms of objective cure （all P 〉 0.005）. Only one paper showed a statistically lower success rate in MiniArc？ vs Advant-age？ slings （40% vs 90%） and higher rates of failure in the SIS group. Since there was a great variability in terms of tests performed, it was not possible to com-pare subjective cure between studies. The vast part of the studies showed no major complications after SIS surgery. We also observed very low reported pain rates in SIS patients. The RCTs on Ajust？ and MiniArc？, showed better outcomes in terms of post-operative pain compared to MUS. None of the patients reported long- term pain complains. CONCLUSION： SIS showed similar effcacy to that of traditional slings but lower short-term pain, complication and failure rates.
文摘Promotion of a model of the criminal law of public order represents an important point of reflection in criminal law doctrine. Public order, as a juridical good, has many predispositions to be exposed to criminal activity, and in this point of view, its special protection through criminal law norms constitutes a major concern of criminal legislation objectives. Criminal legislation （as a regulatory and modifying tool within society） is an intelligent social product It is a concrete expression of the important contribution of society in ensuring qualitative and quantitative relations of the model of public order. The latter finds expression as the object of a subjective right, which cannot be divided from the affirmation made by criminal legislation as a primary juridical good. In this context, the model of public order is associated with that of protection of general interest, in the subjective sense of the right to punish （ius puniendO, implemented by state authorities. In their universal meaning, all criminal offences in one way or another affect the normal functioning of public order, but terrorist acts can violate or impinge upon public order more closely and specifically. While affecting the designated model of public order, terrorist crimes put in question the architecture of the rule of law. In response to the mechanisms of terrorist offences, two main criminalization techniques are elaborated： （1） the classical technique of criminalization; and （2] the enumerative technique of criminalization. Criminal sanctions, by which the repression of this criminal vector is carried out, aim at ensuring not only the survival of human society, but also its cardinal values and interests, as well as the technical and scientific progress.
基金Academy-rank research project of China Academy of Chinese Medical Sciences:ZZ 2006084
文摘Aiming at the conclusion that ＂there is no difference in efficacy between acupuncture and sham-acupuncture＂ in clinical research field of migraine in foreign countries in recent years, through the discussions on the definition of sham acupuncture （placebo acupuncture）, the principles required to be obey in satisfactory placebo acupuncture, the definition, location, function as well as clinical results of shallow puncture, the authors probed into whether shallow puncture could be the control method of sham acupuncture （placebo acupuncture） in clinical research of acupuncture. It was demonstrated in the results that ＂acupuncture with minimal stimulation on skin superficial layer of meridian points or non-meridian points＂, the so-called control method of ＂sham acupuncture （placebo acupuncture）＂ excited holistic regulation of human body quite probably through ＂shallow puncture on cutaneous region of meridians＂ to achieve therapeutic effects. Hence, this method is not the appropriate control method of placebo acupuncture and cannot be the control method of sham acupuncture （placebo acupuncture） in clinical research of acupuncture. Therefore, it is naturally to repudiate the conclusion that ＂there is no difference in efficacy between acupuncture and sham acupuncture＂ in the research where this method is taken as the control of placebo acupuncture.
基金National Natural Science Foundation of China (No. 30873299, 90409014, 81001548, 30701123)Shanghai Leading Academic Discipline Project (S30304)
文摘Objective： Different kinds of sham acupuncture are widely applied in randomized controlled trials （RCTs） to explore whether acupuncture has intrinsic therapeutic effects beyond the placebo effects for certain indication. To make conclusions of trials more comparable and convincing, it is of great necessity to unify the sham acupuncture procedure. Methods： RCTs of acupuncture with high quality in the recent 14 years were reviewed, and the appropriateness of the sham acupuncture procedures was assessed. Results： The sham acupuncture procedures were mainly classified into five kinds according to their administered sites, penetrating, and intervention apparatus. Conclusion： Among the sham acupuncture procedures, needling near the selected acupoints, needling at a distant non-acupoints, and non-penetrating sham acupuncture are most commonly used. Sham acupuncture performed at distant site belongs to non-meridian and non-acupoint may be an ideal control for the study of the intrinsic therapeutic effects of acupuncture. Besides, the selection of controls must focus on the design and aim of RCTs, such as non-inferiority, equivalence and superiority trials.
