Objective To assess the effectiveness and safety of various types of acupuncture in the treatment of mammary dysplasia. Methods We searched The Cochrane Library, CENTRAL, MEDLINE (1966 to 2004), EMBASE (1980 to 2004), CBM (1975 to 2004), CNKI (1997 to 2004) and reference lists, databases of ongoing trials and relevent academic conference proceedings. Results Five studies involving 534 women ranging from 78 to 180 met the inclusion criteria. The recovery rates of two groups in one study showed acupuncture was statistically superior to Rupixiao (RR 9.00, 95%CI 2.29 to 35.43; RR 8.04, 95%CI 2.20 to 32.02), six good improvement rates (including groups analysis) indicated that there was no significant difference between acupuncture and other therapies. None of the studies reported incidence of adverse reaction. Conclusions Overall, there is no conclusive evidence for acupuncture in the treatment of mammary dysplasia because the quality of included studies and amount of evidence are both poor and insufficient. There is an urgent need for larger, well-designed randomised controlled trials to assess the effectiveness and adverse-effect of acupuncture.
Objectives To systematically review the efficacy and safety of bonesetting combined acupuncture in the treatment of cervical vertigo. Methods PubMed, CNKI, VIP, CBM and WanFang Data databases were searched to collect randomized controlled trials (RCTs) on bonesetting combined acupuncture in the treatment of cervical vertigo from inception to February 15th, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was performed by RevMan 5.3 software. Results Eighteenth RCTs involving 1 915 patients were included. The results of meta-analysis showed that, compared with acupuncture or bonesetting alone group, the effective rate in bonesetting combining acupuncture group was higher (RRacupuncture=1.17, 95%CI 1.12 to 1.23, P<0.000 01; RRbonesetting=1.16, 95%CI 1.10 to 1.23, P<0.000 01). Improvement of the cervical vertigo symptom and function in the combined group was better than that in the acupuncture group or bonesetting group (MDacupuncture=3.42, 95%CI 2.29 to 4.56, P<0.000 01; MDbonesetting=6.45, 95%CI 5.56 to 7.33, P<0.000 01). Average flow velocity of cervical vertigo basilar artery (BA) in the combined group was superior to the bonesetting group (MD=7.54, 95%CIP=0.02). 1.08 to 13.99, Conclusions Bonesetting combining acupuncture treatment of cervical vertigo in terms of effectiveness and function improvement are better than those of acupuncture alone or pure bonesetting. Due to the limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.
Objective To evaluate the reporting quality of randomized controlled trials (RCTs) on acupuncture for acute ischemic stroke. Methods Six databases including The Cochrane Central Register of Controlled Trials (CENTRAL, Issue 4, 2005), MEDLINE (1966 to December 2005), EMbase (1984 to December 2005), China National Knowledge Infrastructure (CNKI, 1994 to December 2005), China Biomedicine Database disc (CBMdisc, 1980 to December 2005), VIP (a full text issues database of China, 1989 to December 2005) were searched systematically. Handsearch for further references was conducted. Language was limited to Chinese and English. We identified 74 RCTs that used acupuncture as an intervention and assessed the quality of these reports against the Consolidated Standards for Reporting of Trials (CONSORT) statement and Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA).Results In regard to the items in the CONSORT statement, 54 (73%) RCTs described baseline demographic and clinical characteristics in each group. Twenty-six (35%) mentioned the method of generating the random sequence, with 4 (5%) using a computer allocation. Only 6 (8%) RCTs had adequate allocation concealment, with 5 RCTs using sealed opaque envelopes and 1 RCT using centralized computer allocation. Only 8 (11%) RCTs used blinding, including 5 described as double-blind. Four (5%) RCTs reported the sample size calculation and 5 (7%) RCTs reported that an intention-to-treat (ITT) analysis. In regard to the items in STRICTA , only 4 (5%) RCTs reported the numbers of needles inserted. In 35 (47%) RCTs the needle type was reported, but only 26 (35%) mentioned the depths of insertion. Only 1 (1%) RCT mentioned the length of clinical experience and 6 (8%) RCTs reported the background of the acupuncture practitioners, but none stated the duration of their training.Conclusion The reporting quality of RCTs of acupuncture for acute ischemic stroke was low. The CONSORT statement and STRICTA should be used to standardize the reporting of RCTs of acupuncture.
ObjectiveTo evaluate the feasibility and short-term effectiveness of bilateral percutaneous balloon kyphoplasty through unilateral transverse process-extrapedicular approach for osteoporotic vertebral compression fracture (OVCF) of lumbar.MethodsA retrospective analysis was made on the clinical data of 93 patients with OVCF of lumbar who met the selection criteria between January 2018 and June 2019. According to the different surgical methods, they were divided into group A (44 cases, treated with bilateral percutaneous balloon kyphoplasty through unilateral transverse process-extrapedicular approach) and group B [49 cases, treated with percutaneous kyphoplasty (PKP) via bilateral transpedicle approach]. There was no significant difference in gender, age, body mass index, T value of bone mineral density, injury cause, fractured level, time from injury to operation, comorbidities, and preoperative Cobb angle of injured vertebra, visual analogue scale (VAS) score, and Oswestry disability index (ODI) between the two groups (P>0.05). The operation time, intraoperative fluoroscopy times, bone cement injection amount, and incidence of bone cement leakage were recorded and compared between the two groups; Cobb angle of the injured vertebrae, VAS score, and ODI were measured before operation, at 2 days and 1 year after operation. The contralateral distribution ratio of bone cement was calculated according to the anteroposterior X-ray film at 2 days after operation.ResultsThe operation time and the intraoperative fluoroscopy times in group A were significantly less than those in group B (P<0.05). There was no bone cement adverse reactions, cardiac and cerebrovascular adverse events, and no complications such as puncture needles erroneously inserted into the spinal canal and nerve injuries occurred in the two groups. Bone cement leakage occurred in 6 cases and 8 cases in groups A and B, respectively, all of which were asymptomatic paravertebral or intervertebral leakage, and no intraspinal leakage occurred; the bone cement injection amount and incidence of bone cement leakage between the two groups showed no significant differences (P>0.05). The contralateral distribution ratio of bone cement in group A was significantly lower than that in group B (t=2.685, P=0.009). Patients in both groups were followed up 12-20 months, with an average of 15.3 months. The Cobb angle of the injured vertebrae, VAS score, and ODI in the two groups were significantly improved at 2 days after operation, however, the Cobb angle of the injured vertebra at 1 year after operation was significantly lost when compared with the 2 days after operation, the VAS score and ODI at 1 year after operation were significantly further improved when compared with the 2 days after operation, the differences were all significant (P<0.05). There was no significant difference in the Cobb angle of the injured vertebrae, VAS score, and ODI between the two groups at each time point after operation (P>0.05).ConclusionBilateral percutaneous balloon kyphoplasty through unilateral transverse process-extrapedicular approach is comparable to bilateral PKP in short-term effectiveness with regard to fracture reduction, reduction maintenance, pain relief, and functional improvement. It has great advantages in reducing operation time and radiation exposure, although it is inferior in bone cement distribution.
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.
Objective To assess the efficacy and safety of acupuncture versus western medicine in the treatment of parkinson disease. Methods Randomized controlled trials (RCTs) involving acupuncture versus western medicines in the treatment of parkinson disease were identified from CBM (1978 to 2008), VIP (1989 to 2008), Wanfang Database (1998 to 2008), CNKI (1979 to 2008), PubMed (1966 to 2008), EMbase (1980 to 2008), and The Cochrane Library (Issue 4, 2008). And some relevant journals were handsearched. Data were extracted and evaluated by two reviewers independently with a specially-designed extraction form. The Cochrane Collaboration’s RevMan 5.0.20 software was used for meta-analyses. Results A total of 13 trials involving 832 patients were included. The result of meta-analyses showed that the total effective rates of the acupuncture group or of the group of acupuncture plus Madopar were similar when compared with Madopar alone in Webster score. (1) The total effective rate: The total effective rate in acupuncture plus Madopar was similar when compared with Madopar alone in UPDRS score at Day 30 (RR=1.33, 95%CI 0.95 to 1.88) and Day 66 (RR=1.38, 95%CI 0.84 to 2.24), but there were significant differences between acupuncture plus Madopar and Madopar alone (RR=1.61, 95%CI (1.19 to 2.17) at Day 84. The total effective rate in acupuncture plus benserazide-levodopa was higher than benserazide-levodopa alone (RR=1.70, 95%CI 1.08 to 2.68) at Day 66. (2)Webster score: There were no significant differences between acupuncture and Madopar at Day 30 (WMD= –2.51, 95%CI –2.83 to –2.19) and at Day 63 (WMD= –2.48, 95%CI –3.01 to –1.95). There were significant differences between acupuncture plus Madopar and Madopar alone at Day 30 (WMD= –13.48, 95%CI –15.35 to –11.61), but not at Day 42 (WMD= 0.50, 95%CI –1.22 to 2.22). (3) UPDRS score: There were no significant differences between acupuncture and Madopar at Day 60 (WMD= –7.19, 95%CI –14.49 to 0.11). There were significant differences between acupuncture plus Madopar and Madopar alone at Day 30 (WMD= 7.07 and 95%CI 2.95 to 11.19) and at Day 84 (WMD= –12.49,95%CI –16.75 to –8.23), but no significant differences were found at Day 66 and Day 33 (WMD= –14.90, 95%CI –31.89 to 2.09; WMD= –8.60, 95%CI –21.51 to 4.31).But there were statistical differences between acupuncture plus Madopar and Madopar alone at Day 30 (WMD= 7.07, 95%CI 2.95 to 11.19). There were no differences between acupuncture plus benserazide-levodopa and benserazide-levodopa alone at Day 66 (WMD=-10.80,95%CI-21.78 to 0.18) and at Day 33 (WMD=-15.60,95%CI-28.38 to -2.82). (4) Adverse reaction: Three trials reported adverse reactions including dizziness, heartbeat acceleration, slight mouth drying and nausea, but all of these were relieved or disappeared in the course of treatment. Conclusion Acupuncture is safe and effective in the treatment of parkinson disease. Acupuncture plus western drugs may be superior to western drugs alone. Because of the defects in the methodological quality of the included trials, the conclusion is to be confirmed by more high-quality RCTs.
Objectives To evaluate the methodological bias and the reliability of the conclusions of systematic reviews on acupuncture for polycystic ovary syndrome. Methods We comprehensively searched PubMed, EMbase, The Cochrane Library, CBM, CNKI and WanFang Data to collect systematic reviews on acupuncture for polycystic ovary syndrome from the establishment time of databases to January 5th, 2018. The AMSTAR tool was applied for methodological quality assessment of included studies and the GRADE system was applied for evidence quality assessment of included outcomes of systematic reviews. Results A total of 11 systematic reviews were included. The results of assessment using AMSTAR showed that, among the 11 items, most problems occurred in Item 5 " Were there any lists of research articles included and excluded”, followed by Item 1" Was an‘a prior’design provided?”and Item 11" Were potential conflict of interest included?”. GRADE grading results showed that quality of evidence for the outcome measure were" low”or" very low”. Conclusions Current acupuncture treatment of polycystic ovary syndrome has a certain effect, however, the quality of evidence is low. Thus, physicians should apply the evidence to make decision on acupuncture for polycystic ovary syndrome with caution in clinical practice and consider the actual situation, combined with the patient’s value preferences and economic factors.
ObjectiveTo evaluate the effectiveness of Curved Diffusion Needle in unilateral percutaneous vertebroplasty (PVP) by compared with bilateral PVP. MethodsA clinical data of 93 patients with osteoporotic vertebral compression fracture (OVCF) treated with PVP between January 2020 and January 2021 was retrospectively analyzed, including 47 patients underwent unilateral PVP assisted with Curved Diffusion Needle (unilateral group) and 46 patients underwent bilateral PVP (bilateral group). There was no significant difference in gender, age, cause of injury, time from injury to operation, T value of bone mineral density, AO classification, distribution of injured vertebrae, and preoperative visual analogue scale (VAS) score, Oswestry disability index (ODI), relative height of injured vertebrae, and Cobb angle between the two groups (P>0.05). The operation time, the amount of bone cement injection, the incidence of bone cement leakage, the bone cement diffusion distribution, VAS score, ODI, the relative height of injured vertebrae, and Cobb angle were recorded and compared between the two groups. Results All operations successfully completed. The operation time was significantly shorter in unilateral group than in bilateral group (t=?13.936, P=0.000), and the amount of bone cement injection was significantly less in unilateral group than in bilateral group (t=?13.237, P=0.000). The incidence of bone cement leakage in unilateral group was 19.14%, which was significantly lower than that in bilateral group (39.13%) (χ2=4.505, P=0.034). The score of bone cement distribution in unilateral group was 7.0±1.3, of which 41 cases were excellent and 6 cases were well. The score of bilateral group was 7.4±0.8, of which 43 cases were excellent and 3 cases were well. There was no significant difference in score and grading of bone cement distribution between the two groups (t=?1.630, P=0.107; Z=?1.013, P=0.311). All patients were followed up and the follow-up time was 3-10 months (mean, 6.5 months) in unilateral group and 3-10 months (mean, 6.1 months) in bilateral group. The VAS score, ODI, the relative height of injured vertebrae, and Cobb angle at 24 hours after operation and last follow-up were significantly better than those before operation in the two groups (P<0.05). There were significant differences in all indicators between 24 hours after operation and last follow-up (P<0.05). There was no significant difference in all indexes between the two groups (P>0.05) at the same time point after operation. During follow-up, there was no complication such as contralateral vertebral collapse, refracture, adjacent vertebral fracture, or local kyphosis in the two groups. ConclusionUnilateral PVP assisted with Curved Diffusion Needle for OVCF is beneficial to the distribution of bone cement, which can not only achieve similar effectiveness to bilateral PVP, but also achieve shorter operation time, less bone cement injection, and lower risk of bone cement leakage.
Objective To observe and evaluate the efficacy of continuous drainage with intravenous catheter in the treatment of breast abscess infected by methicillin resistant staphylococcus aureus (MRSA) and to explore the best treatment methods. Methods Sixty cases of breast abscess infected by MRSA were retrospectively analyzed. The patients were divided into continuous drainage group and puncture drainage group according to the treatment. Continuous drainage with 14G intravenous catheter and intermittent aspiration with 20 mL syringe were performed to treat the breast abscesses in the continuous drainage group (n=36) and puncture drainage group (n=24), respectively. Meanwhile, sensitive antibiotics were used according to the results of susceptibility test. The therapeutic effects of the 2 groups were compared. Results There were no significant differences in baseline data between continuous drainage group and puncture drainage group (P>0.05). There was no significant differences of cure rate between the two groups (P=0.717). Compared with the puncture drainage group, the continuous drainage group showed shorter period of time to heal the breast abscess (P=0.001), shorter period of time to control the ache (P=0.038), less punctures (P<0.001) and more daily volume of drainage (P<0.001). No significant differences were found in the period of time to control the fever between the two groups (P=0.127). Conclusions Continuous drainage with intravenous catheter can shorten the course of disease, reduce the suffering of patients, reduce the difficulty of hospital infection prevention and control. It’s an ideal choice for the treatment of breast abscess infected by MRSA.
Percutaneous renal puncture biopsy is an invasive procedure, and there are still some risks in its application. Bleeding after puncture is a major risk of percutaneous renal biopsy. In order to improve the safety of percutaneous renal puncture biopsy, clinical researchers have been exploring and studying the possible etiology, risk factors and prevention measures of postoperative bleeding in recent years. It is of great significance to clarify the risk factors of bleeding after percutaneous renal puncture biopsy and take timely targeted measures to reduce the risk to the maximum extent for improving the control effect of postoperative bleeding and other complications. This article intends to analyze and summarize the clinical research progress on the occurrence and risk factors of bleeding after percutaneous renal biopsy, in order to provide reference for the prevention and treatment of bleeding after percutaneous renal puncture biopsy.