ABSTRACT
Objective: To review the systematic reviews of acupuncture for diabetic peripheral neuropathy (DPN) and to provide evidence for clinical decisions. Methods: Published systematic reviews targeting acupuncture treatment of DPN were searched using computer through both Chinese and English databases till July 1, 2019. Two researchers screened the papers based on inclusion and exclusion criteria and conducted report quality evaluation, methodological quality assessment and evidence quality grading using the preferred reporting items for systematic reviews and meta-analyses (PRISMA), assessment of multiple systematic review 2 (AMSTAR 2) and grading of recommendations assessment, development and evaluation (GRADE). Results: Ten systematic reviews were included, involving 11 outcome measures. According to PRISMA, 6 items were sufficiently reported while 1 item was not; AMSTAR 2 appraised that all the included systematic reviews were of low quality in the methodological evaluation; according to GRADE, of the 30 clinical evidences, only 5 were graded moderate while the remained were graded low or extremely low. Descriptive analysis showed that acupuncture can significantly improve DPN symptoms, accelerate the conduction velocities of sensory and motor nerves, and up-regulate the content of plasma nitric oxide (NO), while the adverse reaction rate was low. Conclusion: Acupuncture can produce satisfactory clinical efficacy in treating DPN, but the existing problems, such as low-quality evidence, unitary outcome measures, poor methodological quality of systematic reviews and nonstandard reporting, need to be treated cautiously; meanwhile, more high-quality clinical trials are required to elevate the level of evidence.
ABSTRACT
Objective To compare the effectivenessbetween the use of computer simulationin the teaching of abdomen diagnosis skills and the traditional teaching mode by conducting the real－time assessment and after－school questionnaire survey. Method Weselected 308 undergraduates with 165 (4 classes) majoring in clinical medicine and 143 (4 classes) majoring in medical laboratory in Kunming Medical Universityas the research object. Students were randomly divided into two groups and taught using demonstration method. One group practiced abdominal examination on other students while the other group adopted computer simulation.Both groups were giventests of practical skills and anonymous open－ended questionnaires after class.Results The average score of computer simulation group was higher than the other group. The questionnaire survey showed that computer simulation was suitable for repeatable exercises and easy to review after class (P＜0.05).Conclusion In thediagnostic practice of abdominal examination,teaching assisted with computer simulation showing an outstanding performance should be combined and promoted with the traditional teaching.