Questionnaire survey and analysis of implementability of clinical practice guidelines for acupuncture-moxibustion / 中国针灸

The current usage and the existing problems in the implementability of clinical practice guidelines for acupuncture-moxibustion were investigated by questionnaire survey, aiming to provide reference for the development or update of clinical practice guidelines for acupuncture-moxibustion in the future. The results showed most of the acupuncture-moxibustion clinicians did not have a deep understanding of the guidelines, but they had a strong will of uniform standards and related guidelines. Although the published clinical practice guidelines for acupuncture-moxibustion achieved some success, they still had not got rid of the shackles of the previous textbook. The main existing problems in the guidelines included insufficient promotion, poor credibility, no evaluation criteria for curative effect, and lack of consideration for patients' will, etc. As the guidelines for acupuncture-moxibustion were based on the latest evidence of current clinical research, it reflected the low quality of current clinical research on acupuncture-moxibustion and lacking of evidence-based concept among acupuncture-moxibustion clinicians. The implementability of clinical practice guidelines is a key step in evidence-based translational medicine, while the research on the implementability of acupuncture-moxibustion guidelines is still blank. More attention should be paid to this field in the future.

Effectiveness of preoperative autologous plateletpheresis combined with intraoperative autotransfusion on the blood coagulation in orthopaedic patients / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effectiveness of preoperative plateletpheresis combined with intraoperative autotransfusion on the blood coagulation of orthopaedic patients.</p><p><b>METHODS</b>Sixty patients (ASA I-II) undergoing selective orthopaedic surgery were randomized into three groups (n = 20), that is, preoperative plateletpheresis combined with intraoperative autotransfusion for group I, intraoperative autotransfusion for group II, and group III without any managements of blood conservation. Coagulation parameters (prothrombin time, partial thromboplastin time, fibrinogen), hemoglobin and hematocrit values, platelet counts and aggregability were evaluated before the anaesthesia, 10 minutes after plateletpheresis, 10 minutes before the infusion of platelet rich plasma or autologous blood, 10 minutes after infusion, 24 and 48 hours postoperation. Intra- and postoperation blood loss and homologous blood transfusion requirements were also recorded.</p><p><b>RESULTS</b>Among three groups, there were no differences in intraoperative blood loss, perioperative haemoglobin level (Hb and Hct). As compared with group I, significant lower level of platelet counts and aggregability were observed in group II and III at the time of 24 and 48 hours after operation (P < 0.05), while postoperation blood loss and homologous blood-transfusion requirements increased at the same period (P < 0.01).</p><p><b>CONCLUSIONS</b>Preoperative plateletpheresis combined with intraoperative autotransfusion can ameliorate the blood coagulation in orthopaedic patients, and it is an effective way to decrease blood loss and homologous blood-transfusions requirements.</p>