International communication system of acupuncture-moxibustion based on OSI model / 中国针灸

Borrowing the open system interconnection (OSI) model of internet protocol and the 5W theory in communication studies, the links in the international communication of acupuncture-moxibustion can be classified into seven layers: physical layer, data link layer, network layer, transport layer, session layer, presentation layer and application layer, therefore it is built an OSI model of international communication system of acupuncture-moxibustion. It is pointed out that present international communication system of acupuncture-moxibustion is similar to the user datagram protocol (UDP) in internet technology. Evidence-based medicine (EBM) plays a key role to modernize acupuncture- moxibustion theory based upon its clinical effects. According to phenomenon-taking by classified analogy, it is found that the PICO model of EBM agrees pretty well with the "three-way handshakes" mechanism of the internet transmission control protocol (TCP), which is promising to construct an international discourse of acupuncture-moxibustion compatible with western medicine. Thus it will benefit to explore the scientific connotation of acupuncture-moxibustion theory and significantly improve the international prestige of acupuncture-moxibustion.

Contents of Evidence-based Medicine Information Services Based on Information-Knowledge-Wisdom Transformation Law / 医学信息学杂志

Introducing information-knowledge-wisdom transformation law and its four sub processes including information acquisition,recognition,decision and implementation,the paper summarizes the process of Evidence-based Medicine (EBM) information services,analyzes the scope of carrying out EBM information services by the hospital library under the guidance of new perspective,and discusses the specific forms of EBM information services by exampling the practice of EBM information services carried out by the library of the First Affiliated Hospital of Chongqing University of Medical Sciences.

Comparison of Foreign Famous Evidence-based Medicine Databases / 医学信息学杂志

The paper selects 4 famous foreign Evidence-based Medicine (EBM) databases-UpToDate,DynaMed,Medskills and CISMeF for analysis and comparison from 3 perspectives of the structures,retrieval methods and evidence grading standards,in order to provide reference for the construction and development of the EBM databases in China.

Report on 2012 International Research Congress on Integrative Medicine and Health / 全日本鍼灸学会雑誌

The 2012 International Research Congress on Integrative Medicine and Health was held in the US in Portland, Oregon on May 15-18, 2012. This conference was organized by the International Society for Complementary Medicine Research (ISCMR) and the Consortium of Academic Health Centers for Integrative Medicine (CAHCIM) . There were 1000 participants at the conference, which offered 7 workshops, 8plenary sessions, 30 symposiums, 65 oral presentations, and 433posters. Many researchers with grants from NIH or NCCAM gave presentations. These presentations were not only about acupuncture but also complementary and alternative medicine in general. My attendance to this conference was sponsored by the Department of International Affairs of the Japan Society of Acupuncture and Moxibustion.

Report on 6th ICCMR (International Congress on Complementary Medicine Research) 2011 in Chengdu / 全日本鍼灸学会雑誌

The 6th International Congress on Complementary Medicine Research (ICCMR) was held at the Sofitel Wanda Hotel in Chengdu, China on May 7-9, 2011. A pre-conference workshop was held on the 6th at Sichuan University. This conference was organized by the International Society for Complementary Medicine Research (ISCMR). There were 400 participants at the conference, which offered 4 workshops, 12 plenary sessions, 134 oral presentations, and 287 posters. Half of total presentations were from China and also many were from South Korea. The methodology of Randomized Controlled Trial (RCT) and Systematic Review (SR) were discussed for building Evidence-Based Medicine for Complementary and Alternative Medicine (CAM) and many researches with RCT and SR were at the presentation. I attended this conference by reguest from the International Department of The Japan Society of Acupuncture and Moxibustion.

Practice and Educational Effects of a Simulated Randomized Controlled Trial for Acupuncture School Teachers / 全日本鍼灸学会雑誌

[Objective]To motivate acupuncture school teachers to introduce higher-quality methodology in clinical acupuncture research.<BR>[Methods]Twenty-eight teachers from 18 acupuncture schools participated in the simulated randomized, subject and evaluator-blinded, and sham-controlled trial of acupuncture for low back pain. Twenty of them played a role as subjects, four of them were raters, and another four were therapists. Before and after conducting the trial, all the participants were asked several questions using the Visual Analogue Scale (VAS) regarding necessity of Evidence-Based Medicine (EBM) in acupuncture and their level of understanding of several terms related to a Randomized Controlled Trial (RCT),<BR>[Results]After the simulated RCT, the understanding level of all terms related to RCT increased significantly ("RCT":from 58.0 ± 27.2 to 75.5 ± 25.7, "informed consent":from 88.1 ± 15.4 to 99.2 ± 10, "recruitment":from 43.0 ± 41.0 to 74.8 ± 31.3, "random allocation":from 55.5 ± 35.0 to 78.7 ± 25.8, "masking":from 54.7 ± 35.0 to 79.0 ± 26.0) (mean ±SD). Nineteen teachers answered that they would try to conduct RCT and introduce it to their education program.<BR>[Conclusion]The results suggest that the practice of simulated RCT is effective in understanding RCT and motivating acupuncture teachers to introduce it to their education program.

Efficacy of Twin-block appliance in Class II division 1 of adolescents: A systematic review / 实用口腔医学杂志

Objective; To evaluate the efficacy of Twin-block appliance in Class Ⅱ division 1 of adolescents. Methods: Several e-lectronic databases (PubMed, The Cochrane library, Embase, CBMdisk, CNKI, VIP)were searched. Abstract that appears to fulfill the initial selection criteria were selected by consensus and original articles were retrieved. Five Chinese journals were hand searched for possible missing articles. Randomized controlled trials(RCTs) that evaluate the efficacy of Twin-block appliance in Class Ⅱ division I adolescents without any surgical intervention or syndromic characteristics were considered. A comparable untreated control group was required to factor out normal growth changes. The quality of included studies was evaluated according to Cochrane Reviewers Handbook 4.2.6 Meta-analysis was performed by using RevMan 5.0.0 software. Results: Four RCTs including 289 patients were identified. The results of our meta-analysis showed a significant increase on SNB angle, Ar-Gn, Nasolabial angle and Labial-mental fold compared with control group(P<0.05). Whereas overjet, overbite, ANB angle and Ls-E had a significant decrease. In addition, SNA angle and Li-E didnt show statistical significant changes(P>0. 05). Conclusion; In Class II division 1 of adolescents, Twin-block appliance can effectively decrease their overjet, overbite, ANB angle, and induce anterior-posterior growth of mandible. The effect on restrain forward growth of the maxilla was unclear. More RCTs are required to evaluate the efficacy of Twin-block appliance.

How to Write Abstractor's Comments on Structured Abstract of RCT in Kampo / 日本東洋医学雑誌

The Japan Society for Oriental Medicine (JSOM) began its second Special Committee for EBM (evidence- based medicine) project in 2005. Evidence Report Task Force (ER-TF) of the furthered the project on Evidence Reporting in Kampo Treatment initiated by the previous committee in 2001. The second Committee once again collected randomized control trial (RCT) literature only, to produce structured abstracts (SA). ors were then asked to make comments in these SA, as would be found in international EBM medical journals. There was concern, however, that their comments were reviewed negatively by authors of original article. Therefore a workshop entitled “How to Write Appropriate Comments” was held at the 58th Annual Meeting of JSOM in Hiroshima, on June 17, 2007. This workshop proved educational, and demonstrated ways to write more positive comments, including the so-called “sandwich technique” of writing first positive, then negative, then positive comments (PNP).

Percepção da aplicabilidade da Medicina Baseada em Evidência / Perception of Evidence-Based Medicine applicability

Na década de 90, surgiu o conceito de Medicina Baseada em Evidências (MBE), ciência baseada na lógica e no conhecimento científico, integrado à experiência prática do médico. Para ser aplicada, são necessários a atualização médico-acadêmica e o aperfeiçoamento das técnicas de procura e leitura crítica de artigos científicos. O objetivo do estudo foi verificar a percepção de discentes do curso de medicina e de médicos quanto ao conhecimento, aceitabilidade e aplicabilidade da MBE, avaliando os meios utilizados para atualização médico-acadêmica e para a tomada de decisões clínicas, bem como a necessidade de elaboração de roteiros de busca e uso de informações científicas. Aplicou-se questionário contendo 11 perguntas, respondidas individual e voluntariamente por 200 acadêmicos de Medicina e 120 médicos. Verificou-se que 71,7% dos médicos e 62,4% dos acadêmicos entrevistados concordam com a utilização da MBE na prática clínica; 29,2% dos médicos e 30,9% dos alunos reconhecem dificuldades de aplicabilidade da mesma; a internet mostrou ser o principal meio utilizado para atualização médico-acadêmica (80,8% dos médicos e 80,6% dos discentes). Os achados permitem concluir que, apesar de difundidos o conceito e a concordância com a MBE, sua aplicabilidade ainda esbarra em algumas dificuldades e limitações, o que nos permite inferir que a elaboração e divulgação de roteiros podem auxiliar na construção da pergunta clínica básica e aplicação de informações científicas.

In the 90's, the concept of Evidence-Based Medicine (EBM) arose, a science based on logic and scientific knowledge, integrated to the practical experience of the physician. To be put into practice, medical-academic update and na improvement of the techniques of search and critical reading of scientific articles are necessary. The aim of this study was to verify the perception of Medicine graduation course students and physicians about the knowledge, acceptability and aplicability of EBM, evaluating the means used to medical-academic update and to make clinical decisions, as well as the necessity of elaboration of search scripts and scientific information use. A questionaire of 11 questions was answered individually and voluntarily by 200 Medicine graduation course students and 120 physicians. It was verified that 71,7% of the physicians and 62,4% of the students interviewed agree with the use of EBM in clinical practice; 29,2% of the physicians and 30,9 % of the students admit difficulties in its applicability; Internet has been shown as the main mean for medical-academic update (80,8% the physicians and 80,6% of the students. The findings allow us to conclude that, although the concept and agreement with EBM are diffused, its applicability still colides with some difficulties and limitations, what allow us to infer that the elaboration and the publishment of scripts can assist in the basic clinical question construction and in the scientific informations application.

Hacia un cambio de paradigma en la medicina transfusional: propuesta de acción en un Hospital Público / Towards a change in the paradigm of transfusion medicine: proposal of action in a Public Hospital

Una de las características del modelo médico imperante hoy en cuanto a algunas acciones del trabajo clínico-quirúrgico diario y cotidiano, lo constituye ciertas prácticas basadas en los "usos y costumbres" conducente al "automatismo terapéutico", alejándose así de una práctica reflexiva con base firme en la adecuada evidencia científica en la valoración de su indicación. El uso y las indicaciones de la transfusión de sangre, en muchos casos, entra de lleno en ése marco y constituye un buen ejemplo de la práctica médica rutinaria que no siempre parte de un posicionamiento científico sólido. Presentamos aquí un “Proyecto de Inversión o Intervención” en un Hospital Público del país como plan de acción de un programa de 2 años de duración sobre adecuado uso e indicación de la transfusión de sangre, con el objetivo de impacto de ir transitando por el camino del modelo de la Medicina Basada en la Evidencia. Con ello pretendemos una rentabilidad social concreta en cuanto a evitar al paciente una práctica innecesaria y potencialmente peligrosa y, además, contribuir a la implementación de un modelo de acción médica más sustentado en la evidencia mundial que en la experiencia individual. Creemos que así el desarrollo de la indicación médica será más correcto conduciendo a una Medicina más beneficiosa y barata.

We present in this work an Intervention Project, as a social project, in a attempt to solve a common problem to many hospitals, in this particular case one hospital of the city of San Juan, Argentina, which is the daily medicine practice based on "uses and habits" and "automatic therapeutic indication" instead of Evidence Based Medicine (EBM). Transfusion Medicine is a good example of that way of behavior and, despite a marked revision process during the last two decades, medical doctors continue to indicate blood and derivates without a solid scientific base. Patients are placed under the situation of a no necessary and potential harmful and dangerous practice and the costs of medical attention increases without benefits. It can also produce moral and juridical conflicts in the daily medicine practice (Jehovah Witness). We propose a 2 years program based on a "Properly Use of Blood" plan using the "logical frame approach" (LFA) as a specific management tool and looking at the EBM as the guide paradigm. We hope to reach, in achieving our aims, a more correct, harmless and cheaper diary medical action.

Education in Complementary and Alternative Medicine in Japanese Medical Schools: Follow-Up Study, 1999-2004 / 医学教育

This is a follow-up study to our 1999 telephone survey of education in complementary and alternative medicine (CAM) in Japanese medical schools. We surveyed the same workers in curriculum offices in all 80 Japanese medical schools in 2004. The number of medical schools that offer CAM education has increased significantly, from 16 schools (20%) in 1999 to 69 schools (86%) in 2004. Treatment with <I>kampo</I> is being taught in all 69 schools with CAM education. Fourteen (20%) of these 69 schools also teach a new framework of CAM and integrative medicine, and 7 schools teach evidence-based medicine in relation to CAM, although almost all schools (95%) taught <I>kampo</I> and acupuncture as types of traditional Asian medicine in 1999.

New concepts and new techniques affecting development of orthopaedic trauma / 中华创伤骨科杂志

The techniques and concepts in the field of orthopaedic trauma have been changed in these years by new ideas of osteosynthesis, minimal invasive surgery (MIS), computer assisted orthopaedic surgery (CAOS) and evidence based medicine (EBM). This paper briefly introduces the development trend in orthopaedic trauma through discussion of the papers exchanged in the 2nd Congress of Chinese Orthopaedic Trauma Association.

Physicians' Awareness Regarding Evidence-based Medicine, Practice Guidelines and Clinical Information Resources in Japan / General Medicine

BACKGROUND: physicians' awareness regarding evidence-based medicine (EBM), clinical practice guidelines, and clinical information resources were rarely examined in Japan. We need to know them prior to the initiation of the Medical Information Network Distribution Service (Minds) by the Japan Council for Quality Health Care (JCQHC) .<BR>METHODS: A total of 10, 000 directors/owners of private clinics (CDs: clinic physicians) affiliated with the Japan Medical Association (JMA) and 8682 physicians working for hospitals certified by the JCQHC (HDs: hospital physicians) were randomly selected and surveyed by a mailed questionnaire.<BR>RESULTS: The response rate to the questionnaire was 18.7% (n=1865) among CDs and 67.8% (n=5885) among HDs. The percentage of respondents who uses internet was 39.9% among CDs and 69.3% among HDs. The information resource most commonly used by all respondents was medical journals, followed by textbooks. The percentage of respondents who used medical literature database was 10.8% among CDs and 49.7% among HDs, respectively. Approximately 80% of all respondents approved implementing EBM in daily practice. Fifty percent of all respondents indicated to have used clinical practice guidelines, and 90% of all the guideline users replied that clinical practice guidelines are useful tools for clinical decision-making. Over half of HDs required to access to the abstracts of the literature cited in the guidelines.<BR>CONCLUSIONS: Many physicians who responded to the survey acknowledged that EBM will contribute to improving the quality of medical services. They are positive in using clinical practice guidelines that include a series of recommendations proposed by specialists in the relevant field (s) in accordance to the reviewed evidence.