Effectiveness of Acupoint Application in Patients with Pharyngeal Pain: Evidence from CHUNBO, A Prospective Real-World Study / 中国结合医学杂志

OBJECTIVE@#To assess the outcomes after acupoint application in patients with pharyngeal pain in a real-world settings, and analyze the characteristics of effective population and prescription characteristics of acupoint application.@*METHODS@#Based on CHUNBO platform, patients with pharyngeal pain who were candidates for acupoint application on the basis of physician-evaluation, were enrolled in a nationwide, prospective, 69-week multicenter observational study from August 2020 to February 2022. Propensity score matching (PSM) was used to match the confounding factors and the association rules were used to analyze the characteristics of effective population and prescription characteristics of acupoint application. Outcome assessments included the disappearance rate of pharyngeal pain (within 3, 7, and 14 days), disappearance time of pharyngeal pain, as well as adverse events.@*RESULTS@#Of 7,699 enrolled participants, 6,693 (86.9%) received acupoint application and 1,450 (21.7%) with non-acupoint application. After PSM, there were 1,004 patients each in the application group (AG) and non-application group (NAG). The disappearance rate of pharyngeal pain in the AG at 3, 7, and 14 days were all higher than those in the NAG (P<0.05). The disappearance time of pharyngeal pain in the AG were shorter than that in the NAG (logrank P<0.001, hazard ratio=1.51, 95% confidence interval: 1.41-1.63). The median age of effective cases was 4 years, mainly 3-6 years old (40.21%). The disappearance rate of pharyngeal pain in the application group with tonsil diseases was 2.19 times higher than that in the NAG (P<0.05). The commonly used acupoints for the effective cases were Tiantu (RN 22), Shenque (RN 8) and Dazhui (DU 14). The commonly used herbs for the effective cases were Natrii sulfas, Radix et Rhizoma Rhei, and Herba Ephedrae. Among them, Natrii sulfas was applied to RN 8 most frequently (support 84.39%). A total of 1,324 (17.2%) patients experienced AEs, and mainly occurred in the AG, with significant difference in the incidence of AEs between goups (P<0.05). All AEs reported were the first grade, and the average regression days of AEs was 2.8 days.@*CONCLUSIONS@#Acupoint application in patients with pharyngeal pain resulted in improved effective rate and shortened duration, especially children aged 3-6 years old, and those with tonsil diseases. Acupoint of RN 22, RN 8 and DU 14, Natrii sulfas, Radix et Rhizoma Rhei, and Herba Ephedrae were the most commonly used herbs in the treatment of pharyngeal pain.

Two years into the Brazilian Reproducibility Initiative: reflections on conducting a large-scale replication of Brazilian biomedical science

Scientists have increasingly recognised that low methodological and analytical rigour combined with publish-or-perish incentives can make the published scientific literature unreliable. As a response to this, large-scale systematic replications of the literature have emerged as a way to assess the problem empirically. The Brazilian Reproducibility Initiative is one such effort, aimed at estimating the reproducibility of Brazilian biomedical research. Its goal is to perform multicentre replications of a quasi-random sample of at least 60 experiments from Brazilian articles published over a 20-year period, using a set of common laboratory methods. In this article, we describe the challenges of managing a multicentre project with collaborating teams across the country, as well as its successes and failures over the first two years. We end with a brief discussion of the Initiative's current status and its possible future contributions after the project is concluded in 2021.

Influence of body configuration on the therapeutic effects of totally laparoscopic and laparoscopy-assisted radical total gastrectomies: a multicentre retrospective study (A report of 677 cases) / 中华消化外科杂志

Objective To investigate the influence of body configuration on the therapeutic effects of totally laparoscopic and laparoscopy-assisted radical total gastrectomies.Methods The retrospective cohort study was conducted.The clinicopathological data of 677 patients with gastric cancer who underwent laparoscopic radical total gastrectomies in the 11 clinical centers [100 patients in the First Affiliated Hospital of Army Medical University (Third Military Medical University),98 in the First Affiliated Hospital of Nanjing Medical University,94 in the First Affiliated Hospital of Nanchang University,89 in the First Affiliated Hospital of Xiamen University,81 in the Affiliated Hospital of Qinghai University,81 in the First Affiliated Hospital of Xinjiang Medical University,42 in the First Affiliated Hospital of Xi'an Jiaotong University,39 in the Traditional Chinese Medicine Hospital of Guangdong Province,26 in the First People's Hospital of Hangzhou City,17 in the Second Affiliated Hospital of Jilin University and 10 in the Xijing Hospital of Air Force Medical University (Fourth Military Medical University)] from January 2015 to June 2017 were collected.Among 677 patients,305 [89 patients in the First Affiliated Hospital of Army Medical University (Third Military Medical University),28 in the First Affiliated Hospital of Nanjing Medical University,14 in the First Affiliated Hospital of Nanchang University,26 in the First Affiliated Hospital of Xiamen University,75 in the Affiliated Hospital of Qinghai University,14 in the First Affiliated Hospital of Xinjiang Medical University,10 in the First Affiliated Hospital of Xi'an Jiaotong University,10 in the Traditional Chinese Medicine Hospital of Guangdong Province,19 in the First People's Hospital of Hangzhou City,13 in the Second Affiliated Hospital of Jilin University and 7 in the Xijing Hospital of Air Force Medical University (Fourth Military Medical University)] undergoing totally laparoscopic total gastrectomy were allocated into the totally laparoscopic group,and 372 [11 in the First Affiliated Hospital of Army Medical University (Third Military Medical University),70 in the First Affiliated Hospital of Nanjing Medical University,80 in the First Affiliated Hospital of Nanchang University,63 in the First Affiliated Hospital of Xiamen University,6 in the Affiliated Hospital of Qinghai University,67 in the First Affiliated Hospital of Xinjiang Medical University,32 in the First Affiliated Hospital of Xi'an Jiaotong University,29 in the Traditional Chinese Medicine Hospital of Guangdong Province,7 in the First People's Hospital of Hangzhou City,4 in the Second Affiliated Hospital of Jilin University and 3 in the Xijing Hospital of Air Force Medical University (Fourth Military Medical University)] undergoing laparoscopy-assisted total gastrectomy were allocated into the laparoscopy-assisted group.All patients received laparoscopic radical total gastrectomy and D2 lymphadenectomy using routine five-port method.Roux-en-Y anastomosis was applied for digestive tract reconstruction,and digestive tract reconstruction was performed under laparoscopy in the totally laparoscopic group and via upper abdominal median incision in the laparoscopy assisted group.Observation indicators:(1) surgical and postoperative situations;(2) stratified analysis:surgical and postoperative situations of obese patients [body mass index (BMI) ＞ 25.0 kg/m2,the maximum vertical distance between the anterior abdominal skin and the back skin at the level of the xiphoid bone (X-APD) ＞ an average value of 22.7 cm and X-APD/the maximum horizontal distance of a plane at a right angle to X-APD (X-TD) ＞an average value of 0.8] between groups;(3) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect the postoperative overall survival and tumor recurrence or metastasis up to July 2017.Measurement data with normal distribution were represented as x±s.Comparison between groups was analyzed by the t test.Measurement data with skewed distribution were described as M(Q),and comparison between groups was analyzed by Mann-Whithey test.Comparisons of count data were analyzed using the chi-square test.Results (1) Surgical and postoperative situations:all the patients in the 2 groups underwent successful operations,without perioperative death.Esophagojejunostomy methods of 305 patients in totally laparoscopic group:conventional circular stapler method were performed in 107 patients,antipuncture circular staplar method in 6 patients,OrVilTM method in 5 patients,functional end-to-end esophagojejunostomy method in 76 patients,peristalsis side-to-side esophagojejunostomy method in 106 patients and π esophagojejunostomy method in 5 patients.Three hundred and seventy-two patients in the totally laparoscopic group received conventional circular stapler method,including 361 with end-to-side esophagojejunostomy method and 11 with half end-to-end esophagojejunostomy method.Total operation time,time of esophagojejunostomy,length of assisted incision and using time of analgesics were respectively (235± 72)minutes,(33 ± 15)minutes,(5.6± 1.4) cm,(2.0 ± 1.2) days in the totally laparoscopic group and (223± 63) minutes,(29 ± 10) minutes,(8.0 ± 2.6) cm,(2.3 ± 1.6) days in the laparoscopy-assisted group,with statistically significant differences between groups (t =2.383,3.289,-15.236,-2.780,P ＜ 0.05).The eases with postoperative overall complications,anastomosis bleeding,anastomosis stricture,anastomosis leakage were respectively 38,6,11,11 in the totally laparoscopic group and 35,7,10,13 in the laparoscopy-assisted group,with no statistically significant difference between groups (x2 =1.621,0.007,0.470,0.006,P＞0.05).All the patients with postoperative complications were cured by symptomatic treatment.(2) Stratified analysis:length of assisted incision,using time of analgesics,time to postoperative anal exsufflation,time for initial fluid diet intake,time for initial semi-fluid diet intake,time of postoperative drainage-tube removal and duration of postoperative hospital stay in obese patients with BMI＞25.0 kg/m2,X-APD＞22.7 cm and X-APD/X-TD＞0.8 were respectively (5.9±1.3)cm,(5.7±1.4)cm,(5.6±1.4)cn,(2.0±1.2) days,(2.2±1.1)days,(2.1±1.1)days,(3.4±0.9) days,(3.3±0.9)days,(3.3±0.8)days,(4.7±1.1)days,(4.1±2.0)days,(4.0±1.6)days,(6.6±1.5)days,(6.4±2.3)days,(6.3±1.9)days,(7.8±2.3)days,(7.8±2.7)days,(7.6±2.9)days,(9±4)days,(10±5)days,(10±5) days in the totally laparoscopic group and (8.7±3.1)cm,(8.9±3.0)cm,(8.8±2.8)cm,(2.4±1.3)days,(2.5±1.5)days,(2.5±1.6)days,(3.7±1.0)days,(3.8±1.1)days,(3.7±1.3)days,(5.3±1.7)days,(4.8±1.7)days,(5.0±1.9)days,(7.4±2.3)days,(7.8±2.0)days,(7.0±2.2)days,(8.7±2.4)days,(8.4±1.9)days,(8.1±1.5)days,(1 1±8)days,(11±5)days,(1 1±5)days in the laparoscopy-assisted group,with statistically significant differences between groups (t =-7.950,-2.246,-2.222,-2.500,-2.771,-2.404,-2.251,P＜0.05).There were statistically significant differences in above indicators of patients with X-APD＞22.7 cm between groups (t =-12.089,-2.064,-3.732,-3.220,-5.297,-2.074,-2.208,P＜0.05),and in above indicators of patients with X-APD/X-TD＞0.8 between groups (t =-13.451,-2.736,-3.354,-4.961,-3.280,-2.137,-2.127,P＜0.05).(3) Follow-up and survival situations:of 677 patients,645 were followed up for 1-31 months,with a median time of 12 months,including 283 in the totally laparoscopic group and 362 in the laparoscopy-assisted group.During the follow-up,cases with overall survival,tumor recurrence and tumor metastasis were respectively 255,18 and 21 in the totally laparoscopic group and 327,25 and 20 in the laparoscopy-assisted group (11 and 10 patients in the totally laparoscopic and laparoscopy-assisted groups with simutaneous tumor recurrence and metastasis),showing no statistically significant difference between groups (x2 =0.009,0.076,0.959,P ＞ 0.05).Conclusions Totally laparoscopic and laparoscopy-assisted radical total gastrectomies are safe and feasible in obese patients,with the equivalent time of esophagojejunostomy.Totally laparoscopic radical total gastrectomy is of benefit to short-term recovery of patients.

Awareness of hand hygiene knowledge and compliance status in Chinese hospitals / 中国感染控制杂志

Objective To understand the status of awareness of hand hygiene(HH)knowledge and compliance among health care workers (HCWs)in China,and provide scientific basis for further improvement of HH practice. Methods A multi-centre retrospective survey on awareness of HH knowledge and compliance was conducted in 200 nationwide hospitals in 2015.Results The awareness rates of HH methods and HH indications among HCWs were 86.5% and 82.5% respectively;cleaning staff had the lowest awareness rate of HH indications(69.9%),followed by the other interns and advanced-study students (70.2%),as well as medical technicians (79.8%);attendants had the lowest awareness rate of HH methods(76.9%),followed by advanced-study students and interns(81.0%),and cleaning staff (82.4%);HH knowledge awareness rate among HCWs in secondary hospitals was lower than tertia-ry hospitals,and the district-level hospitals had the lowest awareness rate of HH.HH compliance rate and correct rate were 70.1% and 74.9% respectively;the interns and advanced-study students were at a low level of compliance and correct rates (61.4% and 60.9% respectively);the municipal hospitals had the lowest compliance and correct rates,non-teaching hospitals were lower than teaching hospitals.Conclusion HH in primary hospitals is weak,HH of interns,advanced-study students,as well as attendants and cleaning staffs are not enough,HH management should be strengthened,awareness and compliance of HH should be improved.

A prospective, multicenter, phase II clinical study of three-dimensional radiotherapy with concurrent chemotherapy for stage IV non-small-cell lung cancer-PPRA-RTOG003 / 中华放射肿瘤学杂志

Objective To investigate the efficacy and safety of three?dimensional radiotherapy (3DRT) with concurrent chemotherapy for stage IV non?small?cell lung cancer ( NSCLC). Methods A total of 198 eligible patients from 2008 to 2012 were enrolled as subjects. With an age ranging between 18 and 80 years and a Karnofsky Performance Status ( KPS) score of 70 or more, those patients had no contraindication for radiotherapy and chemotherapy, and were newly diagnosed with stage IV NSCLC confirmed by histology or cytology, as well as limited metastatic disease (≤3 organs). Survival rates and acute toxicities in those patients were evaluated. Results The 3?year follow?up rate was 98?? 5% and the 3?year sample size was 165. The median overall survival (OS) and progression?free survival (PFS) were 13?? 0 months (95% CI,11?? 7 ?14?? 3 months) and 9?? 0 months (95% CI,7?? 7 ?10?? 3 months), respectively, while the 1?, 2?, and 3?year OS rates were 53?? 5%, 15?? 8%, and 9?? 2%, respectively. Multivariate analysis showed that a primary tumor volume smaller than 134 cm3 , a stable or increased KPS score after treatment, and a radiation dose of 63 Gy or more were independent prognostic factors for longer survival time ( P=0?? 008;P= 0?? 010;P= 0?? 014). The incidence rates of grade 3?4 neutropenia, thrombocytopenia, anemia, grade 3 radiation esophagitis, and grade 3 radiation pneumonitis were 37?? 9%, 10?? 1%, 6?? 9%, 2?? 5%, and 6?? 6%, respectively. The main cause of death was distant metastasis, and only 10% of the patients died of recurrence alone. Conclusions 3DRT with concurrent chemotherapy achieves satisfactory treatment outcomes with tolerable toxicities for stage IV NSCLC. Primary tumor volume, change in the KPS score after treatment, and radiation dose are independent prognostic factors for OS.Clinical Trial Registry Chinese Clinical Reistry,registration number:ChiCTRC10001026.

A multicentre retrospective analysis of surgical effects of the 1310 Hypertensive intracerebral hemorrhage / 中华急诊医学杂志

Objective To explore the relationship between different hemorrhage position,hemorrhage volume,surgical time and outcome of treatment with surgical methods of HICH.Methods A total of 1310 patients were admitted from six hospitals from January 2004 to January 2008,the 1310 patients were divided into six groups according to different operation:craniotomy through bone flap (group A),craniotomy through small bone window (group B),stereotactic drilling drainage (group C1 and group C2),neuron-endoscopy operation (group D) and external ventricular drainage (group E),considering hemorrhage position,hemorrhage volume,surgical time and result of surgical methods were reviewed and analyzed.Results ①Craniotomy through bone flap should be selected with the case of superficial or deep hematoma volume (＞ 80 mL),median line structure distinct motion,metaphase or advanced stage of hernia of brain.②Craniotomy through small bone window and neuron-endoscopy should be selected with the case of moderate hematoma volume (50-80 mL) ③Drilling drainage should be selected with the case of small hematoma volume in superficial or deep hematoma volume (20-50 mL) ④Extemal drainage should be selected in dealing with ventricular hemorrhage.Small bone window or neuron-endoscopy should be selected in ventricular casting mould.⑤The appropriate operation time for patients with hematoma volume less than 80 mL should be 6-12 hours and large hematoma should be immediately operated to save lives.The operation time should depend on patients detail condition.Conclusions Craniotomy through bone flap was suitable for large hematoma and hernia of brain; Stereotactic drilling drainage should be selected in patients with hematoma volume less than 80mL; and the operation results in dealing with HICH would be improved via suitable operation time and surgical methods and adividual according to Hemorrhage position and Hemorrhage volume.

Efficacy and safety of domestic inhaled N-acetyl-L-cysteine solution in mucolytic therapy / 中国药学杂志

OBJECTIVE: To evaluate the clinical efficacy and safety of domestic inhaled N-acetyl-L-cysteine (NAC) solution in mucolytic therapy. METHODS: This was a multi-centre, randomized, double blinded and positive parallel trial. Fluimucil, an imported drug with the same active ingredient was used as control. Two hundred and thirty-four patients suffering from acute and chronic lower respiratory tract infection were enrolled, 117 patients in study group and control group respectively. Both groups were treated by respective drug 3 mL given by inhalation, bid, for 5-7 d. Non-inferiority test and two-sided test were used to analyze the statistic difference. RESULTS: The effective rates of the study group were 74.8% (PPS) and 74.1% (FAS). There was no significant difference (P > 0.05) between the two groups. There were no serious adverse events and major adverse events during the study. The incidence of adverse events in study group was 14.5%. There was no significant difference (P > 0.05) between the two groups. According to the preset non-inferior creteria, ie 15%, the non-inferiority of the test drug was established. CONCLUSION: The clinical efficacy and safety of the domestive inhaled N-acetyl-L-cysteine solution in mucolytic therapy are equal to fluimucil.

Efficacy and safety of azithromycin in the treatment of pediatric upper respiratory tract infections, an open non-comparative multicentre study.

The clinical efficacy and safety of a three-day course of azithromycin was evaluated in 39 children (aged 1-15 years) with clinical diagnosis of acute upper respiratory tract infections (acute pharyngitis and/or acute tonsillitis, acute otitis media and acute sinusitis). Patients received azithromycin in a single daily dose of 10 mg/kg (maximum 500 mg) orally for three days. Clinical assessment and throat culture were carried out before and after therapy. Overall clinical efficacy was fund to be satisfactory (cured or improved) in 37/39 (94.8 percent) of patients. Bacteriological efficacy, which was evaluated by eradication of the pathogens, was found in 16/18 (88.8 percent). In the remaining two patients, one was clinically cured despite persistent Staphylococcus aureus, while the other case of clinical failure was associated with a resistant strain of Psuedomonas seruginosa. The drug was well tolerated and treatment-related side-effects, which were reported in only 3*39 (7.69 percent) of the patients, were gastrointestinal in nature and of mild severity. The results of the study indicated that a single daily dose, in a three-day regimen, of azithromycin is effective and well-tolerated in the treatment of children with acute upper respiratory tract infections.

Efficacy of itraconazole pulse therapy in treatment of onychomycosis:a multicentre open study / 第二军医大学学报

Objective:To observe the efficacy and safety of itraconazole in treatment of onychomycosis and its influence on nail growth speed. Methods: In a multicentre open study involving 15 medical units nationwide, patients with onychomycosis were treated with orally itraconazole pulse therapy. At each stage after treatment, the clinical efficacy,mycological efficacy, and side-effects of the therapy and the net growth length of normal nail deck were observed.Results: The therapy had a satisfactory efficacy and prolonged effect in treating onychomycosis for both affected fingers and toe nails. The therapy was effective for onychomycosis infected with dermatophyton, yeast or non-dermatophyton fungus and had a fungus-eliminating-rate of 97.86%. The average net growth length of normal nail deck in affected toe nails was slightly longer than that in finger nails on 6 months and 9 months after treatment.No severe side effects were found. Conclusion: Itraconazole pulse therapy is effective and safe for onychomychosis and can increase nail growth length,especially for toe nails.