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 investigate the effects of gefitinib in the treatment of sarcomatoid carcinoma. Methods Clinical data of a case of sarcomatoid carcinoma was analyzed and related literatures were reviewed.Results A patient with sarcomatoid carcinoma was admitted with progressive dry cough,chest pain and dyspnea for 3 months. The patient was diagnosed as lung sarcomatoid carcinoma by thoracoscopy and treated with gefitinib. After 2 weeks treatment, symptoms disappeared and tumor was stable for 4 months. Literatures review suggested that sarcomatoid carcinoma is a rare malignant tumor. Treatment of sarcomatoid carcinoma includes surgery, chemotherapy and radiotherapy, but these methods show little effect in advanced patients. In our case, the patient with sarcomatoid carcinoma in stage Ⅳ was treated by gefitinib and showed favourable effect. Conclusions Advanced sarcomatoid carcinoma patients have a short life span and poor life quality. Gefitinib may provide these patients a feasible therapeutic approach.
ObjectiveTo systematically review the current status of doctor-patient conflicts in China.MethodsWe searched CNKI and CSSCI databases to collect literatures about the doctor-patient conflicts from inception to April 23rd, 2017. The literatures were categorized by the published time, the high-frequency vocabulary, the citation frequency, the researching discipline, the researching facility, the quality of literature, the theme of literature and so on. The current research status of the doctor-patient conflicts was analyzed.ResultsA total of 226 literatures were included, in which 72 defined and classified the doctor-patient conflicts, 122 analyzed the causing reasons of doctor-patient conflicts, and 160 analyzed the governance paths of doctor-patient conflicts. The research disciplinary vision was limited to the policies, regulations and the medical education and so on, and the researches in psychology or economics disciplinary vision were insufficient. The medical and comprehensive universities were the main research units of the studies of the doctor-patient conflicts. The frequency and quality of the researches about doctor-patient conflicts were low.ConclusionThe classified studies of doctor-patient conflicts are insufficient, so the scientific and manageable classified criterions are needed in the further studies. Systematic studies in influential factors of doctor-patient conflicts are insufficient, so the occurring mechanisms of conflicts are needed to be done by systematical researches on patient-centered way. The studies of governance paths of doctor-patient conflicts are insufficient, so the strategies of classified and systematical management which according to the different conflicting forms and entire process of the conflict occurrence should be put forward.
ObjectiveTo analyze the retrieval status of master and doctoral dissertations entitled systematic review/meta-analysis (SR/MA) in China. MethodsThe China Dissertation Database was searched for master and doctoral dissertations entitled SR/MA from 1980 to March 2015. Two reviewers independently extracted the basic characteristics of included dissertations, the name of retrieval databases, retrieval strategies and the method of screening literature. Then related data were analysed by Stata 12.0 software. ResultsA total of 1 639 master and doctoral dissertations entitled SR/MA were included for data analysis. Among them, 1 259 (79.5%) retrieved both Chinese databases and English databases, 107 (6.5%) retrieved Chinese databases alone, and the other 237 (14.5%) retrieved English databases alone. 1 137 (69.4%) retrieved two or more Chinese databases, while 1 316 (80.3%) retrieved two or more English databases. The most commonly retrieved Chinese databases were CNKI, VIP, CBM, and WanFang Data; while the most frequently retrieved English databases were PubMed, The Cochrane Library, EMbase and Ovid. 89.9% reported the duration of search time, 73.4% reported manual retrieval, 68.6% reported reference retrieval, 23.3% reported conference retrieval, 23.3% reported using search engine and 26.8% reported contact with experts and authors. 45.8% reported their steps of screening papers, 37.5% provided a flow screening chart, and only 14.9% reported the number of papers from each database. ConclusionThe current study suggests that the retrieved databases of master and doctoral dissertations entitled SR/MA in China are still not enough. We suggest the authors of dissertations on SR/MA retrieve at least 3 common databases, reference, engines, conference paper at the same time, and improve information on search strategy and paper screening methods.
Objective To discover the similarities and differences between CBM and MEDLINE databases in the field of post-earthquake health issue research characteristics in order to provide references and aids to the scientific research administration, professional education and training, research subjects selection and project finance support. Methods CBM and MEDLINE databases (from January 1987 to December 2009) were systematically searched to obtain literature about post-earthquake health issues. Those studies were classified and compared by the characteristics of research objects, health issues, research periods, and types of study design. Results A total of 701 literature from CBM and 387 from MEDLINE were included. MEDLINE database provided more studies focusing on victims of natural calamities with specific age description than CBM (Plt;0.05). Research peak of CBM database centralized in the period of three months after earthquake (n=645, 92%), while MEDLINE was three years after the earthquake (n=191, 87.2%). Studies from both databases similarly focused on physical trauma and psychiatric/psychological issues (two types of health issues in total: CBM: n=727, 86.1%; MEDLINE: n=358, 83.4%). Investigations from CBM were primarily designed for retrospective and descriptive research (n=439, 62.6%), cross-sectional investigations (n=146, 20.8%) and case report (n=86, 12.3%) while MEDLINE focalized on cross-sectional investigations (n=177, 45.7%) and retrospective and descriptive research (n=146, 37.7%). Conclusion Compared to MEDLINE, studies from CBM database are relatively weak in the post-earthquake health issues of population with specific age characters, long-term health issues, levels of evidence and types of research design. The possible reasons are insufficient attention to the post-earthquake health issues, inadequate preparation for the research or limited knowledge about research methods.
Objective To study the clinical characteristics of mulifocal motor neuropathy. Methods Patients records in China Biological Medicine Database (CBM-disc 1980-2005)and WanFang Database were searched. Demographic data, clinical manifestations, electrophysiology, and laboratory findings on multifocal motor neuropathy were analyzed. Results Of the total 80 patients, 61 cases were males, and 19 were females. A single limb weakness began in all the patients. Weakness was usually accentuated distally(95.3%), accompanied by muscle amyotrophy(76.3%) and fasciculation(46.3%). Reflexes were reduced (96.4%). Sensory impairment and cranial involvement were rare. 92.1% of the patients showed conduction block of motor nerve. Results Of the total 80 patients, 61 cases were males, and 19 were females. A single limb weakness began in all the patients. Weakness was usually accentuated distally(95.3%), accompanied by muscle amyotrophy(76.3%) and fasciculation(46.3%). Reflexes were reduced (96.4%). Sensory impairment and cranial involvement were rare. 92.1% of the patients showed conduction block of motor nerve. Conclusions Clinical features about multifocal motor neuropathy are a single distal limb weakness, muscle amyotrophy, and conduction block of motor nerve. MMN should be differentiated from motor neuron disease and chronic inflammatory demyelinating polyneuropathy.
Patients with chronic diseases usually face severe challenges during their transition from hospital to home, such as poor discharge preparation, the increased incidence of medical errors, insufficient self-care capability, and poor participation in healthcare decision, which can result in increased readmission and poor patient safety. This paper reviews the definition of transitional care, single-element transitional care intervention strategy, and multiple-element transitional care intervention strategy, in order to provide new insights into the development of effective and safe transitional care strategies in China.
Objective To analyze acupuncture resources in the Cochrane Database of Systematic Reviews (CDSR). Methods We identified acupuncture literature from CDSR (2008 year) electronically. W analyzed this literature by research time date, author, study contents, and conCochrane Library usions. Results We initially found 82 articles. Finally, we identified 67 systematic reviews. The number of acupuncture articles has increased all over the world with higher growth rate in China than overseas. The disease spectrum of acupuncture treatment increased widely, focusing on nervous system diseases and pain diseases. Eight articles (25.8%) definitely supported the efficacy of acupuncture. Twenty two articles (71%) considered the efficacy of acupuncture as uncertain owning to insufficient evidence. Just one article expressed that acupuncture treatment was ineffective according to current evidence.
Objective To explore the condition and quality of domestic clinical therapeutic studies on integrated traditional Chinese and western medicine for posthepatitic cirrhosis in recent 30 years. Methods Jadad scale was used to score 121 literatures selected from January 1980 to January 2010 in periodicals of domestic authoritative resources databases, such as CNKI, VIP, WanFang Data, and CBM. Systematic reviews were conducted to 39 randomized controlled trials (RCTs) literatures of treating posthepatitic cirrhosis with integrated traditional Chinese medicine and western medicine scored two or more points. Results In 30 years, the main problems existing in domestic posthepatitic cirrhosis clinical research of integrated traditional Chinese and western medicine were as follows: the design of clinical RCTs was not strict enough; there was deficiency in the use of blind method; the standardized and uniformed research standard were insufficiency; the sample content was low without specific estimation methods; there was lack of analyses in compliance with cases falling off or without follow-up; and the report of adverse reaction and the quality of life research was neglected. Conclusion Posthepatitic cirrhosis therapy of integrated traditional Chinese and western medical is of “personalized” and “diversified” characteristics. Its therapeutic effects are significantly better than those of pure western medicine and worthy to be popularized in the clinic. However, the quality and level of its clinical scientific research methods still need further improvement.
ObjectiveTo explore the abilities of thesis writing of postgraduate medical freshpeople and their factors, and provide a basis for postgraduate education and course design of thesis writing.MethodsA designed questionnaire was administered to postgraduate medical freshpeople enrolled in West China Medical School of Sichuan University in 2020. The general characteristics, current status of skills or experiences related to thesis writing, and abilities including literature retrieval and reading, statistical analysis, diagramming, research paper writing, and journal selection and submission of the postgraduates were collected in September 2020. Logical regression was conducted to analyze the factors affecting the abilities of thesis writing.ResultsA total of 503 valid questionnaires were collected. Over one half of the graduate students (58.3%) were satisfied with the ability of literature retrieval and reading, with the highest score among the five abilities [median (lower quartile, upper quartile) was 3 (2, 3)]. Less than 20% of the students were satisfied with the remaining four abilities, with the lowest scores in the abilities of diagramming, research paper writing, and journal selection and submission [each median (lower quartile, upper quartile) was 1 (1, 2)]. Research experience and acknowledge of reporting guidelines were independent factors for all abilities related to thesis writing (P<0.05). Proficiency in statistical software was an independent factor for the abilities of data statistical analysis, diagramming, research paper writing, and journal selection and submission (P<0.05). Having published scientific paper was an independent factor for ability of journal selection and submission [odds ratio=4.695, 95% confidence interval (2.166, 10.180), P<0.001].ConclusionsThe postgraduate medical freshpeople of West China Medical School are not satisfied with the ability of statistical analysis, diagramming, paper writing, or journal selection and submission. Attention should be paid to research practice and learning of reporting guidelines, while statistical courses and diagramming courses should be set up expressly.