Objective: To observe the efficacy of acupoint selection by meridian differentiation plus qi-guiding needling in treating lumbar disc herniation (LDH).
Methods: By using the random number table, 549 patients with LDH were randomized into two groups. Two hundred and eighty participants in the observation group were intervened by selecting acupoints by meridian differentiation associated with qi-guiding needling method, and the other 269 participants in the control group were by selecting acupoints by meridian differentiation plus electroacupuncture. At the end of intervention, the changes of conduction velocities of the common peroneal nerve, superficial peroneal nerve, and tibial nerve were observed, and the therapeutic efficacies were compared.
Results: The total effective rate was 87.5% in the observation group versus 86.6% in the control group, and the difference was statistically insignificant (P>0.05). The recovery rate was 51.8% in the observation group versus 37.2% in the control group, and the difference was statistically significant (P<0.05).
Conclusion: Selecting acupoints by meridian differentiation associated with qi-guiding needling can produce a similar total effective rate to selecting acupoints by meridian differentiation plus electroacupuncture, while its recovery rate is comparatively higher.

Objective:To observe the clinical effect of warm needling moxibustion for knee osteoarthritis (KOA) by a randomized controlled trial.
Methods: Sixty cases with KOA were randomly divided into an observation group and a control group, 30 cases in each group. The observation group was treated by warm needling moxibustion. The control group was treated by simple acupuncture. Ten sessions made one course and the two groups were treated for two courses. The scores of knee joint pain, stiffness and knee functions before and after the treatment were observed.
Results: The scores of Western Ontario and McMaster Universities osteoarthritis index (WOMAC) on pain, stiffness and joint functions before and after treatment in both groups were statistically different (all P<0.05). The comparisons of the scores in pain, stiffness and joint function after treatment between the two groups were all statistically different (all P<0.05). The total effective rate was 93.3%in the observation group and 80.0%in the control group. The differences of the clinical effects between the two groups were statistically significant (P<0.05).
Conclusion: Warm needling moxibustion can improve the clinical symptoms and functions of the patients with KOA, and is better than ordinary acupuncture in the therapeutic effect.

For thousands of years, moxibustion has been used for various diseases in China and other Asian countries. Despite the recent surge in Chinese herbal studies, few randomized controlled trials have been conducted on this modality, possibly due to the lacking of suitable double blinding methodology. This is a review of extant sham moxa devices and an introduction to a recently developed device that needs further validation.

Avanaifl, a potent new selective phosphodiesterase type 5 (PDE5) inhibitor, has been developed for the treatment of erectile dysfunction (ED). We carried out a systematic review and meta-analysis to assess the efifcacy and safety of this drug for the treatment of ED. A literature review was performed to identify all published randomized, double-blind, placebo-controlled trials of avanaifl for the treatment of ED. The search included the following databases:MEDLINE, EMBASE and the Cochrane Controlled Trials Register. The reference lists of the retrieved studies were also investigated. Four publications, involving a total of 1381 patients, were used in the analysis, including four randomized controlled trials (RCTs) that compared avanaifl with a placebo. Among the co-primary efifcacy end points indicating that avanaifl 100 mg was more effective than a placebo were successful vaginal penetration (SEP2) (the odds ratio (OR)=5.06, 95%conifdence interval (CI)=3.29-7.78, P<0.00001) and successful intercourse (SEP3) (OR=3.99, 95%CI=2.80-5.67, P<0.00001). Men randomized to receive avanaifl were less likely than those receiving the placebo to drop out due to an adverse event (AE) (OR = 1.48, 95% CI = 0.54-4.08, P= 0.44). Speciifc AEs with avanaifl included headache and lfushing, which were signiifcantly less likely to occur with placebo. This meta-analysis indicates that avanaifl 100 or 200 mg is an effective and well-tolerated treatment for ED. Compared with avanaifl 100 mg, patients who take avanaifl 200 mg are more likely to experience headaches.

Objective:The study is a prospective, open, randomized multicenter phase III clinical trial with two arms that aims to elucidate superiority of D2 plus No.14v lymph node dissection in comparison with standard D2 surgery in patients with curable distal gastric cancer staged cT4N+M0. hTe primary endpoint is overall survival secondary endpoint is disease-free survival. Each treatment arm includes 255 patients, providing an expected hazard ratio of 0.6.Methods:A prospective, open, randomized multicenter phase III clinical trial was designed to elucidate superiority of D2 plus No.14v lymph node dissection in improving overall survival with regard to standard D2 surgery in patients with curable distal gastric cancer staged cT4N+M0. hTe study is a multi-institutional prospective randomized controlled trial, with participating institutions including 20 specialized centers. Treatment methodsEnrolled patients are randomized to 14v- (arm A) or to 14v + (arm B).Results:End points the primary endpoint is overall survival secondary endpoint is disease-free survival.Conclusion:Results are unifnished.

胫骨近端关节外骨折髓内钉治疗与钢板固定治疗的比较

比较髓内钉与钢板内固定治疗胫骨近端关节外骨折的研究很少,且质量较低.两种方法发生骨折不愈合的几率无差异.与钢板内固定相比,髓内钉治疗的患者感染发生率较低,但是骨折畸形愈合和筋膜室综合征的发生率较高.采用髓内钉治疗的患者有内固定失败的报道.通过目前的病例报道,暂时不能得出确切的结论,所以应进一步做前瞻性或随机对照研究来说明该问题.