Acupuncture for Chronic Non-Specific Low Back Pain: A Case Series Study

Ｌｏｗｂａｃｋｐａｉｎｉｓａｃｏｍｍｏｎｃｌｉｎｉｃａｌｃｏｎｄｉ ｔｉｏｎｔｈａｔｉｓｔｈｅｓｅｃｏｎｄｍｏｓｔｃｏｍｍｏｎｒｅａｓｏｎｆｏｒａｖｉｓｉｔｔｏａ ｐｒｉｍａｒｙｃａｒｅｐｈｙｓｉｃｉａｎ（1）．Ｌｏｗｂａｃｋｐａｉｎｉｓｔｈｅｌｅａｄｉｎｇｃａｕｓｅｏｆｄｉｓａｂｉｌｉｔｙｉｎｐｅｏｐｌｅｕｎｄｅｒ 45ａｎｄｔｈｅｓｅｃｏｎｄｌｅａｄｉｎｇｃａｕｓｅｏｆｉｎｄｕｓｔｒｉａｌａｂｓｅｎｔｅｅｉｓｍ．Ｕｐｔｏ 6 0 %ｏｆａｌｌｅｍｐｌｏｙｅｅｓｅｘｐｅｒｉｅｎｃｅｂａｃｋｐａｉｎａｔｓｏ…     

Cryptanalysis and Improvement of ‘A Privacy Enhanced Scheme for Telecare Medical Information Systems’

To ensure reliable telecare services some user authentication schemes for telecare medical information system (TMIS) have been presented in literature. These schemes are proposed with intent to regulate only authorized access to medical services so that medical information can be protected from misuse. Very recently Jiang et al. proposed a user authentication scheme for TMIS which they claimed to provide enhanced privacy. They made use of symmetric encryption/decryption with cipher block chaining mode (CBC) to achieve the claimed user privacy. Their scheme provides features like user anonymity and user un-traceability unlike its preceding schemes on which it is built. Unluckily, authors overlook some important aspects in designing their scheme due to which it falls short to resist user impersonation attack, guessing attacks and denial of service attack. Besides, its password change phase is not secure; air message confidentiality is at risk and also has some other drawbacks. Therefore, we propose an improved scheme free from problems observed in Jiang et al.’s scheme and more suitable for TMIS.     

Evaluation of the Medical Records System in an Upcoming Teaching Hospital—A Project for Improvisation

The medical records system of an upcoming teaching hospital in a developing nation was evaluated for its accessibility, completeness, physician satisfaction, presence of any lacunae, suggestion of necessary steps for improvisation and to emphasize the importance of Medical records system in education and research work. The salient aspects of the medical records department were evaluated based on a questionnaire which was evaluated by a team of 40 participants—30 doctors, 5 personnel from Medical Records Department and 5 from staff of Hospital administration. Most of the physicians (65%) were partly satisfied with the existing medical record system. 92.5% were of the opinion that upgradation of the present system is necessary. The need of the hour in the present teaching hospital is the implementation of a hospital-wide patient registration and medical records re-engineering process in the form of electronic medical records system and regular review by the audit commission.     

Needling Neiguan （P 6） for Treatment of Low Pulse Pressure Syndrome ——A Report of 31 Cases

Objective: To observe the impact of needling Neiguan (P 6) on the cardiovascular functional status in low pulse pressure syndrome. Method: 49 eligible patients were randomly assigned to a acupuncture group with bilateral Neiguan (P 6) needled for successive 3 days, and a medication group given a daily 20 mL of Shenmai Injectio intravenously dripped for successive 6 days. The blood pressure, pulse pressure, stroke volume (SV), cardiac output(CO)/min, left ventricle work index (LVWI), mean arterial pressure (MAP), total peripheral resistance (TPR), coronary perfusion pressure (CPP), pulmonary arterial wedge pressure (PAWP), effective blood volume (BV), blood viscosity (N), microcirculation half renewal rate (MHR), and cardiac muscle blood volume (CMBV) were determined before and after the treatment, which were compared with the parameters obtained in 23 healthy subjects. Results: The decreased pulse pressure of all patients before treatment (P＜0.01) increased significantly after treatment (P＜0.001). The levels of SV, CO, LVWI, PAWP, BV, MHR and CMBV were lowed when compared with the healthy subjects before treatment (P＜0.01), but all of them significantly increased after treatment (P＜0.01). The increased CPP, TPR and N before treatment (P＜0.01) were decreased after treatment (P＜0.01). Conclusion: The therapeutic effect of acupuncture at point Neiguan (P 6) was better than medication though some of the indexes showed no significant difference (P＜0.05).     

A Systematic Review of Wearable Patient Monitoring Systems – Current Challenges and Opportunities for Clinical Adoption

The aim of this review is to investigate barriers and challenges of wearable patient monitoring (WPM) solutions adopted by clinicians in acute, as well as in community, care settings. Currently, healthcare providers are coping with ever-growing healthcare challenges including an ageing population, chronic diseases, the cost of hospitalization, and the risk of medical errors. WPM systems are a potential solution for addressing some of these challenges by enabling advanced sensors, wearable technology, and secure and effective communication platforms between the clinicians and patients. A total of 791 articles were screened and 20 were selected for this review. The most common publication venue was conference proceedings (13, 54%). This review only considered recent studies published between 2015 and 2017. The identified studies involved chronic conditions (6, 30%), rehabilitation (7, 35%), cardiovascular diseases (4, 20%), falls (2, 10%) and mental health (1, 5%). Most studies focussed on the system aspects of WPM solutions including advanced sensors, wireless data collection, communication platform and clinical usability based on a specific area or disease. The current studies are progressing with localized sensor-software integration to solve a specific use-case/health area using non-scalable and ‘silo’ solutions. There is further work required regarding interoperability and clinical acceptance challenges. The advancement of wearable technology and possibilities of using machine learning and artificial intelligence in healthcare is a concept that has been investigated by many studies. We believe future patient monitoring and medical treatments will build upon efficient and affordable solutions of wearable technology.     

Effects of Aidi Injection(艾迪注射液)with Western Medical Therapies on Quality of Life for Patients with Primary Liver Cancer:A Systematic Review and Meta-Analysis

Objective: To evaluate the effects of Aidi Injection(艾迪注射液, AD) in combination with Western medical therapies(WMT) in patients with primary liver cancer(PLC). Methods: Randomized controlled trials(RCTs) comparing AD plus WMT with WMT alone were retrieved from inception to March 2013 by retrieving the literature database thoroughly and systematically. The extracted data from included studies were analyzed and synthesized by Review Manager 5.2 software. The Cochrane risk of bias tool was used to assess the quality of included studies, and Begg's and Egger's tests were used to evaluate the potential presence of publication bias. The studies were divided into 7 separate subgroups in terms of quality of life(QOL), recent chemotherapy and the incidence of leukocyte reduction. The subgroup analysis was applied to assess the heterogeneity between included researches, and the sensitivity analysis was used to weigh the stability of studies. Results: Twenty-four RCTs were included in this study. Compared with WMT used alone, AD as additional intervention was more effective on improving QOL(P0.01), increasing short-term efficacy(P0.01), prolonging life(P0.05 or P0.01), relieving clinical symptoms(P0.01), and reducing adverse events(e.g. reduce white blood cell counts, P=0.002; reduce in platelet counts, P0.01). Subgroup analysis showed that the hepatic artery interventions with AD was superior in improving QOL(P0.01) and enhancing short-term response rates(P=0.007) and reducing white blood cell counts(P=0.0004) than hepatic artery interventions alone(P0.01). The chemoembolization plus AD or the chemotherapy plus AD were both better than chemoembolization or the chemotherapy alone in improving the QOL and short-term response rate(P0.05 or P0.01). Conclusions: AD in combination with WMT improves QOL in patients with PLC. Considering the inherent limitations of the included studies, further well-designed, rigorously performed, high-quality, and double-blinded RCTs with large sample sizes are needed.