Integrated traditional Chinese medicine(TCM)and Western medicine(WM)is a new medical science grounded in the knowledge bases of both TCM and WM,which then forms a unique modern medical system in China.Integrated TCM a...Integrated traditional Chinese medicine(TCM)and Western medicine(WM)is a new medical science grounded in the knowledge bases of both TCM and WM,which then forms a unique modern medical system in China.Integrated TCM and WM has a long history in China,and has made important achievements in the process of clinical diagnosis and treatment.However,the methodological defects in currently published clinical practice guidelines(CPGs)limit its development.The organic integration of TCM and WM is a deeper integration of TCM and WM.To realize the progression of"integration"to"organic integration",a targeted and standardized guideline development methodology is needed.Therefore,the purpose of this study is to establish a standardized development procedure for clinical practice guidelines for the organic integration of TCM and WM to promote the systematic integration of TCM and WM research results into clinical practice guidelines in order to achieve optimal results as the whole is greater than the sum of the parts.展开更多
目的评估经尿道前列腺等离子双极电切术(TUPKP)治疗良性前列腺增生(BPH)的相关并发症类型及其发生率。方法计算机检索PubMed、Embase、Web of Science、The Cochrane Library、中国知网、维普、中国生物医学文献数据库及万方数据库,搜...目的评估经尿道前列腺等离子双极电切术(TUPKP)治疗良性前列腺增生(BPH)的相关并发症类型及其发生率。方法计算机检索PubMed、Embase、Web of Science、The Cochrane Library、中国知网、维普、中国生物医学文献数据库及万方数据库,搜集有关TUPKP治疗BPH并发症发生率的横断面研究,检索时限均至2020年9月15日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用R软件meta程序包进行Meta分析。结果共纳入27项研究,包括5247例患者。文献中报告的并发症有尿道狭窄、暂时性尿失禁、排尿困难、需要输血等31种。Meta分析结果显示:发生率最高的并发症为术后6个月射精异常,其次是术后逆行性射精、术后尿路刺激症状,发生率分别为75.15%[95%CI(68.25%,81.47%)]、24.77%[95%CI(0.00%,73.81%)]和17.15%[95%CI(9.61%,26.22%)]。其他并发症发生率均低于10%,有21种并发症的发生率低于3%。15项研究报告了经尿道电切综合征,且发生率均为0。结论当前证据显示,TUPKP治疗BPH术后并发症种类较多,发生率差异较大。展开更多
Background Qishen(QS) capsules, a Traditional Chinese Medicine, has been widely used to treat coronary heart disease in China. However, evidence of its effectiveness remains unclear. Methods To explore whether QS has ...Background Qishen(QS) capsules, a Traditional Chinese Medicine, has been widely used to treat coronary heart disease in China. However, evidence of its effectiveness remains unclear. Methods To explore whether QS has cardioprotective efficacy and/or promotes angiogenesis after myocardial infarction (MI), we performed experiments in a preclinical rat MI model. One month after left anterior descending coronary artery ligation, the rats received either QS solution (0.4 g/kg/day) or the same volume of saline by intragastric injection for four weeks. Results Echocardiographic and hemodynamic analyses demonstrated relatively preserved cardiac function in MI rats administered QS. Indeed, QS treatment was associated with reduced infarct scar size and heart weight index, and these beneficial effects were responsible for enhancing angiogenesis. Mechanistically, QS treatment increased phosphorylation of protein kinase B (Akt) and downregulated phosphorylation of mitogen-activated protein kinase/extracellular-regulated kinase (MEK/ERK). Conclusions QS therapy can improve the cardiac function of rats after MI by an underlying mechanism involving increased angiogenesis, at least partially via activation of the Akt signaling pathway and inhibition of MEK/ERK phosphorylation.展开更多
Non-muscle invasive bladder cancer(NMIBC)is a major type of bladder cancer with a high incidence worldwide,resulting in a great disease burden.Treatment and surveillance are the most important part of NIMBC management...Non-muscle invasive bladder cancer(NMIBC)is a major type of bladder cancer with a high incidence worldwide,resulting in a great disease burden.Treatment and surveillance are the most important part of NIMBC management.In 2018,we issued“Treatment and surveillance for non-muscle-invasive bladder cancer in China:an evidencebased clinical practice guideline”.Since then,various studies on the treatment and surveillance of NMIBC have been published.There is a need to incorporate these materials and also to take into account the relatively limited medical resources in primary medical institutions in China.Developing a version of guideline which takes these two issues into account to promote the management of NMIBC is therefore indicated.We formed a working group of clinical experts and methodologists.Through questionnaire investigation of clinicians including primary medical institutions,24 clinically concerned issues,involving transurethral resection of bladder tumor(TURBT),intravesical chemotherapy and intravesical immunotherapy of NMIBC,and follow-up and surveillance of the NMIBC patients,were determined for this guideline.Researches and recommendations on the management of NMIBC in databases,guideline development professional societies and monographs were referred to,and the European Association of Urology was used to assess the certainty of generated recommendations.Finally,we issued 29 statements,among which 22 were strong recommendations,and 7 were weak recommendations.These recommendations cover the topics of TURBT,postoperative chemotherapy after TURBT,Bacillus Calmette–Guérin(BCG)immunotherapy after TURBT,combination treatment of BCG and chemotherapy after TURBT,treatment of carcinoma in situ,radical cystectomy,treatment of NMIBC recurrence,and follow-up and surveillance.We hope these recommendations can help promote the treatment and surveillance of NMIBC in China,especially for the primary medical institutions.展开更多
BACKGROUND Chinese herbal medicine is widely used as a complement or alternative treatment in coronary artery disease(CAD)patients after percutaneous coronary intervention(PCI)in China.We compared the incidence of the...BACKGROUND Chinese herbal medicine is widely used as a complement or alternative treatment in coronary artery disease(CAD)patients after percutaneous coronary intervention(PCI)in China.We compared the incidence of the major adverse cardi-ovascular event(MACE)of CAD patients with or without the complement use of Chinese herbal medicine after PCI.METHODS In this prospective,observational study that was conducted from September 2016 to August 2019 in Fuwai Hospital(China),we followed up consecutive patients who received PCI treatment for two years.MACE was defined as the composite all-cause mortality,revascularization,and myocardial infarction(MI)and was compared between those using(integrative medicine group)or those not using Chinese herbal medicine as an additional treatment to standard Western medicine,with unadjusted(Kaplan-Meier curves)and risk-adjusted(multivariable Cox regression)analyses.RESULTS A total of 5942 patients after PCI were enrolled in this study,and 5453 patients were included in the final analysis(4189[76.8%]male;mean age:61.9±9.9%years).During the follow-ups,2932(53.8%)patients used only Western medicine while 2521(46.2%)patients had used Chinese herbal medicine as an additional treatment to standard Western medicine.Patients in the integrative medicine group(IM group)were older than the Western medicine group(WM group),had more females and less pre-vious MI.The incidence of MACE was 15.3%(449/2932)in WM group and 11.54%(291/2521)in IM group.Cox regression ana-lysis showed that cumulative incidence of MACE was 27%lower in patients of the IM group than those in WM group(hazard ra-tio=0.73;95%CI:0.63-0.85;P<0.0001).CONCLUSIONS For CAD patients after PCI treatment,complement use of Chinese herbal medicine is associated with a lower 2-year MACE incidence.Randomized prospective studies are warranted to provide higher levels of benefit evidence in these pa-tients.展开更多
基金supported by the National Natural Science Foundation of China(82174230)the Fundamental Research Funds for the Central Universities(2042022kf1213)。
文摘Integrated traditional Chinese medicine(TCM)and Western medicine(WM)is a new medical science grounded in the knowledge bases of both TCM and WM,which then forms a unique modern medical system in China.Integrated TCM and WM has a long history in China,and has made important achievements in the process of clinical diagnosis and treatment.However,the methodological defects in currently published clinical practice guidelines(CPGs)limit its development.The organic integration of TCM and WM is a deeper integration of TCM and WM.To realize the progression of"integration"to"organic integration",a targeted and standardized guideline development methodology is needed.Therefore,the purpose of this study is to establish a standardized development procedure for clinical practice guidelines for the organic integration of TCM and WM to promote the systematic integration of TCM and WM research results into clinical practice guidelines in order to achieve optimal results as the whole is greater than the sum of the parts.
文摘目的评估经尿道前列腺等离子双极电切术(TUPKP)治疗良性前列腺增生(BPH)的相关并发症类型及其发生率。方法计算机检索PubMed、Embase、Web of Science、The Cochrane Library、中国知网、维普、中国生物医学文献数据库及万方数据库,搜集有关TUPKP治疗BPH并发症发生率的横断面研究,检索时限均至2020年9月15日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用R软件meta程序包进行Meta分析。结果共纳入27项研究,包括5247例患者。文献中报告的并发症有尿道狭窄、暂时性尿失禁、排尿困难、需要输血等31种。Meta分析结果显示:发生率最高的并发症为术后6个月射精异常,其次是术后逆行性射精、术后尿路刺激症状,发生率分别为75.15%[95%CI(68.25%,81.47%)]、24.77%[95%CI(0.00%,73.81%)]和17.15%[95%CI(9.61%,26.22%)]。其他并发症发生率均低于10%,有21种并发症的发生率低于3%。15项研究报告了经尿道电切综合征,且发生率均为0。结论当前证据显示,TUPKP治疗BPH术后并发症种类较多,发生率差异较大。
文摘Background Qishen(QS) capsules, a Traditional Chinese Medicine, has been widely used to treat coronary heart disease in China. However, evidence of its effectiveness remains unclear. Methods To explore whether QS has cardioprotective efficacy and/or promotes angiogenesis after myocardial infarction (MI), we performed experiments in a preclinical rat MI model. One month after left anterior descending coronary artery ligation, the rats received either QS solution (0.4 g/kg/day) or the same volume of saline by intragastric injection for four weeks. Results Echocardiographic and hemodynamic analyses demonstrated relatively preserved cardiac function in MI rats administered QS. Indeed, QS treatment was associated with reduced infarct scar size and heart weight index, and these beneficial effects were responsible for enhancing angiogenesis. Mechanistically, QS treatment increased phosphorylation of protein kinase B (Akt) and downregulated phosphorylation of mitogen-activated protein kinase/extracellular-regulated kinase (MEK/ERK). Conclusions QS therapy can improve the cardiac function of rats after MI by an underlying mechanism involving increased angiogenesis, at least partially via activation of the Akt signaling pathway and inhibition of MEK/ERK phosphorylation.
基金suppor ted by the National Key Research and Development Plan of China(Technology helps Economy 2020,2016YFC0106300)the National Natural Science Foundation of China(82174230)the Major Program Fund of Technical Innovation Project of Department of Science and Technology of Hubei Province(2016ACAl52)。
文摘Non-muscle invasive bladder cancer(NMIBC)is a major type of bladder cancer with a high incidence worldwide,resulting in a great disease burden.Treatment and surveillance are the most important part of NIMBC management.In 2018,we issued“Treatment and surveillance for non-muscle-invasive bladder cancer in China:an evidencebased clinical practice guideline”.Since then,various studies on the treatment and surveillance of NMIBC have been published.There is a need to incorporate these materials and also to take into account the relatively limited medical resources in primary medical institutions in China.Developing a version of guideline which takes these two issues into account to promote the management of NMIBC is therefore indicated.We formed a working group of clinical experts and methodologists.Through questionnaire investigation of clinicians including primary medical institutions,24 clinically concerned issues,involving transurethral resection of bladder tumor(TURBT),intravesical chemotherapy and intravesical immunotherapy of NMIBC,and follow-up and surveillance of the NMIBC patients,were determined for this guideline.Researches and recommendations on the management of NMIBC in databases,guideline development professional societies and monographs were referred to,and the European Association of Urology was used to assess the certainty of generated recommendations.Finally,we issued 29 statements,among which 22 were strong recommendations,and 7 were weak recommendations.These recommendations cover the topics of TURBT,postoperative chemotherapy after TURBT,Bacillus Calmette–Guérin(BCG)immunotherapy after TURBT,combination treatment of BCG and chemotherapy after TURBT,treatment of carcinoma in situ,radical cystectomy,treatment of NMIBC recurrence,and follow-up and surveillance.We hope these recommendations can help promote the treatment and surveillance of NMIBC in China,especially for the primary medical institutions.
基金This work was supported by the National Key R&D Program of China(2021ZD0111003)the Capital Health Development Project of China grant(SHF-2016-2-4032).
文摘BACKGROUND Chinese herbal medicine is widely used as a complement or alternative treatment in coronary artery disease(CAD)patients after percutaneous coronary intervention(PCI)in China.We compared the incidence of the major adverse cardi-ovascular event(MACE)of CAD patients with or without the complement use of Chinese herbal medicine after PCI.METHODS In this prospective,observational study that was conducted from September 2016 to August 2019 in Fuwai Hospital(China),we followed up consecutive patients who received PCI treatment for two years.MACE was defined as the composite all-cause mortality,revascularization,and myocardial infarction(MI)and was compared between those using(integrative medicine group)or those not using Chinese herbal medicine as an additional treatment to standard Western medicine,with unadjusted(Kaplan-Meier curves)and risk-adjusted(multivariable Cox regression)analyses.RESULTS A total of 5942 patients after PCI were enrolled in this study,and 5453 patients were included in the final analysis(4189[76.8%]male;mean age:61.9±9.9%years).During the follow-ups,2932(53.8%)patients used only Western medicine while 2521(46.2%)patients had used Chinese herbal medicine as an additional treatment to standard Western medicine.Patients in the integrative medicine group(IM group)were older than the Western medicine group(WM group),had more females and less pre-vious MI.The incidence of MACE was 15.3%(449/2932)in WM group and 11.54%(291/2521)in IM group.Cox regression ana-lysis showed that cumulative incidence of MACE was 27%lower in patients of the IM group than those in WM group(hazard ra-tio=0.73;95%CI:0.63-0.85;P<0.0001).CONCLUSIONS For CAD patients after PCI treatment,complement use of Chinese herbal medicine is associated with a lower 2-year MACE incidence.Randomized prospective studies are warranted to provide higher levels of benefit evidence in these pa-tients.
