Chinese medicine (CM) has been an experience based practice over the past three thousand years. The safety and efficacy of CM has been practised through experience, rather than nowadays’ modern scientific measurement...Chinese medicine (CM) has been an experience based practice over the past three thousand years. The safety and efficacy of CM has been practised through experience, rather than nowadays’ modern scientific measurements. In this way, the development of CM has not been keeping pace with the advance in science and technology and the progress in orthodox medicine. In order to meet the requirements of modern science and technology, an evidence based approach must be adopted. Reassurance is needed to convince people for safety and efficacy of CM and give confidence to the evidence based demands ——“Tradition is confirmed by Modern Science” (1) .展开更多
<strong>Background:</strong> The main purpose of the present study was to assess the short term performance of a cementless femoral stem in total hip replacement. <strong>Methods:</strong> Cros...<strong>Background:</strong> The main purpose of the present study was to assess the short term performance of a cementless femoral stem in total hip replacement. <strong>Methods:</strong> Cross-sectional observational study of a 48-patient cohort with Phenom? femoral stems implanted between June 1, 2014 and September 1, 2018, to determine clinical performance, stability, and radiographic osseointegration. Patients were followed-up from 13 to 76 months (mean: 44.5 months) and assessed using the Harris Hip Score-HHS, the Hip Disability and Osteoarthritis Outcome Score-HOOS and radiographs. <strong>Results:</strong> All stems were radiologically stable. Mean Harris Hip Score was 89.8 and the HOOS was 80.4. No statistical differences were observed among patients with different diagnoses. <strong>Conclusions:</strong> The short-term results revealed satisfactory clinical outcomes and radiological signs of implant stability in all cases. Using two functional scores was useful in detecting biases and a low to moderate agreement was found between the scores.展开更多
Background:Lung cancer is one of the most common cancers globally with high incidence and mortality rate.Acupuncture and moxibustion have been used as adjuvant therapies to relieve the symptoms and complications of lu...Background:Lung cancer is one of the most common cancers globally with high incidence and mortality rate.Acupuncture and moxibustion have been used as adjuvant therapies to relieve the symptoms and complications of lung cancer.At present,acupuncture and moxibustion can partially improve the quality of life(QOL)of cancer patients.However,the evidence that acupuncture and moxibustion can improve patient-reported outcomes(PROs)in patients with lung cancer is still insufficient.We aimed to conduct a systematic review and meta-analysis of published randomized controlled trials(RCTs)to determine whether acupuncture and moxibustion can improve PROs among patients with lung cancer,providing a support basis for acupuncture and moxibustion inclusion in relevant guidelines.Methods:We will search the following electronic databases:PubMed,Embase,Cochrane Library,Web of Science,CNKI,CQVIP,Wanfang Data,Sinomed,and gray literature including the ClinicalTrials.gov Database(clinicaltrials.gov)and Chinese Clinical Trial Register(chictr.org.cn).All English and Chinese articles will be searched until July 1,2021.Two researchers independently extracted data.Any disagreement was resolved by discussion until consensus was reached or by consulting a third researcher.The primary outcomes mainly included the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30),functional assessment of cancer therapy-lung(FACT-L),and Karnofsky Performance Status(KPS).The secondary outcomes included improvement of individual lung cancerrelated symptoms and the safety of acupuncture intervention.Discussion:Our study is the first to focus on the PROs of acupuncture and moxibustion for lung cancer treatment.The results will contribute to a deeper understanding of the evidence distribution of acupuncture and moxibustion in PROs,which may support the use of acupuncture and moxibustion in lung cancer patients.展开更多
BACKGROUND Adjuvant chemotherapy is recommended in high-risk breast cancer. However, no universally accepted guidelines exist on pre-chemotherapy assessment. In particular, the number and frequency of medical visits v...BACKGROUND Adjuvant chemotherapy is recommended in high-risk breast cancer. However, no universally accepted guidelines exist on pre-chemotherapy assessment. In particular, the number and frequency of medical visits vary according to each institution’s policy. We hypothesised that the Edmonton Symptom Assessment Scale(ESAS) may have a favourable impact on the pre-treatment assessment in candidates for adjuvant chemotherapy.AIM To investigate whether the ESAS can be used to safely reduce the number of medical visits in women with breast cancer undergoing adjuvant chemotherapy.METHODS In a retrospectively prospective matched-pair analysis, 100 patients who completed the ESAS questionnaire before administration of adjuvant chemotherapy(ESAS Group) were compared with 100 patients who underwent chemotherapy according to the traditional modality, without ESAS(no-ESAS Group). Patients of the ESAS Group received additional visits before treatment if their ESAS score was > 3. The primary endpoint was the total number of medical visits during the entire duration of the chemotherapy period. The secondary endpoints were the occurrence of severe complications(grade 3-4) and the number of unplanned visits during the chemotherapy period.RESULTS The study variables did not statistically differ between patients of the ESAS Group and no-ESAS Group(age P = 0.880;breast cancer stage P = 0.56;cancer histology P = 0.415;tumour size P = 0.258;lymph node status P = 0.883;immunohistochemical classification P = 0.754;type of surgery P = 0.157), except for premenopausal status(P = 0.015). The study variables did not statistically differ between patients of the ESAS Group and no-ESAS Group regarding age, cancer stage, histology, tumour size, lymph node status, immunohistochemical classification, and type of surgery. Unplanned visits during the entire duration of chemotherapy were 8 in the ESAS Group and 18 in the no-ESAS Group visits(P = 0.035). Grade 3-4 toxicity did not differ between the study groups(P = 0.652). Forty-eight patients of the ESAS Group received additional visits due to an ESAS score > 3. The mean number of medical visits was 4.38 ± 0.51 in the ESAS Group and 16.18 ± 1.82 in the no-ESAS group(P < 0.001). With multivariate analysis, women of the ESAS group were more likely to undergo additional visits for an ESAS score > 3 if they were aged 60 or older, received a mastectomy, or had tumour stage Ⅱ/Ⅲ.CONCLUSION The ESAS score may safely reduce the number of medical visits in candidates for adjuvant chemotherapy for early breast cancer. Our results suggest that the ESAS score may be used for selecting a group of breast cancer patients for whom it is safe to reduce the number of medical visits in the setting of adjuvant chemotherapy. This may translate into several advantages, such as a more rational utilization of human resources and a possible reduction of coronavirus pandemic infection risk in oncologic patients.展开更多
The uremic symptoms of advanced chronic kidney disease(CKD)can severely impair physical function,psychological health and social life.Some patients,especially for the older,chose conservative kidney management(CKM)and...The uremic symptoms of advanced chronic kidney disease(CKD)can severely impair physical function,psychological health and social life.Some patients,especially for the older,chose conservative kidney management(CKM)and Traditional Chinese medicine(TCM)but not dialysis in this stage.To measure the patients-reported outcome(PRO)from these people,Advanced Chronic Kidney展开更多
目的:分析中医理论指导下患者评价量表的研制现状,探讨其存在的问题。方法:检索中国知网、万方数据库、中国生物医学文献数据库、维普网、PubMed和Web of Science,纳入中医患者评价量表相关文献,对量表种类、研制及考评方法进行分析。结...目的:分析中医理论指导下患者评价量表的研制现状,探讨其存在的问题。方法:检索中国知网、万方数据库、中国生物医学文献数据库、维普网、PubMed和Web of Science,纳入中医患者评价量表相关文献,对量表种类、研制及考评方法进行分析。结果:纳入文献331篇,共184个量表,主要为PRO量表[76(41.30%)]和QoL量表[58(31.52%)]。量表的理论框架以生理[123(83.67%)]、心理[129(87.76%)]、社会维度[109(74.15%)]为主。条目产生来源以文献研究[133(91.72%)]、患者访谈[72(49.66%)]、已有量表[65(44.83%)]为主。条目筛选多基于经典测量理论,主要采用离散趋势法[102(64.15%)]、相关系数法[98(61.64%)]、因子分析法[96(60.38%)]、克朗巴赫系数法[92(57.86%)]。量表的测量属性考评主要包括信度[159(96.95%)]、效度[157(95.73%)]、反应度[94(57.32%)]及可行性[93(56.71%)]等。结论:中医量表缺乏公认的测量结构,应基于中医理论的系统指导对量表的理论框架进行规范;一些中医量表的测量属性证据不足,须进一步完善和修订;量表种类繁多,质量参差不齐,亟待开展量表的系统评价研究。展开更多
文摘Chinese medicine (CM) has been an experience based practice over the past three thousand years. The safety and efficacy of CM has been practised through experience, rather than nowadays’ modern scientific measurements. In this way, the development of CM has not been keeping pace with the advance in science and technology and the progress in orthodox medicine. In order to meet the requirements of modern science and technology, an evidence based approach must be adopted. Reassurance is needed to convince people for safety and efficacy of CM and give confidence to the evidence based demands ——“Tradition is confirmed by Modern Science” (1) .
文摘<strong>Background:</strong> The main purpose of the present study was to assess the short term performance of a cementless femoral stem in total hip replacement. <strong>Methods:</strong> Cross-sectional observational study of a 48-patient cohort with Phenom? femoral stems implanted between June 1, 2014 and September 1, 2018, to determine clinical performance, stability, and radiographic osseointegration. Patients were followed-up from 13 to 76 months (mean: 44.5 months) and assessed using the Harris Hip Score-HHS, the Hip Disability and Osteoarthritis Outcome Score-HOOS and radiographs. <strong>Results:</strong> All stems were radiologically stable. Mean Harris Hip Score was 89.8 and the HOOS was 80.4. No statistical differences were observed among patients with different diagnoses. <strong>Conclusions:</strong> The short-term results revealed satisfactory clinical outcomes and radiological signs of implant stability in all cases. Using two functional scores was useful in detecting biases and a low to moderate agreement was found between the scores.
基金Supported by the Project BEBPC-TCM2019XZZX-ZJ0011Shanghai Clinical Research Center for Acupuncture and Moxibustion Accelerating20MC1920500Clinical Key Specialty Construction Foundation of Shanghaishslczdzk04701。
文摘Background:Lung cancer is one of the most common cancers globally with high incidence and mortality rate.Acupuncture and moxibustion have been used as adjuvant therapies to relieve the symptoms and complications of lung cancer.At present,acupuncture and moxibustion can partially improve the quality of life(QOL)of cancer patients.However,the evidence that acupuncture and moxibustion can improve patient-reported outcomes(PROs)in patients with lung cancer is still insufficient.We aimed to conduct a systematic review and meta-analysis of published randomized controlled trials(RCTs)to determine whether acupuncture and moxibustion can improve PROs among patients with lung cancer,providing a support basis for acupuncture and moxibustion inclusion in relevant guidelines.Methods:We will search the following electronic databases:PubMed,Embase,Cochrane Library,Web of Science,CNKI,CQVIP,Wanfang Data,Sinomed,and gray literature including the ClinicalTrials.gov Database(clinicaltrials.gov)and Chinese Clinical Trial Register(chictr.org.cn).All English and Chinese articles will be searched until July 1,2021.Two researchers independently extracted data.Any disagreement was resolved by discussion until consensus was reached or by consulting a third researcher.The primary outcomes mainly included the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30),functional assessment of cancer therapy-lung(FACT-L),and Karnofsky Performance Status(KPS).The secondary outcomes included improvement of individual lung cancerrelated symptoms and the safety of acupuncture intervention.Discussion:Our study is the first to focus on the PROs of acupuncture and moxibustion for lung cancer treatment.The results will contribute to a deeper understanding of the evidence distribution of acupuncture and moxibustion in PROs,which may support the use of acupuncture and moxibustion in lung cancer patients.
文摘BACKGROUND Adjuvant chemotherapy is recommended in high-risk breast cancer. However, no universally accepted guidelines exist on pre-chemotherapy assessment. In particular, the number and frequency of medical visits vary according to each institution’s policy. We hypothesised that the Edmonton Symptom Assessment Scale(ESAS) may have a favourable impact on the pre-treatment assessment in candidates for adjuvant chemotherapy.AIM To investigate whether the ESAS can be used to safely reduce the number of medical visits in women with breast cancer undergoing adjuvant chemotherapy.METHODS In a retrospectively prospective matched-pair analysis, 100 patients who completed the ESAS questionnaire before administration of adjuvant chemotherapy(ESAS Group) were compared with 100 patients who underwent chemotherapy according to the traditional modality, without ESAS(no-ESAS Group). Patients of the ESAS Group received additional visits before treatment if their ESAS score was > 3. The primary endpoint was the total number of medical visits during the entire duration of the chemotherapy period. The secondary endpoints were the occurrence of severe complications(grade 3-4) and the number of unplanned visits during the chemotherapy period.RESULTS The study variables did not statistically differ between patients of the ESAS Group and no-ESAS Group(age P = 0.880;breast cancer stage P = 0.56;cancer histology P = 0.415;tumour size P = 0.258;lymph node status P = 0.883;immunohistochemical classification P = 0.754;type of surgery P = 0.157), except for premenopausal status(P = 0.015). The study variables did not statistically differ between patients of the ESAS Group and no-ESAS Group regarding age, cancer stage, histology, tumour size, lymph node status, immunohistochemical classification, and type of surgery. Unplanned visits during the entire duration of chemotherapy were 8 in the ESAS Group and 18 in the no-ESAS Group visits(P = 0.035). Grade 3-4 toxicity did not differ between the study groups(P = 0.652). Forty-eight patients of the ESAS Group received additional visits due to an ESAS score > 3. The mean number of medical visits was 4.38 ± 0.51 in the ESAS Group and 16.18 ± 1.82 in the no-ESAS group(P < 0.001). With multivariate analysis, women of the ESAS group were more likely to undergo additional visits for an ESAS score > 3 if they were aged 60 or older, received a mastectomy, or had tumour stage Ⅱ/Ⅲ.CONCLUSION The ESAS score may safely reduce the number of medical visits in candidates for adjuvant chemotherapy for early breast cancer. Our results suggest that the ESAS score may be used for selecting a group of breast cancer patients for whom it is safe to reduce the number of medical visits in the setting of adjuvant chemotherapy. This may translate into several advantages, such as a more rational utilization of human resources and a possible reduction of coronavirus pandemic infection risk in oncologic patients.
基金supported by MOST/SATCM of the People's Republic of China grant2013BAI02B04
文摘The uremic symptoms of advanced chronic kidney disease(CKD)can severely impair physical function,psychological health and social life.Some patients,especially for the older,chose conservative kidney management(CKM)and Traditional Chinese medicine(TCM)but not dialysis in this stage.To measure the patients-reported outcome(PRO)from these people,Advanced Chronic Kidney
文摘目的:分析中医理论指导下患者评价量表的研制现状,探讨其存在的问题。方法:检索中国知网、万方数据库、中国生物医学文献数据库、维普网、PubMed和Web of Science,纳入中医患者评价量表相关文献,对量表种类、研制及考评方法进行分析。结果:纳入文献331篇,共184个量表,主要为PRO量表[76(41.30%)]和QoL量表[58(31.52%)]。量表的理论框架以生理[123(83.67%)]、心理[129(87.76%)]、社会维度[109(74.15%)]为主。条目产生来源以文献研究[133(91.72%)]、患者访谈[72(49.66%)]、已有量表[65(44.83%)]为主。条目筛选多基于经典测量理论,主要采用离散趋势法[102(64.15%)]、相关系数法[98(61.64%)]、因子分析法[96(60.38%)]、克朗巴赫系数法[92(57.86%)]。量表的测量属性考评主要包括信度[159(96.95%)]、效度[157(95.73%)]、反应度[94(57.32%)]及可行性[93(56.71%)]等。结论:中医量表缺乏公认的测量结构,应基于中医理论的系统指导对量表的理论框架进行规范;一些中医量表的测量属性证据不足,须进一步完善和修订;量表种类繁多,质量参差不齐,亟待开展量表的系统评价研究。
