Comparative effectiveness research and health care reform in C hina

China has made significant progress in modernizing its healthcare system in the past 20 years. However, there are some issues that are difficult to solve on the current healthcare status, including the lack of medical care satisfaction in rural areas and urban areas, excessive consumption of medical resources, conflict and tension between the healthcare provider and patients, and the problems caused by the change of model of healthcare. Therefore, the State Council introduced the Opinions of the CPC Central Committee and the State Council on Deepening the Health Care System Reform in 2009 in order to provide basic, safe, effective, convenient and affordable healthcare for all residents. Despite the goals and policies set by the government, how to implement them remains to be challenging. Like evidence-based medicine, comparative effective research （ CER ） which started in the US in 2000 ＇s can provide diagnosis and treatment information for patients, doctors, and health policy makers to make decisions on the effective ways of caring for both individual and population. It also may apply to the conditions of healthcare reform in China. And there are opportunities and challenges of conducting CER in our country. We suggest that the government should establish the national-level CER research institute, CER Leadership Committee and relevant standards, fund the CER projects, and begin CER in certain disciplines.

Which Research Is Needed to Support Clinical Decision-Making on Integrative Medicine?——Can Comparative Effectiveness Research Close the Gap?

In clinical research on complementary and integrative medicine, experts and scientists have often pursued a research agenda in spite of an incomplete understanding of the needs of end users. Consequently, the majority of previous clinical trials have mainly assessed the efficacy of interventions. Scant data is available on their effectiveness. Comparative effectiveness research （CER） promises to support decision makers by generating evidence that compares the benefits and harms of the best care options. This evidence, more generalizable than the evidence generated by traditional randomized controlled trials （RCTs）, is better suited to inform real-world care decisions. An emphasis on CER supports the development of the evidence base for clinical and policy decision-making. Whereas in most areas of complementary and integrative medicine data on comparative effectiveness is scarce, available acupuncture research already contributes to CER evidence. This paper wil introduce CER and make suggestions for future research.

What Can Comparative Effectiveness Research,Propensity Score and Registry Study Bring to Chinese Medicine?

The impact of evidence-based medicine and clinical epidemiology on clinical research has contributed to the development of Chinese medicine in modem times over the past two decades.Many concepts and methods of modem science and technology are emerging in Chinese medicine research,resulting in constant progress.Systematic reviews,randomized controlled trials and other advanced mathematic approaches and statistical analysis methods have brought reform to Chinese medicine.In this new era,Chinese medicine researchers have many opportunities and challenges.On the one hand,Chinese medicine researchers need to dedicate themselves to providing enough evidence to the world through rigorous studies,whilst on the other hand,they also need to keep up with the speed of modem medicine research.For example,recently,real world study,comparative effectiveness research,propensity score techniques and registry study have emerged.This article aims to inspire Chinese medicine researchers to explore new areas by introducing these new ideas and new techniques.

EXPERIMENTAL RESEARCH ON THE ANTI-CANCER IMMUNOMODULA-TIVE EFFECT OF THE POLYSOCOHARIBE-PEPTIDE OF CORIOLUS VERSICOLOR

Polysocoharibe-peptide of Coriolus Versicolor (PSP) is a new anti-cancer immunomodulative drug. The present paper reports on the experimental research done with this drug. It was found that PSP had the ability to recover hemolysin HC50, to increase the weight of the thymus, and increase the alexin of serum C3 and the IgG content of tumor bearing mice. FSP also significantly raised the pha-gocytic activity of macrophages in normal mice. PSP had a significant inhibitory effect on P38S and S180 cells. At the concentration of 1 mg/ml, PSP inhibited the proliferating activity of some human tumor call lines, such as SGC 7901, SPC, SLY and Mei. It had a direct toxic effect on SPC cells. PSP significantly inhibited the synthesis of nucleic acids of Ehrlich ascites carcinoma cells. In addition, PSP was antagonistic to the side effects of chemotherapy and radiotherapy.

Research on Replacing Effects & Examination System of TBT against Tariff Impediment to Textile and Apparel Trade

With the cutoff and limitation of tariff and traditional non-tariff Barriers to Trade by GATT/WTO, Technical Barriers to Trade (TBT) has gradually replaced tariff and general non-tariff Barriers to Trade and become an important measurement in new trade protectionism. This article analyzes the replacement of TBT on tariff barrier for exporting countries, as well as the trading pattern of TBT in its maturing period through the discussion of macro strategies of surpassing TBT; meanwhile it also probes into the examination and supervision policies of governmental functional departments.

Research on the effects of PIAS3 expression on the invasion of glioma TJ905 cells

Objective To investigate the function and possible mechanisms of PIAS3 expression on the invasion of TJ905 cells. Methods PIAS3 overexpression vectors were constructed and PIAS3 siRNA were chemically synthesized, which were separately transfected into TJ905 cells for upregulation or

Delayed assessment and eager adoption of laparoscopic cholecystectomy:Implications for developing surgical technologies

Despite the prevailing emphasis in the medical literature on establishing evidence,many changes in the practice of surgery have not been achieved using proper evidence-based assessment.This paper examines the adoption of laparoscopic cholecystectomy(LC)into regular use for the treatment of cholecystitis and the process of its acceptance,focusing on the limited role of technology assessment in its appraisal.A review of the published medical literature concerning LC was performed.Approximately 3000 studies of LC have been conducted since 1985,and there have been nearly 8500 publications to date.As LC was adopted enthusiastically into practice,the results of outcome studies generally showed that it compared favorably with the traditional,open cholecystectomy with regard to mortality,complications,and length of hospital stay.However,despite the rapid general agreement on surgical technique,efficacy,and appropriateness,there remained lingering doubts about safety,outcomes,and cost of the procedure that suggested that essential research questions were ignored even as the procedure became standard.Using LC as a case study,there are important lessons to be learned about the need for important guidelines for surgical innovation and the adoption of minimally invasive surgical techniques into current clinical and surgical practice.We highlight one recent example,natural orifice transluminal endoscopic surgery and how necessary it is to properly evaluate this new technology before it is accepted as a safe and effective surgical option.

Postrandomization Confounding Challenges the Applicability of Randomized Clinical Trials in Comparative Effectiveness Research

Different from trials for regulatory approvals of new interventions aimed to test the efficacy, comparative effectiveness research （CER） is the direct comparison of existing health-care interventions （compared with active controls） to examine which treatment works best, for whom,

Health Analytics, Economics and Medicine toward a 21st Century Health Care System

After a review of recent developments in precision medicine, population health sciences and innovative clinical trial designs, and in health economics and policy, we show how innovations in health analytics can capitalize on the advances in biomedicine and health economics towards developing a data-driven and cost-effective 21st century health care system. In particular, we propose a mutually beneficial public-private partnership that combines individual responsibility with community solidarity in building this health care system.

Clinical Dissemination and Implementation of EBTs From the Ground Up:How to Develop a Multi-Site CBT“Clinical Dissemination Practice”The Case Example of the Child&Family Institute

The recent proliferation of empirically-supported treatments(ESTs)into the private sector has led to more U.S.children and families receiving high quality treatments and improved treatment outcomes.However,there remains a significant dearth of evidence-based clinics,service providers,and training programs nationally,particularly in more remote communities.The Child&Family Institute(CFI)was founded in 2011 as the world’s first Clinical Dissemination Practice and training institute,comprising five core unifying stages and initiatives:(1)Dissemination Through Training,(2)Dissemination Through Community Partnership,(3)Dissemination Through Integrated Behavioral Health,(4)Dissemination Through Technology,and(5)Dissemination Through Multi-State,Multi-Site Program Development and Implementation,all with a common goal of raising awareness and leveraging local and national resources to disseminate and implement accessible,affordable,evidence-based care to children,families,and communities across the United States,and beyond.Perhaps most central and unique to CFI’s five initiatives,and its overall core values and mission,is the accessibility and affordability of services for each and every child.Preliminary feedback from patients,students,collaborators,local politicians and stakeholders,partner organizations,and the broader communities in the regions served has been enthusiastic,and several grant submissions and research partnerships are underway,to test the effectiveness of CFI programming and evidence-based treatments in“real-world”clinics nationwide.

Research methods in complementary and alternative medicine： an integrative review

The scientific literature presents a modest amount ot evidence m the use or complementary ana al[erna- tire medicine （CAM）. On the other hand, in practice, relevant results are common. The debates among CAM practitioners about the quality and execution of scientific research are important, Therefore, the aim of this review is to gather, synthesize and describe the differentiated methodological models that encompass the complexity of therapeutic interventions. The process of bringing evidence-based medicine into clinical practice in CAM is essential for the growth and strengthening of complementary medicines worldwide.

Foundation and Clinical Research on the Effect of Traditional Chinese Herbs on Gastrointestinal Motility

Gastric dyskinesis functional dyspepsia is a commonly clinical condition characterized as epigastric discomfort,distension after meals,early satiety and belching,which are commonly associated with the dysfunction of gastrointestinal motility.

Placebo Effects and Research in Alternative and Conventional Medicine

Abstract The placebo effect is a very powerful and unpredictable aspect of any medical treatment. Assuch, it dramatically complicates efforts at convincingly demonstrating the effectiveness of specitic effects inmedicine, conventional or alternative. This review provides a tlieoretical overview of tlie placebo effect toassist researchers in designing trials, controlled or otliereise, so that more convincing demoiistrations of spe-cific effects can be achieved.

Research of bright pupil effect based on Chinese human eye model

An optical model of bright pupil effect based on Chinese human eye model is presented. The effects of the incident rays angle and the size of pupil on bright pupil effect are analyzed theoretically. For the incident rays with 5°–15° field of view, the spot diagram of emergent light is also presented. With the pupil diameters of 3–8 mm, the intensity distributions formed by emergent light are calculated. The optical model of bright pupil effect based on Chinese human eye provides a suitable model for the related further research studies and applications on bright pupil effect with Chinese eye.

Experimental research on impulse coupling effect of a multi-pulse laser on an aluminum target

Impact and torsion pendulums are applied in impulse coupling experiments of high-energy laser irradiation of space debris. It is difficult to achieve a multi-pulse experiment and thus hard to analyze the multi-pulse impulse coupling effect. Here, we designed a new recoil impulse experimental measurement system of non-contact, multidegrees of freedom, and multi-pulse irradiation. The system used a low-pressure and low-temperature vacuum chamber to simulate the space environment, the pinning effect of magnetic levitation to achieve aluminum target suspension, and high-speed cameras to record the displacement over time to calculate the impulse of the target.Then the impulse coupling experiment of multi-pulse laser irradiation on the aluminum target was performed.The result shows that the multi-pulse impulse coupling effect is not the linear accumulation of coupling results by every single-pulse and multi-pulse coefficient that decreases with the increase of the number of pulses, and eventually stabilizes as the decrease gets smaller.

A RESEARCH INTO THE EFFECT OF BACKGROUND KNOWLEDGE ON BUSINESS ENGLISH READING COMPREHENSION

With the arrival of the new millennium,the demand fortalented people with both professional knowledge and excellentlanguage abilities is getting stronger and stronger.For business major students,reading is paramount inBusiness English teaching and learning.And their reading abilityis often assessed by a text of reading comprehension.However,from my experience as a college teacher ofBusiness English,I have noticed some problems among studentswho have little knowledge of business.They seem to readBusiness English materials at a slower rate and with lessunderstanding than general English materials.Then there is the question:is Business English reading"simply"a problem of language competence? Or are there anyother more important factors?This article is an investigation into the effect of backgroundknowledge on Business English reading comprehension.Thestudy attempts to assess to what extent L2 readers might beaffected because of their lack of a background schematapresupposed by the author by comparing the test results of twopassages comparable in language lightness or heaviness.Morecomparable passages like these can be used in investigating intothe rival effects of background knowledge and linguisticcompetence.The implications of comprehension theory for L2pedagogy are discussed and suggestions for Business Englishteaching is put forward.

Clinical curative effect of electric acupuncture on acute cerebral infarction:a randomized controlled multicenter trial

OBJECTIVE: To examine whether electric acupuncture can improve the daily life of patients with ischemic cerebral apoplexy at acute stage.METHODS: A stratified-block randomized controlled multicenter trial was designed for this study.Totally 340 patients with acute ischemic cerebral apoplexy were randomly divided into an electric acupuncture group and a control group. In the electric acupuncture group, 170 patients were treated with electric acupuncture and routine therapy, and170 patients in the control group with routine therapy alone. Major indexes for judging curative effect were Barthel index at 3- and 6- months follow-up visits and number of re-hospitalized patients. Mi-nor indexes for judging curative effect were change in the score for nervous dysfunction at 4and 12 weeks follow-up visits and number of patients persisting in rehabilitation treatment with acupuncture during follow-up visit.RESULTS: Baseline data at the time of case selection between the two groups were similar. The odds ratio(OR) was 0.92, and the 95% confidence interval(CI) was 0.49-1.73 in disabled rate and 0.73 and 0.51-1.05 in the number of re-hospitalized patients in the electric acupuncture group at 6-month follow up visit compared with the control group.There was no difference in the score for nervous dysfunction at the end of 12-week follow-up visit between the two groups. The score for nervous dysfunction at the end of 4-week treatment in the electric acupuncture group was significantly higher than that in the control group(P<0.05). The number of patients discharged from hospital who persisted in rehabilitation treatment with acupuncture in the acupuncture group was significantly higher than that in the control group.CONCLUSION: Using electric acupuncture to treat patients with acute ischemic cerebral apoplexy can effectively improve the nervous dysfunction scores after 4-week treatment and their ability to deal with daily life after 6-month follow-up visit. Systematic treatment with acupuncture may also reduce the number of patients with secondary apoplexy.