Application of evidence-based medicine methods in integrative oncology research

To present the advances of evidence-based medicine and clinical research methodology in integrative oncology,we conducted a literature review of real-world studies of traditional Chinese medicine(TCM)in cancer care and summarized the available evidence.Pragmatic randomized controlled trials(pRCTs)and clinical registry studies are becoming more popular as they could compensate for the limitations of RCTs.Many RCTs of TCM for cancer treatment as well as systematic reviews have been published.The most investigated therapies are based on acupuncture,Chinese herbal compounds,and Chinese patent medicines.Acupuncture has a significant advantage in relieving cancer-related symptoms.Published studies focus more on improving clinical symptoms and laboratory indicators.However,the patient's quality of life deserves more attention.

Evidence-based Clinical Chinese Medicine:What Has Changed Over the Past 20 Years

Chinese medicine has been used for centuries to treat a range of health conditions.This history has produced a wealth of classical literature,case studies and clinical research data detailing its use and effectiveness.However,high-quality and conclusive evidence that meets modern requirements for clinical decision support is lacking.This evidence gap limits the integration of Chinese medicine with contemporary medicine,which in turn limits global access and acceptance of Chinese medicine as a form of safe and effective health care.Over the past 20 years,researchers and organisations around the world,including the World Health Organization(WHO)and United Nations,have worked to support the integration of traditional medicines,such as Chinese medicine,with conventional medicines to improve global health care.This paper provides an overview of Chinese medicine studies published in the top four general medical journals(BMJ,JAMA,Lancet and New England Journal of Medicine)from February 2005 to February 2024 in the past 20 years to highlight the progress in the development of this evidence base.It also highlights key actions taken to promote evidence-based clinical Chinese medicine,including product and practitioner regulation,formalising education standards,and international collaborations.Research conducted at the China-Australia International Research Centre for Chinese Medicine demonstrates the benefits of such a collaboration.Through development of its unique and inclusive‘whole-evidence’approach,plus clinical studies and systematic reviews,the Centre has significantly contributed to the evidence base for clinical Chinese medicine.In addition,its high-impact papers and groundbreaking monographs have been cited in international conventional medicine guidelines.While progress has certainly been made during the past 20 years to build a stronger evidence base for clinical Chinese medicine,there is still a considerable gap that limits its integration with conventional medicine.Future funding and research are needed to continue this work and achieve to safe,effective and accessible traditional medicine as part of the WHO’s Universal Health Coverage strategy.

The Development of Doctor-nurse-patient Co-construction through Evidence-based Narrative Exploration of Traditional Chinese Medicine

Traditional Chinese medicine(TCM)is the wisdom crystallization and cultural treasure of the Chinese nation.Establishing a positive relationship among doctors,nurses,and patients is essential for promoting the sustainable development of TCM culture.As an important branch of evidence-based narrative medicine,evidence-based narrative of TCM significantly contributes to the co-construction of doctors,nurses and patients.This paper discusses the necessity and clinical practice value of promoting co-construction of doctors,nurses and patients based on the principles of evidence-based narrative TCM.By working together to select optimal diagnosis and treatment options,we aim to enhance patient compliance,alleviate tensions among the parties involved,and establish equitable collaborative relationships.Creating a harmonious medical environment is crucial for promoting the continuous development of this collaborative model in clinical practice,thereby improving patients'overall health,increasing public recognition of TCM,and supporting its sustainable growth.

A Review of Knowledge Graph in Traditional Chinese Medicine:Analysis,Construction,Application and Prospects

As an advanced data science technology,the knowledge graph systematically integrates and displays the knowledge framework within the field of traditional Chinese medicine(TCM).This not only contributes to a deeper comprehension of traditional Chinese medical theories but also provides robust support for the intelligent decision systems and medical applications of TCM.Against this backdrop,this paper aims to systematically review the current status and development trends of TCM knowledge graphs,offering theoretical and technical foundations to facilitate the inheritance,innovation,and integrated development of TCM.Firstly,we introduce the relevant concepts and research status of TCM knowledge graphs.Secondly,we conduct an in-depth analysis of the challenges and trends faced by key technologies in TCM knowledge graph construction,such as knowledge representation,extraction,fusion,and reasoning,and classifies typical knowledge graphs in various subfields of TCM.Next,we comprehensively outline the current medical applications of TCM knowledge graphs in areas such as information retrieval,diagnosis,question answering,recommendation,and knowledge mining.Finally,the current research status and future directions of TCM knowledge graphs are concluded and discussed.We believe this paper contributes to a deeper understanding of the research dynamics in TCM knowledge graphs and provides essential references for scholars in related fields.

Advances in clinical applications of bioceramics in the new regenerative medicine era

In this editorial,we comment on the hard and soft tissue applications of different ceramic-based scaffolds prepared by different mechanisms such as 3D printing,sol-gel,and electrospinning.The new concept of regenerative medicine relies on biomaterials that can trigger in situ tissue regeneration and stem cell recruitment at the defect site.A large percentage of these biomaterials is ceramic-based as they provide the essential requirements of biomaterial principles such as tailored multisize porosity,antibacterial properties,and angiogenic properties.All these previously mentioned properties put bioceramics on top of the hierarchy of biomaterials utilized to stimulate tissue regeneration in soft and hard tissue wounds.Multiple clinical applications registered the use of these materials in triggering soft tissue regeneration in healthy and diabetic patients such as bioactive glass nanofibers.The results were promising and opened new frontiers for utilizing these materials on a larger scale.The same results were mentioned when using different forms and formulas of bioceramics in hard defect regeneration.Some bioceramics were used in combination with other polymers and biological scaffolds to improve their regenerative and mechanical properties.All this progress will enable a larger scale of patients to receive such services with ease and decrease the financial burden on the government.

Potential prospects of Chinese medicine application in diabetic retinopathy

Current treatment strategies for diabetic retinopathy(DR),an eye condition that can lead to blindness,have mainly focused on proliferative DR,including vitreous injection,retinal photocoagulation,and vitrectomy.Vitreous injections mainly depend on anti-vascular endothelial growth factor therapy.In this editorial,we comment on the article by Sun et al.We focus specifically on the mechanisms of the protective effect of genipin on the retina.Genipin is a gardenia extract used in traditional Chinese medicine(TCM).In their study,the authors suggest that controlling advanced glycosylation by the intraocular injection of genipin may be a strategy for preventing retinopathy.The innovative use of a Chinese medicine extract injected into the eye to achieve a curative effect has attracted our attention.Although TCM is effective in treating DR,the topical application of DR,especially intraocular injections,is not yet feasible.Herein,we present a brief analysis of effective Chinese medicines for the treatment of DR.The effectiveness of local injections of TCM applied directly into the eyes holds promise as an effective treatment approach for DR.

Insights into Fermentation Technology for Traditional Chinese Medicine:Progress and Applications

Traditional Chinese medicine(TCM)has an exemplary role in the treatment and prevention of diseases.However,the advancement of TCM has been constrained by several factors,including its intricate structure,low active ingredient concentration,prolonged growth cycle,and the dfficulty in artificial cultivation.In recent years,research on the fermentation technology of TCM has increased.This paper provides an overview of the advantages of TCM fermentation technology,including efficiency enhancement and toxicity reduction,the development of new drugs,and the secondary utilization of dregs.Additionally,it discusses the progress of research on the application of fermented TCM in animal husbandry and disease treatment.The aim is to provide theoretical guidance for TCM fermentation technology research and the development of fermented TCM.

Visual Analysis of the Application and Development Trend of Cinnamon in the Field of Traditional Chinese Medicine Based on CiteSpace

[Objectives]This study was conducted to explore the application and development trend of Chinese medicinal material cinnamon in the field of traditional Chinese medicine.[Methods]Articles published from 2008 to 2023 were exported using"cinnamon"as the subject word in the Chinese database of CNKI.Knowledge graphs were drawn by CiteSpace software on the number of articles published,the institutions publishing articles,and keyword clustering,and the data were sorted by Excel.Combined with the extracted information,the application of cinnamon in traditional Chinese medicine and integrated traditional Chinese and Western medicine was analyzed,and its development trend was discussed and prospected,providing further reference for researchers.[Results]The number of articles published showed an overall upward trend and maintained a high number of articles.In the analysis of the journals publishing articles,the journal with the largest number of articles was West China Journal of Pharmaceutical Sciences,which had certain representativeness.In the analysis of institutions publishing articles,the institution with the largest number of articles was Beijing University of Chinese Medicine,and most institutions had little cooperation.Four categories was obtained in keyword clustering,respectively,general research,component identification,production process and product development of cinnamon."Glycyrrhizin"was the keyword with the earliest burst time,and the hot words that have received much attention in recent years are"medication law"and"data mining".[Conclusions]The application of cinnamon in the field of traditional Chinese medicine is mainly to treat diseases and as raw materials for traditional Chinese medicine products.The development trend is"quality control"and"product research and development".Further research and development of cinnamon in traditional Chinese medicine need to promote the participation of more institutions to participate,and cooperation and communication between institutions should be strengthened to promote the deep integration of production,research and academia.

Improving the Selection Model of Essential Medicines in China by Evidence-based Thinking

Objective To sort out the problems in the selection model of essential medicines in China,and to put forward some suggestions to optimize the selection model to ensure the rationality of the medicines in the essential medicines list.Methods The domestic and foreign literature on the selection of essential medicines was reviewed.Then,the opinions on the selection methods and results of essential medicines from foreign literature were investigated to make a comparison with the selection of essential medicines in China.Finally,the general and special laws of the selection process of the essential medicines were explored.Results and Conclusion It is recommended that the selection model of essential medicines in China should be further optimized,and the evidence-based thinking and methods should be utilized to enhance the scientific nature of the selection process.

Advances in Research Methods of Pharmacodynamic Substances in Traditional Chinese Medicines and Their Application in the Teaching of Traditional Chinese Medicine Analysi

With the continuous progress of science and technology,the research methods of pharmacodynamic substances in traditional Chinese medicine are developing,and the application of these methods in teaching is becoming more and more extensive.By introducing these research methods into the classroom,teachers can help students to deeply understand the nature and mechanism of action of pharmacodynamic substances in traditional Chinese medicine,and improve their interest in and knowledge of traditional Chinese medicine.This paper introduces the definition of pharmacodynamic substances in traditional Chinese medicine,research methods,and their application in the teaching of traditional Chinese medicine analysis.

Progress in the Application of Simulated Teaching in Diagnosis and Internal Medicine Teaching

With the rapid development of modern medical education,traditional teaching methods are unable to meet the needs and have obvious limitations.In this situation,simulation teaching,as an innovative teaching method,has gradually become a focus in the educational practice of diagnosis and internal medicine,demonstrating irreplaceable advantages.Simulated teaching is a teaching strategy that involves the careful design and guidance of a mentor,role-playing,entering a special context constructed by the mentor,using professional teaching equipment,and reproducing real medical scenes in a simulated environment.Simulation teaching,as an effective alternative method,has gradually become increasingly important in the field of medical education,receiving widespread attention and application,and has become an important way to solve current teaching problems.

Advances in the Application of DNA Chip in Animal Medicine

Accompanying with the increasingly saturated genome figures,DNA chip has been widely applied.Thanks to its advantages of integration,miniaturization and automation,DNA chip becomes a powerful research tool in various research fields including biology,medicine and chemistry.This article overviews the application of DNA chip technology in animal medicine from gene expression spectrum research,pathogenic microbial detection,bacterial typing,genetic mutations and polymorphism detection,pathogenic microbial genomics research,as well as its principle and classification.

Irritable bowel syndrome: Pathogenesis, diagnosis, treatment, and evidence-based medicine

Irritable bowel syndrome (IBS) is a chronic and debilitating functional gastrointestinal disorder that affects 9%-23% of the population across the world. The percentage of patients seeking health care related to IBS approaches 12% in primary care practices and is by far the largest subgroup seen in gastroenterology clinics. It has been well documented that these patients exhibit a poorer quality of life and utilize the health care system to a greater degree than patients without this diagnosis. The pathophysiology of IBS is not clear. Many theories have been put forward, but the exact cause of IBS is still uncertain. According to the updated ROME III criteria, IBS is a clinical diagnosis and presents as one of the three predominant subtypes: (1) IBS with constipation (IBS-C); (2) IBS with diarrhea (IBS-D); and (3) mixed IBS (IBS-M); former ROME definitions refer to IBS-M as alternating IBS (IBS-A). Across the IBS subtypes, the presentation of symptoms may vary among patients and change over time. Patients report the most distressing symptoms to be abdominal pain, straining, myalgias, urgency, bloating and feelings of serious illness. The complexity and diversity of IBS presentation makes treatment difficult. Although there are reviews and guidelines for treating IBS, they focus on the efficacy of medications for IBS symptoms using high-priority endpoints, leaving those of lower priority largely unreported. Therefore, the aim of this review is to provide a comprehensive evidence-based review of the diagnosis, pathogenesis and treatment to guide clinicians diagnosing and treating their patients.

Traditional Chinese Medicine as a Treatment for Rheumatoid Arthritis:From Empirical Practice to Evidence-Based Therapy

Rheumatoid arthritis(RA)is a common autoimmune condition with an elusive etiology.Conventional and biological disease-modifying drugs sometimes fail or produce only partial responses.Traditional Chinese medicine(TCM)has long been used in China as a treatment for RA and is achieving everincreasing acceptance worldwide.TCM treatments are traditionally guided by the theory of treatment based on TCM syndrome differentiation;however,they remain a matter of empirical practice relying on TCM theories and doctors’own experience,which places severe restrictions on worldwide TCM application.Nevertheless,TCM is a treasure trove for drug discovery,particularly as a treatment for complicated human conditions.The discoveries of artemisinin as a treatment for malaria and of TCM–arsenic trioxide(As2O3)combination therapy as a treatment for acute promyelocytic leukemia(APL)are excellent examples of the great value of TCM.Regarding RA treatments,many Chinese medicinal herbs and their formulas,extracts,ingredients,and even single compounds have been used in clinical applications.Several Chinese proprietary medicines(CPMs)derived from TCM formulas or herbal bioactive components,such as the controlled-release ZhengQingFengTongNing(ZQFTN)Tablets,Tripterygium Glycoside Tablets,and Total Glucosides of Peony(TGP)Capsules,have been included in the National Health Insurance Directory of China,and show comparable therapeutic efficacies to those of western chemical drugs with fewer side effects.As TCM research has advanced,particularly in the use of multidisciplinary technologies,the scientific foundations and characteristics of the use of TCM to treat RA have been revealed,and the quality of TCM treatments have been increasingly enhanced.However,TCM generally lacks sufficient clinical and laboratory data to be consistent with international standards for quality,safety,and efficacy in order to support its application worldwide.Therefore,intensive basic and clinical studies on TCM are required.In particular,investigations that use cutting-edge technologies in analytical chemistry,biology,and biomedical sciences,and the development of randomized clinical trials(RCTs)and personalized pragmatic randomized controlled trials(PPRCTs)are necessary.Researchers should also collaborate to advance TCM from empirical practice to evidence-based therapy,thus consistently promoting TCM development and globalization in a vital,beneficial,and contributable manner.

Application of Artificial Intelligence in Medicine: An Overview

Artificial intelligence(AI)is a new technical discipline that uses computer technology to research and develop the theory,method,technique,and application system for the simulation,extension,and expansion of human intelligence.With the assistance of new AI technology,the traditional medical environment has changed a lot.For example,a patient’s diagnosis based on radiological,pathological,endoscopic,ultrasonographic,and biochemical examinations has been effectively promoted with a higher accuracy and a lower human workload.The medical treatments during the perioperative period,including the preoperative preparation,surgical period,and postoperative recovery period,have been significantly enhanced with better surgical effects.In addition,AI technology has also played a crucial role in medical drug production,medical management,and medical education,taking them into a new direction.The purpose of this review is to introduce the application of AI in medicine and to provide an outiook of future trends.

Optimization of evidence-based research in the prevention and treatment of coronary heart disease with traditional Chinese medicine:A comprehensive review

Coronary heart disease(CHD) has severely impacted the lives and health of patients for ages. Although the modern methods used for the prevention and treatment of CHD have been increasingly perfected,clinical problems remain that require solutions. In the prevention and treatment of CHD with traditional Chinese medicine(TCM), great therapeutic advantages have been demonstrated. However, the expression of its advantages relies on scientific evidence-based research and evaluation, which require further optimization and improvement. Therefore, this review aims to comprehensively emphasize our understanding of the current deficiencies in TCM evidence-based studies and the necessity of adopting scientific evidence-based optimization methods for use in research. In this process, evidence should be produced in a standard manner, and the advantages of TCM patterns should be accurately stated because these factors contribute to efficient transformation and proper verification of the obtained evidence.Additionally, focusing on patient-oriented medicine and doctor-patient relationships is also essential.These methods are of great significance to prove the clinical efficacy of TCM and promote its development.

Problems faced by evidence-based medicine in evaluating lymphadenectomy for gastric cancer

Gastric cancer surgical management differs between Eastern Asia and Western countries. Extended lymphadenectomy (D2) is the standard of care in Japan and South Korea since decades, while the majority of United States patients receive at most a limited lymphadenectomy (D1). United States and Northern Europe are considered the scientific leaders in medicine and evidence-based procedures are the cornerstone of their clinical practice. However, surgeons in Eastern Asia are more experienced, as there are more new cases of gastric cancer in Japan (107898 in 2012) than in the entire European Union (81592), or in South Korea (31269) than in the entire United States (21155). For quite a long time evidence-based medicine (EBM) did not solve the question whether D2 improves long-term prognosis with respect to D1. Indeed, eastern surgeons were reluctant to perform D1 even in the frame of a clinical trial, as their patients had a very good prognosis after D2. Evidence-based surgical indications provided by Western trials were questioned, as surgical procedures could not be properly standardized. In the present study we analyzed indications about the optimal extension of lymphadenectomy in gastric cancer according to current scientific literature (2008-2012) and surgical guidelines. We searched PubMed for papers using the key words “lymphadenectomy or D1 or D2” AND “gastric cancer” from 2008 to 2012. Moreover, we reviewed national guidelines for gastric cancer management. The support to D2 lymphadenectomy increased progressively from 2008 to 2012: since 2010 papers supporting D2 have achieved a higher overall impact factor than the other papers. Till 2011, D2 was the procedure of choice according to experts’ opinion, while three meta-analyses found no survival advantage after D2 with respect to D1. In 2012-2013, however, two meta-analyses reported that D2 improves prognosis with respect to D1. D2 lymphadenectomy was proposed as the standard of care for advanced gastric cancer by Japanese National Guidelines since 1981 and was adopted as the standard procedure by the Italian Research Group for Gastric Cancer since the Nineties. D2 is now indicated as the standard of surgical treatment with curative intent by the German, British and ESMO-ESSO-ESTRO guidelines. At variance American NCCN guidelines recommend a D1+ or a modified D2 lymph node dissection. In conclusion, D2 lymphadenectomy, originally developed by Eastern surgeons, is now becoming the procedure of choice also in the West. In gastric cancer surgery EBM is lagging behind national guidelines, rather than preceding and orienting them. To eliminate this lag, EBM should value to a larger extent Eastern Asian literature and should evaluate not only the quality of the study design but also the quality of surgical procedures.

External Application of Herbal Medicine to Acupoints

Application of herbal medicine to acupoints is to regulate the meridians, yin-yang, and qi and blood for preventing and treating diseases through the pharmacological action of herbal medicines and with their stimulation to the acupoints. This article explains how to apply herbal medicines and gave the examples for the treatment of hypertension, asthma, chronic bronchitis and allergic rhinitis. Application of herbal medicines to acupoints is one of the important components of TCM, which shows satisfactory effects in treatment of some chronic diseases.

Recent advances in network pharmacology applications in Chinese herbal medicine

Network pharmacology is a new discipline based on the theory of systems biology and network analysis of biological systems to design the drugs.It comprehensively observes the intervention and influence of drugs on the disease network,and reveals the mystery of multi-molecular drugs synergistically acting on disease.These concepts reflect the ideas of multi-component,multi-target and system regulation,and have many similarities with the research ideas of traditional Chinese medicine,which focuses on syndrome differentiation and treatment,emphasizes the overall understanding of the etiology and pathogenesis.Network pharmacology can be used to predict and identify the target and active component of traditional herbal medicine,to clarify the mechanism of action,to scientifically explain the rules of the prescription,to explore the rules of real-world prescription,to discover new indications and new active compounds,and to study drug relocation,etc.The applications of network pharmacology in traditional herbal medicine were systematically summarized to demonstrate the significant value in these areas.

Under the narrative medicine theory to establish the evidence-based medical record written by doctors and patients through integrated therapy of traditional Chinese and western on digestive system diseases

Objective:The aim of this article was to discuss the theory of doctor-patient co-operated evidence-based medical record and set up the preliminary frame of the doctor-patient co-operated evidence-based medical record following the concept of narrative evidence-based medicine.Methods:The information was searched from Pubmed,Embase,CBMdisc,CNKI.A preliminary agreement was reached by referring to the principles of narrative medicine and advises given by experts of digestive system and evidence-based medicine in both Traditional Chinese Medicine and Western Medicine.Result:This research is a useful attempt to discuss the establishment of doctor-patient co-operated evidence-based medical record guided by the direction of narrative evidence-based medicine.Reflection and outlook:Doctor-patient co-operated medical record can be a key factor of the curative effect evaluation methodology system of integrated therapy of Tradition Chinese Medicine and Western Medicine on spleen and stomach diseases.