Research on the development methodology for clinical practice guidelines for organic integration of traditional Chinese medicine and Western medicine

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.

Homogenization Construction of Three-Level Teaching Bases for General Practice Medicine Under the Internet+Model

With the continuous expansion of medical student enrollment,the number of clinical teaching bases is gradually increasing.However,there are significant differences in clinical teaching management models and teaching levels among different bases.Most clinical teaching bases have incomplete teaching management systems,inadequate teaching management institutions,insufficient teaching personnel,and inadequate implementation of teaching rules and regulations.This article combines the construction practice of three-level clinical teaching base of the General Medicine College and the First Affiliated Hospital of Xi’an Medical University.We establish a standardized management system for the three-level clinical teaching base;implement a teaching supervision system and strengthen the monitoring of teaching quality;adopt multiple evaluations to test the effectiveness of clinical teaching implementation;explore the path of homogenization construction of teaching bases in terms of unified teacher training,promoting the development of teacher teaching abilities with equal quality and excellence,and providing a reference for improving the quality of medical talent training.

Patients’Knowledge, Attitude and Practices on Disposal Methods of Expired and Unused Medicines: Implication for Creation of Drug Take-Back Program

Background: Handling of medicines is a day-to-day activity by patients and many health care providers. However, multiple studies have brought to light inappropriate disposal methods for expired and unused medication (EUM). Improper disposal of expired and unused medicines is hazardous both to humans and the environment. Objective: This sought to measure patients’ knowledge, attitude, and practices on disposal methods of EUM. Methods: A cross-sectional study was carried out among 384 patients at three outpatient pharmacies at the University Teaching Hospitals (UTHs). The structured questionnaire was used to collect data and STAT version 15.1 was used to analyse the data. Results: 384 respondents participated in this study and, at some point, had EUM. In this study, 356 (92.7%) of the participants reported that they had never heard of a drug take-back system. Most of the participants 285 (74.2%) and 239 (62.2%) kept and donated their unused medicine, respectively. Additionally, 244 (63.5%), 212 (55.2%), and 176 (44.8%) of the participants disposed of expired medicines in the bin or garbage, flushed them in toilets or sinks, or burned them, respectively. Occupation was significantly associated with unsafe disposal of unused medicine [P-value = 0.019]. Conclusion and Relevance: Knowledge of safe disposal methods for EUM was good amongst most participants. However, used unsafe disposal methods. The majority of the participants exhibited positive attitude concerning safe disposal methods. This study highlights the need for drug-take-back program creation in Zambia.

Artificial Intelligence;a Pragmatic Approach to Implementation in Medicine, a Review of the literature and a Survey of Local Practice in Midlands in UK

The use of Artificial Intelligence (AI) for clinical pathway management and decision making is believed to improve clinical care and has been used to improve pathways for treatment in most medical disciplines. Methods: A literature review was undertaken to identify the hurdles and steps required to introduce supported clinical decision-making using AI within hospitals. This was supported by a survey of local hospital practice within the Midlands of the United Kingdom to see what systems had been introduced and were functioning effectively. Results: It is unclear how to practically implement systems using AI within medicine easily. Algorithmic medicine based on a set of rules calculated from data only takes a clinician so far to deliver patient centred optimal treatment. AI facilitates a clinician’s ability to assimilate data from disparate sources and can help with some of the analysis and decision making. However, learning remains organic and the subtleties of difference between patients, care providers who exhibit non-verbal communication for instance make it difficult for an AI to capture all the pertinent information required to make the correct clinical decision for any given individual. Hence it assists rather than controls any process in clinical practice. It also must continually renew and adapt considering changes in practise and trends as the goalposts change to meet fluctuations in resources and workload. Precision surgery is benefiting from robotic-assisted surgery in parts driven by AI and being used in 80% of trusts locally. Conclusion: The use of AI in clinical practice remains patchy with it being adopted where research groups have studied a more effective method of monitoring or treatment. The use of robotic-assisted surgery on the other hand has been more rapid as the precision of treatment that this provides appears attractive in improving clinical care.

The Inheritance and Development of Chinese Narrative Medicine Practice to the Philosophical Wisdom of Traditional Chinese Medicine

Starting from the inheritance and promotion of Chinese life philosophy and traditional Chinese medicine wisdom by Chinese narrative medicine practice,this paper discusses the inheritance and echo relationship between the“close textual reading ability”in Chinese narrative medicine practice and the“four diagnoses”in traditional Chinese medicine wisdom,narrative mediation and the“mind-body holistic philosophy”in traditional Chinese medicine,and narrative wisdom and Dao Sheng in Chinese life philosophy.Meanwhile,by analyzing the stories of contemporary doctors’practice of narrative intelligence,this paper expounds that Chinese narrative medicine is a new model of medical education and clinical practice based on the absorption of Chinese traditional life wisdom and the essence of traditional Chinese medicine culture,and the integration of western narrative medicine concepts.It also advocates Chinese scholars to actively build the discipline of“narrative traditional Chinese medicine,”constantly translate the academic achievements to foreign countries,and create a good narrative ecology of traditional Chinese medicine.

Application and Practice of Traditional Chinese Medicine Characteristic Technology Inheritance in Research and Development of Traditional Chinese Medicine Preparations in Medical Institutions

Medical institution preparations play an important role in the development of hospitals,being one of the main forms of traditional Chinese medicine clinical characteristic medication,as well as an important carrier for the inheritance and innovation of traditional Chinese medicine.In recent years,the research and development of traditional Chinese medicine preparations has become a hot spot in the research and development of preparations by medical institutions.Traditional Chinese medicine preparations prepared by traditional processes and their entrusted preparation matters have changed from the current licensing management to filing management.The registration model of traditional Chinese medicine preparations has undergone significant changes,emphasizing more on real data and evaluation results from the objective world,respecting traditional medication experience,and emphasizing the inheritance and innovative development of traditional technological experience.In the process of following teachers in the inheritance project of traditional Chinese medicine,we combined the inheritance of traditional Chinese medicine characteristic technology with the research and development practice of traditional Chinese medicine preparations in medical institutions,and focused on the analysis and discussion of technical problems such as prescription screening,dosage form selection,process route design and clinical observation of traditional Chinese medicine preparations,hoping to provide reference for scholars in the same field of traditional Chinese medicine.

Defensive medicine practices among gastroenterologists in Japan

AIM： To clarify the prevalence of defensive medicine and the specific defensive medicine practices among gastroenterologists in Japan. METHODS： A survey of gastroenterologists in Hiroshima, Japan, was conducted by mail in March 2006. The number of gastroenterologists reporting defensive medicine behaviors or changes in their scope of practice and the reported defensive medicine practices, i.e., assurance and avoidance behaviors, were examined. RESULTS： A total of 131 （77%） out of 171 gastroenterologists completed the survey. Three （2%） respondents were sued, and most respondents （96%） had liability insurance. Nearly all respondents （98%） reported practicing defensive medicine. Avoidance behaviors, such as avoiding certain procedures or interventions and avoiding caring for high-risk patients, were very common （96%）. Seventy-five percent of respondents reported often avoiding certain procedures or interventions. However, seasoned gastroenterologists （those in practice for more than 20 years） adopted avoidance behaviors significantly less often than those in practice for less than 10 years. Assurance behaviors, i.e., supplying additional services of marginal or no medical value, were also widespread （91%）. Sixty-eight percent of respondents reported that they sometimes or often referred patients to other specialists unnecessarily. CONCLUSION： Defensive medicine may be highly prevalent among gastroenterologists throughout 3apan, with potentially serious implications regarding costs, access, and both technical and interpersonal quality of care.

Promoting integrative medicine by computerization of traditional Chinese medicine for scientific research and clinical practice: The SuiteTCM Project

BACKGROUND： Chinese and contemporary Western medical practices evolved on different cultures and historical contexts and, therefore, their medical knowledge represents this cultural divergence. Computerization of traditional Chinese medicine （TCM） is being used to promote the integrative medicine to manage, process and integrate the knowledge related to TCM anatomy, physiology, semiology, pathophysiology, and therapy. METHODS： We proposed the development of the SuiteTCM software, a collection of integrated computational models mainly derived from epidemiology and statistical sciences for computerization of Chinese medicine scientific research and clinical practice in all levels of prevention. The software includes components for data management （DataTCM）, simulation of cases （SimTCM）, analyses and validation of datasets （SciTCM）, clinical examination and pattern differentiation （DiagTCM, TongueTCM, and PulseTCM）, intervention selection （AcuTCM, HerbsTCM, and DietTCM）, management of medical records （ProntTCM）, epidemiologic investigation of sampled data （ResearchTCM）, and medical education, training, and assessment （StudentTCM）. DISCUSSION： The SuiteTCM project is expected to contribute to the ongoing development of integrative medicine and the applicability of TCM in worldwide scientific research and health care. The SuiteTCM 1.0 runs on Windows XP or later and is freely available for download as an executable application.

Role of traditional Chinese medicine in the initiative practice for health

To achieve awareness of the initiative practice for health concept in the Chinese population,traditional Chinese medicine(TCM)doctors should popularize TCM culture and knowledge among young people,people with a low level of education,in low-income populations,and in rural populations.

The concept of narrative evidence-based medicine and shared decision-making in traditional Chinese medical practice

For the explosive development of emerging diagnostic and therapeutic technologies brought by the advancement of precision medicine strategy, shared decision-making could improve the quality of clinical decision-making and promote the transformation of clinical research evidence in TCM. Paying attention to patients＇ narrative needs and strengthening medical humanistic concerns could improve clinical outcome and patient satisfaction. We described the origins and development of evidence-based medicine, narrative medicine and shared decision-making, and analyzed the existing problems in TCM clinical decision-making. Further, we put forward the model of shared decision-making between clinicians and patients under the guidance of narrative evidence-based medicine concepts and methods.

Prevention and treatment of traditional Chinese medicine against angiogenesis related cardiovascular diseases based on translational medicine

As a major medical and scientific problem perplexing mankind,cardiovascular disease seriously endangers human health and life safety,which is still the primary cause of death.Traditional Chinese medicine(TCM)plays an irreplaceable role in the prevention and treatment of cardiovascular diseases and has its own characteristics and definite advantages.However,the unclear mechanism hinders its further promotion,which is not conducive to the prevention and treatment of cardiovascular diseases.Translational medicine advocates interdisciplinary integration and cooperation between academic groups,to establish effective interaction between basic research and clinical application,lead more medical research to focus on the prevention and treatment of clinical diseases,as well as to accelerate the transformation from“discovery”to“realization”,and finally to benefit patients,that is,“from clinic and serve clinic”.This provides a reference mode for the development and research direction of TCM,which comes from clinical practice originally.Based on this,considering the important role of angiogenesis in the occurrence and prognosis of cardiovascular diseases,under the guidance of the concept of translational medicine,this manuscript sorts out the overview of TCM treatment on angiogenesis related cardiovascular diseases from four aspects:theoretical basis,pathogenesis and pathology,applied prescriptions and material basis,in order to summarize the translational medicine experience of TCM prevention and treatment from clinical practice to modern research,to provide a basis for basic research and clinical diagnosis and treatment of related diseases.

Emergency medicine providers＇ opioid prescribing practices stratified by gender, age, and years in practice

BACKGROUND: Emergency medicine providers(EMPs) prescribe about 25% of opioids, but the effect of EMP risk perception on decisions to prescribe opioids is unknown. This study was undertaken to identify factors that infl uence EMP risk and opioid prescribing practices.METHODS: We distributed an anonymous questionnaire to EMPs at a military trauma and referral center. Response frequencies and distributions were assessed for independence using the Chi-square test.RESULTS: Eighty-nine EMPs completed the questionnaire(100% response). Respondents were primarily younger male physicians(80%) in practice under fi ve years(55%). Male EMPs were more likely to prescribe more opioid tablets than female ones both when and when not concerned for opioid misuse(P<0.001, P<0.007, respectively). Of the providers, 70% stated that patient age would inf luence their prescribing decisions. Hydrocodone and oxycodone were the opioids prescribed most frequently. About 60% of the providers reported changing their prescribing behavior would not prevent opioid misuse. Additionally, 40% of the providers believed at least 10% of patients seen at this military ED misused opioids.CONCLUSION: Female EM providers reported prescribing fewer opioid tablets. Patient age infl uenced prescribing behavior, but the effect is unknown. Finally, EM providers reported that altering their prescribing behavior would not prevent prescription opioid misuse.

Transcontinental Translational Medicine Collaboration: A Successful SinoCuban Joint B-to-B Program

Translational medicine is a comprehensive discipline that aims to convert laboratory research results into products and technology for clinical application using modern molecular biological techniques, to improve our understanding of the human body and disease and to optimize laboratory design for clinical observation and analysis for basic research. Its ultimate goal is improving holistic medicine and helping patients solve their health problems. Translational medicine includes two processes： bench to bedside and bedside to bench, known as B-to-B processes. The first B-to-B （bench to bedside） refers to the application of results of the laboratory to clinical use as a medical product or a diagnosis and treatment technology. The second B-to-B （bedside to bench） describes the process by which clinical observation and analysis provides ideas and guidance for experiment design for basic medical research. The two processes complement each other and constitute the two-way cycle of translational medicine. Translational medicine can be applied to clinical disease detection in the form of new biomarkers and can accelerate drug discovery. In recent years, with the biotechnology, increasing rapid development of outcomes of research on molecular pathogenesis can be directly applied to clinical theraDv.

Contribution Invitation of Oncology and Translational Medicine

Oncology and Translational Medicine is an international professional academic periodical on oncology and translational medicine.The Journal,with the authors from around world,especially from China,is dominated in introducing the clinical experience of diagnosis and treatment as well as leading scientific research achievement in the tumor and

Prospects for the future of clinical efficacy evaluation of traditional Chinese medicine——Emphasis on original theory and clinical practice

Traditional Chinese medicine(TCM)clinical efficacy evaluation runs through the development of TCM and has been progressing so far.With the introduction of evidence-based medicine(EBM)in recent 20 years,TCM clinical efficacy evaluation has developed rapidly,accumulated research and experience,improved the quality and standardization of research,but also gradually found deep-seated deficiencies.In 2019,the China Center for Evidence-based Traditional Chinese Medicine(CCEBTCM)was established,and TCM was included in the 11th revision of the International Statistical Classification of Diseases(ICD-11).In above opportunities for TCM clinical efficacy evaluation,it is necessary to face up to the previous deficiencies,so that the TCM clinical efficacy evaluation can truly reflect the actual clinical practice characteristics,including TCM clinical problems,TCM thinking and TCM diagnosis&treatment mode.Based on the summary and analysis of past research,development concepts are proposed in this article.On the one hand,original concepts of TCM should be confidently paid more attention to the design and implementation of TCM clinical efficacy evaluation to be close to TCM clinical practice.On the other hand,it is necessary to consolidate the foundation of TCM clinical practice before evaluating efficacy.Evaluated object built on TCM ontology knowledge should be demonstrated based on clinical practice,and unknown evaluated object combined with new methods,technologies and concepts should be maturely integrated in clinical practice firstly.

Formulation of international standards of Chinese medicine technology:clinical practice guide of Chinese medicine for cough

OBJECTIVE:To formulate the first clinical practice guideline for the treatment of cough using Chinese medicine based on the grading of recommendations assessment,development,and evaluation(GRADE)systematic approach,including clinical evidence,evaluation of ancient literature,and expert consensus.METHODS:In the process of development,the regulation of"evidence-based,consensus-assisted,and empirical"was followed,and a comprehensive systematic approach of recommendation assessment,GRADE,evidence-based evaluation,expert consensus,and the Delphi method was used.In the process of guideline development,evidence-based evaluation of ancient literature was included for the first time,and clinical evidence was fully integrated with clinical expert consensus.RESULTS:The clinical practice guidelines for the treatment of cough with Chinese herbal medicine were developed after a comprehensive consideration of evidence-based evaluation and expert opinions.The guideline recommendations focused on recommending herbal compound decoctions and Chinese patent medicines for cough in different conditions.Based on the GRADE systematic approach,we conducted an evidence-based evaluation of the recommended Chinese patent medicines one by one;meanwhile,the expert consensus method was used to unify the recommendations of both.CONCLUSION:Based on clinical evidence,ancient literature evaluation,and expert consensus,a clinical practice guideline for Traditional Chinese Medicine(TCM)in the treatment of cough was developed,providing the first current clinical practice guideline for domestic and foreign TCM and Western medicine practitioners,especially respiratory professionals at home and abroad.

What is the purpose of launching the World Journal of Translational Medicine?

Congratulations to the publisher,members of the editorial board of the journal,all the authors and readers on the launch of the World Journal of Translational Medicine(WJTM)as a new member of the World series journal family!Translational medicine is a complex field in which ethical,regulatory and economic issues are integral to efforts to close the circle of translational efforts by bringing diagnostic or therapeutic products to the market,that is,to the patient.WJTM is a peer-reviewed open-access periodical centered in translational medicine but with multidisciplinary coverage primarily intended to facilitate the translation of biomedical knowledge into improved human healthcare,and covering every element involved in the field.A special emphasis of the WJTM will be the publication of novel or revolutionary ideas,even if these are not contemplated within the current molecular research paradigm,as long as they are scientifically sound.

Oncology and Translational Medicine

Oncology and Translational Medicine is an international professional academic periodical. The Journal is designed to report progress in research and the latest findings in domestic and international oncology and translational medicine, to facilitate international academic exchanges, and to promote research in oncology and translational medicine as well as levels of service in clinical practice. The entire journal is published in English for a domestic and international readership.

Contribution Invitation of Oncology and Translational Medicine

Oncology and Translational Medicine is an international professional academic periodical on oncology and translational medicine.The Journal,with the authors from around world,especially from China,is dominated in introducing the clinical experience of diagnosis and treatment as well as leading scientific research achievement in the tumor and translational medicine domain,in addition to report basic theory researches which help instruct the clinical practice of oncology and closely connect with the discipline.All the manuscripts are published in English,bimonthly issued both internal and external,48–64 pages,16 opens domains,art paper in offset printing,with layout by international customs,unified issuing number:ISSN 2095-9621/CN 42-1865/R.

Contribution Invitation of Oncology and Translational Medicine

Oncology and Translational Medicine is an international professional academic periodical on oncology and translational medicine. The Journal, with the authors from around world, especially from China, is dominated in introducing the clinical experience of diagnosis and treatment as well as leading scientific research achievement in the tumor and translational medicine domain, in addition to report basic theory researches which help instruct the clinical practice of oncology and closely connect with the discipline. All the manuscripts are published in English, bimonthly issued both internal and external, 48–64 pages, 16 opens domains, art paper in offset printing, with layout by international customs, unified issuing number: ISSN 2095-9621 / CN 42-1865/R.