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.

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.

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.

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.

A Brief Discussion on the Construction of Practical Teaching System for the Traditional Chinese Medicine Resources and Development Major

China’s traditional medicine,science,and technology industry has great development potential.However,there is a problem of insufficient practitioners in the current industrial development.At the same time,the capabilities of existing practitioners do not match the demand standards.Therefore,it is necessary to actively promote the education of resources and development in Central Asia.As an institution for cultivating talents,colleges and universities must establish a practical teaching system for cultivating talents.Based on the requirements put forward by China in education,this article studies the development status of the traditional Chinese medicine resources and development major,determines the talent training goals,starts from the practical teaching aspect,and locates the industry’s requirements for the capabilities of personnel in the field of traditional Chinese medicine.It also puts forward the overall idea of the construction of the practical teaching system,summarizes the reform content of the practical teaching system,and lastly provides the specific path of the reform.

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.

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.

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.

Integrative medicine:the guide line in women's reproductive health and the treatment of gynecological disease

Integrative medicine follows the principles in TCM that nature and human beings being correspondent with its holistic and dialectic views and explores the integrating point with theories and scientific data in modern medicine. During study on 16 gynecological diseases, the deficiency. In patients with pubertal uterine bleeding, ovulation is induced by acupuncture via decrease in central β-endorphin (β-EP) levels, which leads to the cure of anorexia nervosa by acupuncture via decrease in serum cortisol levels in early 1980s. These results in TCM lead to the idea that neuro-endocrine system is directly related to metabolic system which is also proved to be true in the treatment of polycystic ovary syndrome (PCOS) with or without hyperinsulinemia by two formulas (Yu's Tonifying Ricipe and Tian Gui Recipe,TGR) respectively according to differential diagnosis in TCM. Ovulation resulted with decrease in obesity, acanthosis nigricans, serum androgen, insulin, leptin and hyperthalamic neuropeptide Y (NPY), proopiomalanocortin (POMC) levels based on scientific data from both patients and an animal modal. It suggests that metabolic network, and the incidence of obesity, hypertension, diabetes and cancers of the endometrium and breast may be reduced among patients with PCOS in their future life while these recipes being taken long period. For perimenopausal syndrome, formula Geng Nian Chun (GNC)without increase in serum estrogen levels. In aging rats, it was found that GNC increased the ER and ERmRNA expressions in the ovarian axis and the spleen accompanying with increase in central β-EP, serotonin (5-HT) and peripheral interlutin-2 (IL-2) levels in aging rats without changes of estrogen levels. These data may refer to the release of symptoms in women with postmenopausal syndome. It suggests that GNC up-regulates the fading of neuro-endocrine-immune network. Prevention, alleviation of osteoporosis, cardiovascular disease and Alzheimer disease may be expected in aging women with long period taking GNC.

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.

How modern teaching technology affects the transmission of traditional Chinese medicine knowledge: reflections from educators in clinical Chinese pharmaceutical education

Traditional Chinese medicine(TCM)education plays a crucial role in cultivating TCM talents and preserving the profound cultural heritage of the Chinese nation.This paper explores the current situation and problems of TCM education and proposes philosophical reflections on this issue.The analysis shows that the current TCM education faces various challenges,including an unbalanced curriculum,a narrow teaching approach,a lack of practical experience,and an insufficient number of qualified teachers.To enhance the teaching effectiveness and foster a new generation of high-quality Chinese medicine professionals,it is necessary to reform the teaching methods of TCM and integrate the depth of humanities into the teaching process.The paper argues that a philosophical perspective can provide a more comprehensive understanding of TCM education and its role in the development of Chinese medicine.

Teaching Reform of “Nursing of Traditional Chinese Medicine” Course Based on OBE Concept

Traditional Chinese medicine(TCM)nursing is one of the important disciplines in TCM.It is based on TCM theory and combined with modern nursing theory and technology,aiming to provide comprehensive and individualized nursing services.With the changes in the medical environment and the continuous improvement of people’s health needs,the teaching of TCM nursing is facing new challenges and opportunities.This paper aims to discuss the teaching reform of TCM nursing course based on the concept of outcome-based education(OBE)or student-centered teaching.The significance of this study is to provide theoretical basis and practical guidance for the teaching reform of TCM nursing course,and to promote the development and progress of TCM nursing education.Through the teaching reform based on OBE concept,we can better cultivate TCM nursing talents with innovative spirit and practical skills,and contribute to the development of TCM.

Research on the Reform of“Traditional Chinese Medicine Nursing”Teaching Based on the Concept of Outcome-Based Education

Continuously evolving teaching concepts and the adoption of diverse teaching methods have led to outcome-oriented education becoming a fundamental focus of teaching reform in colleges and universities.In this article,the“Traditional Chinese Medicine Nursing”course is used as an example to discuss the reform of education based on the concept of outcome-based education,with the purpose of improving students'learning outcomes and practical skills.

Practice Instruction of Innovative and Entrepreneurial Training Program for Aquatic Animal Medicine Students

As an important platform for the combination of theory and practice,college students' innovative and entrepreneurial training program has an important impact on improving the comprehensive ability of undergraduates. The major of aquatic animal medicine is a new sea-related major. The continuous development and transformation and upgrading of aquaculture in the new period have put forward newer and higher requirements for the innovative and practical ability and comprehensive quality of aquatic animal medicine graduates. Taking the innovation and entrepreneurship program of college students majoring in aquatic animal medicine as an example,this paper analyzes the significance of the innovation training program for college students,the cultivation of students' scientific research ability,and the problems existing in the application and operation of the program,in order to provide a reference for the innovative education and talent training for students majoring in aquatic animal medicine.

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.

Organic Integration of Traditional Chinese and Western Medicines—Future of Clinical Practice Guidelines of Integrated Traditional Chinese and Western Medicines

The transformation and implementation of clinical practice guidelines for integrated traditional Chinese medicine(TCM)and Western medicine(WM)is crucial to the adoption of medical science and technological findings and is an important way for TCM to be made available to the world.First,clinical practice guidelines(CPGs)of TCM and WM integration in recent years was analyzed to clarify the current situation and problems in the existing guidelines according to the following four perspectives:(1)perspective of TCM and WM integration in guidelines,(2)diagnosis Using integrated TCM and WM,(3)integration of TCM and WM treatment,(4)promoting TCM and WM integration.Secondly,the information and quality evaluation of CPGs for integrated Chinese and Western medicine in 2020–2022 were analyzed to explore the degree and methods of integration of Chinese and Western medicine guidelines.And last this study aimed to lay a foundation for the further establishment of Chinese characteristic,repeatable,and calculable clinical practice guidelines of TCM and WM integration.

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.

Mapping the clinical practice of traditional,complementary and integrative medicine in oncology in Western countries:A multinational cross-sectional survey

Background Many cancer patients seek adjunctive therapies to biomedical cancer treatments at some point of their disease trajectory.While acupuncture is increasingly recommended by leading oncological associations,limited evidence exists concerning the evidence-informed practice and adherence to current guidelines of traditional complementary and integrative medicine(TCIM)practitioners treating cancer patients.Methods An international online-survey assessed the demographical data,clinical practice,and sources of information used by TCIM practitioners in Austria,Germany,United States of America,Australia,and New Zealand.Results In total,404 respondents completed the survey,of which 254(62.9%)treated cancer patients.Most practitioners were acupuncturists and herbalists(57.1%),had(16.8±9.9)years of clinical experience and see a median of 2(1,4)cancer patients per week.Breast cancer(61.8%)is the most common cancer type seen in TCIM clinics.Adjunctive TCIM treatments are frequently concurrent with the patient’s cancer specific treatment(39.9%),which is also reflected by the main goal of a TCIM treatment to alleviate side effects(52.4%).However,only 28.0%of the respondents are in contact with the treating oncologist.According to the respondents,pain is most effectively treated using acupuncture,while herbal medicine is best for cancer-related fatigue.TCIM practitioners mostly use certified courses(33.1%)or online databases(28.3%)but often believe that experts are more reliable to inform their practice(37.0%)than research publications(32.7%).Conclusion Acupuncturists and herbalists commonly treat cancer patients.Most practitioners use TCIM as an adjunct to biomedicine as supportive care and use it largely in accordance with current oncological guidelines.

Assessment of knowledge, attitude and practice regarding oxygen therapy at emergency departments in Riyadh in 2017: A cross-sectional study

BACKGROUND: Administering oxygen therapy(OT) has an essential role in preventing/managing hypoxemia in both acute and chronic conditions. It should be adjusted to achieve the normal oxygen saturation of 94%–98% in most cases. This study aims to evaluate knowledge, attitude and practice(KAP) of nurses, paramedics, emergency medical technicians(EMTs) and Emergency Medical Services(EMS) physicians working at emergency departments(ED) in Riyadh, Saudi Arabia. METHODS: In this cross-sectional study, a structured questionnaire was used to assess KAP related to OT of nurses, paramedics, EMTs and EMS physicians currently working at an ED of a tertiary care hospital. Knowledge and attitude were assessed using a Likert scale from 1–5, whereas practice was assessed as a yes/no categorical variable.RESULTS: A total of 444 emergency health-care workers(EHCWs) participated, of which 225(50.7%) were male, with the majority(77%) in the age group of 20–35 years. Over half of the sample were nurses(266; 59.9%). The mean score for knowledge about OT was 5.51±1.45, attitude was 26.31±3.17 and for practices 4.55±1.76. The main factors which were associated with poor KAP were workload and lack of local guidelines. The distribution of overall practice score was signifi cantly better among paramedics – nurses group and EMT – nurses group.CONCLUSION: This study demonstrates that there is a gap in EHCWs' KAP, particularly regarding when to provide OT to a patient. This gap can affect patients' safety. Extensive educational and training programs about OT are needed to raise awareness among health-care providers.