With the wide application of clinical guidelines and standardization of Chinese medicine (CM), guidelines of CM and/or integrative medicine (IM) were also emerging. By the guideline evaluation instruments such as the Appraisal of Guidelines Research and Evaluation (AGREE) Instrument and Conference on Guideline Standardization (COGS), a preliminary assessment of 11 clinical guidelines for CM and/or IM published before October 2008 was performed. Methodological description of evidence collection or synthesization was absent in most clinical guidelines, and evidence-grading criteria were listed in only one of the eleven guidelines. Inadequate standardization of guideline development, single professional background of guideline developers, and lack of high-grade evidence were the current problems. It was suggested that guideline development group should include individuals from multiple relevant professional fields. Stress should be laid on evidence collection and recommendation grading. Guideline developers should follow the rigorous development methodology of evidence-based guidelines, and the methods for evaluating evidence and grading recommendations should be set up according to the characteristics of medical literature of CM. In addition, more attention should be paid to appraise the quality of clinical practice guidelines of CM and IM.

The correlation between vegetarian diets and cardiovascular health is always one of the hotspots. Many scholars have performed so many clinical researches all over the world, providing evidence-based medicine (EBM) reference for clarifying their correlation. In this paper, we raise ideas and expectation on the basis of a Meta-analysis about vegetarian diets and blood pressure (published on JAMA Internal Medicine in Feb 2014) in combination of main clinical research literature in this field in recent 20 years.
Cardiovascular System ; Diet, Vegetarian ; Evidence-Based Medicine ; Humans ; Meta-Analysis as Topic

Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Phytotherapy

Background and purpose:Recent researches have shown that Secreted Protien Acidic and Rich in Cysteine (SPARC) was closely related to tumor genesis, tumor progression and tumor metastasis. SPARC was highly expressed in malignant melanoma, glioma, meningioma, bladder cancer, lung cancer and prostate cancer, etc. In this study we investigated SPARC expression in hepatocellar carcinoma (HCC) and its signifi cance. Methods:RT-PCR was used to detect SPARC mRNA expression in cancer tissue samples and their adjacent liver tissue samples from 62 patients with hepatocellar carcinoma and 30 normal liver tissue samples, respectively. And the differential protein expression of SPARC between these groups was analyzed by immunohistochemistry (IHC). Results:SPARC mRNA was highly expressed in HCC(14.0?3.6) and in the adjacent liver tissue (6.8?1.8); compared with low expression of 2.7?0.9 in normal liver tissue, there were signifi cant differences among the three groups (p=0.000). SPARC positively stained was found in 54 of 62 patients with HCC and 4 of 30 normal liver tissue, there was significant difference between these two groups (P=0.000). SPARC immunohistochemical score was 21.5?4.8 in the carcinoma group; 11.3?3.6 in paracarcinoma group and 5.7?1.8 in the normal group, there were also significant differences among the three groups (P=0.000). The expression of SPARC protein was significantly upregulated with the progress of Enmondson pathological classification. There was obviously differences between Ⅰvs Ⅱ(P=0.029), and Ⅱ vs Ⅲ Ⅳ(P=0.008). There was more SPARC expression in the patients with metastasis of HCC (26/27, 96.3%) than that without metastasis(23/35, 65.7%)(P=0.004). Conclusion:SPARC mRNA expression and its protein were related to HCC histological differentiation and metastatic lymph node; SPARC is helpful to clinical evaluation of HCC.

0.05),but enhanced 6-keto-PGF_(1?) synthesis at concentrations of 1,0.5,0.1 and 0.01 ?mol?L~(-1)(P

OBJECTIVE: To investigate the differential gene expression profiles in patients with blood stasis syndrome by oligonucleotide microarray technique. METHODS: Sixteen patients with blood stasis syndrome were divided into patients with coronary heart disease (CAD) (n=8) and non-CAD patients (n=8) by using coronary angiography. The sex- and age-matched eight healthy persons were enrolled as control group. Venous bloods were collected for extracting RNA. Test-3 chip was first employed to examine the quality of samples. Then the samples were hybridized with Affymetrix U133 Plus 2.0 array to compare the gene expression profiles among the three groups. Gene-array scanner and gene chip operating software were applied to screen hybridization signals and analyze gene expression respectively. Based on the comparison of the three groups of samples, the differential genes related with blood stasis syndrome were analyzed by Gene Ontology (GO) and pathway, and confirmed by real-time reverse transcription polymerase chain reaction (RT-PCR). RESULTS: Forty-eight differential genes were found being associated with blood stasis syndrome, including 26 up-regulated genes and 22 down-regulated genes. Five of the forty-eight genes (10.4%) were related to inflammatory reaction and immune response through the GO analysis. In the pathway analysis, five of ten significant pathways were referred to inflammation and immune response. The results of real-time RT-PCR proved the accuracy of the gene chip. CONCLUSION: Inflammatory- and immune-related genes have a remarkable predominance in blood stasis syndrome gene expression profiles, which may explain the function of inflammation and immune response in the occurrence and development of blood stasis syndrome.

To investigate the genotype distributions of PLA1/PLA2 polymorphism in Chinese Han population from Beijing and Hebei Province and to study the correlation between the platelet membrane glycoprotein IIIa polymorphism and coronary heart disease (CHD) or CHD with blood-stasis syndrome.

AIM:To investigate the genotype distributions of HPA-3 in Han people from Beijing and Hebei province,and to study the association of the platelet glycoprotein IIb polymorphism with coronary heart disease(CHD).METHODS:Two hundred and twelve patients with coronary heart disease and 106 healthy controls were enrolled in this case-control study.The number of occlusive coronary artery was performed in all subjects.The genotypes of HPA-3 were determined by TaqMan probe technology.RESULTS:In CHD patients(older than 45 years)carriers of HPA-3b were over-represented compared with healthy controls(P

Objective To prospectively study the diagnostic and therapeutic status and prognosis in elderly patients with coronary heart disease(CHD) in national 3rd class-A level hospitals of traditional Chinese medicine(TCM) or integrative western and Chinese medicine(IWCM) in Beijing and Tianjin. The problems and strategies of their in-hospital treatment and secondary prevention of CHD were analyzed combining with follow-up clinical events. Methods Using individualized Information Acquisition Platform of CHD, we collected in-hospital clinical information of CHD patients and then followed up for one year. The diagnostic and therapeutic conditions of elder CHD patients were evaluated based on clinical guidelines. The outcome-related indices were analyzed with one-way ANOVA and muhi-factors analysis. Results The average age of 1864 elderly CHD patients was (72.2±6.8) years, among those 1113 cases were male and 751 cases were female. The major accompanied diseases were hypertension, diabetes, cerebrovascular disease and hyperlipidemia.The standard-reaching rate of blood-lipid level of CHD patients with hyperlipidemia was as follows:TC 74.1%, TG 32. 9%, LDL-C 19. 4%, HDL-C 87. 8%, while it was 64.6% ( systolic pressure)and 84.70% ( diastolic pressure) respectively in CHD with hypertension. As for in-hospital treatment:β-receptor blocker 69.6%, ACEI/ARB 68. 4%, lipid-lowering statina 63. 6%, revascularization 29.1%. During the 12 months of follow-up, cardiogenic death 72 cases (4. 3%, 72/1682), other reasons 5 cases (0. 3%), acute myocardial infarction (AMI) 9 cases (0. 5%), revascularization 15cases (0. 8%). The multi-factors analysis showed that AMI, cardiac dysfunction could increase the incidence rate of endpoint events. Meanwhile, lipid-lowering statins, none of peripheral vessels disease, revaseularization, IWCM treatment, age below 75 years were related with the decreased incidence rate of endpoint events. Conclusions The standard-reaching rates of hlood-lipids (TG,LDL-C) of elderly CHD patients in TCM or IWCM hospitals in Beijing and Tianjin are insufficient,and revascularization should be intensified. There is still certain gap between the usage of ACEI/ARB,β-receptor blocker, lipid-lowering statins and related guidelines, and secondary prevention of CHD must be strengthened. It is the main strategy in preventing cardiovascular events to follow clinical guidelines in medical practice, control multiple risks factors and intervene comprehensively.