1.Methodological Consideration on Combination Model of TCM Clinical Practice Guidelines and Real-world Study
Guozhen ZHAO ; Huizhen LI ; Ning LIANG ; Haili ZHANG ; Bin LIU ; Qianzi CHE ; Feng ZHOU ; He LI ; Xiaowen CHEN ; Long YE ; Jiahao LIN ; Xingyu ZONG ; Dingyi WANG ; Nannan SHI ; Yanping WANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(22):87-93
The clinical practice guidelines of traditional Chinese medicine (TCM) have problems such as limited clinical application and unclear implementation effects, which may be related to the lack of clinical practice evidence. To provide reliable and precise evidence for clinical practice, this article proposes a model of combining TCM guidelines with real-world study, which includes 4 steps. Firstly, during the implementation process of the guidelines, a high-quality research database is established. Secondly, the recommendations in the guidelines are evaluated based on the established database in multiple dimensions, including applicability, effectiveness, safety, and cost-effectiveness, and thus their effectiveness in practical applications can be determined. Thirdly, based on the established database, core prescriptions are identified, and the targeted populations and medication plans are determined. That is, the best treatment regimen is established based on the analysis of abundant clinical data regarding the effects of different medication frequencies, dosages, and duration on efficacy. Fourthly, the guidelines are updated according to the real-world evidence. The research based on this model can provide real-world evidence for ancient and empirical prescriptions, improving their application in clinical practice. Moreover, this model can reduce research costs and improve research efficiency. When applying this model, researchers need to pay attention to the quality of real-world evidence, ensuring that it can truly reflect the situation in clinical practice. In addition, importance should be attached to the clinical application of guideline recommendations, ensuring that doctors can conduct standardized diagnosis and treatment according to the guidelines. Finally, full-process participation of multidisciplinary experts is encouraged to ensure the comprehensiveness and scientificity of the study. In conclusion, the application of this model will contribute to the development of TCM guidelines responsive to the needs of clinical practice and achieve the goal of promoting the homogenization of TCM clinical diagnosis and treatment.
2.Methodology for Developing Patient Guideline (3):Reporting Frameworks and Presentation
Lijiao YAN ; Ning LIANG ; Haili ZHANG ; Nannan SHI ; Ziyu TIAN ; Ruixiang WANG ; Xiaojia NI ; Yufang HAO ; Wei CHEN ; Yingfeng ZHOU ; Dan YANG ; Shuyu YANG ; Yujing ZHANG ; Ziteng HU ; Jianping LIU
Journal of Traditional Chinese Medicine 2024;65(22):2304-2309
Standardized reporting is a crucial factor affecting the use of patient guidelines (PGs), particularly in the reporting and presentation of recommendations. This paper introduced the current status of PG reporting, including the research on PG content and presentation formats, and provided comprehensive recommendations for PG reporting from aspects such as overall framework, recommendations, presentation format, and readability. First, the presentation of PG recommendations should include clearly defined clinical questions, recommendations and their rationale, and guidance on how patients should implement the interventions; for specific content in the PG, such as level of evidence, level of recommendation, it is recommended to explain in text the reasons for giving different levels of recommendation, i.e., to present the logic behind giving the level of recommendation to the patient; additional information needed in the recommendation framework should be supplemented by tracing references or authoritative textbooks and literature that support the recommendations. Subsequently, the PG text should be written based on the Reporting Checklist for Public Versions of Guidelines (RIGHT-PVG) reporting framework. Finally, to enhance readability and comprehension, it is recommended to refer to the Patient Education Materials Assessment Tool (PEMAT) for translating PG content. To enhance the readability of PGs, it is suggested to present the PG content in a persona-lized and layered manner.
3.Mechanism of Bone Destruction in Rheumatoid Arthritis Based on the Theory of Kidney Deficiency and Essence Deficiency
Wenju ZHU ; Xiaojun SU ; Qian HE ; Huan WANG ; Zhiming ZHANG ; Haili SHEN ; Xiaotao YE
Journal of Traditional Chinese Medicine 2024;65(19):2045-2049
Rheumatoid arthritis is a common clinical autoimmune disease characterized by persistent synovitis and pannus formation. In late stage, irreversible destruction and deformation of bone and joint may occur. In this paper, the authors believe that kidney deficiency and essence deficiency is the core mechanism of rheumatoid arthritis bone destruction, and its disease evolution law is summarized as "marrow reduction, flesh flaccid, collaterals blocked". On the basis of modern medical understanding of bone destruction in rheumatoid arthritis, it is considered that the mechanism in Chinese medicine of "marrow reduction, flesh flaccid, collaterals blocked" ultimately leads to bone destruction, is similar to that in the western medicine of abnormal differentiation of osteoclasts, high expression of nuclear factor-κB receptor activator of ligand, and abnormal expression of inflammatory factors. This point of view may provide a more comprehensive and scientific understanding of the key pathogenic mechanism of bone destruction in rheumatoid arthritis.
4.Visual analysis of the impact of T cells on rheumatoid arthritis in the past decade based on multiple analysis methods
Xiaojun SU ; Wenju ZHU ; Huan WANG ; Qian HE ; Qiang BAO ; Ying GUO ; Yihong KE ; Haili SHEN ; Zhiming ZHANG
China Modern Doctor 2024;62(12):1-8
Objective Through a multi-software visual analysis of the literature on the influence of T cells on rheumatoid arthritis(RA)in recent ten years,the research hotspot and frontier development in this field were summarized.Methods The Chinese and English literature on the influence of T cells on RA from 2012 to 2022 years was retrieved from CNKI and Web of Science database as the research object.CiteSpace and VOSviewer software were used to analyze the number of publications,authors and keywords.Results 519 articles in Chinese and 861 in English were retrieved.The results showed that the number of articles in Chinese increased slowly from 2020 to 2022 years,while the overall trend in English was stable.Keyword analysis shows that it is predicted that future research in this field will focus on the pathogenesis of T cells in RA,the mechanism of bone destruction in RA,disease activity,oxidative stress.Conclusion The influence of T cells on RA has attracted much attention in the past,present and future,and has great research value.However,due to the differences in research priorities at home and abroad,the teams should interact positively and communicate with each other to reveal the internal mechanism of RA and provide theoretical basis for targeted therapy.
5.Visual Analysis on Research Hotspots and Trends of Wuzhuyu Decoction
Qingqing XIA ; Ouying CHEN ; Yong ZENG ; Jinxing WANG ; Yanhong KANG ; Fang FANG ; Yan CHEN ; Dongya LI ; Haili ZHU
Chinese Journal of Information on Traditional Chinese Medicine 2024;31(2):84-89
Objective To understand the research status,hotspots and trends of Wuzhuyu Decoction;To provide reference for relevant research.Methods The literature related to Wuzhuyu Decoction was retrieved from CNKI,VIP,Wanfang Data and CBM databases from the establishment to February 28,2023.NoteExpress 3.6 was used to merge and deduplicate,and the author,organization and keywords were mapped and interpreted by CiteSpace 6.1.R6 software.Results A total of 822 articles were included,and the number of publications showed a wave upward trend;the top journals were New Chinese Medicine,Henan Traditional Chinese Medicine and Sichuan Traditional Chinese Medicine;the main research institutions were Beijing University of Chinese Medicine,China Academy of Chinese Medical Sciences and Shandong University of Traditional Chinese Medicine;a total of 566 authors were involved,and the authors with more publications included Wang Zhimin(12),Gong Muxin(9)and Bi Kaishun(5);high-frequency keywords included"headache","Shang Han Lun","TCM therapy"and so on.Conclusion Wuzhuyu Decoction is effective in treating chronic gastritis,hypertension and other primary diseases,which is a research hotspot in this field.It is a research trend in this field to explore its active components by high performance liquid chromatography and explain its action mechanism and target at the molecular level.
6.Visualization Analysis on Research Hotspots and Trends of Animal Medicinal Materials from 2000 to 2003
Qingqing XIA ; Ouying CHEN ; Yong ZENG ; Jinxing WANG ; Yanhong KANG ; Fang FANG ; Yan CHEN ; Dongya LI ; Haili ZHU
Chinese Journal of Information on Traditional Chinese Medicine 2024;31(4):72-78
Objective To understand the research status,hotspots and trends of animal medicinal materials;To provide reference for future research.Methods The literature related to animal medicinal materials was retrieved from CNKI,VIP,Wanfang Data and CBM from January 1,2000 to April 30,2023.NoteExpress 3.6 was used to merge and deduplicate,and the author,institution and keywords were mapped and interpreted by CiteSpace 6.1.R6 software.Results A total of 1 169 articles were included,and the overall publication quantity in this field showed a stable fluctuation trend;the top journals were Lishizhen Medicine and Materia Medica Research,China Journal of Chinese Materia Medica and Modern Chinese Medicine;the main research institutions were China Academy of Chinese Medical Sciences,Changchun University of Chinese Medicine and Chinese Academy of Medical Sciences;a total of 676 authors were involved,and the authors with more publications included Zhang Hui(22),Liu Rui(15),Lin Zhe and Ma Shuangcheng(14);high-frequency keywords included"identification","TCM resources","clinical application"and so on.Conclusion Resource survey of animal medicinal materials,standardized breeding of medicinal animals,development of alternatives to rare medicinal animal resources,and construction of quality standard system for animal medicinal materials are the research hotspots in this field.The basic research of pharmacodynamic substances of animal medicinal materials based on the integrated analysis strategies of proteomics,peptideomics and transcriptomics,and the revelation of the signaling pathways and targets of animal medicinal materials from the molecular biology level are the research trends in this field.
7.Methodology for Developing Rapid and Living Guidelines of Traditional Chinese Medicine (RALIG-TCM) (Part 3): Rapid Evidence Collection, Integration and Recommendation Formation
Ziteng HU ; Lijiao YAN ; Yujing ZHANG ; Yaxin CHEN ; Xiaoling LI ; Haili ZHANG ; Huizhen LI ; Jingya WANG ; An LI ; Zhao CHEN ; Ning LIANG ; Nannan SHI ; Yanping WANG
Journal of Traditional Chinese Medicine 2024;65(3):281-286
The lack of direct evidence is an important problem faced in the formation of recommendations in rapid living guidelines of traditional Chinese medicine under public health emergencies, and the supplementation of indirect evidence can be a key method to solve this problem. For the collection of evidence, the type of evidence required, including direct and indirect evidence, should be clarified, and ‘direct first’ principle for selecting evidence can be set to standardize and accelerate the guideline development. When integrating evidence, recommendations can be formed directly if there is sufficient direct evidence, while regarding insufficient direct evidence, recommendations need to be supplemented and improved by integrating indirect evidence. In addition, when the body of evidence contains evidence from multiple sources, it is suggested to rate the evidence according to “higher rather than lower” principle. Finally, when forming recommendations, the level of evidence, safety and economic efficiency should be taken into consideration to determine the strength of the recommendation.
8.Clinical diagnosis and treatment of peripelvic cysts
Wenyao LIN ; Yangyang PANG ; Jie CHENG ; Haili WANG ; Hang WANG ; Jianming GUO
Chinese Journal of Clinical Medicine 2024;31(4):633-638
Objective To explore the diagnosis and treatment method of peripelvic cysts.Methods A retrospective analysis was conducted on 65 patients with peripelvic cysts admitted to the Department of Urology at Shanghai Xuhui Central Hospital from January 2019 to January 2023.The diagnostic value of ultrasound,intravenous urography(IVU),and computed tomography urography(CTU)for peripelvic cysts was compared,and the efficacy of different surgical treatments for peripelvic cysts was further evaluated.Results All 65 patients underwent ultrasound examination,which indicated cystic lesions at the renal hilum.55 patients underwent IVU examination,but no cyst enhancement was found.Among them,7 patients underwent retrograde pyelography due to poor imaging of the affected renal pelvis.All 53 patients who underwent CTU examination,which clearly showed the renal pelvis and cysts.Among the 65 patients,5 did not undergo surgical treatment and were followed up,while 60 underwent surgery.Four patients were considered for radical nephrectomy due to suspected malignancy.56 cases underwent renal cysts decompression surgery,including 11 open surgeries,37 laparoscopic surgeries,and 8 Da Vinci robot-assisted laparoscopic surgeries.The operative time in the open surgery group was significantly shorter than that in the laparoscopic surgery group and robot-assisted laparoscopic surgery group.Compared with the open surgery group and laparoscopic surgery group,the robot-assisted laparoscopic surgery group had less intraoperative blood loss,lower postoperative analgesic use,shorter time to first ambulation after surgery,and shorter hospital stay.Conclusions Ultrasound,IVU,and CTU are commonly used effective diagnostic tools for peripelvic cysts.Ultrasound can be used as a routine examination,while CTU is more accurate and has a higher diagnostic accuracy than IVU for this condition.Compared with open surgery,laparoscopic and robot-assisted laparoscopic cyst decompression surgery for peripelvic cysts result in less intraoperative blood loss and faster postoperative recovery.
9.Exploration of Value Variable Selection and Measurement for Chinese Patent Medicine Based on Hedonic Price Theory
Yijiu YANG ; Haili ZHANG ; He ZHU ; Wei LI ; Zhao CHEN ; Bin LIU ; Ning LIANG ; Huizhen LI ; Tian SONG ; Wenjie CAO ; Weili WANG ; Ziteng HU ; Yanping WANG ; Sheng HAN ; Nannan SHI
Chinese Health Economics 2024;43(5):68-71,78
To reduce the subjectivity and uncertainty present in the current international methods of drug value pricing when converting value into monetary prices,based on the hedonic pricing theory,it considers the post-negotiation price between manufacturers and payers as a reasonable price reference in the value pricing of Chinese patent medicine.By constructing an indicator system for the characteristics of Chinese patent medicine,it selects and measures the value characteristic variables that affect the price of Chinese patent medicine.It serves as the theoretical foundation and research basis for establishing a Hedonic price model between characteristic price variables and negotiation prices,thereby promoting the enhancement of rationality and objectivity in value-guided pricing of Chinese patent medicine.
10.Evaluation of the Key Steps and Core Indicators of Priority Setting of Health Technology Assessment
Wenjie CAO ; Haili ZHANG ; Bin LIU ; Ning LIANG ; Yijiu YANG ; Weili WANG ; Ziteng HU ; Yanping WANG ; Nannan SHI
Chinese Hospital Management 2024;44(10):43-48
Objective The purpose is to sort out the key steps and core indicators of priority setting for health technology assessment,and provide references for the research of priority setting for health technology assessment in China.Methods To search information from the official website of the World Health Organization,the websites of international health technology assessment agencies/organizations,and CNKI,Wanfang,Pubmed,Embase and other databases related for the setting of health technology assessment priority topics,and the key steps and core indicators of the setting of priority topics were analyzed by descriptive statistical analysis.Results 21 priority setting schemes for health technology assessment were finally incorporated,and the key steps were extracted to set indicators for collecting evaluations.Ratings and rankings and review decisions.The core indicators are disease burden,economic impact and clinical/health impact.Conclusion The key steps and core indicators of international priority setting provide rich practical experience for China's health technology assessment priority setting,which should be actively used for reference to promote evidence-based and scientific decision-making of health technology assessment in China.

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