1.Clinical practice guidelines for prevention and treatment of postoperative gastrointestinal disorder by integrated traditional Chinese and Western medicine: a protocol
Jianjun XUE ; Huaijing HOU ; Lili WEI ; Ziqing XU ; Jie ZHANG ; Xiaohong ZHAO ; Liping CHEN ; Yang XUE ; Li MA ; Kehu YANG ; Yongqiang ZHAO
Chinese Journal of Anesthesiology 2023;43(9):1025-1030
To further improve the diagnosis and treatment level of integrated traditional Chinese and Western medicine for the prevention and treatment of postoperative gastrointestinal disorder, and to promote the standardization of clinical practice guidelines for postoperative gastrointestinal disorder. It was initiated by the Chinese Society of Integrative Anesthesiology, and the " Clinical practice guidelines for prevention and treatment of postoperative gastrointestinal disorder by integrated traditional Chinese and Western medicine: a protocol" was jointly formulated by the institutions such as Gansu Province Clinical Research Center of Integrative Anaesthesiology, Center of Anesthesiology and Pain Medicine of Gansu Provincial Hospital of Traditional Chinese Medicine, World Health Organization Collaborating Center for Guidelines Implementation and Knowledge Translation, GRADE China Center, Industry Technology Centre for Medical Guidelines of Gansu Province, and Evidence-based Medicine Center of Lanzhou University. The Guidelines Formulation Committee followed the principles, methods and procedures of evidence-based guidelines formulation, assembled a multidisciplinary team of experts, and provided an evidence-based clinical practice guidelines using the GRADE method. This protocol mainly expounds the purpose and method of guidelines formulation and the publication, promotion, implementation and update of guidelines.
2.Interpretation of clinical practice guidelines for prevention and treatment of postoperative gastrointestinal disorder with Integrated Traditional Chinese and Western Medicine (2023)
Huaijing HOU ; Jianjun XUE ; Fanfan DING ; Ziqing XU ; Jie ZHANG ; Yang XUE ; Xiaohong ZHAO ; Liping CHEN ; Li MA ; Kehu YANG ; Yongqiang ZHAO
Chinese Journal of Anesthesiology 2024;44(8):909-916
The clinical practice guidelines for prevention and treatment of postoperative gastrointestinal disorder with Integrated Traditional Chinese and Western Medicine (2023) issued by the Anaesthesia Committee and Perioperative Medicine Committee of the Chinese Society of Integrative Medicine is the first evidence-based guideline for postoperative gastrointestinal disorder in China. It covers the definition, aetiology and pathogenesis, diagnosis and treatment of postoperative gastrointestinal disorder. Compared with previous expert consensus, this guideline has advantages in terms of scientific and rigorous methodology and is quite representative. Interpreting this guideline can help strengthen clinicians′ understanding of postoperative gastrointestinal disorder and enhance clinical practitioners′ understanding of the methodology of this guideline, thus enabling a better integration of recommendations and evidence for clinical practice and hastening the implementation of the guidelines. It also accelerates the dissemination of the methodological development of guidelines in China, helps clinicians understand the connotation and value of the guidelines, and provides methodological guidance and references for formulating clinical practice guidelines based on the current situation in China and involving other clinical disciplines.
3.Effect of preoperative electroacupuncture intervention on gastrointestinal function in patients after abdominal surgery:a meta-analysis
Xiaohong ZHAO ; Liping CHEN ; Jie ZHANG ; Fanfan DING ; Ziqing XU ; Huaijing HOU ; Jianjun XUE
The Journal of Clinical Anesthesiology 2024;40(8):848-854
Objective To evaluate the efficacy of preoperative electroacupuncture intervention in promoting postoperative gastrointestinal functional recovery by meta-analysis.Methods The databases of PubMed,Cochrane Library,Web of Science,Embase,CBM,CNKI,VIP,and WanFang were searched systematically.The search period ranged from the inception of the databases to March 2024.Two researchers screened the literature independently,extracted the data,used Cochrane Risk of Bias tools to evaluate the quality of the inclusion study,and used RevMan 5.3 software for meta-analysis.Results Twelve RCTs were included,with 773 patients.There were 421 patients in the preoperative electroacupuncture group and 352 patients in the control group.The results of the meta-analysis showed that,time to first flatus(SMD=-0.56,95%CI-0.84 to-0.28,P<0.001),time to first defecation(MD=-6.40 hours,95%CI-9.27 to-3.53,P<0.001),time to bowel sound recovery(MD=-8.45 hours,95%CI-10.37 to-6.52,P<0.001),time to first oral feeding(MD=-16.88 hours,95%CI-23.92 to-9.83,P<0.001),the incidence of PONV(RR=0.75,95%CI 0.57 to 0.98,P=0.04)and length of hospital stay(MD=-0.78 d,95%CI-1.38 to-0.19,P=0.010)were significantly lower than the control group.Conclusion Electroacupuncture intervention before operation can effectively promote the recovery of post-operative exhaust,defecation,and bowel sound,shorten the time of fasting and drinking,reduce the inci-dence of PONV,shorten the length of hospital stay,and has good clinical value in promoting the recovery of postoperative gastrointestinal function.
4.Evidence Graph Analysis of Postoperative Pain Sensitization Induced by Perioperative Sleep Deprivation
Jianjun XUE ; Caihong WANG ; Lingling GUO ; Xiuxia LI ; Jie ZHANG ; Ziqing XU ; Huaijing HOU ; Kehu YANG
Medical Journal of Peking Union Medical College Hospital 2024;16(1):143-156
To describe and evaluate the clinical studies of postoperative pain sensitization caused by sleep deprivation through the evidence map system, understand the distribution of evidence in this field, and provide reference for subsequent evidence research. A computer-based search of PubMed, EMBASE, Cochrane library, Web of Science, CNKI, Wanfang Data, VIP and Chinese Biomedical Literature Database from inception to August 2023 was conducted to obtain intervention studies, observational studies and systematic reviews/Meta-analysis of postoperative pain sensitization caused by sleep deprivation. The research characteristics and methodological quality were analyzed and evaluated. The Cochrane Handbook for Systematic Reviews, the Newcastle-Ottawa Scale (NOS) and the AMSTAR-2 scale were used to evaluate the quality of the included studies, and the evidence was comprehensively analyzed and displayed by means of bubble chart, table and text. A total of 35 observational studies (31 cohort studies and 4 case-control studies), 15 randomized controlled trials and 4 systematic reviews/Meta-analyses were included. The number of publications increased rapidly after 2018 and peaked in 2022, and clinical studies in this field mainly focused on cohort studies, with fewer randomized controlled trials and systematic reviews/Meta-analysis studies. The results of the evidence map showed that in terms of quality, 22 studies were 'high quality', 24 studies were 'medium quality', and 8 studies were 'low quality'.Thirty studies showed that sleep deprivation could induce postoperative pain sensitization. Only 2 studies suggested that sleep disorders were not significantly associated with postoperative pain sensitization, and ten studies were uncertain whether sleep deprivation could induce postoperative pain sensitization. Overall evidence shows that sleep deprivation can induce postoperative pain sensitization, but the evaluation dimensions are limited and the methodological quality of the included literature needs to be improved. More high-quality, large-sample and standardized clinical studies should be carried out in the future to provide better scientific basis for clinical work.