ObjectiveTo construct a comprehensive evaluation indicator system for clinical practice guidelines of traditional Chinese medicine （TCM） that is scientific， systematic， and reflects the characteristics of TCM. MethodsA systematic search was conducted in Chinese and English databases， including CNKI， Wanfang， VIP， SinoMed， PubMed， Embase， and Cochrane Library， to include literature on domestic and international guideline evaluation tools and TCM-related research. Document analysis and CiteSpace were utilized for keyword co-occurrence and clustering analysis. ResultsA total of 65 relevant studies were included， from which seven core thematic domains were identified. Based on the research objectives， a two-step construction strategy was adopted： first， an external evaluation framework was established by referencing international tools to cover methodological rigor and procedural standardization； second， an internal evaluation framework was developed to reflect the distinctive features of TCM clinical practice， including syndrome differentiation and efficacy feedback. Through expert consensus， the indicator system was refined， resulting in a dual-layered structure comprising 8 primary indicators， 22 secondary indicators， and 62 evaluation criteria. ConclusionThe comprehensive evaluation system for TCM clinical practice guidelines， based on bibliometric analysis and core element extraction， integrates both theoretical integrity and practical applicability. This study provides a preliminary research foundation for further optimization， validation， and development of a refined comprehensive evaluation system.

Objective To observe the effects of different ligation sites and fasting method on a C57BL/6J mouse model of partial bile duct ligation(pBDL)-induced cholestasis,to establish a pBDL modeling method with a high modeling rate,typical symptoms,and good stability.Methods C57BL/6J mice were subjected to selective ligation of the left hepatic bile duct(L-pBDL)and left-to-median bile duct junction ligation(ML-pBDL)for modeling,and the effects of different pBDL ligation method on serum alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase(ALP),total bilirubin,total bile acid,and liver histopathology were observed.The effects of different fasting method on symptoms and liver injury in the ML-pBDL model were also observed after fasting for 12 and 16 h before surgery,and for 4 h after surgery.Results(1)The incidence of jaundice in the ML-pBDL group was 52.94%and the survival rate within 3 weeks after surgery was 64.71%,while the incidence of jaundice in the L-pBDL group was 11.76%and the survival rate within 3 weeks after surgery was 82.35%.Compared with those in the sham surgery group,serum liver function indicators were significantly increased in the L-pBDL and ML-pBDL groups(P＜0.01),and ALP activity was significantly higher in the ML-pBDL group than in the L-pBDL group(P＜0.05).Compared with mice in the L-pBDL group,mice in the ML-pBDL group had more severe liver fibrosis at 3 weeks post-surgery(P＜0.01).(2)In addition,the incidence of jaundice in the 16 h fasting group was 93.33%and the survival rate within 3 weeks after surgery was 73.77%,while the incidence of jaundice in the 12 h fasting group was 42.86%and the survival rate within 3 weeks after surgery was 71.42%.Compared with those in the normal group,ALP activity,alanine aminotransferase/aspartate aminotransferase ratio,total bile acid level,and proportion of collagen fiber area were all significantly increased in the 16 h and 12 h fasting groups(P＜0.05).Although the observed indicators were higher in the 16 h fasting group compared with those in the 12 h fasting group,the difference was not significant(P＞0.05).Mice in the 12 h and 16 h fasting groups both showed significant bile duct hyperplasia and liver fibrosis(P＜0.01),with more severe liver fibrosis in the 16 h fasting group(P＜0.01).Conclusions Both L-pBDL and ML-pBDL ligation method can be used to establish a mouse model of cholestasis;however,symptoms in the L-pBDL model only exhibit transient damage characteristics,while the liver lesions in the ML-pBDL model are typical and stable.Prolonging the preoperative fasting time can improve the modeling rate and stability of the ML-pBDL model and produce more-typical pathological symptoms.

OBJECTIVETo explore the trend change of the morbidity and mortality of colorectal cancer in China in order to provide reference to the prevention and control of colorectal cancer.

METHODSAccording to the 1-3 volumes of "Pathogenesis and death of malignancies in pilot program city and county of China", "Pathogenesis and death of cancer in China"(2003-2007) and "Registration annual report of tumor in China" published in 2011 and 2012, data of pathogenesis and death of colorectal cancer from 10 tumor registration spots, including Beijing urban, Shanghai urban, Wuhan urban, Harbin urban (defined as city urban), and Hebei Ci County, Jiangsu Qidong District, Zhejiang Jiashan District, Guangxi Fusui County, Fujian Changle District, Henan Lin County (defined as rural district), between 1988 and 2009 were collected. The morbidity and mortality were elucidated with world population standardized rate. Ratio of pathogenesis to death was calculated with crude rate of morbidity and mortality. Data of 22 years were enrolled into the linear regression analysis to calculate the annual change rate of morbidity and mortality statistically.

RESULTS(1) Colon cancer: morbidity presented increasing trend; male morbidity in city urban increased faster; mortality presented increasing trend as well; no significant difference of increasing velocity was observed between city urban and rural district; morbidity and mortality in city urban were higher compared to rural district; morbidity and mortality of males were higher compared to females; except stable Fujian Changle District, ratio of pathogenesis to death presented decreased trend in Shanghai urban and Hebei Ci County, and increased trend in other 7 spots (all P<0.05). (2) Rectal cancer: morbidity presented increasing trend, and its increasing velocity of city urban was faster compared to rural district; mortality presented decreased trend, especially in females, and this trend in rural district was worse compared to city urban; morbidity and mortality of males were higher compared to females, while no significant difference was observed between city urban and rural district; morbidity and mortality of males and females in Zhejiang Jiashan District were all decreased (all P<0.05); except stable Harbin city, ratio of pathogenesis to death presented increased trend in other 9 spots (all P<0.05). (3) Ratio analysis of morbidity and mortality showed that percentage of colon cancer increased gradually in all 10 spots between 1988-2009.

CONCLUSIONSIn the past 2 decades, the overall morbidity and mortality of colorectal cancer are higher in city urban and in male as compared with rural district and female. Colon cancer has higher morbidity than rectal cancer and its morbidity and mortality present increased trend, while morbidity of rectal cancer presents increased trend but its mortality presents decreased trend.

OBJECTIVETo evaluate the clinical therapeutic effects and safety on moderate and severe persistent allergic rhinitis treated with acupoint application therapy of the different intensity during the dog days.

METHODSOne hundred and sixty patients of moderate and severe persistent allergic rhinitis were randomized into a No.1 treatment group, a No.2 treatment group, a No.3 treatment group and a placebo group, 40 cases in each one. The same acupoints were used in the four groups, named Dazhui (GV 14), Dingchuan (EX-B1), Feishu (BL 13), Pishu (BL 20), Mingmen (GV 4), Gaohuang (BL 43), Shenshu (BL 23) and Qihai (CV 6). In the three treatment groups, the fine powder of the ingredients (,,,) of compoundformula was used. In the No.1 treatment group, the herbal paste (ginger-prepared paste) was prepared with ginger juice and the above herbal powder. In the No.2 and No.3 treatment groups, the herbal paste (honey-prepared paste) was prepared with honey with the above herbal powder. In the placebo group, the pseudo-herbal paste of the same appearance was prepared with millet powder and distilled water. The acupoint application was given for 2 h in the No.1 and No.2 groups and was for 6 h in the No.3 treatment group and the placebo group. The acupoint application therapy was given once every week during the dogdays, continuously for 5 weeks. The total nasal symptom score (TNSS), the score of the rhinoconjunctivitis quality of life questionnaire (RQLQ) and the count of blood eosinophils (EOS) were observed in the patients of the 4 groups before and after treatment. The clinical therapeutic effects were compared among the 4 groups. The incidences of the skin adverse reactions were observed in each treatment group.

RESULTSAfter treatment, the scores of TNSS and RQLQ were all reduced as compared with those before treatment in the three treatment groups (<0.05,<0.01), in which, the improvements in the No.3 treatment group were better than those in the No.1 treatment group and the No.2 treatment group (both<0.05). After treatment, the count of EOS was all reduced as compared with that before treatment in the three treatment groups (all<0.05). The differences were not significant statistically among the three treatment groups (all>0.05). The total effective rate was 85.0% (34/40) in the No.3 treatment group, better than 76.3% (29/38) in the No.1 treatment group, 71.8% (28/39) in the No.2 treatment group and 5.0% (2/40) in the placebo group (<0.05,<0.01). The incidences of the skin adverse reaction in the No.3 treatment group and the No.2 treatment group were lower than those in the No.1 treatment group (both<0.01).

CONCLUSIONThe acupoint application of the different intensity relieves the symptoms and improves the living quality in the patients of moderate and severe persistent allergic rhinitis. The stimulation of the ginger-prepared herbal paste is strong and induces skin blisters after 2 h herbal application. The stimulation of the honey-prepared herbal paste is moderate and does not induce blisters. The 6 h stimulation of the honey-prepared herbal paste is mild and the therapeutic effect is optimal.

OBJECTIVETo investigate the differences of clinical characteristics and molecular features among colorectal cancer subsides and provide evidence for colorectal cancer protection, diagnosis and treatment.

METHODSAll of 4 316 colorectal patients from Shanghai cancer center were selected for clinical character analysis, among which, 2 224 subjects for molecular feature analysis. Clinic pathological characteristics like age, gender, tumor types, histological types, differentiation and T-stage, as well as molecular features like hMLH1, hMSH2, CD44, p21, p53, COX2,E-cadherin, Her2 and Ki-67, were involved into this research.

RESULTSIt showed that compared with left-sided colon and rectal cancers, right-sided cancers occurred more in women (46.0% (541/1 176); 39.2% (424/1 083); 41.2% (848/2 057), respectively, χ² = 11.85, P < 0.01), had more mucinous or signet-ring carcinoma (12.0% (128/1 064), 5.8% (56/960), 4.0% (75/1 859), respectively, χ² = 31.27, P < 0.01), poor differentiated carcinoma (32.1% (343/1 069), 19.5% (201/1 033), 19.3% (380/1 967), respectively, χ² = 72.66, P < 0.01) , and advanced T stage (87.9% (992/1 129), 83.2% (869/1 045), 72.2% (1 486/2 057), respectively, χ² = 121.44, P < 0.01). Meanwhile, the rates of hMLH1 were higher in right-sided colon cancers when compared with rectal cancers (13.4% (59/439) vs 8.5% (88/1 035), OR (95%CI): 1.67 (1.18-2.37)), as well as the rates of hMSH2 negative expression (4.9% (22/452) vs 2.4% (26/1 083), OR (95% CI): 2.08(1.17-3.71)). The rates of p53 positive expression were higher in right-sided colon cancers when compared with rectal cancers (76.2% (321/421) vs 68.4%, (776/1 134), OR (95% CI): 0.68 (0.52-0.87)). Compared with right-sided colon cancers, the rates of Her2 positive expression were higher in rectal cancers (19.3% (176/913) vs 13.2% (45/340), OR (95% CI): 1.57 (1.10-2.23)) , as well as the rates of Ki-67 expression which was positive in more than 50% cells (73.6% (840/1 141) vs 65.6% (299/456), OR (95% CI): 0.68 (0.54-0.86)).

CONCLUSIONThere are specific characteristics in right-sided colon cancers. The difference of molecular features between right-sided colon and rectal cancers are more significant.

Adenocarcinoma, Mucinous ; Cadherins ; Carcinoma ; Carcinoma, Signet Ring Cell ; China ; Colonic Neoplasms ; Colorectal Neoplasms ; Female ; Humans ; Neoplasm Grading ; Neoplasm Staging ; Rectal Neoplasms ; Sex Factors

Objective To investigate the differences of clinical characteristics and molecular features among colorectal cancer subsides and provide evidence for colorectal cancer protection,diagnosis and treatment.Methods All of 4 316 colorectal patients from Shanghai cancer center were selected for clinical character analysis, among which, 2 224 subjects for molecular feature analysis.Clinic pathological characteristics like age, gender, tumor types, histological types, differentiation and T-stage, as well as molecular features like hMLH1,hMSH2,CD44,p21,p53,COX2,E-cadherin,Her2 and Ki-67,were involved into this research.Results It showed that compared with left-sided colon and rectal cancers, right-sided cancers occurred more in women ( 46.0% ( 541/1 176 ); 39.2% ( 424/1 083 ); 41.2% ( 848/2 057 ) , respectively,χ2 =11.85,P<0.01), had more mucinous or signet-ring carcinoma(12.0%(128/1 064), 5.8%(56/960),4.0%(75/1 859),respectively,χ2 =31.27,P <0.01), poor differentiated carcinoma (32.1%(343/1 069),19.5%(201/1 033), 19.3%(380/1 967),respectively,χ2 =72.66,P<0.01), and advanced T stage(87.9%(992/1 129), 83.2%(869/1 045), 72.2%(1 486/2 057),respectively,χ2 =121.44,P <0.01).Meanwhile,the rates of hMLH1 were higher in right-sided colon cancers when compared with rectal cancers ( 13.4% ( 59/439 ) vs 8.5% ( 88/1 035 ) , OR ( 95%CI ): 1.67 ( 1.18-2.37)),as well as the rates of hMSH2 negative expression(4.9% (22/452) vs 2.4% (26/1 083),OR (95%CI):2.08(1.17-3.71)).The rates of p53 positive expression were higher in right-sided colon cancers when compared with rectal cancers ( 76.2% ( 321/421 ) vs 68.4%, ( 776/1 134 ) , OR ( 95%CI ): 0.68 (0.52-0.87)).Compared with right-sided colon cancers,the rates of Her2 positive expression were higher in rectal cancers(19.3%(176/913) vs 13.2% (45/340),OR(95%CI):1.57 (1.10-2.23)),as well as the rates of Ki-67 expression which was positive in more than 50%cells (73.6%(840/1 141) vs 65.6%(299/456),OR(95%CI):0.68 (0.54-0.86)).Conclusion There are specific characteristics in right-sided colon cancers.The difference of molecular features between right-sided colon and rectal cancers are more significant.

Objective To investigate the differences of clinical characteristics and molecular features among colorectal cancer subsides and provide evidence for colorectal cancer protection,diagnosis and treatment.Methods All of 4 316 colorectal patients from Shanghai cancer center were selected for clinical character analysis, among which, 2 224 subjects for molecular feature analysis.Clinic pathological characteristics like age, gender, tumor types, histological types, differentiation and T-stage, as well as molecular features like hMLH1,hMSH2,CD44,p21,p53,COX2,E-cadherin,Her2 and Ki-67,were involved into this research.Results It showed that compared with left-sided colon and rectal cancers, right-sided cancers occurred more in women ( 46.0% ( 541/1 176 ); 39.2% ( 424/1 083 ); 41.2% ( 848/2 057 ) , respectively,χ2 =11.85,P<0.01), had more mucinous or signet-ring carcinoma(12.0%(128/1 064), 5.8%(56/960),4.0%(75/1 859),respectively,χ2 =31.27,P <0.01), poor differentiated carcinoma (32.1%(343/1 069),19.5%(201/1 033), 19.3%(380/1 967),respectively,χ2 =72.66,P<0.01), and advanced T stage(87.9%(992/1 129), 83.2%(869/1 045), 72.2%(1 486/2 057),respectively,χ2 =121.44,P <0.01).Meanwhile,the rates of hMLH1 were higher in right-sided colon cancers when compared with rectal cancers ( 13.4% ( 59/439 ) vs 8.5% ( 88/1 035 ) , OR ( 95%CI ): 1.67 ( 1.18-2.37)),as well as the rates of hMSH2 negative expression(4.9% (22/452) vs 2.4% (26/1 083),OR (95%CI):2.08(1.17-3.71)).The rates of p53 positive expression were higher in right-sided colon cancers when compared with rectal cancers ( 76.2% ( 321/421 ) vs 68.4%, ( 776/1 134 ) , OR ( 95%CI ): 0.68 (0.52-0.87)).Compared with right-sided colon cancers,the rates of Her2 positive expression were higher in rectal cancers(19.3%(176/913) vs 13.2% (45/340),OR(95%CI):1.57 (1.10-2.23)),as well as the rates of Ki-67 expression which was positive in more than 50%cells (73.6%(840/1 141) vs 65.6%(299/456),OR(95%CI):0.68 (0.54-0.86)).Conclusion There are specific characteristics in right-sided colon cancers.The difference of molecular features between right-sided colon and rectal cancers are more significant.

Objective To describe the discovery of a residual foci of bancroftian filariasis in Fuchuan County where the disease was announced to have been eliminated, and reveal its epidemiologic feature.Methods The investigation was carried out from August 2007 to March 2008 among residents in Changtang village where the first caseof filariasiswas found and the neighboring villages.They were screened with two thick blood smears.Immunochromatographic technology(ICT) was conducted for those going out but returned and those in surrounding areas.Vector mosquitoes were collected and dissected to find filaria larvae.Historical documents were reviewed and relevant people were interviewed.Results In Changtang administrative village, 1 052 residents were screened and 19 cases with microfilaremia were found in 2 natural villages, with a Mf-positive rate of 1.8%(5.1% in Gangshang and 1.4% in Yinshan respectively).No Mf-positive case was found in 4 119 residents screened in other 3 villages.The average microfilaria density in the 19 cases was 17.37/60 ?l blood.All the 19 cases belonged to 12 families, and 13 cases were relatives to each other, which showed a feature of spatial clustering and family clustering.More patients were identified in the age groups of 20-29 and 50-59, and 57.9% of them were older than 50 years.No larvae were found in 54 Culex pipiens fatigans dissected.Conclusion The Changtang village is identified as a residual focus of bancroftian filariasis with a low, limited endemicity.More cases have been among the elderly with a low average microfilaremia.