1.Construction and Testing of Health LifeStyle Evidence (HLSE)
Chen TIAN ; Yong WANG ; Yilong YAN ; Yafei LIU ; Yao LU ; Mingyao SUN ; Jianing LIU ; Yan MA ; Jinling NING ; Ziying YE ; Qianji CHENG ; Ying LI ; Jiajie HUANG ; Shuihua YANG ; Yiyun WANG ; Bo TONG ; Jiale LU ; Long GE
Medical Journal of Peking Union Medical College Hospital 2024;15(6):1413-1421
Healthy lifestyles and good living habits are effective strategies and important approaches to prevent chronic non-communicable diseases. With the development of evidence-based medicine, the evidence translation system has made some achievements in clinical practice. There is, however, no comprehensive, professional and efficient system for translating lifestyle evidence globally. Therefore, the Health Lifestyle Evidence (HLSE) Group of Lanzhou University constructed the HLSE Evidence Translation System (
2.Method for Developing Patient Decision Aid in China
Yao LU ; Qian ZHANG ; Qianji CHENG ; Jianing LIU ; Mingyao SUN ; Jinling NING ; Jiajie HUANG ; Simeng REN ; Wenzheng ZHANG ; Yajie LIU ; Xiyuan DENG ; Jinhui TIAN ; Jie LIU ; Long GE
Medical Journal of Peking Union Medical College Hospital 2024;15(6):1422-1431
To systematically construct a guideline to provide a methodological guide for researchers to develop patient decision aids. Through a literature review of international methodological guidance for developing patient decision aids, sorting out the similarities and differences in the processes and methods for developing patient decision aids, and combining them with the topic discussion of the working group, the initial guideline was drafted. A total of 13 guidances was included, with the initial version containing 3 phases, 13 steps, and 48 points. We invited 19 multidisciplinary domain experts for forming consensus. The final version of the guideline contains 3 phases, 11 steps, and 24 points. The guideline has great potential to guide the development of patient decision aids in China and is expected to fill the methodological gap in the field. In the future, several rounds of pilot testing of the guideline based on specific decision issues will be conducted, and the guideline will be further revised and improved.
3.Multi-evidence Integration Methodology for Traditional Chinese Medicine: the MERGE Framework
Honghao LAI ; Zhe WANG ; Ying LI ; Wenjing TANG ; Beibei WANG ; Peidong SUN ; Mingyao SUN ; Jiajie HUANG ; Zhipan XIAO ; Ying LI ; Chen ZHAO ; Hongcai SHANG ; Kehu YANG ; Jie LIU ; Long GE
Medical Journal of Peking Union Medical College Hospital 2024;15(1):172-182
In the era of evidence-based medicine, it is necessary to explore the unique advantages of traditional Chinese medicine (TCM) based on standardized technical methods and operating procedures in order to achieve the modernization and internationalization of TCM and benefit all humanity. The proposal of a three-pronged evidence system combining TCM theory, human experience and experimental evidence marks an important progress in the thinking method of the TCM evaluation system. The multi-evidence body integrated through appropriate methods provides a strong support for the clinical guideline recommendations and evidence-based health decision-making in TCM. Based on the current methodological progress of international evidence synthesis and grading, this paper proposes a novel approach for integrating multi-evidence in TCM: the MERGE framework. The aim is to establish a solid foundation for the development of this methodology and provide guidance for the advancement of evidence-based medicine framework in TCM.
4.Methods for Developing Rapid and Living Evidence-based Guidelines
Chen TIAN ; Qiuyu YANG ; Mingyao SUN ; Jie LIU ; Jinhui TIAN ; Yaolong CHEN ; Kehu YANG ; Long GE
Medical Journal of Peking Union Medical College Hospital 2024;15(1):183-191
The aims of developing rapid and living guidelines is to keep the recommendations in the guideline up-to-date. Compared with the conventional guideline, the rapid and living guideline can make better use of the existing evidence and apply and transform the evidence in a timely manner. This paper introduces the advantages and usage of rapid and living guidelines, the development process and existing challenges, and offers some insights, in order to provide reference for domestic organizations and scholars engaged in guideline development.
5.Construction and Testing of Health LifeStyle Evidence (HLSE)
Chen TIAN ; Yong WANG ; Yilong YAN ; Yafei LIU ; Yao LU ; Mingyao SUN ; Jianing LIU ; Yan MA ; Jinling NING ; Ziying YE ; Qianji CHENG ; Ying LI ; Jiajie HUANG ; Shuihua YANG ; Yiyun WANG ; Bo TONG ; Jiale LU ; Long GE
Medical Journal of Peking Union Medical College Hospital 2024;15(6):1413-1421
Healthy lifestyles and good living habits are effective strategies and important approaches to prevent chronic non-communicable diseases. With the development of evidence-based medicine, the evidence translation system has made some achievements in clinical practice. There is, however, no comprehensive, professional and efficient system for translating lifestyle evidence globally. Therefore, the Health Lifestyle Evidence (HLSE) Group of Lanzhou University constructed the HLSE Evidence Translation System (
6.Method for Developing Patient Decision Aid in China
Yao LU ; Qian ZHANG ; Qianji CHENG ; Jianing LIU ; Mingyao SUN ; Jinling NING ; Jiajie HUANG ; Simeng REN ; Wenzheng ZHANG ; Yajie LIU ; Xiyuan DENG ; Jinhui TIAN ; Jie LIU ; Long GE
Medical Journal of Peking Union Medical College Hospital 2024;15(6):1422-1431
To systematically construct a guideline to provide a methodological guide for researchers to develop patient decision aids. Through a literature review of international methodological guidance for developing patient decision aids, sorting out the similarities and differences in the processes and methods for developing patient decision aids, and combining them with the topic discussion of the working group, the initial guideline was drafted. A total of 13 guidances was included, with the initial version containing 3 phases, 13 steps, and 48 points. We invited 19 multidisciplinary domain experts for forming consensus. The final version of the guideline contains 3 phases, 11 steps, and 24 points. The guideline has great potential to guide the development of patient decision aids in China and is expected to fill the methodological gap in the field. In the future, several rounds of pilot testing of the guideline based on specific decision issues will be conducted, and the guideline will be further revised and improved.
7.The role of CYP1A1/2 in cholesterol ester accumulation provides a new perspective for the treatment of hypercholesterolemia.
Jian LU ; Xuyang SHANG ; Bingyi YAO ; Dongyi SUN ; Jie LIU ; Yuanjin ZHANG ; He WANG ; Jingru SHI ; Huaqing CHEN ; Tieliu SHI ; Mingyao LIU ; Xin WANG
Acta Pharmaceutica Sinica B 2023;13(2):648-661
Cholesterol is an important precursor of many endogenous molecules. Disruption of cholesterol homeostasis can cause many pathological changes, leading to liver and cardiovascular diseases. CYP1A is widely involved in cholesterol metabolic network, but its exact function has not been fully elucidated. Here, we aim to explore how CYP1A regulates cholesterol homeostasis. Our data showed that CYP1A1/2 knockout (KO) rats presented cholesterol deposition in blood and liver. The serum levels of low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and total cholesterol were significantly increased in KO rats. Further studies found that the lipogenesis pathway (LXRα-SREBP1-SCD1) of KO rats was activated, and the key protein of cholesterol ester hydrolysis (CES1) was inhibited. Importantly, lansoprazole can significantly alleviate rat hepatic lipid deposition in hypercholesterolemia models by inducing CYP1A. Our findings reveal the role of CYP1A as a potential regulator of cholesterol homeostasis and provide a new perspective for the treatment of hypercholesterolemia.
8.Current situation and reflections on art therapy guidelines
Mingyao SUN ; Honghao LAI ; Zhigang ZHANG ; Jinhui TIAN ; Zheng XU ; Long GE
Chinese Journal of Behavioral Medicine and Brain Science 2023;32(2):177-181
Art therapy plays an important role in enhancing the emotional expression of patients, treating mental and psychological diseases, and promoting the recovery of cancer patients.Due to its extensive meaning and various intervention measures, strengthening the guidance and monitoring of art therapy are important in improving the medical quality of related fields.Clinical practice guidelines are important tools to guide and standardize medical behavior, and also are important guarantees for the implementation effect of medical behavior.Therefore, this article will summarize the current situation of art therapy guidelines, and on this basis, reflect on the formulation and implementation of relevant guidelines and recommendations.
9.Carotid endarterectomy combined with vertebral artery transposition treating vertebral artery V1 segment stenosis combined with ipsilateral carotid artery stenosis
Yuanrui GU ; Zeming ZHOU ; Yangxue SUN ; Yilang QIN ; Chen TIAN ; Jingjing REN ; Chuan TIAN ; Kun FANG ; Wenbin OUYANG ; Ying ZHANG ; Mingyao LUO ; Chang SHU ; Chenxi OUYANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2023;30(05):704-709
Objective To explore the treatment outcome of carotid endarterectomy combined with vertebral artery transposition in patients with severe stenosis to occlusion of the vertebral artery V1 segment and the ipsilateral carotid artery. Methods From June 2017 to September 2020, patients with severe stenosis to occlusion of the vertebral artery V1 segment and the ipsilateral carotid artery treated with carotid endarterectomy combined with vertebral artery transposition in Fuwai Hospital were retrospectively analyzed. Results Finally 12 patients were enrolled, including 10 males and 2 females with an average age of 67.8±6.0 years. Twelve patients were successfully operated and the follow-up time was 1-3 years. The stenosis degree of the V1 segment of the vertebral artery decreased from 83.5%±11.8% to 24.9%±14.3% (P<0.001). The stenosis degree of carotid artery decreased from 85.6%±11.0% to 0% (P<0.001). Postoperative follow-up showed that the symptoms of symptomatic patients before surgery improved. The 1-year and 3-year patency rates were 100.0%, and there were no peripheral nerve injury complications, perioperative deaths or strokes. Conclusion Carotid endarterectomy combined with vertebral artery transposition can treat ipsilateral carotid artery stenosis and vertebral artery stenosis at the same time, improve blood supply to the brain, improve patients' symptoms and has high promotion value.
10.Preoperative left ventricular ejection fraction and risk for postoperative major adverse cardiovascular events in elderly patients with hip fracture
Mingyao SUN ; Man LI ; Sanbao HU
Chinese Journal of Orthopaedic Trauma 2023;25(9):785-791
Objective:To investigate the relationship between preoperative left ventricular ejection fraction (LVEF) and the risk for postoperative major adverse cardiovascular events (MACE) in elderly patients with hip fracture.Methods:A retrospective study was conducted to analyze the data of 403 elderly patients with hip fracture who had undergone surgical treatment at Department of Orthopedics, Beijing Anzhen Hospital from January 2015 to January 2021. Gender: 118 males and 285 females; age: 80 (74, 85) years; fracture type: 228 femoral neck fractures and 175 intertrochanteric (including subtrochanteric) fractures. Cardiovascular disease was complicated in 161 patients before surgery. The incidence of MACE within 30 days after surgery was statistically analyzed. The patients were divided into 2 groups according to whether MACE occurred 30 days after surgery: an MACE group and a non-MACE group. The baseline data, LVEF, preoperative cardiovascular complications, American Society of Anesthesiologists(ASA) grading and other indicators were compared between the 2 groups. Based on patient sample analysis, the receiver operating characteristic curve (ROC) was plotted to determine the optimal cutoff value of preoperative LVEF, according to which the relationship was analyzed between preoperative LVEF and the risk for postoperative MACE.Results:The overall incidence of postoperative MACE was 12.4% (50/403). There were statistically significant differences between the MACE group and the non-MACE group in preoperative LVEF[60.0% (56.0%, 63.0%) versus 62.0% (60.0%, 65.0%)], preoperative cardiovascular complications[74.0% (37/50) versus 35.1% (124/353)] and ASA grade ≥3[90.0% (45/50) versus 74.8% (264/353)]. ROC analysis showed that LVEF=60% was the optimal threshold for prediction of postoperative MACE (area under curve=0.680, sensitivity 48.0%, and specificity 83.0%). Multivariate logistic regression analysis showed that LVEF<60% and preoperative cardiovascular disease were risk factors for postoperative MACE. Subgroup analysis showed that the incidence of MACE in patients with LVEF<60% was significantly higher than that in patients with LVEF≥60% regardless of preoperative cardiovascular disease ( P<0.05). Conclusion:Preoperative LVEF<60% is a risk factor for postoperative MACE in elderly patients with hip fracture.

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