For TCM to go global,while carrying forward its own characteristics,it should also build a set of measurement methods recognized by the international medical field.PRO scale is more and more widely used in the field of traditional Chinese medicine because there are many confluence points between PRO scale and TCM connotation.The patient-reported outcomes measurement information system(PROMIS)provides a reference for the development of PRO scales in the field of TCM.We can learn from the methods and models relied on by PROMIS and build a PRO evaluation system for TCM diseases based on TCM culture,so as to promote the standardization,standardization and modernization of TCM.

For TCM to go global,while carrying forward its own characteristics,it should also build a set of measurement methods recognized by the international medical field.PRO scale is more and more widely used in the field of traditional Chinese medicine because there are many confluence points between PRO scale and TCM connotation.The patient-reported outcomes measurement information system(PROMIS)provides a reference for the development of PRO scales in the field of TCM.We can learn from the methods and models relied on by PROMIS and build a PRO evaluation system for TCM diseases based on TCM culture,so as to promote the standardization,standardization and modernization of TCM.

  Objective   To systematically assess the applicability of the clinical practice guidelines (CPGs) integrating Chinese and western medicine, thereby providing reference for enhancing their future usability.   Methods   PubMed, Web of Science, Embase, SinoMed, WanFang Data, and CNKI databases were searched for guidelines for the integration of Chinese and western medicine. Supplementary searches of Chinese Medical Association, Chinese Medicine Administration, MedSci websites, Website of China Association of Chinese Medicine, Medlive, Website of Dangdang, Chinese Association of Integrative Medicine and World Federation of Traditional Chinese Medicine Societies were conducted. The search time frame was from inception of the databases to December 31, 2022. Four reviewers independently evaluated the implementability of clinical practice guidelines by using "Clinical Practice Guideline (CPG) implementation evaluation tool".   Results   A total of 61 integrative Chinese and western medicine guidelines were included. Of the guidelines assessed, 9 guidelines(14.75%) exhibited strong implementability, 40(65.57%) demonstrated average implementability, and 12 (19.67%) demonstrated poor implementability. Among the 5 domains, the dimensions of "accessibility" and "implementability" were found to be of high quality, while those of "communication", "ease of identification" and "applicability" were relatively poor. Notably, compared to guidelines published between 2006—2016, those published between 2017—2022 showed improvements in the areas of "identification" and "application".   Conclusions   The implementabilityof the existing clinical practice guidelines of the integrative Chinese and western medicine is average and needs to be improved. In the future, emphasis should be placed on the integration of medical education and research, publicity of the guidelines, continuous medical education and training, a more concise form of recommendations, application of the guidelines by clinicians, and the implementability of the integrative Chinese and western medicine guideline.

Objective:To study the efficacy of different systemic chemotherapy regimens as first-line and second-line therapy and to determine the prognostic factors for patients with advanced biliary tract cancer.Methods:The clinical data of patients with advanced biliary tract cancer who underwent systemic chemotherapy in Cancer Hospital of Chinese Academy of Medical Sciences from January 2011 to December 2018 were studied. The efficacy of chemotherapy on objective response rate (ORR) and disease control rate (DCR) were evaluated. Potential prognostic factors for survival were studied using the Cox proportional hazards models.Results:Of 151 patients enrolled into this study, there were 75 males and 76 females, with ages ranging from 31 to 77 years (median 58 years). Two treatment protocols were used: (1) 104 patients received a gemcitabine-based regimen (combined with platinums or fluorouracils) or a combination of platinums and fluorouracils, while (2) 47 patients received a combination of albumin-bound paclitaxel and S-1. The corresponding ORR for each group were 15.4%(16/104) and 27.6%(13/47), respectively, and the DCR were 65.4%(68/104) and 72.3%(34/47), respectively. Of 58 evaluable patients who received chemotherapy as a second-line therapy, 31 patients received the regimen containing gemcitabine, platinums or fluorouracils with an ORR of 3.2% (1/31) and a DCR of 35.5%(11/31); a total of 18 patients received the taxanes-based regimen with an ORR of 11.1%(2/18) and a DCR of 38.9%(7/18); 9 patients received the irinotecan-based regimen with an ORR of 22.2%(2/9) and a DCR of 44.4%(4/9). Univariate analysis showed positive liver metastasis and elevated carbohydrate antigen (CA)19-9 level to be significantly correlated with worse survival outcomes ( HR=1.540, 95% CI: 1.019-2.328, P=0.040 and HR=1.892, 95% CI: 1.123-3.188, P=0.017). Conclusion:For patients with advanced biliary tract cancer, in addition to the conventional regimens containing gemcitabine, platinums and fluorouracils, the combination of albumin-bound paclitaxel and S-1 was shown to be an effective chemotherapeutic regimen for these patients. Second-line chemotherapy was insufficient and ineffective, and an irinotecan-based regimen deserves to be further investigated. Liver metastasis and elevated CA19-9 level were worse prognosis after chemotherapy for patients with advanced biliary tract cancer.

Objective:To investigate the relationship between plasma levels of complements before treatment and the clinicopathological feathers and prognoses of diffuse large B-cell lymphoma (DLBCL) patients treated with Rituximab (R)-CHOP or R-CHOP-like therapy.Methods:The clinicopathological data of 105 DLBCL patients treated in cancer Hospital of Chinese Academy of Medical Sciences from 2010 to 2016 were collected. The plasma samples from 105 DLBCL patients treated with R-CHOP or R-CHOP-like therapy and 80 healthy controls were used to detect 34 complement levels before treatment by utilizing antibody microarray. The relationship between plasma levels of complements and the clinicopathological feathers and prognosis of DLBCL patients were analyzed.Results:The signal values of C1QA and CR1L in patients with international prognostic index (IPI) scores of 3-5 were 1 261.43±138.9 and 2 214.69±98.58, respectively, higher than 950.79±80.19 and 984.67±121.79 in patients with IPI scores of 0~2 (both P<0.05). The levels of C1QA and CR1L in the non-complete response (CR) group were 1 165.43±98.56 and 2 263.13±145.63, respectively, higher than 914.70±100.77 and 1 821.34±84.68 in the CR group (both P<0.05). Cox regression analysis showed that elevated C1QA signal value was associated with poor progression-free survival (PFS) and poor overall survival (OS) (PFS: HR=2.063, 95% CI: 1.220-3.489, P=0.007; OS: HR=2.23, 95% CI: 1.036~4.798, P=0.040). After IPI correction by Cox multivariate model, the elevated C1QA signal value was still correlated with poor PFS ( HR=1.765, 95% CI 1.034~3.013, P=0.037). Conclusions:The baseline plasma levels of C1QA and CR1L are correlated with IPI scores and therapeutic effects of DLBCL patients treated with R-CHOP. The baseline plasma level of C1QA has a certain predictive value for the prognostic evaluation of DLBCL.

Objective:To investigate the relationship between plasma levels of complements before treatment and the clinicopathological feathers and prognoses of diffuse large B-cell lymphoma (DLBCL) patients treated with Rituximab (R)-CHOP or R-CHOP-like therapy.Methods:The clinicopathological data of 105 DLBCL patients treated in cancer Hospital of Chinese Academy of Medical Sciences from 2010 to 2016 were collected. The plasma samples from 105 DLBCL patients treated with R-CHOP or R-CHOP-like therapy and 80 healthy controls were used to detect 34 complement levels before treatment by utilizing antibody microarray. The relationship between plasma levels of complements and the clinicopathological feathers and prognosis of DLBCL patients were analyzed.Results:The signal values of C1QA and CR1L in patients with international prognostic index (IPI) scores of 3-5 were 1 261.43±138.9 and 2 214.69±98.58, respectively, higher than 950.79±80.19 and 984.67±121.79 in patients with IPI scores of 0~2 (both P<0.05). The levels of C1QA and CR1L in the non-complete response (CR) group were 1 165.43±98.56 and 2 263.13±145.63, respectively, higher than 914.70±100.77 and 1 821.34±84.68 in the CR group (both P<0.05). Cox regression analysis showed that elevated C1QA signal value was associated with poor progression-free survival (PFS) and poor overall survival (OS) (PFS: HR=2.063, 95% CI: 1.220-3.489, P=0.007; OS: HR=2.23, 95% CI: 1.036~4.798, P=0.040). After IPI correction by Cox multivariate model, the elevated C1QA signal value was still correlated with poor PFS ( HR=1.765, 95% CI 1.034~3.013, P=0.037). Conclusions:The baseline plasma levels of C1QA and CR1L are correlated with IPI scores and therapeutic effects of DLBCL patients treated with R-CHOP. The baseline plasma level of C1QA has a certain predictive value for the prognostic evaluation of DLBCL.

Preeclampsia is a multiple system disease in obstetrics, which often leads to adverse pregnancy outcome.Twin pregnancy is a high-risk pregnancy.When preeclampsia occurs, the condition is very serious, and the complications of mother and child are increasing.The pathogenesis of preeclampsia is diversified.The high risk factors of twin pregnancy with preeclampsia are bichorionic, assisted reproductive technology pregnancy, primipara, and advanced age.The timing of termination of pregnancy should be selected according to chorionic nature, and the indications of cesarean section should be relaxed to reduce the adverse pregnancy outcomes.Clinical studies mostly use comprehensive indicators combined with screening to predict preeclampsia.How to prevent preeclampsia still needs further clinical and basic research.

Objective? To investigate the present situation of nurse's metabolic syndrome, and explore the correlation between diet, behavior and occupational stress and nurse's metabolic syndrome. Methods? In April to May 2015, using stratified cluster random sampling method, a total of 393 nurses in Fuzhou were investigated by physical examination, blood tests, Nurse Stressor Scale (NSS) and a general information questionnaire for metabolic syndrome and its influencing factors. Totally 393 questionnaires were distributed and 380 valid questionnaires were collected. Results? There were 54 cases of metabolic syndrome among 380 nurses, accounting for 14.21%. Logistic regression analysis showed that age, working age, occupational stress, sleep time, the amount of meat in diet, cooking oil were the risk factors of metabolic syndrome (P＜0.05). The physical exercise and the quantity of vegetables in diet were the protective factors of metabolic syndrome (P＜0.05). Conclusions? Unreasonable diet, inadequate exercise and occupational stress are the factors that affect the metabolic syndrome in nurses, which are related to their professional characteristics.

Purpose To prepare the tranexamic acid liposome with high encapsulation efficiency and stability, through interaction of avidin and biotin, and to prepare its microbubble-liposome compound whose properties are to be assessed. Materials and Methods Thin film hydration technology was used to prepare tranexamic acid liposome. Taking encapsulation efficiency as indication, the microbubble-liposome compound was optimized by the design of orthogonal experiment. The basic properties of the compound were tested and the acoustic characteristic was measured by ultrasound and gray-scale values. Results The optimum formula of tranexamic acid liposome were as follows:molar ratio of 1,2-dipalmitoyl-sn-glycero-3-phosphocholine, cholesterol and 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-[biotinyl (polyethylene glycol) 2000] was 85∶10∶5;concentration of tranexamic acid was 5.0%;ultrasonic time was 15 min. The encapsulation efficiency was 62.62%. The size was approximately (104.00±1.84) nm. The Zeta potential was approximately (-50.50±0.56) mV. The liposome was good in stability. The size of the microbubble-liposome compound was approximately (4.56±0.28)μm. Under the microscope, they were round with transparent center, evenly distributed without aggregation. The acoustic characteristic of the compound in vitro showed typical characteristics of microbubble, which was compatible with the results under the microscope. As the concentrations of the compound increased, both ultrasound imaging effect and the gray-scale values enhanced. However, to avoid acoustic shadows, the imaging concentrations were supposed to be at least lower than 1.15×108/ml in vitro. Conclusion The preparation of the tranexamic acid microbubble-liposome compound can be optimized by taking encapsulation efficiency as reference, and it can be effectively traced by ultrasound according to its acoustic characteristics in vitro.