1.Application of Ancient Books in Clinical Practice Guidelines and Expert Consensus of Traditional Chinese Medicine: Current Status and Methodological Recommendations
Changhao LIANG ; Dingran YIN ; Jing CUI ; Xinshuai YAO ; Xinyi GU ; Yifei YAN ; Wanting LIU ; Yingqiao WANG ; Yingqi CHANG ; Haoyu DONG ; Mengqi LI ; Yuanyuan LI ; Yutong FEI
Journal of Traditional Chinese Medicine 2024;65(8):801-809
ObjectiveTo explore the current status and issues regarding the application of ancient books in clinical practice guidelines and expert consensus of traditional Chinese medicine (TCM) published in China, and to provide methodological recommendations for the incorporation of ancient books in the development of TCM guidelines. MethodsWe searched China National Knowledge Infrastructure (CNKI), WanFang Data, VIP, SinoMed, PubMed, Embase, as well as six industry websites including China Association of Chinese Medicine, National Group Standards Information Platform, and Chinese Association of the Integration of Traditional and Western Medicine,etc. TCM clinical practice guidelines or expert consensus issued during January 1st, 2017, to November 26th, 2022 were searched. Clinical practice guidelines or expert consensus that explicitly referred to ancient books were included, and the content regarding the searching for ancient books, sources of access to ancient books, methods of evaluating the level of evidence, methods of evaluating the level of recommendation, and methods of evaluating the evidence for the ancient books were analysed. ResultsA total of 1,215 TCM clinical practice guidelines or expert consensus were retrieved, with 442 articles explicitly mentioning the application of ancient books, including 300 (67.87%) clinical practice guidelines and 142 (32.13%) expert consensus. Sixty of the 442 publications explicitly reported that ancient books searching had been conducted (13.57%); among these 60 publications 27 (45.00%) explicitly reported ancient books searching strategies, and the most frequent method was manual searching with a total of 24 articles (40.00%). The most popular search source was Chinese Medical Dictionary, a TCM classics database, with a total of 18 articles. 197 articles (44.57%) explicitly reported the evaluation criteria for the level of evidence, of which 141 articles (71.57%) involved the evaluation criteria for the ancient books; 413 articles (93.44%) mentioned ancient books in the recommendations, and only the source of formula name was mentioned in 409 (99.03%) of the publications. ConclusionThe current application of ancient books in TCM clinical practice guidelines and expert consensus is limited, with issues of non-standard searching and evaluation methods. Standar-dization and uniformity are needed in evidence grading and recommendation standards. Future research should clarify the scope and methods of applying ancient book, emphasize their integration with modern research evidence, and enhance their value and quality in the development of TCM clinical practice guidelines.
2.Research advances in modulating microglia for intervening in Alzheimer’s disease
Yuan CHANG ; Mageta Samwel MAGETA ; Nibowen LI ; Yingqi TANG ; Huangjuan LI ; Chenggen QIAN
Journal of China Pharmaceutical University 2024;55(5):603-612
Alzheimer’s disease (AD) is the most common neurodegenerative disease in the world with dementia as its main manifestation. The pathological regulation strategies based on microglia in immune cells have shown their unique advantages in treating AD by preventing the pathological progression of AD at an early stage. This paper firstly introduces the role of microglia in the pathogenesis of AD, then summarizes the relationship between microglia and the common key pathologies of Aβ, tau proteins, neuroinflammation, and impaired energy metabolism in AD, and finally reviews feasible microglia-targeted intervention strategies against AD with some discussion about some current issues for improvement in each study, in the hope of deepening the understanding of strategies that regulate microglia to block AD pathology and providing some new ideas for the early intervention and treatment of AD patients in the future.
3.Systematic analysis of clinical pharmaceutical rehabilitation model based on data mining
Chang SONG ; Chunshuo ZHU ; Shuai GUAN ; Yingqi JIAO ; Fengjin WANG ; Jiyan ZHANG ; Weiying GAO ; Jiali ZHANG ; Lele XU
Journal of Navy Medicine 2024;45(9):973-978
Objective To systematically analyze the clinical pharmaceutical rehabilitation model based on data mining,so as to explore its role in improving drug treatment efficacy,reducing drug side effects,and optimizing rehabilitation experience.Methods We retrieved published literatures related to clinical pharmaceutical rehabilitation from CNKI,Wanfang,VIP,and PubMed,with a search time from inception to June 30,2022.Results Totally 11 articles were enrolled in this study.A study involving 69 randomized controlled trials(RCTs)demonstrated that the involvement of pharmacists in medication reviews significantly improved the control of hypertension,type 2 diabetes,and high cholesterol.The odds ratio(OR)for improved control was 2.71(95%confidence interval[CI]:1.03-7.01)for hypertension,3.12(95%CI:1.12-5.84)for type 2 diabetes,and 1.90(95%CI:1.05-3.35)for high cholesterol.A study involving 6 RCTs and 2 573 patients with chronic kidney disease(CKD)showed that pharmacist-led blood pressure monitoring,lifestyle,and medication regimen assessments significantly improved blood pressure control in CKD patients,with an OR of 1.51(95%CI:1.13-2.03).A Meta-analysis,including 5 RCTs and 3 observational studies,explored the impact of medication education and behavioral interventions on the treatment outcomes of gout.The results revealed that patients receiving medication education and behavioral interventions had a significantly higher rate of uric acid control and a higher proportion of patient with uric acid less than 360 μmol/L.A Meta-analysis of 14 RCTs involving 4 509 patients showed that pharmacist interventions such as medication education and counseling significantly reduced the 30-day readmission rates for hypertension and diabetes patients,with a relative risk(RR)of 0.75(95%CI:0.53-0.96).Eighteen RCTs involving 7 244 patients investigated the impact of pharmacist-led discharge counseling on the readmission rate.The findings showed that discharge counseling significantly reduced readmission rate,with a RR of 0.864(95%CI:0.763-0.997,P=0.020).Eight studies assessed the impact of pharmacist services on readmission rate,and the result showed that patients receiving pharmacy-related services had significantly reduced readmission rates,with a 32%reduction in the risk of readmission(OR=0.74,95%CI:0.62-0.89).A Meta-analysis including 123 studies investigated the effect of pharmacist interventions in patient care on the readmission rate,and the result indicated that pharmacist interventions led to a decrease in readmission rates,with the maximum decrease of 44.5%.A Meta-analysis of 23 RCTs evaluated the impact of pharmacist interventions on medication-related adverse events in elderly residents of nursing homes.The study found that pharmacist-led medication reviews and education significantly reduced adverse events.Another Meta-analysis of 14 RCTs and intervention studies explored the effect of pharmacist involvement in multidisciplinary care on medication-related adverse events.The analysis showed that pharmacist participation in multidisciplinary care was significantly associated with a reduction in the incidence of adverse events(RR=0.47,95%CI:0.28-0.77,P<0.01).A Meta-analysis of 6 RCTs involving 29 291 pediatric inpatients revealed that pharmacist interventions effectively reduced the risk of medication errors in hospitalized children(OR=0.27,95%CI:0.15-0.49).A literature analysis on the effectiveness of clinical pharmaceutical services in patient drug treatment showed that introducing a clinical pharmaceutical service model can reduce the use of antibiotics,lower medical costs,and improve medication satisfaction among patients treated with antibiotics.Conclusion In-depth exploration of clinical pharmaceutical rehabilitation model plays an important role in clinical treatment,which can improve the effectiveness of rehabilitation and reduce the incidence of adverse reactions.

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