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.Present situation of health education on school myopia prevention and control in primary and middle schools in Beijing
WANG Yao, QIN Tingting, GU Mingyu, YANG Yutong, GUO Junjun, LI Xingming
Chinese Journal of School Health 2024;45(8):1136-1139
Objective:
To investigate the present situation of health education on school myopia prevention and control in primary and middle schools in Beijing, so as to provide scientific basis and suggestions for effective implementation of health education on school myopia prevention and control.
Methods:
From November 6-17, 2023, a total of 551 school doctors and health care teachers from public primary and secondary schools in seven districts of Beijing were investigated by using stratified random cluster sampling method. The contents included basic information, the basic situation of school health work, and the status of myopia prevention and control in schools. The data was described by frequency and proportion. Chisquare test was used to analyze the influencing factors.
Results:
A total of 89.8% of the respondents were found in the school of offering health education courses about myopia prevention and control. Among these respondents, 54.5% were equipped with health education course material of professional myopia prevention and control, and the teachers were primarily class teachers (57.6%), health care teachers (45.5%), and physical education teachers (45.1%), and most of the classes were conducted once a month (33.7%) and once a semester (28.1%). A total of 95.6% of the subjects had health education activities about myopia prevention and control at their schools. The frequency of activities was once a month (38.5%) and once a semester (27.9%). There were statistically significant differences of the report rate in setting up health education courses on myopia prevention and control, and the frequency of activities in different areas and different types of schools (χ2=19.53, 13.15, 34.30, 20.32, P<0.05).
Conclusions
Health education on school myopia prevention and control in primary and middle schools in Beijing is supportive. But health education courses taught by professional teachers should pay attention to the norms of the course material to complete a certain amount of class time, and development of health education activities should be diversified, so as to effectively implement health education of myopia prevention and control at school.
3.Pharmacoeconomic evaluation of pembrolizumab versus platinum chemotherapy as first-line treatment in advanced non-small cell lung cancer
Yutong SONG ; Derun XIA ; Heng GU ; Shaowen TANG ; Honggang YI ; Hongmei WO
Journal of Pharmaceutical Practice and Service 2024;42(8):334-340
Objective To make the cost-effectiveness analysis of pembrolizumab and platinum chemotherapy as the first-line treatment for advanced non-small cell lung cancer(NSCLC)in the population with tumor proportion score(TPS)≥1%of PD-L1,and provide some reference for the clinical use and future price negotiation of pembrolizumab.Methods Based on Pubmed database,the published RCT literatures of pembrolizumab were analyzed,and the survival data were extracted,combined with the treatment plan of a tertiary hospital,the Markov model were established to simulate the cost and health effectiveness of patients for twenty years,and the stability of the model was tested by one-way sensitivity analysis and probability sensitivity analysis.Results Twenty years later,the cost-effectiveness ratio of pembrolizumab group and chemotherapy group was ¥58 517.60/quality adjusted life month(QALM)and ¥41 213.08/QALM.Compared with the chemotherapy group,the incremental cost effective ratio(ICER)was ¥104 485.36/QALM.Conclusion When the willingness to pay(WTP)value was ¥30 902/QALM,the pembrolizumab therapy was not more cost-effective advantages than platinum chemotherapy,and the sensitivity analysis showed that the results of the model were relatively stable.
4.Protocol for the Traditional Chinese Medicine Diagnosis and Treatment Guidelines for Children with Upper Airway cough Syndrome
Lingyun ZHANG ; Xiyou WANG ; Daxin LIU ; Qiang HE ; Xuefeng WANG ; Xun LI ; Yutong FEI ; Yi XIAO ; Xiaoxue LAN ; Yuanwen LIANG ; Xiaoxuan LIN ; Rong ZHOU ; Sirui GU ; Ying ZHANG ; Yue WANG ; Xingzhu YE ; Wenke LIU ; Hong CHEN ; Changhe YU
International Journal of Traditional Chinese Medicine 2024;46(8):961-966
In order to standardize the clinical diagnosis and treatment of upper airway cough syndrome (UACS) for children in China, Dongzhimen Hospital of Beijing University of Chinese Medicine and Affiliated Hospital of Liaoning University of Traditional Chinese Medicine initiated the development of this Traditional Chinese Medicine Diagnosis and Treatment Guidelines for Children with Upper Airway cough Syndrome based on evidence-based medical evidence. This guideline will process registration, write a plan, and develop relevant processes and writing norms, develop and publish official documents. This plan mainly introduces the scope of the guidelines, the purpose and significance, the composition of the guidelines working group, the management of conflicts of interest, the collection, selection and determination of clinical problems, the retrieval, screening and rating of evidence, and the consensus of recommendations. Registration information: This study has been registered in the international practice guidelines registry platform with the registration code of PREPARE-2023CN087.
5.Circular RNA ame_circ_000115 regulates expression of genes in larval gusts of Apis mellifera ligustica stressed by Ascosphaera apis.
Yaping YE ; Jie WANG ; Jiaxin ZHANG ; Kaiyao ZHANG ; Xiaoyu GU ; Yutong YAO ; Zhongmin REN ; Yang ZHANG ; Dafu CHEN ; Rui GUO
Chinese Journal of Biotechnology 2023;39(1):217-230
Circular RNAs (circRNAs) are a new class of non-coding RNAs, which have been confirmed to regulate insect gene expression and immune response through multiple manners such as competing endogenous RNA (ceRNA) regulatory network. Currently, function of circRNA in honey bee immune response remains unclear. In this study, PCR and Sanger sequencing were performed to validate the back splicing (BS) site of ame_circ_000115 (in short ac115). RT-qPCR was used to detect the expression profile of ac115 in larval guts of Apis mellifera ligustica stressed by Ascosphaera apis. Dual-luciferase reporter gene assay was conducted to verify the binding relationship between ac115 and ame-miR-13b. Interference of ac115 in larval guts was carried out by feeding specific siRNA, followed by determination of the effect of ac115 interference on expression of six genes relevant to host immune response. The results confirmed the existence of BS site within ac115. Compared with the un-inoculated group, the expression of ac115 in 4-day-old larval gut of the A. apis-inoculated group was up-regulated with extreme significance (P < 0.000 1), while that in 5- and 6-day-old larval guts were significantly up-regulated (P < 0.05). The brightness of specific band for ac115 in 4-, 5- and 6-day-old larval guts of the siRNA-circ_000115-fed group gradually became weak, whereas that of the siRNA-scrambl-fed group was pretty high without obvious variation. Compared with that of the siRNA-scramble-fed group, the expression of ac115 in 4-day-old larval gut of the siRNA-circ_000115-fed group was significantly down-regulated (P < 0.05), whereas that of the 5- and 6-day-old larval guts were down-regulated with extreme significance (P < 0.001). Ame-miR-13b was truly existed and expressed in A. m. ligustica larval guts, and there was true binding relationship between ac115 and ame-miR-13b. Compared with that of the siRNA-scramble-fed group, the expression of antimicrobial peptide genes hymenoptaecin and abaecin in 6-day-old larval gut of the siRNA-circ_000115-fed group was significantly up-regulated (P < 0.05), while that of ecdysone receptor (Ecr) was down-regulated with extreme significance (P < 0.01). These results indicate that ac115 is truly expressed in A. m. ligustica larval guts, BS site truly exists within ac115, and effective interference of ac115 in A. m. ligustica larval guts can be achieved via feeding siRNA. Moreover, ac115 potentially regulates Ecr expression through adsorption of ame-miR-13b and expression of hymenoptaecin and abaecin using a non-ceRNA manner, further participating in host stress-response.
Bees/genetics*
;
Animals
;
Larva/metabolism*
;
RNA, Circular/genetics*
;
RNA, Small Interfering/genetics*
;
MicroRNAs/genetics*
6.Chinese expert consensus on diagnosis, treatment and prevention of venous thrombus embolism associated with chest trauma (2022 version)
Kaibin LIU ; Yi YANG ; Hui LI ; Yonten TSRING ; Zhiming CHEN ; Hao CHEN ; Xinglong FAN ; Congrong GAO ; Chundong GU ; Yutong GU ; Guangwei GUO ; Zhanlin GUO ; Jian HU ; Ping HU ; Hai HUANG ; Lijun HUANG ; Weiwei HE ; Longyu JIN ; Baoli JING ; Zhigang LIANG ; Feng LIN ; Wenpan LIU ; Danqing LI ; Xiaoliang LI ; Zhenyu LI ; Haitao MA ; Guibin QIAO ; Zheng RUAN ; Gang SUI ; Dongbin WANG ; Mingsong WANG ; Lei XUE ; Fei XIA ; Enwu XU ; Quan XU ; Jun YI ; Yunfeng YI ; Jianguo ZHANG ; Dongsheng ZHANG ; Qiang ZHANG ; Zhiming ZHOU ; Zhiqiang ZOU
Chinese Journal of Trauma 2022;38(7):581-591
Chest trauma is one of the most common injuries. Venous thromboembolism (VTE) as a common complication of chest trauma seriously affects the quality of patients′ life and even leads to death. Although there are some consensus and guidelines on the prevention and treatment of VTE at home and abroad, the current literatures lack specificity considering the diagnosis, treatment and prevention of VTE in patients with chest trauma have their own characteristics, especially for those with blunt trauma. Accordingly, China Chest Injury Research Society and editorial board of Chinese Journal of Traumatology organized relevant domestic experts to jointly formulate the Chinese expert consensus on the diagnosis, treatment and prevention of chest trauma venous thromboembolism associated with chest trauma (2022 version). This consensus provides expert recommendations of different levels as academic guidance in terms of the characteristics, clinical manifestations, risk assessment, diagnosis, treatment, and prevention of chest trauma-related VTE, so as to offer a reference for clinical application.
7.Clinical outcomes of transcatheter aortic valve implantation in oncology versus non-oncology patients with severe aortic stenosis: A systematic review and meta-analysis
Yumeng SONG ; Tianqi CHANG ; Yiyu GU ; Yinan XU ; Mingyang ZHANG ; Yutong WANG ; Tingbo JIANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2022;29(05):634-641
Objective To compare the clinical outcomes of transcatheter aortic valve implantation (TAVI) in oncology and non-oncology patients with severe aortic stenosis (AS). Methods A computer-based search in PubMed, The Cochrane Library, EMbase, CBM, CNKI and Wanfang databases from their date of inception to December 2021 was performed, together with reference screening, to identify eligible clinical trials. Two investigators screened the articles, extracted data, and evaluated quality independently. RevMan 5.3 and Stata 12.0 softwares were used for meta-analysis. Results The selected 8 cohort studies contained 57 988 patients, including 12 335 cancer patients and 45 653 non-cancer patients. The results of meta-analysis showed that in patients with cancer, the 30-day mortality [OR=0.74, 95%CI (0.65, 0.84), I2=0%, P<0.000 01], stroke [OR=0.87, 95%CI (0.76, 0.99), I2=0%, P=0.04] and acute kidney injury [OR=0.81, 95%CI (0.76, 0.85), I2=49%, P<0.000 01] were lower than those in patients without cancer. The 1-year mortality [OR=1.46, 95%CI (1.15, 1.86), I2=62%, P=0.002] and late mortality [OR=1.51, 95%CI (1.24, 1.85), I2=61%, P<0.000 1] were higher in patients with cancer. Conclusion It is effective and safe in cancer patients with severe AS undergoing TAVI. However, compared with patients without cancer, it is still high in long-term mortality, and further study of the role of TAVI in cancer patients with AS is necessary.
8.The role of basophils in asthma
Wenwei ZHONG ; Jingyang LI ; Mengxue CHEN ; Shasha BAI ; Yutong GU ; Jianhua ZHANG
Chinese Journal of Applied Clinical Pediatrics 2020;35(21):1608-1609
Basophils have been neglected for a long time as an immune cell.Recently, it gained respect because of its important role in helper T lymphocytes(Th)2 immune response.Basophils are involved in the pathogenesis of bronchial asthma through a variety of possible mechanisms.Basophils can act as initiators initiate and establish Th2 immune response by interacting with dendritic cells; basophils can act as immune regulators, regulate immune cell functions such as type 2 innate lymphoid cells by secreting cytokines such as interleukin 4 to consolidate allergic inflammation; basophils can also act as immune effectors participate in allergic airway inflammation through IgE-depended and non IgE-depended activation.In addition, clinical research is focused on the usage of basophil activation status as possible biomarker in predicting the outcome of allergic disease therapy, which is of great clinic value in individualized management of asthma.
9.Analysis of the Differences between Artificially Cultivated and Wild Xinjiang Artemisia rupestris
Xiaocui CAI ; Zhengyi GU ; Jinhua HE ; Ruiping ZHANG ; Yan MAO ; Yutong KANG
China Pharmacy 2017;28(16):2224-2227
OBJECTIVE:To compare the differences between artificially cultivated and wild Xinjiang Artemisia rupestris,and screen the different components. METHODS:HPLC-MS was adopted to establish the fingerprints of artificially cultivated and wild Xinjiang A. rupestris from different origin and harvest time. Principal component analysis was conducted by Marker ViewTM soft-ware and SIMCA-P 11.5 software,the characteristics of principal components were analyzed,difference variable was screened, and different components of artificially cultivated and wild varieties were obtained. RESULTS:Fingerprints of 22 batches of A. rup-estris(12 batches of wild varieties,10 batches of artificially cultivated varieties)were established. According to the principal com-ponent analysis,artificially cultivated and wild varieties were well grouped,with obvious differences;the principal components of artificially cultivated varieties with different harvest time showed certain difference,mainly before and after flowering,concentrat-ing in to-be flowering and full flowering periods. Wild varieties from different origins had obvious regional difference,showing cer-tain differences in composition and content. 268 variables were found in matrix of positive ion mode and 155 in negative ion mode. 28 groups of variables were extracted by difference variable,and 19 variables were determined. CONCLUSIONS:Artificially culti-vated and wild varieties have obvious difference in principal component,mainly in flowering period and picking places. It can pro-vide theoretical basis for the standardized cultivation and origin protection of Xinjiang A. rupestris.
10.Minimally Invasive Pedicle Screw Fixation Combined with Vertebroplasty with Calcium Phosphate Bone Cement in the Treatment of Thoracolumbar Burst Fracture
Yutong GU ; Chaoge LIANG ; Liang ZHANG ; Hong LIN ; Jian ZHOU
Chinese Journal of Clinical Medicine 2015;(2):181-185
Objective:To evaluate the efficacy and safety of minimally invasive pedicle screw fixation combined with percutaneous vertebroplasty(PVP) with calcium phosphate bone cement in the treatment of acute thoracolumbar burst fracture . Methods:Twenty‐three patients ,who suffered from single fresh thoracolumbar burst fracture without neurologic deficits and were classified as A3 fracture located between T11~L2 ,underwent the procedure of minimally invasive pedicle screw fixation combined with PVP with calcium phosphate bone cement .Duration of operation and blood loss ,injected volume of bone cement and length of stay ,were recorded .Lumbago and backache scores assessed by visual analogue scale (VAS) were recorded before surgery ,immediately after surgery ,as well as 1 month ,2 months ,3 months ,6 months ,1 year and 2 years after surgery . Vertebral compression rate and restoring rate ,Cobb angle and correction rate of vertebral kyphosis ,were measured at each time point and compared among the time points .Results:The average injected volume of calcium phosphate bone cement was 4 .9(3 .8~6 .4)mL .The mean duration of operation was 92(75~120)min .The average blood loss was 52(40~75)mL .The mean length of stay was 5 .6(4~ 7) d and the average follow‐up period was 26 months (24 ~ 29) .The VAS significantly decreased from 8 .8 ± 1 .2 before surgery to 1 .8 ± 0 .6 immediately after surgery and 0 .4 ± 0 .5 at 2 years after surgery ,and the differences were statistically significant(P< 0 .001) .The compression rate of vertebral body height decreased from(50 .4 ± 7 .2)% before surgery to (6 .2 ± 1 .5)% immediately after surgery and(6 .9 ± 1 .4)% at 2 years after surgery ,and the differences were statistically significant(P<0 .001) .The Cobb angle decreased from (22 .6 ± 1 .8)° before surgery to (3 .2 ± 1 .7)° immediately after surgery and (5 .1 ± 1 .5)° at 2 years after surgery ,and the differences were statistically significant(P<0 .001) .No significant decrease in both kyphosis correction and vertebral body height restoration was observed during the follow‐up .There was no loosen screw or broken screw .Conclusions:Minimally invasive pedicle screw fixation combined with PVP with calcium phosphate bone cement is a safe and efficacious method for the treatment of thoracolumbar vertebral burst fracture .


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