BACKGROUND: The STAR (Scientific, Transparent, and Applicable Rankings) working group conducts regular evaluations of Chinese guidelines and consensus statements. This study gathered insights from STAR working group members using qualitative interviews. METHODS: From March to August 2023, members of the STAR specialist committees were interviewed using semi-structured interview outline. The interviewees were selected through purpose-based sampling. Subject analysis was employed to summarize the findings. RESULTS: We conducted interviews with 37 members from 36 committees and summarized the contents into four main themes and 16 specific topics. The value of STAR in enhancing the development and selection of high-quality guidelines in China was commonly mentioned. Challenges identified included the lack of resources and suboptimal organizational structures, collaboration, and evaluation efficiency. Suggestions for the STAR tool included developing extensions for different guideline types, adjusting certain items, and better covering guideline applicability. The promotion of STAR and the consideration of an international committee for global outreach were also highlighted. CONCLUSION STAR has exerted a substantial influence on the evaluation of Chinese guidelines, and the insights gained from interviews offer valuable directions for its further enhancement.
Humans ; China ; Qualitative Research ; Practice Guidelines as Topic ; Interviews as Topic

Objective To predict the core targets and action pathways of Hedysari Radix based on UPLC-MS/MS and network pharmacology methods,and to verify the results of network pharmacology by molecular docking and molecular dynamics techniques.This article aims to investigate immune regulation mechanism of effective components absorbed into blood from Hedysari Radix.Methods Qualitative quantification of effective components absorbed into blood from Hedysari Radix were operated by using UPLC-MS/MS technique.The corresponding targets of effective components absorbed into blood from Hedysari Radix were screened by TCMSP and HERB databases.Targets of immune-related disease were obtained through DisGeNET,OMIM,TTD,and MalaCards databases.The network of"components absorbed into blood from Hedysari Radix-immune-related diseases"was then constructed.GO and KEGG enrichment analysis and mapped the PPI network were performed.Molecular docking and molecular dynamics techniques were applied for validation.Results A total of 8 prototype components absorbed into blood,synergistically acting on 101 targets,were identified by UPLC-MS/MS.They mediated 538 biological processes including immune response,positive regulation of gene expression,receptor binding,and cytokine activity.Meanuhile,116 signaling pathways,such as HIF-1,Toll-like receptor,JAK-STAT,T cell receptor,PI3K-Akt,and FoxO etc.were involved.The core targets were MAPK14,PTGS2,MMP9,PPARG,CCND1,etc..The results of molecular docking showed that formononetin and calycosin had strong docking binding activity with MAPK14.And molecular dynamics simulations further demonstrated that the binding between MAPK14 and formononetin or calycosin had good structural stability and binding affinity.Conclusion The results of serum pharmacochemistry,network pharmacology and molecular dynamics were verified to reveal the material basis and mechanism of Hedysari Radix in regulating immunity.The aim of this study is to provide scientific basis for its immunomodulatory mechanism.

BACKGROUNDAllergic asthma is a chronic airway inflammatory disease partly characterised by high concentration of T help 2 (Th2) cytokines in bronchoalveolar lavage fluid (BALF). There is no report on the relation of peripherally circulating blood lymphocytes and asthma. We explored the balance of Th2/Th1 cytokines in asthmatic mice. Exogenous recombinant interleukin (IL) 33 acted on murine peripheral circulating blood lymphocytes, IL-5 cytokine was selected for assessing Th2 cytokines and interferon-gamma (IFN-γ) for Th1 cytokines.

METHODSFemale specific pathogen free BABL/c mice were sensitised by intraperitoneal injection of 20 µg of ovalbumin emulsified in 1 mg of aluminium hydroxide gel in a total volume of 200 µl, and challenged for 30 minutes in 7 consecutive days with an aerosol of 2 g ovalbumin in 100 ml of PBS. Then we collected BALF and isolated lymphocytes from the peripheral blood. The lymphocytes were divided into two groups: asthmatic group and normal group. Th1/Th2 cytokines was detected by enzyme-linked immunosorbent assay (ELISA) kits.

RESULTSIn the asthma group, we found numerous eosinophils and lymphocytes on the glass slides. We then confirmed that the optimal concentration of IL-33 was 10 ng/ml and time of IL-33 stimulating lymphocytes was 24 hours. In the asthma group, the production of IL-5 was significantly increased over normal group after stimulation with IL-33 (P < 0.05) and the production of IFNγ was supressed from IL-33 stimulated lymphocytes (P < 0.05).

CONCLUSIONIL-33 acts on lymphocytes of peripheral blood increasing secretion of Th2 cytokines and inhibiting secretion of Th1 cytokines.

Animals ; Asthma ; chemically induced ; immunology ; metabolism ; Enzyme-Linked Immunosorbent Assay ; Female ; Interferon-gamma ; immunology ; metabolism ; Interleukin-33 ; Interleukin-5 ; immunology ; metabolism ; Interleukins ; immunology ; metabolism ; Lymphocytes ; immunology ; metabolism ; Mice ; Mice, Inbred BALB C

Objective The palliation of dysphagia in metastatic esophageal cancer remains a challenge ,and the optimal approach for this difficult clinical scenario is not clear .We therefore sought to define and determine the efficacy of various treatment options used at our institution for this condition .Methods Methods We reviewed a prospective database for all patients managed in an e-sophageal cancer referral centre over a 5-year period .All patients receiving palliation of malignant dysphagia were reviewed for de-mographics ,palliative treatment modalities ,complications ,and dysphagia scores (0= none to 4= complete) .The Wilcoxon signed rank test was used to determine significance (P<0 .05) .Results During 2005~2010 ,80 patients with inoperable esophageal cancer were treated for palliation of dysphagia .The primary treatment was radiotherapy in 66% ,metal stenting in 21% and radiotherapy combined with stent in 13% .Mean duration of treatment was 1 day in he stent group and 40 days in the radiotherapy group(P=0 . 001) .In patients treated initially by stenting ,dysphagia improved within 2 weeks of treatment in 82% of patients(dysphagia score of 0 or 1) .However ,18% of patients presented with recurrence of dysphagia at 10 weeks of treatment .In the radiotherapy group , the onset of palliation was slower ,with only 50% of patients palliated at 2 weeks(dysphagia score of 0 or 1) .However ,long-term palliation was more satisfactory ,with 90% of patients remaining palliated after 10 weeks of treatment .Conclusion In inoperable e-sophageal cancer at our centre ,radiation treatment provided durable long-term relief ,but came at a high price of a long wait time for initiation of treatment and a long lag time between initiation of treatment and relief of symptoms .On the other hand ,stenting pro-vided more rapid and effective early relief from symptoms ,but was affected by recurrence of dysphagia in the long-term .

Objective:To explore social support and personality characteristic of patients with clinically chronic pains to provide a new idea for clinical psycho-intervention.Method:45 patients with clinically chronic pains were evaluated by the Symptom Checklist(SCL-90),EPQ and SSRS,and compared with the control group.Results:Somatization,interpersonal sensitivity,anxiety,fear and psychotic factors have significant differences from those of the control group when being compared(p