1.Exploration of an Intelligent Evidence Achieve Mode of Evidence-Based Chinese Medicine:Take Systematic Review of Coronary Heart Disease Syndrome Research as an Example
Qianzi CHE ; Qingyang ZENG ; Tian SONG ; Lin CHEN ; Jing WAN ; Nannan SHI
Journal of Traditional Chinese Medicine 2025;66(15):1597-1603
ObjectiveTo construct an intelligent model for literature screening, retrieval, and data extraction with a systematic review of coronary heart disease syndromes as an example, so as to improve the efficiency of evidence-based Chinese medicine research. MethodsBased on China National Knowledge Infrastructure (CNKI), VIP and Wanfang Data Resource System, the articles related to coronary heart disease syndrome research published from January 1, 2000 to December 31, 2023 were retrieved. Automated tools were used to batch retrieve paper metadata. Using text similarity algorithms, papers were merged, deduplicated, and subjected to preliminary screening based on titles and abstracts. Further screening was performed using object detection and image processing technologies on the full texts and statistical tables. Natural language processing (NLP) techniques and pre-trained models were applied to extract information. ResultsThe initial search retrieved 56 255 coronary heart disease syndrome-related articles. By artificial intelligence-assisted preliminary and secondary screening, the manual verification scope was narrowed to 1075 articles. Ultimately, 646 coronary heart disease syndrome related studies were included manually. With accuracy verification showing over 90% consistency in semantic recognition and element decomposition processes, we achieved data extraction and standardization processing for both basic literature information and 38 syndrome element statistics. ConclusionBy incorporating natural language processing, pre-trained models, artificial intelligence image processing and other technologies, this study enabled efficient retrieval, screening and standardized data extraction of Chinese medicine research literature.
2.Exploration of Value Variable Selection and Measurement for Chinese Patent Medicine Based on Hedonic Price Theory
Yijiu YANG ; Haili ZHANG ; He ZHU ; Wei LI ; Zhao CHEN ; Bin LIU ; Ning LIANG ; Huizhen LI ; Tian SONG ; Wenjie CAO ; Weili WANG ; Ziteng HU ; Yanping WANG ; Sheng HAN ; Nannan SHI
Chinese Health Economics 2024;43(5):68-71,78
To reduce the subjectivity and uncertainty present in the current international methods of drug value pricing when converting value into monetary prices,based on the hedonic pricing theory,it considers the post-negotiation price between manufacturers and payers as a reasonable price reference in the value pricing of Chinese patent medicine.By constructing an indicator system for the characteristics of Chinese patent medicine,it selects and measures the value characteristic variables that affect the price of Chinese patent medicine.It serves as the theoretical foundation and research basis for establishing a Hedonic price model between characteristic price variables and negotiation prices,thereby promoting the enhancement of rationality and objectivity in value-guided pricing of Chinese patent medicine.
3.Association between short-term exposure to atmospheric fine particulate matter and ozone and inflammatory indicators in peripheral blood of patients with pneumonia
Lulu SONG ; Qi YU ; Nannan LIU ; Yuhui GAO ; Zeyu NIU ; Yan ZHANG ; Huiqiu ZHENG ; Jiayu TIAN ; Junxia LIU ; Lifang ZHAO ; Zhihong ZHANG
Shanghai Journal of Preventive Medicine 2024;36(6):551-558
ObjectiveTo explore the association between short-term exposure to atmospheric fine particulate matter (PM2.5) and ozone (O3) and systemic inflammatory indicators in patients with pneumonia, and to identify the susceptible populations. MethodsFrom September 2018 to April 2020, data of 1 480 patients admitted for pneumonia was collected from a tertiary hospital in Taiyuan City. Generalized additive models (GAMs) were used to explore the associations between PM2.5 and O3 exposure and inflammatory indicators of patients with pneumonia; and to explore the susceptibility factors and susceptible populations to PM2.5 and O3 exposures through stratified analyses. ResultsThe short-term exposure to PM2.5 was associated with changes in peripheral blood C-reation protein (CRP), erythrocyte sedimentation (ESR), easinophil (EOS), neutrophil (NEU) and neutrophil-lymphocyte ratio (NLR) in patients with pneumonia, and there were different degrees of hysteresis effects, with the effect values reaching a maximum at lag03, lag03, lag0, lag03, lag03, respectively, which were 4.13% (95%CI: 0.43%‒7.84%), 3.10% (95%CI: 0.24%‒5.97%), 5.27% (95%CI: 3.12%‒7.42%), 1.85% (95%CI: 0.36%‒3.34%), and 2.53% (95%CI: 0.53%‒4.74%) for every 10 μg·m-3 of PM2.5. The changes in O3 concentration were associated with the elevation of peripheral blood PCT and ESR in patients with pneumonia, and their effect values all reached the maximum at lag01 d, every 1 μg·m-3 of O3 elevation increased by 0.38% (95%CI: 0.04%‒0.73%) and 0.47% (95%CI: 0.19%‒0.76%), respectively. Stratified analyses showed that the associations of PM2.5 with peripheral blood CRP, ESR, NEU, and NLR in pneumonia patients were more significant in males, the elderly, and those with onset in the cold season; the associations of O3 with peripheral blood PCT and ESR in pneumonia patients were more significant in the elderly and those with onset in the warm season, and the peripheral blood CRP and PCT in female patients with pneumonia were more susceptible to the changes of O3. ConclusionShort-term exposure to atmospheric PM2.5 and O3 are positively associated with changes in inflammatory indicators in patients with pneumonia, and the effects of PM2.5 on patients with pneumonia are more extensive than those of O3, with a longer lag effect. In addition, elderly patients with pneumonia are more sensitive to air pollution, male patients with pneumonia are more sensitive to PM2.5, and female patients with pneumonia are more sensitive to O3. Cold and warm seasons can exacerbate the effects of PM2.5 and O3 on inflammatory indicators in patients with pneumonia, respectively, and the patients must be protected well.
4.Issues and Solutions for Symptom Efficacy Evaluation in the Big Data Era of Traditional Chinese Medicine
Xiaoyu ZHANG ; Sichao TIAN ; Liangzhen YOU ; Xi GUO ; Zhao CHEN ; Chunling LIU ; Nannan SHI ; Hongcai SHANG
Journal of Traditional Chinese Medicine 2024;65(8):792-795
Emphasizing symptom efficacy is an important manifestation of the personalized diagnosis and treatment of traditional Chinese medicine (TCM). However, in current clinical practice of TCM, there are challenges such as diverse symptom expressions, difficulty in standardization, inconsistent evaluation standards for symptom efficacy, lack of universal quantitative methods, and complexity in collecting complete and accurate symptom information. These issues hinder the full and effective utilization of symptom information. Addressing the current research status and existing problems of symptom terminology standardization, quantification and grading of symptom efficacy, and collection of symptom information, this paper proposes methodological strategies for effectively recording and utilizing TCM symptom efficacy information in the era of big data. These strategies include collecting TCM symptom information based on patient reporting, standardizing the evaluation of TCM symptom efficacy from measurement scales and evaluation dimensions, integrating TCM symptom efficacy evaluation into clinical diagnosis and treatment processes, and utilizing artificial intelligence technology to acquire and process TCM symptom efficacy information. TCM symptom efficacy evaluation strategies based on patient perspectives and artificial intelligence technology will help fully explore the value of data elements, promote the objective demonstration of the specific efficacy of TCM, and facilitate the discovery of effective patterns.
5.Expert consensus on surgical treatment of oropharyngeal cancer
China Anti-Cancer Association Head and Neck Oncology Committee ; China Anti-Cancer Association Holistic Integrative Oral Cancer on Preventing and Screen-ing Committee ; Min RUAN ; Nannan HAN ; Changming AN ; Chao CHEN ; Chuanjun CHEN ; Minjun DONG ; Wei HAN ; Jinsong HOU ; Jun HOU ; Zhiquan HUANG ; Chao LI ; Siyi LI ; Bing LIU ; Fayu LIU ; Xiaozhi LV ; Zheng-Hua LV ; Guoxin REN ; Xiaofeng SHAN ; Zhengjun SHANG ; Shuyang SUN ; Tong JI ; Chuanzheng SUN ; Guowen SUN ; Hao TIAN ; Yuanyin WANG ; Yueping WANG ; Shuxin WEN ; Wei WU ; Jinhai YE ; Di YU ; Chunye ZHANG ; Kai ZHANG ; Ming ZHANG ; Sheng ZHANG ; Jiawei ZHENG ; Xuan ZHOU ; Yu ZHOU ; Guopei ZHU ; Ling ZHU ; Susheng MIAO ; Yue HE ; Jugao FANG ; Chenping ZHANG ; Zhiyuan ZHANG
Journal of Prevention and Treatment for Stomatological Diseases 2024;32(11):821-833
With the increasing proportion of human papilloma virus(HPV)infection in the pathogenic factors of oro-pharyngeal cancer,a series of changes have occurred in the surgical treatment.While the treatment mode has been im-proved,there are still many problems,including the inconsistency between diagnosis and treatment modes,the lack of popularization of reconstruction technology,the imperfect post-treatment rehabilitation system,and the lack of effective preventive measures.Especially in terms of treatment mode for early oropharyngeal cancer,there is no unified conclu-sion whether it is surgery alone or radiotherapy alone,and whether robotic minimally invasive surgery has better func-tional protection than radiotherapy.For advanced oropharyngeal cancer,there is greater controversy over the treatment mode.It is still unclear whether to adopt a non-surgical treatment mode of synchronous chemoradiotherapy or induction chemotherapy combined with synchronous chemoradiotherapy,or a treatment mode of surgery combined with postopera-tive chemoradiotherapy.In order to standardize the surgical treatment of oropharyngeal cancer in China and clarify the indications for surgical treatment of oropharyngeal cancer,this expert consensus,based on the characteristics and treat-ment status of oropharyngeal cancer in China and combined with the international latest theories and practices,forms consensus opinions in multiple aspects of preoperative evaluation,surgical indication determination,primary tumor re-section,neck lymph node dissection,postoperative defect repair,postoperative complication management prognosis and follow-up of oropharyngeal cancer patients.The key points include:① Before the treatment of oropharyngeal cancer,the expression of P16 protein should be detected to clarify HPV status;② Perform enhanced magnetic resonance imaging of the maxillofacial region before surgery to evaluate the invasion of oropharyngeal cancer and guide precise surgical resec-tion of oropharyngeal cancer.Evaluating mouth opening and airway status is crucial for surgical approach decisions and postoperative risk prediction;③ For oropharyngeal cancer patients who have to undergo major surgery and cannot eat for one to two months,it is recommended to undergo percutaneous endoscopic gastrostomy before surgery to effectively improve their nutritional intake during treatment;④ Early-stage oropharyngeal cancer patients may opt for either sur-gery alone or radiation therapy alone.For intermediate and advanced stages,HPV-related oropharyngeal cancer general-ly prioritizes radiation therapy,with concurrent chemotherapy considered based on tumor staging.Surgical treatment is recommended as the first choice for HPV unrelated oropharyngeal squamous cell carcinoma(including primary and re-current)and recurrent HPV related oropharyngeal squamous cell carcinoma after radiotherapy and chemotherapy;⑤ For primary exogenous T1-2 oropharyngeal cancer,direct surgery through the oral approach or da Vinci robotic sur-gery is preferred.For T3-4 patients with advanced oropharyngeal cancer,it is recommended to use temporary mandibu-lectomy approach and lateral pharyngotomy approach for surgery as appropriate;⑥ For cT1-2N0 oropharyngeal cancer patients with tumor invasion depth>3 mm and cT3-4N0 HPV unrelated oropharyngeal cancer patients,selective neck dissection of levels ⅠB to Ⅳ is recommended.For cN+HPV unrelated oropharyngeal cancer patients,therapeutic neck dissection in regions Ⅰ-Ⅴ is advised;⑦ If PET-CT scan at 12 or more weeks after completion of radiation shows intense FDG uptake in any node,or imaging suggests continuous enlargement of lymph nodes,the patient should undergo neck dissection;⑧ For patients with suspected extracapsular invasion preoperatively,lymph node dissection should include removal of surrounding muscle and adipose connective tissue;⑨ The reconstruction of oropharyngeal cancer defects should follow the principle of reconstruction steps,with priority given to adjacent flaps,followed by distal pedicled flaps,and finally free flaps.The anterolateral thigh flap with abundant tissue can be used as the preferred flap for large-scale postoperative defects.
6.Characteristics of Emergency Health Systems Guidance Based on AGREE-HS
Danping ZHENG ; Wei YANG ; Nannan SHI ; Dongfeng WEI ; An LI ; Gezhi ZHANG ; Xue CHEN ; Fangqi LIU ; Zhaoshuai YAN ; Weixuan BAI ; Xinghua XIANG ; Yaxin TIAN ; Mengyu LIU ; Huamin ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(22):137-148
This study used the Appraisal of Guidelines Research & Evaluation-Health Systems (AGREE-HS) to demonstratively compare 34 global coronavirus disease-2019 (COVID-19) health systems guidance documents (HSGs) and 6 World Health Organization (WHO) standard HSGs. The comparison involved topic, participants, methods, recommendations, and implementability, with the aim of exploring the characteristics of emergency HSGs. The results showed that the emergency HSGs had an overall average score of 49%, with topic having the highest score, recommendations having the second highest score, and participants having the lowest score. The standard HSGs had an overall average score of 79%, with high scores in all items. The emergency HSGs had lower scores in participants, methods, recommendations, and implementability than the standard HSGs (P<0.001), while the COVID-19 emergency HSGs developed by the WHO had higher score in topic than the standard HSGs (P<0.05). Compared with those released by countries, the COVID-19 emergency HSG developed by the WHO showed superiority in all items and overall scores (P=0.000 2). This indicates that emergency HSGs, represented by the COVID-19 emergency HSG, place equal emphasis on topic and recommendations as standard HSGs but have low requirements in terms of expert participation, evidence support, and comprehensive consideration in the time- and resource-limited context. They have the characteristics of prominent topics, clear purposes, orientation to demand, keeping up with the latest evidence, flexible adjustment, and timeliness, emphasizing immediate implementation effects, weakening long-term effects, and focusing on comprehensive benefits. Additionally, developers, types, and report completeness are important influencing factors.
7.Methodology for Developing Patient Guideline (3):Reporting Frameworks and Presentation
Lijiao YAN ; Ning LIANG ; Haili ZHANG ; Nannan SHI ; Ziyu TIAN ; Ruixiang WANG ; Xiaojia NI ; Yufang HAO ; Wei CHEN ; Yingfeng ZHOU ; Dan YANG ; Shuyu YANG ; Yujing ZHANG ; Ziteng HU ; Jianping LIU
Journal of Traditional Chinese Medicine 2024;65(22):2304-2309
Standardized reporting is a crucial factor affecting the use of patient guidelines (PGs), particularly in the reporting and presentation of recommendations. This paper introduced the current status of PG reporting, including the research on PG content and presentation formats, and provided comprehensive recommendations for PG reporting from aspects such as overall framework, recommendations, presentation format, and readability. First, the presentation of PG recommendations should include clearly defined clinical questions, recommendations and their rationale, and guidance on how patients should implement the interventions; for specific content in the PG, such as level of evidence, level of recommendation, it is recommended to explain in text the reasons for giving different levels of recommendation, i.e., to present the logic behind giving the level of recommendation to the patient; additional information needed in the recommendation framework should be supplemented by tracing references or authoritative textbooks and literature that support the recommendations. Subsequently, the PG text should be written based on the Reporting Checklist for Public Versions of Guidelines (RIGHT-PVG) reporting framework. Finally, to enhance readability and comprehension, it is recommended to refer to the Patient Education Materials Assessment Tool (PEMAT) for translating PG content. To enhance the readability of PGs, it is suggested to present the PG content in a persona-lized and layered manner.
8.Methodology for Developing Patient Guideline(1):The Concept of Patient Guideline
Lijiao YAN ; Ning LIANG ; Ziyu TIAN ; Nannan SHI ; Sihong YANG ; Yufang HAO ; Wei CHEN ; Xiaojia NI ; Yingfeng ZHOU ; Ruixiang WANG ; Zeyu YU ; Shuyu YANG ; Yujing ZHANG ; Ziteng HU ; Jianping LIU
Journal of Traditional Chinese Medicine 2024;65(20):2086-2091
Since the concept of patient versions of guidelines (PVGs) was introduced into China, several PVGs have been published in China, but we found that there is a big difference between the concept of PVG at home and abroad, and the reason for this difference has not been reasonably explained, which has led to ambiguity and even misapplication of the PVG concept by guideline developers. By analyzing the background and purpose of PVGs, and the understanding of the PVG concept by domestic scholars, we proposed the term patient guidelines (PGs). This refers to guidelines developed under the principles of evidence-based medicine, centered on health issues that concern patients, and based on the best available evidence, intended for patient use. Except for the general attribute of providing information or education, which is typical of common health education materials, PGs also provide recommendations and assist in decision-making, so PGs include both the patient versions of guidelines (PVG) as defined by the Guidelines International Network (GIN) and "patient-directed guidelines", i.e. clinical practice guidelines resulting from the adaptation or reformulation of recommendations through clinical practice guidelines.
9.Methodology for Developing Patient Guideline (2):Process and Methodology
Lijiao YAN ; Ning LIANG ; Nannan SHI ; Sihong YANG ; Ziyu TIAN ; Dan YANG ; Xiaojia NI ; Yufang HAO ; Wei CHEN ; Ruixiang WANG ; Yingfeng ZHOU ; Shibing LIANG ; Shuyu YANG ; Yujing ZHANG ; Ziteng HU ; Jianping LIU
Journal of Traditional Chinese Medicine 2024;65(21):2194-2198
At present, the process and methodology of patient guidelines (PGs) development varies greatly and lacks systematic and standardised guidance. In addition to the interviews with PG developers, we have sorted out the relevant methodology for the adaptation and development of existing clinical practice guideline recommendations and facilitated expert deliberations to achieve a consensus, so as to finally put forward a proposal for guidance on the process and methodology for the development of PGs. The development of PGs can be divided into the preparation stage, the construction stage, and the completion stage in general, but the specific steps vary according to the different modes of development of PGs. The development process of Model 1 is basically the same as the patient version of the guideline development process provided by the International Guidelines Network, i.e., team formation, screening of recommendations, guideline drafing, user testing and feedback, approval and dissemination. The developer should also first determine the need for and scope of translating the clinical practice guideline into a patient version during the preparation phase. Model 2 adds user experience and feedback to the conventional clinical practice guideline development process (forming a team, determining the scope of the PG, searching, evaluating and integrating evidence, forming recommendations, writing the guideline, and expert review). Based on the different models, we sort out the process and methods of PG development and introduce the specific methods of PG development, including how to identify the clinical problem and how to form recommendations based on the existing clinical practice guidelines, with a view to providing reference for guideline developers and related researchers.
10.Exploration of Value Variable Selection and Measurement for Chinese Patent Medicine Based on Hedonic Price Theory
Yijiu YANG ; Haili ZHANG ; He ZHU ; Wei LI ; Zhao CHEN ; Bin LIU ; Ning LIANG ; Huizhen LI ; Tian SONG ; Wenjie CAO ; Weili WANG ; Ziteng HU ; Yanping WANG ; Sheng HAN ; Nannan SHI
Chinese Health Economics 2024;43(5):68-71,78
To reduce the subjectivity and uncertainty present in the current international methods of drug value pricing when converting value into monetary prices,based on the hedonic pricing theory,it considers the post-negotiation price between manufacturers and payers as a reasonable price reference in the value pricing of Chinese patent medicine.By constructing an indicator system for the characteristics of Chinese patent medicine,it selects and measures the value characteristic variables that affect the price of Chinese patent medicine.It serves as the theoretical foundation and research basis for establishing a Hedonic price model between characteristic price variables and negotiation prices,thereby promoting the enhancement of rationality and objectivity in value-guided pricing of Chinese patent medicine.


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