Quality of Evidence and Strength of Recommendations of Clinical Practice Guidelines of Rehabilitation Based on GRADE / 中国康复理论与实践

Objective:To analyze the results of Grading of Recommendations Assessment, Development and Evaluation (GRADE) for clinical practice guidelines of rehabilitation. Methods:Clinical practice guidelines of rehabilitation were systematically retrieved from PubMed, EMBASE, CNKI, China Biology Medicine disc, Wanfang database and the guideline-related websites until January 11, 2020. Two researchers independently screened guidelines using Grading of Recommendations Assessment, Development and Evaluation (GRADE), and extracted and analyzed the results. Results:A total of 83 clinical practice guidelines of rehabilitation were included, in which 46 (55.4%) applied grading systems. Only four (4.8%) guidelines applied GRADE, including 44 recommendations, in which 39 guidelines (88.6%) had quality of evidence. Among the evidences citied in the recommendations, low quality evidences were the most (34.1%); among the recommendations, weak recommendations were more (56.8%). The quality of strong recommendation supporting evidence was higher than that of weak recommendation (χ2 = 8.218,P < 0.05). Conclusion:The application of the GRADE grading system in clinical practice guidelines of rehabilitation remains to be improved. It is proposed for guideline makers to further implement the methodology of guidelines and GRADE to improve the reliability and applicability of the clinical practice guidelines of rehabilitation more effectively.

Effects of light intensity on growth and content of active components of Uncaria rhynchophyll / 中国中药杂志

The aim of this study was to study the effects of different light intensity on the growth,biomass accumulation and distribution,chlorophyll content and effective components of Uncaria rhynchophylla seedlings,and explore the suitable light intensity conditions for artificial cultivation of U. rhynchophylla seedlings. Three-year-old U. rhynchophylla seedlings were used as experimental materials. Four light intensity levels( 100%,70%-75%,30%-35%,5%-10%) were set up with different layers of black shading net. With the decrease of light intensity,the results showed that the plant height,basal diameter and biomass( root,stem,leaf and hook) of U.rhynchophylla seedlings exhibited the trend of " increase-decrease". Under 70%-75% light intensity,the plant height,basal diameter,biomass( root,stem,leaf,hook) of U. rhynchophylla seedlings were significantly higher than those of other treatments( P< 0. 05);under 5%-10% light intensity,the plant height,basal diameter and biomass( root,hook) of U. rhynchophylla seedlings were significantly lower than those of other treatments( P<0. 05). With the decrease of light intensity,the chlorophyll content of U. rhynchophylla seedlings increased gradually: under 100% light intensity,the chlorophyll content of U. rhynchophylla seedlings were the smallest,while under 100% light intensity,its chlorophyll content was the highest. With the decrease of light intensity,the contents of rhynchophylline and isorhynchophylline in different organs of U. rhynchophylla seedlings varied: under 30%-35% light intensity,the contents of rhynchophylline and isorhynchophylline in hooks and rhynchophylline content in stems were the highest; under 5%-10% light intensity,the contents of rhynchophylline and isorhynchophylline in leaves and stems of U. rhynchophylla were the highest. In conclusion,70%-75% light intensity is suitable for seedling growth and biomass accumulation,and 30%-35% light intensity is suitable for the accumulation of effective components in U. rhynchophylla seedlings.

Perioperative nutrition support for esophageal cancer complicated with diabetes mellitus / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the efficacy between perioperative enteral and parenteral nutrition support for esophageal cancer patients complicated with diabetes mellitus.</p><p><b>METHODS</b>Thirty esophageal cancer patients complicated with diabetes mellitus between September and November 2012 were prospectively enrolled in this trial. According to random number table, 30 cases were randomly divided into enteral group (n=15) and parenteral group (n=15). During the period between 3 days before operation and 8 days after operation, patients received enteral nutrition (AnSure) and parenteral nutrition support respectively. The daily dynamic monitoring of blood glucose was performed. Nutritional indexes (albumin and prealbumin) were evaluated 1-day before operation and 8-day after operation. Postoperative recovery time of gastrointestinal function and complications associated with nutritional support were observed. The cost of nutritional support was calculated.</p><p><b>RESULTS</b>Patients in the two groups achieved satisfactory perioperative blood glucose control. Finger tip blood glucose was 5.0-9.0 mmol/L before meal, 7.0-10.0 mmol/L 2-hour after meal, and 4.0-8.0 mmol/L at 10 PM and 3 AM. No hypoglycemia (<3.5 mmol/L) was found in all the patients. The time to first flatus after surgery was (62.4±15.7) in the enteral group, significantly earlier than (90.8±22.4) h in the parenteral group (P<0.01). Postoperative nutritional indices and associated complications were not significantly different between two groups (all P>0.05). Cost in the enteral group was significantly lower than that in the parenteral group [(650.8±45.8) RMB vs. (3016.5±152.6) RMB, P<0.01].</p><p><b>CONCLUSION</b>Perioperative nutrition support can effectively control blood glucose and improve perioperative nutritional status simultaneously for esophageal cancer patients with diabetes mellitus. Compared with parenteral nutrition, enteral nutrition can accelerate the recovery of gastric bowel function and reduce the cost of nutritional support.</p>

Effect of PC cell-derived growth factor RNA interference on biological behavior of esophageal squamous carcinoma cells / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of PC cell-derived growth factor (PCDGF) RNA interference on esophageal squamous carcinoma cells Eca-109 in vitro.</p><p><b>METHODS</b>The PCDGF-shRNA expression vector was transfected into the Eca-109 cells by liposome. After transfection, the mRNA and protein expressions of PCDGF were detected by RT-PCR and Western-blot respectively. Cell Counting Kit-8 (CCK-8) assay and Boyden chamber method were performed to measure the cell proliferation and invasion ability respectively.</p><p><b>RESULTS</b>The expression levels of PCDGF mRNA and protein were both decreased in Eca-109 cells transfected with PCDGF-shRNA expression vector (transfection group). Twenty-four, 48 and 72 h after transfection, the cells proliferation in the transfection group was inhibited, and the inhibition rate was 20.4%, 21.1% and 20.9% respectively. The cell proliferation activity in the transfection group was significantly lower than that in the non-transfection group, liposome group and negative vector group (all P<0.05). The number of cell migration in the non-transfection group,negative vector group, liposome group and transfection group was 118.8±12.0, 100.8±9.0, 114.3±4.7, and 53.5±16.3 respectively. The differences were statistically significant between the transfection group and the other 3 groups (all P<0.05).</p><p><b>CONCLUSIONS</b>PCDGF RNA interference can inhibit the proliferation and invasion abilities of esophageal squamous carcinoma cells in vitro. PCDGF gene may be the new target of gene therapy.</p>