Effect of electroacupuncture on motor function and gait in patients with post-stroke spasticity in lower limbs / 中国针灸

OBJECTIVE@#To observe the effect on motor function, spasticity degree, muscle strength and the relevant parameters of three-dimensional gait analysis in the patients with post-stroke spasticity in the lower limbs treated with the combined therapy of electroacupuncture (EA) and muscle electricity biofeedback or the simple muscle electricity biofeedback therapy on the base of rehabilitation medicine.@*METHODS@#A total of 60 patients with post-stroke spasticity in the lower limbs were randomized into an EA + biofeedback group, a biofeedback group and a rehabilitation group, 20 cases in each one. In the rehabilitation group, the basic rehabilitation training was provided, 45 min each time. In the biofeedback group, on the base of the treatment as the rehabilitation group, the biofeedback therapy was added, 30 min each time. In the EA + biofeedback group, besides the treatment as the biofeedback group, acupuncture was supplemented at Futu (ST 32), Liangqiu (ST 34), Zusanli (ST 36) and Fenglong (ST 40), etc, and EA was applid at Zusanli (ST 36) and Taichong (LR 3) with continuous wave and 5 Hz in frequency. In each group, the treatment was given once daily, 5 times a week, for 6 weeks totally. Separately, before and after treatment, the score of Fugle-Meyer assessment (FMA), the score of clinical spasticity index (CSI) in the lower limbs and the strength of the anterior tibial muscle on the affected side were assessed, and the spatial-temporal parameters (step frequency and steep speed) in the three-dimensional gait analysis and the kinematic parameters (maximum dorsal flexion and maximum plantar flexion of ankle joint on the affected side) were measured in the patients of three groups.@*RESULTS@#After treatment, FMA score was increased as compared with that before treatment in all of three groups (P<0.05). FMA score in the EA + biofeedback group and the biofeedback group was higher than the rehabilitation group respectively (P<0.05). CSI score in the EA + biofeedback group and the biofeedback group was lower than that before treatment respectively (P<0.05), and lower than the rehabilitation group (P<0.05). After treatment, the step frequency and speed were all improved and the angles of maximum dorsal flexion and maximum plantar flexion of ankle joint on the affected side were all increased as compared with those before treatment in the patients of three groups separately (P<0.05). The step frequency and speed, as well as the angles of maximum dorsal flexion and maximum plantar flexion of ankle joint on the affected side in either the EA + biofeedback group or the biofeedback group were all higher than the rehabilitation group (P<0.05), and the step speed in the EA + biofeedback group was higher than the biofeedback group (P<0.05). After treatment, the strength of the anterior tibial muscle on the affected side was increased as compared with that before treatment in the patients of each group (P<0.05); and the strength of the anterior tibial muscle in the EA + biofeedback group and the biofeedback group was larger than the rehabilitation group (P<0.05).@*CONCLUSION@#On the base of rehabilitation treatment, the combined regimen of EA and muscle electricity biofeedback therapy and the simple muscle electricity biofeedback therapy all effectively strengthen the motor functions and reduce spasticity as well as improve step frequency, step speed and the range of motion of ankle joint in the patients with post-stroke spasticity in the lower limbs. Regarding the gait improvement, the combined regimen of EA and muscle electricity biofeedback is better than the simple muscle electricity biofeedback.

Application of rituximab in children with primary nephrotic syndrome / 医学研究生学报

Childhood primary nephrotic syndrome (PNS) is a challenging and persistent renal disorder. Corticosteroids is the first-line drug for the treatment of PNS. To reduce the side effects caused by the accumulation of corticosteroids dose and to maintain the remission state of the disease, immunosuppressants are applied to the treatment of PNS. However, many children with PNS still cannot get remission. Rituximab (RTX) is a novel immunosuppressive agent. In recent years, many studies have reported the treatment of PNS in children with RTX. This review analyzes the mechanism, course of treatment, dose, efficacy, and safety of RTX in the treatment of children with PNS.

Research progress of specific biomarkers in IgA nephropathy / 医学研究生学报

IgA nephropathy (IgAN) is the most common primary glomerular disease in the worldwide, and its immunopathological features are mainly the deposition of IgA in glomerular mesangial region and / or vascular loop. It has been found that the expression and changes of some factors involved in the pathological injury of IgAN can provide some evidence for the diagnosis, evaluation and prognosis of IgAN. This paper reviews the research progress of IgAN biomarkers in Multiple-Hits theory, miRNAs, complement system and cytokines.

A novel splicing mutation identified in a Chinese family with Alport syndrome and analysis of its pathogenicity / 医学研究生学报

Objective The purpose of this study was to identify a pathogenic variant in a Chinese family with Alport syndrome and analyze the pathogenicity of the variant. Methods Using targeted region capture and high-throughput sequencing technology, we identified the genetic variant of the proband with Alport syndrome, verified the variant in the family members by Sanger sequencing, and analyzed its influence on the pre-mRNA splicing process by in vitro minigene assay. Results A heterozygous variant c.2767G>T (p.Gly923Cys) was identified as a novel variant in exon 32 of the COL4A5 gene in the proband, which was confirmed by Sanger sequencing to be cosegregated with disease in the family. The minigene assay demonstrated that the c.2767G>T variant induced deletion of exon 32 of the COL4A5 gene. Conclusion A novel COL4A5 mutation was identified by targeted region capture and high-throughput sequencing, which has enriched the gene mutation spectrum of Alport syndrome. The exonic mutation c.2767G>T confirmed to be a splicing mutation by in vitro minigene assay, which may lead to a deeper insight into the molecular pathogenesis of Alport syndrome.

Accumulation and Toxicity of Mercury in Zhuhong Ointment in Rats with Damaged Skin Model / 中国实验方剂学杂志

Objective: To study the accumulation of mercury in liver, kidney and brain of rats and its toxicity on liver and kidney after 4 weeks of administration of different doses of Zhuhong ointment, in order to provide data reference for the safe clinical use of Zhuhong ointment. Method: Forty-four Sprague-Dawley (SD) rats were randomly divided into 4 groups:control group, normal-dose group (1.875 mg·kg-1), medium-dose group (37.5 mg·kg-1), and high-dose group (75 mg·kg-1). After transdermal administration for consecutive 4 weeks, the mercury content in the urine, blood, liver, kidney and brain of the rats was measured. In addition, serum alanine aminotransferase (ALT), serum aspartate aminotransferase (AST), serum urea nitrogen (BUN), and serum creatinine (SCr), urine β2-miSCroglobulin (β2-BMG) and urine N-acetyl-beta-D glucosidase (NAG) contents were measured, and pathological morphology changes of liver and kidney were observed. Result:Compared with the control group, the levels of blood mercury and urine mercury in Zhuhong ointment groups showed significant increases after administration for 4 weeks(PPPPPPConclusion:Zhuhong ointment is not toxic at the normal dose, but long-term use can lead to the accumulation of mercury in liver, kidney and bra, which causes liver and kidney toxicity. This study did not find a more sensitive indicator of liver and kidney toxicity than liver and kidney pathology. However, because the rising levels of urinary mercury and blood mercury may predict toxicity, the relationship between mercury exposure and toxicity could be further studied. This study provides a reference for the rational use and toxicity monitoring of Zhuhong ointment.

Panax notoginseng saponins inhibits early-stage cell apoptosis in steonecrosis of rabbit femoral head / 西安交通大学学报(医学版)

Objective To investigate the effects of panax notoginseng saponins (PNS) on early-stage apoptosis in steonecrosis of rabbit femoral head .Methods The 24 rabbits were randomly divided into three groups :normal control group ,model group ,and PNS group .In model group ,equine serum (10 mL/kg) and methylprednisolone (40 mg/kg) were injected alternatively to induce osteonecrosis of the femoral head .In PNS group ,PNS (50 mg/kg , i .v .) was administered continuously before methylprednisolone management .In control group ,the rabbits were fed routinely .TUNEL method was used to detect apoptotic cells .Caspase-3 activity in the femoral head was measured by caspase-3 assay kit . Immunohistochemistry method and Western blot analysis were applied to detect the expressions of Bcl-2 and Bax .Results In model group ,typical appearance of apoptotic cells was observed in the femoral head by TUNEL staining (P< 0 .05) .PNS treatment significantly inhibited cell apoptosis of the femoral head in model group .Furthermore ,pretreatment with PNS significantly reversed the inhibition of Bcl-2 expression , augmentation of Bax expression and caspase-3 activity ( P< 0 .05 ) . Conclusion PNS could up-regulate the expression of Bcl-2 ,down-regulate that of Bax ,reduce the activity of caspase-3 ,and inhibit cell apoptosis of the femoral head .

Analysis of efficacy of rituximab in treating primary focal segmental glomerulosclerosis in children / 医学研究生学报

Objective There are few studies on children with primary focal segmental glomerulosclerosis (FSGS) treated with rituximab (RTX).This study aimed to analyze the side effects and safety of the single dose of RTX in 10 children with primary FSGS, and further provide reference for the RTX treatment of FSGS . Methods We retrospectively analysed the clinical data of 10 FSGS children who hospitalized in the department of pediatrics in Nanjing General Hospital of Nanjing Military Area Command from April 2014 to August 2017.24 hours urinary protein, serum albumin, the count of circulating CD20+B cells and the RTX adverse reactions were analyzed after the treatment of RTX . Results From the 10 ca-ses, 6 cases were steroid-resistant nephrotic syndrome (SRNS), and 4 cases were frequently relapsing /steroid dependent nephrotic syn -drome (FRNS/SDNS).After single dose of RTX treatment , 5 cases achieved complete remission (CR), 2 partial remission (PR), and 3 non-remission (NR).Among the 6 cases of SRNS, 2, 1, 3 ca-ses achieved CR, PR, NR respectively; Among the 4 cases of FRNS/SDNS, CR was achieved in 3 patients, PR was achieved in 1 pa-tient.3 months after RTX treatment, urinary protein decreased from [2.41 (0.89-6.82) g/24 h] to [0.43 (0.05-1.1) g/24h], ser-um albumin increased from [31.60 (13.00-38.22) g/L] to [38.30 (27.18-53.20) g/L] .Adverse reactions occurred in 1 case in-cluding fever, chills, and chest tightness.These adverse reactions relieved after the decreased of RTX infusion speed .One developed severe pneumonia and proteinuria one month after RTX treatment .There was no increase in the number of infections in other children and no abnormalities in the respiratory tract , digestive tract, and nervous system during follow-up. Conclusion RTX treatment of primary FSGS has high security and has no serious adverse reactions .It is one of the effective treatments for children with FSGS .

The recognition of clinical application of glucocorticoids / 医学研究生学报

Because of the significant anti-inflammatory and immunosuppressive effects,glucocorticoids (GCs) have been widely used in clinic However,adverse reactions caused by long-term use of GCs and glucocorticoid resistance (GR) are always troublesome problems in clinical department.Therefore,it is the hot point to explore the ways to reduce adverse reactions of GCs and to improve sensitivity of GCs.In this article,we mainly discuss new strategies of reducing adverse reactions and improving sensitivity of GCs.

Inspirations of Rome Ⅳ on clinical evaluation of traditional Chinese medicine for functional gastrointestinal disease / 中国中药杂志

The Rome Foundation released the Rome Ⅳ for functional gastrointestinal diseases (FGIDs) in 2016, which fully presented the latest advances and views on the disease origin, definition, diagnosis, classification, pathology, mechanism, clinical features, influential factors, interventions, clinical evaluation, clinical research design and so on, showing high positive effects on global researches. Traditional Chinese medicines (TCM) have cognitive advantages and well-recognized and-demonstrated efficacy in the prevention and treatment for FGIDs. However, the monotonous presentation ways and weak interpretation on clinical evaluation have also hindered the inherent advantages explanation, characteristics quantization, evidence and communication accumulation. This study first analyzed the background and key points on clinical evaluation of Rome Ⅳ and corresponding inspirations, believed that its concept and viewpoints were assimilated with systematic medicine, and emphasized the important influence of subjective factors such as mental psychology and social culture on the disease and its importance in clinical evaluation. Its views on several aspects such as the theoretical model, internal and external causes, and transfer process were highly consistent with TCM. Therefore, TCM researchers should devote more dedication and courage on the innovation and collaboration with global researches to advance related studies. Then, based on 59 TCM clinical researches for FGIDs funded by national projects upon searching in CNKI with strict search strategy, the clinical evaluation methods and indexes and their correlations were summarized and analyzed, and it was found that more attention was paid to the disease symptoms and impact, symptom/syndrome score, patient report outcome, et al. However, many limitations were also founded, such as disordered relationships among different indexes, ambiguous explanation of research results, and extremely few domestic evaluation instruments in Chinese culture. Therefore, it is suggested that future research should regress and highlight the subjective features of patients and diseases, standardize the elemental structure and management mode of clinical evaluation, enhance the values and status of reported outcomes. It is highly recommended that the domestic disease-specific instruments developed in Chinese culture should be adopted as primary outcome for clinical evaluation, assisted with symptoms/signs assessment tools and doctors reporting outcome scale, et al. The common used TCM syndrome scores in current researches are not recommended as the primary outcome. However, there are some limitations in the above suggestions. We hope that more relevant researches will explore and establish a unified outcome assessment system for FGIDs and improve the quality of TCM clinical research.

Clinical experience and academic thoughts of Professor LIU Feng-bin on case series of gastroesophageal reflux disease based on data mining / 中国中药杂志

To analyze and summarize Professor LIU Feng-bin's clinical experience and academic thoughts on gastroesophageal reflux disease (GERD), the study group adopted the retrospective study for case series and expert interview, extracted the retrospective data, including the herbs, diseases, syndrome type, medical expense and quantity of herbs of GERD patients attended the First Affiliated Hospital of Guangzhou University of Chinese Medicine. Statistical description and binary Logistic regression were used for the identification and modification of syndrome type and initial core herbs. After expert interviews were performed for the syndrome type and herbs, the final scheme were formed. A total of 112 GERD patients ages（48.97±13.13）y; male: 35 (31.3%), female: 77(68.7%) were enrolled. The numbers of patients with liver and stomach incoordination syndrome, heat stagnation of liver and stomach syndrome, syndrome of dual deficiency of Qi and Yin, syndrome of spleen deficiency and dampness-heat, spleen-stomach disharmony syndrome were 40, 26, 19, 17 and 10, respectively. The patients used totally 80 herbs, and 26 of them had significant differences among different syndrome groups. According to the logistic regression analysis on the 23 herbs used by 112 patients, the herbs scheme was modified for the second time. After the expert interviews and modification, the final consensus was reached. The main causes for GERD were dietary irregularities, moodiness, and weak constitution. The basic mechanism of GERD was spleen deficiency with Qi adverseness. The spleen-stomach disharmony syndrome was deleted by expert interviews. The 10 core herbs for GERD treatment were Taizishen(Pseudostellariae Radix), Fuling(Poria), Baizhu(Atractylodismacrocephalae Rhizoma), Gancao(Glycyrrhizae Radix Et Rhizoma), Zhebeimu(Fritillariae Thunbergii Bulbus), Haipiaoxiao(Sepiae Endoconcha), Zhiqiao(Aurantii Fructus), Chenxiang(Alosewood), Pugongying(Taraxaci Herba), Zhizitan(Cape Jasmine Fruit). The modification and psychological and diet interventions were also identified. This study summarized Professor LIU Feng-bin's clinical experience and academic thoughts of chronic atrophic gastritis based on data mining of case series and expert interviews. The quality of methodologies and report were both well. The results provide a foundation and ideas for further study on the complex intervention for GERD, and can be directly applied in clinical practice.

Controversies on the values for health instruments of Chinese medicine / 中国结合医学杂志

Currently, there are increasing debates on the necessity of health instruments in Chinese medicine (CM) emerging in China. This study aims to reevaluate its status and values. Analyzing the causes, limits, advantages, and properties characters of health instruments in CM, it is found that weak fundamental research, incomplete self-awareness, and complicated social factors are the primary causes of debates. A comprehensive analysis showed health instruments in CM have health evaluation benefits to people from a dominant Chinese culture, meet the requirements of cultural background, and bring long-term value to Chinese instrument researches. However, its values and status should be treated differently depending on various subtypes. Although little theoretical and practical evidences proved that patients-reported health instruments in CM should be proposed independently, the doctors- and nurses-reported questionnaires are necessary. With this in mind, the study group proposes the 'Chinese cultural instruments (CCIs)' and 'health-related CCIs'. The latter one aims to evaluate the health status of people in a dominant Chinese culture. The CCIs theory represents Chinese instrument researches on a larger regional and higher level, and resolves the debates on instruments between CM and Western medicine in China. Health instruments in CM bring more scientific and social benefits for Chinese instrument researches. However, it does not include cultural demands, and lacks scientific significance. CCIs have all its virtues, and add solutions to the latter's theory bottleneck and scientific debates, thus bringing increased benefits to clinical assessment in complementary and alternative medicine researches.

Traditional Chinese medicine syndrome distribution and neuroendocrine mechanisms of irritable bowel syndrome: cross-sectional study / 中国中药杂志

In order to clarify the traditional Chinese medicine(TCM) syndrome distribution and pathogenesis of irritable bowel syndrome(IBS), the patients in the first affiliated hospital of Guangzhou university of Chinese medicine were enrolled for the cross-sectional study. The data of 12 sociological variables, 13 risk factors, 84 symptoms and signs variables(in 9 aspects), and 19 neuroendocrine indices were extracted for group-between analysis with one-way ANOVA, chi-square test and nonparametric test, and the relationship analysis between clinical symptoms and diseases sub-types was done with binary Logistic regression. In addition, the patterns of TCM syndromes were divided by several syndrome factors to analyze the difference in neuroendocrine indices between various patterns and syndrome factors. A total of 383 IBS patients were enrolled, including 353(92.2%) cases of diarrhea, 14(3.7%) cases of constipation and 16(4.1%) cases of mixed types. In IBS-diarrhea patients, there were 291(76.0%), 18(4.7%), 48(12.5%) and 26(6.8%)cases of syndrome of liver depression and spleen deficiency (sLDSD), syndrome of liver depression and qi stagnation (sLDQS), syndrome of dampness-heat in the spleen and stomach (sDHSS), and syndrome of spleen deficiency with dampness encumbrance (sSDDE) respectively. There was significant differences in blood groups between IBS-diarrhea patients, IBS-constipation patients and IBS-mixed types patients; their disease classification was significantly correlated with the allergies, drinking, irregular meals habits, no or less vacations, and other causes of morbidity (P<0.05, f<0.3). A total of 15 symptoms and signs variables (e.g., chills, facial abnormalities, epigastric fullness, etc.) had significant differences between different groups (P<0.05), and 5, 8, 5 variables were respective independent factors for IBS-diarrhea, constipation and mixed type. There was no significant difference in neuroendocrine indices between various groups. The sLDSD, sLDQS, sDHSS, sSDDE patients had significant differences in genders, living conditions and occupations, and the TCM syndrome type was significantly correlated with the drinking, smoking, no or less breakfast, less than 8 sleeping hours(P<0.05, f<0.3). Meanwhile, a total of 14 symptoms and signs variables (e.g., dysphoria heat, fatigue, stretching, etc.) had significant differences between various groups(P<0.05) and 3, 4, 6, 3 variables were respective independent factors for sLDSD, sLDQS, sDHSS, and sSDDE. There were significant differences in acetylcholine(Ach) and angiotensin Ⅱ(AT-Ⅱ) between the sLDSD group and sSDDE group. There were significant difference in Ach, AT-Ⅱ, adrenotrophin(ACTH) and estradiol (E2) in comparison between several pattern factors. This study preliminary identified the sociological characters, risk factors, syndromes distribution, diseases and subgroup mechanisms of this disease. More samples and multi-centers are required for future study to improve the scientificity and representativeness.

Mining analysis and experience summary for chronic atrophic gastritis cases treated by Professor LIU Feng-bin / 中国中药杂志

To summarize Professor LIU Feng-bin's clinical experience and theoretical thoughts on chronic atrophic gastritis (CAG), the study group designed a retrospective study on his case series and expert interview. First of all, the data of CAG patients treated in the First Affiliated Hospital of Guangzhou University of Chinese Medicine between 2009 and 2013, e. g. herbs, diseases, syndrome type, prescription amount and number of herbs, was collected and processed. The statistical description and binary logistic regression were used to determined the syndrome type, initial basic remedy and modification. During the statistics, a complete and sub-group analysis was performed simultaneously. After the expert interview, the syndrome type and medication were finalized. As a result, a total of 228 CAG patients aged at (50.30 ± 10.18) were collected, including 151 males (66.23%). Of them, the TCM diagnosis and syndrome type were extracted from the information of 157 patients, including 115 cases with gastric stuffiness, 23 cases with gastric pain, 19 missing cases, 2 cases with spleen-stomach weakness syndrome, 57 cases with spleen deficiency and dampness-heat syndrome, 18 cases with spleen-stomach disharmony syndrome, 23 cases with syndrome of liver depression syndrome, 21 cases with liver qi invading stomach syndrome and 26 qi and yin deficiency syndrome, respectively. All of the 228 patients used totally 104 herbs, while the subgroups with 157 patients used 94 herbs. The most frequently used 15 herbs used in each groups were analyzed to determine the initial basic remedy and modification. Subsequently, based on the information of the sub-groups with 157 patients, with the syndrome type as the dependent variable, the logistic regression analysis was made on the most frequently used 32 herbs, in order to determined the modification in herbs for different syndrome types. After experts reviewed and modified, they believed the main causes of CAG were dietary irregularities, moodiness and weak constitution; the pathogenesis of CAG was spleen deficiency with qi stagnation, heat depression and blood stasis in the stomach meridian. The above six syndrome types and 12 herbs were determined, including Pseudostellariae Radix, Poria, Atractylodismacrocephalae Rhizoma, Glycyrrhizae Radix et Rhizoma, Fritillariae Thunbergii Bulbus, Sepiae Endoconcha, Arecae Pericarpium, Aurantii Fructus, Perillae Caulis, Herba Hedyotis Diffusae, Scutellariae Barbatae Herba, Curcumae Rhizoma. This study summarized Professor LIU Feng-bin's clinical experience and theoretical thoughts of chronic atrophic gastritis based on clinical practice data and expert interview, with a rigorous design and good scientificity and practicability.

Development and Evaluation of GS-SF for Gastric Stuffiness (Wei PI) Patients Based on Item Response Theory, Computerized Adaptive Testing, and Data Simiuation / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To develop and evaluate the short version of patient reported outcomes (PROs) questionnaire for gastric stuffiness (Wei Pi) patients with modern test theory and technologies, hoping to provide testing tools for related clinical practice and scientific researches with higher quality and less administrative and response burdens.</p><p><b>METHODS</b>Using descriptive study design, clinical data were collected with sociological questionnaire and previous developed full items version of PROs instrument for gastric stuffiness (Wei Pi) patients via field and online surveys between Sep 2011 and Mar 2012. The statistical analysis group identified the termination parameters firstly, and then selected items with discrimination, fitting residual, item information curve (IIC) , item characteristic curve (ICC), and the rank of computerized adaptive testing (CAT) select proportion, etc. After assumption evaluation of item response theory (IRT), IIC, ICC, difficulty coefficient distribution, items-response relation and thresholds, etc. were used for psychometric evaluation of instrument.</p><p><b>RESULTS</b>A total of 331 patients [Ages: 31.99 +/- 10.29 yrs; Male: 186 (56.3%)] were enrolled in statistical analysis. The test termination criterion was Max SE = 0.2 or Max items number =16. After items selection, a 15-item short version of instrument, which contains symptoms facet (8 items) and impact facet (7 items) was generated. With good unidimensionality, local independence, and monotonicity, the IC and ICC in IRT analysis showed good working capability of the questionnaire. The difficulty coefficient distribution and items-response relation were also rational, as well as response thresholds.</p><p><b>CONCLUSIONS</b>The short version of PROs instrument for adult gastric stuffiness (Wei Pi) patients was successfully developed and assessed. The instrument with good methodological and reporting quality could be used in clinical and scientific evaluating their symptoms and impact.</p>

General integral medicine: the strategic direction for complex health interventions / 中国中西医结合杂志

Nowadays, the simple combination of Western medicine (WM) and complementary and alternative medicine (CAM) cannot resolve all the health problems and various requirements. This article proposed the general integral medicine (GIM) theoretical model, which declares the disease causes analysis, clinical intervention and outcomes assessment should be recognized, managed and evaluated both from physiological, psychological, and spiritual status, and all the four dimensions: orthodox medicine (WM, Chinese medicine, etc.), individual inherent characteristics (emotion, attitude, psychology, etc.), cultural influences (doctors, caregivers, groups care, etc.), and natural environment and social systems (economic status, social security system, environmental pollution, etc). As for health outcomes assessment, a more comprehensive system including biological, doctors, patients, health intimate, social and environmental evaluations were required. The GIM model has individualized, dynamic, standardized, objective, systematic inherent characteristics, and opening and compatible external characteristics. It aims to provide the new theoretical guidance and strategic development direction for complex health interventions, and solve various medical related psychological and social problems.

Effect and safety of Mizoribine on frequency recurrence nephrotic syndrome in children / 中华实用儿科临床杂志

Objective To observe urinary protein,serum albumin,cholesterol and recurrence of children with frequency recurrence nephrotic syndrome(NS) after using Mizorbine (MZR).Methods Eighteen cases of recurrent frequency NS were given enough hormone and MZR.Urinary protein,serum albumin,cholesterol,urinary N-acetyl-β-D-glucosaminidase(NAG) and recurrence were observed.The difference of recurrence between the children treated with steroid and the children treated with steroid and MZR more than 6 months were compared.Results In the combined treatment with both sufficient hormone and MZR,out of the 18 cases,there were one lost case and one invalid case.For the remaining 16 cases,edema subsided when they were reexamined in the first month,and the urine protein changed to negative within about 3 to 10 days (the average time was 6.33 days).There were 10 cases who were reexamined after 6 months,in which for 8 cases the serum albumin returned to normal in the first month (≥35 g/L),1case returned to normal in 3 month and 1 case in 6 month.The level of blood cholesterol returned to normal for 7 cases in the first month (＜ 5.7 mmol/L),3 cases returned to normal in 3 months.In the reexamining of urine protein in 24hours in the first month,7 cases returned to normal (＜0.4 g),2 cases reduced and there was no change in 1 case.Relapse occurred in 2 cases,in one of which the level of urine protein returned to normal if changing the MZR to alternate-day implosive therapy.After treatment,partial tubular functions restored and in the first month,the level of NAG returned to normal in 7 cases,decreased in 9 cases and increased in 1 case.In the experiment group,no child was observed vomiting,to have diarrhea and other gastrointestinal symptoms.The blood pressure,breathing and heart rate were within the normal range before and after the treatment.The increase of urea nitrogen and creatinine was observed only in 1 case.Conclusions MZR with enough hormone treating frequency recurrence NS can promote urine protein negative,and make serum albumin,cholesterol,urinary NAG decrease,and reduce the recurrence.When MZR made regular doses of the application can not effectively reduce the recurrence frequency,and the pulse treatment may be a kind of effective methods.

Advising on Preferred Reporting Items for patient-reported outcome instrument development: the PRIPROID / 中国结合医学杂志

<p><b>OBJECTIVE</b>The reporting of patient-reported outcomes (PRO) instrument development is vital for both researchers and clinicians to determine its validity, thus, we propose the Preferred Reporting Items for PRO Instrument Development (PRIPROID) to improve the quality of reports.</p><p><b>METHODS</b>Abiding by the guidance published by the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) Network, we had performed 6 steps for items development: identified the need for a guideline, performed a literature review, obtained funding for the guideline initiative, identified participants, conducted a Delphi exercise and generated a list of PRIPROID items for consideration at the face-to-face meeting.</p><p><b>RESULTS</b>Twenty three items subheadings under 7 topics were included: title and structured abstract, rationale, objectives, intention, eligibility criteria, conceptual framework, items generation, response options, scoring, times, administrative modes, burden assessment, properties assessment, statistical methods, participants, main results, and additional analysis, summary of evidence, limitations, clinical attentions, and conclusions, item pools or final form, and funding.</p><p><b>CONCLUSIONS</b>The PRIPROID contains many elements of the PRO research, and this assists researchers to report their results more accurately and to a certain degree use this instrument to evaluate the quality of the research methods.</p>

Literature review and analysis of the development of health outcomes assessment instruments in Chinese medicine / 中西医结合学报

<p><b>OBJECTIVE</b>To evaluate the development of health outcomes assessment instruments in Chinese medicine.</p><p><b>METHODS</b>A comprehensive literature search for all published articles in China National Knowledge Infrastructure Database, Chongqing VIP Database and WANFANG Data was conducted. The studies that met the inclusion and exclusion criteria were used to extract information according to a predesigned assessment instrument.</p><p><b>RESULTS</b>A total of 97 instruments for health outcome assessment in Chinese medicine were identified. Of these questionnaires, 7 were generic, 12 were condition-specific and 78 were disease-specific. All instruments were suitable for adults, children, and both men and women. These instruments aimed to evaluate the health-related quality of life, signs and symptoms as well as patient satisfaction and doctor-reported outcome. However, the descriptions were poorly constructed for some of the most basic parameters, such as the domains and items, administrative mode, response options, memory recall periods, burden evaluation, format, copyright, content validity, and other properties.</p><p><b>CONCLUSION</b>The instrument development for health outcomes assessment in Chinese medicine is increasing rapidly; however, there are many limitations in current methodologies and standards, and further studies are needed.</p>

Literature review and analysis of the application of health outcome assessment instruments in Chinese medicine / 中西医结合学报

<p><b>OBJECTIVE</b>To evaluate the application of health assessment instruments in Chinese medicine.</p><p><b>METHODS</b>According to a pre-defined search strategy, a comprehensive literature search for all articles published in China National Knowledge Infrastructure databases was conducted. The resulting articles that met the defined inclusion and exclusion criteria were used for analysis.</p><p><b>RESULTS</b>A total of 97 instruments for health outcome assessment in Chinese medicine have been used in fundamental and theoretical research, and 14 of these were also used in 29 clinical trials that were randomized controlled trials, or descriptive or cross-sectional studies. In 2 152 Chinese medicine-based studies that used instruments in their methodology, more than 150 questionnaires were identified. Among the identified questionnaires, 51 were used in more than 10 articles (0.5%). Most of these instruments were developed in Western countries and few studies (4%) used the instrument as the primary evidence for their conclusions.</p><p><b>CONCLUSION</b>Usage of instruments for health outcome assessment in Chinese medicine is increasing rapidly; however, current limitations include selection rationale, result interpretation and standardization, which must be addressed accordingly.</p>

Investigation and study on pictogram commonly used in medical equipment / 中国医疗器械杂志

Investigated and analyzed the graphical symbols commonly used in medical equipment, their benefits and drawbacks. From the perspective of human factors engineering, some root causes of poor pictogram as well as their relations with medical equipment adverse events were addressed. Furthermore, how to deal with the problems with current pictogram aiming at reducing use error was also discussed.