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Background The novel coronavirus infection is widespread in the world, resulting in more pneumoconiosis patients complicated with coronavirus disease 2019 (COVID-19). Objective To understand the clinical characteristics and prognosis of hospitalized COVID-19 patients complicated with or without pneumoconiosis. Methods A total of 36 COVID-19 patients admitted to the Shandong Provincial Occupational Disease Hospital from 10 December to 31 December 2022 were selected, including 21 cases in the complication group (pneumoconiosis complicated with COVID-19) and 15 cases in the COVID-19 group without pneumoconiosis. Symptoms, signs, laboratory test results(e.g. routine blood test), imaging findings, treatment plans and prognosis of the two groups were observed and compared. Results Regarding symptoms and signs in the complication group and the COVID-19 group, the proportions of dyspnea (57.14% vs 0.00%), lung wheezing (28.57% vs 0.00%), wet rales (76.19% vs 33.30%), and fever (61.90% vs 93.33%) were significantly different (P<0.05). Compared with the COVID-19 group, the level of D-dimer in the complication group was significantly increased [2.340 (1.0, 6.5) mg·L−1 vs 0.250 (0.2, 0.4) mg·L−1] (P<0.01), the serum sodium level was decreased [(138.10±2.68) mmol·L−1 vs (140.47±2.27) mmol·L−1] (P<0.05). In terms of drug treatment and prognosis, there were statistically significant differences in the proportion of antiviral drugs (19.00% vs 80.00%), glucocorticoids (38.10% vs 80.00%), and anticoagulants (28.60% vs 0.00%) between the complication group and the COVID-19 group (P<0.05). Compared with the COVID-19 group, the cure rate of the complication group (90.50% vs 100.00%) showed no statistical difference. However, there were 2 deaths in the complication group. Conclusion Patients with pneumoconiosis complicated with COVID-19 have less fever and more dyspnea, wheezing, and wet rales. The increase of plasma D-dimer is a potential predictor in patients with pneumoconiosis complicated with COVID-19.
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Clinical research is usually aimed at and guided by therapeutic efficacy. Clarifying the placebo effect and the nocebo effect from treatment outcomes is an important issue in clinical research. This paper reviews the meaning of the placebo effect, suggesting that factors that may produce the placebo effect in clinical practice include past experience associations, patient expectations, suggestion, and doctor-patient relationships. It also summarizes the characteristics of the nocebo effect, its influencing factors, and its impact on clinical prognosis. Combining the characteristics of traditional Chinese medicine, this paper explores the design of acupuncture clinical trials that can reflect the measurement of the placebo effect, attempting to provide a clearer interpretation of the placebo effect in the evaluation of acupuncture efficacy in traditional Chinese medicine. Taking primary insomnia as an example, a prospective randomized placebo-controlled trial is designed to observe and evaluate the relationship between the treatment effects of acupuncture and the placebo effect in different patients under the treatment of the same doctor. Group comparisons will help better distinguish clinical effects in different situations. The authors also attempt to explore the responsive population to the placebo effect and the effects of placebos in different populations.
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The frontier of science and technology has widely entered the era of studying complexity and regulating complex systems.Especially in medicine,research on the complexity of the human system will attract more scholars'and clinicians'attention.Facing the complexity of the human body system directly,this paper applied the definition of complexity,state estimation,and system control models in modern system science to reveal the unique advantages of traditional Chinese medicine(TCM)in understanding human body complexity and regulating human body complex systems.Thus,this paper may not only lay a foundation for dealing with complex diseases in the future but also provides new ideas and methods for forming the future medical model.
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Acupuncture is a promising treatment for relieving pain and improving lower back function in clinical practice. However, evidence from randomized clinical trials (RCTs) remains controversial. Most RCTs conclude that acupuncture procedures for chronic low back pain (CLBP) had no significant difference in efficacy and belonged to placebo. We carefully reviewed and analyzed the methodology and implementation of sham acupuncture in RCTs. Controversial evidence of acupuncture for CLBP is only a microcosm of the evaluation methodological limitation of acupuncture. Inappropriate selection of sham acupuncture controls, rigorous RCT research models, and incorrect interpretation of results may contribute to negative evidence. Evaluating and disregarding the holistic efficacy of acupuncture with an explanatory RCT model based on evaluation drugs may be unwise. Moreover, sham acupuncture is often proven to be non-inert, unreasonable, and with low fidelity. Pitfalls of the explanatory RCT model and sham acupuncture design should be avoided. Establishing a new evaluation system that is in line with the clinical characteristics of acupuncture and obtaining high-quality evidence are difficult but promising tasks.
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Humans , Acupuncture Therapy , Chronic Pain/therapy , Low Back Pain/therapy , Randomized Controlled Trials as Topic , Treatment OutcomeABSTRACT
Coronavirus disease 2019 (COVID-19) is now pandemic worldwide and has heavily overloaded hospitals in Wuhan City, China during the time between late January and February. We reported the clinical features and therapeutic characteristics of moderate COVID-19 cases in Wuhan that were treated via the integration of traditional Chinese medicine (TCM) and Western medicine. We collected electronic medical record (EMR) data, which included the full clinical profiles of patients, from a designated TCM hospital in Wuhan. The structured data of symptoms and drugs from admission notes were obtained through an information extraction process. Other key clinical entities were also confirmed and normalized to obtain information on the diagnosis, clinical treatments, laboratory tests, and outcomes of the patients. A total of 293 COVID-19 inpatient cases, including 207 moderate and 86 (29.3%) severe cases, were included in our research. Among these cases, 238 were discharged, 31 were transferred, and 24 (all severe cases) died in the hospital. Our COVID-19 cases involved elderly patients with advanced ages (57 years on average) and high comorbidity rates (61%). Our results reconfirmed several well-recognized risk factors, such as age, gender (male), and comorbidities, as well as provided novel laboratory indications (e.g., cholesterol) and TCM-specific phenotype markers (e.g., dull tongue) that were relevant to COVID-19 infections and prognosis. In addition to antiviral/antibiotics and standard supportive therapies, TCM herbal prescriptions incorporating 290 distinct herbs were used in 273 (93%) cases. The cases that received TCM treatment had lower death rates than those that did not receive TCM treatment (17/273 = 6.2% vs. 7/20= 35%, P = 0.0004 for all cases; 17/77= 22% vs. 7/9= 77.7%, P = 0.002 for severe cases). The TCM herbal prescriptions used for the treatment of COVID-19 infections mainly consisted of Pericarpium Citri Reticulatae, Radix Scutellariae, Rhizoma Pinellia, and their combinations, which reflected the practical TCM principles (e.g., clearing heat and dampening phlegm). Lastly, 59% of the patients received treatment, including antiviral, antibiotics, and Chinese patent medicine, before admission. This situation might have some effects on symptoms, such as fever and dry cough. By using EMR data, we described the clinical features and therapeutic characteristics of 293 COVID-19 cases treated via the integration of TCM herbal prescriptions and Western medicine. Clinical manifestations and treatments before admission and in the hospital were investigated. Our results preliminarily showed the potential effectiveness of TCM herbal prescriptions and their regularities in COVID-19 treatment.
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , COVID-19/therapy , China , Combined Modality Therapy , Drugs, Chinese Herbal/therapeutic use , Hospitalization , Medicine, Chinese Traditional , Retrospective Studies , Survival Rate , Treatment OutcomeABSTRACT
Premature ovarian insufficiency (POI) is characterized by amenorrhea before age 40 with raised FSH level and decreased E2 level. POI, as a main reason for infertility, poses great threat on patients. physical and psychological health.By reviewing clinical trials of acupuncture in treating premature ovarian insufficiency, this study focuses on the significance and feasibility of patient registry about acupuncture therapy for premature ovarian insufficiency. Patient registry can be used in collecting real-world evidence and exploring effective intervention to improve pregnancy rate
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Syndromes of coronary heart disease with angina pectoris were analyzed to provide guidance for clinical practice and to improve accuracy of traditional Chinese medicine (TCM) diagnoses and efficacy of TCM treatment. A total of 860 cases with coronary heart disease with angina pectoris were selected from TCM Clinical Research Information Sharing System for TCM clinics and research. Syndromes were automatically extracted with the cluster method and were analyzed to provide objective evidence for clinical studies. Final syndrome classifications were recognized and confirmed by clinical experts. Popular syndromes included Qi and blood deficiency, blood stasis and obstruction collaterals, liver depression and spleen deficiency, and Qi stagnation and blood stasis. Syndromes Qi and blood deficiency and blood stasis and obstruction collaterals accounted for 28.61% of total syndromes, whereas liver depression and spleen deficiency and Qi stagnation and blood stasis accounted for 26.44%. The main syndrome elements comprised Qi deficiency, blood deficiency, blood stasis, and Qi stagnation.
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Aged , Female , Humans , Male , Middle Aged , Angina Pectoris , Diagnosis , Therapeutics , Cluster Analysis , Coronary Disease , Diagnosis , Therapeutics , Diagnosis, Differential , Hemostasis , Medicine, Chinese Traditional , SyndromeABSTRACT
Determining effective traditional Chinese medicine (TCM) treatments for specific disease conditions or particular patient groups is a difficult issue that necessitates investigation because of the complicated personalized manifestations in real-world patients and the individualized combination therapies prescribed in clinical settings. In this study, a multistage analysis method that integrates propensity case matching, complex network analysis, and herb set enrichment analysis was proposed to identify effective herb prescriptions for particular diseases (e.g., insomnia). First, propensity case matching was applied to match clinical cases. Then, core network extraction and herb set enrichment were combined to detect core effective herb prescriptions. Effectiveness-based mutual information was used to detect strong herb-symptom relationships. This method was applied on a TCM clinical data set with 955 patients collected from well-designed observational studies. Results revealed that groups of herb prescriptions with higher effectiveness rates (76.9% vs. 42.8% for matched samples; 94.2% vs. 84.9% for all samples) compared with the original prescriptions were found. Particular patient groups with symptom manifestations were also identified to help investigate the indications of the effective herb prescriptions.
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Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Young Adult , Case-Control Studies , China , Drugs, Chinese Herbal , Therapeutic Uses , Medicine, Chinese Traditional , Propensity Score , Sleep Initiation and Maintenance Disorders , Drug TherapyABSTRACT
With the increasing popularity of acupuncture therapy in the world, the safety of acupuncture has attracted more attention. The objective and impartial assessment of the safety of acupuncture becomes very important. The "adverse events of acupuncture" and "adverse reactions of acupuncture" are the common concepts in the research of acupuncture safety. In the paper, on the basis of the conceptual characteristics of "adverse events" and "adverse reactions" and in combination with the particular characteristics of acupuncture itself, the connation and features of the concepts of the "adverse events of acupuncture" and "adverse reactions of acupuncture" are analyzed. The interaction and differences are summarized. Both "adverse events of acupuncture" and "adverse reactions of acupuncture" are in the category of adverse medical events. The "adverse events of acupuncture" includes the damages induced by acupuncture therapy and also those without relationship with acupuncture therapy. The "adverse reactions of acupuncture" refers to the adverse outcomes induced by acupuncture therapy specially. It has the definite relationship with acupuncture therapy. Hence, the application of "adverse reactions of acupuncture" is more objective and accurate in the assessment of acupuncture safety.
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OBJECTIVE:To establish a method for simultaneous determination of 5 nucleoside from different parts of cultured Cordyceps militaris. METHODS:HPLC method was adopted. The determination was performed on InertSustain C18 column with mobile phase consisting of methanol-0.02 mol/L monobasic potassium phosphate solution (gradient elution) at the flow rate of 0.6 mL/min. The detection wavelength was set at 254 nm,the column temperature was 30 ℃. RESULTS:The linear ranges of uridine, inosine,guanosine,adenosine and cordycepin were 0.568-3.408 μg(r=0.9999),0.284-1.704 μg(r=0.9999),0.264-1.584 μg(r=0.9999),0.232-1.392 μg(r=0.9999)and 1.672-10.032 μg(r=0.9998),respectively. RSDs of precision,stability and repeatabili-ty tests were all lower than 3.0%. The recoveries were 98.2%-103.9%(RSD=1.97%,n=9),96.2%-101.6%(RSD=1.76%,n=9),96.7%-102.0%(RSD=1.94%,n=9),95.1%-99.4%(RSD=1.43%,n=9) and 95.6%-101.3%(RSD=1.82%,n=9). CON-CLUSIONS:The method is simple,precise,stable and repeatable,and can be used for simultaneous determination of 5 nucleoside from cultured C. militaris,the content of nucleosides are different in different parts of C. militaris.
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Objective To compare risk factors and bacterial etiology in patients with early-onset versus late-onset ventilator-associated pneumonia (VAP) in intensive care unit (ICU).Methods This prospective cohort study enrolled mechanically ventilated patients hospitalized for more than 48 hours in the first affiliated hospital,China Medical University from Jan 2012 to Jun 2016.Subjects were classified by ventilator status:early-onset VAP (< 5 d ventilation,E-VAP) or late-onset VAP (≥ 5 d ventilation,L-VAP).Potential risk factors and pathogen were evaluated.Results A total of 4 179 patients in adult ICU were screened,3 989 (95.5%) of whom were mechanically ventilated,962 patients with mechanical ventilation time ≥ 48 h.VAP developed in 142 patients.E-VAP and L-VAP had different potential risk factors based on statistical analysis.Independent risk factors for E-VAP included male (OR =1.825,95% CI 1.006-3.310),chronic obstructive pulmonary disease (COPD;OR =3.746,95% CI 1.795-7.818),emergency intubation (OR =1.932,95% CI 1.139-3.276),aspiration (OR =3.324,95% CI 1.359-8.130).Whereas independent risk factors for L-VAP were coma (OR =2.335,95% CI 1.300-4.194),renal dysfunction (OR =0.524,95% CI O.290-O.947),emergency intubation (OR =2.184,95% CI 1.334-3.574).Mortality in E-VAP and L-VAP group were both higher than the non-VAP group[30.2%(19/63)vs 19.8% (162/820),P=0.044;29.1% (23/79) vs 19.8%(162/820),P=0.046].The pathogens isolated from early-onset versus late-onset VAP were not significantly different between groups,which the most common ones were acinetobacter baumannii,pseudomonas aeruginosa and klebsiella pneumoniae.Conclusion E-VAP and L-VAP have different risk factors,however related pathogens are similar.Different specific preventive strategies are suggested based on different onset of VAP.
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Objective To compare risk factors and bacterial etiology in patients with early-onset versus late-onset ventilator-associated pneumonia (VAP) in intensive care unit (ICU).Methods This prospective cohort study enrolled mechanically ventilated patients hospitalized for more than 48 hours in the first affiliated hospital,China Medical University from Jan 2012 to Jun 2016.Subjects were classified by ventilator status:early-onset VAP (< 5 d ventilation,E-VAP) or late-onset VAP (≥ 5 d ventilation,L-VAP).Potential risk factors and pathogen were evaluated.Results A total of 4 179 patients in adult ICU were screened,3 989 (95.5%) of whom were mechanically ventilated,962 patients with mechanical ventilation time ≥ 48 h.VAP developed in 142 patients.E-VAP and L-VAP had different potential risk factors based on statistical analysis.Independent risk factors for E-VAP included male (OR =1.825,95% CI 1.006-3.310),chronic obstructive pulmonary disease (COPD;OR =3.746,95% CI 1.795-7.818),emergency intubation (OR =1.932,95% CI 1.139-3.276),aspiration (OR =3.324,95% CI 1.359-8.130).Whereas independent risk factors for L-VAP were coma (OR =2.335,95% CI 1.300-4.194),renal dysfunction (OR =0.524,95% CI O.290-O.947),emergency intubation (OR =2.184,95% CI 1.334-3.574).Mortality in E-VAP and L-VAP group were both higher than the non-VAP group[30.2%(19/63)vs 19.8% (162/820),P=0.044;29.1% (23/79) vs 19.8%(162/820),P=0.046].The pathogens isolated from early-onset versus late-onset VAP were not significantly different between groups,which the most common ones were acinetobacter baumannii,pseudomonas aeruginosa and klebsiella pneumoniae.Conclusion E-VAP and L-VAP have different risk factors,however related pathogens are similar.Different specific preventive strategies are suggested based on different onset of VAP.
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How to discover the valuable knowledge from the large amount of prescription data accumulated in the long-term medical practice of traditional Chinese medicine (TCM) is one of the important contents of TCM modernization.Based on the prescription data of Xue' s clinical practice of many years,this paper explored the method of combining TCM network and prescription network to find out Xue' s common core drug combination.Based on 9,584 prescriptions in the Hospital Information System of Guang'anmen Hospital of China Academy of Chinese Medical Sciences,prescription network and drug network were constructed according to the similarity of prescription composition and drug co-occurrence relationship.Using the complex network analysis methods,such as community analysis method,to analyze the prescription and drug compatibility,the results were evaluated and analyzed by Xue and his successors.As a result,through complex network analysis,126 modular prescriptions and 4 TCM modules were obtained.One of the core components of the prescription module included Xiao Chai Hu decoction,Yin Qiao powder,and Sheng Jiang powder compound addition and subtraction.It was in consistent with the drug composition of exogenous febrile prescriptions excavated earlier.In conclusion,using the complex network methods,we can get some core drug combinations prescribed by Prof.Xue,and achieve the common compound core drug combination for treating diseases with certain vantages,laying a foundation for further inheriting and excavating Xue' s effective experience.
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OBJECTIVE:To establish the method for the simultaneous determination of contents of 4 heavy metal elements in cultured Cordyceps militaris. METHODS:The samples were digested by nitric acid heating method and then determined by ICP-MS including radio-frequency power of 1.15 kW,sampling depth of 65 nm,auxiliary gas flow rate of 1.0 L/min,cooling gas flow of 13.0 L/min,temperature of 25 ℃,automatic plasma. RESULTS:The linear ranges of arsenic(As),cadmium(Cd),mer-cury (Hg) and lead (Pb) were 0-20 μg/mL(r=0.9970),0-10 μg/mL(r=0.9995),0-5 μg/mL(r=0.9955),0-20 μg/mL(r=0.9960),respectively. Detectio limit were 0.128,0.003,0.002,0.004 mg. RSDs of precision,stability and reproducibility tests were all lower than 6.5%. Recoveries of them were 90.4%-100.6%(RSD=3.45%,n=9),94.3%-101.3%(RSD=2.93%,n=9), 90.0%-102.3%(RSD=4.03%,n=9),92.3%-103.0%(RSD=3.53%,n=9),respectively. CONCLUSIONS:The method is sim-ple,precise,stable,reproducible,and can be used for simultaneous determination of contents of 4 heavy metal elements in cul-tured C. militaris. The contents of As,Cd,Hg and Pb in 10 batches of sample are all in line with related national standards.
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As the new development of scientometrics and informetrics, knowledge graph has infiltrated into the financial, industrial and medical fields, and become a hot issue in the real world research. In this article, the concept and features of knowledge graph, construction and the existing softwares, the application status and development prospect in the TCM field were reviewed, which may provide references for research on the knowledge graph in the TCM field.
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This study was aimed to assess scales with the unidimensional item response models (UIRM) and classical test theory.The reliability and validity of 841 sub-health status samples were analyzed by CTT.Surveying evaluation from the project perspective was also conducted.The results showed that Cronbach'so coefficients in five areas were all larger than 0.6 with relatively high consistency.The scale structures of five areas were relatively good and the CFI was 0.96.When discriminations of all items were larger than 0.3,the sensitivity of item for its area was high.When the scale test information was 33.8,the accuracy of sub-health status was relatively high.However,there were still some items should be further revised.It was concluded that UIRM can be used to evaluate the psychological measurement performance in the project.It is a supplement to the evaluation result of classical test theory.The reliability and validity of sub-health status scale are relatively high.After IRT correction,it can be used for human-computer interaction techniques “preventive treatment” dynamic monitoring.
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Acupuncture-moxibustion has been used in more than 180 countries,but high quality evidences for its efficacy and safety are still insufficient,which is a key issue limiting the development of acupuncture-moxibustion.Combined with characteristics of acupuncture-moxibustion discipline,this study was aimed to use international patient registry to collect real world clinical data and design meaningful clinical outcome in order to exploit the efficacy and safety of acupuncture-moxibustion and to provide important basis and supplement for confirmatory research.This paper summarized key technologies of international patient registry study for acupuncture-moxibustion based on real world to guide the design,implementation and evaluation.
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Acupuncture is developing rapidly in the world, and more attention is paid on acupuncture in various countries. Because of the cultural differences, there are different views on acupuncture between China and the west, which has brought influence and challenge to the development of acupuncture in the world. Acupuncture-related research is becoming increasingly extensive and complex, but the definition of acupuncture is lack of unified standards. The definition of acupuncture is in urgent need. Based on the analysis of acupuncture definition in the 201 international organizations of 48 countries on five continents and legislation of representative countries, this paper summarized the development status of acupuncture in foreign countries, and put forward that the definition of acupuncture should adopt the model of small connotation and large extension, integrate discipline superiority, expand the scope of acupuncture, and focus on the overall situation.
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Acupuncture has been applied in 183 countries and regions and gradually become a name card as TCM spreads across the world. The international influence of which plays a significant role in enhancing TCM development. The laws and regulations of TCM acupuncture along One-Belt-One-Road countries were compared and analyzed in this article. With comprehensive research and analysis, the international development strategy of acupuncture was rationally proposed. Combined with the historical background of China's national initiative One-Belt-One-Road, the acupuncture was taken as a breakthrough to lead the global spreading of TCM culture and Chinese herbs, so as to enhance China's soft strength, which could further create a fine cultural environment for the economic prosperity of One-Belt-One-Road countries. In addition, the strategy selection for China regarding TCM acupuncture development along One-Belt-One-Road countries was proposed, and the suggestive solution and implementation strategy for the essential missions and significant issues were provided.
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As a kind of intervention measures of traditional Chinese medicine, acupuncture-moxibustion is highly adopted on global clinical practice. Even though the global clinical trial registration system was established more than 10 years ago, the proportion of acupuncture-moxibustion clinical trial registration is still very low; and it is very problematic on the methodological quality and report quality in the published acupuncture-moxibustion clinical trials. In order to manage particularly the acupuncture-moxibustion clinical trials, China Academy of Chinese Medical Sciences, collaborated with China Association of Acupuncture and Moxibustion and World Federation of Acupuncture Societies, established the Acupuncture-Moxibustion Clinical Trail Registry (AMCTR). AMCTR is a secondary registry platform affiliated to the Chinese Clinical Trial Registry (ChiCTR) and WHO International Clinical Trials Registry Platform (ICTRP), specifically for the acceptance and management of clinical trials in the field of acupuncture and moxibustion. It is a nonprofit academic organization, located in China Academy of Chinese Medical Sciences.