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ObjectiveTo explore the feasibility and rationality of applying relevant diagnostic and treatment programmes from textbooks as evidence in traditional Chinese medicine (TCM) diagnosis and treatment guidelines, using allergic rhinitis as an example. MethodsTextbooks published from October 1949 to December 2022, as well as TCM diagnosis and treatment guidelines published until December 2022 on allergic rhinitis were searched, and the contents of diagnosis and treatment related to allergic rhinitis were extracted. The similarities and differences between textbooks in different periods, between textbooks in different versions, and between textbooks and guidelines were compared and analyzed. ResultsA total of 12 national planning textbooks on TCM otolaryngology and 4 Chinese medicine diagnosis and treatment guidelines on allergic rhinitis from 1975 to 2021 were included. The evolution of diagnostic and treatment programmes was shown by the textbooks in different periods. Since 2003, syndrome of latent heat in lung channel has been added in the published textbook, and TCM featured therapies, such as nasal packing, intranasal spray were enriched, as well as the contents related to prevention and prognosis. The main syndromes included lung qi deficiency and cold, spleen qi deficiency, kidney yang deficiency, and latent heat in lung meridian. The most common recommended prescriptions were Wenfei Zhiliu Pill (温肺止流丹), Yupingfeng Powder (玉屏风散) and Cangerzi Powder (苍耳子散); Buzhong Yiqi Decoction (补中益气汤), Shenling Baizhu Powder (参苓白术散); Shenqi Pill (肾气丸) or Zhenwu Decoction (真武汤); Xinyi Qingfei Decoction (辛夷清肺饮). A comparison of different versions of textbooks showed that the classification of syndromes was consistent, while the formulas were slightly different. The comparison between different versions of the current textbooks and the guidelines showed that the recommended prescriptions of the textbooks had more Cangerzi Powder, Xiaoqinglong Decoction (小青龙汤), Zhenwu Decoction, etc., while TCM featured therapies such as nose blowing, smelling, nasal plugging, nasal washing were enriched, and information on formula modification, prevention and adjustment, prognosis were also added, which can supplement the corresponding evidence for the guidelines. ConclusionTextbooks could serve as a strong supplement for the evidence-based development of TCM clinical guidelines. However, there is still a need for further research on the quality assessment system of textbook evidence to improve the credibility of its applicability of the guidelines evidence.
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ObjectiveTo explore the role of efficacy evaluation methods in providing evidence for traditional Chinese medicine (TCM) clinical practice guidelines based on a demonstration study of clinical efficacy evaluation of TCM for allergic rhinitis (AR),aiming to enrich the sources of evidence for guideline development. MethodReal-world data of TCM medication for AR were collected and efficacy evaluation was carried out. SPSS 16.0 software was used to calculate the conformity of clinical syndromes,main prescriptions, and medications to the guidelines. Correlation analysis of efficacy and medications was performed according to guideline conformity to compare the differences in medications between real-world clinical applications and current guidelines. ResultA total of 198 cases were collected and the clinical medications were compared with the relevant guidelines for AR. It was found that the clinical syndrome conformity was above 70%,and in addition to the guideline syndrome,there were also syndromes in six meridians and other mixed syndromes in clinical practice. The guideline conformity of the main prescriptions used in clinical practice showed a positive correlation trend with efficacy. There were some differences between the commonly used drugs in clinical practice and those recommended by the guidelines. For example,for lung Qi deficiency and cold syndrome,drugs such as Angelicae Dahuricae Radix, Magnoliae Flos, and Schisandrae Chinensis Fructus were often used. For kidney Yang deficiency syndrome,drugs such as Atractylodis Macrocephalae Rhizoma and Ostreae Concha were often used. For spleen Qi deficiency and weakness syndrome,drugs such as Poria, Cinnamomi Ramulus, and Magnoliae Flos were used. For lung Qi deficiency and cold syndrome in children,drugs such as Chebulae Fructus, Cicadae Periostracum, Zingiberis Rhizoma, and Ginseng Radix et Rhizoma were used. For lung and spleen Qi deficiency syndrome,drugs such as Dioscoreae Rhizoma, Menthae Haplocalycis Herba, Amomi Fructus, and Zingiberis Rhizoma were used. There were also some differences in the commonly used drugs for adults and children. For example,for lung Qi deficiency and cold syndrome,adults often used Angelicae Dahuricae Radix, Magnoliae Flos, and Tribuli Fructus,while children often used Ginseng Radix et Rhizoma, Paeoniae Radix Alba, and Poria. For lung meridian hidden heat syndrome, adults often used Bupleuri Radix, Asari Radix et Rhizoma, Pinelliae Rhizoma, and Xanthii Fructus, while children often used Houttuyniae Herba, Menthae Haplocalycis Herba, Citri Reticulatae Pericarpium, and Massa Medicata Fermentata. ConclusionEffective medication regimens can be screened out based on efficacy evaluation methods,which can help supplement immediate, objective, and clinically relevant evidence of medication for the development of clinical practice guidelines in TCM from the perspective of clinical effectiveness.
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The construction of the comprehensive evaluation index system of the famous classical formula preparations after the marketing has both theoretical and practical significance. In this study, literature related to the post-marketing comprehensive evaluation of traditional Chinese medicine(TCM) compound preparations was retrieved from China National Knowledge Infrastructure(CNKI), China Science and Technology Journal Database(VIP), Wanfang Data Knowledge Service Platform(WanFang) and SinoMed from January 1, 2000 to April 30, 2022. CiteSpace 6.1.R2, a scientometrics software, was used to visualize the keywords involved, and to analyze the dynamic evolution trend and research hotspots in this field. Then, the existing comprehensive post-marketing evaluation index system of TCM compound preparations was screened and extracted, and the research status was systematically analyzed by mathematical statistics. It was found that there were problems such as the generalized boundaries between assessment dimensions and assessment elements, the lack of data sources for individual evaluation indexes, unset weight of some index system and insufficient application degree. In addition, according to the characteristics of famous classical formulas, the authors discuss the importance of evidence evaluation based on combination of disease and syndrome, pharmacovigilance of famous classical formulas preparations, and whole-process quality control of famous classical formulas, and put forward the construction strategy of comprehensive post-marketing evaluation of the famous classical formula preparations, which is oriented by clinical value, centered on evidence evaluation, and guaranteed by the whole-process quality control.
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Objective:To explore the effect of scientific research group-based model on the improvement of nursing scientific research ability in a county-level hospital.Methods:A nursing research group was established, the composition of team members and work contents of the group were clarified, tiered focused scientific research training was implemented through progressive research content and flexible training methods, and individual and progressive research guidance was provided through research counseling application forms, while literature reading activities were conducted through article reports and literature debriefings. Retrospective analysis of the nursing research practice, the number of scientific research outputs, and research capacity were applied to evaluate the effect of the nursing research group-based model.Results:Within 2 years of the establishment of the nursing research group, 37 training programs were conducted, 33 scientific research materials were pushed to the WeChat public account, 23 scientific research projects were tutored, and 6 research projects were successfully declared. The scientific research ability score of nursing staff participating in literature reading debriefing increased from 44.24±19.12 to 53.57±13.86( P<0.001). Conclusions:The application of the nursing research group-based model can improve the nursing scientific research ability of the county-level hospital.
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Objective:To evaluate the potential effects of serum lipid levels, appendicular skeletal muscle mass index (ASMI) and body mass index (BMI), together with its dynamic changes, on tumor progression in renal clear cell carcinoma patients, so as to inform body weight management.Methods:This prospective cohort study included a total of 100 patients with high-risk clear cell renal cell carcinoma. Serum lipid levels were detected, ASMI and BMI were measured using bioelectrical impedance analysis and the dynamic changes of BMI were tracked. The effects of BMI, ASMI and serum lipid levels on tumor progression within 2 years were explored.Results:Patients with normal BMI and low ASMI had 5.248 (95% CI: 1.946 to 14.153, P = 0.001) times higher risk of tumor progression than those who were overweight or obese. For every 0.1-unit increase in pre-operative HDL-C, the risk of tumor progression decreased by 0.771 (95% CI: 0.631 to 0.942, P = 0.011) times. Patients who experienced more than 5% decrease in BMI compared with baseline had 5.165 (95% CI: 1.735 to 15.370, P = 0.003) times the progression risk of patients whose BMI changed within ±5% from baseline. Conclusions:The advantage of obese clear cell carcinoma patients over normal-weight patients in tumor progression-free survival may be influenced by ASMI, pre-onset involuntary weight loss and lipid levels. Therefore, patient weight management should not merely focus on absolute BMI but tailor to individual characteristics, including cancer stage, body composition and metabolic status.
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Taohe Chengqitang is a classical prescription published in The Catalogue of Ancient Classic Recipes (The First Batch). This study systematically summarized traditional Chinese medicine (TCM) ancient books and modern clinical reports on Taohe Chengqitang and investigated its origin, composition, basis, and historical evolution in processing requirements, dosage, preparation and administration, and functions. The findings indicated different opinions on drug basis, preparation of decoction pieces, and drug dosage conversion. Based on sufficient literature review, the actual development needs of classical prescriptions, and the usage habits of modern clinical practice, this study recommended dried mature seeds of Prunus persica or P. davidiana for Persicae Semen, dried twigs of Cinnamomum cassia for Cinnamomi Ramulus, honey-fried Glycyrrhiza uralensis for Glycyrrhizae Radix et Rhizoma, raw Rheum palmatum, R. tanguticum, or R. offìcinale for Rhei Radix et Rhizoma, and mirabilite for Natrii Sulfas. In terms of drug dosage, the doses directed converted from weights and measures in the Han dynasty were large. According to the common doses in modern clinical practice, conversion was carried out based on 6 g of Cinnamomi Ramulus, 6 g of Natrii Sulfas, 6 g of Glycyrrhizae Radix et Rhizoma, and 12 g of Rhei Radix et Rhizoma. The weight of Persicae Semen should be determined according to the actual measurement. In terms of preparation and administration, the drugs in the pot were decocted with 1 400 mL of water to obtain 500 mL of decoction, which was filtered and slightly boiled in the presence of Natrii Sulfas. About 100 mL of warm decoction was taken before meals, three times a day. It was recorded in the ancient books that Taohe Chengqitang was indicated for the syndromes of heat invading the bladder and accumulating inside in the case of released exterior syndrome in Taiyang. After symptom-based flexible application by doctors, it is currently commonly used in the treatment of diabetic nephropathy, constipation, chronic renal failure, and other diseases.
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Taohe Chengqitang is a classical prescription published in The Catalogue of Ancient Classic Recipes (The First Batch). This study systematically summarized traditional Chinese medicine (TCM) ancient books and modern clinical reports on Taohe Chengqitang and investigated its origin, composition, basis, and historical evolution in processing requirements, dosage, preparation and administration, and functions. The findings indicated different opinions on drug basis, preparation of decoction pieces, and drug dosage conversion. Based on sufficient literature review, the actual development needs of classical prescriptions, and the usage habits of modern clinical practice, this study recommended dried mature seeds of Prunus persica or P. davidiana for Persicae Semen, dried twigs of Cinnamomum cassia for Cinnamomi Ramulus, honey-fried Glycyrrhiza uralensis for Glycyrrhizae Radix et Rhizoma, raw Rheum palmatum, R. tanguticum, or R. offìcinale for Rhei Radix et Rhizoma, and mirabilite for Natrii Sulfas. In terms of drug dosage, the doses directed converted from weights and measures in the Han dynasty were large. According to the common doses in modern clinical practice, conversion was carried out based on 6 g of Cinnamomi Ramulus, 6 g of Natrii Sulfas, 6 g of Glycyrrhizae Radix et Rhizoma, and 12 g of Rhei Radix et Rhizoma. The weight of Persicae Semen should be determined according to the actual measurement. In terms of preparation and administration, the drugs in the pot were decocted with 1 400 mL of water to obtain 500 mL of decoction, which was filtered and slightly boiled in the presence of Natrii Sulfas. About 100 mL of warm decoction was taken before meals, three times a day. It was recorded in the ancient books that Taohe Chengqitang was indicated for the syndromes of heat invading the bladder and accumulating inside in the case of released exterior syndrome in Taiyang. After symptom-based flexible application by doctors, it is currently commonly used in the treatment of diabetic nephropathy, constipation, chronic renal failure, and other diseases.
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A new cool-tip radiofrequency (RF) ablation therapeutic instrument based on impedance control algorithm is introduced in this paper. The equipment is composed of hardware system and software system. The RF power output and real time data acquisition are completed by the hardware system, while the software is used mainly to finish the control of the ablation range, the core of which is impedance control algorithm, and it also used to complete the display of the real time data in the course of the experiment. The impedance algorithm has solved the problem of impedance increased rapidly during the RF ablation, which has also expanded the scope of ablation. The pig liver experiments showed that the impedance control algorithm had strong adaptability. It also obtained a result of ablation range up to 3.5-4.5 cm single needle. It has the high clinical practical value of one-time inactivation of 3-5 cm tumor.