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ObjectiveTo explore the current status and issues regarding the application of ancient books in clinical practice guidelines and expert consensus of traditional Chinese medicine (TCM) published in China, and to provide methodological recommendations for the incorporation of ancient books in the development of TCM guidelines. MethodsWe searched China National Knowledge Infrastructure (CNKI), WanFang Data, VIP, SinoMed, PubMed, Embase, as well as six industry websites including China Association of Chinese Medicine, National Group Standards Information Platform, and Chinese Association of the Integration of Traditional and Western Medicine,etc. TCM clinical practice guidelines or expert consensus issued during January 1st, 2017, to November 26th, 2022 were searched. Clinical practice guidelines or expert consensus that explicitly referred to ancient books were included, and the content regarding the searching for ancient books, sources of access to ancient books, methods of evaluating the level of evidence, methods of evaluating the level of recommendation, and methods of evaluating the evidence for the ancient books were analysed. ResultsA total of 1,215 TCM clinical practice guidelines or expert consensus were retrieved, with 442 articles explicitly mentioning the application of ancient books, including 300 (67.87%) clinical practice guidelines and 142 (32.13%) expert consensus. Sixty of the 442 publications explicitly reported that ancient books searching had been conducted (13.57%); among these 60 publications 27 (45.00%) explicitly reported ancient books searching strategies, and the most frequent method was manual searching with a total of 24 articles (40.00%). The most popular search source was Chinese Medical Dictionary, a TCM classics database, with a total of 18 articles. 197 articles (44.57%) explicitly reported the evaluation criteria for the level of evidence, of which 141 articles (71.57%) involved the evaluation criteria for the ancient books; 413 articles (93.44%) mentioned ancient books in the recommendations, and only the source of formula name was mentioned in 409 (99.03%) of the publications. ConclusionThe current application of ancient books in TCM clinical practice guidelines and expert consensus is limited, with issues of non-standard searching and evaluation methods. Standar-dization and uniformity are needed in evidence grading and recommendation standards. Future research should clarify the scope and methods of applying ancient book, emphasize their integration with modern research evidence, and enhance their value and quality in the development of TCM clinical practice guidelines.
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Objective To investigate the"Precision Treatment for Oncology"course,which is offered by Peking Union Medical College.The course is aiming for collecting students'opinions and suggestions to optimize the course setting and improve the teaching quality.Methods This investigation collected data by questionnaire survey and in-terviewing from Dec.2021 to Feb.2022.The questionnaire data and interview data were analysed.Results Thirty-six quantitative questionnaires and five qualitative questionnaires were included.Improving professional knowledge and personal interests were two main reasons for students to choose courses,which existed statistical differences on different aspects of course evaluation.The overall score evaluated by medical students was 9.22 and 94.4%of the students thought the course achieved the desired goal.The scores of teachers'teaching attitude,frontier and practi-cality of course content were 9.81,9.08 and 8.86 points respectively.The students hoped to increase the case analysis practice and thematic discussion activities to enrich the teaching form.Conclusions This elective course for graduate is recognized and accepted by students.More efforts are needed in future to optimize curriculum set-tings,innovate teaching methods,improve teaching quality and explore new pathways for medical graduate educa-tion matching the needs of students.
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Objective To explore the advantages and disadvantages of laparoscopic combined with colonoscopic surgery (double endoscope surgery) and open surgery in the treatment of special types of colorectal polyps. Methods The clinical data of 62 patients with special types of colorectal polyps (wide base sessile, special parts or suspected cancerous, endoscopic resection difficult or high risk) were retrospectively analyzed. Among them, 42 patients underwent double endoscope surgery (double endoscope group), and 20 patients underwent open surgery (open group). The operating time, amount of bleeding during operation, postoperative exhaust time, postoperative hospital stay and complication rate were compared between 2 groups. Results All the patients had successful resection of the polyps, and there were no operative deaths. There was no conversion to open surgery in double endoscope group. Two patients in the open group were unable to locate the lesion by the tactile sensation of the hand and then succeeded in locating by intraoperative colonoscopy. The operating time, amount of bleeding during operation, postoperative exhaust time, postoperative hospital stay and complication rate in double endoscope group were significantly lower than those in open group: (60.5 ± 25.4) min vs. (75.8 ± 20.6) min, (30.5 ± 15.8) ml vs. (55.2 ± 24.6) ml, (24.6 ± 10.5) h vs. (40.5 ± 16.8) h, (3.2 ± 1.0) d vs. (5.8 ± 2.2) d and 0 vs. 20% (4/20), and there were statistical differences (P<0.05). There was 1 case with early postoperative inflammatory bowel obstruction, 1 case with abdominal infection and 2 cases with incision infection in open group. There was no operative death in the two groups, and these patients were cured by conservative treatment. The follow-up time was 3-36 (18.6 ± 12.3) months, and all the patients survived. The patients in 2 groups had no recurrence and metastasis, no anastomotic stenosis, anastomotic leakage and other complications. Conclusions For the special types of colorectal polyps, double endoscope surgery is less invasive, with faster recovery and less complications. It is the first choice except for endoscopic resection.
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Objective To investigate the familial incidence of multiple primary carcinoma in Chinese hereditary nonpolyposis colorectal cancer patients (HNPCC) in Northeast China.Methods By family line investigation,multiple primary carcinoma (MPC) spectrum' s characteristics of 509 patients in 85 families registered in strict conformity with the HNPCC Amsterdam criteria Ⅱ were analyzed retrospectively.Results Of the 85 HNPCC families,multiple primary carcinoma developed in 55 patients in 25 families,among them 45 patients had metachronous carcinoma in 17 families,16 patients had synchronous carcinoma occurred in 12 families,6 patients with both synchronous carcinoma and metachronous carcinoma in 4 families.Conclusions Multiple primary carcinoma developed in significantly high incidence in Northeast China in Chinese hereditary nonpolyposis colorectal cancer patients,the most common MPC are colorectal cancer and endometrial cancer.