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Application of Grading of Recommendations Assessment, Development, and Evaluation (GRADE) to the guidelinedevelopment for clinical practice with acupuncture and moxibustion

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《医学前沿（英文）》 2017年 第11卷 第4期   页码 590-594 doi: 10.1007/s11684-017-0537-4

摘要：

Grading of Recommendations Assessment, Development, and Evaluation (GRADE) offers a worldwide approach to guideline development for clinical practice. For the clinical practice of acupuncture therapy, 18 evidence-based guidelines have been developed in China using GRADE. In this study, we review the advantages and limitations of the GRADE approach in the guideline development for acupuncture and moxibustion and propose some solutions to these limitations. Scientific advantages of rating the quality of evidence, outcome-centric direction, overall progression to develop recommendations, and strength of recommendations providing specific clinical guidance are the advantages of GRADE. The limitations of GRADE in the development of guidelines for acupuncture and moxibustion include rating the quality of evidence for ancient literature and literature on famous traditional Chinese medicine experts’ experiences and specific guidelines for formulating recommendations from evidence. In the guideline development for clinical practice with acupuncture and moxibustion, we suggest that a specific method should be explored based on the GRADE approach and the characteristics of acupuncture therapy.

关键词： guideline     acupuncture     GRADE    

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Clinical research of traditional Chinese medicine in big data era

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《医学前沿（英文）》 2014年 第8卷 第3期   页码 321-327 doi: 10.1007/s11684-014-0370-y

摘要：

With the advent of big data era, our thinking, technology and methodology are being transformed. Data-intensive scientific discovery based on big data, named “The Fourth Paradigm,” has become a new paradigm of scientific research. Along with the development and application of the Internet information technology in the field of healthcare, individual health records, clinical data of diagnosis and treatment, and genomic data have been accumulated dramatically, which generates big data in medical field for clinical research and assessment. With the support of big data, the defects and weakness may be overcome in the methodology of the conventional clinical evaluation based on sampling. Our research target shifts from the “causality inference” to “correlativity analysis.” This not only facilitates the evaluation of individualized treatment, disease prediction, prevention and prognosis, but also is suitable for the practice of preventive healthcare and symptom pattern differentiation for treatment in terms of traditional Chinese medicine (TCM), and for the post-marketing evaluation of Chinese patent medicines. To conduct clinical studies involved in big data in TCM domain, top level design is needed and should be performed orderly. The fundamental construction and innovation studies should be strengthened in the sections of data platform creation, data analysis technology and big-data professionals fostering and training.

关键词： big data     traditional Chinese medicine     clinical evaluation     evidence based medicine    

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Reevaluation of the effect of Dianxianning on seizure rate of refractory epilepsy as additive treatment in clinical

Liyun He, Tiancai Wen, Shiyan Yan, Runjin Li, Zufa Liu, Hui Ren, Jinmin Liu, Fengshan Zhang, Jianzhong Wu, Jian Liu

《医学前沿（英文）》 2011年 第5卷 第2期   页码 229-234 doi: 10.1007/s11684-011-0139-5

摘要： We observed the effect of Dianxianning, which was used as additive treatment to treat 206 epilepsy patients, on the epilepsy seizure rate. Based on a multicenter, prospective, randomized, and controlled clinical trial design, we used the seizure rate of epilepsy as the main index. For the treatment group comprising 137 patients, we combined Dianxianning with chemical medicine, which is the basic treatment. For the control group with 69 patients, we added placebo. The results showed that 1) Effect on seizure rate: After a three-month treatment, the seizure rate of the treatment group decreased by 37.84% on average, whereas that of the control group decreased by 13.18% on average. Statistically comparing the two groups, there was a significant difference between these groups ( <0.05). 2) Effect on seizure frequency: As time passed, the frequency in each group gradually decreased. After a three-month treatment, there was a significant difference between the two groups ( <0.05). 3) Comparison between the before and after treatment of each group: There was a very significant difference between the two groups ( <0.0001). The results indicated that, as an additive treatment, Dianxianning has a good effect on controlling the epilepsy seizure rate and frequency management. It is more effective than using chemical medicine alone.

关键词： Dianxianning     epilepsy seizure     evaluation    

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新冠病毒疫苗的下一步效力评价

江湖大川, 张力, 李靖欣,朱凤才

《工程（英文）》 2021年 第7卷 第7期   页码 903-907 doi: 10.1016/j.eng.2021.04.013

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整合药学发展的战略思考

张勇,赵一秀,杨宝峰

《中国工程科学》 2021年 第23卷 第1期   页码 185-192 doi: 10.15302/J-SSCAE-2021.01.022

摘要：

整合药学是以现代药学为基础、随着人类对复杂性疾病认识的日益深刻而提出来的，涉及新药研发、传统医药创新、 临床药学实践、药学学科建设及人才培养等诸多领域。为推进我国整合药学实践的发展，本文运用文献研究、学术交流、专 家咨询等方法，阐明了整合药学理念及内涵，提出了整合药学的未来发展战略。研究指出，要促进现代药学与传统药学的整 合，应建立健全整合用药临床实践指南、鼓励基于整合思维的创新中药研究、规范整合中西药临床应用；推进基于整合药学 的新药研发，应创新整合药物设计思路、开发适应整合药学的药物评价体系、加快建设整合药物的新药研发体系；推进整合 药学的临床实践，应进一步完善以患者为中心的临床用药指导、实现个体化治疗、丰富整合药学临床实践内容、加强整合药 物合理应用；推进整合药学学科建设，应丰富基于整合药学的药学本科理论和实践课程、加强教育培训及专业间协作。整合 药学是现代药学理论和实践的变革与发展，融合药学各相关学科的理论与实践，是构建促进人类健康、完善医疗体系的新型 药学理论和实践体系。

关键词： 整合药学，整合药物，新药研发，药物评价，临床用药指导    

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Clinical evaluation of recombinant human growth hormone injection in children with growth hormone deficiency

Ling HOU, Xiaoping LUO, Minlian DU, Huamei MA, Chunxiu GONG, Yuchuan LI, Shuixian SHEN, Zhuhui ZHAO, Li LIANG, Guanping DONG, Chaoying YAN, Hongwei DU

《医学前沿（英文）》 2009年 第3卷 第2期   页码 171-176 doi: 10.1007/s11684-009-0027-4

摘要： Recombinant human growth hormone (rhGH) has been widely used in the clinical treatment of growth hormone deficiency. To simplify the injection process and increase drug compliance, application of the GH injection has become a new treatment plan in recent years. The purpose of the current study was to evaluate the efficacy and safety of rhGH injection for the treatment of growth hormone deficiency (GHD) in children in China. In a nationwide, noncomparative, prospective, randomized, open trial, 31 children with confirmed complete GHD received subcutaneous injection of rhGH at 0.25 mg/kg·wk (0.107 IU/kg·d). The injection was given daily and the total weekly amount was separated into 6-7 injections. The patients were followed up at 3-month intervals and the treatment duration was 12 months. The height (HT), annual growth velocity (GV), mean height standard deviation score (HT SDS), blood serum insulin-like growth factor I (IGF-I), insulin-like growth factor binding protein 3 (IGFBP-3), and bone maturity before and after treatment were compared, and the safety of the treatment was analyzed. The mean HT, GV, and HT SDS were increased from 109.0±14 cm, 2.7±0.9 cm/yr, and -4.62±1.46 at baseline to 121.8±13.4 cm, 12.9±3.3 cm/yr, and -2.47±1.86 after 12 months of treatment, respectively ( <0.001). At the same time, blood IGF-I and IGFBP-3 were increased significantly [41.27±64.43 μg/L 159.21±167.92 μg/L and 1540.00±1325.11 mg/L 3533.93±1413.82 mg/L, respectively ( <0.001)]. The bone age assessments performed 6 and 12 months after the treatment showed that no advanced bone maturation was noted. No serious adverse events occurred during the treatment, and the drug-related adverse events were mainly decreased thyroid function. We conclude that rhGH injection is a safe and effective drug for treatment of growth hormone deficiency in children.

关键词： recombinant human growth hormone     injection     growth hormone deficiency    

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Ontological reconstruction of the clinical terminology of traditional Chinese medicine

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《医学前沿（英文）》 2014年 第8卷 第3期   页码 358-361 doi: 10.1007/s11684-014-0348-9

摘要：

This study proposes the ontological reconstruction of the current clinical terminology of traditional Chinese medicine (TCM). It also provides an overview of preliminary work related to the said reconstruction, including the ontology-based analysis of TCM clinical terminology. We conclude that the ontological reconstruction of TCM clinical terminology provides a proper translation from the idealized organizational model to real-world implementation and to a formalized, shared, and knowledge-based framework.

关键词： ontology     traditional Chinese medicine     clinical terminology    

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The clinical impact of tricuspid regurgitation in patients with a biatrial orthotopic heart transplant

《医学前沿（英文）》 2023年 第17卷 第3期   页码 527-533 doi: 10.1007/s11684-022-0967-5

摘要： In this study, we aim to elucidate the clinical impact and long-term course of tricuspid regurgitation (TR), taking into account its dynamic nature, after biatrial orthotopic heart transplant (OHT). All consecutive adult patients undergoing biatrial OHT (1984−2017) with an available follow-up echocardiogram were included. Mixed-models were used to model the evolution of TR. The mixed-model was inserted into a Cox model in order to address the association of the dynamic TR with mortality. In total, 572 patients were included (median age: 50 years, males: 74.9%). Approximately 32% of patients had moderate-to-severe TR immediately after surgery. However, this declined to 11% on 5 years and 9% on 10 years after surgery, adjusted for survival bias. Pre-implant mechanical support was associated with less TR during follow-up, whereas concurrent LV dysfunction was significantly associated with more TR during follow-up. Survival at 1, 5, 10, 20 years was 97% ± 1%, 88% ± 1%, 66% ± 2% and 23% ± 2%, respectively. The presence of moderate-to-severe TR during follow-up was associated with higher mortality (HR: 1.07, 95% CI (1.02–1.12), p = 0.006). The course of TR was positively correlated with the course of creatinine (R = 0.45). TR during follow-up is significantly associated with higher mortality and worse renal function. Nevertheless, probability of TR is the highest immediately after OHT and decreases thereafter. Therefore, it may be reasonable to refrain from surgical intervention for TR during earlier phase after OHT.

关键词： orthotopic heart transplant     tricuspid regurgitation     clinical impact     biatrial heart transplantation    

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Obesity-related glomerulopathy: pathogenesis, pathologic, clinical characteristics and treatment

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《医学前沿（英文）》 2017年 第11卷 第3期   页码 340-348 doi: 10.1007/s11684-017-0570-3

摘要：

In light of the rapid increase in the number of obesity incidences worldwide, obesity has become an independent risk factor for chronic kidney disease. Obesity-related glomerulopathy (ORG) is characterized by glomerulomegaly in the presence or absence of focal and segmental glomerulosclerosis lesions. IgM and complement 3 (C3) nonspecifically deposit in lesions without immune-complex-type deposits during ORG immunofluorescence. ORG-associated glomerulomegaly and focal and segmental glomerulosclerosis can superimpose on other renal pathologies. The mechanisms under ORG are complex, especially hemodynamic changes, inflammation, oxidative stress, apoptosis, and reduced functioning nephrons. These mechanisms synergize with obesity to induce end-stage renal disease. A slow increase of subnephrotic proteinuria (<3.5 g/d) is the most common clinical manifestation of ORG. Several treatment methods for ORG have been developed. Of these methods, renin–angiotensin–aldosterone system blockade and weight loss are proven effective. Targeting mitochondria may offer a novel strategy for ORG therapy. Nevertheless, more research is needed to further understand ORG.

关键词： obesity-related glomerulopathy     pathogenesis     pathologic     clinical characteristics    

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Coronavirus disease 2019 (COVID-19): a clinical update

Min Zhou, Xinxin Zhang, Jieming Qu

《医学前沿（英文）》 2020年 第14卷 第2期   页码 126-135 doi: 10.1007/s11684-020-0767-8

摘要： Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has posed a significant threat to global health. It caused a total of 80 868 confirmed cases and 3101 deaths in Chinese mainland until March 8, 2020. This novel virus spread mainly through respiratory droplets and close contact. As disease progressed, a series of complications tend to develop, especially in critically ill patients. Pathological findings showed representative features of acute respiratory distress syndrome and involvement of multiple organs. Apart from supportive care, no specific treatment has been established for COVID-19. The efficacy of some promising antivirals, convalescent plasma transfusion, and tocilizumab needs to be investigated by ongoing clinical trials.

关键词： coronavirus disease 2019     epidemiology     pathology     radiology     clinical characteristics     treatment    

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Hypertension in patients with CKD in China: clinical characteristics and management

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《医学前沿（英文）》 2017年 第11卷 第3期   页码 307-309 doi: 10.1007/s11684-017-0578-8

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Bone metastasis of hepatocellular carcinoma: facts and hopes from clinical and translational perspectives

《医学前沿（英文）》 2022年 第16卷 第4期   页码 551-573 doi: 10.1007/s11684-022-0928-z

摘要： Patients with hepatocellular carcinoma (HCC) and bone metastasis (BM) suffer from greatly reduced life quality and a dismal prognosis. However, BM in HCC has long been overlooked possibly due to its relatively low prevalence in previous decades. To date, no consensus or guidelines have been reached or formulated for the prevention and management of HCC BM. Our narrative review manifests the increasing incidence of HCC BM to sound the alarm for additional attention. The risk factors, diagnosis, prognosis, and therapeutic approaches of HCC BM are detailed to provide a panoramic view of this disease to clinicians and specialists. We further delineate an informative cancer bone metastatic cascade based on evidence from recent studies and point out the main factors responsible for the tumor-associated disruption of bone homeostasis and the formation of skeletal cancer lesions. We also present the advances in the pathological and molecular mechanisms of HCC BM to shed light on translational opportunities. Dilemmas and challenges in the treatment and investigation of HCC BM are outlined and discussed to encourage further endeavors in the exploration of underlying pathogenic and molecular mechanisms, as well as the development of novel effective therapies for HCC patients with BM.

关键词： HCC     bone     osteotropism     clinical     basic researches     advances    

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Heterogeneity of the tumor immune microenvironment and clinical interventions

《医学前沿（英文）》 2023年 第17卷 第4期   页码 617-648 doi: 10.1007/s11684-023-1015-9

摘要： Heterogeneity of the tumor immune microenvironment and clinical interventions

关键词： Heterogeneity tumor immune    

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Pathogen evolution, prevention/control strategy and clinical features of COVID-19: experiences from China

《医学前沿（英文）》 doi: 10.1007/s11684-023-1043-5

摘要： Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was reported at the end of 2019 as a worldwide health concern causing a pandemic of unusual viral pneumonia and many other organ damages, which was defined by the World Health Organization as coronavirus disease 2019 (COVID-19). The pandemic is considered a significant threat to global public health till now. In this review, we have summarized the lessons learnt during the emergence and spread of SARS-CoV-2, including its prototype and variants. The overall clinical features of variants of concern (VOC), heterogeneity in the clinical manifestations, radiology and pathology of COVID-19 patients are also discussed, along with advances in therapeutic agents.

关键词： coronavirus disease 2019     SARS-CoV-2     epidemiology     clinical features    

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Genetic and clinical markers for predicting treatment responsiveness in rheumatoid arthritis

Xin Wu, Xiaobao Sheng, Rong Sheng, Hongjuan Lu, Huji Xu

《医学前沿（英文）》 2019年 第13卷 第4期   页码 411-419 doi: 10.1007/s11684-018-0659-3

摘要： Although many drugs and therapeutic strategies have been developed for rheumatoid arthritis (RA) treatment, numerous patients with RA fail to respond to currently available agents. In this review, we provide an overview of the complexity of this autoimmune disease by showing the rapidly increasing number of genes associated with RA. We then systematically review various factors that have a predictive value (predictors) for the response to different drugs in RA treatment, especially recent advances. These predictors include but are certainly not limited to genetic variations, clinical factors, and demographic factors. However, no clinical application is currently available. This review also describes the challenges in treating patients with RA and the need for personalized medicine. At the end of this review, we discuss possible strategies to enhance the prediction of drug responsiveness in patients with RA.

关键词： rheumatoid arthritis     gene     clinical markers     therapy    

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标题 作者 时间 类型 操作

Application of Grading of Recommendations Assessment, Development, and Evaluation (GRADE) to the guidelinedevelopment for clinical practice with acupuncture and moxibustion

null

期刊论文

Clinical research of traditional Chinese medicine in big data era

null

期刊论文

Reevaluation of the effect of Dianxianning on seizure rate of refractory epilepsy as additive treatment in clinical

Liyun He, Tiancai Wen, Shiyan Yan, Runjin Li, Zufa Liu, Hui Ren, Jinmin Liu, Fengshan Zhang, Jianzhong Wu, Jian Liu

期刊论文

新冠病毒疫苗的下一步效力评价

江湖大川, 张力, 李靖欣,朱凤才

期刊论文

整合药学发展的战略思考

张勇,赵一秀,杨宝峰

期刊论文

Clinical evaluation of recombinant human growth hormone injection in children with growth hormone deficiency

Ling HOU, Xiaoping LUO, Minlian DU, Huamei MA, Chunxiu GONG, Yuchuan LI, Shuixian SHEN, Zhuhui ZHAO, Li LIANG, Guanping DONG, Chaoying YAN, Hongwei DU

期刊论文

Ontological reconstruction of the clinical terminology of traditional Chinese medicine

null

期刊论文

The clinical impact of tricuspid regurgitation in patients with a biatrial orthotopic heart transplant

期刊论文

Obesity-related glomerulopathy: pathogenesis, pathologic, clinical characteristics and treatment

null

期刊论文

Coronavirus disease 2019 (COVID-19): a clinical update

Min Zhou, Xinxin Zhang, Jieming Qu

期刊论文

Hypertension in patients with CKD in China: clinical characteristics and management

null

期刊论文

Bone metastasis of hepatocellular carcinoma: facts and hopes from clinical and translational perspectives

期刊论文

Heterogeneity of the tumor immune microenvironment and clinical interventions

期刊论文

Pathogen evolution, prevention/control strategy and clinical features of COVID-19: experiences from China

期刊论文

Genetic and clinical markers for predicting treatment responsiveness in rheumatoid arthritis

Xin Wu, Xiaobao Sheng, Rong Sheng, Hongjuan Lu, Huji Xu

期刊论文