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Chinese Journal of Integrative medicine 2012年第10期18卷 723-729页

作者： claudia m.witt 黄文静 Lixing Lao Berman Bm Charit University medical Center Institute for Social MedicineEpidemiology and Health Economics University of maryland School of medicine Center for Integrative Medicine Chengdu University of Traditional Chinese medicine The Institute for Integrative Health

In clinical research on complementary and integrative medicine, experts and scientists have often pursued a research agenda in spite of an incomplete understanding of the needs of end users. Consequently, the majority of previous clinical trials have mainly assessed the efficacy of interventions. Scant data is available on their effectiveness. Comparative effectiveness research （CER） promises to support decision makers by generating evidence that compares the benefits and harms of the best care options. This evidence, more generalizable than the evidence generated by traditional randomized controlled trials （RCTs）, is better suited to inform real-world care decisions. An emphasis on CER supports the development of the evidence base for clinical and policy decision-making. Whereas in most areas of complementary and integrative medicine data on comparative effectiveness is scarce, available acupuncture research already contributes to CER evidence. This paper wil introduce CER and make suggestions for future research.

关键词： comparative effectiveness research decision making integrative medicine Chinese medicine acupuncture

我们需要什么研究来支持将结合医学运用于临床的决策?--效益比较研究可以填补其间的沟壑吗?

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中国中西医结合杂志 2013年第8期33卷 1030-1035页

作者： claudia m.witt 黄文静劳力行 Brian m.Berman 德国柏林医科大学社会医学、流行病学及卫生经济学研究所德国柏林10117 马里兰大学医学院结合医学中心美国巴尔的摩21201 成都中医药大学针灸推拿学院成都610075 结合卫生研究所美国巴尔的摩21231

在补充和结合医学临床研究中,专家和科研工作者往往片面地追求研究纲领而没有充分考虑到最终服务对象,即患者的需求。因此,以往大多数的临床研究都集中在评价治疗措施的效力,却缺乏关于其临床效果的研究数据。效益比较研究(comparative ... 详细信息

在补充和结合医学临床研究中,专家和科研工作者往往片面地追求研究纲领而没有充分考虑到最终服务对象,即患者的需求。因此,以往大多数的临床研究都集中在评价治疗措施的效力,却缺乏关于其临床效果的研究数据。效益比较研究(comparative effectivenesresearch,CER)旨在通过提供对可能的最佳治疗方案利弊的比较证据,使决策者能明智选择最佳治疗方案。这种证据,较之传统意义上的RCT研究证据更普遍,更适用于对实际医疗方案的决策。重视CER将为临床循证医学的发展及政策制定提供支持。诚然,在补充和结合医学的大多数领域中,CER的数据还很匮乏,针灸研究已为CER提供了一定的证据。笔者将重点介绍CER,并对将来的研究方向提供建议。

关键词：效益比较研究决策结合医学中医针刺

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西方国家藏医临床研究综述

中国藏学 2014年第2期 163-167页

作者： K.Philip Reuter Thorolf E.R.Weiβ huhn claudia m.witt 罗辉中国藏学研究中心藏医药研究所

本文通过全面检索各医学文献数据库中收录的以英文、德文、芬兰文或西班牙文发表的临床研究文献,对西方国家近40年来开展的医临床研究进行了系统综述。结果显示:这些研究在类型和规模、试验条件、治疗措施、结局测量指标和研究质量方面... 详细信息

本文通过全面检索各医学文献数据库中收录的以英文、德文、芬兰文或西班牙文发表的临床研究文献,对西方国家近40年来开展的医临床研究进行了系统综述。结果显示:这些研究在类型和规模、试验条件、治疗措施、结局测量指标和研究质量方面具有很大的异质性。本检索分析后认为,目前西方开展的藏医临床研究数量少,研究的方法和结果各异,今后还需要开展高质量、大样本的临床试验,进一步探索藏医药的疗效。

关键词：西方藏医药研究状况

STANDARDIZED *** ACUPUNCTURE FOR CHRONIC LOW BACK PAIN — A RANDOmIZED CONTROLLED TRIAL

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Journal of Integrative medicine 2014年第3期 224-225页

作者： Daniel Pach Xiaoli Yang-Strobel Rainer Lüdtke Lüdtke Stephanie Roll Katja Icke Benno Brinkhaus claudia m.witt Institute for Social medicine Epidemiology and Health EconomicsCharité-Universittsmedizin Berlin Karl and Veronica Carstens Foundation 3. Center for Integrative medicine University of Maryland School of Medicine

Background: Chinese medical diagnoses and treatment recommendations for specific patients with chronic low back pain vary widely across practitioners.A comparison of individualized treatment with a thoughtfully developed standardized approach is useful to determine which, if either, is ***: We aimed to compare the effectiveness of standardized and individualized acupuncture treatment in patients with chronic low back ***: We performed a single-centre randomized controlled single-blind trial in a general medical practice in Germany run by a Chinese born medical doctor trained in Western and Chinese medicine.150 outpatients with chronic low back pain were randomly allocated to two groups(78 standardized acupuncture and 72 individualized acupuncture).Patients received either standardized acupuncture or individualized *** encompassed between 10 to 15 treatments based on individual symptoms with two treatments per *** main outcome measure was the area under the curve(AUC), summarizing eight weeks of daily rated pain severity measured with a visual analogue scale(0 mm=no pain, 100 mm=worst imaginable pain).Results: No significant differences between groups were observed for the AUC(individualized acupuncture mean:1768.7 [95% CI, 1460.4; 2077.1]; standardized acupuncture 1482.9 [1177.2; 1788.7]; group difference, 285.8 [-33.9; 605.5] P=0.080).Conclusion: In this single-centre trial individualized acupuncture was not superior to standardized acupuncture for patients suffering from chronic *** a next step a multi-centre non-inferiority study should be performed to investigate whether standardized acupuncture treatment for chronic low back pain might be applicable in a broader usual care setting.

关键词： AUC STANDARDIZED VS.INDIVIDUALIZED ACUPUNCTURE FOR CHRONIC LOW BACK PAIN A RANDOmIZED CONTROLLED TRIAL

DIFFERENTIAL CEREBRAL RESPONSE TO SOmATOSENSORY STImULATION OF AN ACUPUNCTURE POINT VERSUS TWO NONACUPUNCTURE POINTS mEASURED WITH fmRI

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Journal of Integrative medicine 2014年第3期 219-219页

作者： Daniel Pach Till Nierhaus Wenjing Huang Xiangyu Long Vitaly Napadow Stephanie Roll Fanrong Liang Burkhard Pleger Arno Villringer claudia m.witt Institute for Social medicine Epidemiologyand Health EconomicsCharité-Universittsmedizin Berlin mind-Brain Institute and Berlin School of mind and Brain Charité-Universittsmedizin Berlin and Humboldt-University max Planck Institute for Human Cognitive and Brain Sciences Chengdu University of Traditional Chinese medicine Athinoula A.martinos Center for Biomedical Imaging Department of RadiologyMassachusetts General Hospital 6. Department of RadiologyLogan College of Chiropractic 7. Center for Integrative MedicineUniversity of Maryland School of Medicine

Objective: To evaluate whether different point locations chosen for a somatosensory stimulation with acupuncture needles differently change the brain activity in healthy ***: We used event-related fmRI, and resting-state functional connectivity fmRI to assess neural responses to standardized manual needle stimulation of the acupuncture point ST36(lower leg) and two control point locations(CP1 same dermatome, and CP2 different dermatome) that are not *** responses were expected to differ for stimulation in two different dermatomes(CP2 different from ST36 & CP1), or stimulation at the acupuncture point versus the control *** scans all healthy subjects(n=22) received manual needle stimulation at all 3 points in a randomized *** needle stimulation consisted of 6-minute intermittent penetrating needle manipulation on one *** sensation was measured by the massachusetts General Hospital Acupuncture Sensation Scale(mASS) and correlated with fmRI ***: The fmRI analysis found that insula and S2 activation was more pronounced with ST36 stimulation, and there was increased S2 connectivity to thalamus and brainstem following ST36 *** in needle sensation between ST36 ***1 and ST36 ***2 were statistically significant(pairwise t-test, P=0.009 and P=0.005, respectively).No correlation was found when exploring the relationship between the mASS index and the β values of the fmRI BOLD ***: Our results suggest that stimulation at acupoints may modulate somatosensory and saliency processing regions more readily.

关键词： fmRI DIFFERENTIAL CEREBRAL RESPONSE TO SOmATOSENSORY STImULATION OF AN ACUPUNCTURE POINT VERSUS TWO NONACUPUNCTURE POINTS mEASURED WITH fmRI ST

Clinical Research on Acupuncture-Concepts and Guidance on Efficacy and Effectiveness Research

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Chinese Journal of Integrative medicine 2011年第2期17卷 166-172页

作者： claudia m.witt Institute for Social medicine Epidemiology and Health EconomicsCharite University Medical Center10098 BerlinGermany

Over the last few years a number of large acupuncture trials have been carried out in western countries. The following article draws on the experience from these recent large-scale trials on acupuncture to outline the way randomized trials could be used to answer questions on efficacy, effectiveness and efficiency. It will provide guidance, firstly on the underlying concepts of both efficacy and effectiveness and secondly on designing both types of trials. In addition, the controversy over specific and non-specific effects of acupuncture, emerging from the results of the above-mentioned trials, will be highlighted. Suggestions for future clinical research on acupuncture include： greater reflection on the complex approach of Chinese medicine, and transparent and detailed reporting according to CONSORT and STRICTA guidelines. The current data on acupuncture point-specific effects do indeed have relevance, however for valid decision-making on acupuncture, further clinical trials on effectiveness and cost-effectiveness are required to provide realistic benefit estimates for future health care.

关键词： acupuncture efficacy effectiveness randomized controlled trial randomized pragmatic trial

Crystal structure evolution of complex metal aluminum hydrides upon hydrogen release

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Journal of Energy Chemistry 2020年第3期29卷 133-143页

作者： claudia Weidenthaler max-Planck-Institut für Kohlenforschung 45470 Mülheim an der RuhrGermany

Complex aluminum hydrides have been widely studied as potential hydrogen storage materials but also,for some time now, for electrochemical applications. This review summarizes the crystal structures of alkali and alkaline earth aluminum hydrides and correlates structure properties with physical and chemical properties of the hydride compounds. The crystal structures of the alkali metal aluminum hydrides change significantly during the stepwise dehydrogenation. The general pathway follows a transformation of structures built of isolated [AlH4]- tetrahedra to structures built of isolated [Al H6]3- *** crystal structure relations in the group of alkaline earth metal aluminum hydrides are much more complicated than those of the alkali metal aluminum hydrides. The structures of the alkaline earth metal aluminum hydrides consist of isolated tetrahedra but the intermediate structures exhibit chains of cornershared octahedra. The coordination numbers within the alkali metal group increase with cation sizes which goes along with an increase of the decomposition temperatures of the primary hydrides. Alkaline earth metal hydrides have higher coordination numbers but decompose at slightly lower temperatures than their alkali metal counterparts. The decomposition pathways of alkaline metal aluminum hydrides have not been studied in all cases and require future research.

关键词： Complex aluminum hydrides Hydrogen storage Crystal structure

Significance of preoperative C-reactive protein as a parameter of the perioperative course and long-term prognosis in squamous cell carcinoma and adenocarcinoma of the oesophagus

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World Journal of Gastroenterology 2006年第23期12卷 3746-3750页

作者： Ines Gockel Kathrin Dirksen claudia m messow Theodor Junginger Department of General and Abdominal Surgery Johannes Gutenberg-UniversityMainzGermany Institute of Biostatistics and Documentation Johannes Gutenberg-UniversityMainzGermany

AIm： C-reactive protein （CRP） is an acute-phase reactant and a known indicator of the malignant potential of the tumour. The aim of this study was to investigate the significance of preoperative CRP as a parameter of the perioperative course and long-term prognosis in patients with squamous cell carcinoma and aclenocarcinoma of the oesophagus. mETHODS： Serum CRP was determined preoperatively in 291 of 371 patients undergoing oesophagectomy for cancer from December 1989 to march 2004. median patient age was 59 （28-79） year, 82.5% of patients were males. Squamous cell carcinoma was diagnosed in 151 （51.9%） and aclenocarcinoma in 122 patients. Transhiatal oesophagectomy was clone in 151 （51.9%） patients and 134 （46.0%） patients underwent the abclominothoracic procedure. RESULTS： In 127 （43.6%） patients the preoperative serum CRP concentration was within the normal range （〈 5 mg/clL）, elevated CRP levels were measured in 164 （56.4%） patients. Tumour extension （P 〈 0.0005） and the number of lymph nodes affected by metastatic spread （P = 0.015） were significantly increased in the group with elevated CRP levels. Among the perioperative parameters both the number of blood transfusions （P = 0.006） and the general complication rate （P = 0.002） were higher in patients with elevated preoperative CRP levels. The long-term survival rate of 13.6 （0-109.8） mo was poorer in the group with elevated CRP levels compared to 18.9 （0-155.4） mo in the group with normal CRP levels （log-rank test： P = 0.107）. multivariateanalysis with backward variables selection identified preoperative CRP as an independent prognostic factor of the long-term prognosis in patients with oesophageal carcinoma, with a hazard ratio of 1.182 （95% confidence interval： 1.030-1.356）. CONCLUSION： The preoperative serum CRP-level is an easily determined independent prognostic marker in patients with squamous cell carcinoma and adenocarcinoma of the oesophagus.

关键词： Preoperative C-reactive protein Perioperativecourse Long-term prognosis Squamous cell carcinoma Aclenocarcinoma Oesophagus

Seroconversion of HBsAG coincides with hepatitis A superinfection: A case report

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World Journal of Clinical Cases 2020年第9期8卷 1651-1655页

作者： claudia Beisel marylyn m Addo Julian Schulze zur Wiesch Department of Internal medicine Division of Infectious DiseaseUniversity Medical Center Hamburg-EppendorfHamburg 20251Germany German Center for Infection Research Hamburg 20251Germany

BACKGROUND Hepatitis B virus(HBV)is a hepatotropic virus that can cause acute and chronic liver *** to the world health organization 257 million people are infected with chronic HBV infection ***-infection with other hepadnaviruses,including hepatitis A virus(HAV),hepatitis C virus,hepatitis D virus,and hepatitis E virus is associated with increased risk of acute liver failure in patients with chronic *** SUmmARY Here,we report a case of a 47-year old male patient with HBV-related compensated Child A cirrhosis,who presented with general fatigue,malaise and laboratory signs of acute *** the patient was regularly seen at a specialized university liver unit,the HAV vaccination status was *** HAV super-infection was diagnosed by positive serological and polymerase chain reaction *** acute HAV super-infection,spontaneous HBsAg elimination and development of an anti-HBs titer were *** This case illustrates the importance of carefully checking the vaccination *** our patient,unspecific immunological responses to HAV led to functional cure of HBV.

关键词： Chronic hepatitis B infection Liver cirrhosis Acute hepatitis A infection HBsAg clearance Functional cure Case report

Barriers and Facilitators in Interorganizational Disaster Response: Identifying Examples Across Europe

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International Journal of Disaster Risk Science 2020年第1期11卷 46-58页

作者： claudia Berchtold maike Vollmer Philip Sendrowski Florian Neisser Larissa müller Sonja Grigoleit Department for Technology Analysis and Strategic Planning(TASP) Fraunhofer Institute for Technological Trend Analysis53879 EuskirchenGermany

Disaster response actors are facing new challenges, which encompass not only new and ever more complex threats but also the need to collaborate across organizational boundaries and even state *** on scale, these interactions have to work across governance setups, political and legal conditions, organizational cultures, as well as personal preferences and experiences that vary among actors, organizations, and countries. But which concrete measures are taken by crisis management actors at different scales to bridge these challenges and which of these could serve others as example to address comparable challenges in their contexts? This study made attempts to analyze whether certain solutions across organizations and states exist that facilitate effective interorganizational crisis management in the member states of the European Union(EU). It is based on selected expert interviews with representatives of different types of disaster response organizations(health services,police services, fire services, and other crisis management organizations) from seven EU member states(Germany,Netherlands, United Kingdom, Ireland, Italy, Austria, and Greece).

关键词： Disaster response European union Interorganizational crisis management Transboundary cooperation