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Research on the development methodology for clinical practice guidelines for organic integration of traditional Chinese medicine and Western medicine

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Military Medical Research 2024年第3期11卷 313-322页

作者： Ying-Hui Jin Yan-Ping Wang Ying-Lan Xie Gui-Hua Tian Xiao-Yu Zhang Nan-Nan Shi Ke-Hu Yang Xin Sun Yao-Long Chen Da-Rong Wu Xin-Feng Guo Long Ge Chen Zhao Cheng Lu Yin Jiang Jing Guo Si-Yu Yan Yong-Bo Wang Qiao Huang xiang-Ying Ren Ying-Yue Rao Yun-Yun Wang Meng-Qian Yuan xian-tao zeng Hong-Cai Shang Center for Evidence-Based and Translational Medicine Zhongnan Hospital of Wuhan UniversityWuhan 430071China Institute of Basic Research in Clinical Medicine China Academy of Chinese Medical SciencesBeijing 100700China China Center for Evidence Based Traditional Chinese Medicine Beijing 100029China Hubei Provincial Hospital of Traditional Chinese Medicine Wuhan 430074China Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing Dongzhimen HospitalBeijing University of Chinese MedicineBeijing 100700China Evidence-Based Medicine Center School of Basic Medical SciencesLanzhou UniversityLanzhou 730000China China Center for Evidence-Based Medicine West China Hospital of Sichuan UniversityChengdu 610041China State Key Laboratory of Dampness Syndrome of Chinese Medicine the Second Affliated Hospital of Guangzhou University of Chinese MedicineGuangzhou 510120China Evidence-based Medicine Team Guangdong Provincial Hospital of Traditional Chinese MedicineGuangzhou 510120China Nanjing University of Chinese Medicine Nanjing 210023China Jiangsu Province Hospital of Chinese Medicine Nanjing 210029China

Integrated traditional Chinese medicine(TCM)and Western medicine(WM)is a new medical science grounded in the knowledge bases of both TCM and WM,which then forms a unique modern medical system in *** TCM and WM has a long history in China,and has made important achievements in the process of clinical diagnosis and ***,the methodological defects in currently published clinical practice guidelines(CPGs)limit its *** organic integration of TCM and WM is a deeper integration of TCM and *** realize the progression of"integration"to"organic integration",a targeted and standardized guideline development methodology is ***,the purpose of this study is to establish a standardized development procedure for clinical practice guidelines for the organic integration of TCM and WM to promote the systematic integration of TCM and WM research results into clinical practice guidelines in order to achieve optimal results as the whole is greater than the sum of the parts.

关键词： Methodology Traditional Chinese medicine Western medicine Organic integration Clinical practice guidelines(CPGs)

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Development of rapid advice guideline and standard and continuous updating guideline:experiences and practice

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Military Medical Research 2021年第4期8卷 581-583页

作者： Ying-Hui Jin Xiao-Mei Yao xian-tao zeng Center for Evidence-Based and Translational Medicine ZhongnanHospital of Wuhan UniversityWuhan 430071China. Department ofHealth Research Evidence and ImpactMcMaster UniversityHamiltonOntario L8S 4L8Canada. Department of Urology Zhongnan Hospitalof Wuhan University169 Donghu RoadWuchang DistrictWuhan430071China.

We published rapid advice guidelines and updated guidelines for coronavirus disease 2019(COVID-19)management on February 6,2020,and September 4,2020,*** two guidelines vary widely in their developmental background,type of evidence,grade of recommendation and so *** shared our experience for the development of these two guidelines to help clinical practitioners better understand and implement guidelines and to help guideline developers facilitate communication and discussion for guideline development during the pandemic.

关键词： Coronavirus disease 2019 Severe acute respiratory syndrome coronavirus 2 Rapid advice guideline Clinical practice guideline Evidence-based medicine

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Methodological quality(risk of bias) assessment tools for primary and secondary medical studies: What are they and which is better?

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Military Medical Research 2020年第3期7卷 359-370页

作者： Lin-Lu Ma Yun-Yun Wang Zhi-Hua Yang Di Huang Hong Weng xian-tao zeng Center for Evidence-Based and Translational Medicine Zhongnan HospitalWuhan University169 Donghu RoadWuchang DistrictWuhan 430071HubeiChina Department of Evidence-Based Medicine and Clinical Epidemiology the Second Clinical CollegeWuhan UniversityWuhan 430071China Center for Evidence-Based and Translational Medicine Wuhan UniversityWuhan 430071China Global Health Institute Wuhan UniversityWuhan 430072China

Methodological quality(risk of bias)assessment is an important step before study initiation ***,accurately judging study type is the first priority,and the choosing proper tool is also *** this review,we introduced methodological quality assessment tools for randomized controlled trial(including individual and cluster),animal study,non-randomized interventional studies(including follow-up study,controlled before-and-after study,before-after/pre-post study,uncontrolled longitudinal study,interrupted time series study),cohort study,case-control study,cross-sectional study(including analytical and descriptive),observational case series and case reports,comparative effectiveness research,diagnostic study,health economic evaluation,prediction study(including predictor finding study,prediction model impact study,prognostic prediction model study),qualitative study,outcome measurement instruments(including patient-reported outcome measure development,content validity,structural validity,internal consistency,cross-cultural validity/measurement invariance,reliability,measurement error,criterion validity,hypotheses testing for construct validity,and responsiveness),systematic review and meta-analysis,and clinical practice *** readers of our review can distinguish the types of medical studies and choose appropriate *** one word,comprehensively mastering relevant knowledge and implementing more practices are basic requirements for correctly assessing the methodological quality.

关键词： Methodological quality Risk of bias Quality assessment Critical appraisal Methodology checklist Appraisal tool Observational study Qualitative study Interventional study Outcome measurement instrument

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Meta-analysis with zero-event studies:a comparative study with application to COVID-19 data

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Military Medical Research 2022年第1期9卷 126-137页

作者： Jia-Jin Wei En-Xuan Lin Jian-Dong Shi Ke Yang Zong-Liang Hu xian-tao zeng Tie-Jun Tong department of Mathematics Hong Kong Baptist UniversityHong KongChina Shenzhen Research Institute of Big Data ShenzhenChina College of Mathematics and Statistics Shenzhen UniversityShenzhenChina Center for Evidence-Based and Translational Medicine Zhongnan Hospital of Wuhan UniversityWuhanChina.

Background:Meta-analysis is a statistical method to synthesize evidence from a number of independent studies,including those from clinical studies with binary *** practice,when there are zero events in one or both groups,it may cause statistical problems in the subsequent ***:In this paper,by considering the relative risk as the effect size,we conduct a comparative study that consists of four continuity correction methods and another state-of-the-art method without the continuity correction,namely the generalized linear mixed models(GLMMs).To further advance the literature,we also introduce a new method of the continuity correction for estimating the relative ***:From the simulation studies,the new method performs well in terms of mean squared error when there are few *** contrast,the generalized linear mixed model performs the best when the number of studies is *** addition,by reanalyzing recent coronavirus disease 2019(COVID-19)data,it is evident that the double-zero-event studies impact the estimate of the mean effect ***:We recommend the new method to handle the zero-event studies when there are few studies in a meta-analysis,or instead use the GLMM when the number of studies is *** double-zero-event studies may be informative,and so we suggest not excluding them.

关键词： Continuity correction Coronavirus disease 2019 data Meta-analysis Relative risk Zero-event studies

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Oral microbiota in the oral-genitourinary axis:identifying periodontitis as a potential risk of genitourinary cancers

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Military Medical Research 2021年第4期8卷 564-578页

作者： Shuai Yuan Cheng Fang Wei-Dong Leng Lan Wu Bing-Hui Li Xing-Huan Wang Hailiang Hu xian-tao zeng Center for Evidence-Based and Translational Medicine Zhongnan Hospital of Wuhan UniversityWuhan 430071China. Department of Stomatology Taihe HospitalHubei University of MedicineShiyan 442000China. Department of Stomatology Zhongnan Hospital of Wuhan UniversityWuhan 430071China. Department of Urology Zhongnan Hospital of Wuhan UniversityWuhan 430071China. Department of Pathology Duke University School of MedicineDurhamNC 27710USA. School of Medicine Southern University of Science and TechnologyShenzhen 518055GuangdongChina.

Periodontitis has been proposed as a novel risk factor of genitourinary cancers:although periodontitis and genitourinary cancers are two totally distinct types of disorders,epidemiological and clinical studies,have established associations between *** of oral microbiota has already been established as a major factor contributing to *** emerging epidemiological evidence and the detection of oral microbiota in genitourinary organs indicate the presence of an oral-genitourinary axis and oral microbiota may be involved in the pathogenesis of genitourinary ***,oral microbiota provides the bridge between periodontitis and genitourinary *** have carried out this narrative review which summarizes epidemiological studies exploring the association between periodontitis and genitourinary *** have also highlighted the current evidence demonstrating the capacity of oral microbiota to regulate almost all hallmarks of cancer,and proposed the potential mechanisms of oral microbiota in the development of genitourinary cancers.

关键词： Oral microbiota Oral-genitourinary axis Periodontitis Urogenital neoplasms Prostatic neoplasms Kidney neoplasms Urinary bladder neoplasms

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Periodontal disease and risk of benign prostate hyperplasia: a cross-sectional study

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Military Medical Research 2020年第2期7卷 157-165页

作者： Lan Wu Bing-Hui Li Yun-Yun Wang Chao-Yang Wang Hao Zi Hong Weng Qiao Huang You-Jia Zhu xian-tao zeng Center for Evidence-Based and Translational Medicine Zhongnan Hospital of Wuhan UniversityWuhan 430071China department of Stomatology Zhongnan Hospital of Wuhan UniversityWuhan 430071China Center for Evidence-Based Medicine Institute of Evidence-Based Medicine and Knowledge TranslationHenan UniversityKaifeng 475000China Department of Urology Zhongnan Hospital of Wuhan UniversityWuhan 430071China

Background:Both periodontal disease and benign prostatic hyperplasia are age-related diseases that affect millions of people ***,this study aimed to investigate the association between periodontal disease and the risk of benign prostatic ***:A total of 4930 participants were selected from an available health examination that was carried out in 2017,only males were considered for further *** eligible males were divided into benign prostatic hyperplasia and normal groups,the benign prostatic hyperplasia group was then divided into prostate volume≤60 g and>60 g subgroups;all their periodontal status was extracted and then into normal(CPI score of 0),periodontal disease(CPI score between 1 and 4),and periodontitis(CPI score between 3 and 4)*** correlation between periodontal disease and benign prostatic hyperplasia was investigated using logistic regression analyses and greedy matching case-control *** analysis based on prostate volume was also *** analyses were conducted with SAS 9.4 ***:A total of 2171 males were selected for this *** presence of periodontal disease significantly increased the risk of benign prostatic hyperplasia by 1.68 times(OR=1.68,95%CI:1.26–2.24),and individuals with periodontitis showed a higher risk(OR=4.18,95%CI:2.75–6.35).In addition,among matched cases and controls,this association remained robust(periodontal disease:OR=1.85,95%CI:1.30–2.64;periodontitis:OR=4.83,95%CI:2.57–9.07).Subgroup analysis revealed that periodontal disease significantly increased benign prostate hyperplasia risk as well(for prostate volume≤60 g:OR=1.64,95%CI:1.22–2.20;for volume>60 g:OR=2.17,95%CI:1.04–4.53),and there was a higher risk in the group with a prostate volume greater than 60 ***:Periodontal disease is significantly and positively associated with an increased risk of benign prostatic *** validation studies should be performed to explore the re

关键词： Benign prostate hyperplasia Periodontal disease Periodontitis Risk factor Inflammatory disease

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Alterations of gut microbiota diversity, composition and metabonomics in testosterone-induced benign prostatic hyperplasia rats

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Military Medical Research 2023年第1期10卷 1-16页

作者： Lu-Yao Li Jie Han Lan Wu Cheng Fang Wei-Guang Li Jia-Min Gu Tong Deng Chang-Jiang Qin Jia-Yan Nie xian-tao zeng Center for Evidence‑Based and Translational Medicine Zhongnan Hospital of Wuhan UniversityWuhan 430071China Department of Gastrointestinal Surgery Huaihe Hospital of Henan UniversityKaifeng 475000HenanChina Department of Gastroenterology Zhongnan Hospital of Wuhan UniversityWuhan 430071China Department of Stomatology Zhongnan Hospital of Wuhan UniversityWuhan 430071China Department of Urology Zhong‑nan Hospital of Wuhan UniversityWuhan 430071China

Background: Studies had shown many diseases affect the stability of human microbiota, but how this relates to benign prostatic hyperplasia(BPH) has not been well understood. Hence, this study aimed to investigate the regulation of BPH on gut microbiota composition and ***: We analyzed gut samples from rats with BPH and healthy control rats, the gut microbiota composition and metabonomics were detected by 16S rDNA sequencing and liquid chromatography tandem mass spectrometry(LC–MS/MS).Results: High-throughput sequencing results showed that gut microbiota beta-diversity increased(P0.05), Bacteroidetes(46.54% vs. 41.64%,P>0.05), Clostridia(50.89% vs. 54.66%, P>0.05), Ruminococcaceae(25.67% vs. 20.56%, P>0.05). LC–MS/MS of intestinal contents revealed that differential metabolites were mainly involved in cellular processes, environmental information processing, metabolism and organismal systems. The most important pathways were global and overview maps, lipid metabolism, amino acid metabolism, digestive system and endocrine system. Through enrichment analysis, we found that the differential metabolites were significantly enriched in metabolic pathways, steroid hormone biosynthesis,ovarian steroidogenesis, biosynthesis of unsaturated fatty acids and bile secretion. Pearson correlation analysis(R=0.94) showed that there was a strong correlation between Prevotellaceae, Corynebacteriaceae, Turicibacteraceae,Bifid

关键词： Benign prostatic hyperplasia Gut microbiota Intestinal metabolites Microbial diversity

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Epidemiological trends of urinary tract infections,urolithiasis and benign prostatic hyperplasia in 203 countries and territories from 1990 to 2019

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Military Medical Research 2022年第4期9卷 432-443页

作者： Cong Zhu Dan-Qi Wang Hao Zi Qiao Huang Jia-Min Gu Lu-Yao Li Xing-Pei Guo Fei Li Cheng Fang Xiao-Dong Li xian-tao zeng Department of Urology Zhongnan Hospital of Wuhan UniversityWuhan 430071China Center for Evidence-Based and Translational Medicine Zhongnan Hospital of Wuhan UniversityWuhan 430071China Department of Evidence-Based Medicine and Clinical Epidemiology Second School of Clinical MedicineWuhan UniversityWuhan 430071China Institutes of Evidence-Based Medicine and Knowledge Translation Henan UniversityKaifeng 475000HenanChina Department of Urology Huaihe Hospital of Henan UniversityKaifeng 475000HenanChina

Background:Urinary tract infections(UTI),urolithiasis,and benign prostatic hyperplasia(BPH)are three of the most common nonmalignant conditions in ***,there is still a lack of comprehensive and updated epidemiological *** study aimed to investigate the disease burden of UTI,urolithiasis,and BPH in 203 countries and territories from 1990 to ***:Data were extracted from the Global Burden of Disease 2019,including incident cases,deaths,disabilityadjusted life-years(DALYs)and corresponding age-standardized rate(ASR)from 1990 to *** annual percentage changes(EAPC)were calculated to evaluate the trends of *** associations between disease burden and social development degrees were analyzed using a sociodemographic index(SDI).Results:Compared with 1990,the incident cases of UTI,urolithiasis,and BPH increased by 60.40%,48.57%,and 105.70%in 2019,*** age-standardized incidence rate(ASIR)of UTI increased(EAPC=0.08),while urolithiasis(EAPC=–0.83)and BPH(EAPC=–0.03)decreased from 1990 to *** 2019,the age-standardized mortality rate(ASMR)of UTI and urolithiasis were 3.13/100,000 and 0.17/100,000,*** had the largest increase(110.56%)in DALYs in the past three decades,followed by UTI(68.89%)and urolithiasis(16.95%).The burden of UTI was mainly concentrated in South Asia and Tropical Latin America,while the burden of urolithiasis and BPH was recorded in Asia and Eastern ***,the ASIR and SDI of urolithiasis in high-SDI regions from 1990to 2019 were negatively correlated,while the opposite trend was seen in low-SDI *** 2019,the ASIR of UTI in females was 3.59 times that of males,while the ASIR of urolithiasis in males was 1.96 times higher than that in *** incidence was highest in the 30–34,55–59,and 65–69 age groups among the UTI,urolithiasis,and BPH groups,***:Over the past three decades,the disease burden has increased for UTI but decreased for urolithiasis and BPH

关键词： Urinary tract infections Urolithiasis Benign prostatic hyperplasia Disease burden Incidence Mortality Disability-adjusted life-years

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Prognostic value of modified Lauren classification in gastric cancer

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World Journal of Gastrointestinal Oncology 2021年第9期13卷 1184-1195页

作者： Fei-Long Ning Nan-Nan Zhang Jun Wang Yi-Feng Jin Hong-Guang Quan Jun-Peng Pei Yan Zhao xian-tao zeng Masanobu Abe Chun-Dong Zhang Department of General Surgery Xuzhou Hospital of Traditional Chinese MedicineXuzhou 221000Jiangsu ProvinceChina State Key Laboratory of Cancer Biology and National Clinical Research Center for Digestive Diseases Xijing Hospital of Digestive DiseasesThe Fourth Military Medical UniversityXi’an 710000Shannxi ProvinceChina Department of General Surgery Jiading Hospital of Traditional Chinese MedicineShanghai 201800China Department of Gastrointestinal Surgery The Fourth Affiliated Hospital of China Medical UniversityShenyang 110032Liaoning ProvinceChina Department of Stomach Surgery Liaoning Cancer Hospital and InstituteCancer Hospital of China Medical UniversityShenyang 110042Liaoning ProvinceChina Center for Evidence-Based and Translational Medicine Zhongnan Hospital of Wuhan UniversityWuhan 430071Hubei ProvinceChina Department of Evidence-Based Medicine and Clinical Epidemiology The Second Clinical College of Wuhan UniversityWuhan 430071Hubei ProvinceChina Division for Health Service Promotion The University of TokyoTokyo 113-0033Japan Department of Gastrointestinal Surgery Graduate School of MedicineThe University of TokyoTokyo 113-0033Japan

BACKGROUND It remains controversial as to which pathological classification is most valuable in predicting the overall survival(OS)of patients with gastric cancer(GC).AIM To assess the prognostic performances of three pathological classifications in GC and develop a novel prognostic nomogram for individually predicting *** Patients were identified from the Surveillance,Epidemiology,and End Results *** and multivariate analyses were performed to identify the independent prognostic *** discrimination and model fitting were evaluated by receiver operating characteristic curves and Akaike information *** curve analysis was performed to assess clinical *** independent prognostic factors identified by multivariate analysis were further applied to develop a novel prognostic *** A total of 2718 eligible GC patients were *** modified Lauren classification was identified as one of the independent prognostic factors for *** showed superior model discriminative ability and model-fitting performance over the other pathological classifications,and similar results were obtained in various patient *** addition,it showed superior net benefits over the Lauren classification and tumor differentiation grade in predicting 3-and 5-year OS.A novel prognostic nomogram incorporating the modified Lauren classification showed superior model discriminative ability,model-fitting performance,and net benefits over the American Joint Committee on Cancer 8th edition tumor-nodemetastasis *** The modified Lauren classification shows superior net benefits over the Lauren classification and tumor differentiation grade in predicting OS.A novel prognostic nomogram incorporating the modified Lauren classification shows good model discriminative ability,model-fitting performance,and net benefits.

关键词： Gastric cancer Pathological classification Prognostic model Tumor-nodemetastasis classification Survival outcome

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Updating the diagnostic criteria of COVID-19 “suspected case” and “confirmed case” is necessary

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Military Medical Research 2020年第4期7卷 507-509页

作者： Yun-Yun Wang Ying-Hui Jin Xue-Qun Ren Yi-Rong Li Xiao-Chun Zhang xian-tao zeng Xing-Huan Wang the Zhongnan Hospital of Wuhan University Novel Coronavirus Management and Research Team Center for Evidence-Based and Translational Medicine Zhongnan Hospital of Wuhan UniversityWuhan 430071HubeiChina Institute of Evidence-Based Medicine and Knowledge Translation Henan UniversityKaifeng 475000HenanChina Department of Clinical Laboratory Zhongnan Hospital of Wuhan UniversityWuhan 430071HubeiChina Leishenshan Hospital of Wuhan Wuhan 430200HubeiChina Department of Radiology Zhongnan Hospital of Wuhan UniversityWuhan 430071HubeiChina 不详

On 6 February 2020,our team had published a rapid advice guideline for diagnosis and treatment of 2019 novel coronavirus(2019-nCoV)infection,and this guideline provided our experience and make well reference for fighting against this pandemic ***,the coronavirus disease 2019(COVID-19)is a new disease,our awareness and knowledge are gradually increasing based on the ongoing research findings and clinical practice experience;hence,the strategies of diagnosis and treatment are also continually *** this letter,we answered one comment on our guideline and provided the newest diagnostic criteria of"suspected case"and"confirmed case"according to the latest Diagnosis and Treatment Guidelines for COVID-19(seventh version)that issued by the National Health Committee of the People’s Republic of China.

关键词： COVID-19 SARS-CoV-2 2019-nCoV Guideline Prevention Diagnosis Treatment Novel coronavirus

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