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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 china.Integrated TCM and WM has a long history in china,and has made important achievements in the process of clinical diagnosis and treatment.However,the methodological defects in currently published clinical practice guidelines(CPGs)limit its development.The organic integration of TCM and WM is a deeper integration of TCM and WM.To realize the progression of"integration"to"organic integration",a targeted and standardized guideline development methodology is needed.Therefore,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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Efficacy and safety of extracorporeal shock wave therapy combined with sodium hyaluronate in treatment of knee osteoarthritis:a systematic review and Meta-analysis

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Journal of traditional chinese medicine 2024年第2期44卷 243-250页

作者： ZHOU Mingwang DONG Zhuanli WEI Changhao FENG Lufang WANG Xiaoping LIU Haiping JI Xing YANG Kehu LI Shenghua Department of Orthopaedics Gansu Provincial Hospital of Traditional Chinese MedicineLanzhou 730050China Department of Quality Management Lanzhou Petrochemical General HospitalLanzhou 730050China Department of Orthopaedics Lanzhou Petrochemical General HospitalLanzhou 730050China evidence-based Social Science Research center School of Public HealthLanzhou UniversityLanzhou730000China evidence-based medicine center School of Basic Medical SciencesLanzhou UniversityLanzhou 730000China Key Laboratory of evidence based medicine and Knowledge Translation of Gansu Province Lanzhou 730000China center for Translational medicine Gansu Provincial Hospital of Traditional Chinese MedicineLanzhou 730050China Department of Orthopaedics Gansu Provincial Hospital of Traditional Chinese MedicineLanzhou 730000China

OBJECTIVE:To assess the efficacy and safety of extracorporeal shockwave therapy(ESWT)combined with sodium hyaluronate(HA)for the treatment of knee osteoarthritis(KOA).METHODS:PubM ed,Embase,the Cochrane Library,Web of Science,china National Knowledge Infrastructure,Wanfang database,china Science and Technology Journal Database,and SinoMed were searched from inception to July 2020.The quality of the randomized controlled trials was evaluated independently by two reviewers according to the criteria in the Cochrane Collaboration for Systematic Reviews.The identified articles were then screened individually using EndnoteX9 for eligibility in this Meta-analysis.The heterogeneity among the articles was evaluated using I2.RESULTS:A total of 17 studies,comprising 2000 individuals,were included in this Meta-analysis.The results showed that a significant improvement was observed in knee pain and function based on the clinical efficacy of ESWT combined with HA.Statistical analysis of clinical efficacy showed that[relative risk(RR)=1.21,95%confidence interval(CI)(1.12,1.30),Pevidence showed that ESWT combined with HA offers an inexpensive,welltolerated,safe,and effective method to improve pain and functionality in patients with KOA.However,tightly controlled,randomized,large multicenter trials are warranted to validate the current findings.

关键词： osteoarthritis knee randomized controlled trial extracorporeal shockwave therapy hyaluronic acid Meta-analysis

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Moxibustion of Zusanli(ST36)and Shenshu(BL23)alleviates the inflammation of rheumatoid arthritis in rats through regulating macrophage migration inhibitory factor/glucocorticoids signaling

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Journal of traditional chinese medicine 2024年第2期44卷 353-361页

作者： ZHANG Linlin ZHONG Yumei LU Wenting SHANG Yanan GUO Yanding LUO Xiaochao CHEN Yang LUO Kun HU Danhui YU Huiling ZHOU Haiyan Acupuncture and Moxibustion College Chengdu University of Traditional Chinese MedicineChengdu 610075China Department of Painology First People's Hospital of ChengduChengdu 610095China chinese evidence-based medicine Centre West China HospitalSichuan UniversityChengdu 610044China traditional chinese medicine College Chongqing Medical UniversityChongqing 400016China External treatment center First People's Hospital of ChengduChengdu 610095China

OBJECTIVE:To test the hypothesis that moxibustion may inhibit rheumatoid arthritis(RA)synovial inflammation by regulating the expression of macrophage migration inhibitory factor(MIF)/glucocorticoids(GCs).METHODS:Fifty male Sprague-Dawley rats were randomly divided into five groups(n=10 each):blank Control(CON)group,RA Model(RA)group,Moxibustion(MOX)group,MIF inhibitor(S,R)-3-(4-hydroxyphenyl)-4,5-dihydro-5-isoxazole acetic acid methyl ester(ISO-1)group,and Moxibustion+MIF inhibitor ISO-1(MOX+ISO-1)group.Rats in the ISO-1 group and ISO-1+MOX group were intraperitoneally injected with the inhibitor ISO-1.The rats in the RA group,ISO-1 group,MOX group,and ISO-1+MOX group were injected with Freund's complete adjuvant(FCA)in the right hind footpad to establish an experimental RA rat model.In the MOX group and MOX+ISO-1 group,rats were treated with Moxa.The thickness of the footpads of the rats in each group was measured at three-time points before,after modeling and after moxibustion treatment.The contents of serum MIF,corticosterone(CORT),tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)were detected by enzyme-linked immunosorbent assay;and the contents of synovial MIF were detected by Western blot.Hematoxylin-eosin(HE)staining method was used to observe the pathological changes of synovial tissue under a section light microscope,and pathological scoring was performed according to the grading standard of the degree of synovial tissue disease.RESULTS:Moxibustion was found to reduce the level of MIF and alleviate inflammation in RA rats in this study.In addition,after inhibiting the expression of MIF,the level of CORT increased,and the level of TNF-α decreased.Treating RA rats with inhibited MIF by moxibustion,the level of CORT was almost unchanged,but the level of TNF-α further decreased.The correlation analysis data suggested that MIF was positively related to the expression of TNF-α and negatively correlated with the expression of CORT.CONCLUSION:Reducing MIF to increase CORT and decrease TNF-α by moxibustion

关键词： rheumatoid arthritis macrophage migration inhibitory factor moxibustion corticosterone glucocorticoids

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Mechanism of Mingjing Granules in Treating Wet Age-Related Macular Degeneration based on Network Pharmacology and Experimental Verification

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World Journal of traditional chinese medicine 2024年第1期10卷 22-32页

作者： Xiao-Yu Li Li-Na Liang Wei-Jun Zhang Yun Gao Qiang Chen Eye Function Laboratory Eye HospitalChina Academy of Chinese Medical SciencesBeijingChina china evidence-based medicine center for traditional chinese medicine BeijingChina center for East-West medicine UCLA David Geffen School of MedicineLos AngelesCAUSA

Objective:To analyze the potential mechanism of Mingjing granules in the treatment of wet age-related macular degeneration(wAMD)based on the research methods of network pharmacology and molecular docking approach and to provide a new reference for the currently limited treatment of wAMD.Materials and Methods:We searched TCMSP,GeneCards,OMIM,PharmGkb,TTD,and DrugBank database to screen the main active ingredients of Mingjing granules and their therapeutic targets of wAMD.The network of active components and targets was constructed using Cytoscape3.6.1 software,which was also used for the topological analysis of target genes.The network of Protein-Protein Interactions(PPI)was mapped using the String platform.We also used R language to do the Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway for additional analysis.Molecular docking studies were finished by Chemoffice,Autodock,and Pymol.Finally,the efficacy of the Mingjing granules was examined in animal experiments,in which we used enzyme-linked immunosorbent assay to the contents of vascular endothelial growth factor(VEGF)and matrix metalloproteinase-9(MMP-9)levels in peripheral blood.Results:Active compounds,including quercetin,lignocaine,and kaempferol,were found.PPI network analysis showed that tumor necrosis factor(TNF),MMP-9,epidermal growth factor(EGF),prostaglandin-endoperoxide synthase 2(PTGS2),and caspase-3(CASP3)were related to both Mingjing granules and wAMD.GO and KEGG pathway analysis showed that these targets were mainly involving lipids and atherosclerosis,TNF,and interleukin-17(IL-17)signaling pathways.Docking studies suggested that quercetin and luteolin can fit in the binding pocket of four target proteins(CASP3,EGF,PTGS2,and TNF).In the vivo experiment,the Mingjing granules were found to be effective on the expression of VEGF and MMP-9 in peripheral blood.Conclusions:This study initially reveals the multi-constituent,multi-target,and multi-pathway mechanism of action of Mingjing granules in the treatment of wAMD and impli

关键词： Experimental verification Mingjing granules molecular docking network pharmacology wet age-related macular degeneration

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Complementary and alternative medicine on cognitive defects and neuroinflammation after sepsis

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Journal of traditional chinese medicine 2024年第2期44卷 408-416页

作者： LI Zhenxuan WANG Xuerui Luis Ulloa Ayman Youssef BAI Yunjing XU Xiaolong LIU Qingquan Department of Infectious Diseases Beijing Hospital of Traditional Chinese MedicineCapital Medical UniversityBeijing 100010China Beijing Key Laboratory of Basic Research with traditional chinese medicine on Infectious Diseases Beijing 100010China Infection immunity laboratory Beijing Institute of Traditional Chinese MedicineBeijing 100010China Clinical College of traditional chinese medicine Capital Medical UniversityBeijing 100069China center for Perioperative Organ Protection Department of AnesthesiologyDuke University Medical CenterDurhamNorth Carolina 27710USA

Sepsis-associated encephalopathy(SAE)is a common manifestation of sepsis,ranging from mild confusion and delirium to severe cognitive impairment and deep coma.SAE is associated with higher mortality and long-term outcomes,particularly substantial declines in cognitive function.The mechanisms of SAE probably include neuroinflammation that is mediated by systemic inflammation and ischemic lesions in the brain,a disrupted blood–brain barrier,oxidative stress,neurotransmitter dysfunction,and severe microglial activation.Increasing evidence suggests that complementary and alternative medicine,especially traditional chinese medicine(TCM),is favorable in alleviating cognitive decline after sepsis.Here,we summarized the studies of traditional herbal remedies,TCM formulas and acupuncture therapy in animal models of neurological dysfunctions after sepsis in recent decades and reviewed their potential mechanisms.

关键词： sepsis-associated encephalopathy cognitive dysfunction complementary therapies neuroinflammatory diseases medicine chinese traditional review

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Bibliometrics analysis based on the Web of Science:Current trends and perspective of gastric organoid during 2010-2023

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World Journal of Gastroenterology 2024年第8期30卷 969-983页

作者： Kai-Lin Jiang Yue-Bo Jia Xue-Jiao Liu Qing-Ling Jia Li-Kun Guo Xiang-Xiang Wang Ke-Ming Yang Chen-Heng Wu Bei-Bei Liang Jiang-Hong Ling Department of Gastroenterology Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese MedicineShanghai 200021China Laboratory of cancer Biology University of OxfordOxford OX37DQUnited Kingdom School of traditional chinese medicine Shanghai University of Chinese MedicineShanghai 200021China Shanghai Key Laboratory of Molecular Imaging Shanghai University of Medicine and Health SciencesShanghai 201318China

BACKGROUND Three-dimensional organoid culture systems have been established as a robust tool for elucidating mechanisms and performing drug efficacy testing.The use of gastric organoid models holds significant promise for advancing personalized medicine research.However,a comprehensive bibliometric review of this burgeoning field has not yet been published.AIM To analyze and understand the development,impact,and direction of gastric organoid research using bibliometric methods using data from the Web of Science Core Collection(WoSCC)database.METHODS This analysis encompassed literature pertaining to gastric organoids published between 2010 and 2023,as indexed in the WoSCC.CiteSpace and VOSviewer were used to depict network maps illustrating collaborations among authors,institutions and keywords related to gastric organoid.Citation,co-citation,and burst analysis methodologies were applied to assess the impact and progress of research.RESULTS A total of 656 relevant studies were evaluated.The majority of research was published in gastroenterology-focused journals.Globally,Yana Zavros,Hans Clevers,James M Wells,Sina Bartfeld,and Chen Zheng were the 5 most productive authors,while Hans Clevers,Huch Meritxell,Johan H van Es,Marc Van de Wetering,and Sato Toshiro were the foremost influential scientists in this area.Institutions from the University Medical center Utrecht,Netherlands Institute for Developmental Biology(Utrecht),and University of Cincinnati(Cincinnati,OH,United States)made the most significant contributions.Currently,gastric organoids are used mainly in studies investigating gastric cancer(GC),Helicobacter pylori-infective gastritis,with a focus on the mechanisms of GC,and drug screening tests.CONCLUSION Key focus areas of research using gastric organoids include unraveling disease mechanisms and enhancing drug screening techniques.Major contributions from renowned academic institutions highlight this field’s dynamic growth.

关键词： Gastric organoid Gastric disease Bibliometrics analysis Gastric cancer Gastritis

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Acupuncture for ischemic stroke:where are we now?

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Acupuncture and Herbal medicine 2024年第1期4卷 36-55页

作者： Weiming Zhu Qingqing Jia Alberto Cantidio Ferreira Hailun Jiang Jieying Zhang Boxuan Li Menglong Zhang Bifang Zhuo Yuanhao Lyu Junjie Chen Li Li Guang Tian Shizhe Deng Zhihong Meng Xuemin Shi Graduate School Tianjin University of Traditional Chinese MedicineTianjinChina First Teaching Hospital Tianjin University of Traditional Chinese MedicineTianjinChina National Clinical Research center for chinese medicine Acupuncture and Moxibustion TianjinChina The Second Affiliated Hospital of Shandong University of traditional chinese medicine JinanChina Taos Institute of traditional chinese medicine Recife/PEBrazil

Acupuncture is an effective treatment for ischemic stroke(IS)and plays a key role in neurological rehabilitation after IS.Acupuncture can improve the clinical symptoms of various complications after IS,including motor dysfunction,swallowing disorders,speech disorders,cognitive impairment,depression,insomnia,and fatigue.However,the mechanisms underlying the effects of acupuncture in IS remain unclear.Available evidence suggests that acupuncture may exert neuroprotective effects through neuroplasticity(neurogenesis and synaptogenesis),angiogenesis,cell proliferation and apoptosis,and regulation of oxidative stress,inflammation,and immunity.Further studies should be conducted to improve the high-quality evidence-based system of acupuncture intervention for IS,by focusing on the clinical and basic research design,increasing the sample size,standardizing and quantifying the standards of acupuncture operations,using multidisciplinary techniques and methods to systematically explore the key targets of acupuncture intervention for IS,and reveal the efficacy and mechanism of acupuncture in the treatment of IS.

关键词： Acupuncture Curative effect Electroacupuncture Ischemic stroke Mechanism Review

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Reduced expression of semaphorin 3A in osteoclasts causes lymphatic expansion in a Gorham-Stout disease(GSD)mouse model

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2024年第1期25卷 38-50页

作者： Dongfang ZHANG Hao XU Chi QIN Kangming CAI Jing ZHANG Xinqiu XIA Jingwen BI Li ZHANG Lianping XING Qianqian LIANG Wensheng WANG Laboratory of Molecular medicine College of Life Science and State Key Laboratory of Cell Differentiation and RegulationHenan Normal UniversityXinxiang453007China Longhua Hospital&Spine Institute Shanghai University of Traditional Chinese MedicineShanghai200032China Key Laboratory of Theory and Therapy of Muscles and Bones Ministry of Education(Shanghai University of Traditional Chinese Medicine)Shanghai201203China Department of Pathology and Laboratory medicine University of Rochester Medical CenterRochester14642USA

Gorham-Stout disease(GSD)is a sporadic chronic disease characterized by progressive bone dissolution,absorption,and disappearance along with lymphatic vessel infiltration in bone-marrow cavities.Although the osteolytic mechanism of GSD has been widely studied,the cause of lymphatic hyperplasia in GSD is rarely investigated.In this study,by comparing the RNA expression profile of osteoclasts(OCs)with that of OC precursors(OCPs)by RNA sequencing,we identified a new factor,semaphorin 3A(Sema3A),which is an osteoprotective factor involved in the lymphatic expansion of GSD.Compared to OCPs,OCs enhanced the growth,migration,and tube formation of lymphatic endothelial cells(LECs),in which the expression of Sema3A is low compared to that in OCPs.In the presence of recombinant Sema3A,the growth,migration,and tube formation of LECs were inhibited,further confirming the inhibitory effect of Sema3A on LECs in vitro.Using an LEC-induced GSD mouse model,the effect of Sema3A was examined by injecting lentivirus-expressing Sema3A into the tibiae in vivo.We found that the overexpression of Sema3A in tibiae suppressed the expansion of LECs and alleviated bone loss,whereas the injection of lentivirus expressing Sema3A short hairpin RNA(shRNA)into the tibiae caused GSD-like phenotypes.Histological staining further demonstrated that OCs decreased and osteocalcin increased after Sema3A lentiviral treatment,compared with the control.based on the above results,we propose that reduced Sema3A in OCs is one of the mechanisms contributing to the pathogeneses of GSD and that expressing Sema3A represents a new approach for the treatment of GSD.

关键词： Semaphorin 3A Gorham-Stout disease Osteoclast Osteolysis Lymphatic endothelial cell

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Effect of pediatric Tuina on children's recurrent acute respiratory tract infections: a retrospective cohort study in Southern china

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Journal of traditional chinese medicine 2024年第3期44卷 586-594页

作者： YIN Lingjia ST?LSBY LUNDBORG Cecilia WU Darong YANG Jinghua ALVESSON Helle M?lsted CAI Jianxiong LU Taoying XIE Qianwen MARRONE Gaetano Department of Global Public Health Karolinska Institutet State Key Laboratory of Dampness Syndrome of chinese medicine the Second Affiliated Hospital of Guangzhou University of Chinese Medicine Outcome Assessment Research team in chinese medicine the Second Affiliated Hospital of Guangzhou University of Chinese Medicine Health Construction Administration Centre Guangdong Provincial Hospital of Chinese Medicine Guangdong Provincial Key Laboratory of Clinical Research on traditional chinese medicine Syndrome the Second Affiliated Hospital of Guangzhou University of Chinese Medicine Department of Pediatrics the Second Affiliated Hospital of Guangzhou University of Chinese Medicine

OBJECTIVE: To determine the effectiveness of pediatric Tuina(PT) in preventing recurrent acute respiratory tract infections(ARTIs) in children. METHODS: This is a retrospective cohort study based on the electronic medical records of children with recurrent ARTIs in 2016. Children were divided into a PT group or a non-PT group, according to whether they had received PT or not in 2016. The primary outcome was the number of ARTI episodes in 2017 and 2018. The secondary outcomes were the number of ARTIs leading to outpatient department visits and outpatient antibiotic prescriptions due to ARTIs in the same time period. Negative binomial regressions were used to detect the association between PT and the outcomes. RESULTS: A total of 2303 children were included in the analysis, including 94 in the PT group and 2209 in the non-PT group. Children who received PT six or more times in 2016 had fewer episodes of ARTIs in 2017 [incidence rate ratio(IRR): 0.59, 95% confidence interval(CI)(0.42-0.84)] and 2018 [IRR: 0.58, 95% CI(0.36-0.94)] and fewer outpatient department visits due to ARTIs in 2017 [IRR: 0.56, 95% CI(0.38-0.83)] than children who had not received PT in 2016. There was no significant difference in the number of outpatient antibiotic prescriptions between the two groups. CONCLUSIONS: Receiving PT six or more times within one year is associated with a decrease in recurrent ARTIs in children in the following two years. Randomized controlled trials are needed for effect evaluation prior to establishing PT as a method for preventing recurrent ARTIs among children.

关键词： child massage pediatric Tuina respiratory tract infections

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Effectiveness of Acupoint Application in Patients with Pharyngeal Pain: evidence from CHUNBO, A Prospective Real-World Study

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chinese Journal of Integrative medicine 2024年第1期30卷 18-24页

作者： MA Hang-kun WANG Yi-ming GUO Man-ping LI Chen-fei LI Rui GAO Rui Emergency Department Xiyuan Hospital Affiliated to China Academy of Chinese Medical SciencesBeijing(100091)China National Medical Products Administration for Laboratory of Clinical Research and Evaluation of traditional chinese medicine Beijing(100091)China National Clinical Research center for chinese medicine Cardiology Beijing(100091)China Postdoctoral Workstation of Yabao Pharmaceutical Group Co. Ltd.YunchengShanxi Province(044602)China

Objective: To assess the outcomes after acupoint application in patients with pharyngeal pain in a real-world settings, and analyze the characteristics of effective population and prescription characteristics of acupoint application. Methods: based on CHUNBO platform, patients with pharyngeal pain who were candidates for acupoint application on the basis of physician-evaluation, were enrolled in a nationwide, prospective, 69-week multicenter observational study from August 2020 to February 2022. Propensity score matching(PSM) was used to match the confounding factors and the association rules were used to analyze the characteristics of effective population and prescription characteristics of acupoint application. Outcome assessments included the disappearance rate of pharyngeal pain(within 3, 7, and 14 days), disappearance time of pharyngeal pain, as well as adverse events. Results: Of 7,699 enrolled participants, 6,693(86.9%) received acupoint application and 1,450(21.7%) with non-acupoint application. After PSM, there were 1,004 patients each in the application group(AG) and non-application group(NAG). The disappearance rate of pharyngeal pain in the AG at 3, 7, and 14 days were all higher than those in the NAG(P<0.05). The disappearance time of pharyngeal pain in the AG were shorter than that in the NAG(logrank P<0.001, hazard ratio=1.51, 95% confidence interval: 1.41–1.63). The median age of effective cases was 4 years, mainly 3–6 years old(40.21%). The disappearance rate of pharyngeal pain in the application group with tonsil diseases was 2.19 times higher than that in the NAG(P<0.05). The commonly used acupoints for the effective cases were Tiantu(RN 22), Shenque(RN 8) and Dazhui(DU 14). The commonly used herbs for the effective cases were Natrii sulfas, Radix et Rhizoma Rhei, and Herba Ephedrae. Among them, Natrii sulfas was applied to RN 8 most frequently(support 84.39%). A total of 1,324(17.2%) patients experienced AEs, and mainly occurred in the AG, with significant difference in the incidence of AEs be

关键词： acupoint application chinese medicine pharyngeal pain multicentre effectiveness characters real-world study

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