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Characteristics and quality of clinical practice guidelines for diabetic kidney disease: a systematic review

Journal of Traditional Chinese Medicine 2024年第3期44卷 609-619页

作者： WANG Yuhuang ZHANG Le ZHANG Zhengshan YAO Zhi LI Xiyao SUN Luying LIAO Xing Department of Nephropathy and Endocrine Dongzhimen HospitalBeijing University of Chinese Medicine centre for evidence-based Chinese Medicine Institute of Basic Research in Clinical MedicineChina Academy of Chinese Medical Sciences Department of Endocrine One Zone Fangshan HospitalBeijing University of Chinese Medicine

OBJECTIVE: To assess the quality of Clinical practice guidelines(CPGs) in the context of diabetic kidney disease(DKD) and determine whether any factors affect the quality. METHODS: We searched eight databases along with five international and national organizations to develop or archive guidelines from their inception to July 2023, with an additional search of ***. And the authoritative organizations related to nephrology. CPGs and consensus statements created using direct differential diagnosis or therapy for DKD were included without language restrictions. Their quality was evaluated by four reviewers using the Appraisal of Guidelines for research and Evaluation Ⅱ(AGREE Ⅱ) instrument. Along with the item and domain scores, the guideline was also allocated an overall quality score, which ranged from 1(lowest possible quality) to 7(highest possible quality). Moreover, an overall recommendation for use was also assigned(“recommended”, “recommended with modifications” or “not recommended”). RESULTS: A total of 16 CPGs were included, of which 14 were from Asia and the remaining two from Europe. These two CPGs were updated in the third version. Six CPGs were recommended for use because their primary domains scored in the medium or high category. Furthermore, five CPGs were recommended with modifications as the stakeholder involvement, applicability, and editorial independence domains were evaluated as low categories. In all domains, the lowest average score was for rigour of development(33%), followed by application(36%), and stakeholder involvement(51%). The highest average score was for scope and purpose(79%), followed by clarity of presentation(75%). None of the CPGs considered the patient's viewpoint, and six of 16 CPGs did not use any grading system to translate the evidence into recommendations. Additionally, only three of 16 CPGs shared search strategy, and eight of 16 CPGs did not declare a funding source. CONCLUSIONS: According to the AGREE II evaluation, more than one in four CPGs for DKD had poor methodolo

关键词： appraisal of guidelines for research and evaluation II diabetic nephropathies practice guideline quality assessment systematic review

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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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Long-term follow-up of intravesical abobotulinumtoxinA (Dysport®) injections in women with idiopathic detrusor overactivity

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Asian Journal of Urology 2024年第1期11卷 93-98页

作者： Mohammad Sajjad Rahnama'i Amin Bagheri Elham Jahantabi Hanieh Salehi-Pourmehr Hadi Mostafaei Brigitte Schurch Aida Javan Balegh Marand Sakineh Hajebrahimi Department of Urology St.Elisabeth-Tweesteden Hospital Tilburgthe Netherlands research Center for evidence-based Medicine Iranian EBM Centre:A Joanna Briggs Institute(JBI)Center of ExcellenceTabriz University of Medical SciencesTabrizIran Urology Department Faculty of MedicineTabriz University of Medical SciencesTabrizIran Department of Urology Comprehensive Cancer CenterMedical University of ViennaViennaAustria Service de Neuroréhabilitation CHUVLausanneSwitzerland Society of Urological research and Education(SURE) Heerlenthe Netherlands

Objective:Only a few numbers of studies have been published on the use of abobotulinumtoxinA(Dysport®)in idiopathic detrusor overactivity(IDO).This study reported the long-term follow-up of women with IDO who were treated with intravesical Dysport®injections.Methods:Two hundred and thirty-six patients with IDO who had failed first-line conservative and antimuscarinic therapy received 500-900 units of Dysport®between April 2014 and July 2015.All patients were followed up for 5 years after their initial injection and interviewed on the phone.Results:A total of 236 women with IDO aged from 18 years to 84 years(mean±standard deviation:49.6±15.9 years)were included in our study.The median follow-up time for patients was 36.5(range:10-70)months,and the median recovery time after injection was 18.5(range:0-70)months.A total of 83(35.2%)patients stated that they had subjective improvement of their symptoms whereas 84(35.6%)patients did not report any improvement in symptoms.The initial International Consultation on Incontinence Questionnaire Overactive Bladder mean score was 6.9(standard deviation 3.4).There was a positive association between the median recovery time and the components of the International Consultation on Incontinence Questionnaire Overactive Bladder questionnaire.Conclusion:In a sub-population of overactive bladder patients with IDO who have failed first-line therapy,a single intravesical Dysport®injection can resolve patient symptoms completely or reduce the symptoms to an acceptable level that can be controlled with antimuscarinics or re-injection on demands.

关键词： AbobotulinumtoxinA Dysport Intravesical ldiopathic Detrusor overactivity

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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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护理领域专家共识论文的质量评价要点

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中华护理杂志 2024年第3期59卷 267-270页

作者：王志稳韩舒羽北京大学护理学院/Peking University Health Science centre for evidence-based Nursing:A JBI centre of Excellence 北京市100191

专家共识作为一种行业指导性文件,其发表数量逐年增多。由于尚缺乏统一的论文报告指南和方法学规范,目前护理领域发表的专家共识存在撰写格式不统一、质量参差不齐的现象。该文结合澳大利亚乔安娜布里格斯研究所循证卫生保健中心关于专... 详细信息

专家共识作为一种行业指导性文件,其发表数量逐年增多。由于尚缺乏统一的论文报告指南和方法学规范,目前护理领域发表的专家共识存在撰写格式不统一、质量参差不齐的现象。该文结合澳大利亚乔安娜布里格斯研究所循证卫生保健中心关于专家意见类文章的质量评价要点,重点从观点是否来自该领域有影响力的专家、观点表述是否清晰、证据基础是否充分、达成共识的过程是否规范、是否以研究相关人群利益为中心、是否能在一定情境下推广应用6个方面,介绍了对护理领域专家共识论文的质量评价要点,为今后提升专家共识论文的质量和规范性提供参考。

关键词：专家共识质量评价同行评审护理

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Transcranial photobiomodulation for the brain: a wide range of clinical applications

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Neural Regeneration research 2024年第3期19卷 483-484页

作者： Michael R.Hamblin Laser research centre Faculty of Health ScienceUniversity of Johannesburg-Doornfontein CampusDoornfonteinSouth Africa

Photobiomodulation therapy(PBMT)is a rapidly growing approach to the healing,stimulation,protection,and regeneration of many human organs and tissue types.PBMT started in the 1960s as low-level laser therapy for wound healing,but since then the introduction of light-emitting diodes(LEDs)has dramatically increased the number of applications and reports of positive results.PBMT generally uses red(620-700 nm)and/or near-infrared(780-1270 nm)wavelengths of light at an intensity that causes no tissue heating,and its activity is based on well-established biological and cellular mechanisms(de Freitas and Hamblin,2016).While laser therapists continue to use various types of laser in their office practice,LEDs are ideally suited for home use devices because they are completely safe and without any known significant adverse effects.Among the various body parts on which PBMT has been shown to exert beneficial effects,the brain stands out as perhaps the most promising overall.PBMT has been shown to reduce neuroinflammation,while increasing mitochondrial function,oxygen consumption,and blood flow within the brain(Hamblin,2016).Moreover,PBMT can stimulate the processes of synaptogenesis,neurogenesis,and neuroplasticity thus helping the brain to heal itself.

关键词： healing stimulation wound

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Review: update on performance assessment and monitoring systems for ophthalmologists

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Annals of Eye Science 2024年第1期9卷 24-33页

作者： Heather G.Mack centre for Eye research Australia University of MelbourneMelbourneAustralia

Performance assessment and monitoring systems are the process by which ophthalmologists demonstrate they are fit to continue practicing.Revalidation is the process by which licensed doctors are legally required to demonstrate to medical regulators that they are up to date and fit to practice in order to maintain their medical license,and began in the United Kingdom(UK)in 2012 following well-publicized events.Recertification is a different process which began in North America and demonstrates doctors have maintained competence,without involvement of external stakeholders.Arguments for and against the concept of performance assessment are reviewed.Stakeholders in performance assessment,whether part of the process or not,are doctors themselves,peers and other health care providers,patients,hospitals and health systems,medical regulators,and health policy makers.Early models of performance assessment included portfolios,credit accumulation,and closed-book examinations.Models are in evolution with the value of formative rather than summative assessments,and the need for methods of assessing procedural competency increasingly recognized.Emerging methods of performance assessment of practicing ophthalmologists include use of performance indicators,simulation,and workplace-based assessments.Alternate methods of assuring the public by improved detection of outliers are discussed.Despite weak evidence supporting performance assessments in demonstrating continuing competency to practice,the process is gradually being accepted worldwide.Further research into optimum methods of performance assessment and monitoring processes is required,along with cost-benefit analysis.

关键词： Performance assessment revalidation recertification maintenance of competency relicensure

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Comprehensive effects of traditional Chinese medicine treatment on heart failure and changes in B-type natriuretic peptide levels: A meta-analysis

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World Journal of Clinical Cases 2024年第4期12卷 766-776页

作者： Li-Li Xia Shu-Yun Yang Jun-Yao Xu Han-Qing Chen Zhu-Yuan Fang Hypertension research Institute Affiliated Hospital of Nanjing University of Chinese MedicineNanjing 210004Jiangsu ProvinceChina Department of General practice Southeast University Affiliated Zhongda HospitalNanjing 210009Jiangsu ProvinceChina

BACKGROUND Heart failure(HF),a common cardiovascular condition,is characterized by significant morbidity and mortality.While traditional Chinese medicine(TCM)is often used as a complementary approach in HF management,systematic evalua-tions of its impact on clinical outcomes,TCM syndrome scores,and B-type natriuretic peptide(BNP)levels are lacking.This study fills this gap through a comprehensive analysis of randomized controlled trials(RCTs)focusing on TCM for HF treatment.It encompasses an assessment of methodological quality,a meta-analysis,and an evaluation of evidence quality based on established standards.The results offer crucial insights into the potential advantages and constraints of TCM in HF management.RCTs on TCM for HF treatment published since the establishment of the database were searched in four Chinese and English databases,including China National Knowledge Infrastructure,Wanfang,VIP Information Chinese Science and Technology Journal,and PubMed.Methodological quality was assessed for the included studies with the Cochrane risk-of-bias assessment tool,and the meta-analysis and publication bias assessment was performed with the RevMan5.3 software.Finally,the quality of evidence was rated according to the GRADE criteria.RESULTS A total of 1098 RCTs were initially retrieved.After screening,16 RCTs were finally included in our study,which were published between 2020 and 2023.These RCTs involved 1660 HF patients,including 832 in the TCM group[TCM combined with conventional Western medicine(CMW)treatment]and 828 in the CWM group(CWM treatment).The course of treatments varied from 1 wk to 3 months.TCM syndrome differentiation was analyzed in 11 of the included RCTs.In all included RCTs,outcome indicators included comprehensive clinical outcomes,TCM syndrome scores,and BNP levels.The meta-analysis results showed significant differences between the TCM and CWM groups in terms of comprehensive clinical outcomes[risk ratio=-0.54;95%confidence interval(CI)=-0.61,-0.47;P<0.00001],TCM syndrome scores[weighte

关键词： Traditional Chinese medicine Heart failure Comprehensive clinical outcomes Traditional Chinese medicine syndrome score B-type natriuretic peptide level Meta-analysis©The Author(s)2024.Published by Baishideng Publishing Group Inc.

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Comparative efficacy and optimal duration of first-line antibiotic regimens for acute otitis media in children and adolescents:a systematic review and network meta-analysis of 89 randomized clinicaltrials

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World Journal of Pediatrics 2024年第3期20卷 219-229页

作者： Min Seo Kim Jae Han Kim Seohyun Ryu Seung Won Lee Dong Keon Yon Eunyoung Kim Ai Koyanagi Elena Dragioti Jae Il Shin Lee Smith Samsung Advanced Institute forHealth Sciences&Technology(SAIHST) Samsung Medical CenterSungkyunkwan UniversitySeoulRepublic of Korea Yonsei University Collegeof Medicine SeoulRepublicof Korea Department of Precision Medicine Sungkyunkwan University School of MedicineSuwonRepublic of Korea Center for Digital Health Medical Science Research InstituteKyung Hee University College of MedicineSeoulRepublic of Korea evidence-based research Laboratory Department of Clinical Pharmacy and Pharmaceutical CareCollege of PharmacyChung-Ang UniversitySeoulRepublic of Korea Parc Sanitari Sant Joan de Deu/CIBERSAM/ISCIII Universitat de BarcelonaFundacio Sant Joan de Déu.Sant Boi de LlobregatBarcelonaSpain ICREA Pg.Lluis Companys 23BarcelonaSpain Pain and Rehabilitation centre and Department of Medical and Health SciencesLinkoping University58185 LinkopingSweden Department of Pediatrics Yonsei University College of MedicineYonsei-ro 50Seodaemun-gu8044Seoul 03722Republic of Korea centre for Health Performanceand WellbeingAnglia Ruskin UniversityCambridge CB11PTUK research Laboratory Psychology of Patients Families&Health ProfessionalsDepartment of NursingSchool of Health SciencesUniversity of IoanninaIoannina 45500Greece

Introduction Antibiotic use for acute otitis media(AOM)is one of the major sources of antimicrobial resistance.However,the effective minimal antibiotic duration for AOM remains unclear.Moreover,guidelines often recommend broad ranges(5-10 days)of antibiotic use,yet the clinical impact of such a wide window has not been assessed.Methods We systematically searched PubMed/MEDLINE,Embase,Scopus,Web of Science,and Cochrane Library from database inception to 6 October 2021.Network meta-analysis was conducted on randomized controlled trials that assessed antibiotic treatment for AOM in children(PROSPERO CRD42020196107).Results For amoxicillin and amoxicillin-clavulanate,7-day regimens were noninferior to 10-day regimens in clinical responses[amoxicillin:risk ratio(RR)0.919(95%CI 0.820-1.031),amoxicillin-clavulanate:RR 1.108(0.957-1.282)],except for≤2 years.For the third-generation cephalosporins,7-day and 10-day regimens had similar clinical responses compared to placebo[7-day:RR 1.420(1.190-1.694),10-day:RR 1.238(1.125-1.362)compared to placebo].However,5-day regimens of amoxicillin-clavulanate and third-generation cephalosporins were inferior to 10-day regimens.Compared to amoxicillin,a shorter treatment duration was tolerable with amoxicillin-clavulanate.Conclusions Our findings indicated that 1O days of antibiotic use may be unnecessarily long,while the treatment duration should be longer than 5 days.Otherwise,5-day regimens would be sufficient for a modest treatment goal.Our findings revealed that the current wide range of recommended antibiotic durations may have influenced the clinical outcome of AOM,and a narrower antibiotic duration window should be re-established.

关键词： Amoxicillin-potassium Amoxicillin Antibacterial agents Cephalosporins Duration of therapy

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