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Levels of evidence and grades of recommendation supporting European society for medical oncology clinical practice guidelines

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Oncology Research 2024年第5期32卷 807-815页

作者： MARKO SKELIN BRUNA PERKOV-STIPIČIN SANJA VUŠKOVIĆ MARINAŠANDRK PLEHAČEK ANE BAŠIĆ DAVIDŠARČEVIĆ MAJA ILIĆ IVAN KREČAK pharmacy Department General Hospital ofŠibenik-Knin CountyŠibenikCroatia Faculty of Medicine University of RijekaRijekaCroatia undergraduate Study in Nursing University of Applied SciencesŠibenikCroatia Department of Oncology University Hospital Center ZagrebZagrebCroatia Pharmacies Joukhadar Sveta NedeljaCroatia Pharmacies Prima Pharme ZagrebCroatia pharmacy Department General Hospital ZadarZadarCroatia pharmacy Department General Hospital PulaPulaCroatia Department of Internal Medicine General Hospital ofŠibenik-Knin CountyŠibenikCroatia

Background:The European Society for Medical Oncology(ESMO)guidelines are among the most comprehensive and widely used clinical practice guidelines(CPGs)***,the level of scientific evidence supporting ESMO CPG recommendations has not been systematically *** study assessed ESMO CPG levels of evidence(LOE)and grades of recommendations(GOR),as well as their trends over time across various cancer ***:We manually extracted every recommendation with the Infectious Diseases Society of America(IDSA)classification from each *** examined the distribution of LOE and GOR in all available ESMO CPG guidelines across different topics and cancer ***:Among the 1,823 recommendations in the current CPG,30%were classified as LOEⅠ,and 43%were classified as GOR ***,there was a slight decrease in LOEⅠ(−2%)and an increase in the proportion of GOR A(+1%)in the current CPG compared to previous *** proportion of GOR A recommendations based on higher levels of evidence such as randomized trials(LOEⅠ–Ⅱ)shows a decrease(71%vs.63%,p=0.009)while recommendations based on lower levels of evidence(LOEⅢ–Ⅴ)show an increase(29%vs.37%,p=0.01)between previous and current *** the current versions,the highest proportion of LOEⅠ(42%)was found in recommendations related to pharmacotherapy,while the highest proportion of GOR A recommendations was found in the areas of pathology(50%)and diagnostic(50%)*** variability in LOEⅠand GOR A recommendations and their changes over time was observed across different cancer ***:One-third of the current ESMO CPG recommendations are supported by the highest level of *** well-designed randomized clinical trials are needed to increase the proportion of LOEⅠand GOR A recommendations,ultimately leading to improved outcomes for cancer patients.

关键词： ESMO guidelines Clinical practice guidelines Level of evidence Grade of recommendation

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Research progress in the off-target effects of Bacille Calmette-Guérin vaccine

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中华医学杂志(英文版) 2024年第17期137卷 2065-2074页

作者： Wu Yanfei Zhang Xiaoyin Zhou Li Lu Jiayu Zhu Fengcai Li Jingxin School of Public Health Southeast University Nanjing Jiangsu China Center for Global Health School of Public Health Nanjing Medical University Nanjing Jiangsu China IB course Center of High School Affiliated to Shanghai Jiaotong University Shanghai China NHC Key Laboratory of Enteric Pathogenic Microbiology Jiangsu Provincial Center for Disease Control and Prevention Nanjing Jiangsu China Institute of Global Public Health and Emergency pharmacy China Pharmaceutical University Nanjing Jiangsu China

Bacille Calmette-Guérin (BCG) vaccine is designed to provide protection against tuberculosis (TB). However, numerous epidemiological, clinical, and immunological studies have shown that BCG vaccination affects neonatal and infant mortality, which may be related to the reduction of TB-unrelated infections and diseases by BCG vaccine. We aimed to discuss the off-target effects of BCG vaccine on un-TB infections and diseases, as well as the potential mechanism and influencing factors. Literature was retrieved mainly from PubMed using medical subject headings "BCG, variations, and non-specific, heterologous or off-target". Studies have showed that BCG vaccination can prevent various heterologous infections, including respiratory tract infections, leprosy, and malaria, treat viral infections including human papillomavirus and herpes simplex virus infection as immunotherapy, and improve the immune responses as vaccine adjuvant. Besides, BCG vaccine can reduce the recurrence rate of non-muscle-invasive bladder cancer, and may provide protection against autoimmune diseases. These off-target effects of BCG vaccine are thought to be achieved by modulating heterologous lymphocyte responses or inducing trained immunity, which were found to be sex-differentiated and affected by the BCG vaccine strains, sequence or time of vaccination.

关键词： BCG vaccine Off-target effects of vaccines Infections Non-muscle-invasive bladder cancer Autoimmune diseases Trained immunity

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Prenatal amoxicillin exposure induces developmental toxicity in fetal mice and its characteristics

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Journal of Environmental Sciences 2024年第3期137卷 287-301页

作者： Yongguo Dai Yu Peng Wen Hu Yi Liu Hui Wang Department of Pharmacology Wuhan University School of Basic Medical SciencesWuhan 430071China Department of pharmacy Zhongnan Hospital of Wuhan UniversityWuhan 430071China Hubei Provincial Key Laboratory of Developmentally Originated Disease Wuhan 430071China

Amoxicillin,a widely used antibiotic in human and veterinary pharmaceuticals,is now considered as an“emerging contaminant”because it exists widespreadly in the environment and brings a series of adverse ***,systematic studies about the developmental toxicity of amoxicillin are still *** explored the potential effects of amoxicillin exposure on pregnancy outcomes,maternal/fetal serum phenotypes,and fetal multiple organ development in mice,at different doses(75,150,300 mg/(kg·day))during late-pregnancy,or at a dose of 300 mg/(kg·day)during different stages(mid-/latepregnancy)and courses(single-/multi-course).Results showed that prenatal amoxicillin exposure(PAmE)had no significant infuence on the body weights of dams,but it could inhibit the physical development and reduce the survival rate of fetuses,especially during the ***,PAmE altered multiple maternal/fetal serum phenotypes,especially in *** multi-organ function results showed that PAmE inhibited testicular/adrenal steroid synthesis,long bone/cartilage and hippocampal development,and enhanced ovarian steroid synthesis and hepatic glycogenesis/lipogenesis,and the order of severity might be gonad(testis,ovary)>liver>*** analysis found that PAmE-induced multiorgan developmental and functional alterations had differences in stages,courses and fetal gender,and the most obvious changes might be in high-dose,late-pregnancy and multicourse,but there was no typical rule of a dose-response *** conclusion,this study confirmed that PAmE could cause abnormal development and multi-organ function alterations,which deepens our understanding of the risk of PAmE and provides an experimental basis for further exploration of the long-term harm.

关键词： Amoxicillin Prenatal exposure Fetal development Organ function Developmental toxicity

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Normal pregnancy outcome after first-trimester exposure to semaglutide in an overweight woman: a case report

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Clinical Research Communications 2024年第2期7卷 30-33页

作者： Xi-Mei Zhu Qian-Yun Huang Yue Chen Ying Zhou Cai-Hua Yang Clinical pharmacy Center Nanfang HospitalSouthern Medical UniversityGuangzhou 510515China Department of pharmacy Baiyun Branch of Nanfang HospitalSouthern Medical UniversityGuangzhou 510599China

We reported a case of an overweight 34-year-old woman who unexpectedly became pregnant while undergoing semaglutide in early pregnancy and delivered a healthy male infant by caesarean section at 37 weeks and 4 days of *** now,the safety of semaglutide for use during pregnancy was *** report may contribute to the limited knowledge available on pregnant women exposure to semaglutide.

关键词： case report glucagon-like peptide-1 receptor agonist semaglutide normal pregnancy outcome

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Research and Discussion on Flipped Classroom Combined with Case-Based Learning in Pharmacoeconomics Teaching

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Journal of Contemporary Educational Research 2024年第4期8卷 120-125页

作者： Xingwen Zhou Zilong Dang Xingdong Wang Chen Chen Zhi Rao Ting Wei Yanping Wang Department of pharmacy the First Hospital of Lanzhou UniversityLanzhou 730000Gansu ProvinceChina

Objective:To explore the application effect of flipped classroom combined with case-based learning teaching methods in pharmacoeconomics ***:The students majoring in clinical pharmacy in 2019 were selected as the study subjects,and the cost-effectiveness analysis of different dosage forms of Yinzhihuang in the treatment of neonatal jaundice was selected as the teaching *** flipped classroom combined with case-based learning teaching method was used to carry out theoretical teaching to the *** the course,questionnaires were distributed through the Sojump platform to evaluate the teaching ***:The results of the questionnaire showed that 85.71%of the students believed that the flipped classroom combined with case-based learning teaching method was helpful in mobilizing the learning enthusiasm and initiative,and improving the comprehensive application ability of the knowledge of pharmacoeconomics.92.86%of the students think that it is conducive to the understanding and memorization of learning content,as well as the cultivation of teamwork,communication,***:Flipped classroom combined with case-based learning teaching method can improve students’knowledge mastery,thinking skills,and practical application skills,as well as optimize and improve teachers’teaching levels.

关键词： Flipped classroom Case-based learning teaching method Pharmacoeconomics Teaching methods

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Traditional Chinese Medicine in the treatment of recurrent respiratory tract infections in children: an overview of systematic reviews and Meta-analyses

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Journal of Traditional Chinese Medicine 2024年第5期44卷 871-884页

作者： DENG Yasheng HAN Siyin XI Lanhua HUANG Hui LIANG Tianwei ZHENG Yiqing FAN Yanping LIN Jiang School of Basic Medical Sciences Guangxi University of Chinese Medicine School of Basic Medical Sciences Guangxi University of Chinese MedicineGuangxi Key Laboratory of Marine Drugs Department of pharmacy Hainan Traditional Chinese Medicine Hospital

OBJECTIVE: To evaluate and summarise the evidence from published Meta-analyses/systematic reviews(MAs/SRs) of Traditional Chinese Medicine(TCM) in the treatment of recurrent respiratory tract infections(RRTIs) and to provide a scientific basis for the clinical treatment of RRTIs with TCM. METHODS: Studies were retrieved from Chinese and English databases including the China National Knowledge Infrastructure, Wanfang database, China Science and Technology Journal Database, SinoM ed, PubM ed, Web of Science, the Cochrane Library and EMbase from their establishment date to March 2023. Involved studies were screened, extracted, and evaluated for quality by two researchers independently. The a measurement tool to assess systematic reviews(AMSTAR) 2 scale was used for methodological quality evaluation, as well as the preferred reporting items for systematic reviews and Meta-analyses(PRISMA) 2020 statement for report quality evaluation, the risk of bias in systematic reviews(ROBIS) tool for risk of bias, and the grading of recommendations, assessment, development and evaluation(GRADE) quality assessment tool for evidence quality. RESULTS: Twenty MAs/SRs studies were included, including analyses of 274 original studies involving 38 335 patients with RRTIs. The AMSTAR 2 scale evaluation results showed that 19 studies were of very low quality and one of moderate quality. The ROBIS evaluation results showed that 11 MAs/SRs were at high risk and nine at low risk of bias. The PRISMA 2020 report quality showed the included studies had scores between 23.5 and 35.5, among them one with high quality, 17 with moderate quality and two with low quality. The GRADE system results showed that among 126 outcome indicators, only 17 had moderate quality of evidence, 27 had low quality, 82 had very low quality, and none had high quality. CONCLUSIONS: The MAs/SRs methodological quality of using TCM for treatment RRTIs is generally poor, the quality of reports as well as of evidence is generall

关键词： Meta-analysis child medicine, Chinese traditional randomized controlled trial respiratory tract infections systematic review

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Optimization of Extraction Process for Total Flavonoids from Penthorum chinense Pursh and Comparison of Their Contents from Different Parts

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Medicinal Plant 2024年第2期15卷 10-14页

作者： Hongsheng LIU Jiqiang YAO Xue BAI Jianying KANG Yefei YUAN Department of pharmacy Luzhou Hospital of Traditional Chinese MedicineLuzhou 646000China Luzhou Feixiang Pharmaceutical Technology Co. LtdLuzhou 646000China Department of pharmacy Southwest Medical UniversityLuzhou 646000China

[Objectives]This study was conducted to optimize the extraction process of total flavonoids from Penthorum chinense Pursh and compare their contents from different parts.[Methods]Single factor and orthogonal experiments were designed to optimize the extraction process of total flavonoids from *** Pursh with the volume fraction of ethanol,the ratio of material to liquid,heating reflux extraction time and extraction times as factors,and the content of total flavonoids as the index.A verification test was carried *** optimized extraction process was adopted to compare the contents of total flavonoids from different parts of *** Pursh.[Results]The best extraction process was extracting the powder of *** Pursh for 2.0 h with 20 times of 55%ethanol by reflux *** this condition,the contents of total flavonoids were 3.63%,8.90%,11.28%,and 4.36%from stems,leaves,flowers and whole grass of *** Pursh,respectively.[Conclusions]The process is reasonable,feasible and stable,and can effectively extract total flavonoids from *** *** contents of total flavonoids from different parts of *** Pursh were quite different,and the value was higher in the leaves and flowers,so the proportions of leaves and flowers should be paid attention to in the industrial processing of *** Pursh.

关键词： Penthorum chinense Pursh Total flavonoids Orthogonal experiments Extraction process Content determination

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Lupus and Pregnancy

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Open Journal of Rheumatology and Autoimmune Diseases 2024年第3期14卷 125-131页

作者： Soukaina Zaher Hussein Boufettal Kawtar Nassar Naima Samouh Saadia Janani Rheumatology Department Ibn Rochd University Hospital of Casablanca Faculty of Medicine and Pharmacy Hassan II University Casablanca Morocco Obstetrics and Gynecology Department Ibn Rochd University Hospital of Casablanca Faculty of Medicine and Pharmacy Hassan II University Casablanca Morocco

Introduction: Systemic lupus erythematosus is a multifactorial autoimmune disease characterised by its clinical polymorphism and its course in flares. The aim of our study was to determine the effects of pregnancy on lupus and vice versa. Material and Methods: This is a retrospective study conducted over a period of 14 years from 2002 to 2015. We included cases of systemic lupus erythematosus associated with pregnancy followed at the obstetrics and gynecology department “C” of the Ibn Rochd University Hospital in Casablanca. Results: The mean age of our parturients was 31.4 years. All our patients were known to have lupus and were followed up. Pregnancy was terminated in six (20%) cases. We noted one (3%) case of intrauterine fetal death, four (13%) cases of intrauterine growth retardation, and five (16%) cases of prematurity. Lupus flare during pregnancy occurred in 16 (52%) cases, including one (3%) patient who developed superimposed pre-eclampsia, had a renal relapse in the third trimester requiring an abortion at 32 weeks of gestation with three sessions of hemodialysis, and another patient who developed eclampsia. Conclusion: A better understanding of the aggravating factors and compatible treatments has led to a more widespread authorization of pregnancy.

关键词： Systemic Lupus Erythematosus Pregnancy Morbidity Prognosis Retrospective Study

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Individualized anti-thrombotic therapy for acute myocardial infarction complicated with left ventricular thrombus: A case report

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World Journal of Clinical Cases 2024年第4期12卷 835-841页

作者： Yan Song Hua Li Xia Zhang Lei Wang Hong-Yan Xu Zhi-Chao Lu Xiao-Gang Wang Bo Liu Department of Clinical pharmacy Zibo Municipal HospitalZibo 255400Shandong ProvinceChina Department of Cardiology Zibo Municipal HospitalZibo 255400Shandong ProvinceChina Department of pharmacy Zibo Municipal HospitalZibo 255400Shandong ProvinceChina Department of Imaging Zibo Municipal HospitalZibo 255400Shandong ProvinceChina Department of Pulmonary and Critical Care Medicine Department of Clinical MicrobiologyZibo City Key Laboratory of Respiratory Infection and Clinical MicrobiologyZibo City Engineering Technology Research Center of Etiology Molecular DiagnosisZibo Municipal HospitalZibo 255400Shandong ProvinceChina

BACKGROUND Presently,there is no established standard anti-blood clot therapy for patients facing acute myocardial infarction(AMI)complicated by left ventricular thrombus(LVT).While vitamin K antagonists are the preferred choice for oral blood thinning,determining the best course of blood-thinning medication remains *** is unclear if non-vitamin K antagonist oral blood thinners have different effectiveness in treating *** study significantly contributes to the medical *** SUMMARY The blood-thinning treatment of a patient with AMI and LVT was *** blood-thinning therapy included daily enteric-coated aspirin tablets at 0.1 g,daily clopidogrel hydrogen sulfate at 75 mg,and dabigatran etexilate at 110 mg twice *** 15 d,the patient’s LVT did not decrease but instead *** pharmacists comprehensively analyzed the cases from the perspective of the patient’s disease status and drug *** drug regimen was reformulated for the patient,replacing dabigatran etexilate with warfarin,and was administered for six *** clinical pharmacist provided the patient with professional and standardized pharmaceutical *** patient’s condition was discharged after meeting the international normalized ratio value(2-3)*** patient fully complied with the follow-up,and the time in the therapeutic range was 78.57%,with no serious adverse effects during pharmaceutical *** Warfarin proves to be an effective drug for patients with AMI complicated by LVT,and its blood-thinning course lasts for six months.

关键词： Myocardial infarction Left ventricular thrombus Dabigatran etexilate Warfarin Clinical pharmacist Case report

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Knowledge towards Physical Medicine and Rehabilitation among Training Doctors and Medical Students at the Mohammed VI University Hospital of Marrakech

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Open Journal of Therapy and Rehabilitation 2024年第2期12卷 132-144页

作者： Asma Elhanafi Douaa Elmejdoubi Youness Abdelfettah Physical Medicine and Rehabilitation Department University Hospital MOHAMMED VI of Marrakech Faculty of Medicine and Pharmacy of Marrakesh Cadi Ayyad University Marrakech Morocco

The aim of our study is to evaluate the knowledge regarding physical medicine and rehabilitation among physicians in training and medical students at the Mohammed VI University Hospital in Marrakech, to approach the knowledge, attitudes, and practices of doctors regarding physical medicine and rehabilitation and evaluate the knowledge in theoretical training related to PRM among the students. We conducted a monocentric cross-sectional analytical study, using a web-based anonymous survey, carried out among 558 undergraduate student and training doctors, randomly selected in the form of a survey on the knowledge towards Physical Medicine and rehabilitation. We received 558 survey duly completed by students of the Faculty of Medicine and pharmacy of Marrakech (62.4%) and training doctors (37.6%). The mean age of the participants was 24.53 ± 3.9 years, with extremes ranging from 17 to 39 years. 52.7% of the participants were from the former educational reform, The predominance of participation was remarkable among pediatricians 23%, The population who knew PRM was the majority (79.3%), 40.7% of the participants were unaware of the availability of a PRM department at Mohamed VI University Hospital, 0.5% of all training doctors and medical students questioned strongly agreed with the sufficiency of their training in disability management were belonging to the new reform, 84.1% of participants had never attended or referred a patient to the PRM department. 23.2% of training doctors affirmed the referral of patients to PRM for further management. Despite the essential role of PRM in the management of diseases, it remains little known by training doctors and medical students. This lack of knowledge of PRM reflects the lack of the undergraduate and postgraduate of the medical education in the field of rehabilitation.

关键词： Physical Medicine and Rehabilitation PRM Knowledge Training Doctors Medical Students

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