Epigenetics has been very hot in the research of biomedicine. In addition to genetic factors, the occurrence of a disease is also influenced by environmental factors. Retinal vascular diseases are a type of irreversible blind eye disease, such as age-related macular degeneration and diabetic retinopathy. The retinal vessel changes are the major features of retinal vascular diseases, which are the result of interaction of multiple environmental factors and genes. Epigenetic modification mainly includes DNA methylation, histone modification, and non-coding RNA regulation. Epigenetic mechanisms mediate the effects of environmental factors on genes related to retinal vascular diseases, and affect the eventual development of the diseases. Therefore, ophthalmologists should keep eyes close on the role of epigenetics in retinal vascular diseases, track the progress of epigenetic methods in the treatment of retinal vascular diseases, and pay attention to the application prospects of epigenetics. Finding the epigenetic regulators of these diseases can not only deepen the understanding of the pathological mechanism of these diseases, but also provide new ideas for the diagnosis and treatment of these diseases.
Compared with traditional clinical trials, the real-world studies set higher requirements on the authenticity (reality), applicability, and timeliness of the evidence obtained. In this paper, we brought up a hypothesis that creating synergies between observational and experimental studies may meet these requirements. And then it was discussed in three aspects including providing evidence, research design and execution. In addition, data analysis facilitated generating efficient and robust evidence which was in support of decision making. Finally, some enlightenment may be offered for Traditional Chinese Medicine evaluation methods based on the synergies of both study types.
ObjectiveUsing SYRCLE tool (the SYstematic Review Centre for Laboratory animal Experimentation) to evaluate the risk of bias of animal studies in stroke field published in Chinese journals, identify problems of these studies in design, implementation and measurement, in order to provide references for improving the quality of animal studies in China. MethodsWe searched databases including CBM, VIP, CNKI and WanFang Data from inception to December 31st, 2014. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included animal studies using SYRCLE tool developed by the National Centre for the Replacement, Refinement and Reduction of Animals in Research. ResultsA total of 582 studies were included. The assessment results showed that the number of reported items with "Low Risk" in SYRCLE, which have 22 items, reported in >50% of the 4 items and in <30% the 16 items in articles of animals experiments. More than 99% of the studies fulfilled the 3 items and more than 17% of the articles to meet the 10 items while less than 1% of the documents met the 17 items. The quality of studies increased excepted the period of 2010 to 2014. The methodological quality of animal experiments presented a trend of increasing and no significant differences were found in CSCD indexed or not. ConclusionThe methodological quality of animal experiments of stroke is poor in China in terms of the selection bias, implementation bias, measurement bias, withdraw bias and reporting bias.
Evidence-based medicine advocates to support clinical decision-making with the best evidence, which is useful to objectively evaluate the clinical efficacy of traditional Chinese medicine and optimize clinical diagnosis and treatment. However, significant individualized characteristics identified from syndrome differentiation and treatment are incompatible with evidence-based clinical decision-making, which highlights population-level evidence, to some extent. In recent years, a number of new methods and technologies have been introduced into individualized clinical efficacy evaluation research of traditional Chinese medicine to assist managing and processing complex and multivariate information. These methods and technologies share similarities with evidence-based medicine, and are expected to link the clinical practice of traditional Chinese medicine with evidence-based clinical decision-making. They will guide the development of evidence-based clinical decision-making in traditional Chinese medicine.
ObjectiveTo evaluate the clinical therapeutic effect of biceps tendon tenotomy and fixation versus biceps tendon repair for shoulder superior labrum anterior posterior (SLAP) lesions with Meta-analysis. MethodsThe databases such as PubMed, EMbase, the Cochrane Library (Issue 3, 2014), CBM, VIP and CJFD (from the establishment time of databases to December 2014) were searched to collect all randomized controlled trials (RCT) on the clinical effectiveness of biceps tendon tenotomy and fixation versus biceps tendon repair for shoulder SLAP lesions. Two reviewers independently screened the literature according to the inclusive and exclusive criteria, extracted the data, and assessed the methodological quality of included studies. After the data extraction and methodological quality evaluation, meta-analysis was conducted with RevMan 5.0 software. ResultsThree RCT were included. Among the total 137 patients involved, Meta-analysis showed that, compared with the biceps tendon repair group, the biceps tenotomy group had superior amount in the UCLA score [WMD=3.43, 95%CI (2.29, 4.56), P<0.000 01], the shoulder pain [WMD=1.18, 95%CI (0.30, 2.05), P=0.009], function [WMD=0.96, 95%CI (0.51, 1.41), P<0.000 1] and satisfaction [WMD=1.16, 95%CI (0.31, 2.01), P=0.007] with significant differences. But there were no significant differences between the two groups in the shoulder flextion [WMD=0.10, 95%CI (-0.87, 1.06), P=0.84] and strength [WMD=0.13, 95%CI (-0.09, 0.35), P=0.25]. ConclusionBased on the current studies, the biceps tenotomy and fixation is superior to the biceps tendon repair in treating shoulder SLAP lesions. For the quality restrictions and possible publication bias of the included studies, more double blind, high quality RCT are required to further evaluate the effects.
ObjectiveTo systematically review the effect of compound Danshen dripping pills combined with Western medicine on inflammatory factors and cardiac function after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction.MethodsDatabases including CNKI, WanFang Data, VIP, CBM, PubMed, Web of Science, EMbase and The Cochrane Library were searched for randomized controlled trials of compound Danshen dripping pills combined with Western medicine in the treatment of acute myocardial infarction after PCI. The retrieval time was from the establishment of the databases to June 11th, 2020. Two reviewers independently screened literature, extracted data and evaluated the risk bias of included studies. RevMan 5.3 software was used for meta-analysis.ResultsA total of 16 studies were included, involving 2 069 patients. The results of the meta-analysis showed that the combination of compound Danshen dripping pills could increase the left ventricular ejection fraction (MD =−4.74, 95%CI 4.07 to 5.42, P<0.01), decrease the B-type natriuretic peptide (SMD=−3.81, 95%CI −5.06 to −2.57, P<0.01), the level of interleukin-6 (SMD=−3.20, 95%CI −4.54 to −1.86, P<0.01) and level of tumor necrosis factor-a (SMD=−4.96, 95%CI −7.03 to −2.89, P<0.01).ConclusionsCurrent evidence suggests that the combination of compound Danshen dropping pills has potential benefits in inhibiting inflammation and improving cardiac function after PCI. Due to the limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusions.
ObjectiveTo reveal the pathogenic mutation in a three-generation Chinese family with autosomal dominant familial exudative vitreoretinopathy (FEVR). MethodsThree patients and a healthy spouse from the index family with FEVR were recruited. The proband was a 5 years old boy. His mother and grandpa were presented with typical FEVR presentations, while his father with normal ocular fundus. DNA was extracted from peripheral blood samples taken from all four participants. All coding and exon-intron boundary regions of five targeted genes, including NDP, FZD4, LRP5, TSPAN12 and ZNF408 were amplified with polymerase chain reaction and sequenced using direct sequencing. In silico analyses were applied to determine the conservation of the mutation site, pathogenic effect and the potential protein crystal structural changes caused by the mutation. ResultsFZD4 c.478G > A, a susceptible mutation was found after four high frequency mutation sites which MAF values were higher than 0.001 was filtered among 5 single nucleotide variations detected in four participants, leading to the residue 160 changing from glutamate to lysine (p.E160K). Co-segregation analysis between genotypes and phenotypes revealed FZD4 p.E160K as the disease-causing mutation for this family. Conservational analysis suggested that this mutation site was highly conserved among all tested species. Functional analysis predicated that this mutation may be a damaging mutation. Crystal structural analysis also indicated that this mutation could lead to the elimination of the hydrogen bond between residue 160 and asparagine at residue 152, thus altering the tertiary structure of the protein and further impairing the protein function. ConclusionOur study demonstrates FZD4 p.E160K as a novel pathogenic mutation for FEVR.
The prominent feature and form of clinical diagnosis and treatment of traditional Chinese medicine is individualization, which has generated difficulty for clinical evaluation and has restricted the production of high-level evidence for traditional Chinese medicine for a long time. Based on the complexity and dynamics of individualized information under the characteristics of time and space, this paper references the theory of space-time of system science to analyze the individualized data of diagnosis and treatment of traditional Chinese medicine and summarizes the concept of the long time course for clinical evaluation. Based on the concept of the long time course, this paper starts with the origin of clinical evaluation, which is the construction of clinical problem elements named PICO, introduces dynamic evaluation factors, explores the construction of individualized dynamic evaluation method of traditional Chinese medicine, and provides demonstration and examples for the design and implementation of individualized clinical research in future.