ObjectiveTo assess the efficacy of lymphadenectomy in different regions for esophageal squamous cell carcinomas located differently according to the lymph node grouping by Chinese expert consensus. MethodsThe medical records of 1 061 patients (886 males and 175 females with a median age of 60 (54, 65) years with esophageal cancer from March 2011 to December 2017 in our hospital were retrospectively analyzed. According to the pathological report, the lymph nodes were regrouped according to the Chinese lymph nodes grouping standard of esophageal cancer. The metastasis rate of each group of lymph nodes, the 5-year survival rate of metastatic patients and efficacy index (EI) were calculated. ResultsThe upper thoracic esophageal cancer mainly metastasized to the lymph nodes of C201-203 groups. The middle and lower thoracic tumors mainly metastasized to the lymph nodes of C205-207 groups. The lower thoracic tumor had a higher rate of metastasis to the abdominal lymph nodes. According to the metastasis rate, the mediastinal lymph nodes were divided into three regions: an upper mediastinum (C201-204), a middle mediastinum (C205-206), and a lower mediastinum (C207-209). The EIs of lymph nodes of C201-203 and C205-207 groups were higher. For patients with C201-207 groups metastasis, the 5-year survival rates ranged from 13.39% to 21.60%. For patients with positive lymph nodes in each region, tumors at different primary locations had no statistical difference in long-term survival (P>0.05). Patients with lymph nodes of C205 group in the upper thoracic tumors had lower EI and those in the middle and lower thoracic tumors had higher EIs. ConclusionThe effect of lymph node dissection in each area varies with the location of the tumor. No matter where the tumor is, it is necessary to dissect the upper mediastinal lymph nodes, especially the lymph nodes adjacent to the left and right recurrent laryngeal nerves. Group C205 should be classified into the lower mediastinal lymph nodes.
ObjectiveTo systematically review the risk factors for knee osteoarthritis among Chinese population.MethodsCNKI, WanFang Data, PubMed and EMbase databases were electronically searched to collect studies related to risk factors for knee osteoarthritis in Chinese population from January 2005 to November 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies; meta-analysis was then performed using RevMan 5.4 software.ResultsA total of 18 studies involving 46 375 patients were included. The results of meta-analysis showed that body mass index (BMI)≥28 kg/m2 (OR=1.78, 95%CI 1.47 to 2.14, P<0.000 1), females (OR=2.20, 95%CI 1.98 to 2.45, P<0.000 1), family history of osteoarthritis (OR=3.56, 95%CI 1.88 to 6.73, P<0.000 1), age≥60 years old (OR=1.42, 95%CI 1.26 to 1.59, P<0.000 1), history of joint trauma (OR=4.11, 95%CI 2.85 to 5.93, P<0.000 1), manual labor (OR=1.57, 95%CI 1.32 to 1.86, P<0.000 1), heavy housework (OR=1.63, 95%CI 1.20 to 2.22, P<0.000 1), humid environment (OR=4.33, 95%CI 2.99 to 6.29, P<0.000 1), drinking habit (OR=1.69, 95%CI 1.21 to 2.36, P=0.002), non-elevator building (OR=1.78, 95%CI 1.18 to 2.70, P=0.006), joint load (OR=9.14, 95%CI 3.05 to 27.45, P<0.000 1), cold environment (OR=2.13, 95%CI 1.32 to 3.44, P=0.002), and habit of sitting cross-legged (OR=7.56, 95%CI 1.74 to 32.79, P=0.007) were risk factors for knee osteoarthritis among Chinese population.ConclusionsControlling and reducing weight, preventing knee injuries, keeping joints warm, controlling alcohol consumption, improving humid and cold living environment, appropriately reducing heavy physical labor, reducing joint weight, and changing the habit of sitting cross-legged can prevent the occurrence of knee osteoarthritis.
ObjectiveTo systematically review the efficacy of Chinese medicine injection (CMI) for treating heart failure (HF).MethodsCNKI, WanFang Data, VIP, The Cochrane Library, PubMed, and EMbase databases were electronically searched from inception to January 2021 to identify randomized controlled trials (RCTs) on CMI for treating HF. Two reviewers independently screened literature, extracted data, and evaluated the risk of bias of included studies. Network meta-analysis was then performed by RevMan 5.2 software and Stata 16.0 software.ResultsA total of 47 studies were included involving 4 902 patients and 5 types of CMIs, including Shenmai, Shenfu, Yiqi Fumai (lyophilized), Shengmai, and Danhong injections. The results of network meta-analysis showed that the efficacy of combined CMIs was superior to conventional Western medicine alone. For the main efficacy, Shenmai, Shengmai, and Shenfu injections had significant advantages in improving the total clinical effectiveness. Shengmai, Shenmai, and Yiqi Fumai (lyophilized) injections were significantly more effective for reducing NT pro-BNP levels than other injections. Shenfu and Shengmai injections were significantly more effective for reducing BNP levels than other injections. Shenmai, Danhong and Shengmai injections were significantly more effective for improving the left ventricular ejection fraction than the other injections. These CMIs showed similar advantages for secondary efficacy indicators as for main efficacy indicators.ConclusionsThe combined 5 types of CMIs for treating HF can improve the clinical efficacy when compared with conventional Western medicine treatment. Shenmai injection, Yiqi Fumai injection (lyophilized), and Shengmai injection, which is part of Sheng Mai San, have clear advantages in terms of the overall curative effect or on individual indices.
Objective To assess the efficacy and safety of Chinese medicinal herbs for treating endometriosis. Methods We searched Cochrane Library, MEDLINE, EMBASE, CBM (from establishment to 2003). Randomized controlled trials (RCTs) and quasi-randomized controlled trials of patients with endometriosis were included. The quality of included studies such as randomization, blinding, allocation concealment and loss of follow up were evaluated and meta-analysis was performed by RevMan 4.3 software. Results Ten RCTs or quasi-RCTs involving 1 120 patients were included. Because of different therapies in the treatment and control groups, the results of outcome were described separately. Most of included studies suggested that the effects of traditional Chinese medicine (TCM) on general effect, pregnancy rate improvement and alleviating dysmenorrhoea were similar to Danazol or Tamoxifen, only a few studies showed better effects. There was no evidence to support that TCM was more effective than western medicine in reducing the size of endometriotic cysts. Only one study mentioned the recurrence rate and showed that TCM enema had lower recurrence rate than oral Tamoxifen with OR 0.17, 95%CI 0.04 to 0.67. Five studies mentioned adverse reactions and showed TCM had fewer adverse effects than western medicine. Conclusions Chinese medicinal herbs are effective in treating endometriosis with fewer adverse effects. The evidence is not b enough because of low quality of the included studies. Therefore, more high quality randomized controlled trials are required.
Objective To analyze the differences in distribution of traditional Chinese medicine (TCM) syndrome elements and salivary microbiota between the individuals with pulmonary nodules and those without, and to explore the potential correlation between the distribution of TCM syndrome elements and salivary microbiota in patients with pulmonary nodules. Methods We retrospectively recruited 173 patients with pulmonary nodules (PN) and 40 healthy controls (HC). The four diagnostic information was collected from all participants, and syndrome differentiation method was used to analyze the distribution of TCM syndrome elements in both groups. Saliva samples were obtained from the subjects for 16S rRNA high-throughput sequencing to obtain differential microbiota and to explore the correlation between TCM syndrome elements and salivary microbiota in the evolution of the pulmonary nodule disease. Results The study found that in the PN group, the primary TCM syndrome elements related to disease location were the lung and liver, and the primary TCM syndrome elements related to disease nature were yin deficiency and phlegm. In the HC group, the primary TCM syndrome elements related to disease location were the lung and spleen, and the primary TCM syndrome elements related to disease nature were dampness and qi deficiency. There were differences between the two groups in the distribution of TCM syndrome elements related to disease location (lung, liver, kidney, exterior, heart) and disease nature (yin deficiency, phlegm, qi stagnation, qi deficiency, dampness, blood deficiency, heat, blood stasis) (P<0.05). The species abundance of the salivary microbiota was higher in the PN group than that in the HC group (P<0.05), and there was significant difference in community composition between the two groups (P<0.05). Correlation analysis using multiple methods, including Mantel test network heatmap analysis and Spearman correlation analysis and so on, the results showed that in the PN group, Prevotella and Porphyromonas were positively correlated with disease location in the lung, and Porphyromonas and Granulicatella were positively correlated with disease nature in yin deficiency (P<0.05). ConclusionThe study concludes that there are notable differences in the distribution of TCM syndrome elements and the species abundance and composition of salivary microbiota between the patients with pulmonary nodules and the healthy individuals. The distinct external syndrome manifestations in patients with pulmonary nodules, compared to healthy individuals, may be a cascade event triggered by changes in the salivary microbiota. The dual correlation of Porphyromonas with both disease location and nature suggests that changes in its abundance may serve as an objective indicator for the improvement of symptoms in patients with yin deficiency-type pulmonary nodules.
Acute pancreatitis (AP) is a common clinical emergency of the abdomen with increasing incidence and lack of effective treatment. Traditional Chinese medicine, as a treasure of the Chinese people, has been used in the treatment of AP for decades with favorable therapeutic effects. Currently, clinical trials and experimental studies have shown that traditional Chinese medicine has the effects of inhibiting pancreatic enzyme activity, anti-inflammation, promoting gastrointestinal dynamics, as well as delaying the progress of AP, improving clinical symptoms, reducing related complications, and reducing the mortality rate. Therefore, traditional Chinese medicine has considerable clinic value in treating AP. Based on the related research progress and clinical practice of our team, the authors summarized the targets and mechanism of traditional Chinese medicine in treating AP.
This paper systematically reviews the important events and their significance in different stages of the construction of the Chinese discipline system of wound repair, and puts forward the following suggestions for its future development: the disciplinary content should be more normalized, standardized and organized; it is necessary to break through policy restrictions, and establish multidisciplinary integrated management, seamlessly connected treatment model, and integrated combination of therapy and rehabilitation, basing on models and standards of research-oriented hospitals and departments; the application of information technology in the discipline should be strengthened; some other items and problems, such as medical management, medical supervision and medical insurance, need further in-depth research and specific solutions.
Chinese medicine case report, a special method, records the experience of practitioners and guides students to inherit and develop Chinese medicine. It can transfer a large amount of medical and humanistic information and contribute to the development of Chinese medicine. It is a literary style that has been widely accepted and helps to document and disseminate the culture of Chinese medicine. With the advent of big data and information, more Chinese medicine case reports have been published. However, many have insufficient quality to properly guide and apply in the clinical practice, which might be caused by little guidance of Chinese medicine case report standards published. This paper summarized the case report standards, synthesized and appraised the feasibility and problems specific for improving the quality of Chinese medicine case reports, and proposed suggestions and guidance for developing the standardization of Chinese medicine medical case reports.
It is very important to develop and revise expert panel consensus on Chinese patent medical clinical application. The contents of the expert panel consensus include determination of the subject, clarity of the application scope, indications, dosage and administration, and safety of Chinese patent medicine. In the process, clinical researchers establish project team, formulate clinical management questions, select the outcome index, retrieve and make the evidence, and develop expert consensus with consensus methods strictly according to the requirements of methodology.
ObjectiveTo systematically review the status of alexithymia in the Chinese elderly.MethodsCNKI, VIP, CBM, WanFang Data, PubMed, EMbase, Web of Science, PsycINFO, and The Cochrane Library databases were electronically searched to collect cross-sectional studies related to the epidemiological characteristics of alexithymia among the elderly in China from inception to February 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; meta-analysis was then performed using Stata 16.0 software.ResultsA total of 11 cross-sectional studies involving 3 592 elderly individuals were included. The results of meta-analysis showed that the prevalence of alexithymia in the Chinese elderly was 36% (95%CI 30% to 42%), and the score of alexithymia was 58.59 (95%CI 54.60 to 62.57). Subgroup analyses indicated that the prevalence of alexithymia was 39% (95%CI 32% to 45%) in northern China, 33% (95%CI 30% to 37%) in northeast China, 36% (95%CI 31% to 41%) in eastern China, 51% (95%CI 44% to 58%) in central China, and 20% (95%CI 16% to 24%) in the southwest China. The prevalence rates of hospitalized, nursing home, and community elderly were 42% (95%CI 34% to 49%), 37% (95%CI 28% to 45%), and 29% (95%CI 20% to 38%), respectively. The scores of alexithymia were higher among the elderly males, 80 years or older, engaged in heavy physical work prior to retirement, suffering from severer chronic diseases, low education background, low monthly income, living alone, and low frequency of participation in group activities and visited by relatives.ConclusionsCurrent evidence shows that the overall prevalence of alexithymia is high in the Chinese elderly, and varies with regions. The levels of alexithymia among gender, age, occupation prior to retirement, number of chronic diseases, educational level, monthly income, habitation manner, the frequency of participating in group activities, and being visited by relatives and friends are different.