As an important policy tool, real-world evidence is the basis for health insurance catalogue adjustment, and relevant policies and regulations have been issued in foreign countries to guide the use of real-world research for health insurance access, but the field of traditional Chinese medicine in China in particular is still in the exploratory stage. Since TCM protocols are widely used in clinical practice and have significant clinical value, this paper takes TCM protocols as an example and systematically constructs a technical pathway based on real-world research to support health insurance access, including clinical needs assessment, basic requirements of protocols, key points for conducting real-world research and evaluating real-world evidence, the process of access, the strategy of access, and the dynamic monitoring of access, with the aim of providing guidance for the application of real-world research in China's health insurance catalogue adjustment. Access to real-world research to provide reference for the application of real-world research in China's health insurance.
3D printing technology has a promising prospect of medical use and clinical value, and may play an important role in the field of thoracic and cardiovascular surgery, such as preoperative diagnosis, surgical planning, surgical approach alternatives and organ replacement. This review focuses on the development of 3D printing technology in recent years and its use and prospect in the field of thoracic and cardiovascular surgery including surgical teaching and simulation, personalized prosthesis implantation, and artificial organ transplantation.
Objective To determine whether lymph node-targeted chemotherapy with carbon nanoparticles absorbing 5-FU affects expressions of bcl-2, bax and caspase-3 in gastric cancer tissues, metastatic lymph nodes and normal gastric mucosa. Methods Twenty-eight patients with gastric cancer in our department were divided into lymph node-targeted chemotherapy (LNTC) group and control group from October 2005 to August 2006. The patients were treated with carbon nanoparticles absorbing 5-FU before operation in LNTC group and those were operated directly in control group. The gastric cancer tissues, metastatic lymph nodes and normal gastric mucosa were collected after operation. The expressions of bcl-2, bax and caspase-3 in those tissues were determined by immunohistochemical technique. Results In LNTC group, the positive expression rate of bcl-2 in gastric cancer tissues and metastatic lymph nodes was significantly lower than those in control group (28.6% vs . 78.6% , 25.0% vs . 70.0% , P ＜ 0.05), the positive expression rate of bax (85.7% vs . 28.6% , 80.0% vs . 30.0% ) and caspase-3 (57.1% vs . 14.3% , 55.0% vs . 15.0% ) in gastric cancer tissues and metastatic lymph nodes was significantly higher than those in control group ( P ＜ 0.05). The positive expression rate of bcl-2, bax and caspase-3 in normal gastric mucosa was not significantly different between two groups ( P ＞ 0.05). Conclusion The lymph node-targeted chemotherapy with carbon nanoparticles absorbing 5-FU can down-regulate the expression of bcl-2 and up-regulate the expression of bax and caspase-3 in gastric cancer tissues and metastatic lymph nodes, and therefore by affecting the expression levels of these apoptosis molecules may be one of the ways to induce tumor cell apoptosis.
Objective To study the mechanism of immune hyporesponsiveness of allograft rejection induced by transfusion nonpufsed allopeptide syngeneic immature dendritic cell (imDC) generated from recipient bone marrow progenitors and to explore a possible strategy for liver allograft protection in clinic. Methods Forty experimental rats were randomly divided into 4 group: control group, cyclosporine A (CsA) group, mature DC (mDC) group and imDC group. In control group, Wistar rats only received liver transplantation. In CsA group, Wistar rats underwent liver transplantation plus CsA treatment 〔10 mg/（kg·d)〕. In mDC group, recipient-derived mDC 1×106 were infused intravenously through the penile vein to Wistar rats. In imDC group, ImDC with the dose of 1×106 were injected into Wistar rats via the dorsum vein of penile. In each group, five recipients were killed on the 10th day after transplantation, the other five recipients were left to observe survival time. The levels of ALT, AST, TBIL, IL-2, IFN-γ, IL-4 and IL-10 were detected. The acute rejection and the expression of FasL/Fas in the grafts were detected by HE and immunohistochemical staining. Western blot was used to detect Scurfin protein expression of CD4+ CD25+ T cells. Results The median survival time of the liver allografts in CsA group and imDC group were significantly longer than that in control group and mDC group ( P ＜ 0.05). The levels of ALT and TBIL in control group and mDC group were significantly higher than those in CsA group and imDC group ( P ＜ 0.05). Compared with CsA group and imDC group, the levels of IL-2 and IFN-γ were higher but the levels of IL-4 and IL-10 were lower in control group and mDC group ( P ＜ 0.01). Slightly or no rejection reaction was found in CsA group and imDC group ( P ＜ 0.05). The Scurfin protein expressions of CD4+ CD25+ T cells of imDC group were significantly higher than those of other three groups. Conclusion Application of nonpufsed allopeptide syngeneic recipient-derived imDC is an effective way to induce immune hyporesponsiveness by blocking indirect recognition in rat liver transplantation model. Survival span is significantly prolonged by its protective effect. The mechanism of immune hyporesponsiveness induced by imDC transfusion might be involved in some aspects: T cell apoptosis, immune deviation of Thl/Th2 cytokine net and inhibition of T lymphocytes responsiveness by regulatory T cells.
In 1994, a statement on the performance of lung function testing was issued by the Association for Respiratory Technology & Physiology (ARTP), and it has been updated in 2020. In this paper, we introduced the updated content, including general procedures, normal value ranges and interpretations of obstructive ventilation dysfunction, precautions of lung function tests, and paediatric lung function testing. We also compared the differences between the ARTP statement and the lung function guidelines issued by the Chinese Thoracic Society (CTS) and put forward some appropriate suggestions from the viewpoint of our current situation. We expected it to provide valuable references for the normative update and application of pulmonary function tests in China.
Mini health technology assessment (mini-HTA) is a decision support tool based on the principle and method of evidence-based medicine and traditional HTAs. It systematically reviews healthy technologies and provides references for decision makers at the hospital level in terms of introducing relevant health technologies. In order to provide a new insight to the decision makers, this paper briefly introduces the features of mini-HTA.
Abstract: Objective To investigate the feasibility of the bone marrow mesenchymal stem cells (BMSCs) as the seed cells for construction of small diameter blood vessels and its induced mechanisms. Methods The bone marrow cells were obtained from hind femur and tibia of male Sprague-Dawley（SD） rats with a body weight of 100 g. The cells were purified by whole bone marrow primary culture before repeated passage in vitro amplification. Cell morphology was observed, and expressions of CD34, CD90, and CD105 cell factors were examined by flow cytometry to identify whether they were the BMSCs. Then, the BMSCs obtained were divided into the experiment group and the control group. The cells in the experiment group were induced to differentiate into the vascular smooth musclelike cells by the Dulbecco’s modified Eagle’s mediumlow glucose(DMEM-LG) plus alltrans retinoic acid and dbcAMP, while the cells in the control group were cultured by the normal DMEM-LG. We observed the morphological characteristics of the BMSCs and detected the expressions of smooth muscle-α actin (SM-α-actin), calponin, and vascular smooth muscle myosin heavy chain(SMMHC) by immunofluorescence and flow cytometry with the fifth generations cells after induction. Results The cells obtained through primary culture appeared spindleshaped and showed characteristic swirling growth. The surface marker CD34 was negative, while CD90 and CD105 were positive. After induction, the cells in the experiment group grew slowly and were slightly ovalshaped. The expression of SM-α-actin, calponin, and SMMHC was significant in the experiment group. In the control group, cell morphology and cell growth were similar to the those of BMSCs in the experiment group, but the expression of SM-α-actin, calponin, and SMMHC was negative. Conclusion The BMSCs can be induced to differentiate into the phenotype of vascular smooth musclelike cells by alltrans retinoic acid，the induced cells which can act as seed cells for tissue engineering construction of small diameter blood vessels.
Brain–computer interface (BCI) technology faces structural risks due to a misalignment between its technological maturity and industrialization expectations. This study used the Technology Readiness Level (TRL) framework to assess the status of major BCI paradigms—such as steady-state visual evoked potential (SSVEP), motor imagery, and P300—and found that they predominantly remained at TRL4 to TRL6, with few stable applications reaching TRL9. The analysis identified four interrelated sources of bubble risk: overly broad definitions of BCI, excessive focus on decoding performance, asynchronous translational progress, and imprecise terminology usage. These distortions have contributed to the misallocation of research resources and public misunderstanding. To foster the sustainable development of BCI, this paper advocated the establishment of a standardized TRL evaluation system, clearer terminological boundaries, stronger support for fundamental research, enhanced ethical oversight, and the implementation of inclusive and diversified governance mechanisms.
The reporting checklist of health technology assessment (HTA) was a tool developed by the International Network of Agencies for Health Technology Assessment (INAHTA) to be used to guide the reporting of HTA. Experiential evidence showed that the tool was effective to improve the reporting quality of HTA and also could be used as a reference in performing HTA and translating the research evidence into decision-making. This paper introduced the background, developing process and main contents of the checklist, so as to improve the reporting quality of HTA in China.