[Outcome indicators in randomized controlled trials on traditional Chinese medicine intervention for tension-type headache in recent five years].

To evaluate the application of outcome indicators in randomized controlled trials(RCTs) concerning the treatment of tension-type headache(TTH) with traditional Chinese medicine(TCM) in recent five years, so as to provide a basis for the study of core outcome set(COS) for TCM intervention in TTH. The RCTs on TCM treatment of TTH in recent five years were systematically retrieved from CNKI, Wanfang, VIP, CBM, EMbase, PubMed, Cochrane Library, Web of Science, ClinicalTrials.gov and China Clinical Trial Registry. After literature screening, data extraction and evaluation of the risk of bias, the outcome indicators in the included RCTs were subjected to qualitative analysis. The preliminary search yielded 19 042 articles, and 10 983 were left after the elimination of duplication. Finally, 52 RCTs(48 in Chinese and 4 in English) were included for qualitative analysis. The outcome indicators of RCTs included in this study were classified into seven domains: TCM syndrome, symptom and sign, physical and chemical detection, quality of life, long-term prognosis, economic evaluation, and safety event. The findings demonstrated that headache characteristic index in the symptom and sign domain was the index with the highest reporting frequency and reporting rate. Seventeen RCTs used TCM syndrome score as the outcome indicator. Further analysis revealed that there existed such problems in research design as non-distinction between primary and secondary outcome indicators, great difference in the adopted measurement tools for outcome indicators, and the neglect of measurement time of outcome indicators. Moreover, the syndrome indicators reflecting TCM advantages, objective evaluation indicators, safety and health-economic indicators were lacking. These limitations have affected the quality and reliability of RCTs on TTH treatment with TCM. It is suggested that the efficacy and characteristics of TCM should be combined into current clinical research, and the COS in RCTs regarding TCM treatment of TTH should be established according to internationally recognized standard procedures.

Prospective assessment of a nasopharyngeal carcinoma risk score in a population undergoing screening.

Despite evidence suggesting the utility of Epstein-Barr virus (EBV) markers to stratify individuals with respect to nasopharyngeal carcinoma (NPC) risk in NPC high-risk regions, no validated NPC risk prediction model exists. We aimed to validate an EBV-based NPC risk score in an endemic population undergoing screening for NPC. This prospective study was embedded within an ongoing NPC screening trial in southern China initiated in 2008, with 51 235 adult participants. We assessed the score's discriminatory ability (area under the receiver-operator-characteristics curve, AUC). A new model incorporating the EBV score, sex and family history was developed using logistic regression and internally validated using cross-validation. AUCs were compared. We also calculated absolute NPC risk combining the risk score with population incidence and competing mortality data. A total of 151 NPC cases were detected in 2008 to 2016. The EBV-based score was highly discriminating, with AUC = 0.95 (95% CI = 0.93-0.97). For 90% specificity, the score had 87.4% sensitivity (95% CI = 81.0-92.3%). As specificity increased from 90% to 99%, the positive predictive value increased from 2.4% (95% CI = 1.9-3.0%) to 12.5% (9.9-15.5%). Correspondingly, the number of positive tests per detected NPC case decreased from 272 (95% CI = 255-290) to 50 (41-59). Combining the score with other risk factors (sex, first-degree family history of NPC) did not improve AUC. Men aged 55 to 59 years with the highest risk profile had the highest 5-year absolute NPC risk of 6.5%. We externally validated the discriminatory accuracy of a previously developed EBV score in a high-risk population. Adding nonviral risk factors did not improve NPC prediction.

Assessment of the subtypes and the zoonotic risk of Blastocystis sp. of experimental macaques in Yunnan province, southwestern China.

Blastocystis is an enteral eukaryote with an omnipresent existence in animals and humans globally. Animals have been proposed to be a major reservoir for the transmission of Blastocystis to individuals due to their high prevalence and large amount of zoonotic subtypes. However, limited data on Blastocystis infection in experimental macaques in China exists. The objective of the current study was to investigate the frequency and subtypes of Blastocystis infection in macaques in southwestern China. A total of 505 fecal samples were collected from experimental macaques in Yunnan province and were analyzed by nested PCR and phylogenetic analyses on the basis of small subunit rRNA (SSU rRNA) gene fragments. A total of 235 specimens were positive for Blastocystis sp., and the prevalence of Blastocystis sp. was 46.5% (235/505). Significant differences in prevalence were also observed among the various species of macaques (P < 0.0133, df = 2, χ2 = 8.64) and the different feed types (P < 0.0093, df = 1, χ2 = 6.77). Moreover, three zoonotic subtypes, ST1, ST3, and ST5, were identified by DNA sequence analysis. There were mainly single subtype infections with some mixed subtype infections, and the predominant subtype was ST3. The results suggested a high prevalence and diversified subtypes in macaques in Yunnan province, southwestern China. Macaques are likely to be potential reservoirs capable of zoonotic transmission of Blastocystis sp. to humans. To our knowledge, this study is the first large-scale systematic analysis of Blastocystis sp. colonization in Yunnan province in the subtropics of China; these results contribute to the in-depth study of genetic characteristics and the prevention, control, and treatment of Blastocystis sp. in macaques in Yunnan province and other regions.