ABSTRACT
Trujillo, one of the main provinces of Peru, is home to a multicultural population, coming from the Coast, Sierra and Selva; of different ideologies, cultures, and ancestral knowledge about the correct use of medicinal flora. In this sense and in an effort to rescue this ancestral knowledge, the ethnobotanical study of the medicinal flora of the province of Trujillo was carried out. For which 96 semi - structured interviews were applied, using the "snowball" technique; followed by the collection, taxonomic determination and calculation of ethnobotanical indices: Use Value Index (IVU) and Informant Consensus Factor Index (FCI). It is concluded that the inhabitants of Trujillo make use of 102 species of medicinal flora, distributed in 95 genera and 46 families for the treatment and/or cure of 62 diseases. Of the total species, 24 turned out to be the most important (according to their IVU) for the cure of diseases of the Trujillo po pulation.
Trujillo, una de las principales provincias de Perú, alberga una población pluricultural, procedente de la Costa, Sierra y Selv a; de distintas ideologías, culturas, y saberes ancestrales sobre el correcto uso de la flora medicinal. En tal sentido y en el afán de rescatar ese conocimiento ancestral, se realizó el estudio etnobotánico de la flora medicinal de la provincia de Trujill o. Para lo cual se aplicaron 96 entrevistas semiestructuradas, empleando la técnica "bola de nieve"; seguido de la colecta, determinación taxonómica y cálculo de Índices etnobotánicos: Índice de valor de Uso (IVU) e Índice de Factor de Consenso del Informa nte (FCI). Se concluye que los pobladores trujillanos hacen uso de 102 especies de flora medicinal, distribuidas en 95 géneros y 46 familias para el tratamiento y/o cura de 62 enfermedades. Del total de especies, 24 resultaron ser las más importantes (segú n su IVU) para la cura de enfermedades del poblador Trujillano.
Subject(s)
Plants, Medicinal/chemistry , Ethnobotany , Peru , Medicine, Traditional/history , Medicine, Traditional/methodsABSTRACT
RESUMEN A partir de una revisión bibliográfica de la literatura se ha planeado y desarrollado un consenso de expertos internacionales sobre la utilización de las vitaminas B1, B6, B12 en sus déficits y en la neuropatía periférica que puede estar asociada a la misma, como tema que precia de esa aproximación aclaratoria para optimizar su manejo. Se plantearon varias cuestiones de discusión que se consideraron importantes y dignas de ser abordadas y aclaradas, conservando nueve de ellas para su discusión ulterior buscando el consenso en tres rondas consecutivas. Se han propuesto 41 recomendaciones sobre el manejo de estas condiciones, con unanimidad por parte de los participantes en el consenso. Con ellas se ha intentado aclarar puntos oscuros o controvertidos, facilitando la actitud del clínico ante ellos en la práctica médica actual.
ABSTRACT Based on a bibliographic review of the literature, a consensus of international experts has been carried out on the use of vitamins B1, B6, B12, in their deficiencies, and in the peripheral neuropathy that may be associated with them, to optimize the management of these conditions. Several questions considered important and worthy of being addressed and clarified were raised, retaining nine of them for further discussion to achieve consensus. Forty one recommendations on the management of these conditions have been proposed, with unanimity of the participants in the consensus. This has been an attempt to clarify controversial points, assisting the clinician's attitude in current medical practice.
ABSTRACT
The incidence of breast cancer is rising annually.Along with the broader implementation of tumor screening and increased health awareness,there has been a significant uptick in the diagnosis of early-stage breast cancer.Early-stage breast cancer is generalized to breast cancer without distant metastasis,which is compared to the concept of late-stage breast cancer.The aim of treatment for early-stage breast cancer is to achieve a cure.Treatment is guided by evidence-based medicine,following guidelines and consensus to administer personalized and precise therapies to patients.Clinical research,as the foundational evidence for these guidelines and consensus,brings more optimized treatment for breast cancer patients.According to the updates of domestic and international guidelines and consensus between 2022 and 2023,this review summarized and classified the important clinical studies that have changed the clinical practice for early-stage breast cancer.These studies were based on molecular sub-types and categorized into optimization of neoadjuvant and adjuvant treatment of early breast cancer,escalating and de-escalating of adjuvant treatment,and the optimization of local treatment.The studies related to the optimization of neoadjuvant and adjuvant treatment of human epidermal growth factor receptor 2(HER2)-positive breast cancer included the PHEDRA study which aimed at the application of pyrotinib,a small molecule tyrosine kinase inhibitor(TKI),to neoadjuvant treatment,the ExteNET study which investigated adjuvant treatment of neratinib,and FDChina study which confirmed the efficacy and safety of pertuzumab and trastuzumab fixed dose combination subcutaneous injection(PH FDC SC).The primary study addressing the optimization of neoadjuvant and adjuvant therapy in triple-negative breast cancer(TNBC)was the KEYNOTE-522 study.In terms of escalating in adjuvant therapy,the APHINITY study evaluated the efficacy of pertuzumab added to trastuzumab in high-risk HER2-positive breast cancer.MonarchE and NATALEE focused on the efficacy of abemaciclib and ribociclib in patients with hormone receptor-positive breast cancer.The SOFT TEXT study focused on ovarian function suppression(OFS)combining exemestane or tamoxifen in high-risk premenopausal breast cancer.Descending related studies in adjuvant therapy included the PLAN B study confirming 6 cycles of docetaxel in combination with cyclophosphamide in HER2 negative early intermediate to high-risk breast cancer.Among the studies related to the local treatment of breast cancer,the ACOSOG Z11102 study explored the feasibility of breast conservation in multicenter focal breast cancer.The SOUND study explored the exemption from axillary surgery in people with low-risk breast cancer.The PRIMEⅡ study explored the possibility of exemption from radiotherapy after breast conservation in elderly patients with low-risk breast cancer,and the IMPORT HIGH study compared different dose-escalated simultaneous integrated boost radiotherapy regimens after breast conservation surgery.The FAST-Forward study focused on hypofractionated breast radiotherapy.These studies provided robust evidence for the implementation of clinical practice and the formulation of diagnostic and treatment guidelines and consensus.In this review,we focused on the update of domestic and international breast cancer treatment guidelines,and the impact of these studies on the clinical practice for early-stage breast cancer.
ABSTRACT
The Chinese Journal of Interventional Cardiology,Volume 31,Issue 6,published the Chinese expert consensus on the clinical application of drug coated balloon(2nd Edition)in June 2023.The new consensus incorporates the evidence-based medicine evidence of drug-coated balloons in the field of interventional therapy for coronary heart disease in recent years,updating the indications,standardized operations,intracoronary imaging,and the application of coronary functional studies in the treatment of drug-coated balloons.Based on clinical diagnosis and treatment practices and evidence-based medicine evidence,this article interprets the highlights of the new guidelines,aiming to provide references for clinical practice.
ABSTRACT
Contrast-induced encephalopathy(CIE)is a rare neurological complication of the intravascular application of a contrast media.The clinical manifestation of CIE which is easily misdiagnosed in clinical is not specific.Recently,with the extensive development of interventional diagnosis and therapy in different disciplines,case report of CIE patient is increasing yearly.At present,there is not a uniform diagnosis and treatment standard for CIE in China and abroad.Chinese Federation of Interventional Clinical Neurosciences organized relevant experts in China and developed the expert consensus,to provide suggestions and references for clinicians at all levels to prevent,identify and treat CIE.
ABSTRACT
Scrub typhus is a type of natural focal disease caused by a bacteria called Orientia tsutsugamushi and mainly en-demic in East and Southeast Asia.The most common clinical symptoms of scrub typhus include fever,eschar,ulcer,lymph node enlargement and rash,which are not typical on early stage and could easily lead to misdiagnosis and missed diagnosis.By reviewing relevant guidelines and references at home and abroad,combining clinical diagnosis and treatment experiences in Chi-na,the experts from Biodiagnostic Technology Branch of China Medical Biotechnology Association and Chinese Society of Mi-crobiology Committee on Zoonotic Pathogens formed this consensus on the clinical diagnosis and treatment of scrub typhus.
ABSTRACT
On August 2-4,2023,the"Third Summit Forum on'Building a Community of Shared Future for Doctors and Patients'"was jointly organized by institutions such as the Chinese Medical Ethics,the Hospital Humanities Management and Talent Training Special Committee of the China Population and Culture Promotion Association,Center for Ethical Studies of Renmin University of China,the Newspaper for China's Physicians,the China Health Law Society,the China Anti-Cancer Association,and the China Association For Ethical Studies in Harbin.The conference arranged a sub-forum for the"Seminar on the Construction of Chinese Medical Humanities",with domestic medical humanities scholars attending the conference.After heated discussions at the seminar,the Scholars'Consensus on the Construction and Development of Chinese Medical Humanities was formed.It was proposed that in the new era,it is urgent to build the medical humanities discipline,as well as lead the academic integration and development of medical humanities under the core socialist values.At the same time,for the construction of the medical humanities discipline,it is necessary to optimize the organizational mechanism,prosper and develop the overall framework of the medical humanities discipline,accelerate the construction of a professional teaching team for the medical humanities discipline,promote the establishment of a new carrier medical humanities education and teaching in cultivating morality and nurturing talents,as well as focus on solving problems related to the cultivation of medical humanities graduate students.
ABSTRACT
Objective:To evaluate the scientificity, transparency and applicability of the Chinese guidelines and consensuses in medical imaging published in 2022 by the STAR scale.Methods:Medical imaging guidelines and consensuses were searched in CNKI, Wanfang data, CMB, Chinese Medical Journal Network, and Medline (PubMed). The publication date was selected from January 1 to December 31, 2022. Each guideline or consensus was independently evaluated and cross-checked by two evaluators using STAR scale.Results:A total of 65 guidelines and consensus that were published as Chinese or English were included, including 15 guidelines and 50 consensuses. Some guidelines and consensus have distinct disciplinary characteristics with topics such as artificial intelligence (4 articles) and Evidence-Based Medical Imaging-Medical Imaging Clinical Appropriateness (EB-MICA, 4 articles). In all guidelines and consensuses, the highest score was 89.9, the lowest was 3.6, and the M( Q1, Q3) was 25.0 (20.8, 35.4). There was no statistical difference in the scores of guidelines and consensuses ( P=0.383). The highest scoring areas were recommendation opinions (reporting rate of 56.0%), working groups (reporting rate of 38.2%), and clinical issues (reporting rate of 36.7%), while the lowest scoring areas were proposal (reporting rate of 9.6%), registration (reporting rate of 10.8%), and consensus methods (reporting rate of 21.8%). Conclusion:It is recommended that guidelines and consensuses initiators of medical imaging strengthen the learning of evidence-based medicine methods, such as STAR tools, in order to further improve the quality of guidelines and consensuses of medical imaging.
ABSTRACT
In recent years, digital radiography (DR) system is widely used in China, and digital X-ray radiography is one of the most common examinations for bone and joint. Optimizing the osteoarthrographic technique, standardizing osteoarthrogram, and summarizing the requirements for radiation protection, will further enhance the clinical application value of digital X-ray imaging in bone and joint examination. Referring to domestic and foreign literatures, and combining the clinical situation of Guangdong-Hong Kong-Macao Greater Bay Area, the experts recruited by the Guangdong-Hong Kong-Macao Greater Bay Area Imaging Technology Alliance reach a consensus on the technique and protection specifications for bone and joint examination to guide and standardize the work related to X-ray examination of bone and joint in the medical imaging department of medical institutions at all levels in the Greater Bay Area.
ABSTRACT
The number of expert consensus publications has been increasing year by year as an industry guidance document.However,due to the lack of unified reporting guidelines and methodological standards,the current published expert consensuses in nursing exhibit inconsistent writing formats and varying quality.This article combines the quality evaluation points for expert opinions from the Jonna Briggs Institute in Australia,focusing on 6 aspects,covering the authority of the expert team,clarity of viewpoint expression,adequacy of evidence-based foundation,standardization of the consensus-reaching process,taking into account of interests of relevant research populations,and the potential for application in specific clinical settings.These points are introduced as review criteria for expert consensus papers,aiming to provide references for improving the quality and standardization of expert consensus papers in the future.
ABSTRACT
Multiple system atrophy(MSA)is a serious and rapidly progressive neurodegenerative disease.The currently used diagnostic criteria are the second edition of MSA diagnostic criteria published in 2008.Although widely recognized in clinical research, they lack sensitivity for early diagnosis of the disease.Reliable early diagnosis of MSA is particularly important for patient care and counseling, recruitment for clinical trials of disease-modifying therapies, and development and validation of diagnostic tools.To overcome the shortcomings of the second edition of the diagnostic criteria, the International Parkinson and Movement Disorder Society developed a new version of diagnostic criteria for MSA, which was published in April 2022.This paper interprets the new MSA diagnostic criteria and examines the scientific research areas that need to be further explored in future research, which will be important in guiding the management of elderly patients and related research.
ABSTRACT
High quality guidelines/consensuses have always been a key focus of professional journals. Since 2000, especially in the past decade, the Chinese Journal of Neurology has published a series of disease related diagnostic standards and treatment guidelines/consensuses, providing clinical doctors with standardized, efficient, and scientifically economical diagnosis and treatment plans. The article discusses the conditions that high-quality guidelines/consensuses should meet and what situations should not occur, and encourages more and better high-quality guidelines/consensuses articles to be published in the Chinese Journal of Neurology in the new year.
ABSTRACT
Sepsis-associated acute kidney injury (SA-AKI) is defined as the presence of acute kidney injury (AKI) in the context of sepsis. In the setting of genetic susceptibility, sepsis can lead to SA-AKI through various mechanisms. Based on differences in pathophysiological mechanisms, SA-AKI is categorized into different "endotypes" and manifests as distinct "subtypes". The combination of biomarkers and predictive models has the potential to early identify high-risk AKI patients and elucidate SA-AKI "endotypes". Volume resuscitation and blood purification are optimized strategies for SA-AKI treatment. Furthermore, clinical research on SA-AKI in children is promising.
ABSTRACT
As a new treatment option after conventional corticosteroids and immunomodulatory drugs, biologics have been widely used in the clinical management of non-infectious uveitis in many countries due to their approved efficacy and safety. Anti-tumor necrosis factor-alpha monoclonal antibody is the most commonly used one. However, the guidance on its standardized application is lacking. The Ocular Immunology Group of Immunology and Rheumatology Academy in Cross-Straits Medicine Exchange Association compiled the Chinese expert consensus on treatment of non-infectious uveitis with anti-tumor necrosis factor-alpha monoclonal antibody. This evidence-based consensus is made according to the principle of consensus building and combines the clinical experience of the experts. Twelve recommendations are formatted on the application of Adalimumab and Infliximab. The interpretation of this consensus point will help improve the normative and effective application of anti-tumor necrosis factor-alpha monoclonal antibody in ophthalmologists, rheumatologists and immunologists.
ABSTRACT
Diabetic retinopathy is one of the microvascular complications of diabetes and a major cause of blindness in adults. Early screening is an effective way to reduce blindness caused by diabetic retinopathy. The diabetic retinopathy is one of the chronic retinal diseases highlighted in the "14th Five-Year" National Eye Health Plan (2021-2025). The establishment of effective and practical community screening model is a powerful guarantee to complete early screening. It is of great significance to standardize screening methods, screening personnel duties, equipment allocation, referral conditions and screening sustainability. Chinese fundus disease and related field experts developed the consensus through a serious, comprehensive, and complete discussion, to provide more reference for establishing a suitable community screening model of diabetic retinopathy and increasing the screening rate of diabetic retinopathy.
ABSTRACT
Diabetes retinopathy (DR) is listed as one of the chronic diseases that should be focused on in the "14th Five-Year" National Eye Health Plan (2021-2025). Early screening is one of the effective measures to reduce blindness caused by DR. Establishing an efficient and practical community screening model is a powerful guarantee for completing early screening. The Ocular Fundus Diseases Group of the Ophthalmology Branch of the Chinese Medical Association has led the development of Expert consensus on community screening of diabetic retinopathy among DR community screening experts that is suitable for the current national situation, in order to guide and promote the further improvement of DR community screening work in China. This Expert Consensus provides detailed specifications on the current domestic trend of DR, the necessity of screening, the role of artificial intelligence grading, screening process, and quality control. This interpretation further emphasizes the importance of DR community screening, while emphasizing the responsibilities of different departments in the screening process. Finally, recommendations are provided for the sustainability of DR community screening. It is hoped that the screening rate of DR in China can be improved and blindness can be reduced by DR through Expert consensus on community screening of diabetic retinopathy and interpretation of the content.
ABSTRACT
Tuberculosis （TB） and human immunodeficiency virus infection / acquired immune deficiency syndrome （HIV/AIDS） are both serious global public health threats. Early detection of infected persons and/or patients through TB/HIV bi-directional screening is crucial for prevention and control strategy in China and globally. In recent years， with the promotion and application of new TB and HIV detection technologies worldwide， TB/HIV bi-directional screening technologies and strategies have made remarkable changes. This expert consensus introduces the significance and challenges of TB/HIV bi-directional screening， summarizes important progress of research and applications， and makes recommendations on screening measures and procedures to further strengthen TB/HIV bi-directional screening in China.
ABSTRACT
ObjectiveTo explore the current status and issues regarding the application of ancient books in clinical practice guidelines and expert consensus of traditional Chinese medicine （TCM） published in China， and to provide methodological recommendations for the incorporation of ancient books in the development of TCM guidelines. MethodsWe searched China National Knowledge Infrastructure （CNKI）， WanFang Data， VIP， SinoMed， PubMed， Embase， as well as six industry websites including China Association of Chinese Medicine， National Group Standards Information Platform， and Chinese Association of the Integration of Traditional and Western Medicine，etc. TCM clinical practice guidelines or expert consensus issued during January 1st， 2017， to November 26th， 2022 were searched. Clinical practice guidelines or expert consensus that explicitly referred to ancient books were included， and the content regarding the searching for ancient books， sources of access to ancient books， methods of evaluating the level of evidence， methods of evaluating the level of recommendation， and methods of evaluating the evidence for the ancient books were analysed. ResultsA total of 1,215 TCM clinical practice guidelines or expert consensus were retrieved， with 442 articles explicitly mentioning the application of ancient books， including 300 （67.87%） clinical practice guidelines and 142 （32.13%） expert consensus. Sixty of the 442 publications explicitly reported that ancient books searching had been conducted （13.57%）； among these 60 publications 27 （45.00%） explicitly reported ancient books searching strategies， and the most frequent method was manual searching with a total of 24 articles （40.00%）. The most popular search source was Chinese Medical Dictionary， a TCM classics database， with a total of 18 articles. 197 articles （44.57%） explicitly reported the evaluation criteria for the level of evidence， of which 141 articles （71.57%） involved the evaluation criteria for the ancient books； 413 articles （93.44%） mentioned ancient books in the recommendations， and only the source of formula name was mentioned in 409 （99.03%） of the publications. ConclusionThe current application of ancient books in TCM clinical practice guidelines and expert consensus is limited， with issues of non-standard searching and evaluation methods. Standar-dization and uniformity are needed in evidence grading and recommendation standards. Future research should clarify the scope and methods of applying ancient book， emphasize their integration with modern research evidence， and enhance their value and quality in the development of TCM clinical practice guidelines.
ABSTRACT
@#<p>Bartter syndrome (BS) is a rare inherited salt-losing renal tubular disorder characterized by secondary hyperaldosteronism with hypokalemia and hypochloremic metabolic alkalosis, and normal or low blood pressure. In severe cases, preterm delivery, hypovolemia, ventricular arrhythmia, rhabdo-myolysis, renal failure, growth failure and sensorineural deafness may occur. In recent years, research on BS has made significant progress. The Bartter Syndrome Consensus Working Group has performed a systematic literature review, and based on evidence-based medicine, summarized aspects related to BS, including clinical manifestations and classification, diagnosis, treatment strategies, and management of complications. This consensus provides an important reference for the better diagnosis and treatment of BS.</p>
ABSTRACT
@#Objective To construct a new human-derived consensus interferon α(cIFNα)sequence and verify its antiviral effect.Methods Total 57 human-derived IFNα sequences were synthesized,and the conservative amino acid preference at each site was selected by software comparison analysis.A new cIFN sequence,hIC,was synthesized into pUC-57 vector and connected with pCK to construct eukaryotic expression vector pCK-hIC,which was transfected into 293T cells to express the target protein hIC.A549 cells were incubated with the target protein before and after infection with enhanced green fluorescent protein vesicular stomatitis virus(VSV-EGFP).The effect of hIC on VSV-EGFP replication was analyzed by fluorescence observation,crystal violet staining and flow cytometry in vitro,and the downstream gene expression of IFN was verified by qPCR.Results The plasmid pCK-hIC was constructed correctly as verified by double enzyme digestion and sequen-cing.The expressed hIC protein,with a relative molecular mass of about 27 000,significantly reduced the fluorescence expression of VSV-EGFP,significantly inhibited virus proliferation and activated the expression of interferon-stimulated gene 15(ISG15),2′-5′-oligoadenylate synthetase 1(OAS1)and interferon-inducible transmembrane protein(IFITM).Conclusion The hIC has good antiviral effect,which lays a foundation for the follow-up research and development.